CMT Orthopedic Special Tests & Differential Diagnosis 3

Question 1

A positive Spurling's test—cervical compression with lateral flexion and slight extension toward the symptomatic side reproducing arm symptoms—most strongly indicates:

Accepted Answer

Cervical radiculopathy

Answer

Spurling's test narrows the intervertebral foramen ipsilaterally, compressing an irritated cervical nerve root and reproducing radicular symptoms into the arm, confirming cervical radiculopathy.

Question 2

Vertebral artery screening tests (such as the Sharp-Purser or combined cervical extension-rotation test) are performed PRIMARILY to:

Accepted Answer

Screen for contraindications to cervical high-velocity manipulation

Answer

Vertebral artery screening rules out vertebrobasilar insufficiency before applying high-velocity cervical techniques, because manipulation could compromise blood flow and cause serious neurological events.

Question 3

A positive straight leg raise (SLR) that reproduces radicular leg pain between 30° and 60° of hip flexion most strongly indicates:

Accepted Answer

Lumbar nerve root irritation

Answer

SLR at 30-60° creates dural tension on the sciatic nerve roots; reproduction of radicular pain at this early range indicates nerve root irritation, most commonly from a herniated lumbar disc.

Question 4

The Slump test is most useful for differentiating lumbar nerve root compression from:

Accepted Answer

Sacroiliac joint dysfunction or local hip pathology

Answer

The Slump test applies neural tension through the entire spinal canal; reproduction of radicular symptoms with neural loading (and relief with cervical extension) confirms neurodynamic involvement rather than local sacroiliac or hip pathology.

Question 5

Waddell's non-organic signs are best described as indicators of:

Accepted Answer

Non-organic or psychosocial contributors to low back pain

Answer

Waddell's signs identify non-organic pain behaviors and psychosocial yellow flags that may amplify the pain experience; they do not diagnose malingering but signal the need for a biopsychosocial management approach.

(CMT) Certified Manual Therapist Practice Test

(CMT) Certified Manual Therapist Practice Test

CMT Orthopedic Special Tests & Differential Diagnosis 3