NBCE Part 4 Boards Orthopedics Exam 2026 Practice
Questions with Verified Answer Explanations
The patient is seated and actively rotates
head from side to side. Then the doctor
exerts downward pressure and the head is
Foraminal Compression Test rotated to each side with pressure.
Positive Radicular Pain -> Nerve Root
Compression
The patient is seated and the doctor
laterally flexes the patient head to the left
and the right and applies downward
Jackson's Compression Test pressure. Done bilateral
Postive Radicular Pain -> Nerve Root
Compression
, With the patient seated the doctor exerts
upward pressure on the pt.'s head removing
the wt. of the pt.'s head from their neck.
Cervical Distraction Test "does this make the pain better or worse?"
Decreased Pain -> Nerve Root Compression
Increased Pain -> Sprain/Strain
O'Donohue's Test is for.... Determining whether it is a SPRAIN or STRAIN
1) Patient actively moves part against
resistance.
2) Then the doctor moves part passively
O'Donohue's Test Performed through a full ROM.
Pain Active: STRAIN (damage in mm tissue)
Pain Passive: SPRAIN (damage I'm
ligamentous tissue)
The doctor asks the patient to take a deep
breath and hold while bearing down.
Valsalva's Maneuver
Postive Radicular Pain -> SOL
, DON'T TOUCH THE PT.
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.
Maximal Cervical Compression Test
No compression applied.
--Ask to take ear to shoulder and follow
finger with head
Postive Radicular pain -> Nerve Root
Compression
While seated, the patient externally rotates
the shoulders and places both hands behind
the head while doctor lightly supports.
If no symptoms, the patient flexes the
cervical spine
Brachial Plexus Tension Test
Positive: Reproduction of radicular
symptoms
Indication: Nerve root lesion, most likely C5
, Patient is seated, the doctor depressed the
patient's shoulder while laterally flexing the
cervical spine away from the shoulder.
Shoulder Depression Test
Repeat on other side.
Postive Pain -> Nerve Root Adhesion
Patient supine and the doctor places one
hand on the patient's sternum and passively
flexes the patient's head towards his/her
chest.
Soto Hall Sign
Positive localized pain
-> ant: fracture
--> post: ligament tear
Shoulder Abduction Test
Patient is seated and placed affected arm's
palm on top of their head. The elbow should
Bakody's Test AKA
be at the level of the head.
"does this make the pain better or worse"
Positive Relief of Pain -> IVF encroachment
Thoracic Outlet Syndrome AKA Neurovascular Compression Syndrome
Questions with Verified Answer Explanations
The patient is seated and actively rotates
head from side to side. Then the doctor
exerts downward pressure and the head is
Foraminal Compression Test rotated to each side with pressure.
Positive Radicular Pain -> Nerve Root
Compression
The patient is seated and the doctor
laterally flexes the patient head to the left
and the right and applies downward
Jackson's Compression Test pressure. Done bilateral
Postive Radicular Pain -> Nerve Root
Compression
, With the patient seated the doctor exerts
upward pressure on the pt.'s head removing
the wt. of the pt.'s head from their neck.
Cervical Distraction Test "does this make the pain better or worse?"
Decreased Pain -> Nerve Root Compression
Increased Pain -> Sprain/Strain
O'Donohue's Test is for.... Determining whether it is a SPRAIN or STRAIN
1) Patient actively moves part against
resistance.
2) Then the doctor moves part passively
O'Donohue's Test Performed through a full ROM.
Pain Active: STRAIN (damage in mm tissue)
Pain Passive: SPRAIN (damage I'm
ligamentous tissue)
The doctor asks the patient to take a deep
breath and hold while bearing down.
Valsalva's Maneuver
Postive Radicular Pain -> SOL
, DON'T TOUCH THE PT.
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.
Maximal Cervical Compression Test
No compression applied.
--Ask to take ear to shoulder and follow
finger with head
Postive Radicular pain -> Nerve Root
Compression
While seated, the patient externally rotates
the shoulders and places both hands behind
the head while doctor lightly supports.
If no symptoms, the patient flexes the
cervical spine
Brachial Plexus Tension Test
Positive: Reproduction of radicular
symptoms
Indication: Nerve root lesion, most likely C5
, Patient is seated, the doctor depressed the
patient's shoulder while laterally flexing the
cervical spine away from the shoulder.
Shoulder Depression Test
Repeat on other side.
Postive Pain -> Nerve Root Adhesion
Patient supine and the doctor places one
hand on the patient's sternum and passively
flexes the patient's head towards his/her
chest.
Soto Hall Sign
Positive localized pain
-> ant: fracture
--> post: ligament tear
Shoulder Abduction Test
Patient is seated and placed affected arm's
palm on top of their head. The elbow should
Bakody's Test AKA
be at the level of the head.
"does this make the pain better or worse"
Positive Relief of Pain -> IVF encroachment
Thoracic Outlet Syndrome AKA Neurovascular Compression Syndrome
