Msk General

Question 1

Excessive upward rotation of the right scapula is noted when a patient attempts to perform shoulder flexion. Which of the following exercises is MOST appropriate to help correct the excessive scapular rotation?

1. Right scapular protraction against resistance with the right arm at
   90° of flexion
2. Bilateral scapular elevation with the upper extremities at 180° of fexion
3. Wall push-ups with an isometric hold at end range with the elbows extended
4. Bilateral scapular adduction with the upper extremities medially (internally) rotated and adducted across the back

Answer 1

4

Excessive upward rotation of the scapula can result from weakness of the rhomboids and latissimus dorsi (downward rotators). The scapular adduction with medial rotation and adduction of the arm would require action by those muscles.

Option 1 would help strengthen the serratus anterior, an upward rotator of the scapula.
Option 2 would activate the upper trapezius as well as the rhomboids and since the upper trapezius is also an upward rotator of the scapula, this would not be the best exercise to use. Option 3 would also help strengthen the serratus anterior, which would tend to aggravate the problem.

Question 2

A patient reports pain lateral to the coracoid process. When palpating the shoulder to assess the possible cause of the pain, starting at the coracoid process and moving laterally, the physical therapist should expect to find the following sequence of structures:

1. lesser tuberosity, biceps tendon, and greater tuberosily.
2. greater tuberosity, biceps tendon, and lesser tuberosity.
3. lesser tuberosity, coracobrachialis tendon, and greater tuberosity, 0 4. greater tuberosity, coracobrachialis tendon, and lesser tuberosity.

Answer 2

1

Question 3

A physical therapist is treating a patient for limitation of motion following knee surgery several weeks ago. The patient’s passive knee extension is lacking 15° from full extension, and knee flexion is limited to 95°. Both movements have a capsular end-feel. Which of the following mobilization techniques is MOST appropriate for increasing knee flexion?

1. Anterior glide of the tibia on the femur
2. Posterior glide of the tibia on the femur
3. Superior glide of the patella
4. Posterior glide of the femur on the tibia

Answer 3

2

During normal knee extension, the tibia moves posterior relative to the femur. Therefore, posterior gliding of the tibia would promote knee flexion. Superior glide of the patella could be used to increase knee extension. Posterior glide of the femur on the tibia would be used to increase knee extension.

Question 4

A patient sustained a Colles’ fracture 8 weeks ago and has been in a cast since that time. Immediately after cast removal, it is MOST appropriate for the physical therapy intervention for the wrist and hand to include:

1. passive and active assistive range of motion exercises.
2. progressive resistive exercises.
3. grade 4 joint mobilization techniques. 4, return to prefracture level of activity.

Answer 4

1

The primary physical therapy goal at this time is to restore range of motion. Therefore, the most appropriate intervention for that goal is passive and active assistive ROM exercises. Although gentle joint mobilization techniques may be indicated, grade 4 techniques at this time would not be. Progressive resistive exercises would come later in the plan of care. Although the long term goal would be to return to normal activities, the short-term goal would not.

Question 5

During examination of the jaw-opening pattern of a patient with a temporomandibular joint problem, the therapist notes early protrusion of the mandible. Which of the following mandibular movements MOST likely causes the protrusion?

1. Condylar translation
2. Mandibular depression
3. Condylar rotation
4. Lateral glide

Answer 5

1

The protrusion component involves the arthrokinematic movement of anterior condylar translation.
Mandibular depression (jaw opening) involves both condylar rotation and anterior translation.

However, this question is asking only about the protrusioncomponent. Lateral glide involves anterior translation on the contralateral side and spin on the ipsilateral side.

Question 6

A patient is being examined for medial epicondylitis. With this diagnosis, the physical therapist should expect to MOST likely find pain over the:
1. origin of the flexor digitorum profundus with resisted finger flexion.
2. origin of the pronator teres muscle with active pronation.
3. medial epicondyle with passive wrist flexion.
4. insertion of the the triceps brachii with passive elbow extension.

Answer 6

2

The lesion is most likely a tendinitis involving a muscle or muscles that originate from the medial epicondyle of the humerus (i.E., pronator teres, palmaris longus, flexor carpi radialis and ulnaris, and flexor digitorum superficialis). Pain would be elicited with active contraction of the involved muscle (or muscles) or when the muscle(s) is/are passively stretched. Resisted wrist flexion and pronation would cause pain over the origin of the pronator teres.
Options 1, 3 and 4 do not meet the criteria for eliciting pain.

FDP: nao insere no med epicondilo
Passive w flex: lateral epicondilite

Question 7

In treating a patient who has had recurrent anterior shoulder dislocation, the physical therapist should AVOID which of the
following extreme shoulder motions?

1. Adduction and lateral (external) rotation
2. Abduction and lateral (external) rotation
3. Hyperextension and medial (internal) rotation
4. Abduction and medial (internal) rotation

Answer 7

2

Question 8

During the examination of a patient with carpal tunnel syndrome, the physical therapist is MOST likely to find:

1. paresthesia of the medial palmar surface of the hand.
2. weakness of finger extension of the lateral 3 digits.
3. paresthesia of the lateral 3 digits.
4. weakness in wrist flexion and unar deviation.

Answer 8

3

lu carpal unnel syndrome there is pain and paresthesias in the nedian nerve distribution of the hand, which includes the lateral three digits. There is weakness of the abductor pollicis brevis, but not of the wrist fexors or finger extensols.

Question 9

The MOST appropriate therapeutic exercise to stretch the neck muscles for a patient with an acute, right-sided torticollis is:

1. right rotation and right lateral flexion.
2. left rotation and right lateral flexion.
3. left rotation and left lateral flexion.
4. right rotation and left lateral flexion.

Answer 9

4

Question 10

The result of which of the following nerve tension tests is MOST likely to be positive for a waiter who has hand pain when carrying trays overhead?
1. Ulnar
2. Median
3. Radial
4. Musculocutaneo

Answer 10

1

The overhead positioning of carrying food trays is similar to the end position of the ulnar nerve tension test. The test for the ulnar nerve includes shoulder depression, abduction and external rotation, elbow
78
I
Nexion, forearm pronation or supination, and wrist and linger extension. The median nerve tension test employs elbow extension, but the position of the waiter is with elbow flexion. The radial nerve test is low by the side, not reaching overhead. The musculocutaneous nerve does not innervate the hand.

Question 11

A patient describes bilateral posterior lower leg aching that resolves with sitting and is exacerbated by walking, especially down hills. What diagnosis is MOST likely responsible for this pain?

1. Lateral spinal stenosis
2. Central disc herniation
3. Bilateral piriformis syndrome
4. Neoplastic spinal lesion

Answer 11

1

Neurogenic claudication may be unilateral or bilateral. This scenario is bilateral. The diagnosis of lateral spinal stenosis is supported because extension increases neurological signs and flexion decreases neurological signs, regardless of weight-bearing factors. Walking down hills is worse for the patient, because the extension of the lumbar spine is greater. Disc derangements tend to be worse with flexion (sitting) and better with walking, and are rarely bilateral.
Piriformis syndrome, although when prosent can result in sciatic pain, is rarely bilateral. Also, walking uphill would probably be more difficult than downhill for an irritated piriformis. Nothing in the question indicates ncoplasm. The sconario seems to indicate a musculoskeletal problem, since the pain changes with position.

Question 12

A patient, who is a tennis player, has been receiving physical therapy intervention following an anterior capsular reconstruction of the dominant shoulder. The physical therapist determines that the patient is ready to begin dynamic stabilization exercises. Which of the following is an appropriate dynamic stabilization exercise for this patient?
1. Hitting a tennis ball against a wall using a forehand stroke
2. Practicing slow forehand strokes with elastic tubing attached to the racquet grip
3. Maintaining a follow through position while the therapist provides rhythmic stabilization resistance
4. Performing push-ups against the wall with emphasis placed on scapular protraction

Answer 12

1

Dynamic stabilization exercises involve unconscious control and loading of the joint. They introduce ballistic and impact exercises to the patient. Practicing the forehand stroke by hitting a ball against a wall incorporates these principles. Practicing slow forehand strokes with elastic tubing attached to the racquet grip will provide a Tunetional exercise, but not a dynamic exercise as it would not introduce ballistic movements, nor load the joint in the same way, as Chis motion is described as a slow movement which limits its dynamic characteristics. Maintaining a follow through position while the therapist provides rhythmic stabilization resistance is a hold position that’s isometric, not dynamice. There is no unconscious or ballistic component. Performing push-ups against the wall with emphasis placed on scapular protraction may be a good exercise, but it does not fit the criteria for being a dynamic stabilization exercise.
It does load the joint, but there is no unconscious or ballistic component.

Question 13

A 50 year-old patient had an uncomplicated open repair of a rotator cuff tear 2 weeks ago. The patient asks the physical therapist when the shoulder will be normal again. Which of the following expected outcome time frames MOST accurately addresses this patient’s question?
1. 3 weeks to lift 5-1b (2.3-kg) objects
2. 3 weeks to sleep on the involved side
3. 3 months to lift the upper extremity overhead to reach into a cabinet
4. 3 months to play golf

Answer 13

3

Three weeks is too carly to lif 5-1b (2.3-kg) objects. Three weeks is too early to sleep on the involved side. Usually by 8 to 12 weeks, a patient who has had an uncomplicaled open repair of a rotator cuff 2 weeks ago is able to actively elevate the arm to functional heights.
Three months is too early to play golt.

Question 14

A patient who had arthroscopie knee surgery 6 weeks ago currently has passive knee range of motion of 25° to 125° with pain at the end of the
available range. Which of the following joint mobilization procedures is MOST appropriate for this patient?
1. Large amplitude oscillations performed within the range of motion, moving the tibia anteriorly on the femur
2. Small amplitude oscillations performed at the limit of the available notion and into tissue resistance, moving the tibia posteriorly on the lemur
3. Small amplitude oscillations performed at the limit of the avatlablo motion and into tissue resistance, moving the tibia anteriorly on the femur
4. Large amplitude oscillations performed within the tange of motion. moving the tibia posteriorly on the femur

Answer 14

3

Option 1 describes a grade 2 oscillation, which is insufficient to gain range. Option 2 is incorrect because it describes the opposite direction. Option 3 is incorrect, because a grade 4 mobilization (as described) is needed to increase range of motion. Knee extension is the primary concern, requiring an anterior glide of the tibia on the femur, but option 2 describes the opposite direction, and is therefore incorrect.

Knee:concavo on convex so same direction

Question 15

In order to manually assess a patient’s lower extremity circulation, a physical therapist should palpate the patient’s peripheral pulse at which of the following locations?
1. Dorsal foot, near the base of the 1ª metatarsal
2. Lateral lower leg, just posterior to the fibular head
3. Lateral ankle, just inferior to the lateral malleolus
4. Plantar foot, just medial to the medial calcaneal tuberosity

Answer 15

1

The therapist should palpate the dorsal pedal pulse, which is found on the dorsal aspect of the foot near the base of the first metatarsal.
The anatomical locations in options 2. 3, and 4 are not approprate to palpate the dorsal pedal pulse.

Question 16

Which of the following positions is BEST to assess the length of a patient’s rectus femoris muscle?
1. Sidelying with tested hip in flexion
2. Supine with tested hip and knee in flexion
3. Prone with tested knee in flexion
4. Sidelying with tested hip in extension

Answer 16

3
Option 1 does not mention the knee position and has the hip flexed, which shortens the rectus femoris. Option 2 has the hip flexed, which shortens the rectus femoris. Prone with the knee in flexion keeps the hip in neutral and does not allow the hip to flex. It describes the Ely test. Option 4 has the hip in the correct position, but does not mention the knee position.

Question 17

A patient with an Lu - L, posterolateral herniated mucleus pulposus is MOST likely to have sensory deficits in which of the following locations?
1. Medial knee
2. Medial ankle
3. Plantar aspect of the foot
4. Dorsum of the great toe

Answer 17

4

Question 18

A patient’s standing posture is characterized by a right thoracolumbar scoliosis. The scoliosis is not present when the patient is sitting. Which of the following dysfunctions is MOST likely the cause of this patient’s scoliosis?
1. Lumbar facet dysfunction
2. Unilaterally weak gluteus medius
3. Short iliopsoas muscle
4. Leg-length discrepancy

Answer 18

4

A facet dysfunction would remain in sitting and in standing. It is unlikely that a postural problem present in standing is due to muscular weakness. A weak gluteus medius would display more problems during gait or movement. Although the iliopsoas is passively shortened in sitting, a short iliopsoas is not a common cause to scoliosis, especially not thoracolumbar scoliosis. Short iliopsoas muscle is correct because when the patient is sitting, leg length does not affect the spinal posture

Question 19

A physical therapist is treating a patient who sustained a complete spinal cord injury. The patient currently walks with bilateral knee-ankle-foot orthoses and forearm crutches. The patient asks the therapist about how to correctly descend 1 step. Which of the following actions is MOST appropriate for the therapist to take?
1. Instruct the patient to approach the step facing forward, lower the legs to the next step, and then place the crutches on that step.
2. Instruct the patient to approach the step facing forward, place the crutches on the lower step, and then lower the legs to that step.
3. Explain to the patient that descending stairs is not an appropriate goal at this time.
4. Instruet the patient to approach the step facing forward, place.one crutch on the lower step. lower the legs to that step, and then place the other crutch on that step.

Answer 19

1

Regarding option 1, the legs need to be lowered first, then the crutches, otherwise the hips would buckle when the patient leans forward to lower the crutches to the next step. Regarding option 2, lowering the crutches first would cause the hips to buckle, When a patient is in knee-ankle-foot orthoses and has a spinal cord injury, the patient does not have sufficient hip control, otherwise the patient would be in ankle-foot orthoses. If the patient is able to walk in knee-ankle-foot orthoses, the patient should be able to learn how to descend 1 step. Regarding option 4, having the crutches on separate steps would cause the patient to be off balance and may cause the hips to unlock.

Question 20

A patient has pronounced weakness of the muscles of mastication on the left. A lesion in which of the following cranial nerves is MOST likely the cause of this impairment in the patient?
1. Trochlear (IV)
2. Trigeminal (V)
3. Facial (VII)
4. Hypoglossal (XII)

Answer 20

2

The trochlear nerve (IV) innervates the superior oblique muscle in the eye. The trigeminal nerve (V) innervates the masseter and temporalis, the major muscles of mastication. The facial nerve (VII) innervates the muscles of facial expression, not the muscles of mastication, The hypoglossal nerve (XIl) innervates the tongue.

Question 21

An athlete sustained a severe inversion sprain of the right ankle while playing basketball. To provide strapping support for the ankle, pressure and support should be applied over the tendons of the:
1. flexor digitorum longus and tibialis posterior.
2. gastrocnemius and fexor hallucis longus.
3. peroneus longus and peroneus brevis.
4, tibialis anterior and tibialis posterior.

Answer 21

3

With an inversion injury, the tendons of the peroneus longus and brevis can become strained. Swelling with an inversion strain usually occurs over the anterolateral part of the ankle. Compression and support is most beneficial by placing tape stirrups on the lateral side of the ankle, over the tendons of the peroneus longus and brevis and pulling the ankle into slight eversion.

Question 22

A patient is asked to grip a white card between the thumb (1* digit) and index finger (2 digit) with both hands. The physical therapist pulls on the card in the direction of the arrow shown. The starting and ending result of the movement is shown in the photograph. The results indicate weakness in which of the following muscles:
1. Flexor pollicis longus
2. Abductor pollicis brevis
3. Adductor pollicis
4. Extensor pollicis longus

Answer 22

3

The action shown in the photograph is the Froment’s test. Both thumbs (1* digits) should stay extended during the test. If the thumb (1* digit) is flexed, it is indicative of weakness of the adductor pollicis with substitution by the flexot pollicis longus, which is usually due to a lesion of the unar nerve.

Question 23

A physical therapist is observing the gait of a patient with a transtibial prosthesis. The therapist observes that at heel strike (initial contact) the patient’s knee is hyperextended. What is the MOST likely cause of the patient’s gait deviation?
1. A heel cushion that is too soft
2. The socket is placed too far anterior to the foot
3. The prosthesis is too long
4. Inadequate suspension of the prosthesis

Answer 23

1

A heel cushion that is too soft allows too rapid plantar flexion after heel strike (initial contact), which causes the knee to go into extension and stay there longer than normal. A socket that is placed too far anterior on the foot causes knee flexion, not extension. A prosthesis that is too long causes vaulting in midstance. Inadequate suspension causes the socket to slip during midswing phase resulting in the toe of the prosthesis catching on the floor.

Question 24

A physical therapist is observing a patient from behind during bilateral shoulder abduction. The therapist notes that the patient’s right scapula is more abducted than the left scapula at the end range of movement. The MOST likely cause of the altered scapula position on the right is:
1. tightness of the thomboid major and minor.
2. weakness of the serratus anterior.
3. restricted motion of the glenohumeral joint.
4. weakness of the upper trapezius.

Answer 24

3

Tightness of the thomboid major and minor would promote downward rotation of the scapula. Weakness of the serratus anterior would himit the upward rotation of the scapula. The most likely reason for the increase in scapular motion is restriction of the glenohumeral joint. To fully abduct the shoulder, the scapula and glenohumeral joint both have to contribute to the motion. If the glenohumeral joint is restricted, the scapula has to increase its motion to accomplish the task. Weakness of the upper trapezius would demonstrate a scapular lag in upward rotation.

Question 25

A physical therapist is evaluating a patient experiencing shoulder pain.
The patient notices the shoulder pain when stocking shelves that are overhead at work. The pain is not apparent when stocking shelves at waist or chest level, The patient MOST likely has weakness in which of the following muscles?
1. Pectoralis minor
2. Upper trapezius
3. Deltoid
4. Rhomboid major

Answer 25

2

Weakness in the pectoralis minor would not cause restriction of the scapula, but would likely cause scapular hypermobility. Weakness in the upper trapezius would decrease upward rotation of the scapula during shoulder flexion and abduction. The more the shoulder is elevated, the more noticeable this would be. The decreased scapular movement would increase the predisposition towards impingement.
Weakness in the deltoid would cause the humerus to move downward, not upward, during shoulder elevation. Weakness in the thomboid major would not cause restriction of the scapula, but would likely cause scapular hypermobility.

Question 26

During evaluation of a patient’s gait, the physical therapist observes that the patient leans forward shortly after heel strike (initial contact), The patient’s forward bending is MOST likely a compensation for weakness of which muscle(s)?
1. Quadriceps
2. Hamstrings
3. Gluteus maximus
4. Anterior tibialis

Answer 26

1

The quadriceps are active shortly after heel strike (initial contact) to prevent excessive knee bending during the loading phase of initial stance. Weakness of the quadriceps causes the patient lo compensate by leaning forward at heel strike (initial contact) and to use the body weight to help keep the knee extended. Weakness of the hamstrings causes excessive knee extension (recurvatum) prior to heel strike (initial contact). Weakness of the gluteus maximus would be observed shortly after heel strike (mitial contact). However, the patient would lean backwards to compensate. Weakness of the anterior tibialis causes a ffoot slap”” just after heel strike (initial contact).

Question 27

A physical therapist evaluates a patient who has back pain and determines that the patient’s pes planus is contributing to this pain.
Which of the following orthotic interventions is MOST appropriate for this patient?
1. Metatarsal pad
2. Solid ankle-foot orthosis
3. Hinged ankle-foot orthosis
4. Longitudinal arch support

Answer 27

4

Question 28

During gait evaluation, a physical therapist notes that a patient demonstrates a shorter step length with the right lower extremity, Which of the following problems is MOST likely the cause of this gait dysfunction?
1. Right iliopsoas contracture
2. Painful left knee
3. Decreased ankle pronation on the right
4. Left gluteus medius weakness

Answer 28

2

Right iliopsoas contracture may cause a shorter step length with the left lower extremity, but the not the right lower extremity.

Left knee pain will cause the patient to spend less time in left-sided stance as the patient will try to minimize the time spent in stance (weight-bearing on the knee) to minimize the pain. Therefore, the patient will take a shorter step with the right lower extremity.

Decreased ankle pronation would not have an effect on right-sided step length.

Gluteus medius weakness would be seen as an increase in lateral pelvic tilt, not step length.

Question 29

A 18-year-old female gymnast comes to your physiotherapy clinic complaining of pain on lower back that increases when walking and gets better when she is in a sitting position. On the assessment you observe a step deformity between L5-S1. What would you include in her treatment plan?
A. Focus on extension-based protocol, stabilization of hypermobile low back with core stability, and postural retraining.
B. Avoidance extension.
C. Focus on flexion-based protocol, stabilization of hypermobile low back with core stability, and postural retraining.
D. Avoidance flexion

Answer 29

C

Question 30

12. You have been asked to assess a 32-year-old patient that has been in a car crash 3 days ago. They complain of neck pain, headache, and during assessment you found decreased ROM of the neck.
    Which of the following correctly states the patient’s WAD grade?
    A. Grade IV
    B. Grade ||
    C. Grade ||I
    D. Grade 0

Answer 30

B

Question 31

16. You are assessing a 43-year-old female. Her chief complaint is pain on the left shoulder and limitation in ADLs. She has history of having the left should immobilized for 2 months due to an AC ligament sprain.
    She is also overweight and has a history of diabetes type II. You suspect that this patient is presenting adhesive capsulitis. What signs would you expect to see that would confirm this diagnose?
    A. Limited AROM - ER, ABD and IR
    B. Pain over shoulder and normal PROM and AROM
    C. Pain, loss of arm swing during gait and equally limited PROM & AROM - ER, ABD and IR
    b. Equally limited PROM & AROM - ER, ABD and IR

Answer 31

D

Pain is a symptom

Question 32

15. You were asked to assess a 22-year-old male at the sports injury clinic you work at. His is a soccer player who fell and landed over his shoulder during practice. He complains of pain when moving the arm through horizontal adduction and full elevation. In the assessment you palpated a step deformity.
    Which of the following would be key to his treatment?
    A. Resting the arm on a sling for 2 weeks regardless of pain.
    B. Isometric exercises targeting deltoid and trapezius once pain permits.
    C. Isometric exercises once pain permits
    D. PRICE.

Answer 32

B

15.
A. Incorrect. Initially the arm is put into a sling for pain relief. This may be for 2-3 days for a minor sprain, up to six weeks for a severe sprain.
B. This is the best answer. The deltoid and trapezius cross the joint, so when there is ligament laxity, contractile support is important to regain early in rehab.
C. This is not the best answer due to lack of information.
D. INCORRECT. This is a general approach to acute phase of rehabilitation

Question 33

16. You are assessing a 43-year-old female. Her chief complaint is pain on the left shoulder and limitation in ADLs. She has history of having the left should immobilized for 2 months due to an AC ligament sprain.
    She is also overweight and has a history of diabetes type II. You suspect that this patient is presenting adhesive capsulitis. What signs would you expect to see that would confirm this diagnose?
    A. Limited AROM - ER, ABD and IR
    B. Pain over shoulder and normal PROM and AROM
    C. Pain, loss of arm swing during gait and equally limited PROM & AROM - ER, ABD and IR
    D. Equally limited PROM & AROM - ER, ABD and IR

Answer 33

D

A. This is not the best answer. While the statement is not wrong, there’s information missing such as limited
PROM.
B. INCORRECT. Limited ROM is a hallmark sign of frozen shoulder. pain is a symptom.
C. This is not the best answer because Pain is a Symptom not a sign.
D. This is the best answer.

Question 34

17. You have been treating a 55-year-old male at the outpatient hospital clinic you work at. He was diagnosed with a complete rotator cuff tear following a fall landing on the shoulder when he was riding a bike over the weekend. Which of the following best describes the test of the most common tendon involved in a rotator cuff tear?
    A. Speed’s test
    B. Empty can test
    C. Mill’s test
    D. Maudsley’s

Answer 34

B

A. INCORRECT. The Speed’s test verify the integrity of biceps tendon.
B. CORRECT.
C. INCORRECT. The Mill’s test verifies lateral epicondylalgia
D. INCORRECT. The Maudsley’s test verifies lateral epicondylalgia

Question 35

19. You assessed 29-year-old female who came to your clinic due to pain on the wrist. Her chief complaint is increased pain after a full day taking care of her 2-month-old baby. Finkelstein’s test is positive.
    Which of the following best describes the structures involved in this injury.
    A. Extensor Pollicis Brevis and Extensor Pollicis Longus
    B. Scaphoid bone
    C. Abductor Pollicis Longus and Extensor Pollicis Brevis
    D. Abductor Pollicis Longus and Extensor Pollicis Brevis and scaphoid bone

Answer 35

C

A. INCORRECT. EPL would not be involved.
B. INCORRECT. This injury is due to irritation of the tendons of the snuff box, not bone related.
C. CORRECT. This injury is due to irritation of the tendons of Abductor Pollicis Longus and Extensor Pollicis
Brevis
D. INCORRECT. This injury is due to irritation of the tendons of the snuff box, not bone related.

Question 36

20. Patient is admitted to an inpatient physiotherapy clinic showing forearm in supination, wrist and MCP joints in hyperextension and IP joints in flexion. They have a history of falling accident while working at a construction site. Injury to what level of brachial plexus reflects his clinical presentation?
    A. Lower trunk of brachial plexus
    B. Ulnar nerve
    C. Upper trunk of brachial plexus
    D. Median nerve

Answer 36

A

A. CORRECT. Injury to this level would cause total claw hand as described in the vignette.
B. INCORRECT. Injury to the ulnar nerve would cause claw hand. Clinical presentation would be similar, however, only in the 4* and 5* finger.
C. INCORRECT. Injury at this level would cause loss of extensors and most movements of shoulder.
D. INCORRECT. Injury to the Median nerve would cause Impairment of thenar muscles innervated by median nerve. Thus, thumb cannot abduct and oppose.

Question 37

22. You are assessing a 13-year-old male presenting R scoliosis of 7•. Your findings indicate this is a functional scoliosis due to habitual postural faults. Which of the following best describes your treatment plan?
    A. Stretching the tight structures (R side) and strengthening weak structures (L side)
    B. Education of importance of exercise and posture to create optimal alignment; Postural exercises; Stretching the tight structures (L side) and strengthening weak structures (R side)
    C. Stretching the tight structures (L side) and strengthening weak structures (R side)
    D. Postural exercises

Answer 37

22.
A. INCORRECT. Stretching the tight structures (CONCAVE side - in this case the left side) and strengthening weak structures (CONVEX side - in this case the RIGHT side).
B. THIS IS THE BEST ANSWER because it incorporates education of the patient, the correct areas for of focus for stretching and strengthening as well as postural exercises which is described as the cause of the scoliosis.
C. This is not the best answer because it does not address education of patient and postural exercises.
D. This is not the best answer because it lacks information and does not address education of patient.

Question 38

29. An 18-year-old male tests positive for shoulder dislocation. This patient may have complications as a result of this shoulder dislocation. Which of the following would most likely be involved if the patient were to have complications?
    A. Axillary artery
    B. Axillary nerve
    C. Radial artery
    D. Radial nerve

Answer 38

B