Orthopedic Exam

Question 1

normal range of cervical flexion

Answer 1

60 degrees

Question 2

normal range of cervical extension

Answer 2

75 degrees

Question 3

normal range of cervical rotation

Answer 3

80 degrees

Question 4

normal range of cervical lateral flexion

Answer 4

45 degrees

Question 5

normal range of thoracic flexion

Answer 5

25-45 degrees

Question 6

normal range of thoracic extension

Answer 6

25-35 degrees

Question 7

normal range of thoracic rotation

Answer 7

35-50 degrees

Question 8

normal range of shoulder flexion

Answer 8

180 degrees

Question 9

normal range of shoulder extension

Answer 9

50 degrees

Question 10

normal range of shoulder abduction

Answer 10

180 degrees

Question 11

normal range of shoulder adduction

Answer 11

50 degrees

Question 12

normal range of shoulder internal and external rotation

Answer 12

90 degrees

Question 13

normal range of elbow flexion

Answer 13

140-150 degrees

Question 14

normal range of elbow extension

Answer 14

0-10 degrees

Question 15

normal range of elbow supination and pronation

Answer 15

90 degrees

Question 16

normal range of wrist flexion

Answer 16

90 degrees

Question 17

normal range of wrist extension

Answer 17

70 degrees

Question 18

normal range of wrist radial deviation

Answer 18

20 degrees

Question 19

normal range of wrist ulnar deviation

Answer 19

55 degrees

Question 20

nonspecific neck pain with radiating symptoms into one arm

Answer 20

cervical radiculopathy

Question 21

neck pain with bilateral upper extremity symptoms

Answer 21

cervical myelopathy

Question 22

best methods for identifying myelopathy

Answer 22

Hoffman’s, deep tending reflexes in upper extremity, inverted supinator reflex, suprapatellar quadriceps reflex, hand withdrawal reflex, Babinski sign, clonus of the ankle

Question 23

purpose of Lhermitte’s test

Answer 23

to traction the posterior column of the spinal cord

Question 24

findings of Lhermitte’s test and what it means

Answer 24

findings=electric shock like sensation radiating down the neck and spine
means=posterior column disease or MS

Question 25

characteristic findings with meningitis

Answer 25

fever, neck stiffness, altered mental state

Question 26

findings of Kernig sign and what it means

Answer 26

with patient lying supine Dr tries to completely extend the leg - if pain prevents it and headache increases then the sign is positive (usually accompanied by involuntary flexion of opposite knee and hip)
means=positive sign means meningitis

Question 27

findings of Brudzinski sign and what it means

Answer 27

with patient lying supine Dr tries to flex patient’s head - if headache increases and both knees flex then positive sign
means=positive sign means meningitis

Question 28

purpose of Soto-Hall test

Answer 28

done when suspected fracture of vertebra

Question 29

findings of Soto-Hall test and what they mean

Answer 29

findings=localized dull or sharp pain in the cervical spine that may radiate into thoracic spine
mean=possible fracture

Question 30

purpose of Valsalva’s maneuver

Answer 30

tests for presence of space occupying lesion within spinal column that is communicating with spinal cord meninges

Question 31

findings of Valsalva’s maneuver and what it means

Answer 31

findings=sharp accentuation of pain at level of lesion

means=space occupying lesion

Question 32

purpose of Dejerine’s sign

Answer 32

to determine if there’s a space occupying lesion in the cervical area

Question 33

findings of Dejerine’s sign and what it means

Answer 33

coughing, sneezing, straining during defecation increase pressure and aggravate symptoms
means=lesion is present such as herniated or protruding disc, spinal cord tumor, spinal compression fracture

Question 34

purpose of swallowing test

Answer 34

to determine if there may be a space occupying lesion, sprain, strain, fracture, disc protrusion, tumor

Question 35

findings of swallowing test and what it means

Answer 35

findings=presence of pain or difficulty swallowing

means=dysphagia is present (something is causing irritation)

Question 36

purpose of Naffzinger’s test

Answer 36

to create a pooling of the venous sinuses that will cause increase in cerebral spinal fluid pressure

Question 37

findings of Naffzinger’s test and what it means

Answer 37

findings=sharp accentuation of pain at the level of the lesion
mean=there’s a lesion present

Question 38

purpose of distraction test

Answer 38

to determine IVF encroachment

Question 39

findings of distraction test and what it means

Answer 39

findings=test is positive in relieving pain in the cervical area
means=IVF encroachment

Question 40

purpose of foraminal compression test

Answer 40

to determine IVF encroachment and nerve root involvement

Question 41

findings of foraminal compression test and what they mean

Answer 41

findings=when the Dr exerts downward pressure on head in neutral position and during bilateral rotation and there’s either localized pain or radicular pain
means=localized pain means foraminal encroachment, radicular pain means pressure on the nerve root

Question 42

purpose of Jackson compression test

Answer 42

to determine IVF encroachment and nerve root involvement

Question 43

findings of Jackson compression test and what it means

Answer 43

findings=can have pain on opposite side or on same side
means=if there’s pain on opposite side of lateral flexion means muscular strain, pain on the side of lateral flexion means facet or nerve root involvement

Question 44

purpose of maximum cervical compression

Answer 44

to determine IVF encroachment and nerve root involvement

Question 45

findings of maximum cervical compression and what it means

Answer 45

findings=can have pain on opposite side or same side

means=pain on the same side means nerve root or facet involvement, pain on opposite side means muscle strain

Question 46

purpose of spurling’s test

Answer 46

to determine IVF encroachment and nerve root involvement

Question 47

findings of spurling’s test and what it means

Answer 47

findings=pain

means=IVF encroachment and nerve root involvement