Thoracic Spine Orthopedic Tests

Question 1

What is the purpose of assessing arterial patency before performing TOS tests?

Answer 1

Establishing a baseline is required prior to performing true TOS tests.

Question 2

Where is the radial pulse taken?

Answer 2

Anteriorly at the wrist over the radius.

Question 3

What attributes should be checked when feeling the radial pulse?

Answer 3

• Amplitude (strength)
• Rate (speed)
• Rhythm (pattern)

Question 4

What does a positive Allen’s Test indicate?

Answer 4

The skin color of the palm remains blanched for more than 5 seconds.

Question 5

What does a negative Allen’s Test indicate?

Answer 5

The pale skin of the palm flushes immediately after an artery is released.

Question 6

What does the Roos Test assess?

Answer 6

Thoracic Outlet Syndrome (TOS) and neurovascular compromise.

Question 7

What is the procedure for Adson’s Test?

Answer 7

Locate the radial pulse, extend and rotate the patient’s head, inhale deeply, and hold the breath.

Question 8

What indicates a positive Adson’s Test?

Answer 8

Loss of the pulse and/or reproduction of patient’s arm symptoms.

Question 9

What does a positive Wright’s Test indicate?

Answer 9

Reproduction of the patient’s arm complaints.

Question 10

What is the significance of a decrease in radial pulse during Wright’s Test?

Answer 10

Indicates neurovascular compromise of the axillary artery.

Question 11

What does the Costoclavicular Maneuver assess?

Answer 11

Compression of the neurovascular bundle between the 1st rib and the clavicle.

Question 12

What is a positive Roos Test?

Answer 12

Inability to keep arms in position for 3 minutes or ischemic symptoms during the test.

Question 13

What does the Spinal Percussion Test assess?

Answer 13

Spinal osseous integrity.

Question 14

What indicates a positive Adams Test?

Answer 14

Rotation of the thoracic cage remains when the patient is in the flexed position.

Question 15

What is the significance of a rib hump noted during Adams Test?

Answer 15

Indicates a structural scoliosis.

Question 16

What does Forestier’s Test assess?

Answer 16

Hypomobility or hypermobility at a specific segment.

Question 17

What indicates a positive Schepelmann Sign?

Answer 17

Pain created on the concave side indicates intercostal neuritis.

Question 18

What does a positive Costovertebral Stress Test indicate?

Answer 18

Pain anywhere along the rib of contact.

Question 19

What is the normal difference in chest expansion measurements?

Answer 19

1.5 - 3 inches.

Question 20

What does less than 1.5 inches in chest expansion suggest?

Answer 20

Suggestive of ankylosing spondylitis.

Question 21

What does a positive finding in the Posterior Respiratory Excursion indicate?

Answer 21

Asymmetry indicating painful rib problems, collapsed lung, or pneumonia.

Question 22

What does the Anterior Rib Motion Test assess?

Answer 22

Hypomobile costal structures.

Question 23

What does a positive Sternal Compression Test indicate?

Answer 23

Potential rib or sternum injury.

Question 24

What is the procedure for performing Allen’s Test?

Answer 24

Patient makes a tight fist, examiner occludes arteries, and observes palm color changes.

Question 25

What is the primary concern of thoracic outlet syndrome tests?

Answer 25

Testing circulation in the upper extremity as an indicator of compromise.

Question 26

What does a fixed elevated rib during exhalation suggest?

Answer 26

A fixed elevated rib suggests a rib failing to move superior during inhalation.

Question 27

What is the procedure for the Sternal Compression Test?

Answer 27

The patient is in a supine position, and the examiner exerts downward pressure on the patient's sternum using knife-edge contact.

Question 28

What should female patients do during the Sternal Compression Test?

Answer 28

Female patients should place their hands over breast tissue to provide a barrier between the examiner’s hands.

Question 29

What does a positive Sternal Compression Test indicate?

Answer 29

Localized rib pain, especially at the lateral border of the ribs, is indicative of a rib fracture.

Question 30

What is the procedure for Lateral Chest (Rib) Compression?

Answer 30

Patients can be seated, supine, or prone. The examiner applies bilateral L-M compression to both lateral aspects of the rib cage.

Question 31

What does a positive Lateral Chest Compression indicate?

Answer 31

Rib pain, pain at the costosternal junction, pain in the back, or localized pain at the lateral rib angle.

Question 32

What may pain at the costosternal junction indicate?

Answer 32

Local inflammation.

Question 33

What may pain in the back during Lateral Chest Compression indicate?

Answer 33

Costotransverse or costovertebral lesions.

Question 34

What is assessed during the Prone (Thoracic) Extension test?

Answer 34

Structural hyperkyphosis.

Question 35

What are the two major reasons for hyperkyphosis in adolescents?

Answer 35

* Slouched posture * Scheuermann’s disease.

Question 36

What is the procedure for assessing structural vs functional kyphosis?

Answer 36

The patient lies prone with arms behind the back and extends the trunk, lifting the chest off the table.

Question 37

What does persistent kyphosis indicate during the Prone Extension test?

Answer 37

It indicates a structural kyphosis.

Question 38

What is the objective of the Seated Spinal Rotation test?

Answer 38

To determine if the patient has good spinal rotation bilaterally.

Question 39

What is the procedure for the Seated Spinal Rotation test?

Answer 39

The patient sits straddling the corner of the table, crosses the leg of the testing side over the opposite foot, and rotates the trunk both to the right and left.

Question 40

What should the manubrium do to pass during the Seated Spinal Rotation test?

Answer 40

The manubrium should break 50 degrees.