NATA-BOC Upper Extremity Injury Assessment 2

Question 1

An athlete presents with lateral elbow pain that worsens with gripping and wrist extension. Which special test would best confirm the diagnosis?

Accepted Answer

Cozen test

Answer

The Cozen test (resisted wrist extension with the elbow extended and forearm pronated) is specific for lateral epicondylitis. Pain at the lateral epicondyle during this test confirms involvement of the wrist extensor muscles, primarily the extensor carpi radialis brevis.

Question 2

A volleyball player complains of shoulder pain and weakness with overhead serving. The Speed test is positive. Which structure is most likely involved?

Accepted Answer

Long head of the biceps tendon

Answer

A positive Speed test indicates pathology of the long head of the biceps tendon. The test is performed with the shoulder flexed to 90 degrees, elbow extended, and forearm supinated while the patient resists a downward force.

Question 3

During a sideline evaluation, an athletic trainer suspects an athlete has dislocated their acromioclavicular (AC) joint. Which finding is most consistent with a Grade III AC separation?

Accepted Answer

Complete displacement of the clavicle above the acromion with obvious deformity

Answer

A Grade III AC separation involves complete disruption of both the AC ligaments and coracoclavicular ligaments, resulting in complete displacement of the clavicle superiorly with an obvious step deformity or 'piano key sign.'

Question 4

An athletic trainer suspects a scaphoid fracture in an athlete who fell on an outstretched hand. Anatomical snuffbox tenderness is present. Initial radiographs are negative. What is the most appropriate next step?

Accepted Answer

Immobilize the wrist in a thumb spica splint and re-evaluate in 10-14 days

Answer

Scaphoid fractures are notoriously difficult to detect on initial radiographs (up to 20% are missed). When clinical suspicion is high (snuffbox tenderness, mechanism of injury), the standard of care is to immobilize in a thumb spica and obtain follow-up X-rays at 10-14 days.

Question 5

Which special test specifically assesses for a SLAP (Superior Labrum Anterior to Posterior) lesion of the shoulder?

Accepted Answer

O'Brien test (Active Compression test)

Answer

The O'Brien test (Active Compression test) is specifically designed to assess for SLAP lesions. It involves two positions: arm forward flexed 90 degrees and adducted 15 degrees with the thumb down (pain), then repeated with the palm up (pain decreases or resolves).

NATA-BOC Test Practice Test

NATA-BOC Test Practice Test

NATA-BOC Upper Extremity Injury Assessment 2