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PCE > LE MSK By Ptdi > Flashcards

LE MSK By Ptdi Flashcards

1
Q

Modifiable risk factors for knee OA

A

Obesity, High impact activities, Inactivity, Muscle weakness, Trauma, Decreased proprioception, Joint mechanics (may or may not be able to modify)

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2
Q

Attachments of the medial meniscus

A

MCL, ACL, PCL, and semimembranosus muscle

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3
Q

Sarcopenia

A

Age related degenerative loss of muscle mass.

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4
Q

Avulsion fracture

A

A fracture in which a fragment of bone attached to a tendon or ligament gets pulled away from the main mass of the bone

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5
Q

Post-op hip precautions for posterolateral approach THA

A

No hip flexion > 90°, No hip internal rotation beyond neutral, No hip ADDuction beyond neutral

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6
Q

Ottawa ankle rules

A

Guideline to help clinicians decide whether or not a patient should be referred for radiographic imaging

Not used for pts under 18yo

Pain post lateralmaleolo
Pain post medial maleolo
Pain on navicular
Pain on 5 metatarsal
Inability to take 4 steps during initial ax and to WB after injury

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7
Q

Special test for LCL sprain

A

Varus stress test

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8
Q

Which nerve typically passes under the piriformis muscle?

A

Sciatic nerve

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9
Q

Provacative movements for anterior shin splints

A

Resisted dorsiflexion (contracting tibialis anterios) and passive plantarflexion (stretching tibialis anterior)

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10
Q

A large Q-angle (>18°) is associated with…

A

with subluxing patella, genu valgum, patella baja (low
sitting patella), and PFPS

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11
Q

Terrible triad (aka unhappy triad)

A

A sprain injury involving the ACL, MCL, and medial meniscus of the knee

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12
Q

Haglund deformity

A

Bony enlargement or bump of the part of the heel where the achilles tendon inserts

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13
Q

Causes of high ankle sprains

A

Involves traumatic incident, External rotation of the foot,
Hyper-dorsiflexion

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14
Q

Loose packed position of the hip

A

30° flexion, 30° abduction, slight ER

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15
Q

Signs and symptoms of meniscal tears

A

May present with joint line tenderness, joint effusion,
“locking”, clicking noise with movement, reports of knee
“giving way”, loss of ROM, and/or “springy block” end feel.

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16
Q

Muscles in the anterior compartment of the lower leg

A

Extensor hallicus longus, Extensor digitorum communis,
Tibialis anterior, Peroneous tertius

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17
Q

Stress fracture and tto

A

Overuse injury to the bone typically from repetitive loading leading to microdamage

Able to see using bone scan test not x ray.

Tto: gradual progressive loading of the bone.
Intial rest
Avoid aggravating activity
Crutches if required

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18
Q

Test for hamstrings tightness or contracture

A

90/90 Straight Leg Raising Test

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19
Q

Presentation of a grade 1 sprain

A

Minimal swelling and pain. No ligament laxity.

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20
Q

Pain characteristics of compartment syndrome

A

Severe cramping, diffuse pain, tightness

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21
Q

Avascular necrosis

A

Death of bone tissue due to a lack of blood supply

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22
Q

Nerve in the posterior deep compartment of the lower leg

A

Tibial nerve

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23
Q

Signs and symptoms of PFPS

A

Anterior knee pain (worse with kneeling, squatting, running, jumping, stairs, prolonged sitting, loaded knee flexion/extension),

Crepitus,
Swelling, ‘

“Buckling or Giving way”,
and Tenderness

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24
Q

Hemarthrosis

A

Bleeding in a joint

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25
Q

Provacative movements for posterior shin splints

A

Active supination (contracting tibialis posterior) and

passive dorsiflexion + eversion (stretching tibialis

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26
Q

Interventions to decrease pain for client with hip OA

A

Grade I or II oscillation techniques with the joint in resting position

Provide assistive devise during ambulation, If LLD is causing joint stress gradually elevate short leg with shoe lifts

Modify chairs and commodes to make sitting and standing up easier

Modalities (e.g., TENS, heat, etc.)

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27
Q

Special test for achiles rupture

A

Thompson’s Test

Test: pt prone, squeeze the calf. Normal response: ankle goes to PF
Se nao tiver eh ruptura

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28
Q

Plica

A

A fold of synovial membrane

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29
Q

Tarsal Tunnel Syndrome

A

Compression of the posterior tibial nerve through the tarsal tunnel

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30
Q

Period of morning stiffness with knee OA

A

Less than 30 minutes

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31
Q

Hammer Toe

A

Extension of MT and flexion of PIP (occurs in D2-D4)

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32
Q

Order of ankle ligament injury during plantarflexion + inversion

A

ATFL- >CFL-> PTEL

Atfl: anterior talofibular
Cfl: calcaneofibular
Ptel: posterior talofibular

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33
Q

Causes of Osgood-Schlatter Disease (OSD)

A

Repeated tension(irritation )on growth plate of upper tibia,

Growth spurt,

Increase incidence in sports that involve running and jumping (quadriceps contraction)

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34
Q

Windlass test procedure

A

The patient stands with their metatarsal heads resting on the edge of a surface (e.g., foot stool) while maintaining their weight through the leg.

The therapist passively dorsiflexes the big toe.

Pain on the plantar fascia or insertion of the plantar fascia is a positive test for plantar fasciitis.

Lack of extension could be hallux rigidus.

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35
Q

Early post-operative complications of THA

A

Deep Vein Thrombosis, Infection, Wound healing problems,
Pneumonia, Dislocation of the prosthetic joint

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36
Q

Turf Toe

A

Sprain of 1st MT due to hyperextension injury combined with compression loading

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37
Q

Special Tests for PFPS

A

Clarke’s Sign (Patellar Grind Test), McConnel Test
Step-Up Test
Eccentric step test (Step-Down test)

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38
Q

Claw Toe

A

Hyperextension of the MTP and flexion of the PIP and DIP

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39
Q

Pain as a result of hip OA and hip fractures is commonly felt in which area?

A

Groin

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40
Q

Intrinsic risk factors for PFPS

A

Abnormal tracking patella which may be caused by Increased Q-angle,

Muscle and fascial tightness,

Hip muscle weakness,

VMO insufficiency,

Lax medial retinaculum

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41
Q

Signs and Symptoms of Iliotibial Band Friction Syndrome

A

Lateral knee pain above joint line

, Increased pain with repetitive knee flexion/extension activities (e.g. walking, running, cycling, stairs, downhill running),

Pain decreases with rest

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42
Q

Nerve(s) in the anterior compartment of the lower leg

A

Deep peroneal nerve

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43
Q

Legg-Calvé-Perthes Disease

A

A childhood hip disorder resulting from vascular necrosis of the femoral head (which overtime can lead to a loss of bone mass, a weak femoral head, and/or deformity of the femoral head which can sometimes cause deformities in the acetabulum)

44
Q

Muscles in the posterior superficial compartment of the lower leg

A

Gastrocnemius, Soleus, Plantaris

45
Q

Special tests for meniscal tears

A

McMurray’s Test,

Apley’s Test,

Thessaly Test, “

Bounce Home” Test

46
Q

Risk factors for developmental dysplasia of the hip (DDH)

A

Family history, First born, Gender (F> M), Breech birth,
Narrow uterus, Certain swaddling position

47
Q

Special test for patellar dislocation/instability

A

Fairbank’s Apprehension Test

Lateral glide of patela. Pt vai ficar com medo

48
Q

Tibial movements restrained by the ACL

A

Anterior tibial translation, medial tibial rotation, tibial valgus/varus (secondary)

49
Q

Muscles in the lateral compartment of the lower leg

A

Peroneous brevis, Peroneous longus

50
Q

Pavlik harness

A

A brace commonly used for infants with hip dysplasia which places the hips in flexion and abduction to promote acetabular development and prevent dislocating positions

Used for 24hrs and US to re ax in 2-3weeks

51
Q

Signs and symptoms of plantar fasciitis

A

Insidious onset

Worse in the morning and may decrease with activity,

Increased pain when activity is recommenced after period of inactivity

, Tenderness on medial calcaneal tubercle which may extend into medial longitudinal arch,

May present with antalgic gait

52
Q

Hallux valgus

A

Great toe deviates towards center of the foot (MT head deviates medial)

53
Q

Autografts used for ACL reconstruction

A

Gracilis + Semitendinosus (Hamstring) graft, Patellar
tendon graft

54
Q

Mechanism of injury for PCL tear

A

Posterior translation of the tibia on the femur (typically knee in flexion), “

Dash-board” injury,
Falling on flexed knee,

Sudden forceful hyperflexion or hyperextension (hyperextension is not as common)

55
Q

Primary muscles involved in Trendelenburg gait

A

Gluteus medius and gluteus minimus muscles

56
Q

Signs and symptoms of hemarthrosis

A

Excessive bruising, swelling, warmth, and ROM limitations

57
Q

Risk factors for Slipped Capital Femoral Epiphysis (SCFE)

A

Obesity, Family history, Endocrine disorders

58
Q

Interventions for patellar tendinosis

A

Manage pain, Manage swelling (if present), Patellar tendon strap (jumper’s knee brace), Avoid overloading quadriceps,
Eccentric quad contraction
Progressive loading -> Return to activity

59
Q

Special test for MCL sprain

A

Valgus stress test

The examiner places one hand at the outside of the knee, acting as a pivot point, while the other hand is placed at the foot. The medial joint line is palpated while the examiner simultaneously applies an abducting force at the the foot, and a valgus force through the knee joint.

This test is typically performed at both 30 and 0 degrees of knee flexion.

Positive findings may include excessive gapping at the medial joint and/or pain, indicating MCL damage. This may also indicate capsular or cruciate ligament laxity, depending on what degree of knee flexion the test is performed at.

60
Q

Muscles in the posterior deep compartment of the lower leg

A

Tibialis posterior, Flexor hallicus longus, Flexor digitorum longus, Popliteus

61
Q

Signs of Development dysplasia of the hip (DDH)

A

Asymmetry(if unilateral ddh)
Hip abduction limitation
Hip clicks

62
Q

Tibial movements restrained by the PCL

A

Posterior tibial translation, medial tibial rotation, tibial valgus/varus (secondary)

63
Q

Petrie cast

A

A bilateral long-leg casts with a fixes bar that holds the legs in abduction (looks like the letter A).

Commonly used in conservative management of children with Legg-Calvé-Perthes Disease( necrose a vascular da femoral head)

64
Q

Differential diagnosis for plantar fasciitis

A

Fat pad contusion (pad under the heel), Calcaneal stress fractures, Lateral plantar nerve entrapment

65
Q

Baker’s cyst and tto

A

Excess fluid collection behind the knee (in the popliteal fossa)

Tto: manage inflammation and pain
Compression sleeve for pain

66
Q

Splint used for early immobilization following reduction of patella post-dislocation

A

Zimmer knee splint

67
Q

Nerve(s) in the lateral compartment of the lower leg

A

Superficial peroneal nerve

68
Q

Contraindicated interventions in the management of
Myositis Ossificans

Tto

A

Massage, passive stretching, and resistive exercise.

Tto: gentle prom,arom,aaron,iso exercises gently

69
Q

Special tests for ACL tear

A

Anterior Drawer Test ( knee at 90d +pull tibia anterior)

Lachman’s Test (knee is extended) it tests the posterolateral band of the acl)

Pivot-shift Test (The patient lies supine with legs relaxed. The examiner grasps the heel of the involved leg with examiners opposite hand placed laterally on the proximal tibia just distal to the knee. The examiner then applies a valgus stress and an axial load while internally rotating the tibia as the knee is moved into flexion from a fully extended position[6]. A positive test is indicated by subluxation of the tibia while the femur rotates externally followed by a reduction of the tibia at 30-40 degrees of flexion.)

70
Q

Intervensions for Osgood-Schlater Disease (OSD)

A

Manage pain,
Manage swelling,
Decrease parameters of aggravating activity (e.g., ., frequency, intensity, duration),
Patellar tendon strap (jumper’s knee brace)
Stretch quads
Hamstring flexibility

71
Q

Self-limiting disease

A

A disease that tends to resolve on its own (even without treatment)

72
Q

Presentation of a grade 2 sprain

A

Moderate swelling, ecchymosis, and pain. Increased ligament laxity, but with firm end feel.

73
Q

Special test (s) to assess for tight hip flexors

A

Ely’s Test (The patient lies prone in a relaxed state. The therapist is standing next to the patient, at the side of the leg that will be tested. One hand should be on the lower back, the other holding the leg at the heel. Passively flex the knee in a rapid fashion. The heel should touch the buttocks. Test both sides for comparison. The test is positive when the heel cannot touch the buttocks, the hip of the tested side rises up from the table, the patient feels pain or tingling in the back or legs.)

Thomas test (pc deita segurando uma perna flex pelo joelho e a outra perna tem q descer)

modified thomas test

74
Q

Sensory impairments) seen in anterior compartment syndrome of lower leg

A

Sensory impairment in webbing between the 1st and 2nd digits of the foot

75
Q

What position would u put the ankle to stress the sural nerve?

A

Sid
Inversion +DF

Nervo eh posterior e na parte lateral

76
Q

A 28 year old male referred to physical therapy by his primary physician complains of recurrent ankle pain. As part of the treatment program the therapist uses ultrasound over the peroneus longus and brevis tendons. The most appropriate location for ultrasound application is

А.inferior to the sustentaculum tali
В.over the sinus tarsi
C.posterior to the lateral malleolus
D. anterior to the lateral malleolus

A

C

77
Q

A therapist observes a patient with an above knee prosthesis during ambulation activities.
The therapist notes that the patient tends to circumduct the involved lower extremity during ambulation. Which of the following is an anatomic cause for this type of gait deviation?
A. abduction contracture
B. hip flexin contracture
C.short amputation limb
D. weak hip extensors

A

A

78
Q

A therapist reviews the surgical report of a patient that sustained extensive burns in a fire. The report indicates that at the time of primary excision cadaver skin was utilized to close the wound. This type of graft is termed a/an ?

A.allograft
B.autograft
C.heterograft
D.xenograft

A

A

autograft (self)
isograft (identical twin)
allograft (another human except
identical twin)
xenograft (one species to another)

79
Q

What is a positive squeeze test and why it is performed?

A

Squeeze the let just below the knee to comprime a tibia e a fibula.

Positive: se tiver pain irradiada pra area do ankle.

Confirma HIGH ANKLE SPRAIN

Outro test p confirmar eh: EXT rot stress test

80
Q

Which of the following movements would you expect to be most painful for a high ankle sprain?

a) Dorsiflexion and external rotation of the ankle

b) Dorsiflexion and internal rotation of the ankle

c) Plantarflexion and external rotation of the ankle

d) Plantarflexion and internal rotation of the ankle

A

A

81
Q

What is the name of the ligament that connects the medial and lateral menisci to each other?

a) Medial Collateral Ligament
b) Coronoid ligament
c) Coronary ligament
d) Transverse ligament

A

D

82
Q

Which of the following is a risk factor for developing patellofemoral pain syndrome?

a) Femoral anteversion
b) Genu varus
c) Genu recurvatum
d) Inactivity

A

A

Causando lateral pull of the patella

83
Q

Which of the following would you expect the patient with PFPS to have the most knee pain with?

a) Prolonged standing
b) Prolonged sitting
c) Prolonged walking
d) Prolonged periods lying in supine

A

B

Movie theater sign: pain in front of the knee.

84
Q

The physiotherapist develops a plan of care which involves stretching and strengthening for a pt with PFPS. Which of the following is the most appropriate plan of care for this patient?

a) Stretching of the left vastus medialis oblique muscle, and medial retinaculum.
Strengthening of left gluteus medius muscle

b) Stretching of the left tensor fasciae latae muscle, left iliotibial band, and left lateral retinaculum. Strengthening of the left vastus medialis oblique muscle and left gluteus medius muscle

c) Stretching of the left gluteus medius muscle, left iliotibial band, and left lateral retinaculum. Strengthening of the left vastus medialis oblique, and tensor fasciae latae muscle

d) Stretching of the left vastus lateralis muscle, left iliotibial band. Strengthening of the left gluteus maximus, and left semimembranosus and semitendinosus muscles

A

B
No PFPS there is a lateral pull of the patela

85
Q

The physiotherapist performs a second special test to confirm the diagnosis of right knee meniscus tear. The physiotherapist performs McMurray’s test and notices the patient winces in pain as the physiotherapist external rotates the patient’s knee while the patient’s knee is in deep flexion. Based on the findings of this special test where do you believe the patient has torn his meniscus?

a) Posterior aspect of the medial meniscus
b) Posterior aspect of the lateral meniscus

c)Anterior aspect of the medial meniscus
d) Anterior aspect of the lateral meniscus

A

A
Deep flexion :injury POSTERIOR side of meniscus

86
Q

A. Lateral Ankle
B. Syndesmosis
C. Medial Ankle

  1. External rotation of the ankle or excessive dorsiflexion and external rotation of the leg on a foot when it’s planted.
  2. Inversion and plantar flexion
  3. Gradual degeneration of ligaments or valgus force to leg creating eversion or an awkward fall resulting in excessive pronation or eversion of foot
A
  1. B
  2. A
  3. C
87
Q
  1. Injury causing separation of the base of the 1st and 2nd metatarsal leading to forefoot instability
  2. Fracture on the base of the fifth metatarsal, often caused by excessive inversion to the foot
  3. Proximal fibular fracture that occurs with avulsion fracture of the medial malleolus and rupture of the deltoid ligament.

Lisfranc injury/ Jones fracture /Maisonneuve Fracture

A
  1. Lisfranc injury
  2. Jones fracture (think JONES - 5 letters, 5th metatarsal)
  3. Maisonneuve Fracture
88
Q

A patient has just undergone an isolated posterior cruciate ligament reconstruction. Which of the following is the MOST correct description of the primary function of the posterior cruciate ligament?

  1. Restrains posterior translation of the tibia
  2. Restrains anterior translation of the tibia
  3. Restrains valgus forces on the knee joint
  4. Restrains varus forces on the knee joint
A

1

  1. This is the correct answer. The PCL restrains posterior translation and external rotation of the tibia.
  2. This is the function of the ACL.
  3. This is the function of the MCL.
  4. This is the function of the LCL.
89
Q

A physical therapist is treating a patient who has undergone an arthroscopic medial meniscus repair two weeks ago. Which of the following is the MOST important consideration during rehabilitation?

  1. Avoid full extension of the knee
  2. Avoid full flexion of the knee
  3. Encourage full weight bearing
  4. Encourage gastrocnemius strength
A

2

  1. This is incorrect because achieving full extension soon after surgery is critical to long term outcomes.
  2. This is the correct answer. Deep knee flexion will shift the menisci posteriorly and will disturb the repair site. Most protocols call for limited weight bearing and flexion for about 6-10 weeks.
  3. Most protocols limit weight bearing at this stage.
  4. This would not be the MOST important consideration.
90
Q

A patient is being evaluated by a physical therapist for a possible sprain of the anterior talofibular ligament. Which of the following special tests will BEST confirm this diagnosis?

  1. Talar tilt test
  2. Anterior drawer test
  3. Ottowa 2-step test
  4. Thompson Test
A

2

  1. This will indicate a torn calcaneofibular ligament.
  2. This is the correct answer.
  3. This ill rule out fracture and is used as a common screening.
  4. This is a test for Achilles tendon rupture.
91
Q

What arch provides primary support to the foot?
a. Spring ligament
b. Long plantar ligament
c. Plantar aponeurosis
d. Short plantar ligament

A

A

92
Q

During push-off in gait, as the foot plantarflexes and supinates and the metatarsophalangeal joints go into extension, increased tension is placed on the plantar aponeurosis which helps increase the arch. What is this called?

a. Windlass mechanism
b. Secondary plantar mechanism
c. Pes cavus
d. None of the above

A

A

93
Q
  1. You have been working with Debbie Johnson for 6 weeks and determine she is ready to return to running as she has reached the appropriate strength and range of motion requirements to progress to this stage. What range of motion is required for dorsiflexion and plantar flexion, respectively, in order to have a normal gait cycle?

a. 5 degrees; 5 degrees
b. 5 degrees; 10 degrees
c. 10 degrees; 15 degrees
d. 10 degrees; 20 degrees

A

D

94
Q

Judy Springer is a 25-year-old competitive long distance runner. She has weakness and pain from the back of her knee to the back of her heel. The pain started after she increased her training 1 month ago. Judy went from running 10-15km 3x a week, to running 15-20km 5x a week.

After performing special tests on Judy’s knee, you determine there to be meniscus involvement on the medial side. Which statement correctly defines a positive McMurray test for Judy?

a. With the patient in the prone position, the knee is flexed to 90 degrees. The patient’s thigh is anchored to the examining table. The examiner then medially and laterally rotated the knee combined with compression.

b. With the patient lying supine, the knee is flexed and the tibia is rotated laterally. The knee is slowly moved into extension with a varus force applied to the knee. The exam is then repeated with the knee flexed and the tibia medially rotated while moving towards extension with a valgus force applied to the knee.

c. With the patient lying supine, the knee is flexed and the tibia is rotated laterally. The knee is slowly moved into extension with a valgus force applied to the knee. The exam is then repeated with the knee flexed and the tibia medially rotated while moving towards extension with a varus force applied to the knee.

d. The patient lies in the supine position with the heel of the patient’s foot cupped in the hands of the therapist. The patient’s knee is completely flexed and the knee is passively allowed to extend.

A

C

95
Q

Judy goes to your clinic after undergoing articular cartilage repair. You begin rehabilitation on her knee 2 weeks postoperatively. Which of the following statements are false regarding precautions for rehabilitation after articular cartilage repair?

a. The larger the lesion, the slower/more cautious the progression of rehabilitation should be.
b. Protective bracing may be used postoperatively where the knee is typically locked in 30-40 degrees of flexion.

c. Range of motion should be started immediately.

d. Protected weight bearing should be initiated as early as possible.

A

B

96
Q

During your sessions, Judy complains of numbness along the medial side of her knee and leg.
You refer her back to her surgeon. He notifies you that the surgery has caused a disruption to a sensory nerve. She will likely return to normal within 1 year of surgery. Which nerve is likely causing this dysfunction?

a. Common Peroneal nerve
b. Sural nerve
c. Saphenous nerve
d. Medial cutaneous nerve of the thigh

A

C

Common Peroneal nerve - Incorrect
Becomes superficial where it winds around the fibula just below the fibular head, a common site for injury. It branches just distal to the head of the fibula into superficial and deep branches. Symptoms of sensory loss are distal to that site in the anterolateral leg and dorsum of foot.

• Sural Nerve - Incorrect. Sensory to the posterolateral aspect of the distal third of the leg. Also gives off sensory branches to the lateral aspect of the foot, heel and ankle.

• Saphenous nerve - Correct
Sensory nerve that innervates the skin along the medial side of the knee and leg. It may be injured with trauma or surgery in the region.

• Medial cutaneous nerve of the thigh - Incorrect. This is a cutaneous nerve that branches off the femoral nerve and supplies
sensation to the medial aspect of the thigh and does not provide sensation to the lower leg.

97
Q

You suspect that the patient has Myositis Ossificans. Your student asks what the difference is between myositis ossificans (MO) and heterotopic ossificans (HO). How should you respond?

A.The terms are used interchangeably to describe the formation of bone in atypical locations of the body.

b. MO only occurs proximal in the body whereas HO occurs distally.

c. HO is used specifically to describe bone formation in the thigh.

d. HO is used to describe MO in the spinal cord population.

A

A

The terms are used interchangeably to describe the formation of bone in atypical locations of the body. - Correct

98
Q

Which of the following treatment options is recommended when working with a patient with myositis ossificans?

a. Massage
b. Passive stretching
C.Resistive exercises
D.Rest the area

A

D

99
Q

After working with a patient twice a week for 2 weeks, you assess his non weight bearing ankle dorsiflexion range of motion to see if he is within normal limits. Which measurement would be considered within normal limits at this stage of healing?

a. 0-17 degrees of dorsiflexion
b. 0-8 degrees of dorsiflexion
c. 0-3 degrees of dorsiflexion
d. 0 degrees dorsiflexion

A

A

• According to Magee, non-weight bearing ankle active dorsiflexion is 20 degrees. Given that the injury is only grade 1, you would expect near to full dorsiflexion by 2 weeks post injury.

100
Q

After several session you suspect your pt has a partial tear in his flexor digitorum brevis muscle. In order to accurately assess the strength of the muscle through manual muscle testing, the therapist should apply pressure against what structure?

a. Plantar surface of the distal phalanx of the lateral four toes in the direction of flexion.
b. Dorsal surface of the middle phalanx of the lateral four toes in the direction of extension.
c. Plantar surface of the middle phalanx of the lateral four toes in the direction of flexion.
d. Dorsal surface of the distal phalanx of the lateral four toes in the direction of extension.

A

C

Plantar surface of the middle phalanx of the lateral four toes in the direction of flexion

101
Q

During the stance phase of gait, which of the following muscles provide the most stability during single leg support?

a. Hip flexors.
b. Ankle dorsiflexors.
c. Knee extensors.
d. Hip abductors.

A

D

102
Q

Upon examining the 8-year-old’s gait pattern, you observe circumduction of the swinging limb. Which of the following would most likely cause weak hip flexors?

a. L1 nerve compression
b. L2 nerve compression
c. L3 nerve compression
d. L4 nerve compression

A

B

103
Q

You are a physical therapist completing a lower leg examination on a new patient. During your examination you complete a series of resisted isometric tests.

During resisted testing of the gastrocnemius muscle, the patient indicates that he begins to experience a cramp like discomfort. What is the most likely explanation for this discomfort?

a. Complete tendon rupture
b. Capsular laxity
c. Intermittent claudication
d. Emotional hypersensitivity.

A

C

104
Q

In the proximal hip joint, you discover that there is a limitation in range of motion. You perform a mobilization technique that involves a large amplitude oscillation that does not reach the end of available range. This description is most representative of what grade of mobilization?

a. Grade I
b. Grade II
c. Grade III
d. Grade iv

A

B

GRADES OF MOBILIZATION (Maitland)

I:Small amplitude out of resistance

II:Large ampitude out of resistance

III:Large amplitude into resistance

IV:Small amplitude into resistance

V:High velocity thrust

105
Q

A second year track student who is attending a local university is seeing you for leg pain. He is 19 years old and is training 5 times a week for 2 hours or more. Training involves long distance running, sprint interval training, plyometric exercises and cross training in the pool.

Palpation reveals tenderness over the lateral aspect of the knee with paresthesia in the same region. Compression of which nerve would most likely create these symptoms?

a. Superficial peroneal nerve
b. Common peroneal nerve
c. Deep peroneal nerve
d. Superficial lateral vehicular nerve

A

B

Keep in mind, the peroneal nerve is synonymous with fibular nerve.

• Superficial peroneal nerve: Innervates the skin over the anterolateral leg and the dorsum of the foot (except the skin between the first and second toes).

• Common peroneal nerve - Correct
Innervates the skin over the lateral aspect of the khee.

• Deep peroneal nerve: Innervates the skin between the first and second toes.

• Superficial lateral genicular nerve:This nerve does not exist - the artery does.

106
Q

Your coworker determines that the patient’s has illiotibial band syndrome due to shortened posterolateral fibers of the tensor fascia latae/illiotibial band. Which of the following is the most appropriate treatment?

a. Prescribe a stretch that involve crossing the legs and places the hip joint in medial rotation.

b. Prescribe a stretch that involves swaying laterally, with the hip medially rotated.

C. Improve muscle performance of the underused synergists coupled with education regarding postural habits.

d. Prescribe an assisted ober stretch, with the hip in extension, lateral rotation and adduction without lateral pelvic tilt.

A

C

• Prescribe a stretch that involve crossing the legs and places the hip joint in medial rotation Not the best answer

• Prescribe a stretch that involves swaying laterally, with the hip medially rotated.
Not the best answer. This stretch targets the gluteus medius and lateral capsule more than just the TFL and ITB

• Improve muscle performance of the underused synergists coupled with education regarding postural habits. - Best Answer
Education regarding postural habits and neuromuscular training of the new movement patterns are essential to restoring length to the ITB on a more permanent basis.

• Prescribe an assisted ober stretch, with the hip in extension, lateral rotation and adduction without lateral pelvic tilt.
Not the best answer. This is difficult to perform without assistance.

107
Q

During an initial assessment, the physiotherapist is assessing the gait pattern of their patient post anterior tibiofibular ligament. You notice they are experiencing early push off in stance phase.
Which of the following is false regarding the ranges required during the stance phase of gait.

a. Knee joint: requires a maximum of 60 degrees of flexion
b. 1st MTP joint: requires a maximum of 70 degrees of extension
c. Hip joint: requires a maximum of 30 degrees of hip flexion
d. Ankle joint: requires a maximum of 20 degrees of plantar flexion

A

A
Only require up to 40 degrees of knee flexion in terminal stance. Up to 60 degrees is required for midswing.

PCE (40 decks)

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