Special Test Questions

Question 1

What are cervical Test

Answer 1

• Distraction Test (Pain Relief Test)
• Spurling’s or Foraminal compression test
• Maximal foraminal compression test
• Valsalva
• Shoulder Depression Test
• Vertebral Artery Test
• Jaw Reflex
• Chvostek’s Test
• Brachial Stretch Tests/Upper Limb Tension Tests
  
  • Median Nerve Dominant
  • Radial Nerve Dominant
  • Ulnar Nerve Dominant

Question 2

What are Thoracic Test

Answer 2

• Scapular protraction (winging)
• Elevated Arm Stress Test or “Hands-up” (ROOS)
• Costoclavicular test
• Wright’s Hyperabduction test
• Adson’s Test
• Halstead’s (Reverse Adson’s)
  Adam’s Sign (Scoliosis)

Question 3

What are the Elbow and Wrist Test

Answer 3

• Valgus Stress Test/Varus Stress
• Mill’s Test & Reverse Mill’s Test
• Ulnar Nerve Instability Test
• Tinel’s Sign (Ulnar and Median Nerve)
• Cozen’s Test & Reverse Cozen’s
• Supination Lift Test
• Triangular Fibrocartilage Compex (TFCC) Load Test
• Allen’s Test
• Finkelstein’s Test
• Phalen’s Test
  Pronator Teres Test

Question 4

What are the Lumbar Test

Answer 4

• Lower Limb Tension Tests
  
  • Sciatic Nerve
  • Femoral Nerve
• Straight Leg Raising Test (SLR)
• Well Leg Raising Test (WLR)
• Bragard’s Test (Sign)
• Valsalva
• Kemp’s Test
• Bechterewis Test
• Belt Test
• Gillet’s Test/Marching Test
  Piriformis Test

Question 5

What are the Hip Test

Answer 5

• Trendelenburg Test
• Yeoman Sign
• Sign of the Buttock Test
• Noble Compression Test
• Thomas Test
• Piriformis Length Test
• Pace Abduction Test
• Ely’s Test/Nachlas Test
• Faber’s Test
• Hibb’s Test
• Gaenslen’s Test
  Quadrant (Scouring) Test

Question 6

What are the Knee Test

Answer 6

• Collateral Ligament Stability Test (MCL & LCL)
• Anterior Drawer Test
• Posterior Drawer Test
• Lachman Test
• McMurray’s Test
• Apley’s Distraction Test
• Apley’s Compression Test
• Ober’s Test (Modified)
  Ober’s Test (Original)

Question 7

What are the Leg, Ankle & Foot Test

Answer 7

• Tibial Torsion Test
• Dorsiflexion Test
• Homan’s Sign
• Thompson’s (Squeeze Test)
• Anterior Drawer Test
• Tinel’s Tap (Peroneal Nerve)
  Windlass Test

Question 8

What region does the Brachial Special Test and how do you perform it?

Answer 8

Cervical region

Think of how to put the maximum stretch on the nerve in here lies your answer on how to perform it.

○ (+) reproduction of dermatomal pain referral

1. Median Nerve Stretch (C5-C8, T1)
   Hand Position: Wrist extension, fingers straight, and elbow extended. The arm may be abducted or externally rotated.
   Why This Stretches the Nerve:
   The median nerve runs down the arm into the palm of the hand, passing through the carpal tunnel in the wrist. Extending the wrist and fingers stretches this nerve because it increases tension along its entire path from the shoulder to the hand.
   The nerve passes through the anterior (front) part of the arm, and extending the wrist and elbow creates a pulling force along the length of the nerve, stretching it at multiple points.
   When the shoulder is abducted or externally rotated, this further elongates the pathway of the nerve.
2. Ulnar Nerve Stretch (C8-T1)
   Hand Position: Elbow flexion, wrist extension (with or without finger flexion), and shoulder abduction (putting the hand near the ear or the side of the head).
   Why This Stretches the Nerve:
   The ulnar nerve runs along the medial (inner) side of the arm, passing behind the elbow (the “funny bone”) and down into the ring and little fingers. Bending the elbow while keeping the wrist extended puts tension on the ulnar nerve.
   Flexing the elbow closes the angle at the cubital tunnel (near the elbow), where the ulnar nerve is susceptible to compression. When combined with wrist extension, it creates a stretch throughout the course of the nerve from the elbow down into the hand.
   Abducting the shoulder adds additional tension to the nerve, stretching it as it courses through the brachial plexus in the upper arm.
3. Radial Nerve Stretch (C5-C8)
   Hand Position: Elbow extension, wrist flexion, and internal rotation of the arm (forearm pronation).
   Why This Stretches the Nerve:
   The radial nerve runs along the posterior (back) part of the arm and controls the extension of the wrist and fingers. Flexing the wrist while extending the elbow creates a stretch along this nerve.
   The nerve winds around the back of the arm (near the triceps) and down into the wrist. Flexing the wrist and extending the elbow together create a pull on the nerve at two major points: the elbow and the wrist.
   Pronation (turning the palm down) and internal rotation of the arm put further tension on the nerve pathway, especially at the radial tunnel near the elbow.

Question 9

What does the Adams Sign test and How do it?

Answer 9

The entire spine generally

How to perform:

• The purpose of the Adam’s forward bend test is detecting structural or functional scoliosis
• The patient takes off his/her t-shirt so that the spine is visible. The patient needs to bend forward, starting at the waist until the back comes in the horizontal plane, with the feet together, arms hanging and the knees in extension. The palms are hold together.
• The examiner stands at the back of the patient and looks along the horizontal plane of the spine, searching for abnormalities of the spinal curve, like increased or decreased lordosis/ kyphosis, and an asymmetry of the trunk.
• Positive = Functional if curve disappears upon bending
• Positive = Structural if curve does not disappear upon bending

○ (+) Structural when Bending makes curve more obvious
(+) Functional, when Bending makes curve go away

* Other Investigations
	○ X-Ray is Best to measure Cobb Angle
* Treatment 
	○ Depends on Cobb Angle
	○ <25 Degrees, Observe only
	○ >25 Degrees, Bracing (many types) also controversial

> 45 Degrees, Surgical Correction (Rods or Spinal Fusion) Due to possible respiratory problems and cosmetically unacceptable

Question 10

What region does the Costoclavicular test and how do you do the it?

Answer 10

Thoracice region

How to perform
* Examiner monitors patients radial pulse
* Examiner draws the patients shoulder down and back as the patient assumes a “military” posture

** Positive =** disappearance or diminution of the pulse, or if symptoms are elicited
Indicates = thoracic outlet syndrome, usually subclavian artery being compressed b/t the 1st rib and the clavicle

Question 11

What region does the Adson’s test or the Halstead’s Test and how do you do the it?
Part 1
Reverse Adson’s Test is the same test as the Halstead’s test T/F?

Answer 11

Thoracic Region
True

How to perform:
Adson’s test
* Examiner abducts the patients arm and palpates the radial pulse
* Patient is instructed to turn his head toward the affected side, extend the neck, and take a deep inhalation
* Positive = disappearance or diminution of the pulse or provocation of symptoms
* Indicates = thoracic outlet syndrome, usually related to tight scalene musculature

Halstead’s (REVERSE ADSON’S)
* Examiner abducts the patients arm and palpates the radial pulse
* Patient is instructed to turn his head AWAY from the affected side, extend the neck, and take a deep inhalation
* Positive = disappearance or diminution of the pulse or provocation of symptoms
* Indicates = thoracic outlet syndrome, usually related to tight

Question 12

What are the shoulder special test?

Answer 12

• Cross Arm Test - indicates acromioclavicular joint pathology
• Active Compression Test - indicates AC pathology if pain is in the AC joint, or a LABRAL (Slap Lesion) pathology if pain is more internal in the shoulder
• Scapular Winging - weakness of serratus anterior or long thoracic nerve medial winging or weakness of trapezius muscle if it wings laterally or cranial nerve 11
• Yergason’s test - Indicates Unstable bicipital tendon and sublaxation
• Speed’s test - Indicates Bicipital tendon pathology, usually tendinitis
• Empty can test/Full Can test - Indicates supraspinatus tendon tear
• Neer Impingement Sign - Indicates rotator cuff impingement pathology, usually supraspinatus or biceps tendon
• Painful Arc - indicates different things at different ranges, supraspinatus if less than rotator cuff impingement pathology
• Drop Arm Test (Codman’s Test) - indicates a tear in the rotator cuff complex. More Specific to Supraspinatus
• Napolean Sign - indicates subscapularis weakness or injury
• Gerber’s (Liftoff) Test - Indicates subscapularis weakness or injury
• Anterior Apprehension sign (Crank Test) - Indicates anterior glenohumeral instability or previous dislocation
• Posterior Apprenhension sign - Posterior Instability due to Labral Pathology
• Clunk Test - indicates a labral pathology