Orthopedic tests

Question 1

foraminal compression

Answer 1

downward pressure in neutral and R/L rotation
-radiating pain, IVF encroachment

Question 2

max foraminal compression

Answer 2

follows fingers into rotation, lateral flexion, and extension
-radiating, IVF encroachment

Question 3

jackson’s compression

Answer 3

downward pressure in lateral flexion
-radiating, IVF encroachment

Question 4

Spurling’s

Answer 4

compression in lateral flexion and lateral flexion w/ extension, followed by fist drop
-radiating, IVF encroachment

Question 5

cervical distraction

Answer 5

from mastoid process
-decreased radiation, IVF encroachment
-increased pain, cervical strain/sprain

Question 6

spinal percussion

Answer 6

-SP fracture or sprain/strain

Question 7

shoulder depression

Answer 7

-over stretched side, mm strain in trap/levator
-on flexed side, facet syndrome or IVF encroachment

Question 8

bakody’s

Answer 8

hand resting on top of head
-reduction of pain, nerve root tension

Question 9

swallowing

Answer 9

-inability, retroesopharyngeal space occupying lesion

Question 10

soto-hall

Answer 10

supine with hands over sternum, passively flex c spine while applying gentle downward pressure on sternum
-localized pain, strain/sprain
-knees flex, meningeal irritation

Question 11

Lhermitte

Answer 11

seated, passively flexes c spine
-lightening radiating pain down spine or arms, dural irritation/multiple sclerosis

Question 12

O’donahue’s maneuver

Answer 12

seated, passive and resisted ROM
-passive pain, ligament sprain
-resisted pain, muscular strain

Question 13

wright’s hyperabduction

Answer 13

pulse, abduct arm slowly to 180
-decreased or disappearing pulse, reproduction of pain

Question 14

allen maneuver

Answer 14

pulse, elbow flexed to 90, shoulder abducted and externally rotated, turns head away
-absent pulse, positive test

Question 15

adson

Answer 15

pulse with arm rotated and extended, rotates head to involved side, extends, and holds deep breath
-absent pulse, positive test

Question 16

modified adsons

Answer 16

patient turns head away instead

Question 17

costoclavicular/eden

Answer 17

radial bilaterally, arms down and shoulders extended, chin to chest
-loss of pain, positive test

Question 18

roos

Answer 18

shoulders and elbows at 90, open and closes fists for up to 30 minutes
-fatigue/slowness/weakness, positive test

Question 19

dejerine’s triad

Answer 19

cough, sneeze, or bear down (triad)
-radiation, SOL

Question 20

schepelmann

Answer 20

both arms in air with lateral flexion to both sides back and forth
-convex, myofascitits/intercostal strain
-concave, intercostal neuritis

Question 21

chest expansion

Answer 21

at T10 level
-limited below 1.5-3 in, poor diaphragmatic breathing, ankylosing spondylitis, COPD

Question 22

passive scapular approximation

Answer 22

seated, adducts scapula bilaterally
-pain in between, T1-2 nerve root compression

Question 23

beevor sign

Answer 23

supine, partial sit up
-upward umbilical drift T10-12 involvement
-downward umbilical drift T7-9 involvement

Question 24

amos sign

Answer 24

rolling to side and dropping legs getting up from supine position
-anklylosing spondylitis, sprain/strain or disc lesion

Question 25

sternal compression

Answer 25

supine, hands over sternum, downward and lateral compression at rib cage
-rib fracture/subluxation on opposite side

Question 26

supported forward bending (belt’s)

Answer 26

standing trunk flexion, supported trunk flexion
-pain in both, lumbar pathology
-no pain when supported, sacral pathology

Question 27

adam’s

Answer 27

hands together with bending at waist, view from both sides
-scoliosis

Question 28

antalgia

Answer 28

-lean to same side as pain, medial disc bulge
-lean to opposite side of pain, lateral disc bulge

Question 29

bechterew

Answer 29

seated at edge, extends one knee and then applies pressure, extends both
-pain or tripod sign, nerve root compression or nerve tension

Question 30

tripod sign

Answer 30

-lumbar disc involvement/nerve root compression

Question 31

kemps

Answer 31

seated or standing, fist over area of pain, rotation through ROM
-leg pain, nerve root compression
-local LBP, facet syndrome

Question 32

SLR

Answer 32

-nerve root compression, disc lesions

Question 33

braggard

Answer 33

stop at SLR pain, decrease 10 degrees, dorsiflex ankle
-nerve root compression, disc lesions

Question 34

sicard

Answer 34

braggards but extending big toe instead
-nerve root compression, disc lesions

Question 35

milgrams

Answer 35

-inability, core weakness
-pain, lumbar spine pathology/strain, disc herniation