DPT 631: Clinical Management of the Musculoskeletal System I Flashcards
(149 cards)
1
Q
Which of the following terms best describes “the degree in which a joint can be moved by a single muscle contraction?
a. flexibility
b. passive ROM
c. AAROM
d. AROM
A
D
2
Q
Which of the following muscle lengthening techniques is considered most effective and functional?
a. massage
b. biofeedback
c. thermotherapy
d. proprioceptive neuromuscular facilitation (PNF)
A
D
3
Q
The muscle that is directly responsible for producing movement is called
a. antagonist
b. prime agonist
c. synergist
d. supporter
A
B
4
Q
A contraction that produces a shortening of the muscle is called:
a. isometric contraction
b. isokinetic contraction
c. eccentric contraction
d. concentric contraction
A
D
5
Q
Delayed Onset Muscle Soreness (DOMS) may appear in approximately how much time after an exercise bout?
a. 8-10 hours
b. 15-20 minutes
c. 24-56 hours
d. 10-15 hours
A
C
6
Q
Which of the following is not an absolute contraindication to exercise?
a. uncontrolled dysrhythmias
b. uncontrolled hypertension
c. unstable angina
d. severe pain rating
A
D
7
Q
Which of the following is considered a closed kinematic chain exercise?
a. mini squat on an AirEx mat
b. terminal knee extension (supine)
c. leg extension/long arc quad
d. standing hamstring curl
A
A
8
Q
The most common cell within Connective Tissue is:
a. elastic
b. fibroblast
c. ground substance
d. collagen
A
B
9
Q
Strength can be tested a number of ways. which of the following is not a way which strength can be tested?
a. manual muscle testing
b. edurance testing
c. isometric testing
d. dynamometer
A
B
10
Q
The open packed position of the GH joint is best described as
a. 30°abduction, 55° horizontal abduction
b. 55° abduction, 30° horizontal adduction
c. 30° adduction, 55° horizontal abduction
d. 55° abduction, 55° horizontal adduction
A
B
11
Q
The area of contact between a nerve and a muscle fiber is known as:
a. sarcomere
b. musculotendinous junction
c. motor end plate
d. cross-bridge
A
B
12
Q
Which of the following is not contained in the ECM?
a. water
b. proteoglycans
c. lipids
d. elastin
A
D: Page 3 in musculo book! under Connective Tissue heading
13
Q
Vascularity within tendons is relatively sparse
a. true
b. false
A
True
14
Q
Functions of a ligament include all of the following except:
a. acting as a guide to direct movement
b. providing proprioceptive feedback
c. preventing excessive motion
d. storing elastic energy
A
D
15
Q
Which of the following is included in the composition of Articular Cartilage?
a. elastin
b. collagen
c. chondrocytes
d. fibroblasts
A
C
16
Q
The primary function of the osteoblast is to:
a. enhance leverage
b. break down spongy bone
c. provide support
d. form trabecular bone
A
D
17
Q
The characteristics of skeletal muscle include all of the following except:
a. flexibility
b. excitability
c. contractility
d. elasticity
A
A
18
Q
Characteristics of the open-packed position include all of the following except:
a. major ligaments of the joint are on slack
b. minimal surface congruity
c. minimal joint surface contact
d. maximal stability of the joint
A
D
19
Q
Which of the following is considered the contractile machinery of the muscle?
a. muscle fiber
b. myofilaments
c. sarcomere
d. endomysium
A
C
20
Q
The situation where the agonistis incapable of shortening to the extent required to simultaneously produce full ROM at all of the joints it crosses is called:
a. passive insufficiency
b. force requirement
c. active insufficiency
d. angle of pennation
A
C
21
Q
Your patient presents with sensory changes to the lateral side of the right forearm, muscle weakness of the biceps brachii and diminished biceps reflex. which of the following nerves is implicated?
a. median nerve
b. axillary nerve
c. radial nerve
d. musculocutaneous nerve
A
D
22
Q
The amount of physiolofical joint motion is based on a number of factors, including:
a. integrity of the joint surfaces
b. pliability of the soft tissues
c. degree of the soft tissue approximation
d. all of the above
e. none of the above
A
D
23
Q
The motions occurring at the joint surfaces are termed
a. osteokinematic
b. arthrokinematic
c. kinetics
d. moment arm
A
B
24
Q
The closed-packed position of the GH joint is best described as:
a. flexion and internal rotation
b. abduction and external rotation
c. adduction and internal rotation
d. flexion and external rotation
A
B
25
Which of the following are the two major types of muscle fiber that have been recognized in skeletal muscle?
a. Type I (slow twitch) and Type II (fast-twitch)
b. Type I (fast twitch and Type II (slow-twitch)
c. Type III and Type C
d. none of the above
A
26
You need to test your patients spinal accessory nerve. which of the following tests would you utilize?
a. inspect the tongue and look for symmetry when the patient sticks it out to you
b. inspect the trapezius muscles looking for any asymmetry and test the strength bilaterally
c. inspect the patients hearing by circling your fingers by the patients ear
d. inspect the face at rest, during conversation and when the patient smiles, and look for any asymmetry
B
27
Which of the following best describes Ataxia?
a. velocity-dependent increase in tonic stretch reflexes
b. drunken-sailor gait pattern
c. loss of balance resulting in a fall without loss of consciousness
d. an undiagnosed change in articulation
B
28
Your patient presents for his first outpatient PT visit after TKR. which of the following automatic postural response/balance techniques would be most appropriate to implement?
a. the hip strategy
b. the stepping strategy
c. weight-shift strategy
d. the suspension strategy
C
29
Which of the following sequences should a clinician use to progress balance training?
a. automatic postural reaction, dynamic balance, then static balance
b. static balance, dynamic balance, then automatic postural reaction
c. static balance, automatic postural reaction, then dynamic balance
d. automatic postural reaction, static balance, then dynamic balance
B
30
Which of the following muscles does not refer pain to the chest region?
a. pectoralis major
b. rectus abdominis
c. pectoralis minor
d. sternocleidomastoid
B
31
Spinal accessory nerve innervates the trapezius and is comprised of which of the following nerve roots?
a. CN X and C3, C4
b. CN XI and C3, C4
c. CN X and C2, C3
d. CN XI and C2, C3
B
32
Which of the following types of pain can be described as the normal, predicted physiological response to an adverse chemical, thermal or mechanical stimulus?
a. chronic pain
b. referred pain
c. acute pain
d. hyperalgesia
C
33
Which of the following types of feedback is considered supplemental feedback and from an external source?
a. knowledge of results
b. intrinsic
c. knowledge of performance
d. extrinsic
D
34
Which of the following joint receptors have a protective function and are able to detect large amounts of tension?
a. pacinian corpuscles
b. ruffini endings
c. GTO
d. bare nerve endings
C
35
The tibial nerve supplies all of the following muscles except:
a. soleus
b. extensor hallucis longus
c. flexor hallucis longus
d. gastrocnemius
B
36
The sciatic nerve is comprised of which of the following nerve roots?
a. L4-L5; S1-S3
b. L3-L5; S1
c. L3-L5; S1-S2
d. L4-L5; S1-S2
A
37
Your patient is able to identify an object via touch only (vision occulded). Which of the following best describes this action?
a. stereognosis
b. pressure identification
c. graphesthesia
d. kinesthesia
A
38
Your patient presents with tingling sensations in the 5th digit, decreased wrist flexion and decreased ability to oppose the fingers. Which of the following nerves should you test further?
a. median nerve
b. radial nerve
c. axillary nerve
d. ulnar nerve
D
39
The load-deformation curve depicts the relationship between:
a. the amount of force applied to a structure and the structures response in terms of load
b. the amount of force applied to a structure and linear stress
c. the amount of force applied to a structure and the structures response in terms of deformation
d. the amount of force applied to a structure and the shear stress
C
40
Which of the following muscles is innervated by the suprascapular nerve (C5-C6)?
a. coracobrachialis
b. subscapularis
c. supraspinatus
d. teres minor
C
41
Articular Cartilage enjoys a rich blood supply and is capable of producing an inflammatory response
a. True
b. False
False
42
The Brachial Plexus arises from:
a. dorsal primary divisions of C5-T1
b. anterior primary divisions C5-T1
c. anterior primary divisions C2-T1
d. dorsal primary divisions C2-T1
B
43
Crimp is seen primarily in all of the following except:
a. joint capsule
b. ligament
c. tendon
d. muscle
D
44
The characteristics of a first-degree muscle strain include all of the following except
a. minimal hemorrhage
b. early resolution
c. minimal structural damage
d. partial tear
D
45
Sarcopenia is best described as
a. cancerous tumor in the muscle tissue
b. decreased tensile strength of muscle tissue
c. lack of muscle due to age
C
46
One of the most effective treatment for tendon injury is:
a. high repetition/low load activities
b. disuse
c. low repetition regardless of resistance used
d. low repetition/high load activities
A
47
Which of the following statements regarding an unstable joint is most accurate?
a. an unstable joint involves disruption of osseous and ligamentous structures
b. clinically, an unstable joint will display decreased AROM
c. clinically, an unstable joint will display pain-free AROM
d. an unstable joint is the same as a hypermobile joint
A
48
Your patient presents with median nerve entrapment. Which of the following muscles may be affected?
a. Brachialis
b. Coracobrachialis
c. Pronator Quadratus
d. Deltoid
C
49
A full-thickness articular cartilage tear:
a. produces a significant inflammatory response
b. involves small, microscopc damage to the chondrocytes
c. does not penetrate the subchondral bone, therefore no inflammatory response occurs
d. is otherwise known as type 2 articular cartilage injury
A
50
A ligament injury that involves moderate pain and significant structural weakening with abnormal motion is classified as:
a. type IV ligament injury
b. Type III ligament injury
c. Type II ligament injury
d. Type I ligament injury
C
51
Which of the following statements is incorrect?
a. mixed nerves are a combination of sensory nerves and motor nerves
b. sensory nerves carry efferents to the skin receptors
c. sensory nerves carry afferents from a portion of the skin
d. sensory nerves carry efferents to muscle
D
52
Indications for manual therapy techniques include all of the following except:
a. nonirritable musculoskeletal condition
b. mild musculoskeletal pain
c. pain that is relieved by rest
d. pain that is unaltered by changes related to sitting or standing
D
53
Your patient presents with pain in the right wrist and hand. She also reports intermittent numbness and tingling, which is worse at night in the 1st and 2nd digits. Please indicate which of the following special tests would be BEST to detect carpal tunnel syndrome?
a. Phalen Test
b. Froment Sign
c. Allen Test
d. Semmes-Weinstein Test
A
54
Which of the following is true regarding the concept of soft tissue mobilization?
a. force applied in a direction away from the maximum restriction
b. deep layers are treated before superficial layers
c. choice of technique is not dependent on the degree of irritability
d. STM is based on the concept that tissue restrictions occur at different layers, ranging from superficial to deep
D
55
Limb advancement has three phases. Which of the following is not one of those phases?
a. Terminal Swing
b. Preswing
c. Midswing
d. Initial Swing
B
56
Which of the following works as force couples during forearm pronation and supination?
a. Pronator Teres and Pronator Quadratus/Supinator
b. Pronator Teres/Pronator Quadratus and Supinator
c. Pronator Teres and Supinator/Biceps Brachii
d. Pronator Teres and Supinator
A
57
The decision about which manual approach or technique to use on a patient has traditionally been based on all of the following, except:
a. abundant research
b. clinical decision making processes
c. clinicians beliefs
d. level of exerpertise
A
58
Your 65 year old patient presents with significant antalgic gait pattern. During the examination, he advises that he has dull, aching pain in the right, right knee, and periodically in the right groin region. He denies history of trauma, fracture, low back pain, and radicular symptoms. Which of the following suspected causes of antalgic gait pattern can you fairly easily eliminate at this time?
a. muscle dysfunction
b. integumentary condition
c. joint disease
d. neurologic condition (this is the correct answer keyed for test but integumentary or answer (b) was also accepted)
B
59
The correct Muscle Energy Technique combines all of the following, except:
a. Muscle reeducation
b. AROM
c. Therapeutic Exercise
d. Passive Mobilization
B
60
Exercise based indications for joint mobilization include:
a. increase joint ROM
b. decrease pain
c. promote muscular relaxation
d. improve muscle performance
e. A and B only
f. all of the above
F
61
Which of the following statement regarding Maitland’s joint mobilization grading system is correct?
a. Grade III – A small amplitude movement at the end of the ROM
b. Grade V – A movement that exceeds the resistance barrier
c. Grade I – A small amplitude technique performed at mid-range of the adaptive ROM
d. Grade II – A large amplitude technique performed at the beginning of the ROM
B
62
Indications for Transverse Friction Massage include:
a. Acute tendon or muscle injuries
b. Chronically inflamed bursae
c. Adhesions in ligament or muscle
d. Adhesions between tissues
e. A and C only
f. All of the above
F
63
Which of the following glenohumeral ligaments is the primary restraint against anterior humeral head dislocations
a. Anterior glenohumeral ligament
b. Inferior glenohumeral ligament
c. Middle glenohumeral ligament
d. Posterior glenohumeral ligament
B
64
Which of the following statements is correct? With regard to muscle actions during the initial contact phase of gait:
a. Gluteus maximus and hamstrings work concentrically to decelerate the leg
b. Plantar flexors contract eccentrically to slow dorsiflexion
c. Dorsiflexors contract concentrically to slow plantar flexion
d. Quadriceps femoris contracts eccentrically to control rapid knee flexion and prevent buckling
D
65
There are three areas called tension sites in which the dura is tethered to the bony canal providing stability to the spinal cord. which of the following is not one of those tension sites?
a. L4
b. C4
c. C6
d. T6
B -- corrected this one! neurodynamic mobility and mobilizations powerpoint- slide 4
66
Which of the following is likely not a characteristic suspected to contribute to neural injury
a. compression
b. posture
c. direct trauma
d. disease process
D
67
Which of the following is not one of the essential requirements for locomotion?
a. Base of support
b. Progression
c. Postural Control
d. Adaptation
A
68
Which statement regarding Double Crush Syndrome (DCS) is inaccurate?
a. DCS refers to the coexistence of dual neuropathies along the course of a peripheral nerve
b. for DCS to occur there need not be an anatomic continuity of nerve fibers between the two lesion sites
c. Mechanism of injury serial compromise of axonal transport along the same nerve fiber causing a subclinical lesion at the distal site to become symptomatic
d. proximal compression may decrease the ability of a nerve to withstand a more distal compression
B
69
Which of the following is inaccurate regarding Neurodynamic Mobility Examination?
a. Positive test is only the reproduction of the patients symptoms
b. neurodynamic testing should be considered in relation to other objective findings
c. positive test is a reproduction of the patients symptoms and a decrease in those symptoms with movement of a distant body part
d. positive symptoms for the presence of neuropathic dysfunction include pain, paresthesia, and spasm
A
70
The resting position of the GH joint is:
a. 30° abduction, 55° horizontal abduction
b. 55° adduction, 30° horizontal adduction
c. 55° abduction, 30° horizontal adduction
d. 30° abduction, 55° horizontal adduction
C
71
All of the following are contained within the cubital fossa except:
a. Median nerve
b. Tendon of triceps brachii
c. Brachial artery
d. Ulnar nerve
D
72
Slump test enables the clinician to detect adverse nerve root tension caused by all of the following except:
a. acute spondylolisthesis
b. vertebral impingement
c. lateral disk herniation
d. spinal stenosis
A
73
The capsular pattern of the GH joint is:
a. IR, Adduction, ER
b. ER, Adduction, IR
c. ER, Abduction, IR
d. IR, Abduction, ER
C
74
Which of the following statements is correct? With regard to joint motions during the loading response phase of gait:
a. knee is in 20°of knee flexion, moving into extension
b. hip moves into flexion, adduction and internal rotation
c. hip moves into extension, abduction and external rotation
d. knee is in 20° of knee extension, moving into extension
A
75
Which of the following indications for the use of joint mobilization is correct?
a. Use Grade III and IV joint mobilization in the acute phase
b. Use Grade III and IV joint mobilization for increasing ROM in the chronic phase
c. Use Grade III and IV joint mobilization for pain control in the subacute phase
d. Use Grade I and II joint mobilization in the chronic phase for increasing ROM
B
76
Ideal postural alignment for standing is defined as “a straight line that passes through” all of the following except:
a. Slightly posterior to the lateral malleolus
b. Slightly posterior to the hip joint
c. Through the bodies of the lumbar vertebrae
d. The bodies of the cervical vertebrae
A
77
Your Patient presents with low back pain, radiating pain into the left leg and intermittent numbness and tingling into the left lower leg and foot. Your have performed the SLR test (with dorsiflexion) with positive e results. You desire to perform another test for objective confirmation of your suspicions that the patient has a herniated nucleus pulposus. Which of the following is the best test for this thought process?
a. Prone Knee Bend Test
b. Crossed Straight Leg Raise Test
c. Bowstring Test
d. Bilateral Straight Leg Raise Test
C
78
Which of the following is the resting position of the humeroulnar joint?
a. 90° elbow flexion, 10° supination
b. 70° elbow flexion, 5° supination
c. 70° elbow flexion, 10° supination
d. 90° elbow flexion, 5° supination
C
79
All of the following are function of the Rotator Cuff muscles, except:
a. Reinforces the GH joint capsule and is a secondary elbow flexor
b. Control much of the active arthrokinematics of the GH joint
c. Actively moves the humerus and fine-tunes the humeral head position in the glenoid
d. Assist in the rotation of the shoulder and arm
A
80
All of the following are benefits of neutral tension mobilization, except:
a. Dispersion of noxious fluids
b. decreased neural vascularity
c. improvement of axoplasmic flow
d. reduction of nerve adherence
B
81
The degree of stability of the shoulder complex is contingenet upon all of the following except:
a. integrity of the osseous articular structures
b. proper function of the muscles
c. supple capsuloligamentous restraints
d. intact capsuloligamentous structures
C
82
Which of the following special tests would be best to test the integrity of the flexor mechanism at the PIP joints?
a. Flexor Digitorum Profundus Test
b. Flexor Digitorum Superficialis Test
c. Reagan Test
d. Integrity of the central slip test
B
83
Which of the following structures is not housed in the subacromial space under the coracoacromial arch?
a. long head of biceps brachii
b. superior aspect of the joint capsule
c. supraspinatus and upper margins of the subscapulars and infraspinatus
d. subdeltoid bursa
e. A and D are not housed in the subacromial space
f. none, they are all housed in the subacromial space
F
84
All of the following statements regarding joint mobilization are correct, except:
a. direction of the glide is determined by the convex-concave rule
b. grades III and IV have mechanical and neurophysiologic effects which aid in reducing restriction and movement
c. grade III and IV are commonly used acutely for pain relief
d. the joint mobilization should begin from the resting position
C
85
Please indicate which direction the glenoid fossa faces
a. medially, anteriorly, inferiorly,
b. laterally, superiorly, posteriorly
c. medially, posteriorly, superiorly
d. laterally, superiorly, anteriorly
D
86
Which of the following muscles work together with the Trapezius, as a force couple, to protract and upwardly rotate the scapula while providing a strong, mobile base of support to position the glenoid for maximum efficiency?
a. Latissimus Dorsi
b. Levator Scapulae
c. Posterior Deltoid
d. Serratus Anterior
D
87
Pain during shoulder abduction is deemed a “painful arc”. Please indicate which of the following statements is true about “painful arc”.
a. pain during 70-110° of shoulder abduction may be indicative of RC impingement
b. pain during 120-180° of shoulder abduction may be indicative of subacromial bursitis
c. pain during 120-180° of shoulder abduction may be indicative of involvement of the AC joint
d. pain during 70-110° of shoulder abduction may be indicative of deltoid pathology
e. A and C are correct
f. A and B are correct
E
88
Your patient presents with left elbow pain after playing a flag football game. The pain is global in the elbow, but upon palpation, you note the patient is exquisitely tender over the lateral epicondyle. Please indicate the best special test to rule our lateral collateral ligament pathology
a. Mill’s Test
b. Cozens Test
c. Varus Stress Test
d. Valgus Stress Test
C
89
Your patient presents with right shoulder pain that is especially noticeable with full shoulder flexion. Which of the following tests should you perform to rule out or rule in subacromial impingement
a. Yocum Test
b. Crank Test
c. O’Briens Test
d. Internal Rotation Lag Sign
A
90
Your patient presents with left shoulder pain noted especially with shoulder flexion and shoulder abduction. Upon examination, you note the right scapula moves appropriately, but the left scapula does not. In addition, the patient hikes the left shoulder as a compensatory pattern for glenohumeral flexion and abduction. The patient is right handed. Which of the following mobilizations is the best option for restoring proper scapulohumeral rhythm?
a. GH posterior mobilization
b. GH interior mobilization
c. GH anterior mobilization
d. Scapulothoracic distraction
D
91
Your patient presents with a recent history of left shoulder dislocation after landing on the mat while sparring at Tae Kwon Do tournament. Which of the following tests would be best for determining the integrity and stability of the anterior glenohumeral joint capsule?
a. Sulcus Sign
b. Jobe Subluxation/Relocation Test
c. Apprehension Test
d. Load and Shift Test
A (this answer was keyed as correct answer but load and shift (D) was also accepted)
92
Which of the following is the closed-packed position of the humeroradial joint?
a. 70°elbow flexion, 10° supination
b. 90°elbow flexion, 10° supination
c. 90°elbow flexion, 5° supination
d. 70°elbow flexion, 5° supination
C
93
All of the following are components of the stance phase of gait, except:
a. limb advancement
b. loading response
c. weight acceptance
d. single-limb support
A:
STANCE PHASE = 2 tasks, 5 intervals
task #1: Weight acceptance with intervals of:
1. initial contact and
2. LOADING RESPONSE
task #2: single-leg advancement with intervals of:
1. midstance
2. terminal stance
3. preswing
SWING PHASE: 1 task, 3 intervals
task #1: LIMB ADVANCEMENT with intervals of:
1. initial swing
2. midswing
3. terminal swing
94
All of the following statements regarding the parameters for all Upper Limb Tension Tests are true, except:
a. The test should only be performed until the patients symptoms are reproduced
b. When the patients symptoms are reproduced, the test is stopped and cervical sidebending to the contralateral side is added to asses if symptoms resolve
c. the patient should be questioned about symptoms at the beginning of the test and as each segment is added
d. compare to contralateral side
B
95
Your patient presents with left elbow pain. During the examination, you note that the pateitns has a radial head dysfunction. Which of the following manual techniques would be best to correct the radial head dysfuntion?
a. humeroradial medial and lateral glide mobilizations
b. humeroulnar distraction/compression mobilizations
c. humeroradial distraction mobilization
d. radial head mobilizations in the anterior/posterior plane
D
96
Criteria for the correct application of manual therapy techniques include all of the following, except:
a. convex/concave rules
b. duration type and irritability of symptoms
c. closed-packed position of the joint to be treated
d. open-packed position of the joint to be treated
C
97
The goals of the functional phase include all of the following, except:
a. improvement of patient comfort by decreasing pain and inflammation
b. restore the normal strength and relationship of the muscle force couples
c. improving neuromuscular control
d. restore normal joint kinematics
A
98
The triangular cartilage complex (TFCC) is a fibrocartilage disk between”
a. the lateral proximal row of carpals and distal ulna
b. the medial proximal row of carpals and distal ulna
c. the medial proximal row of carpals distal radius
d. the lateral proximal row of carpals and distal radius
B
99
Which of the following Special Tests would be best to test he ulnar collateral ligament of the 1st MCP joint?
a. Reagan Test
b. Finger Extension Test
c. Gamekeepers Test
d. Watson Test
C
100
Your patient present to PT with knee pain from a plant and twist injury. The pt is especially tender to palpation along the medial joint line, and you want to test the medial meniscus for a possible tear. Which of the following tests would be best to use?
a. McMurrays with ER
b. McMurrays with IR
c. Figure 4 Test
d. Apley’s
A
101
2. Your patient presents to PT after having a Right Achilles Tendon rupture. Surgery was approximately 4 weeks ago. He has been NWB since surgery. After a follow up with the surgeon yesterday, he ambulates into the clinic with bilateral crutches, PWB, and is wearing a Cam Walker boot with heel lift. Which of the following is the best treatment for this patient (after a complete physical examination)?
a. Muscle strengthening for PF and DF
b. Full weight bearing gait with no assistive devices
c. Joint mobilizations to the ankle/foot
d. AROM in all four planes of motion
C
102
An increase in the inclination angle, causing the femoral head to be directed more superiorly in the acetabulum is commonly called:
a. Retroversion
b. Coxa Vara
c. Coxa Valga
d. Anteversion
C
103
4. Which of the following is the best exercise to correct a muscle dysfunction in a patient that displays a Trendelenburg gait pattern?
a. Wall squats
b. Bridging with SLR
c. Wall squats with resisted abduction
d. Bridging with resisted Adduction
D
104
5. Your 55 year old patient presents with R hip pain and corresponding gait dysfunction. He reports pain with transitions and when squatting for his job. During your examination and special testing, you determine the patient has Femoral Anterior Glide Syndrome. Which is the best manual therapy technique to perform on the hip joint?
a. Posterior Glide
b. Distraction
c. Anterior Glide
d. Inferior Glide
A
105
6. Your patient presents with R knee pain after a nasty fall snow skiing. You decide to test the ACL and PCL on this patient. Which of the following special tests is the best to use for PCL testing?
a. Anterior Drawer Test
b. Apleys Compression Test
c. Posterior Drawer Test
d. Lachmans Test
C
106
7. You are examining a patient following TKR. The patient asks you about the benefits of a continuous passive motion machine. All of the following are reported benefits of a CPM, except:
a. Prevention of muscle atrophy
b. Increase in vascular dynamics
c. Decrease in pain
d. Increase in ROM
A
107
8. You are mobilizing a patients shoulder using a large amplitude movement occurring from near the beginning of available range to near the end of available range. What grade mobilization, according to Maitland, is being performed?
a. Grade I
b. Grade II
c. Grade III
d. Grade IV
B
108
9. A 25 y/o female presents with left ankle pain after twisting her ankle. The ankle present with edema, ecchymosis, but you desire to test the lateral collateral ligaments. Which is the best lateral gapping test to test for ligament injury?
a. Fibula Translation Test
b. Kleiger Test
c. Calcaneous Tilt Test
d. Posterior Drawer Test
C
109
10. Your patient presents to therapy with R knee pain after playing soccer last weekend in a men’s league. He states he heard a pop and has trouble walking with good balance. You test the ACL with the Lachman’s test, and determine there is approximately 8mm translation of the tibia on the femur. Which of the following categories does the patient fit into with regard to the grading of this suspected ACL tear?
a. Grade 2+
b. Grade 3+
c. Grade 4+
d. Grade 5+
A
110
Your 45 y/o post-surgical ACL reconstruction patient presents to PT with leg pain and redness/swelling. This is a recent development. Which is the most appropriate test to proceed with at this time?
a. Homans Sign
b. Ober Test
c. Thompson Test
d. Morton’s Test
A
111
12. You are performing a Tinel’s test on a patient whom reports numbness and tingling into the R foot. Which of the following statements is correct regarding the Tinel’s Sign.
a. The clinician is testing the deep peroneal nerve
b. The clinician taps the patients ankle 2cm above the medial malleolus
c. The clinician taps the patients ankle 2cm above the lateral malleolus
d. The clinician is testing the Posterior Tibial nerve
D
112
Your patient presents with R gluteal pain and pain radiating down into the R LE. You desire to differentiate whether the pain is coming from the back or the piriformis. Which is the best test to determine if the patient has piriformis syndrome?
a. FAIR test
b. Flexion-Adduction Test
c. FABER Test
d. Ely’s Test
A
113
You are providing pt education to a 68 y/o male who had a R THA approximately 24 hours ago. You noted, from the patients chart, that the surgeon used a posterolateral approach. Which precaution would you NOT stress to the patient?
a. Avoid hip abduction
b. Avoid hip flexion beyond 90°
c. Avoid hip IR beyond neutral (with flexed hip)
d. Avoid hip adduction
A
114
To test for maximal passive tibiofemoral IR and ER the knee should be placed in:
a. Full extension
b. 35° flexion
c. 60° flexion
d. 90° flexion
D
115
During your examination of an athlete, you notice that the patient could not fully dorsiflex his R ankle while the R knee was extended. When ankle dorsiflexion is tested with the knee flexed, the ROM remains the same. Which structure is implicated in this scenario?
a. Adaptive shortening of the R gastrocnemius
b. Adaptive shortening of the R hamstrings
c. Adaptive shortening of the R soleus
d. Adaptive shortening of the R hip flexors
C
116
You have been asked to give a presentation on hamstring injury prevention to a group of high school athletes. Which of the following would be your most important consideration when contemplating your presentation?
a. Injecting humor into your presentation
b. Assessing the needs of your target audience
c. Using a PPT presentation
d. Typing an outline of your presentation
B
117
You are designing a strengthening program for a pt with weak hip muscles. Each of the following muscles can produce movement of the hip, except:
a. Obturator Internus
b. Rectus Femoris
c. Vastus Medialis
d. Quadratus Femoris
C
118
All of the following are functions of the lateral & medial meniscus, except:
a. Shock absorption
b. Load Transmission
c. Guiding of movements
d. Primary Mechanical stability
D
119
Manual glide of the talus posteriorly within the ankle joint can be used as a manual therapy technique to increase:
a. Talocalcaneal pronation
b. Tibiotalar dorsiflexion motion
c. Talocalcaneal supination
d. Distal tibiofibular joint motion
B
120
You are treating a 35 y/o male pt who is progressing through your rehab program after an Achilles Tendon rupture and subsequent repair. Which of the following best describes the appropriate balance retraining progression in the adult patient?
a. Sitting, quadraped, tall kneeling, standing
b. Quadraped, sitting, tall kneeling, standing
c. Sitting, tall kneeling, quadraped, standing
d. Quadraped, tall kneeling, sitting, standing
A
121
Your patient presents for his first outpatient PT visit after TKR. Which of the following automatic postural response/balance techniques would be most appropriate to implement at his first visit?
a. Weight Shifting strategy
b. Stepping strategy
c. Suspension strategy
d. Hip strategy
A
122
You are seeing a 15 y/o female gymnast in your clinic for L hip pain. You notice, as she walks in for her initial evaluation, that she displays moderate toe-in on the L. You want to test for femoral anteversion/retroversion. Which test is best for this?
a. Patricks Test
b. Scour Test
c. Craig’s Test
d. Flexion-Adduction Test
C
123
Your pt presents for an eval of L knee and calf pain. During your gait assessment, you notice that the patient has a moderate medial longitudinal arch deficit in standing when compared to sitting. Which of the following is the best ankle/foot special test to determine the severity of this deficit?
a. Matles Test
b. Navicular Drop Test
c. Cotton Test
d. Buerger’s Test
B
124
Characteristics of an open-packed position include all of the following, except:
a. Minimal surface congruity
b. Minimal joint surface contact
c. Major ligaments of the joint are on slack
d. Maximal stability of the joint
D
125
All of the following are considered secondary restraints to anterior translation of the tibia on the femur except:
a. Popliteus
b. Hamstrings
c. Patellar Tendon
d. ACL
D
126
A pt cannot extend his leg and has no sensation over the anteromedial aspect of his thigh. Which nerve did he injure?
a. Obturator Nerve
b. Sciatic Nerve
c. Femoral Nerve
d. Lateral Cutaneous Nerve
C
127
Your 69 y/o female patient presents with general hip pain, which is more pronounced with ambulation and activity, and is relieved with rest. Which of the following tests is the best test to begin your examination with?
a. Scour test
b. Craig test
c. Supine Plank test
d. Pelvic Drop test
A
128
Which of the following statements regarding the hip joint is inaccurate?
a. The hip is designed for BW support
b. The hip is suited for stability first, then mobility
c. The hip is the articulation between the acetabulum and the femur
d. The hip is suited for mobility first, then stability
D: hip PowerPoint slide #2
Hip is suited for STABILITY first, then MOBILITY
129
A patient has R leg pain and displays redness and swelling throughout the foot and ankle distal to the knee that has developed over the last 3 days. The patient reports no trauma and complains of a deep ache in the calf musculature. What is the most appropriate initial treatment/course of action?
a. Instruct the patient on ROM exercises and begin a HEP
b. Elevate the LE and apply ice for 15-20 minutes
c. Perform manual soft tissue mobilization to decrease the swelling
d. Refer to physician to rule out DVT
D
130
The acetabulum faces:
a. Lateral, superior, and anterior
b. Lateral, anterior, and posterior
c. Lateral, inferior, and anterior
d. Lateral, superior, and posterior
A
131
Which of the following muscles does not attach to the greater trochanter?
a. Gluteus Medius
b. Obturator Internus
c. Obturator Externus
d. Piriformis
C
132
Which of the following structures has an attachment to the medial meniscus?
a. PCL
b. Deep band of MCL
c. Superficial band of MCL
d. ACL
B
133
The loose-packed position of the hip joint is:
a. 30° flexion, 30° abduction, slight ER
b. 30° flexion, 20° abduction, 20° ER
c. 20° flexion, 30° abduction, 20° ER
d. 30° flexion, 20° abduction, slight ER
A
134
You are treating a 30 y/o male with R hip/groin pain. You perform the modified Thomas Test, with the patient displaying his thigh parallel to the table. At the end of test you apply overpressure into knee flexion with resulting increased hip flexion. What tissue is implicated with this result?
a. Biceps Femoris
b. TFL
c. Iliopsoas
d. Rectus Femoris
D
135
Your pt presents with limited AROM and PROM after an ACL reconstruction. You want to utilize a joint mobilization to increase flexion. Which of the following is the best joint mobilization to use?
a. Proximal tibiofibular joint mobilization
b. Tibiofibular distraction
c. Posterior glide of the tibia on the femur
d. Anterior glide of the tibia on the femur
C
136
You are working through a rehabilitation program with your s/p ankle fracture/ORIF patient, who you have been seeing for approximately 3 weeks. Which of the following is not a functional goal for this rehab program at this time?
a. Improvement of neuromuscular control on uneven terrain
b. Restoration of full, painfree AROM
c. Attaining strength measurements of 4+/5
d. Protection of the injury site
D
137
A young female athlete develops Patellofemoral Pain Syndrome after starting practice for the season. Which combination of static and dynamic postural alignment tests and measures would be of greatest benefit in identifying potential abnormal Patellofemoral joint biomechanics
a. Q angle and step-down test
b. Patella Alta and heel raise
c. Genu recurvatum and SLS
d. Patellar baja and Hop test
A
138
Your pt presents after a L ankle sprain 5 days ago. The ankle is still mildly swollen with ecchymosis. You notice, as she ambulates, that she pushes off the stance leg prematurely during gait. You suspect that may be due to the patients not attaining enough dorsiflexion during the gait cycle. Which of the following is the best manual therapeutic technique to correct this impairment?
a. Posterior glide of the talocrural joint
b. Anterior glide of the talocrural joint
c. Posterior glide of the tibiofibular joint
d. Anterior glide of the tibiofibular joint
A
139
Which of the following facets is commonly injured in chondromalacia patella?
a. Superior facet
b. Odd facet
c. Medial facet
d. Lateral facet
B
140
A pt complains of pain in the R hip while she is ambulating. Upon examination, you notice that the patient has a significant drop of the L hip while in midstance on the R leg. The most appropriate and functional treatment for this impairment would be:
a. Hip flexion of the L leg while standing on the R leg
b. Hip abduction of the R leg while standing on the L leg
c. Hip flexion of the R leg while standing L leg
d. Hip abduction of the L leg while standing on the R leg
D
141
A 22 y/o female presents to the clinic with a chief complaint of knee pain after a twisting injury while playing soccer 5 days ago. The patients knee is swollen significantly and she is unable to jump or run. What special test would be the most appropriate to diagnose her injury?
a. Posterior Drawer test
b. Dial test
c. Varus stress test
d. Lachmans test
D
142
Your pt is performing minisquats to regain full ankle function. In planning this pt’s rehab program, you not that subtalar pronation consists of:
a. Talar DF, ADD, calcaneal eversion
b. Talar PF, ADD, calcaneal eversion
c. Talar PF, ABD, calcaneal eversion
d. Talar DF, ABD, calcaneal eversion
B
143
The medial condyle serves as the insertion site for all of the following, except:
a. Adductor Magnus
b. Medial head of gastrocnemius
c. MCL
d. Popliteus
D
144
A 20 y/o male soccer player presents with a Grade II R knee MCL sprain upon evaluation. What are the characteristics of a Grade II ligament sprain?
a. Joint space feels the same as the normal knee in full extension
b. Joint space opens 3-5mm more than the contralateral side in 20° knee flexion
c. Joint space opens 5-10mm more than that of the normal knee in 20° flexion
d. Joint space opening is within 2mm of the contralateral side
B
145
You wish to perform joint mobilizations on your patients suffering from chronic knee pain. All of the following statements regarding joint mobilizations are correct, except:
a. Grades III and IV have mechanical and neurophysiologic effects which aid in reducing restriction to movement
b. Grade III and IV are commonly used acutely for pain relief
c. The joint mobilization should begin from the resting position
d. Direction of the glide is determined by the convex-concave rule
B
146
Your 27 y/o male football player presents with R knee pain. After examination you determine he is suffering from patellar tendonitis. One of the best treatments for tendon injury is:
a. Low repetition/Low load activities
b. High repetition/Low load activities
c. High repetition/High load activities
d. Low repetition/High load activities
B
147
Your pt injured her L knee during a soccer game last weekend where she planted her L LE, cut R on the field and was hit from her R side rather hard knocking her into the ground. ACL and PCL tests are negative. You want to test her LCL. What is the best test for this?
a. Varus Stress test
b. Apley’s Compression test
c. Valgus Stress test
d. Lachmans test
A
148
Your pt presents with R ankle pain and instability after a fall. What is the best ankle/foot special test to detect distal tibiofibular instability?
a. One-legged Hop Test
b. Point Test
c. Posterior Drawer Test
d. Heel-Thump Test
C
149
An overweight adult pt complains of R anterior hip and knee pain while walking, especially noted when WB on the R. Lumbar AROM is WNL and pain free. R hip AROM and PROM are limited compared to the L. R knee AROM and PROM are WNL and pain free. There is no pain with resisted testing at the R hip or knee. The scouring test reproduces the pt’s hip and knee symptoms. Hip joint distraction relieves these symptoms. Based on the above findings, the most likely diagnosis would be:
a. Piriformis strain
b. Patellofemoral pain syndrome
c. Trochanteric bursitis
d. Hip degenerative joint disease
D
