NUR 505 Module 6 Study Guide 2026 | Musculoskeletal Assessment, Orthopedic Special Tests &
Sports Physical Exam Prep PDF | University of Alabama
Module 6 MS and Sports Exam Study Guide
Chapter 22 Musculoskeletal Study Guide
1. Know how to grade muscle strength in your patient.
• using a 0-5 scale. 0 meaning he has no ability to move his limbs, 1 is going to be very weak, 2
indicates weakness but is able to move against gravity, 3 is full ROM against gravity but not
resistance, 4 is full ROM against gravity and weak against resistance, and 5 is full ROM against
gravity as well as resistance
2. Complete the table
Exam Steps to Perform Expected Abnormal Finding
Technique Finding and Possible
Indication
McMurray -Any palpable pain,
Test audible click, or
limited extension of
the knee while
assessing rotating
outward (valgus
stress) indicates a
positive sign for
torn medial
meniscus
-palpable pain,
-Have pt lie supine and flex one knee
audible click, or
-position your thumb and fingers on either side of the
limited extension
joint space. Hold heel with your other hand, fully
with inward
flexing the knee, and rotate the foot and knee outward
rotation (varus
(valgus stress) to a lateral position. Extend and then
stress) indicates
flex the knee
positive sign for
-repeat the procedure, rotating the foot and knee
torn lateral
, inward (varus stress) meniscus
Ballottement -if an effusion is
present, a tapping
or clicking will be
sensed. When the
patella is pushed
against the femur
-if an effusion is
present, the patella
will float out as if
fluid wave were
-used to determine the presence of an effusion in the pushing it
knee from excess fluid
-with one knee extended, apply downward pressure on
suprapatellar pouch with the web or thumb and
forefinger of one hand, and then push the patella
quickly downward against the femur with a finger of
your other hand
Then release the pressure against the patella, but keep
your finger lightly touching it
Barlow- High-pitched -Positive Barlow is
Ortolani clicks are when a clunk or
Maneuver common and sensation is felt at
expected. the femoral head
from the
acetabulum
By 3 months of posteriorly
age, muscles
and ligaments -If the head of the
-The Barlow-Ortolani maneuver to detect hip tighten, and femur slips back
dislocation or subluxation should be performed each limited into the acetabulum
time you examine the infant during the first year of abduction of with a palpable
life. Using little force, test one hip at a time, stabilizing the hips clunk when
the pelvis with the other hand. With the infant supine, becomes the pressure is exerted,
position yourself at the infant’s feet, and flex the hip most reliable suspect hip
and knee to 90 degrees. sign of hip subluxation or
-Barlow maneuver adduct thigh and gently apply subluxation or dislocation.
pressure downward on femur in attempt to disengage dislocation
the femoral head from acetabulum
-Ortolani slowly abduct the thigh while maintaining
axial pressure & with fingertips on the greater
trochanter, exert a lever movement in the opposite
direction so that your fingertips press the head of the
femur back toward acetabulum center
, Bulge Sign Observe for a bulge
of returning fluid to
the hollow
-used to determine presence of fluid in the knee
-with the pt’s knee extended, milk the medial aspect of
the knee upward 2-3x, and then milk the lateral side of
the patella
Drawer Test Anterior or
posterior movement
of the knee greater
than 5 mm in either
direction is an
unexpected finding
-The anterior and posterior drawer test is used to
identify instability of the anterior and posterior
cruciate ligaments
-Have pt lie supine and flex knee 45-90 degrees,
placing foot flat on table
-place both hands on the lower leg with the thumbs on
the ridge of the anterior tibia just distal to the tibial
tuberosity. Draw the tibia forward, forcing the tibia to
slide forward of the femur then push tibia backward
Straight leg No pain should Radicular pain
raising test be felt below below knee may be
(SLR) knee with leg associated with disk
raising herniation; flexion
of the knee often
alleviates pain
Crossover pain in
the affected leg
with this maneuver
is associated sciatic
nerve
impingements
-used to test for nerve root irritation or lumbar
Sports Physical Exam Prep PDF | University of Alabama
Module 6 MS and Sports Exam Study Guide
Chapter 22 Musculoskeletal Study Guide
1. Know how to grade muscle strength in your patient.
• using a 0-5 scale. 0 meaning he has no ability to move his limbs, 1 is going to be very weak, 2
indicates weakness but is able to move against gravity, 3 is full ROM against gravity but not
resistance, 4 is full ROM against gravity and weak against resistance, and 5 is full ROM against
gravity as well as resistance
2. Complete the table
Exam Steps to Perform Expected Abnormal Finding
Technique Finding and Possible
Indication
McMurray -Any palpable pain,
Test audible click, or
limited extension of
the knee while
assessing rotating
outward (valgus
stress) indicates a
positive sign for
torn medial
meniscus
-palpable pain,
-Have pt lie supine and flex one knee
audible click, or
-position your thumb and fingers on either side of the
limited extension
joint space. Hold heel with your other hand, fully
with inward
flexing the knee, and rotate the foot and knee outward
rotation (varus
(valgus stress) to a lateral position. Extend and then
stress) indicates
flex the knee
positive sign for
-repeat the procedure, rotating the foot and knee
torn lateral
, inward (varus stress) meniscus
Ballottement -if an effusion is
present, a tapping
or clicking will be
sensed. When the
patella is pushed
against the femur
-if an effusion is
present, the patella
will float out as if
fluid wave were
-used to determine the presence of an effusion in the pushing it
knee from excess fluid
-with one knee extended, apply downward pressure on
suprapatellar pouch with the web or thumb and
forefinger of one hand, and then push the patella
quickly downward against the femur with a finger of
your other hand
Then release the pressure against the patella, but keep
your finger lightly touching it
Barlow- High-pitched -Positive Barlow is
Ortolani clicks are when a clunk or
Maneuver common and sensation is felt at
expected. the femoral head
from the
acetabulum
By 3 months of posteriorly
age, muscles
and ligaments -If the head of the
-The Barlow-Ortolani maneuver to detect hip tighten, and femur slips back
dislocation or subluxation should be performed each limited into the acetabulum
time you examine the infant during the first year of abduction of with a palpable
life. Using little force, test one hip at a time, stabilizing the hips clunk when
the pelvis with the other hand. With the infant supine, becomes the pressure is exerted,
position yourself at the infant’s feet, and flex the hip most reliable suspect hip
and knee to 90 degrees. sign of hip subluxation or
-Barlow maneuver adduct thigh and gently apply subluxation or dislocation.
pressure downward on femur in attempt to disengage dislocation
the femoral head from acetabulum
-Ortolani slowly abduct the thigh while maintaining
axial pressure & with fingertips on the greater
trochanter, exert a lever movement in the opposite
direction so that your fingertips press the head of the
femur back toward acetabulum center
, Bulge Sign Observe for a bulge
of returning fluid to
the hollow
-used to determine presence of fluid in the knee
-with the pt’s knee extended, milk the medial aspect of
the knee upward 2-3x, and then milk the lateral side of
the patella
Drawer Test Anterior or
posterior movement
of the knee greater
than 5 mm in either
direction is an
unexpected finding
-The anterior and posterior drawer test is used to
identify instability of the anterior and posterior
cruciate ligaments
-Have pt lie supine and flex knee 45-90 degrees,
placing foot flat on table
-place both hands on the lower leg with the thumbs on
the ridge of the anterior tibia just distal to the tibial
tuberosity. Draw the tibia forward, forcing the tibia to
slide forward of the femur then push tibia backward
Straight leg No pain should Radicular pain
raising test be felt below below knee may be
(SLR) knee with leg associated with disk
raising herniation; flexion
of the knee often
alleviates pain
Crossover pain in
the affected leg
with this maneuver
is associated sciatic
nerve
impingements
-used to test for nerve root irritation or lumbar
