Lab Material

Question 1

How to position arm for varus vs valgus stress test

Answer 1

Varus: slight abduction and internal rotation, elbow flexed 15 degrees
Valgus: slight abduction and external rotation, elbow flexed 30 degrees

Question 2

Where to tap for the elbow tinel test?

Answer 2

Between olecranon and medial epicondyle (in ulnar groove)

Question 3

Where does the radial head move when the wrist pronates vs supinates?

Answer 3

Pronates: radial head posterior
Supinates: radial head anterior

Question 4

Wrist isotonic MET: three steps

Answer 4

1. Physician crosses thumbs over base of pt’s palm
2. Pts tries to flex wrist, physician applies counter force
3. Physician lightens force to allow pt to overcome physician force

Question 5

Three special tests to test for cervical radiculopathy

Answer 5

1. Neck compression test
2. Neck distraction test
3. Spurlings

Question 6

Three stages of Spurlings

Answer 6

1. Neutral (same as neck compression test)
2. Extended
3. Extended and side bent

Question 7

Four special tests for Thoracic Outlet Syndrome

Answer 7

1. Roo’s/EAST
2. Adson’s test
3. Military/Halstead/Coracoclavicular test
4. Wright’s hyperabduction test

Question 8

Explain Roo’s test (EAST test)

Answer 8

Pt seated with arms up like a field goal, slowly opens and closes hands for 3 minutes

Question 9

Explain Adson’s test: 4 steps

Answer 9

1. Pt seated with elbow extended and hand supinated
2. Physician finds pt’s radial pulse
3. Passively adduct, extend, and externally rotate arm while monitoring pulse
4. Pt extends and rotates head towards affected side, then away from affected side as they inhale and hold their breath

Question 10

Positive test with Adson’s: looking away and looking towards affected arm

Answer 10

Looking away: compression of subclavian A btwn anterior + middle scalenes
Looking towards: compression of subclavian A between 1st rib + clavicle

Question 11

Explain Military/Halstead test: 3 steps

Answer 11

1. Pt seated with elbow extended
2. Physician holds pt’s radial pulse from behind pt, and extends arm back
3. Physician puts downward pressure on shoulder

Question 12

What does positive military/Halstead test mean specifically?

Answer 12

Neurovascular entrapment between 1st rib + clavicle

Question 13

Explain Wright’s hyperabduction test

Answer 13

Pt seated, physician abducts pt’s arm above head while monitoring radial pulse

Question 14

What does positive Wright’s hyperabduction test mean?

Answer 14

Neurovascular entrapment by pec minor

Question 15

MET: Regional Restrictor

Answer 15

Like C-spine bilateral forearm fulcrum foreword bend, but pt contracts against physicians hands, pushing head towards table

Question 16

In a CN 10 lesion, which way would the uvula deviate?

Answer 16

Away from lesion

Question 17

In a CN 12 lesion, which way does the tongue deviate?

Answer 17

Towards lesion (lick the lesion)

Question 18

Romberg - loss of balance with eyes open vs closed

Answer 18

Eyes open -> cerebellar pathology

Eyes closed -> proprioceptive or vestibular lesion

Question 19

What does positive pronator drift indicate

Answer 19

Contralateral CST lesion

Question 20

What does abnormal Babinski indicate?

Answer 20

UMN lesion

Question 21

Wallenberg test

Answer 21

Extend and sidebend/rotate head off the OMM table to check for dizziness or visual changes before performing C spine OMT

Question 22

Stoic

Answer 22

Distinct palpable point of tissue texture changes in an expected tenderpoint location, but without tenderness

Question 23

Where are AC7 and AC8 counterstrain points?

Answer 23

AC7: superior clavicle, 2cm lateral to medial end
AC8: superior clavicle, at medial end

Question 24

Where are PC1 inion, PC1 Occiput, and PC2 Occiput counterstrain points?

Answer 24

PC1 inion: just lateral to inion
PC1 Occiput: inferior nuchal line btwn inion and mastoid
PC2 Occiput: between PC1 inion and PC1 Occiput

Question 25

C2-7 HVLA rotational emphasis vs sidebending emphasis

Answer 25

Rotational emphasis: sidebend towards ease + rotate towards boundary
Sidebending emphasis: rotate towards ease + sidebend towards boundary