| |
Achilles Squeeze test
For Achilles ten-don rupture. Squeezing the calf muscle
fails to produce plantar flexion of the
ankle joint. Also called Simmons Test,
Thompson test.
|
| |
Addis test
For determination of leg
length discrepancy. With patient in
prone position, flexing the knees to 90
degrees reveals the potential discrepancies
of both tibial and femoral
lengths.
|
| |
Adson’s maneuver
See under Adson’s test
|
| |
Adson’s test
For thoracic outlet syndrome.
With the patient in a sitting position,
his hands resting on thighs, the
examiner palpates both radial pulses as
the patient rapidly fills his lungs by deep
inspiration and, holding his breath,
hyperextends his neck and turns his head
toward the affected side. If the radial
pulse on that side is decidedly or completely
obliterated, the result is considered
positive. Also called Adson’s maneuver.
Allen test: For occlusion of radial or
ulnar artery. A method of determining
if radial and ulnar arteries communicate
through the two palmar arches.
Both arteries are occluded digitally by
making a fist repeatedly. First one artery
is released, then the other, to observe
pattern of capillary refill in the
hand. This can be performed with Doppler
placed on the digits during test.
The test is valuable prior to an invasive
procedure on the arteries at the wrist.
|
| |
Allis’ sign
Relaxation of the fascia
between the crest of the ilium and the
greater trochanter; a sign of fracture of
the neck of the femur.
|
| |
Amoss’ sign
In painful flexure of the
spine, the patient, when rising to a sitting
posture from lying in bed, does so
by supporting himself with his hands
placed far behind him in the bed.
|
| |
Anghelescu’s sign
Inability to bend the
spine while lying on the back so as to
rest on the head and heels alone, seen
in tuberculosis of the vertebrae.
|
| |
Anterior drawer sign
See under drawer sign.
|
| |
Anterior tibial sign
Involuntary
contraction of the tibialis anterior muscle
when the thigh is forcibly flexed on the
abdomen; seen in spastic paraplegia.
|
| |
Anvil test (hips)
For early hip joint
disease of diseased vertebrae. A closed fist
striking a blow to the sole of the foot
with leg extended produces pain in the
hip or vertebrae.
|
| |
Anvil test (neck)
For vertebral disorders.
A closed fist striking a blow to
the top of the head elicits pain in the
vertebra(e).
|
| |
Apley test
For differentiating ligamentous
from meniscal injury. Tibial rotation
on femur with traction or compression
with the patient prone and knee
flexed. Also called Apley sign.
|
| |
Axial loading
Putting pressure on top
of the head to identify nerve damage in
the neck. Also used to medically disprove
evidence of a low back problem.
|
| |
Babinski reflex
For loss of brain control
over lower extremities. Scraping
the soles causes toes to pull up. Also
called Babinski reflex, toe sign.
Babinski’s sign: 1. Loss or lessening
of the Achilles tendon reflex in sciatica;
this distinguishes it from hysteric sciatica.
2. Babinski’s reflex. 3. In hemiplegia,
the contraction of the platysma
muscle in the healthy side is more vigorous
than on the affected side, as seen
in opening the mouth, whistling, blowing,
etc. 4. The patient lies supine on
the floor, with arms crossed upon his
chest, and then makes an effort to rise
to the sitting posture. On the paralyzed
side, the thigh is flexed upon the pelvis
and the heel is lifted from the ground,
while on the healthy side the limb does
not move. This phenomenon is repeated
when the patient resumes the
lying posture. It is seen in organic
hemiplegia, but not in hysterical
hemiplegia. 5. When the paralyzed fore-arm
is placed in supination, it turns
over to pronation; seen in organic paralysis.
Called also pronation sign.
|
| |
Bekhterev’s test
The patient seated in
bed is directed to stretch out both legs;
in sciatica he cannot do this, but can
stretch out each leg in turn.
|
| |
Bench test
For nonorganic back pain.
In normal hip motion, the patient
should be able to bend over and touch
the floor kneeling on a 12-inch high
bench; not being able to implies a
nonorganic (or psychologic) back pain.
Also called Burns test.
|
| |
Bowstring sign
With leg raised with
knee bent in same position, pain is felt
in the back of limb pressing on the popliteal fossa. Increased pain is sign
of nerve irritability.
|
| |
Bracelet test
The production of pain
on moderate lateral compression of the
lower ends of the radius and ulna; observed in rheumatoid arthritis.
|
| |
Bragard’s sign
With the knee stiff, the
lower extremity is flexed at the hip until the patient experiences pain; the foot
is then dorsiflexed. Increase of pain
points to disease of the nerve root.
|
| |
British test
For knee pain and/or injury.
Compression of patella during active
quadriceps contraction as knee is ex-
tended elicits pain.
|
| |
Brudzinski’s sign
For meningitis.
Flexion of the neck forward results in flex-
ion of the hip and knee; when passive
flexion of the lower limb on one side is
made, a similar movement will be seen
in the opposite limb. Also called neck
sign, contralateral sign.
|
| |
Burns test
See under bench test
|
| |
Cantelli’s sign
Dissociation between
the movements of the head and eyes;
as the head is raised the eyes are lowered
and vice versa. Called also doll’s eye sign.
|
| |
Chaddock’s sign
For upper motor
neuron loss (brain). The big toe extends
when irritating the skin in the external
malleolar region; indicates lesions of
the corticospinal paths. Also called external malleolus sign, Chaddock reflex.
|
| |
Circumduction maneuver
A maneuver for the thumb; any general test
of motion involving a rotation action of a
group of joints; a range of motion examination.
|
| |
Cleeman’s sign
Creasing of the skin
just above the patella, indicative of fracture
of the femur with overriding of
fragments.
|
| |
Codman’s sign
In rupture of the supraspinatus tendon, the arm can be
passively abducted without pain, but
when support of the arm is removed
and the deltoid contracts suddenly, pain
occurs again.
|
| |
Cogwheel phenomenon
While testing the strength of a muscle,
the patient exhibits jerky motions that are
neither rhythmic nor equal and represent pretending or protection from pain.
|
| |
Comolli’s sign
A sign of scapular
fracture consisting in the appearance in the
scapular region, shortly after the accident,
of a triangular swelling reproducing the
shape of the body of the scapula.
|
| |
Contralateral sign
See under
Brudzinski’s sign
|
| |
Contralateral straight leg raising test
For sciatica. When the leg is flexed,
the hip can also be flexed, but not when
the leg is held straight. Flexing the
sound thigh with the leg held straight
causes pain on the affected side. Also
called Fajersztajn’s crossed sciatic sign.
|
| |
Coopernail sign
Ecchymosis on the
perineum and scrotum or labia; a sign
of fracture of the pelvis.
|
| |
D.T.P. sign
(distal tingling on percussion), Tinel’s sign
|
| |
Dawbarn’s sign
In acute subacromial
bursitis, when the arm hangs by the
side, palpation over the bursa causes
pain but when arm is abducted, this
pain disappears.
|
| |
Dejerine’s sign
Aggravation of symptoms of radiculitis produced by cough-
ing, sneezing, and straining at stool.
|
| |
Demianoff’s sign
A sign that permits
the differentiation of pain originating in
the sacrolumbalis muscles from lumbar pain of any other origin. The sign
is obtained by placing the patient in
dorsal decubitus and lifting his ex-
tended leg. In the presence of lumbago
this produces a pain in the lumbar region which prevents raising the leg high
enough to form an angle of ten degrees.
|
| |
Desault’s sign
A sign of intrascapular
fracture of the femur, consisting of al-
ternation of the arc described by rotation of the great trochanter, which nor-
mally describes the segment of a circle,
but in this fracture rotates only as the
apex of the femur rotates about its own
axis.
|
| |
Doll’s eye sign
See Cantelli’s sign.
|
| |
Drawer sign
For ligamentous instability or ruptured cruciate ligaments. With
the patient supine and knee flexed to
90 degrees, the sign is positive if knee
is not displaced abnormally in a posterior direction with knee pulled forward.
Also called an anterior drawer sign,
meaning the anterior cruciate is lax or
ruptured.
|
| |
Dugas’ test
A test for the existence of
dislocation of the shoulder, made by
placing the hand of the affected side
on the opposite shoulder and bringing
the elbow to the side of the chest. If
this cannot be accomplished (Dugas
sign), dislocation of the shoulder exists.
|
| |
Ely’s test
With the patient prone, if
flexion of the leg on the thigh causes
the buttocks to arch away from the table
and the leg to abduct at the hip joint,
there is contracture of the lateral fascia of the thigh.
|
| |
Fabere sign
See Patrick’s test
|
| |
Fadire test
Forced position of the hip
causing pain; the letters stand for Flex-
ion Adduction Internal External Rotation in Extension. Also called Patrick’s
test, fabere test, figure of 4 test.
|
| |
Fajersztajn’s crossed sciatic sign
In sciatica, when the leg is flexed, the hip
can also be flexed, but not when the
leg is held straight; flexing the sound
thigh with the leg held straight causes
pain on the affected side. See also
contralateral straight leg raising test.
|
| |
Fan sign
Spreading apart of the toes
following the stroking of the sole of the
foot; it forms part of the Babinski’s reflex.
Femoral nerve stretch test:
For lesion of third or fourth lumbar disk.
Passive
knee flexion in the prone position
causes pain in the back or thighs.
Femoral nerve traction test:
For radiculopathy of the second through
fourth lumbar nerves. With patient
prone, the knee is flexed, causing back
or thigh pain.
Finger-nose test:
For coordinated
movements of the extremities. With
arm extended to one side, the patient
is asked to slowly try to touch the end
of his nose with the point of his index
finger.
|
| |
Finkelstein sign
For synovitis.
Bending the thumb into the palm to determine synovitis of the abductor pollicis
longus tendon to wrist.
|
| |
Fournier test
The patient is asked to
rise on command from a sitting position; he is asked to rise and walk, then
stop quickly on command; he is asked
to walk and turn around quickly on
command. The ataxic gait is thus
brought out.
|
| |
Fowler maneuver
A test for tight intrinsic muscles in ulnar deviation of the
digits; in rheumatoid arthritis a heavy,
taut ulnar band is demonstrated when
the digit is held in its normal axial relationship.
|
| |
Froment’s paper sign
Flexion of the
distal phalanx of the thumb when a
sheet of paper is held between the
thumb and index finger; seen in affection of the ulnar nerve.
|
| |
Gaenslen’s sign
With the patient on
his back on the operating table, the
knee and hip of one leg are held in
flexed position by the patient, while the
other leg, hanging over the edge of the
table, is pressed down by the examiner
to produce hyperextension of the hip;
pain occurs on the affected side in lumbosacral disease.
|
| |
Galeazzi’s sign
In congenital dislocation of the hip, the dislocated side is
shorter when both thighs are flexed 90
degrees.
|
| |
Goldthwait’s sign
With the patient lying supine, his leg is raised by the examiner with one hand, the other hand
being placed under the patient’s lower
back. Leverage is then applied to the
side of the pelvis. If pain is felt by the
patient before the lumbar spine is
moved, the lesion is a sprain of the sacroiliac joint. If pain does not appear
until after the lumbar spine moves, the
lesion is in the sacroiliac or lumbosacral articulation.
|
| |
Gower’s sign
Abrupt intermittent oscillation of the iris under the influence
of light; seen in certain stages of tabes
dorsalis. Called also Gower’s maneuver and Gower’s phenomenon.
|
| |
Guilland’s sign
Brisk flexion at the hip
and knee joint when the contralateral
quadriceps muscle is pinched; a sign
of meningeal irritation.
|
| |
Hamilton’s test
When the shoulder
joint is luxated, a rule or straight rod
applied to the humerus can be made to
touch the outer condyle and acromion
at the same time.
|
| |
Harris hip scale
A 100-point scale with
40 points for function and 60 for pain
in the hip.
|
| |
Heberden’s nodules
Small hard
nodules, formed usually at the distal interphalangeal articulations of the fingers,
produced by calcific spurs of the articular cartilage and associated with inter-
phalangeal osteoarthritis. Heredity is an
important etiologic factor. Called also
Heberden’s sign.
|
| |
Heel-knee test
For coordinated
movements of the extremities. The patient,
lying on his back, is asked to touch the
knee of one leg with the heel of the
other and then to pass the heel slowly
down the front of the shin to the ankle.
|
| |
Helbing’s sign
Medialward curving of
the Achilles tendon as viewed from behind;
seen in flatfoot.
|
| |
Hirschberg’s sign
Adduction,
inversion, and slight plantar flexion of the
foot on stroking the inner aspect (not
the sole) of the foot from the great toe
to the heel. Called also adductor reflex
of foot.
|
| |
Hoffmann’s sign
1. Increased mechanical irritability of the
sensory nerves in tetany; the ulnar nerve is
usually tested. 2. A sudden nipping of the
nail of the index, middle, or ring finger
produces flexion of the terminal phalanx of the thumb and of the second
and third phalanxes of some other finger.
Called also digital reflex, Hoffman’s
reflex, and Trommer’s sign.
|
| |
Homan’s sign
Discomfort behind the
knee on forced dorsiflexion of the foot;
a sign of thrombosis in the veins of the
calf.
|
| |
Hoover’s sign
1. In the normal state
or in genuine paralysis, if the patient,
lying on a couch, is directed to press
the leg against the couch, there will be
a lifting movement seen in the other leg;
this phenomenon is absent in hysteria
and malingering. 2. Movement of the
costal margins towards the midline in
inspiration, occurring bilaterally in pulmonary emphysema and unilaterally in
conditions causing flattening of the diaphragm, such pleural effusion and
pneumothorax.
|
| |
Hughston jerk test
For anterolateral
instability of the knee; noted by starting at 45 degrees flexion with tibia internally rotated and applying valgus
force while rotating fibula medially.
There is a jerk at about 20 degrees from
full extension.
|
| |
Huntington’s sign
The patient is re-
cumbent, with his legs hanging over the
edge of the table, and is told to cough.
If the coughing produces flexion of the
thigh and extension of the leg in the
paralyzed limb, it indicates that the pa-
ralysis is due to an upper motor neuron lesion.
|
| |
Jansen’s test
For osteoarthritis deformans of the hip. The patient is told to
cross his legs with a point just above
the ankle resting on the opposite knee;
this motion is impossible when the dis-
ease exists.
|
| |
Jendrassik’s maneuver
A procedure
for emphasizing the patellar reflex: The
patient hooks his hands together by the
flexed fingers and pulls apart as hard
as he can.
|
| |
Kanavel’s sign
A point of maximum
|
| |
Kauffman test
See pivot-shift sign.
|
| |
Keen’s sign
Increased diameter of the
leg at the malleoli in Pott’s fracture of
the fibula.
|
| |
Kernig’s sign
In dorsal decubitus, the
patient can easily and completely extend the leg; in the sitting position, or
when lying with the thigh flexed upon
the abdomen, the leg cannot be com-
pletely extended; it is a sign of meningitis.
|
| |
Kerr’s sign
Alteration of the texture of
the sign below the somatic level in lesions of the spinal cord.
Key pinch:
The strength in the ability
to grasp, as in holding a key; lateral
pinch.
|
| |
Kocher maneuver
For reducing anterior dislocations of the shoulders. Done
by abducting the arm, externally rotating adduction, and then internally rotating.
|
| |
Lachman test
With the patient supine
and the knee flexed to 20 degrees, the
tibia is pulled anteriorly. A “give” reaction or mushy end point indicates a torn
anterior cruciate ligament.
|
| |
Langoria’s sign
Relaxation of the
extensor muscles of the thigh; a symptom of intrascapular fracture of the fe-
mur.
|
| |
Laseque’s sign
In sciatica, flexion of
the hip is painful when the knee is extended,
but painless when the knee is flexed. This distinguishes the disorder
from disease of the hip joint. See also
straight leg raising test.
|
| |
Laugier’s sign
A condition in which the
styloid process of the radius and of the
ulna are on the same level; seen in fracture
of the lower part of the radius.
|
| |
Leichtenstern’s sign
In cerebrospinal
meningitis, lightly tapping any bone of
the extremities causes the patient to
wince suddenly.
|
| |
Leri’s sign
Passive flexion of the hand
and wrist of the affected side in
hemiplegia shows no normal flexion of
the elbow.
|
| |
Lhermitte’s sign
The development of
sudden transient electric-like shocks
spreading down the body when the
patient flexes the head forward; seen
mainly in multiple sclerosis but also in
compression and other disorders of the
cervical cord.
|
| |
Libman’s sign
Extreme tenderness,
but without pain on pressure of the
mastoid bones.
|
| |
Linder’s sign
With the patient
recumbent or sitting with outstretched legs,
passive flexion of the head will cause
pain in the leg or the lumbar region in
sciatica.
|
| |
Long tract sign
Any sign that one
would see in affection of either sensory
or motor tracts in the spinal cord. For
example, Babinski reflex, Romberg test.
|
| |
Ludloff’s sign
Swelling and ecchymosis
at the base of Scarpa’s triangle together with inability to raise the thigh
when in a sitting posture, a sign of traumatic separation of the epiphysis of the
greater trochanter.
|
| |
Mannkopf’s sign
Increase in the frequency of the pulse of pressure over a
painful spot; not present in simulated
pain.
|
| |
McMurray sign
Occurrence of a cartilage click during manipulation of the
knee; indicative of meniscal injury.
|
| |
McMurray’s test
For torn meniscus. As
the patient lies supine with knee fully
flexed, the examiner rotates the
patient’s foot fully outward and the knee
is slowly extended; a painful “click” indicates a tear of the medial meniscus
of the knee joint. If the click occurs
when the foot is rotated inward, the tear
is in the lateral meniscus.
|
| |
Mill’s test
For tennis elbow. With the
wrist and fingers fully flexed and the
forearm pronated, complete extension
of the elbow is painful.
|
| |
Minor’s sign
The method of rising
from a sitting position characteristic of
the patient with sciatica; he supports
himself on the healthy side, placing one
hand on the back, bending the affected
leg and balancing the healthy leg.
|
| |
Moro reflex
For testing normal early neurologic development or the failure
to progress neurologically. The infant
is placed on a table, then the table is
forcibly struck from either side, causing the infants arms to be thrown out
as in an embrace; should disappear as
infancy progresses.
|
| |
Morton sign
For metatarsalgia or neuroma. Transverse pressure across
heads of the metatarsals causes sharp
pain in the forefoot.
|
| |
Naffziger sign
For sciatica or
herniatednucleus pulposus.
Nerve root irritation is produced by external jugular venous
compression by examiner.
|
| |
Naffziger’s test
For nerve root compression. Increase of aggravation of
pain or sensory disturbance over the
distribution of the involved nerve root
upon manual compression of the jugular
veins bilaterally confirms the presence of an extruded intervertebral disk
or other mass.
|
| |
Ober’s test
The patient lies on the side
opposite that to be tested, with the
underneath hip and knee flexed; with the
upper knee flexed to a right angle, the
upper hip is flexed to 90 degrees, fully
abducted, brought into full hyperextension,
and allowed to adduct; the angle
that the thigh makes above the horizontal is
the degree of abduction contracture.
|
| |
Objective sign
One that can be seen,
heard, or felt by the diagnostician.
Called also physical sign.
|
| |
Ortolani’s click
A click felt when the
thigh is abducted in flexion, in congenital dislocation of the hip. It results from
the sliding of the femoral head over the
acetabular rim. A click can also be felt
when the head slips out of the acetabulum
on the opposite maneuver. Called
also Ortolani’s sign.
|
| |
Patellar retraction test
For synovitis.
Compression of patella causes pain
when the patient attempts to set the
quadriceps muscles with the knee in full
extension.
|
| |
Patrick’s test
With the patient supine,
the thigh and knee are flexed and the
external malleolus is placed over the
patella of the opposite leg; the knee is
depressed, and if pain is produced
thereby, arthritis of the hip is indicated.
Patrick calls this test fabere sign, from
the initial letters of movements that are
necessary to elicit it, namely, flexion,
abduction, external rotation, extension.
|
| |
Payr sign
Early sign of impending
postoperative thrombosis, indicated by
tenderness when pressure is placed
over the inner side of the foot.
|
| |
Peroneal sign
Dorsal flexion and abduction of the foot, a sign of latent
tetany elicited by tapping the peroneal
nerve just below the head of the fibula,
while the knee is relaxed and slightly
flexed.
|
| |
Phalen’s maneuver
For detection of
carpal tunnel syndrome. The size of the
carpal tunnel is reduced by holding the
affected hand with the wrist fully flexed
or extended for 30 to 60 seconds or by
placing a sphygmomanometer cuff on
the involved arm and inflating to a point
between diastolic and systolic pressure
for 30 to 60 seconds.
|
| |
Piotrowski’s sign
Percussion of the
anterior tibialis muscle produces dorsal flexion and supination of the foot.
When this reflex is excessive it indicates organic disease of the central
nervous system. Called also anticus
sign or reflex.
|
| |
Postural fixation
A sign noted on
range of motion of the back; any postural deformity (stiffness) noted does
not reverse with range of motion.
|
| |
Pseudo-Babinski’s sign
In poliomyelitis the Babinski reflex is modified so
that only the big toe is extended, because all foot muscles except dorsiflexors of the big toe are paralyzed.
|
| |
Quadriceps test
For hyperthyroidism.
The patient sits well forward on the
edge of the normal chair and holds the
leg out at a right angle to the body.
Normal persons can hold this position
for at least a minute; those with
hyperthyroidism can maintain it for only a
few seconds.
|
| |
Queckenstedt’s sign
When the veins
in the neck are compressed on one or
both sides, there is a rapid rise in the
pressure of the cerebrospinal fluid of healthy persons, and this rise quickly
disappears when pressure is taken off
the neck. But when there is a block in
the vertebral canal, the pressure of the
cerebrospinal fluid is little or not at all
affected by this maneuver.
|
| |
Raimiste’s sign
The patient’s hand and
arm are held upright by the examiner;
if the hand is sound, it remains upright
on being released; if paretic, the hand
flexes abruptly at the wrist.
|
| |
Raynaud phenomenon
Pallor or blue ness of fingers, toes or nose brought by exposure to cold and, less
commonly, by other stresses.
|
| |
Raynaud’s sign
Acrocyanosis
(a condition marked by symmetrical
cyanosis of the extremities, with persistent,
uneven, mottled blue or red discoloration
of the skin of the digits, wrists, and
ankles and with profuse sweating and
coldness of the digits.)
|
| |
Rinne test
A hearing test.
|
| |
Romberg test
For differentiating
between peripheral and cerebellar ataxia.
An increase in clumsiness in all movements
and in the width and uncertainty
of the gait when the patient’s eyes are
closed indicates peripheral ataxia; no
change indicates the cerebellar type.
|
| |
Romberg’s sign
Swaying of the body
or falling when standing with the feet
close together and the eyes closed;
observed in tabes dorsalis.
|
| |
Rust’s phenomenon
In caries or
cancer of the upper cervical vertebrae, the
patient supports his head with his
hands when rising from or assuming a
lying position.
|
| |
Sarbo’s sign
Analgesia of the peroneal
nerve; sometimes noted in tabes dorsalis.
|
| |
Schlesinger’s sign
In tetany, if the
patient’s leg is held at the knee joint and
flexed strongly at the hip joint, there
will follow within a short time an extensor spasm at the knee joint, with
extreme supination of the foot. Called
also Pool’s phenomenon.
|
| |
Simmons test
See Thompson test.
|
| |
Slocum test
For rotary instability of the
knee. The examiner pulls on the upper
calf of a supine patient with the knees
flexed 90 degrees.
|
| |
Somatic sign
Any sign presented by
trunk or limbs rather than sensory apparatus.
|
| |
Soto-hall sign
With the patient flat
on his back, on flexion of the spine be-
ginning at the neck and going down-
ward, a pain will be felt at the site of
the lesion in back abnormalities.
|
| |
Spurling test
For cervical spine and
foraminal nerve encroachment. Compression on the head with extension on
the neck causes radicular pain into the
upper extremities.
|
| |
Straight leg raising (SLR) test
For de termining nerve root irritation. The supine patient elevates his leg straight
until there is ipsilateral extremity pain
or until the pain is increased with dorsiflexion of the foot. Also called
Lasegue sign.
|
| |
Strumpell’s sign
Dorsal flexion of
the foot when the thigh is drawn up to-
ward the body; seen in spastic paralysis of the lower limb. Called also tibialis sign.
2. Inability to close the fist without marked dorsal extension of the wrist. Called also radialis sign.
3. Pronation sign, passive flexion of the forearm caused by pronation; seen in
hemiplegia.
|
| |
Strunsky’s sign
A sign for detecting
lesions of the anterior arch of the foot.
The examiner grasps the toes and
flexes them suddenly. This procedure
is painless in the normal foot but
causes pain if there is inflammation of
the anterior arch.
|
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Thomas sign
1. Flexion of the hip
joint can be compensated for by lordosis.
2. Pinching of the trapezius muscle
causes goose flesh above the level of a
spinal cord lesion.
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Thomas test
With the patient supine,
when one leg is flexed so that the knee
touches the chest and the lumbar spine
is flattened, the angle taken by the other
hip is the degree of flexion deformity.
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Thompson test
Compression of the
calf muscle with foot at rest results in
ankle flexion if Achilles tendon is intact.
Also called Simmons test, Achilles.
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Thumb-nail test
For fractured patella.
The examiner’s thumbnail is passed
over the subcutaneous surface of the
patella; a fracture will be felt as a sharp
crevice.
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Tibialis sign
Strumpell’s sign (def. 1).
Also called tibial phenomenon.
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Tinel’s sign
A tingling sensation in the
distal end of the limb when percussion
is made over the site of a divided nerve.
It indicates a partial lesion or the beginning regeneration of the nerve.
Called also formication sign and distal
tingling on percussion.
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Toe spread sign
For Morton neuroma.
Disproportional spreading of the toes,
comparing one foot with the other. Also
called Nelson sign.
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Tourniquet test
For phlebitis of the leg.
Tourniquet is applied to the thigh and
pressure gradually increased until the
patient complains of pain in the calf;
result is compared with the affect on
the opposite leg.
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Trendelenburg’s test
1. The doctor
raises the patient’s leg above the level
of the heart until the veins are empty,
then lowers it quickly. If the veins be-
come distended at once, varicosity and
incompetence of the valves are indicated.
2. The patient, standing erect, stripped,
with back to the examiner, is
told to lift one leg and then the other.
When weight is supported by the affected
limb, the pelvis on the sound
side falls instead of rising; seen in
disturbances of the gluteus medius
mechanism, as in deformity of femoral
neck, dislocated hip joint, and weakness or paralysis of the gluteus medius
muscle.
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Trunk rotation
A test for malingering.
Positive when incomplete rotation pro-
duces back pain when shoulders and
pelvis are passively rotated in the same
plane as the patient stands relaxed with
the feet together. In the presence of
nerve irritation, leg pain may be produced and should be considered as a
true medical finding.
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Valsalva’s maneuver
1. Forcible
exhalation effort against closed glottis;
the resultant increase in intrathoracic
pressure interferes with venous return
to the heart. 2. Forcible exhalation effort against occluded nostrils and a
closed mouth; the increase pressure in
the eustachian tube and middle ear
cause the tympanic membrane to move
outward.
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Vanzetti’s sign
In sciatica the pelvis
is always horizontal in spite of scoliosis, but in other lesion with scoliosis
the pelvis is inclined.
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Waddell’s criteria
A standardized
group of five types of physician signs
utilized by examiners to detect malingering or pretending:
1. Tenderness that is superficial or does not follow a specific muscle group.
2. Simulation, where the examiner asks a patient to perform a test that has no valid response.
3. Distraction, where the examiner checks that patient’s ability while the patient’s attention is
distracted. 4. Regional disturbances, such
as a give way weakness of muscle
groups that cannot be explained on a
physical basis. Also, sensory losses
that do not follow a specific nerve pat-
tern. 5. Overreaction, such as disproportionate verbalization, facial expression, muscle tension and tremor, collapsing or sweating.
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Wartenberg’s sign
1. A sign of ulnar
palsy, consisting of a position of ab-
duction assumed by the little finger. 2.
Reduction or absence of the pendulum
movements of the arm in walking; seen
in patient with cerebellar disease.
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Weber’s test
A hearing test
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Wilson test
With knee extended from 30 degrees with valgus stress and internal rotation of the foot, a click is
heard in cases of osteochondritis
dissecans.
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Yergason test
For subluxation of the
long head of the biceps tendon. The
elbow is held flexed at 90 degrees with
supination and forced external rotation
of the shoulder against resistance by
the examiner. Painful subluxation of the
tendon can be palpated.
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