DAY 8

Question 1

A patient with a C6 spinal cord injury is evaluated in the clinic. Which objective finding is the
strongest indication that the spinal cord injury is NOT complete?
a. Weakness of the brachioradialis
b. Intact sensation on the lateral portion of the shoulder
c. Diminished sensation on the hypothenar eminence
d. Absent triceps reflex
e. Weakness of the biceps muscle

Answer 1

c. Diminished sensation on the hypothenar eminence

Question 2

The following statements describe the “Screw-Home Mechanism” of the knee EXCEPT when
_______.
i. Seated and a person flexes his knee, the tibia goes into internal rotation to unlock
the knee.
ii. Standing from a seat the femur goes into internal rotation during the last few
degrees of flexion.
iii. Standing from a seat the femur goes in external rotation during the last few degrees
of extension
iv. Seated and a person flexes his knee, the femur goes into external rotation at the
last few degrees of extension.
a. III
b. I
c. II and III
d. II and IV

Answer 2

c. II and III

Question 3

The following are expected in a C4 lesion, EXCEPT:
a. Can provide minimal assistance, therefore dependent in bed mobility
b. Involves the diaphragm and trapezius
c. Chin control can be used to control power wheelchair
d. Can assist with all transfers
e. Dependent in all transfers

Answer 3

d. Can assist with all transfers

Question 4

Despite the presence of third cranial nerve paralysis, it was determined upon examination, that the
eye is able to rotate inward, indicating that the superior oblique muscle is intact. This indicates that
cranial nerve
a. III is also denervated.
b. IV is partially denervated.
c. III is only partially denervated.
d. IV is intact.

Answer 4

d. IV is intact.

Question 5

Which of the following statements describe Horner’s syndrome?
i. Pupil of the eye on injured side is miotic due to dilator paralysis
ii. Partial ptosis due to denervation of levator palpebrae superioris
iii. Anhidrosis and vasodilation on affected side
iv. Complete ptosis and vasodilation on unaffected side
a. III only
b. II, III and IV
c. I, II and III
d. I and IV
e. IV only

Answer 5

c. I, II and III

Question 6

The following are true of the femoral artery EXCEPT
a. if the common iliac or external iliac artery is partially occluded, the femoral artery pulse may
be diminished.
b. the femoral vein lies medial to the femoral artery and is a clinical site for venous puncture.
c. passes under the inguinal ligament at about its midpoint.
d. the femoral nerve lies lateral to the femoral artery.
e. palpable just superior to the inguinal ligament, at a point halfway between the anterior
superior iliac spine and the pubic tubercle.

Answer 6

e. palpable just superior to the inguinal ligament, at a point halfway between the anterior
superior iliac spine and the pubic tubercle.

Question 7

Nerve primarily responsible for ankle plantar flexion
a. Obturator
b. Sciatic
c. Femoral
d. Tibial
e. Peroneal

Answer 7

d. Tibial

Question 8

Which of the following statements is true concerning muscles acting in hip flexion?
a. The hip flexors are inactive during abdominal sit ups
b. Their maximum isometric torques are greatest when the hip is extended
c. The iliopsoas is the only hip flexor that can produce enough tension to flex the hip beyond
90 degrees with the subject in sitting position
d. Their minimum isotonic torque occurs when the hip is flexed

Answer 8

a. The hip flexors are inactive during abdominal sit ups

Question 9

Which of the following are treatment philosophies of neuropathic arthropathy (or Charcot’s joint)?
i. Treatment is mainly palliative
ii. Immobilization and joint protection are two important principles of treatment
iii. Where conservative management fails, joint replacement is performed
iv. Where conservative management fails, surgical fusion is recommended
v. Whenever possible, the underlying neurologic disorder should be treated
a. I, II and V
b. II, IV and V
c. I, III and IV
d. I, II and IV

Answer 9

b. II, IV and V

Question 10

Which of the following statements is true in motions of the knee?
a. Accessory motions are normally produced when the knee is in full extension
b. Axial rotation occurs best when the knee is extended
c. Terminal rotation of the knee is a locking mechanism observed during the last 20 degrees of
knee extension
d. The axis for flexion and extension is clinically approximated as directed through the center
of the lateral and medial condyles of the femur

Answer 10

c. Terminal rotation of the knee is a locking mechanism observed during the last 20 degrees of
knee extension

Question 11

A patient is unable to extend the knee in the sitting position or perform straight leg raising when
supine. This may be due to weakened or paralyzed ________.
a. Gluteus maximus
b. Quadrates femoris
c. Iliopsoas
d. Quadriceps femoris

Answer 11

d. Quadriceps femoris

Question 12

LD is a 35-year-old male who came in for weakness and pain of the left lower extremity of one-week
duration. Past medical history is unremarkable except for (+) history of poliomyelitis at age 7 years.
Pertinent physical examination revealed (+) left lower atrophy with note of leg length discrepancy.
What is the most likely diagnosis? (KRISTAN)
a. Post-polio syndrome
b. Guillain-Barre Syndrome
c. Charcot-Marie-Tooth Disease
d. Spinal cord injury

Answer 12

a. Post-polio syndrome

Question 13

The following findings are compatible with a left hemisection of the T10 cord level EXCEPT
a. absent pain and temperature on the right side of the trunk at the level of the umbilicus.
b. complete paralysis of the left lower rectus abdominis.
c. absent pain and temperature sensation on the left side of the trunk at the level of the
umbilicus.
d. absent pain and temperature sensation on the right anterior thigh area.

Answer 13

c. absent pain and temperature sensation on the left side of the trunk at the level of the
umbilicus.

Question 14

In the foot, the contribution of the first metatarsal head to weight bearing is
a. 1/6
b. 1/5
c. 2/5
d. 2/6
e. 1/7

Answer 14

d. 2/6

Question 15

Sensation to the middle finger is supplied by neurologic level
a. C8
b. C6
c. C7
d. T1
e. C5

Answer 15

c. C7

Question 16

A client with a confirmed posterior cruciate ligament tear is able to return to full dynamic activities
following rehabilitation. The following serve as a secondary restraint to the posterior cruciate
ligament EXCEPT
a. Popliteus.
b. medial collateral ligament.
c. lateral collateral ligament.
d. iliotibial band

Answer 16

d. iliotibial band

Question 17

The following statements describe the pelvic girdle and femur EXCEPT:
a. The pelvic girdle consists of two innominate bones: the sacrum and coccyx
b. The iliofemoral ligament firmly connects the femur’s proximal end to the ilium
c. Gliding and cartilaginous joints allow no movement whatsoever in both sexes
d. The ilium, ischium and symphysis pubis make-up each hip bone
e. The pubic portion of the innominate bones fusing to form the symphysis pubis is of the
cartilaginous joint type

Answer 17

c. Gliding and cartilaginous joints allow no movement whatsoever in both sexes

Question 18

These muscles are supplied by branches of 7th cranial nerve EXCEPT ______.
a. Nasalis
b. Mentalis
c. Levator palpebrae superioris
d. Orbicularis oculi

Answer 18

c. Levator palpebrae superioris

Question 19

An example of telereceptor
a. The ear
b. A free nerve ending
c. Tropomyosin
d. The carotid baroceptor
e. A muscle spindle

Answer 19

a. The ear

Question 20

For the anterior and lateral spinothalamic tract, _______________.
a. The anterior spinothalamic predominantly controls pressure while the anterior
spinothalamic controls touch
b. The lateral spinothalamic predominantly controls pain while the anterior spinothalamic
controls temperature
c. The third order neuron of both tracts will have its cell body at the thalamus
d. The anterior spinothalamic tract is uncrossed while the lateral spinothalamic tract is
predominantly crossed.

Answer 20

c. The third order neuron of both tracts will have its cell body at the thalamus

Question 20

During heavy exercise, there is an increase in sympathetic activity. This would result in
vasoconstriction of the blood vessels in the following organ/s EXCEPT:
a. Splanchnic organs
b. Skeletal muscle
c. Kidneys
d. Liver

Answer 20

b. Skeletal muscle

Question 21

What is the average length of the spinal cord in the adult?
a. 40 to 42 inches
b. 33-35 cm
c. 33-35 inches
d. 43-45 cm
e. 43-45 inches

Answer 21

d. 43-45 cm

Question 22

Which statement explains why visceral pain is referred to a somatic structure?
a. Somatic and visceral afferents project to different spinothalamic neurons
b. Somatic efferents project to the decreased threshold of somatic structures
c. Impulses from the viscera increase the threshold of spinothalamic neurons
d. The pain is referred to the somatic structure with the same embryonic origin

Answer 22

d. The pain is referred to the somatic structure with the same embryonic origin

Question 23

Which of the following nerves is NOT a true peripheral nerve, but an evaginated fiber tract of the
diencephalons?
a. Optic
b. Auditory
c. Oculomotor
d. Olfactory
e. Trochlear

Answer 23

a. Optic

Question 24

Fracture of the second lumbar vertebra will involve which spinal cord segment? a. L2 b. L1 c. T12 d. L4

Answer 24

a. L2

Question 25

A T10 female with complete paraplegia will a. Have normal orgasm b. Experience labor pain c. Still be capable of having children d. Not be able to bear children e. Have decreased libido

Answer 25

c. Still be capable of having children

Question 26

In central cord syndrome, ______________. a. Associated with congenital narrowing of the spinal canal b. Occurs with flexion injuries of the neck c. Sensory deficits are more severe than motor impairments d. Motor function of the lower extremity is more affected than that of the upper extremity.

Answer 26

a. Associated with congenital narrowing of the spinal canal

Question 27

In a C6 lesion, the following may be expected of the client, EXCEPT:___________. a. Bed mobility independent b. Involves the deltoid, biceps, rhomboids, supinator and supraspinatus c. Involves the wrist extensors, latissimus dorsi, pectoralis, serratus anterior, pronator teres and teres minor. d. Can assist in independent transfers

Answer 27

b. Involves the deltoid, biceps, rhomboids, supinator and supraspinatus

Question 28

Which is a characteristic of the intrinsic muscles of the foot? a. Their major function include supporting the arches in walking and running b. Their proximal attachments are either in the tibia or fibula c. Their distal attachments are either in the tibia or fibula d. All but one are located in the plantar surface

Answer 28

a. Their major function include supporting the arches in walking and running

Question 29

Which objective finding is the strongest indication that a C6 spinal cord injury is not complete? a. Intact sensation on the lateral portion of the shoulder b. Weakness of the biceps muscle c. Absent triceps reflex d. Diminished sensation on the hypothenar eminence

Answer 29

d. Diminished sensation on the hypothenar eminence

Question 30

What dermatome is used to test C7? a. Middle finger b. Forearm c. Apex of the axilla d. Thumb

Answer 30

a. Middle finger

Question 31

Sensation in the anterolateral aspect of the thigh is innervated by what nerve? a. Medial femoral cutaneous b. Lateral femoral cutaneous c. Sural d. Saphenous

Answer 31

b. Lateral femoral cutaneous

Question 32

Sensation to the middle finger is supplied by neurologic level __________. a. C6 b. C5 c. C7 d. C8

Answer 32

c. C7

Question 33

In a C5 lesion, the following may be expected of the client, EXCEPT: _____________. a. Can give minimal to moderate assistance resulting in bed mobility dependency b. Can assist with limited transfers due to involved musculature c. Can propel manual wheelchair on level surfaces with the assistance of projection hand rims d. Involves the deltoid, biceps, rhomboids, supinator and supraspinatus

Answer 33

b. Can assist with limited transfers due to involved musculature

Question 34

While there are eight nerves that exit the cervical spine, there are only seven cervical vertebrae. Where does the first thoracic nerve exit? a. Above the second thoracic vertebra b. Below the first thoracic vertebra c. Above the first thoracic vertebra d. Below the second thoracic vertebra e. Below the seventh cervical vertebra

Answer 34

b. Below the first thoracic vertebra

Question 35

Which of the following statement is NOT true of the knee joint? a. Stability is provided by the tissues, ligaments, muscles and cartilage b. Can sustain vertical force up to six times the body weight c. Requires co-contraction of front and back muscles to support the body weight in the erect position d. A trochoginglimus joint with two degrees of freedom of motion

Answer 35

c. Requires co-contraction of front and back muscles to support the body weight in the erect position

Question 36

The quadriceps muscle represents the _________ myotome. a. L1 b. L5 c. L2 d. L3 e. L4

Answer 36

d. L3

Question 37

Chiasmal lesions could result in the following visual field defects EXCEPT: a. Chiasmal lesion produces bitemporal hemianopsia b. Lesion of the right optic tract results in right homonymous hemianopsia c. Lesion involving both the optic nerve and the chiasm produces ipsilateral blindness d. Transaction of the optic nerve results in ipsilateral monocular blindness e. A temporal field defect in the other eye is a result of a lesion involving both optic nerve

Answer 37

b. Lesion of the right optic tract results in right homonymous hemianopsia