Special Tests
A Lachman test should be performed with the knee in which of the following positions? 5-10 degrees of flexion 10-20 degrees of flexion 20-30 degrees of flexion 30-40 degrees of flexion
Correct Answer: 20-30 degrees of flexion The Lachman test is designed to assess the integrity of the anterior cruciate ligament. It is typically performed with the patient in a supine position and the knee flexed 20-30 degrees. A positive test is indicated by excessive anterior translation of the tibia on the femur.
Maximal tension on the S1 nerve root occurs in which range during a straight leg raise test? 0-35 degrees 35-70 degrees 70-90 degrees 90-100 degrees
Correct Answer: 35-70 degrees Slack in the sciatic nerve is taken up in the first 35 degrees of movement and no further deformation occurs after about 70 degrees. This results in maximal tension during a straight leg raise from 35-70 degrees.
What special test would precede the measurement depicted in the image? Ely's test Craig's test Apley's compression test McMurray test
Correct Answer: Craig's test Craig's test is performed with the patient in prone and the test knee flexed to 90 degrees. The test is designed to determine the relative amount of femoral anteversion which can be quantified with a goniometer.
Which of the following tests would be used to assess the rectus femoris? Freiberg test Pace abduction test Ely's test piriformis test
Correct Answer: Ely's test Ely's test is performed with the patient in prone. A positive test is indicated by spontaneous hip flexion occurring simultaneously with knee flexion and may be indicative of a rectus femoris contracture.
What special test is associated with the sequence depicted in the image? Craig's test Ely's test quadrant scouring test sign of the buttock
Correct Answer: Ely's test Ely's test requires the patient to be positioned in prone while the therapist passively flexes the patient's knee. Rectus femoris tightness will result in spontaneous hip flexion occurring simultaneously with passive knee flexion.
Which special test is not designed to identify a contracture or muscle tightness? Ely's test Fromment's sign piriformis test tripod sign
Correct Answer: Fromment's sign Froment's sign is designed to identify the presence of neurological dysfunction, specifically ulnar nerve compromise or paralysis.
What special test is being performed if the therapist flexes the patient's shoulder to 90 degrees, flexes the elbow to 90 degrees, and medially rotates the arm? Yergason's test supraspinatus test Neer impingement test Hawkins-Kennedy impingement test
Correct Answer: Hawkins-Kennedy impingement test The Hawkins-Kennedy impingement test is performed by flexing the patient's shoulder to 90 degrees, flexing the elbow to 90 degrees, and medially rotating the arm. This movement pushes the supraspinatus tendon against the coracoacromial ligament and the coracoid process. Pain indicates a positive test for supraspinatus tendinitis or impingement.
The prone knee bend test places maximal tension on which nerve root? L1 L3 L5 S1
Correct Answer: L3 The prone knee bend is a test for neural tension and involves flexion of the hip and knee in a prone position. The test stresses the femoral nerve and the L2-L4 nerve roots.
Which of the following special tests would be used to assess pain occurring at 60-120 degrees of shoulder flexion? Neer test empty can test crossover test Yergason's test
Correct Answer: Neer test The Neer test is a test for subacromial impingement and is associated with a painful arc. A positive test is indicated by a facial grimace or pain.
Which orthopedic special test would be performed with the patient in sidelying? Lachman test McMurray test Yeoman's test Ober's test
Correct Answer: Ober's test Ober's test is performed with the patient in sidelying. The therapist abducts and extends the patient's top leg and then slowly lowers the leg to assess for tensor fasciae latae tightness. A positive finding would be the inability of the leg to reach the level of the table.
Which of the following special tests would only be administered to infants? Finkelstein test Froment's sign Ortolani's test Murphy sign
Correct Answer: Ortolani's test During Ortolani's test the patient lies supine with the hips flexed to 90 degrees. The therapist abducts the patient's hips and gentle pressure is applied to the greater trochanters until resistance is felt at approximately 30 degrees. A positive test is indicated by a click or a clunk and may be indicative of a dislocation being reduced.
Which of the following describes a test for thoracic outlet syndrome performed by opening and closing the hands for three minutes in shoulder abduction and lateral rotation? Roos Adson's Allen's Phalen's
Correct Answer: Roos Thoracic outlet syndrome is a group of disorders that occur when the neurovascular bundle in the thoracic outlet becomes compromised. A positive Roos test is indicated by an inability to maintain the test position, weakness of the upper extremities, sensory loss or ischemic pain.
Which orthopedic special test would be performed with the patient positioned in sitting? Ober's test Tripod sign Ely's test Thomas test
Correct Answer: Tripod sign The Tripod sign special test begins with the patient positioned in sitting with the knees flexed to 90 degrees over the edge of the table. The therapist passively extends one knee. A positive test is indicated by tightness in the hamstrings or extension of the trunk in order to limit the effect of the tight hamstrings.
True leg length measurements are taken from what two anatomical landmarks? anterior superior iliac spine, medial malleoli anterior superior iliac spine, lateral malleoli iliac crest, medial malleoli iliac crest, lateral malleoli
Correct Answer: anterior superior iliac spine, medial malleoli True leg length measurements are obtained by using a tape measure from the distal point of the anterior superior iliac spines to the distal point of the medial malleoli. The patient should be positioned in supine with the hips and knees extended with the legs 15 to 20 centimeters apart.
What ligament is being tested in this image as the therapist provides a force towards the floor with the right hand? posterior talofibular ligament deltoid ligament calcaneofibular ligament anterior talofibular ligament
Correct Answer: anterior talofibular ligament The anterior drawer test can be performed both in supine and prone. Excessive anterior movement and sucking in of the skin on both sides of the Achilles tendon indicate a positive sign.
A positive foraminal compression (Spurling) test is most indicative of: atlantoaxial instability cervical radiculitis vertebral artery compromise thoracic outlet syndrome
Correct Answer: cervical radiculitis Spurling test is considered positive if pain radiates into the arm toward which the cervical spine is laterally flexed during compression. Radiating pain is caused by pressure on the nerve root (cervical radiculitis).
When administering Ludington's test, the patient is asked to: extend the elbow flex the shoulder contract the biceps brachii contract the triceps brachii
Correct Answer: contract the biceps brachii Ludington's test requires the patient to clasp both hands behind the head with the fingers interlocked. The patient is then asked to alternately contract and relax the biceps muscles. A positive test is indicated by absence of movement in the biceps tendon and may be indicative of a rupture of the long head of the biceps.
A positive Finkelstein's test may be indicative of? ulnar nerve compromise ulnar collateral ligament instability carpal tunnel syndrome de Quervain's disease
Correct Answer: de Quervain's disease A positive Finkelstein's test may be indicative of tenosynovitis of the thumb (de Quervain's disease). The patient is asked to make a fist with the thumb tucked inside the fingers. The therapist stabilizes the patient's forearm and ulnarly deviates the wrist. A positive test is indicated by pain over the abductor pollicis longus and extensor pollicis brevis tendons at the wrist.
What test is being performed in the image? sacral springing test distraction test thigh thrust test compression test
Correct Answer: distraction test The sacroiliac distraction test is similar in concept to the compression test, but utilizes an opposite direction of force. This test stresses the anterior sacroiliac ligaments.
When performing the Bunnel-Littler test, what is done to rule out capsular restriction? flex the metacarpophalangeal joint extend the metacarpophalangeal joint flex the wrist extend the wrist
Correct Answer: flex the metacarpophalangeal joint When performing the Bunnel-Littler test, the metacarpophalangeal (MCP) joint is flexed followed by the proximal interphalangeal (PIP) joint to rule out a capsular restriction of the involved digit. If the range of motion is unrestricted at both joints, the capsule is likely unaffected. The test begins with the MCP in slight extension. If the PIP joint does not flex with the MCP joint extended, there may be a tight intrinsic muscle or capsular tightness.
The Barlow test is used to test the stability of which joint? shoulder hip knee ankle
Correct Answer: hip The Barlow test can be used to detect congenital hip dysplasia. This condition, also known as developmental dysplasia, is characterized by malalignment of the femoral head within the acetabulum. A positive Barlow test is indicated by a click or a clunk and may be indicative of a hip dislocation being reduced.
What is a positive sign for the test depicted in the image? pain in the ulnar distribution lack of return of color to the hand pain in the radial distribution numbness and tingling in the fingers
Correct Answer: lack of return of color to the hand A positive Allen test is characterized by delayed or absent flushing of the radial or ulnar half of the hand and may be indicative of an occlusion in the radial or ulnar artery.
When administering the empty can test, the patient is asked to: maintain 90 degrees of glenohumeral flexion and medial rotation against resistance slowly lower their arm from an abducted position adduct and medially rotate their arm actively open and close their hand with their shoulders and elbows flexed to 90 degrees
Correct Answer: maintain 90 degrees of glenohumeral flexion and medial rotation against resistance The empty can test requires the patient to maintain a position of 90 degrees of shoulder flexion and medial rotation against a downward force applied to the distal forearm. Inability to maintain the position or pain may be indicative of a supraspinatus tear.
Phalen's test assesses which nerve? ulnar musculoskeletal radial median
Correct Answer: median A positive Phalen's test is indicated by tingling in the thumb, index finger, middle finger, and lateral half of the ring finger. A positive test may be indicative of carpal tunnel syndrome due to median nerve compression.
Which of the following would indicate a positive medial epicondylitis test? pain numbness radiculopathy diminished radial pulse
Correct Answer: pain A positive medial epicondylitis test would be indicated by pain in the medial epicondyle region. The therapist palpates the medial epicondyle and supinates the patient's forearm, extends the wrist, and extends the elbow. A positive test may be indicative of medial epicondylitis.
When performing the Hoover test, what patient action is required after the therapist grasps each calcaneus? perform a straight leg raise perform a bridge actively abduct the hip dorsiflex the ankle
Correct Answer: perform a straight leg raise The Hoover test is performed by the therapist grasping each calcaneus and then asking the patient to perform a straight leg raise. A positive test would result if the therapist was unable to detect pressure from the patient's contralateral heel into their hand as the opposing leg performs the straight leg raise. The test is designed to identify if the patient is malingering.
Which of the following does not test for an anterior cruciate ligament injury? lateral pivot shift test Lachman test posterior sag sign anterior drawer test
Correct Answer: posterior sag sign A positive posterior sag test is used to identify a posterior cruciate ligament injury. The patient is supine with the hips and knees flexed to 90 degrees and legs supported at the calves by the clinician. The clinician attempts to identify changes in the contour of the tibial tuberosity between the involved and uninvolved sides.
Which test of the lumbar spine involves overpressure in lumbar extension while the patient laterally flexes and rotates to the side of pain? Ober test quadrant test of the lumbar spine Milgram's test Yeoman's test
Correct Answer: quadrant test of the lumbar spine Lumbar extension, lateral flexion, and rotation causes maximum narrowing of the intervertebral foramen and stress on the facet joint to the side on which the rotation occurs.
Which artery does the examiner palpate while performing the costoclavicular syndrome test? ulnar radial carotid temporal
Correct Answer: radial The examiner palpates the radial artery when performing the costoclavicular syndrome test. The examiner then assists the patient to assume a military posture. A positive test is indicated by an absent or diminished radial pulse and may be indicative of thoracic outlet syndrome caused by compression of the subclavian artery between the first rib and the clavicle.
When performing Speed's test, what is the role of the examiner? passively abduct the shoulder resist active shoulder flexion passively medially rotate the shoulder resist active elbow flexion
Correct Answer: resist active shoulder flexion When performing Speed's test, the therapist should resist active shoulder flexion. The patient is positioned in sitting or standing with the elbow extended and the forearm supinated. The therapist places one hand over the bicipital groove and the other hand on the volar surface of the forearm. A positive test is indicated by pain or tenderness in the bicipital groove region and may be indicative of bicipital tendonitis.
When performing Yergason's test, how is the patient asked to actively move against resistance? supinate the forearm and medially rotate the shoulder pronate the forearm and medially rotate the shoulder supinate the forearm and laterally rotate the shoulder pronate the forearm and laterally rotate the shoulder
Correct Answer: supinate the forearm and laterally rotate the shoulder When performing Yergason's test, the patient is asked to actively supinate the forearm and laterally rotate the shoulder against resistance. The therapist places one hand on the patient's forearm and the other hand over the bicipital groove. A positive test is indicated by pain or tenderness in the bicipital groove and may be indicative of bicipital tendonitis.
An upper limb tension test that combines the motions of shoulder depression, abduction, external rotation, wrist and finger extension, supination, and elbow flexion tests which peripheral nerve? ulnar nerve median nerve radial nerve musculocutaneous nerve
Correct Answer: ulnar nerve The upper limb tension test of the ulnar nerve utilizing the described motions stresses the C8 and T1 nerve roots specifically.
