Free NPTE-PT Test Musculoskeletal System Examination Questions and Answers — Questions and Answers
Question 1: A physical therapist is evaluating a patient with suspected carpal tunnel syndrome. The therapist firmly taps the skin over the median nerve on the volar aspect of the wrist, which reproduces the patient's symptoms of tingling and paresthesia into the thumb, index, and middle fingers. Which special test does this procedure describe?
- Phalen's test
- Froment's sign
- Tinel's sign (Correct answer)
- Reverse Phalen's test
Correct answer: Tinel's sign
Tinel's sign is a provocative test used to identify median nerve compression at the carpal tunnel. It is performed by lightly tapping (percussing) over the median nerve at the wrist. A positive test is indicated by the reproduction of tingling or 'pins-and-needles' sensations in the distribution of the median nerve.
Question 2: A physical therapist performs a FABER test on a patient complaining of hip and groin pain. The patient reports sharp, anterior hip pain during the maneuver. This finding is MOST indicative of which of the following conditions?
- Sacroiliac joint dysfunction
- Piriformis syndrome
- Lumbar radiculopathy
- Intra-articular hip pathology (Correct answer)
Correct answer: Intra-articular hip pathology
The FABER (Flexion, ABduction, External Rotation) test, also known as Patrick's test, stresses the hip joint. Pain elicited in the anterior hip or groin region is suggestive of intra-articular hip pathology, such as femoroacetabular impingement (FAI), a labral tear, or osteoarthritis. Pain in the posterior pelvis or buttock region during this test would be more indicative of sacroiliac joint dysfunction.
Question 3: When comparing the Lachman test to the Anterior Drawer test for assessing the integrity of the anterior cruciate ligament (ACL), the Lachman test is generally considered to be more sensitive. Which of the following provides the BEST rationale for the increased sensitivity of the Lachman test?
- It is performed with the knee in 90 degrees of flexion, which isolates the ACL.
- It minimizes the protective muscle guarding of the hamstrings. (Correct answer)
- It applies a greater anteriorly directed force to the tibia.
- It is easier for the clinician to perform on a large patient.
Correct answer: It minimizes the protective muscle guarding of the hamstrings.
The Lachman test is performed with the knee in 20-30 degrees of flexion. This position places the hamstrings on slack, reducing their ability to dynamically stabilize the knee and mask underlying ACL laxity. The Anterior Drawer test, performed at 90 degrees of flexion, is more likely to be affected by hamstring muscle guarding, which can lead to a false negative result.
Question 4: A physical therapist is evaluating a 4-month-old infant and performs the Galeazzi test (Allis sign). The therapist observes that the infant's left knee is lower than the right knee. What is the MOST likely clinical implication of this finding?
- Congenital tibial shortening on the right
- Developmental dysplasia of the left hip (Correct answer)
- Bilateral hip dislocations
- Femoral anteversion on the left
Correct answer: Developmental dysplasia of the left hip
The Galeazzi test, or Allis sign, is used to screen for developmental dysplasia of the hip (DDH). The test is performed with the infant supine and hips and knees flexed. A positive sign is an observed asymmetry in knee height, which suggests a unilateral hip dislocation or femoral shortening on the side with the lower knee. In this case, the lower left knee points towards potential DDH on the left side. Bilateral dislocations may present with a false negative test.
Question 5: A patient presents with shoulder pain that is reproduced with overhead activities. The physical therapist performs a cluster of special tests for shoulder impingement syndrome. Which of the following combinations of tests has been shown to have the highest diagnostic utility when clustered together for subacromial impingement?
- Speed's test, Yergason's test, and O'Brien's test
- Apprehension test, Relocation test, and Sulcus sign
- Hawkins-Kennedy test, Painful Arc sign, and Infraspinatus muscle test (Correct answer)
- Adson's test, Wright test, and Roos test
Correct answer: Hawkins-Kennedy test, Painful Arc sign, and Infraspinatus muscle test
Research has identified a cluster of tests that, when positive, significantly increases the likelihood of subacromial impingement syndrome. This cluster includes the Hawkins-Kennedy test, the Painful Arc sign, and the Infraspinatus muscle test (resisted external rotation). The other answer choices represent clusters for different pathologies: bicipital tendinopathy/labral tears (A), glenohumeral instability (B), and thoracic outlet syndrome (D).
Question 6: A patient is being examined for lateral elbow pain consistent with lateral epicondylitis. To perform Cozen's test, the therapist should ask the patient to perform which of the following actions against resistance?
- Passive wrist flexion and ulnar deviation with the elbow extended
- Active wrist flexion and ulnar deviation
- Passive wrist extension and radial deviation with the elbow flexed
- Active wrist extension and radial deviation (Correct answer)
Correct answer: Active wrist extension and radial deviation
Cozen's test is a provocative test for lateral epicondylitis. The therapist stabilizes the patient's elbow and palpates the lateral epicondyle. The patient is then asked to make a fist, pronate the forearm, and actively extend and radially deviate the wrist while the therapist applies a counterforce. Pain at the lateral epicondyle constitutes a positive test, indicating involvement of the wrist extensor tendons.
Free NPTE-PT Test Musculoskeletal System Examination Questions and Answers
A physical therapist is evaluating a patient with suspected carpal tunnel syndrome.
The therapist firmly taps the skin over the median nerve on the volar aspect of the wrist, which reproduces the patient's symptoms of tingling and paresthesia into the thumb, index, and middle fingers.
Which special test does this procedure describe?