NBCE PART 4 COMPREHENSIVE EXAM
QUESTIONS AND CORRECT ANSWERS
STUDY GUIDE
●● Distraction Test
Answer: The patient: seated
The doctor: holds under the mastoid BL and pulls the patient's head
superior, removing the weight of the head.
"What did you experience?"
Decreased Pain --> IVF Encroachment
Increased Pain --> Sprain/Strain
●● O'Donohue's Test is used to determine
Answer: whether it is a SPRAIN (muscle) or STRAIN (ligament)
●● O'Donohue's Test is performed how
Answer: Patient: actively moves body part against Dr resistance.
,Doctor: moves part passively through a full ROM.
Pain Active --> STRAIN (mm tissue)
Pain Passive --> SPRAIN (ligamentous tissue)
●● Valsalva's Maneuver
Answer: The doctor asks the patient to take a deep breath and hold 10s
while bearing down.
(Dejereine's triad)
Positive Radicular Pain --> SOL
●● What is Dejereine's triad
Answer: Pain with increased intra-abdominal pressure:
Cough
Sneeze
Bear down
●● Maximal Cervical Compression Test
Answer: Patient: seated
,Doctor: extend and rotate the patients head, laterally bend the neck and
add axial compression (unaffected side first)
Positive Radicular pain --> IVF encroachment
Test negative, but local pain: Facet syndrome DJD, joint sprain, muscle
strain.
●● Shoulder Depression Test
Answer: Patient: seated
Doctor: depresses the patient's shoulder while laterally flexing the neck
contralaterally. Repeat on other side.
Positive radicular pain (on side of shoulder depression) --> IVF
Encroachment,
●● Soto Hall Sign
Answer: Patient: supine
Doctor: places knife edge of hand on the patient's sternum and passively
flexes the patient's head towards chest.
, Positive localized pain --> rib fracture at whatever level of pain
●● 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 radicular pain --> IVF encroachment
*indicates problem at C4/5*
●● Thoracic Outlet Syndrome AKA
Answer: Neurovascular Compression Syndrome
●● Allen's Test
Answer: Patient: seated
Doctor: elevates patient arm above head and have patient pump their fist
and occlude the radial and ulnar artery. Lower patient arm to waist level
and release only one. Repeat and the release the other
*test performed 4x twice on each side*
Positive for delay more than 10 seconds -> occlusion of the tested artery
QUESTIONS AND CORRECT ANSWERS
STUDY GUIDE
●● Distraction Test
Answer: The patient: seated
The doctor: holds under the mastoid BL and pulls the patient's head
superior, removing the weight of the head.
"What did you experience?"
Decreased Pain --> IVF Encroachment
Increased Pain --> Sprain/Strain
●● O'Donohue's Test is used to determine
Answer: whether it is a SPRAIN (muscle) or STRAIN (ligament)
●● O'Donohue's Test is performed how
Answer: Patient: actively moves body part against Dr resistance.
,Doctor: moves part passively through a full ROM.
Pain Active --> STRAIN (mm tissue)
Pain Passive --> SPRAIN (ligamentous tissue)
●● Valsalva's Maneuver
Answer: The doctor asks the patient to take a deep breath and hold 10s
while bearing down.
(Dejereine's triad)
Positive Radicular Pain --> SOL
●● What is Dejereine's triad
Answer: Pain with increased intra-abdominal pressure:
Cough
Sneeze
Bear down
●● Maximal Cervical Compression Test
Answer: Patient: seated
,Doctor: extend and rotate the patients head, laterally bend the neck and
add axial compression (unaffected side first)
Positive Radicular pain --> IVF encroachment
Test negative, but local pain: Facet syndrome DJD, joint sprain, muscle
strain.
●● Shoulder Depression Test
Answer: Patient: seated
Doctor: depresses the patient's shoulder while laterally flexing the neck
contralaterally. Repeat on other side.
Positive radicular pain (on side of shoulder depression) --> IVF
Encroachment,
●● Soto Hall Sign
Answer: Patient: supine
Doctor: places knife edge of hand on the patient's sternum and passively
flexes the patient's head towards chest.
, Positive localized pain --> rib fracture at whatever level of pain
●● 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 radicular pain --> IVF encroachment
*indicates problem at C4/5*
●● Thoracic Outlet Syndrome AKA
Answer: Neurovascular Compression Syndrome
●● Allen's Test
Answer: Patient: seated
Doctor: elevates patient arm above head and have patient pump their fist
and occlude the radial and ulnar artery. Lower patient arm to waist level
and release only one. Repeat and the release the other
*test performed 4x twice on each side*
Positive for delay more than 10 seconds -> occlusion of the tested artery
