S2_L4: Examination of the Lumbosacral Spine & Pelvis

Question 1

which of the ff are true about Chvostek test

A. PT taps the parotid gland (masseter)
B. (+) if facial muscles twitch
C. (+) for CN VII pathology
D. All of the above

Answer 1

D

Question 2

match the ff House-Brackman Facial
Nerve Grading for Bell’s Palsy

Gross:
1. slight weakness noticeable on close inspection; may have very slight synkinesis

2. obvious but not disfiguring difference between 2 sides; noticeable but not severe synkinesis, contracture, and/or
   hemi-facial spasm
3. obvious weakness and/or
   disfiguring asymmetry
4. only barely perceptible motion
5. Normal
6. no movement

A. Gr 1
B. Gr. 2: Slight Dysfunction
C. Gr. 3: Moderate Dysfunction
D. Gr. 4: Moderate Severe Dysfunction
E. Gr. 5: Severe Dysfunction
F. Gr. 6: Total Paralysis

Answer 2

1. B
2. C
3. D
4. E
5. A
6. F

Question 3

match the ff House-Brackman Facial
Nerve Grading for Bell’s Palsy
(can have multiple answers)

at rest:
1. normal symmetry and tone
2. asymmetry

Motion:
3. moderate to good function; eye – complete closure with minimum effort;
mouth – slight asymmetry

4. forehead – slight to moderate movement; eye – complete closure with effort; mouth – slightly weak with
   maximum effort
5. forehead – none; eye – incomplete closure; mouth – asymmetric with maximum effort
6. forehead – none; eye – incomplete closure; mouth – slight movement

A. Gr. 2: Slight Dysfunction
B. Gr. 3: Moderate Dysfunction
C. Gr. 4: Moderate Severe Dysfunction
D. Gr. 5: Severe Dysfunction

Answer 3

1. A,B,C
2. D
3. A
4. B
5. C
6. D

Question 4

modified T/F about Synkinesis

Marin-Amat Syndrome/Inverse Marcus Gunn is eye closure for each jaw closure

Marcus Gunn Syndrome is eye closure for each jaw opening

Answer 4

FF

Marin-Amat Syndrome/Inverse Marcus Gunn is eye closure for each jaw OPENING

Marcus Gunn Syndrome is eye closure for each jaw CLOSURE

Question 5

which of the ff are true about Craniocervical flexion (CCF) Test

A. Test for deep cervical flexors wherein in hook lying position, pressure sensor (at 20 mmHg) is placed under the cervical spine

B. Flex the head in five graded segments of increasing pressure (22, 24, 26, 28, 30 mmHg) and holds each for
10 seconds with 10-second rest

C. (N) = can increase pressure up to 26-30 mmHg without activation of superficial muscles

D. (+) if cannot maintain the pressure at 26 mmHg

E. All of the above

Answer 5

E

Question 6

which of the ff are true about Forminal Compression

A. Spurling’s Test: Neutral head position/Extension of head/Extension and rotation of head + compression with a (+) sign of radicular pain

B. REVERSE SUPRLING’S SIGN: muscle spasm in tension d/t myalgia or whiplash injuries

C. MAXIMUM CERVICAL COMPRESSION: lateral flexion and rotation + compression

D. JACKSON’S COMPRESSION TEST: rotation + compression

E. All of the above

Answer 6

E

Question 7

which of the ff are true about Distraction test

A. Used to alleviate symptoms

B. One hand on the chin and the other on the occiput then head is lifted

C. (+) if radicular pain is decreased or eliminated

D. All of the above

Answer 7

D

Question 8

match the ULTT
(can have multiple answers)

Shoulder
1. Depression and abduction
(110°)

2. Depression and abduction
   (10°)
3. Depression and abduction (10-90°),
   hand to ear

Elbow
4. extension
5. flexion

A. ULTT 1
B. ULTT 2
C. ULTT 3
D. ULTT 4

Answer 8

1. A
2. B,C
3. D
4. A,B,C
5. D

Question 9

match the ULTT
(can have multiple answers)

forearm
1. supination
2. pronation

Wrist
3. Extension
4. Flexion and ulnar deviation
5. Extension and radial deviation

A. ULTT 1
B. ULTT 2
C. ULTT 3
D. ULTT 4

Answer 9

1. C
2. A,B,D
3. A,B
4. C
5. D

Question 10

match the ULTT
(can have multiple answers)

Fingers and thumb
1. Extension
2. Flexion

Shoulder
3. Lateral rotation
4. Medial rotation

Cervical spine
5. CL side flexion

A. ULTT 1
B. ULTT 2
C. ULTT 3
D. ULTT 4

Answer 10

1. A,B,D
2. C
3. B,D
4. C
5. ALL

Question 11

match the ULTT to its nerve bias

1. Median nerve, anterior interosseous nerve, C5, C6, C7
2. Median nerve, musculocutaneous nerve, axillary nerve
3. Radial nerve
4. Ulnar nerve, C8, and T1 nerve roots

A. ULTT 1
B. ULTT 2
C. ULTT 3
D. ULTT 4

Answer 11

1. A
2. B
3. C
4. D

Question 12

which of the ff are true about Shoulder Depression Test

A. For brachial plexus lesions

B. Laterally flex head to contralateral side then apply a downward pressure on the affected shoulder

C. (+) pain on contralateral side = nerve root irritation

D. (+) pain on ipsilateral side = dural adhesions or hypomobile joint capsule

E. All of the above

Answer 12

E

Question 13

which of the ff are true about Brachial Plexus Tension Test

A. Modification of ULTT

B. In sitting, pt abducts arms with elbows extended

C. at onset of Sx, pt ER shoulder

D. pt flexes the elbow (hands lie behind the head)

E. All of the above

Answer 13

E

Question 14

modified T/F on Bikele’s sign

Abduction at 90° with elbow fully flexed

Arm is extended at the shoulder then elbow is extended

Answer 14

TT

Question 15

which of the ff are true about Shoulder Abduction/Relief Test/Bakody’s Sign

A. Test for radicular Sx of C4 and C5

B. In sitting or supine, PT passively or pt actively elevates the arm (hand rests on top of the head)

C. (+) if decreased Sx = cervical extradural compression, epidural vein compression, nerve root compression
(C4-5)

D. All of the above

Answer 15

D

Question 16

which of the ff are true about Scalene Cramp Test

A. Pt sits and rotates head to affected side then pulls the chin down into the clavicle

B. If (+) pain = trigger points on scalene

C. If (+) radicular signs = plexopathy or thoracic outlet syndrome (TOS)

D. All of the above

Answer 16

D

Question 17

modified T/F about Valsalva Test

Its the effect of increased pressure on spinal cord by deep breathing & holding while bearing down as if moving bowels

(+) if with pain d/t increased intrathecal

Answer 17

TT

Question 18

modified T/F

Tinel’s Sign for Brachial Plexus is with the neck slightly flexed, PT taps on area of brachial plexus

Brachial Plexus Compression Test is when you squeeze the plexus between the thumb and fingers

Answer 18

TT

Question 19

modified T/F

Romberg’s Test is where pt stands with eyes closed for 20-30 sec, (+) if excessive sway or loses balance

Lhermitte’s Sign is the passive neck flexion and hip flexion with knees
extended simultaneously while SOTO-HALL TEST is the active head flexion, (+) sign if sharp pain on spine d/t meningeal irritation, cervical myelopathy

Answer 19

TT

Question 20

modified T/F

Vertebral Artery/Cervical Quadrant Test
is done in supine, head is passively extended and laterally flexed (30 seconds) then add rotation (30 seconds)
while DEKELYN-NIEUWENHUYSE doesn’t include lateral flexion

(+) sign if with dizziness, nausea or nystagmus

Answer 20

TT

Question 21

the ff are Provocative positions in sitting of Static Vertebral Artery Test, EXCEPT:

A. Sustained full neck and head flexion

B. Sustained full neck and head rotation
(BARRE-LIEOU SIGN)

C. Sustained full neck and head rotation with extension (DEKLEYN’S)

D. Quick head movement in provocative
position

E. Head still with sustained/repeated trunk movement

Answer 21

A. Sustained full neck and head EXTENSION

Question 22

the ff are Provocative positions in supine of Static Vertebral Artery Test, EXCEPT:

A. Sustained full neck and head extension, head rotation and head rotation with extension (HALLPIKE MANEUVER)

B. Unilateral PA oscillation of C1-2 facets

C. Simulated mobilization / manipulation
position

D. None of the above

Answer 22

D

Question 23

modified T/F on Hautant’s Test

In sitting, pt flexes shoulder to 90° (EO) → (EC) for 10-30 sec,
Loss of arm position = non-vascular

extension and rotation to the head (EO) → (EC) for 10-30 sec
Loss of arm position = vascular

Answer 23

TT

Question 24

match the ff special test
(can have multiple answers)

1. In standing, patient raises shoulder to 90° flexion, elbow straight, forearm supinated, palms up and eye closed
2. Hold the position for 10-20 sec
3. (+) if arm slowly falls with forearm pronation
4. Pt marches in place with the head in extension and rotation to one side
5. Pt seated, PT stands behind the pt with fingers over the jugular veins then compress for 30 seconds then ask pt to cough (+) for nerve root problem or tumors

A. Barre’s Test
B. Underburg’s Test
C. Naffziger’s Test

Answer 24

1. A,B
2. A
3. A,B
4. B
5. C

Question 25

modified T/F

Temperature/caloric test is where PT alternately applies hot and cold behind pt’s ears, (+) sign if with vertigo

Dizziniess test is done in sitting, PT grasps pt’s head then rotates head as far
as possible then hold head (10-30 sec), (+) if with dizziness

Answer 25

TT

Question 26

which of the ff are true about Sharp-Purser Test

A. Should be done with extreme caution

B. Test for subluxation of atlas on axis

C. PT places one hand over the forehead and the thumb of the other hand over the spinous process of axis then pt is asked to slowly flex the head as the PT presses back on the forehead

D. (+) test if sliding backward is felt

E. All of the above

Answer 26

E

• If the sharp-purser test is negative, Aspinall (1990) advocates use of ASPINALL’s TRANSVERSE LIGAMENT TEST done in supine, PT stabilizes occiput on atlas in flexion then an anteriorly directed force is applied from the back

(+) if patient feels a lump on the throat d/t atlantoaxial instability

Question 27

which of the ff are true about Lateral/Transverse Shear Test

A. For atlantoaxial instability d/t odontoid dysplasia

B. In supine, PT places radial side of 2nd MCP against the transverse process of atlas and the other MCP on the
transverse process of axis then PTs hands are pushed together

C. (+) excessive shear or motion (minimal pain is expected)

D. All of the above

Answer 27

E

Question 28

which of the ff are true about Transverse Ligament Stress Test

A. Done in supine, PT supports the occiput while placing the index finger in the space between the occiput and C2
spinous process then the head and C1 is carefully lifted anteriorly (10-20 seconds)

B. (+) if with soft endfeel, muscle spasm, dizziness, nausea, parethesia, nystagmus or lump sensation in the throat

C. (+) for atlantoaxial hypermobility

D. All of the above

Answer 28

D

Question 29

which of the ff are true about Lateral Flexion Alar Ligament Stress Test

A. In supine, PT stabilizes axis with wide-pinch grip

B. PT passively laterally flexes the head

C. (+) test if with excessive motion

D. All of the above

Answer 29

D

Question 30

which of the ff are true about Rotational Alar Ligament Stress Test, EXCEPT:

A. In sitting, PT stabilizes axis with wide-pinch grip

B. PT actively rotates the head

C. Normal if 20-30° rotation occurred without movement of C2

D. (+) excessive motion

Answer 30

B. PT PASSIVELY rotates the head

Question 31

which of the ff are true about Cervical Flexion Rotation Test

A. In supine, PT fully flexes cervical spine then rotates the head to the left and to the right

B. Normal rotation should be at 45°

C. (+) test if hypomobile or hypermobile

D. All of the above

Answer 31

D

Question 32

modified T/F on TESTS FOR 1ST RIB MOBILITY

PT palpates 1st rib as pt takes deep breaths

PT palpates 1st rib as neck is laterally flexed: note when the rib is felt to move up

Answer 32

TT

Question 33

which of the ff are true about LOWER CROSSED SYNDROME

A. Postural compensation pattern

B. Related to an exaggerated lumbar curve (lordosis) and anterior pelvic tilt

C. Tight hip flexors and tight lower back (Quadratus lumborum, erector spinae, hip flexors)

D. Weak core activation & gluteus maximus

E. All of the above

Answer 33

E

Question 34

the ff are Hyperactive postural muscles, EXCEPT

• Iliopsoas
• Rectus femoris
• Tensor fascia latae
• Quadratus lumborum
• Thigh adductors
• Piriformis
• Hamstrings
• Lumbar erector spinae
• Gluteus maximus

Answer 34

Gluteus maximus

Question 35

the ff are inhibition and reflex weakness, EXCEPT:

• Gluteus maximus
• Gluteus medius
• Gluteus minimus
• Rectus abdominis
• Rectus femoris
• External oblique
• Internal oblique

Answer 35

Rectus femoris

Question 36

modified T/F on DISC HERNIATION

One of the most common spinal diseases leading to mild/severe pain in neck or back

When the gelatinous core pushes out through a tear in the fibrous wall, the disc herniates, adding pressure to the surrounding spinal nerves, which causes pain

Answer 36

TT

Question 37

modified T/F

Intervertebral disc is a flexible cushion between 2 vertebrae

It’s comprised of soft gelatinous center
surrounded by a tough outer wall

Answer 37

TT

Question 38

modified T/F

disc herniation is caused by wear and tear or disc degeneration wherein the spinal discs loose their water content with age

Other causes include Long standing trauma, stress fractures, congenital abnormalities

Answer 38

TT

Question 39

which of the ff are s/sx of disc herniation

A. Most commonly occurs in lumbar area and lower back

B. Pain, numbness, or tingling in the arms/legs/site of the injury that worsens when bending, twisting, and/or
sitting

C. Muscle spasms, feeling of heavy limbs

D. Loss of bladder control & coordination, trouble balancing

E. All of the above

Answer 39

E

Question 40

which of the ff are Treatment for disc herniation

A. Physical therapy and strengthening exercises

B. Rest and a restriction of physical activity

C. Injections, medications and analgesics to help reduce the pain and swelling

D.Application of heat/ice to help reduce pain, inflammation and muscle spasms

E. Surgical solutions like Discectomy, Laminectomy

F. All of the above

Answer 40

F

Question 41

modified T/F

Spondylosis is the aging of the spine, as the spine ages, the discs may dehydrate
and lose their shock absorbing function, the back of the disc bulges to the spinal canal

With the loss of height, the ligaments in the back part of the spinal canal lose tension then buckle and push in to the spinal canal

Answer 41

TT

Question 42

modified T/F

Other related conditions and symptoms
are that connector joints (facets) become arthritic & bone growths/
formation of bone spurs can
contribute to spinal stenosis

Signs and symptoms can happen throughout the spine but most
symptoms occur in the upper and lower part of the spine (neck and low back) d/t mobility in these areas that causes aches and pains

Answer 42

TT

Question 43

modified T/F

Spondylolysis is the defect in the vertebral column (pars interarticularis), Scottie dog fracture or Scottie dog collar

It’s caused by repeated microtrauma to the interarticular joints especially to those who have a genetic predisposition of this condition

Answer 43

TT

Question 44

which of the ff are true about Spondylolisthesis

A. Advanced degenerative disc disease resulting in a loss of disc height causing instability and 1 vertebra to slip forward over another one below it

B. Potential causes are stress fractures, congenital abnormalities, tumor, trauma

C. Bones, joints, ligaments of the spine are weakened and cannot maintain the
alignment of the spinal column

D. All of the above

Answer 44

D

Question 45

which of the ff are true about Spondylolisthesis

A. Typically occurs at one of two levels of the lumbar spine (L3, L4) or more commonly in (L4, L5)

B. More common in people aged 50 or individuals over age 65 & women are 2-3x as likely as men to be diagnosed

C. Can cause the impingement of the nerves/fatigue of back muscles, lower back & leg pain

D. All of the above

Answer 45

D

Question 46

which of the ff are Symptoms of spondylolisthesis

A. Lower back and/or leg pain

B. Sciatica, aching pain in the hips, buttocks, and lower back that radiates into the back of the thighs and legs

C. Shuffling gait when walking

D. Weakness in lower extremities & abnormal posture

E. All of the above

Answer 46

E

Question 47

which of the ff are treatments for spondylolisthesis

A. Physical therapy and strengthening exercises

B. Rest and restriction of physical activity

C. Injections, medications and analgesics to help reduce the pain and
swelling (NSAIDs)

D. Surgical solutions like
▪ Posterior Lumbar Interbody Fusion
(PLIF)
▪ Transforaminal Lumbar Interbody
Fusion (TLIF)
▪ NuVasive Maximum Access Surgery
(MAS) TLIF
▪ NuVasive eXtreme Lateral
Interbody Fusion (XLIF)

E. All of the above

Answer 47

E

Question 48

modified T/F

If the bones slip forward/backward out of alignment, it can affect the nerve flow going to the spinal cord and nerve roots, this nerve flow can travel to the tips of the fingers/toes

sx of retrolisthesis includes pain in local area, numbness/tingling/pins and needle sensation going down the leg or arm

Answer 48

TT

Question 49

match the ff slump test
(can have multiple answers)

Cervical
1. Flexion
2. rotation

Thoracic and lumbar
3. Flexion (slump)

Hip
4. Flexion (>90°)
5. Abduction
6.Flexion (20°)

A. ST 1
B. ST 2
C. Side Lying Slump Test (ST 3)
D. Long Sitting Slump Test (ST 4)

Answer 49

1. ALL
2. D
3. ALL
4. A,B,D
5. B
6. C

Question 50

match the ff slump test
(can have multiple answers)

Knee
1. Extension
2. Flexion

Ankle
3. Dorsiflexion
4. Plantarflexion

A. ST 1
B. ST 2
C. Side Lying Slump Test (ST 3)
D. Long Sitting Slump Test (ST 4)

Answer 50

1. A,B,D
2. C
3. A,B,D
4. C

Question 51

match the ff slump test to its Nerve Bias
(can have multiple answers)

1. SC, Cervical & lumbar
   nerve roots, sciatic nerve
2. Obturator nerve
3. Femoral nerve

A. ST 1
B. ST 2
C. Side Lying Slump Test (ST 3)
D. Long Sitting Slump Test (ST 4)

Answer 51

1. A,D
2. B
3. C

Question 52

modified T/F on Slump Test Modifications:

Bechterewis Test: pt actively extends he knee one at a time

Sitting Root Test: pt actively extends both knees

Answer 52

FF

Sitting Root Test: pt actively extends he knee one at a time

Bechterewis Test: pt actively extends both knees

Question 53

modified T/F

Straight Leg Raising (SLR) Test/Lasegue’s test is AKA Well leg raising test of Fajersztajn/Prostate leg raising test
/Sciatic phenomenon/Lhermitt’s test
/Crossover sign

Tension to sciatic nerve roots starts at about 35 degrees SLR while tension to sciatic nerve roots is released over 70
degrees SLR

Answer 53

TT

Question 54

match the ff SLR
(can have multiple answers)

Hip
1. Flex & Adduct
2. Flex
3. Flex & IR

Knee
4. Ext

Ankle
5. DF
6. PF

A. SLR (basic)
B. SLR 2
C. SLR 3
D. SLR 4
E. Cross (Well Leg) SLR 5

Answer 54

1. A
2. B,C,E
3. D
4. ALL
5. A,B,C,E
6. D

Question 55

match the ff SLR
(can have multiple answers)

Foot
1. Evert
2. Invert

Toes
3. Ext

A. SLR (basic)
B. SLR 2
C. SLR 3
D. SLR 4
E. Cross (Well Leg) SLR 5

Answer 55

1. B
2. C,D
3. B

Question 56

match the ff SLR to its nerve bias
(can have multiple answers)

1. Sciatic nerve and tibial nerve
2. Tibial nerve
3. Sural nerve
4. Common Peroneal nerve
5. Nerve root (disc prolapse)

A. SLR (basic)
B. SLR 2
C. SLR 3
D. SLR 4
E. Cross (Well Leg) SLR 5

Answer 56

1. A
2. B
3. C
4. D
5. E

Question 57

match the ff SLR Test Modifications

1. SLR + passive neck flexion
2. Big toe extension only
3. SLR + ankle DF
4. SLR + big toe extension

A. Hyndman’s Sign/Brudzinski’s Sign/Lidner’s Sign/Soto-Hall Test

B. Bragard’s Test

C. Sicard’s Test

D. Turyn’s Test

Answer 57

1. A
2. D
3. B
4. C

Question 58

match the ff Prone Knee Bend (PKB) Test Aka Nachlas Test
(can have multiple answers)

Cervical
1. Rotation to test side

Thoracic & lumbar
2. Neutral

Hip
3. Neutral
4. Extension
5. adduction
6. lateral rotation

A. Basic Prone Knee Bending (PKB 1)
B. PKB 2
C. Prone Knee Extension

Answer 58

1. A,B
2. ALL
3. A
4. B,C
5. B,C
6. C

Question 59

match the ff Prone Knee Bend (PKB) Test Aka Nachlas Test
(can have multiple answers)

Knee
1. Flexion
2. Extension

Ankle
3. DF

Foot
4. Eversion

A. Basic Prone Knee Bending (PKB 1)
B. PKB 2
C. Prone Knee Extension

Answer 59

1. A,B
2. C
3. C
4. C

Question 60

match the ff PKB to its Nerve Bias

1. Femoral nerve, L2-L4 nerve root
2. Lateral femoral cutaneous nerve
3. Saphenous nerve

A. Basic Prone Knee Bending (PKB 1)
B. PKB 2
C. Prone Knee Extension

Answer 60

1. A
2. B
3. C

Question 61

modified T/F on Brudzinski’s Kernig Test

Pt supine with hands cupped behind the head then do
1. Active neck flexion
2. Active SLR
3. At Sx, pt actively bends the knee

Pain is at (1) & (2) and disappearance of Sx at (3) is a (+) sign → meningeal irritation, nerve root involvement, dural irritation

Answer 61

TT

Question 62

modified T/F

Naffziger’s Test is when the PT gently compress jugular vein for ~10 seconds then the face flushes, patient is asked to cough & pain is a (+) Sx of ↑ intrathecal pressure

Valsalva maneuver is when pt is asked to hold breath and bear down as if evacuating the bowels, pain is a (+) Sx of ↑ intrathecal pressure

Answer 62

TT

Question 63

modified T/F on Femoral Nerve Traction Test

Done in sidelying on the unaffected side with slightly extended hip and knee

PT extends the hip with the knee in extension or slight flexion then move the knee into full flexion

Answer 63

FT

Done in sidelying on the unaffected side with slightly FLEXED hip and knee

Question 64

which of the ff are true about “Bowstring Test”/Cram or Popliteal Pressure Sign

A. Pt performs SLR at angle of Sx, PT then slightly flexes pt’s knee to reduce Sx

B. PT applies pressure to the popliteal area

C. (+) affectation of sciatic nerve if radicular Sx is reproduced

D. May be done in sitting: SCIATIC TENSION TEST/DEYERLE’S SIGN

E. All of the above

Answer 64

E

Question 65

which of the ff are true about Gluteal Skyline Test

A. Patient is relaxed in prone with head straight and arms by the sides

B. PT stands at patient’s feet and observes the buttocks from the level of the buttocks

C. (+) if affected gluteus maximus appears flat due to atrophy; affected side shows less contraction

D. (+) for inferior gluteal nerve or pressure on L5, S1 or S2 nerve roots

E. All of the above

Answer 65

E

Question 66

modified T/F

Other neurologic tests include:
Babinski test & Oppenheim test

H and I Stability Test is a test for muscle spasm and can be used to detect lumbar instability

Answer 66

TT

Question 67

modified T/F on H & I stability test

H movement include:
* Resting position in standing
* Side flex as far as possible
* Side flex then flex
* Side flex then extend

I movement include:
* Resting position in standing
* Flex (or extend) the lumbar spine until hip starts to move
* Then pt is guided into side bending

Answer 67

TT

Question 68

modified T/F

Specific Lumbar Spine Torsion Test is used to stress specific levels of the lumbar spine in which the specific level must be rotated and stressed

Farfan Torsion Test is done in prone, wherein the PT stabilizes the spine and ribs at around T12 level & pulls ilium posteriorly, (+) test if with pain and excessive movement

Answer 68

TT

Question 69

1. In sidelying, PT applies downward pressure at around L3 level, (+) test if with pain and excessive movement
2. In sitting, pt’s puts elbows through the PT’s body/shoulders then the PT tries to pull the lumbar spine to create lordosis as pt pushes with the elbows, (+) test if with excessive movement (posterior shear of upper segment)
3. In sidelying while hips flexed at 70°, PT pushes posteriorly through the shaft of the femur while PT palpates spinous processes, (+) test if with excessive movement
4. Pt prone on the edge of the plinth with LE on the floor while PT applies compression then Pt lifts leg off the floor while PT applies compression, (+) test if pain is elicited only when the pt is at prone without lifting leg yet
5. In prone, PT presses down on the lumbar spine then PT flexes the knee, (+) test if there’s pain in the leg (hyperextension of the spine d/t
   instability of segments)

A. Lateral Lumbar Spine Stability Test

B. Test for Anterior Lumbar Spine Instability

C. Test for Posterior Lumbar Spine Instability

D. Segmental Instability Test

E. Pheasant test

Answer 69

1. A
2. C
3. B
4. D
5. E

Question 70

match the ff TESTS FOR JOINT DYSFUNCTION

1. In supine, pt lifts both LE simultaneously off the plinth ~5-10 cm (2-4 inches) for 30 seconds
2. PT grasps pelvis (pull) while shoulders (push) are against the lower thorax, (+) test if increased neurological Sx on the affected side
3. In prone, PT extends hip with the knee extended, PT then extends hip with knee flexed, (+) test if with pain on both tests in the lumbar spine
4. Pt stands on one leg then extends the spine, (+) test means spondylolisthesis/stress fracture
5. Pt stands on one leg then extends the spine with rotation and lateral flexion, overpressure may be applied, (+) test means facet joint disease

A. One Leg Standing Lumbar Extension Test
B. Quadrant Test/Kemp Test
C. Yeoman’s Test
D. Milgram’s Test
E. McKenzie Side Glide test

Answer 70

1. D
2. E
3. C
4. A
5. B

Question 71

Pt flexes head against resistance, coughs or attempts to sit up with hands behind the head, (+) test if umbilicus does not remain in midline

Pt brisk walks (~50m/165ft) until pain is felt on the buttocks or lower limb then bend forward for pain relief while extension motion may bring back Sx, (+) test for Neurogenic Claudication

Pt pedals on a bicycle while leaning backwards until pain is felt on the buttocks or lower limb then bend
forward for pain relief while extension motion may bring back Sx, (+) test for Neurogenic Claudication

Treadmill at 1.2 mph (15 minutes) then treadmill at own pace (15 minutes), Check for any pain

Test for malingering, (+) test if cannot lift the leg or no pressure on the other
heel

Test for malingering wherein Pt kneels on the chair and is asked to reach the floor, (+) test if pt cant perform the task or overbalances

A. Beevor’s sign
B. Stoop test
C. Bicycle test of Van Gelderen
D. Treadmill Test
E. Hoover’s Test
F. Burn’s Test

Answer 71

1. A
2. B
3. C
4. D
5. E
6. F

Question 72

modified T/F on the Sign of the Buttock

Done in supine, PT performs passive SLR, at restriction, PT flexes the knee then further flexes the hip

If hip flexion increases with knee flexed
then its a (-) test that only affects the lumbar spine or hamstrings while if hip flexion is still restricted its a (+) test with hip pathology (bursitis, tumor, or abscess)

Answer 72

TT

Question 73

modified T/F

PELVIC DYSFUNCTION is the loss of stability of the pelvis (including SIJ) that is crucial in etiology of non-specific low back pain, instability, & asymmetry

ILIOSACRAL DYSFUNCTION is due to anterior/posterior rotation, inflare/ outflare & upslip/downslip

Answer 73

TT

Question 74

T/F

the ff are the correct Malalignments of the pelvis

Rotations
* Anteriorly rotated (ASIS lower than PSIS)
* Posteriorly rotated (ASIS higher than PSIS)

Slips
* Upslip (bony landmarks higher on 1 side)
* Downslip (bony landmarks lower on 1 side)

Flares
* Outflare (ASIS farther from umbilicus)
* Inflare (ASIS closer from umbilicus)

Answer 74

T

Question 75

match the ff Malalignments of the hip

1. Weak right abductors, (+) Trendelenburg’s, Right hip adducted
2. Weak left adductors, Right hip abducted

A. Lateral Pelvic Tilt (pelvic drop on R leg stance)

B. Lateral Pelvic Tilt (pelvic hitch on R leg stance)

Answer 75

1. A
2. B

Question 76

match the ff SI JOINT SPECIAL TESTS

In standing, PT’s one thumb palpates the PSIS while the other palpates the sacrum, Pt is instructed to stand on one leg that causes posterior pelvic
rotation, (+) test of minimal movement implying hypomobile or
“blocked” SI joint

In standing, PT’s one thumb palpates the PSIS while the other palpates the sacrum, Pt is then instructed to step back on one leg that causes anterior pelvic rotation (normal PSIS moves superiorly and laterally), (+) test of minimal movement implying hypomobile or “blocked” SI joint

Done in Single leg stance wherein the weight of body is directed downward that causes anterior rotation on stance & posterior rotation on non-WB LE

Pt in sidelying with test leg (upper leg) hyperextended while the lower leg is flexed against the chest, (+) test if with pain in SI joint

A. Gillet’s Test/Sacral Fixation Test/Ipsilateral Posterior Rotation Test

B. Ipsilateral Anterior Rotation Test

C. Flamingo Test

D. Gaenslen’s Test

Answer 76

1. A
2. B
3. C
4. D

Question 77

which of the ff are true about Laguere’s sign

A. In supine, PT moves pt’s LE in FABER

B. PT should stabilize contralateral pelvis

C. (+) test if with pain in SI joint

D. All of the above

Answer 77

D

Question 78

which of the ff are true about Supine-to-Sit (Long Sitting Test)

A. In supine, the medial malleoli should be level

B. Pt sits up and check if LE are level

C. (+) test if leg moves farther that indicates pelvic dysfunction or lumbar pathology (functional leg length discrepancy)

D. All of the above

Answer 78

D

Question 79

which of the ff are true about Goldthwait’s Test

A. In supine, PT places fingers in interspinous processes
(L2-S1)

B. PT then passively does SLR

C. (+) test if pain is elicited prior to interspace movement then there’s a problem in the SI joint

D. (+) test if pain is elicited during interspace movement then there’s a problem in the lumbar spine

E. All of the above

Answer 79

E