Special Test Practice MCQ

Master Orthopedic Special Tests Quiz

Part 1: Shoulder Complex

Q1. A patient presents with a "painful arc" of motion. You suspect a rotator cuff tear. Which test would best assess the integrity of the Supraspinatus muscle specifically?

Answer: B) Empty Can (Jobe) TestAbduction to 90 degrees with internal rotation isolates the supraspinatus tendon.

Q2. During Yergason’s Test, the patient resists supination and external rotation. If the patient feels a "pop" rather than just pain, what is the likely diagnosis?

Answer: C) Transverse Humeral Ligament TearA pop indicates the long head of the biceps is snapping out of the bicipital groove because the ligament holding it down is torn.

Q3. The "Drop Arm Test" is considered positive if the patient acts in which way?

Answer: C) Arm falls uncontrollably...This indicates a massive or full-thickness tear of the supraspinatus.

Q4. Which test is used to identify a SLAP lesion by applying an anterior force and rotating the humerus while the arm is abducted overhead?

Answer: B) Clunk TestThe Clunk test grinds the humeral head against the labrum to catch a torn fragment.

Q5. A positive Neer Impingement Test indicates compression of which structures?

Answer: B) Supraspinatus and Biceps Long HeadPassive flexion jams the greater tuberosity against the anteroinferior acromion.

Q6. The "Posterior Internal Impingement Test" is most relevant for which population?

Answer: B) Overhead throwing athletesIt tests for impingement in the "late cocking" phase of throwing.

Q7. During the AC Shear Test, where does the examiner apply pressure?

Answer: D) Spine of Scapula and ClavicleSqueezing these two structures compresses the AC joint directly.

Q8. A patient reports feeling that their shoulder will "pop out" when you abduct and externally rotate it. This is a positive:

Answer: B) Anterior Apprehension TestThis position places the anterior capsule under maximum stress, simulating an anterior dislocation mechanism.

Part 2: Elbow & Forearm

Q9. A positive "Valgus Stress Test" at the elbow indicates damage to which structure?

Answer: B) Ulnar Collateral Ligament (UCL)Valgus stress gaps the medial side of the elbow, testing the UCL.

Q10. Which of the following correctly differentiates Cozen’s Test from Mill’s Test?

Answer: B) Cozen’s is resistive; Mill’s is passive.Cozen’s uses resisted wrist extension. Mill’s uses passive stretch.

Q11. In the Pronator Teres Syndrome Test, the examiner resists which movement while extending the patient's elbow?

Answer: B) PronationResisted pronation contracts the pronator teres, compressing the median nerve.

Q12. Tinel’s sign at the elbow is testing for irritation of which nerve at which location?

Answer: C) Ulnar nerve at the Cubital TunnelThe ulnar nerve runs in the groove behind the medial epicondyle.

Part 3: Wrist & Hand

Q13. Finkelstein’s test is pathognomonic for:

Answer: B) De Quervain’s TenosynovitisIt stresses the APL and EPB tendons.

Q14. Which test differentiates between intrinsic muscle tightness and joint capsule tightness in the finger?

Answer: C) Bunnel-Littler TestIt compares PIP flexion with the MCP extended vs. flexed.

Q15. During the Allen Test, if the hand does not flush red within 5-10 seconds after releasing the ulnar artery, what does this indicate?

Answer: B) The Ulnar artery is occluded or not patent.Failure of color return means the artery released is not supplying blood effectively.

Q16. A patient showing "Froment’s Sign" (flexion of the thumb IP joint when pinching paper) has a weakness in which muscle?

Answer: B) Adductor PollicisAdductor Pollicis is supplied by the Ulnar nerve. The patient compensates with the Flexor Pollicis Longus.

Q17. In Phalen’s Test, the patient holds their wrists in maximal flexion. A positive result is:

Answer: C) Paresthesia in the median nerve distribution.This compresses the median nerve in the carpal tunnel.

Part 4: Thoracic Outlet & Cervical

Q18. Which test for Thoracic Outlet Syndrome (TOS) involves the patient taking a deep breath and holding it while extending the neck?

Answer: C) Adson’s TestThe breath-hold and neck extension lift the first rib and scalenes, compressing the neurovascular bundle.

Q19. The "Roos Test" is also known as the "Elevated Arm Stress Test" (EAST). How long must the patient perform the action?

Answer: B) 3 minutesThe patient must open and close hands for 3 minutes to induce ischemic symptoms.

Q20. The Vertebral Artery Test (VBI) is crucial before performing cervical manipulation. What are the "5 D's" indicating a positive test?

Answer: A) Dizziness, Diplopia, Dysarthria, Dysphagia, Drop attacksThese are the classic signs of brainstem ischemia.

Q21. Spurling’s Test A involves:

Answer: C) Axial compression with the head extended and rotated...This position maximally narrows the neural foramen to provoke radiculopathy.

Q22. If a patient experiences relief of arm pain when they abduct their shoulder and place their hand on their head, this is known as:

Answer: B) Bakody’s SignThe Shoulder Abduction Test (Bakody's Sign) relieves tension on the C4-C6 nerve roots.

Q23. Lhermitte’s sign is characterized by:

Answer: B) An electric shock sensation down the spine upon neck flexion.Indicates dorsal column irritation (e.g., MS or cervical myelopathy).

Q24. In the Upper Limb Tension Test 1 (ULTT1) for the Median Nerve, which movement is the "sensitizing" maneuver?

Answer: C) Contralateral Cervical Side FlexionBending the neck away increases tension on the entire neural tract.

Part 5: Lumbar Spine

Q25. The "Slump Test" is considered more sensitive than the Straight Leg Raise (SLR) because:

Answer: B) It involves thoracic and cervical flexion...The Slump test winds up the dura from both ends (head and leg).

Q26. In the Straight Leg Raise (Lasegue’s) test, pain occurring between 30 and 70 degrees typically indicates:

Answer: B) Lumbar Disc Herniation0-30 is slack uptake; 30-70 puts maximum tension on the nerve roots.

Q27. The Stork Standing Test (One-Leg Standing Extension) is primarily diagnostic for:

Answer: B) Spondylolysis / SpondylolisthesisExtension on one leg places shear force on the pars interarticularis.

Q28. The Femoral Nerve Traction Test (Femoral Nerve Stretch) is performed in which position?

Answer: B) Sidelying (on non-affected side)The hip is extended while the knee is flexed to stretch the L2-L4 roots.

Q29. The Bicycle (van Gelderen) Test differentiates between:

Answer: B) Neurogenic Claudication and Vascular ClaudicationLeaning forward on the bike relieves Neurogenic (spinal) claudication but does not help Vascular (blood flow) claudication.

Part 6: SI Joint & Hip

Q30. Which of the following is NOT part of the Laslett Cluster for SI Joint pain?

Answer: D) Slump TestThe Slump test assesses the lumbar spine/dura, not the SI joint.

Q31. A positive Trendelenburg sign is caused by weakness of the:

Answer: B) Gluteus MediusThe gluteus medius on the stance leg fails to keep the pelvis level.

Q32. The Thomas Test assesses tightness of which muscle group?

Answer: B) Hip FlexorsLifting the thigh off the table indicates Iliopsoas tightness; knee extension indicates Rectus Femoris tightness.

Q33. In the "Long Sitting Test" (Supine to Sit), if a leg appears LONG in supine and SHORT in sitting, it suggests:

Answer: B) Anterior Innominate RotationRemember "ALPS" (Anterior Long to Posterior Short).

Q34. Craig’s Test measures:

Answer: B) Femoral AnteversionIt finds the point where the greater trochanter is most prominent laterally.

Q35. A positive "Ober's Test" indicates tightness in the:

Answer: A) Iliotibial (IT) Band / TFLThe leg remains abducted and does not drop to the table.

Q36. The "Scouring" or "Grind" test of the hip is used to detect:

Answer: B) Intra-articular pathology (Labrum/OA)Compressing and rotating the femur "scours" the inner surface of the acetabulum.

Part 7: Knee

Q37. Which test is used to detect a "Posterior Sag" of the tibia?

Answer: B) Godfrey’s TestGravity pulls the tibia posterior if the PCL is torn.

Q38. A positive "Pivot Shift Test" reproduces the sensation of the knee giving way. This indicates:

Answer: B) Anterolateral Rotary Instability (ACL Tear)It mimics the subluxation and reduction of the tibia that occurs in unstable ACL-deficient knees.

Q39. The "Patellar Tap Test" (Ballotable Patella) is used to check for:

Answer: B) Major Joint EffusionThe patella "floats" and taps against the femur if there is significant fluid.

Q40. In Apley’s Compression test, pain with compression and rotation indicates ______, while pain with distraction indicates ______.

Answer: B) Meniscal injury; Ligament injuryCompression grinds the meniscus; distraction pulls on the ligaments.

Q41. Which test assesses the Q-Angle?

Answer: B) Angle between lines from ASIS to Patella...This is the geometric definition of the Quadriceps angle.

Q42. The Noble Compression Test is positive if pain is felt at what degree of knee flexion?

Answer: B) 30 degreesAt 30 degrees, the IT band rubs over the lateral femoral epicondyle.

Q43. Hughston’s Plica Test attempts to:

Answer: B) Palpate a "popping" of the medial plicaIt tests for a pathological synovial fold (plica).

Part 8: Ankle & Foot

Q44. The Anterior Drawer Test of the ankle primarily tests the integrity of which ligament?

Answer: B) Anterior Talofibular (ATFL)The ATFL prevents anterior translation of the talus.

Q45. When performing the Talar Tilt test, an *eversion* stress tests which ligament?

Answer: C) Deltoid LigamentThe Deltoid is on the medial side and resists eversion.

Q46. "Mulder’s Click" is a sign associated with which test and condition?

Answer: B) Morton’s Test; Morton’s NeuromaSqueezing the metatarsal heads causes the neuroma to click between the bones.

Q47. Neutral Subtalar Positioning is used to:

Answer: B) Determine the ideal alignment for orthotic castingIt is the biomechanical reference point where the talonavicular joint is congruous.

Part 9: Neurological & Vascular

Q48. What is a positive Romberg’s Test?

Answer: B) Patient sways significantly only when eyes are closed.This indicates sensory ataxia (dorsal column issue).

Q49. The "Two-Point Discrimination" test is best for assessing:

Answer: C) Tactile gnosis and nerve densityIt measures the density of sensory receptors, crucial after nerve repair.

Q50. Homan’s Sign was traditionally used for DVT but is now often discouraged. What is the maneuver?

Answer: A) Passive dorsiflexion of the ankle causing calf pain.While classically taught, it has low sensitivity/specificity.