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General Clinical Examinations

Roos test – Elevated arm test

Purpose:  To test for the integrity of the thoracic outlet. Test procedure: • The patient is seated. • The examiner observes by standing in front. • The patient is asked to abduct their arms to 900 and flex their elbows upwards also at 900 (the surrender position). The patient is then asked to repeatedly open and close their...

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Hautant’s Test

 

Purpose: To assess the integrity of the vertebral arteries Test procedure: • The patient is seated • The examiner stands close to the patient • The patient flexes both arms to 90 with forearms supinated. The patient is instructed to close their eyes and tip the head backward. At this point, the patient may report the presence...

Vertebral Artery Test

 

CAUTIONS! Purpose:  Test for the integrity of the vertebral arteries Test procedure: • The patient is in the supine position • The examiner stands at the head end of the patient • The patient is assisted to extend the cervical spine to end of range. Following this, the upper cervical joints are taken into side bending...

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Roos test – Elevated arm test

Evaluation of radio-radial delay Definition: The use of palpation to simultaneously evaluate both radial pulses in an attempt to determine any delay and/or discrepancy. Test procedure: With your patient lying inclined at roughly forty-five degrees, the practitioner supinates the patient’s wrist and locates the radial artery, just proximal to the carpal tunnel on the lateral side of the wrist, […] Raynaud’s phenomenon test  Definition: Raynaud’s phenomenon is a term used to describe a clinical picture consisting of vasopastic associated discolorations of the fingers and toes and occasionally other peripheral parts of the body. Raynaud’s phenomenon includes: Raynaud’s disease (primary Raynaud’s phenomenon), a term used to describe the condition when it is idiopathic in nature and Raynaud’s syndrome (secondary […] Allen’s test – (radio-ulnar palmar anastomosis) Definition: Allen’s test is an orthopaedic procedure used determine the integrity and adequate functioning of the palmar branch of the ulnar artery. Test procedure: The patient makes a fist and the hand is elevated for approximately thirty seconds. Adequate pressure is applied over the radial and ulnar arteries so as to occlude them both. Whilst […] Adson’s test – a provocative test for Thoracic Outlet Syndrome (TOS) Definition: Adson’s test/manoeuvre is an orthopaedic examination used to determine the presence of thoracic outlet syndrome in patient. Test procedure: The patient’s radial pulse is obtained and retained (palpated), while the patient is instructed to extend their head and rotate it to the ipsilateral side of the arm at which the pulse in being assessed. […] Elevated Arm Stress Test EAST (Roos Stress Test) Definition: The elevated arms stress test is an orthopaedic procedure used to identify signs and symptoms associated with thoracic outlet syndrome. Test procedure: Instruct your patient to raise their arms over their head and for three minutes actively open and close their hands. Test findings: Positive & negative  A reproduction and/or aggravation in symptoms is […] Ankle Brachial Index (ABI) test – Doppler required Definition: The Ankle Brachial Index (ABI) is the ratio of the blood pressure in the ankle (distal leg) compared to the blood pressure measured in the arm. In order to obtain a ABI value by divide the systolic blood pressure at the ankle by the systolic blood pressure in the arm. Test procedure: To obtain […] Buerger’s test (leg raise & capillary refill) Definition: Also referred to as the vascular angle, this test aims to gain some insight as to whether a patient way be suffering from ischaemia. Test procedure: The vascular angle, also known as Buerger’s angle, is the angle at which an individual’s leg has to be raised for it to start turning pale (blood draining). […] Evaluation of Radio-femoral delay Definition: The use of palpation to simultaneously evaluate the radial and femoral pulses in an attempt to determine any delay and/or discrepancy. Test procedure: With your patient lying supine, locate the anterior superior iliac spine and the pubic symphysis. These two points are connected by the inguinal ligament, through which runs the femoral artery. Palpate […] Evaluation of peripheral circulation Definition:  The evaluation of peripheral circulation involves a series of tests and observation often performed alongside a routine cardiovascular examination. Test procedure and findings: Firstly, with the patient suitably undressed and lying inclined, focusing primarily on the extremities, observe the patient for any of the following: o Gangrene and/or pre-gangrenous changes. o Ulcers and/or old […]

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Evaluation for ascites

Definition: The use of clinical examinations to determine the presence of ascites in patient. Ascites is a clinical term used to describe an accumulation of fluid in the peritoneal cavity. Common causes include liver cirrhosis, advanced liver pathologies and metastatic cancer. Â Test procedure and findings: Flank dullness test: with the patient lying supine, percuss the...

Roos test – Elevated arm test

Examination of peripheral arteries – Posterior tibial Definition: Â The clinical use of palpation to obtain a qualitative reading of an individual’s pulse at the Posterior tibial pulse. Test procedure: With your patient lying supine and slightly inclined, locate the tip of the medial malleolus and Achilles tendon, the posterior tibial artery lies mid-way between these two points (Pimenta’s point). Test findings: Positive […] Examination of peripheral arteries – Dorsalis pedis Definition: The clinical use of palpation to obtain a qualitative reading of an individual’s pulse at the dorsalis pedis artery. Test procedure: With your patient lying supine and slightly inclined, locate the tendon of extensor hallucis longus. The dorsalis pedis artery is located directly lateral to this tendon. Test findings: Positive & negative The rate, […] Examination of peripheral arteries – Popliteal artery Definition: The clinical use of palpation to obtain a qualitative reading of an individual’s pulse at the popliteal artery. Test procedure: With your patient lying supine and slightly inclined, bend their knee to be tested at approximately one hundred and twenty-five degree using your hand wrapped around your patient’s knee and your finger-tips in contact […] Examination of peripheral arteries – Femoral artery Definition: The clinical use of palpation to obtain a qualitative reading of an individual’s pulse at the femoral artery. Test procedure: With your patient lying supine and slightly inclined, locate the anterior superior iliac spine and the pubic symphysis. These two points are connected by the inguinal ligament, through which run the femoral vein, artery […] Examination of peripheral arteries – Brachial artery Definition: Â The clinical use of palpation to obtain a qualitative reading of an individual’s pulse at the brachial artery. Â Test procedure: With your patient seated or lying inclined at roughly forty-five degrees, the practitioner locates the patient’s brachial artery which can be palpated using finger-tips, just proximal to the cubital fossa, lateral to the medial […] Venous flow test, Evaluation of venous integrity, Vein emptying test Definition: The venous flow test is a clinical examination performed to evaluate the integrity of the veins, their filling and emptying. Test procedure: Â Locate a visible vein on your patient’s body and with you indexes indent the middle portion of this vein between two valves than draw your fingers apart from each other in the […] Palpation of the abdominal aorta Definition: The use of palpation to determine the approximate width and location of the abdominal aorta. Test procedure: Lay your patient slightly inclined with their knees bent and propped up so as to relax their abdomen. Starting at one side, gently palpate the area between the umbilicus and xiphoid, starting laterally, roughly at the linea […]

Jugular Venous Pressure

 

Definition: Evaluating the pressure in the venous system as the blood is returned to the right side of the heart before it is sent into the pulmonary circulation.
Test procedure: The patient lies supine and at 45 degrees. The internal jugular vein is visualised as it ascends the side of the neck between the two...

 

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Popliteal Aneurysm

Definition: A pathological dilation of the popliteal artery due to a weakness or defect in the arterial wall or predisposed by injury.
Causes: The popliteal artery, a continuation of the femoral artery is common side of peripheral aneurysms. Peripheral aneurysms are more common in males especially over the age of 55. It is often predisposed...

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