NBCE PT II: Orthopedic Testing (from
Irene Gold Review)
Bakody's Test - -Cervical Spine
Active
(+) <Pn
I: IVF Encroachment
P: Seated, pt actively puts affected palm on top of head. Elbow @ level of
head.
-Foraminal Compression Test - -Cervical Spine
Active
(+) Radicular Pn
I: NR Comp/Facet Syndr
P: Seated, pt actively rotates head side to side. Dr exerts downward pressure
from neutral. Head is again rotated to each side with pressure.
-Jackson's Compression Test - -C/S
Passive
(+) Radicular Pn/Local Pn
I: NR Comp/Facet Syndr
P: Seated, DR PASSIVELY laterally flexes pt head to R and applies downwd
pressure. Dr performs same on opposite side
-Max Cervical Compression Test - -C/S
Active
(+) Radicular Pn/Local Pn
I: NR Comp/Facet Syndr
P: Pt seated, ACTIVELY rotates, laterally flexes, hyperextends neck to R. If no
pn, pt asked to maximally laterally flex neck. Repeat on other side. NO
COMPRESSION APPLIED.
-Distraction Test - -C/S
PASSIVE
(+) <Pn
I: NR Comp
OR
(+) >Pn
I: Sprain/Strain (mm pull)
P: Pt seated, Dr PASSIVELY exerts upward pressure on pt head, removing
weight of pt head from neck
-Shoulder Compression Test - -C/S
PASSIVE
, (+) Pn
I: NR Adhesion
P: Pt seated, Dr PASSIVELY depresses pt's shoulder while laterally flexing the
C/S AWAY from that shoulder. Repeat on other side.
-Soto Hall Sign - -C/S
PASSIVE
(+) Local Pn
I: Fracture if anterior pn, ligament damage if posterior pn
P: Pt SUPINE, Dr PASSIVELY places one hand on sternum while PASSIVELY
flexing the pt's head toward chest
-Spurling's Test - -C/S
Active
(+) Pn in neck, shoulder, or arm
I: Space Occupying Lesion
P: Pt ACTIVELY maximally rotates and laterally flexes head to affected side.
Dr delivers a vertical blow to top of pt's head. (can be done b/l or w/neck
hyperextended)
-Valsalva Maneuver - -C/S
Active
(+) Radic Pn
I: Space Occupying Lesion
P: Dr asks pt to ACTIVELY take a deep breath and hold while bearing down
-Naffziger's Test - -C/S
PASSIVE
(+) Pn
I: Space Occupying Lesion
P: Pt seated, Dr holds digital pressure b/l over jugular veins or puts blood
pressure cuff around pt's neck and pumps to 40mm/Hg, holds for ~30s. If no
pn, pt instructed to cough. C/I w/vascular compromise.
-Allen's Test - -TOS
Active
(+) Delay of >10s for blood to return
I: Occlusion of corresponding artery
P: Pt seated, elbow flexed, forearm supinated. Pt pumps hand, keeping
closed while Dr occludes the radial and ulnar arteries until hand is blanched.
Pt slowly opens hand while Dr. opens one artery and records filling time.
Repeat for other artery.
-Adson's Test - -TOS
AKA Scalenus Anticus Test
TOS
Irene Gold Review)
Bakody's Test - -Cervical Spine
Active
(+) <Pn
I: IVF Encroachment
P: Seated, pt actively puts affected palm on top of head. Elbow @ level of
head.
-Foraminal Compression Test - -Cervical Spine
Active
(+) Radicular Pn
I: NR Comp/Facet Syndr
P: Seated, pt actively rotates head side to side. Dr exerts downward pressure
from neutral. Head is again rotated to each side with pressure.
-Jackson's Compression Test - -C/S
Passive
(+) Radicular Pn/Local Pn
I: NR Comp/Facet Syndr
P: Seated, DR PASSIVELY laterally flexes pt head to R and applies downwd
pressure. Dr performs same on opposite side
-Max Cervical Compression Test - -C/S
Active
(+) Radicular Pn/Local Pn
I: NR Comp/Facet Syndr
P: Pt seated, ACTIVELY rotates, laterally flexes, hyperextends neck to R. If no
pn, pt asked to maximally laterally flex neck. Repeat on other side. NO
COMPRESSION APPLIED.
-Distraction Test - -C/S
PASSIVE
(+) <Pn
I: NR Comp
OR
(+) >Pn
I: Sprain/Strain (mm pull)
P: Pt seated, Dr PASSIVELY exerts upward pressure on pt head, removing
weight of pt head from neck
-Shoulder Compression Test - -C/S
PASSIVE
, (+) Pn
I: NR Adhesion
P: Pt seated, Dr PASSIVELY depresses pt's shoulder while laterally flexing the
C/S AWAY from that shoulder. Repeat on other side.
-Soto Hall Sign - -C/S
PASSIVE
(+) Local Pn
I: Fracture if anterior pn, ligament damage if posterior pn
P: Pt SUPINE, Dr PASSIVELY places one hand on sternum while PASSIVELY
flexing the pt's head toward chest
-Spurling's Test - -C/S
Active
(+) Pn in neck, shoulder, or arm
I: Space Occupying Lesion
P: Pt ACTIVELY maximally rotates and laterally flexes head to affected side.
Dr delivers a vertical blow to top of pt's head. (can be done b/l or w/neck
hyperextended)
-Valsalva Maneuver - -C/S
Active
(+) Radic Pn
I: Space Occupying Lesion
P: Dr asks pt to ACTIVELY take a deep breath and hold while bearing down
-Naffziger's Test - -C/S
PASSIVE
(+) Pn
I: Space Occupying Lesion
P: Pt seated, Dr holds digital pressure b/l over jugular veins or puts blood
pressure cuff around pt's neck and pumps to 40mm/Hg, holds for ~30s. If no
pn, pt instructed to cough. C/I w/vascular compromise.
-Allen's Test - -TOS
Active
(+) Delay of >10s for blood to return
I: Occlusion of corresponding artery
P: Pt seated, elbow flexed, forearm supinated. Pt pumps hand, keeping
closed while Dr occludes the radial and ulnar arteries until hand is blanched.
Pt slowly opens hand while Dr. opens one artery and records filling time.
Repeat for other artery.
-Adson's Test - -TOS
AKA Scalenus Anticus Test
TOS
