NBCE PART 4 EXAM 2025 QUESTIONS
WITH ALL CORRECT ANSWERS
Halestead Manuver - Answer-Pain and/or paresthesia, decreased or absent pulse,
pallor -- indicates compression of the neurovascular bundle by scalene anterior or
cervical rib
extend head and traction arm down
Eden's Test/Costoclavicular Maneuver - Answer-pt sits
dr stands behind on side of testing
locates radial pulse
dr abducts, extends and ext rotates arm, thumb back in hitch hiker
dr places hand on shoulder at nape of neck and pushes down
Wright's Test - Answer-Monitor radial pulse and hyperabducting the arm above the head
w/ some extension
(+) Test = indicates compression of the neuromuscular bundle as it passes under the
PECtoralis minor noted when there is severely DEC/absent radial pulse
Allen's Maneuver - Answer-pt seated, examiner palpate radial pulse, pt rotate head to
contralateral side and extend, examiner extend and externally rotate arm, pt take deep
breath and hold for 10-15 sec
middle scalene causes stenosis
(+) decrease or absent pulse = vascular occlusion
(+) vascular okay but pt has symptoms down arm = brachial plexus
Roos Test - Answer-pt in sitting or standing. PT moves pts shoulder into ABD 90 deg,
full ER, & elbow flexion 90 deg. pt instructed to open and close the hands slowly for 3
minutes. (+) pt unable to keep arms in starting position for 3 min, suffers ischemic pain,
heaviness or profound weakness of the arm, numbness & tingling of the hand. (-) if only
minor fatigue and distress. Indicates thoracic outlet pathology.
Apley's Scratch Test - Answer-touch opposite scapula superiorly and inferiorly
Mazion shoulder maneuver - Answer-touch opposite shoulder and bring elbow down
and up
Dugas Test - Answer-The patient places the hand of the affected shoulder on the
opposite shoulder and attempts to touch the chest with the elbow.
,Positive sign is if the patient is unable to perform the test which indicates acute shoulder
dislocation
Shoulder Apprehension Test - Answer-*Evaluates:* Anterior shoulder instability
Patient supine
Abduct arm to 90
Elbow flexed to 90
Slowly externally rotate the shoulder to end range
Calloway's Test - Answer-measure vertical shoulder circumference
Dawburn's (Push Button) Test - Answer-press on bursa while abducting the arm
Abbot-Saunders Test - Answer-INSTRUCT: pt seated, ex fully abducts and externally
rotates the pt's affected arm; ex places his/her fingers on the pt's bicipital groove and
then slowly lowers the pt's affected arm to their side
POSITIVE: palpable and/or audible click
INDICATES: subluxation or dislocation of the biceps tendon (rupture of transverse
humeral ligament or tendon subluxation beneath subscapularis muscle belly)
Yergason's Test - Answer-resist elbow flexion and supination
Speed's Test - Answer-Seated with shoulder elevated 75° to 90° in the sagittal plane.
Elbow extended. Forearm supinated. Resist elevation. Positive pain with bicep tendon.
Impingment sign - Answer-The examiner places the patient's arm shoulder in 90
degrees of shoulder flexion with the elbow flexed to 90 degrees and then internally
rotates the arm
Supraspinatus arc - Answer-resist entire abduction
Empty Can Test - Answer-flexion and internal rotation of the shoulder followed by
resistance to observe for weakening of the supraspinatus muscle
Codman's Drop Arm Test - Answer-The examiner passively abducts arm to above 90
then suddenly removes support. This makes the deltoid suddenly contract causing
increased pain.
Positive sign is inability to maintain arm position indicating tear of the supraspinatus
passive scapular retraction approximation - Answer-empty can test with scapula
pressed to back
, Cozen's Test - Answer-Patient's elbow is flexed to 90 degrees with the forearm
pronated and fist dorsiflexed. Doctor stabilizes the elbow and resists the patient's
dorsiflexion.
Positive for pain in the lateral elbow indicating lateral epicondylitis
Mill's Test - Answer-The patient is instructed to extend the forearm, make a fist, and flex
the wrist, and then maximally pronate the forearm. This test can be passively performed
by the doctor.
Positive sign is pain in lateral elbow indicating lateral epicondylitis
Reverse Cozen's Test - Answer-• Patient is seated with their elbow flexed at 90 degrees
• Doctor instructs the patient to supinate and then flex their wrist
• Doctor palpates medial epicondyle
• Patient is instructed to maintain their wrist in flexion as Doctor applies resistance
• Classical response: Pain in the Medial Epicondyle
• Classical Importance = Medial Epicondylitis
• This is a bilateral test.
ligament stability of elbow - Answer-varus and valgus
Varus Stress Test - Answer-LCL
Valgus Stress Test - Answer-MCL
Tinel's Test - Answer-tap over flexor retinaculum
Phalen's test - Answer-dorsum of hands together and flex wrist
pinch test - Answer-bring fingertip of thumb and index together
froment's - Answer-pull paper between thumb and index
Finklestein's - Answer-ulnar deviate with thumb collected by fingers
Bunnel-Littler test - Answer-The MCP joint is stablized in slight extension while PIP joint
is flexed. Differentiates between a tight capsule and tight intrinsic muscles. (all passive
movements)
- IF MCP joint is slightly extended + PIP joint = no flexion = Tight intrinsic muscles
- IF MCP joint is slightly flexed + PIP joint = FULL flexion = Tight intrinsic muscles
- IF MCP joint is slightly flexed + PIP joint = LITTLE flexion = Capsular tightness
Bracelet Test - Answer-Doctor applies compression around patient's wrist like a
bracelet.
WITH ALL CORRECT ANSWERS
Halestead Manuver - Answer-Pain and/or paresthesia, decreased or absent pulse,
pallor -- indicates compression of the neurovascular bundle by scalene anterior or
cervical rib
extend head and traction arm down
Eden's Test/Costoclavicular Maneuver - Answer-pt sits
dr stands behind on side of testing
locates radial pulse
dr abducts, extends and ext rotates arm, thumb back in hitch hiker
dr places hand on shoulder at nape of neck and pushes down
Wright's Test - Answer-Monitor radial pulse and hyperabducting the arm above the head
w/ some extension
(+) Test = indicates compression of the neuromuscular bundle as it passes under the
PECtoralis minor noted when there is severely DEC/absent radial pulse
Allen's Maneuver - Answer-pt seated, examiner palpate radial pulse, pt rotate head to
contralateral side and extend, examiner extend and externally rotate arm, pt take deep
breath and hold for 10-15 sec
middle scalene causes stenosis
(+) decrease or absent pulse = vascular occlusion
(+) vascular okay but pt has symptoms down arm = brachial plexus
Roos Test - Answer-pt in sitting or standing. PT moves pts shoulder into ABD 90 deg,
full ER, & elbow flexion 90 deg. pt instructed to open and close the hands slowly for 3
minutes. (+) pt unable to keep arms in starting position for 3 min, suffers ischemic pain,
heaviness or profound weakness of the arm, numbness & tingling of the hand. (-) if only
minor fatigue and distress. Indicates thoracic outlet pathology.
Apley's Scratch Test - Answer-touch opposite scapula superiorly and inferiorly
Mazion shoulder maneuver - Answer-touch opposite shoulder and bring elbow down
and up
Dugas Test - Answer-The patient places the hand of the affected shoulder on the
opposite shoulder and attempts to touch the chest with the elbow.
,Positive sign is if the patient is unable to perform the test which indicates acute shoulder
dislocation
Shoulder Apprehension Test - Answer-*Evaluates:* Anterior shoulder instability
Patient supine
Abduct arm to 90
Elbow flexed to 90
Slowly externally rotate the shoulder to end range
Calloway's Test - Answer-measure vertical shoulder circumference
Dawburn's (Push Button) Test - Answer-press on bursa while abducting the arm
Abbot-Saunders Test - Answer-INSTRUCT: pt seated, ex fully abducts and externally
rotates the pt's affected arm; ex places his/her fingers on the pt's bicipital groove and
then slowly lowers the pt's affected arm to their side
POSITIVE: palpable and/or audible click
INDICATES: subluxation or dislocation of the biceps tendon (rupture of transverse
humeral ligament or tendon subluxation beneath subscapularis muscle belly)
Yergason's Test - Answer-resist elbow flexion and supination
Speed's Test - Answer-Seated with shoulder elevated 75° to 90° in the sagittal plane.
Elbow extended. Forearm supinated. Resist elevation. Positive pain with bicep tendon.
Impingment sign - Answer-The examiner places the patient's arm shoulder in 90
degrees of shoulder flexion with the elbow flexed to 90 degrees and then internally
rotates the arm
Supraspinatus arc - Answer-resist entire abduction
Empty Can Test - Answer-flexion and internal rotation of the shoulder followed by
resistance to observe for weakening of the supraspinatus muscle
Codman's Drop Arm Test - Answer-The examiner passively abducts arm to above 90
then suddenly removes support. This makes the deltoid suddenly contract causing
increased pain.
Positive sign is inability to maintain arm position indicating tear of the supraspinatus
passive scapular retraction approximation - Answer-empty can test with scapula
pressed to back
, Cozen's Test - Answer-Patient's elbow is flexed to 90 degrees with the forearm
pronated and fist dorsiflexed. Doctor stabilizes the elbow and resists the patient's
dorsiflexion.
Positive for pain in the lateral elbow indicating lateral epicondylitis
Mill's Test - Answer-The patient is instructed to extend the forearm, make a fist, and flex
the wrist, and then maximally pronate the forearm. This test can be passively performed
by the doctor.
Positive sign is pain in lateral elbow indicating lateral epicondylitis
Reverse Cozen's Test - Answer-• Patient is seated with their elbow flexed at 90 degrees
• Doctor instructs the patient to supinate and then flex their wrist
• Doctor palpates medial epicondyle
• Patient is instructed to maintain their wrist in flexion as Doctor applies resistance
• Classical response: Pain in the Medial Epicondyle
• Classical Importance = Medial Epicondylitis
• This is a bilateral test.
ligament stability of elbow - Answer-varus and valgus
Varus Stress Test - Answer-LCL
Valgus Stress Test - Answer-MCL
Tinel's Test - Answer-tap over flexor retinaculum
Phalen's test - Answer-dorsum of hands together and flex wrist
pinch test - Answer-bring fingertip of thumb and index together
froment's - Answer-pull paper between thumb and index
Finklestein's - Answer-ulnar deviate with thumb collected by fingers
Bunnel-Littler test - Answer-The MCP joint is stablized in slight extension while PIP joint
is flexed. Differentiates between a tight capsule and tight intrinsic muscles. (all passive
movements)
- IF MCP joint is slightly extended + PIP joint = no flexion = Tight intrinsic muscles
- IF MCP joint is slightly flexed + PIP joint = FULL flexion = Tight intrinsic muscles
- IF MCP joint is slightly flexed + PIP joint = LITTLE flexion = Capsular tightness
Bracelet Test - Answer-Doctor applies compression around patient's wrist like a
bracelet.
