CCEP Orthopedic Testing 3 — Questions and Answers
Question 1: The Tinel's Sign at the carpal tunnel is elicited by tapping over the flexor retinaculum; a positive result produces what response?
- Tingling into the median nerve distribution (Correct answer)
- Sharp wrist pain
- Tingling into the ulnar two digits
- Grip weakness
Correct answer: Tingling into the median nerve distribution
Tapping over the carpal tunnel in carpal tunnel syndrome provokes paresthesia in the thumb, index, middle, and radial half of the ring finger — the median nerve distribution.
Question 2: Ober's Test is used to assess tightness of which structure in patients with IT band syndrome or hip pathology?
- Iliotibial band and tensor fasciae latae (Correct answer)
- Hip flexor complex
- Piriformis muscle
- Gluteus medius
Correct answer: Iliotibial band and tensor fasciae latae
Ober's Test places the patient in sidelying and drops the upper leg into adduction; inability to adduct indicates tightness of the iliotibial band and tensor fasciae latae.
Question 3: A positive Froment's Sign — flexing the IP joint of the thumb to hold a paper — indicates weakness of which muscle?
- Adductor pollicis (Correct answer)
- Abductor pollicis brevis
- Opponens pollicis
- Flexor pollicis longus
Correct answer: Adductor pollicis
Froment's Sign reveals weakness of the adductor pollicis (ulnar nerve), causing the patient to compensate using the FPL (median nerve) to maintain grip on paper.
Question 4: The Posterior Drawer Test of the knee assesses the integrity of which ligament?
- Posterior cruciate ligament (Correct answer)
- Anterior cruciate ligament
- Lateral collateral ligament
- Arcuate ligament complex
Correct answer: Posterior cruciate ligament
The Posterior Drawer Test posteriorly translates the tibia on the femur at 90° of knee flexion to stress the posterior cruciate ligament (PCL).
Question 5: During the Empty Can (Jobe) Test, which movement is combined with 90° of shoulder abduction in the scapular plane to assess supraspinatus integrity?
- Internal rotation with thumbs pointing down (Correct answer)
- External rotation with thumbs pointing up
- Horizontal adduction with elbows flexed
- Neutral rotation with palms flat
Correct answer: Internal rotation with thumbs pointing down
The Empty Can Test isolates the supraspinatus by positioning the shoulder at 90° abduction in the scapular plane with internal rotation (thumbs down), then applying downward resistance.
Question 6: Which test for lateral ankle ligament integrity involves applying inversion stress to the hindfoot to assess the calcaneofibular ligament?
- Talar Tilt Test (Correct answer)
- Anterior Drawer Test
- Squeeze Test
- Ottawa Ankle Rule assessment
Correct answer: Talar Tilt Test
The Talar Tilt Test applies inversion stress to the ankle; excessive inversion compared to the contralateral side suggests calcaneofibular ligament laxity.
Question 7: A positive Phalen's Test — wrists fully flexed together for 60 seconds reproducing paresthesia — is most associated with which diagnosis?
- Carpal tunnel syndrome (Correct answer)
- de Quervain's tenosynovitis
- Cubital tunnel syndrome
- Pronator syndrome
Correct answer: Carpal tunnel syndrome
Sustained wrist flexion in Phalen's Test increases carpal tunnel pressure, compressing the median nerve and reproducing paresthesia in the first 3.5 digits.
CCEP Orthopedic Testing 3
The Tinel's Sign at the carpal tunnel is elicited by tapping over the flexor retinaculum; a positive result produces what response?