Medical Tests, Signs & Maneuvers Guide
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Medical Tests, Signs & Maneuvers Guide Achilles Squeeze test: For Achilles This can be performed with tendon rupture. Squeezing the calf Doppler placed on the digits muscle fails to produce plantar during test. The test is valuable flexion of the ankle joint. Also called prior to an invasive procedure on Simmons Test, Thompson test. the arteries at the wrist, Addis test: For determination of Allis' sign: Relaxation of the leg length discrepancy. With fascia between the crest of the patient in prone position, flexing ilium and the greater trochanter: a the knees to 90 degrees reveals the sign of fracture of the neck of the potential discrepancies of both femur. tibial and femoral lengths. Amoss' sign: In painful flexure of Adson's maneuver: See under the spine, the patient, when rising Adson's test to a sitting posture from lying in bed, does so by supporting him- For thoracic outlet Adson's test: self with his hands placed far syndrome. With the patient in a behind him in the bed. sitting position, his hands resting on thighs, the examiner palpates Anghelescu's sign: Inability to both radial pulses as the patient bend the spine while lying on the rapidly fills his lungs by deep back so as to rest on the head and inspiration and, holding his breath, heels alone, seen in tuberculosis hyperextends his neck and turns of the vertebrae. his head toward the affected side. If the radial pulse on that side is Anterior drawer sign: See under decidedly or completely obliter- drawer sign. ated, the result is considered Anterior tibial sign: Involuntary positive. Also called Adson's contraction of the tibialis anterior maneuver. muscle when the thigh is forcibly Allen test: For occlusion of radial flexed on the abdomen; seen in or ulnar artery. A method of deter- spastic paraplegia. mining if radial and ulnar arteries Anvil test (hips): For early hip communicate through the two joint disease of diseased verte- palmar arches. Both arteries are brae. A closed fist striking a blow occluded digitally by making a fist to the sole of the foot with leg repeatedly. First one artery is extended produces pain in the hip released, then the other, to observe or vertebrae. pattern of capillary refill in the hand. Anvil test (neck): For vertebral supination, it turns over to prona- disorders. A closed fist striking a tion; seen in organic paralysis. blow to the top of the head elicits Called also pronation sign. pain in the vertebra(e). Bekhterev's test: The patient Apley test: For differentiating seated in bed is directed to stretch ligamentous from meniscal injury. out both legs; in sciatica he cannot Tibial rotation on femur with do this, but can stretch out each traction or compression with the leg in turn. patient prone and knee flexed. Also For nonorganic back called Apley sign. Bench test: pain. In normal hip motion, the Axial loading: Putting pressure on patient should be able to bend top of the head to identify nerve over and touch the floor kneeling damage in the neck. Also used to on a 12-inch high bench; not being medically disprove evidence of a able to implies a nonorganic (or low back problem. psychologic) back pain. Also called Burns test. Babinski reflex: For loss of brain control over lower extremities. Bowstring sign: With leg raised Scraping the soles causes toes to with knee bent in same position, pull up. Also called Babinski reflex, pain is felt in the back of limb toe sign. pressing on the popliteal fossa. Increased pain is sign of nerve Babinski's sign: 1. Loss or lessen- irritability. ing of the Achilles tendon reflex in sciatica; this distinguishes it from Bracelet test: The production of hysteric sciatica. 2. Babinski's pain on moderate lateral compres- reflex. 3, In hemiplegia, the con- sion of the lower ends of the radius traction of the platysma muscle in and ulna; observed in rheumatoid the healthy side is more vigorous arthritis. than on the affected side, as seen in With the knee opening the mouth, whistling, Bragard’s sign: stiff, the lower extremity is flexed blowing, etc. 4. The patient lies at the hip until the patient experi- supine on the floor, with arms ences pain; the foot is then crossed upon his chest, and then dorsiflexed. Increase of pain points makes an effort to rise to the sitting to disease of the nerve root. posture. On the paralyzed side, the thigh is flexed upon the pelvis and British test: For knee pain and/or the heel is lifted from the ground, injury. Compression of patella while on the healthy side the limb during active quadriceps contrac- does not move. This phenomenon tion as knee is extended elicits is repeated when the patient pain. resumes the lying posture. It is seen in organic hemiplegia, but not in Brudzinski's sign: For meningitis. hysterical hemiplegia. 5. When the Flexion of the neck forward results paralyzed forearm is placed in in flexion of the hip and knee; when passive flexion of the lower Comolli's sign: A sign of scapular limb on one side is made, a similar fracture consisting in the appear- movement will be seen in the ance in the scapular region, shortly opposite limb. Also called neck sign, after the accident, of a triangular contralateral sign. swelling reproducing the shape of the body of the scapula. Burns test: See under bench test Contralateral sign: See under Cantelli's sign: Dissociation be- Brudzinski's sign tween the movements of the head and eyes; as the head is raised the Contralateral straight leg raising eyes are lowered and vice versa. test: For sciatica. When the leg is Called also doll's eye sign. flexed, the hip can also be flexed, but not when the leg is held Chaddock's sign: For upper motor straight. Flexing the sound thigh neuron loss (brain). The big toe with the leg held straight causes extends when irritating the skin in pain on the affected side. Also the external malleolar region; called Fajersztajn's crossed indicates lesions of the corticospinal sciatic sign. paths. Also called external malleolus sign, Chaddock reflex. Coopernail sign: Ecchymosis on the perineum and scrotum or labia; Circumduction maneuver: A a sign of fracture of the pelvis. maneuver for the thumb; any general test of motion involving a Dawbarn's sign: In acute subacro- rotation action of a group of joints; a mial bursitis, when the arm hangs range of motion examination. by the side, palpation over the bursa causes pain but when arm is Cleeman's sign: Creasing of the abducted, this pain disappears. skin just above the patella, indica- tive of fracture of the femur with Dejerine's sign: Aggravation of overriding of fragments. symptoms of radiculitis produced by coughing, sneezing, and strain- Codman's sign: In rupture of the ing at stool. supraspinatus tendon, the arm can be passively abducted without pain, Demianoff’s sign: A sign that but when support of the arm is permits the differentiation of pain removed and the deltoid contracts originating in the sacrolumbalis suddenly, pain occurs again. muscles from lumbar pain of any other origin. The sign is obtained Cogwheel phenomenon:While by placing the patient in dorsal testing the strength of a muscle, the decubitus and lifting his extended patient exhibits jerky motions that leg. In the presence of lumbago are neither rhythmic nor equal and this produces a pain in the lumbar represent pretending or protection region which prevents raising the from pain. leg high enough to form an angle of ten degrees, or even less, with the table or bed on which the patient reposes. The pain is due to Fabere sign: See Patrick’s test the stretching of the Forced position of sacrolumbalis. Fadire test: the hip causing pain; the letters Desault’s sign: A sign of stand for Flexion Adduction intrascapular fracture of the femur, Internal External Rotation in consisting of alternation of the arc Extension. Also called Patrick’s described by rotation of the great test, fabere test, figure of 4 test. trochanter, which normally de- scribes the segment of a circle, but Fajersztajn’s crossed sciatic In sciatica, when the leg is in this fracture rotates only as the sign: flexed, the hip can also be flexed, apex of the femur rotates about its own axis. but not when the leg is held straight; flexing the sound thigh Doll’s eye sign: See Cantelli’s with the leg held straight causes sign. pain on the affected side. See also contralateral straight leg raising Drawer sign: For ligamentous test. instability or ruptured cruciate ligaments, With the patient supine Fan sign: Spreading apart of the and knee flexed to 90 degrees, the toes following the stroking of the sign is positive if knee is not sole of the foot; it forms part of displaced abnormally in a posterior the Babinski’s reflex. direction with knee pulled for- For ward. Also called an anterior Femoral nerve stretch test: lesion of third or fourth lumbar drawer sign, meaning the anterior disk. Passive knee flexion in the cruciate is lax or ruptured. prone position causes pain in the D.T.P. sign: (distal tingling on back or thighs. percussion), Tinel’s sign Femoral nerve traction test: For Dugas' test: A test for the exist- radiculopathy of the second ence of dislocation of the shoul- through fourth lumbar nerves. der, made by placing the hand With patient prone, the knee is of the affected side on the opposite flexed, causing back or thigh pain. shoulder and bringing the elbow For coordinated to the side of the chest.