NBCE Part 4 Boards - Part IV NBCE
questions with complete solution
Foraminal Compression Test - answer-The patient is seated and actively rotates head
from side to side. Then the doctor exerts downward pressure and the head is rotated to
each side with pressure.
Positive Radicular Pain -> Nerve Root Compression
Positive Local Pain -> Foraminal Encroachment
Jackson's Compression Test - answer-The patient is seated and the doctor laterally
flexes the patient head to the left and the right and applies downward pressure.
Postive Radicular Pain -> Nerve Root Compression
Distraction Test - answer-The patient is seated and the doctor holds under the mastoid
and pulls the patient's head superior, removing the weight of the head.
"What did you experience?"
Decreased Pain -> Nerve Root Compression
Increased Pain -> Sprain/Strain
O'Donohue's Test is for.... - answer-Determining whether it is a SPRAIN or STRAIN
O'Donohue's Test Performed - answer-1) Patient actively moves part against resistance.
2) Then the doctor moves part passively through a full ROM.
Pain Active: STRAIN (damage in mm tissue)
Pain Passive: SPRAIN (damage I'm ligamentous tissue)
,Valsalva's Maneuver - answer-The doctor asks the patient to take a deep breath and
hold while bearing down.
Postive Radicular Pain -> SOL
Maximal Cervical Compression Test - answer-Patient is seated and actively rotated and
extended head. If no pain the patient is asked to maximally laterally flex head in the
same direction. Repeat on the other side. No compression applied.
Postive Radicular pain -> Nerve Root Compression
Shoulder Depression Test - answer-Patient is seated, the doctor depressed the patient's
shoulder while laterally flexing the cervical spine away from the shoulder. Repeat on
other side.
Postive Pain -> Nerve Root Adhesion
Soto Hall Sign - answer-Patient supine and the doctor places one hand on the patient's
stream and passively flexes the patient's head towards his/her chest.
Positive localized pain -> ant: fracture/ post: ligament tear
Bakody's Test AKA Shoulder Abduction Test - answer-Patient is seated and placed
affected arm's palm on top of their head. The elbow should be at the level of the head.
Postive Relief of Pain -> IVF encroachment
Thoracic Outlet Syndrome AKA - answer-Neurovascular Compression Syndrome
Allen's Test - answer-Patient is seated with their elbow flexed and forearm supinated.
Ask patient to pump their hand while doctor occludes the radial and ulnar arteries until
hand whitens. The patient the opens hand and doctor releases on artery, recording fill
time (until hand regains color). Repeat for other artery.
Postive for delay more than 10 seconds -> occlusion of the tested artery
Costoclavicular Maneuver AKA - answer-Eden's Test
Eden's Test Performed - answer-Patient is seated and doctor palpated for the radial
pulse. Patient brings shoulder down and back and then flexes chin to their chest.
, Positive if alteration to amplitude of radial pulse -> compression between first rib and
clavicle
Adson's Test AKA - answer-Scalenus Anticus Test
Scalenus Anticus Test Performed (MUST KNOW) - answer-Patient is seated and doctor
abducts, extends and externally rotates arm while taking the radial pulse. Patient rotates
head TOWARDS the tested side and extends head. Patient takes a deep breath and
holds it.
Postive if alteration to amplitude of radial pulse -> Scalenus Anticus Syndrome (Cervical
"Halstead" rib)
Modified Adson's Test AKA - answer-Scalenus Medius Test
Scalenus Medius Test Performed (MUST KNOW) - answer-Patient is seated and doctor
abducts, extends and externally rotates arm while taking the radial pulse. Patient rotates
head AWAY from the tested side and extends head. Patient takes a deep breath and
holds it.
Positive if alteration to amplitude of radial pulse -> Scalenus medium syndrome
(Subclavian Artery)
Wright's Test AKA - answer-Hyperabduction Maneuver
Hyperabduction Maneuver Performed (MUST KNOW) - answer-Patient is seated and
doctor palpated radial pulse. Both arms are abducted 180degrees. The doctor notes at
what angle the radial pulse diminishes or disappears.
Positive f pulses are lost greater than 10degrees difference -> Pectorals Minor
Syndrome (Axillary Artery)
Reverse Bakody Maneuver - answer-Patient is seated and patient actively placed palm
on top of their head.
Positive is pain is increased -> TOS
questions with complete solution
Foraminal Compression Test - answer-The patient is seated and actively rotates head
from side to side. Then the doctor exerts downward pressure and the head is rotated to
each side with pressure.
Positive Radicular Pain -> Nerve Root Compression
Positive Local Pain -> Foraminal Encroachment
Jackson's Compression Test - answer-The patient is seated and the doctor laterally
flexes the patient head to the left and the right and applies downward pressure.
Postive Radicular Pain -> Nerve Root Compression
Distraction Test - answer-The patient is seated and the doctor holds under the mastoid
and pulls the patient's head superior, removing the weight of the head.
"What did you experience?"
Decreased Pain -> Nerve Root Compression
Increased Pain -> Sprain/Strain
O'Donohue's Test is for.... - answer-Determining whether it is a SPRAIN or STRAIN
O'Donohue's Test Performed - answer-1) Patient actively moves part against resistance.
2) Then the doctor moves part passively through a full ROM.
Pain Active: STRAIN (damage in mm tissue)
Pain Passive: SPRAIN (damage I'm ligamentous tissue)
,Valsalva's Maneuver - answer-The doctor asks the patient to take a deep breath and
hold while bearing down.
Postive Radicular Pain -> SOL
Maximal Cervical Compression Test - answer-Patient is seated and actively rotated and
extended head. If no pain the patient is asked to maximally laterally flex head in the
same direction. Repeat on the other side. No compression applied.
Postive Radicular pain -> Nerve Root Compression
Shoulder Depression Test - answer-Patient is seated, the doctor depressed the patient's
shoulder while laterally flexing the cervical spine away from the shoulder. Repeat on
other side.
Postive Pain -> Nerve Root Adhesion
Soto Hall Sign - answer-Patient supine and the doctor places one hand on the patient's
stream and passively flexes the patient's head towards his/her chest.
Positive localized pain -> ant: fracture/ post: ligament tear
Bakody's Test AKA Shoulder Abduction Test - answer-Patient is seated and placed
affected arm's palm on top of their head. The elbow should be at the level of the head.
Postive Relief of Pain -> IVF encroachment
Thoracic Outlet Syndrome AKA - answer-Neurovascular Compression Syndrome
Allen's Test - answer-Patient is seated with their elbow flexed and forearm supinated.
Ask patient to pump their hand while doctor occludes the radial and ulnar arteries until
hand whitens. The patient the opens hand and doctor releases on artery, recording fill
time (until hand regains color). Repeat for other artery.
Postive for delay more than 10 seconds -> occlusion of the tested artery
Costoclavicular Maneuver AKA - answer-Eden's Test
Eden's Test Performed - answer-Patient is seated and doctor palpated for the radial
pulse. Patient brings shoulder down and back and then flexes chin to their chest.
, Positive if alteration to amplitude of radial pulse -> compression between first rib and
clavicle
Adson's Test AKA - answer-Scalenus Anticus Test
Scalenus Anticus Test Performed (MUST KNOW) - answer-Patient is seated and doctor
abducts, extends and externally rotates arm while taking the radial pulse. Patient rotates
head TOWARDS the tested side and extends head. Patient takes a deep breath and
holds it.
Postive if alteration to amplitude of radial pulse -> Scalenus Anticus Syndrome (Cervical
"Halstead" rib)
Modified Adson's Test AKA - answer-Scalenus Medius Test
Scalenus Medius Test Performed (MUST KNOW) - answer-Patient is seated and doctor
abducts, extends and externally rotates arm while taking the radial pulse. Patient rotates
head AWAY from the tested side and extends head. Patient takes a deep breath and
holds it.
Positive if alteration to amplitude of radial pulse -> Scalenus medium syndrome
(Subclavian Artery)
Wright's Test AKA - answer-Hyperabduction Maneuver
Hyperabduction Maneuver Performed (MUST KNOW) - answer-Patient is seated and
doctor palpated radial pulse. Both arms are abducted 180degrees. The doctor notes at
what angle the radial pulse diminishes or disappears.
Positive f pulses are lost greater than 10degrees difference -> Pectorals Minor
Syndrome (Axillary Artery)
Reverse Bakody Maneuver - answer-Patient is seated and patient actively placed palm
on top of their head.
Positive is pain is increased -> TOS
