Ortho Quizzes + Midterm

Question 1

A classic example of positional relief for a stenotic patient is?

Answer 1

A patient who leans on a shopping cart while walking to alleviate back and lower extremity symptoms

Question 2

In trunk side bending, an area of angulation indicates?

Answer 2

hypomobility below the level or hyper mobility above the level in the lumbar spin

Question 3

Which of the following clinical findings for muscle weakness in a patient with a lesion affecting the 5th lumbar nerve root would you expect to find when examining your patient?

Answer 3

Weakness of EHL
Weakness of hip abductors
Weakness of the peroneals

Question 4

The lumbar multifidus is the largest of the intrinsic back muscles and is palpated and found?

Answer 4

Most medially in the spinal gutter

Question 5

Hypomobility of the zygapophyseal joint can have an extra-articular, periarticular, or pathomechanical cause. The distinction is made by the results of?

Answer 5

the end-feel obtained during PPIVM and PAIVM tests

Question 6

In the anterior instability test, testing L4/5, the patient’s hips are placed in __?__ degs of flexion and the knees are flexed prior to the clinician applying pressure through the patient’s knees along the line of the femur.

Answer 6

70 degrees

Question 7

An anterior pelvic tilt has what affect on lumbar lordosis?

Answer 7

Increases the lumbar lordosis

Question 8

The outer half of the IVD and the posterior longitudinal ligament are innervated by?

Answer 8

the sinuvertebral nerve

Question 9

Your patient reports repeated unprovoked episodes(s) of feeling unstable or giving way in their back. following a minor provocation, you suspect which condition?

Answer 9

clinical instability of the lumbar spine

Question 10

A hairy patch or tuft that is located at the base of the lumbar spine may indicate?

Answer 10

spina bifida occulta

Question 11

(T/F) These two motions, sacral nutation and counternutation are normally occurring motions between the L5 and the sacrum

Answer 11

True

Question 12

(T/F) In the Fortin Finger Test, the patient points to the same painful area over several trials and this area is located 1 cm of and immediately inferior to the PSIS

Answer 12

True

Question 13

(T/F) The piriformis muscle arises from the posterior aspect of the sacrum, S2, S3 and S4 segments

Answer 13

False

Question 14

(T/F) The sacral sulcus is located over the sacral base

Answer 14

True

Question 15

(T/F) The current reference standard for confirming pain stemming from the SIJ is fluoroscopically guided, contrast enhanced, intra-articular anesthetic blocks

Answer 15

True

Question 16

Which of the following is the most correct statement concerning the long dorsal SI ligament?

it connects the PSIS to the lateral crest of the 3rd and 4th segments of the sacrum

it blends laterally with the sacrotuberous ligament

it attaches medially to the erector spinae muscle, the multifidus muscle, and the thoracodorsal fascia

All of the above

None of the above

Answer 16

ALL TRUE

it connects the PSIS to the lateral crest of the 3rd and 4th segments of the sacrum

it blends laterally with the sacrotuberous ligament

it attaches medially to the erector spinae muscle, the multifidus muscle, and the thoracodorsal fascia

Question 17

Which of the following is the most correct statement about the sacrotuberous ligament?

it is composed of three large bands

it has attachments with the lower fibers of glut max and the piriformis muscle

it has attachment to the tendon of the biceps femoris

all of the above are correct statements

none of the above are correct statements

Answer 17

ALL TRUE

it is composed of three large bands

it has attachments with the lower fibers of glut max and the piriformis muscle

it has attachment to the tendon of the biceps femoris

Question 18

(T/F) The pubic symphysis contains a fibrocartilaginous lamina or disk.

Answer 18

True

Question 19

(T/F) Ankylosing spondylitis is a chronic rheumatoid disorder that is usually progressive, resulting in full ankylosing of the sacro illiac joints (SIJ’s)

Answer 19

True

Question 20

(T/F) The most common presenting symptoms in patients with SIJ dysfunction are complaints of pain or tenderness over the region of the PSIS

Answer 20

True

Question 21

When performing passive accessory inter-vertebral mobility testing, the therapist is concentrating on obtaining the quality of?

Answer 21

the end feel

Question 22

You find during your PPIVM movement testing a loss of extension at L3 on L4, you are going to perform a PAIVM testing to the segment you would?

Answer 22

apply a PA glide to the bilateral TVP of L4 and feel the quality of movement and end feel

Question 23

Which of the following statements is most correct concerning common signs and symptoms of a patient presenting with a lumbar instability?

most aggravating movement is lumbar extension

is easily able to return to upright standing after performing trunk flexion

a painful catch, sway, or shift at a lumbar level may be observed as the patient returns to standing from forward bending

none of the above

all of the above

Answer 23

a painful catch, sway, or shift at a lumbar level may be observed as the patient returns to standing from forward bending

Question 24

You find during your PPIVM movement testing a loss of flexion of L3 on L4, you are going to perform a PAIVM testing for this segment, you would?

Answer 24

apply a PA glide to the bilateral TVP of L3 and feel the quality of movement and end feel

Question 25

You are going to perform a pain provocation test to stress the long dorsal ligament of the right SIJ, you would perform?

Answer 25

compress the sacrum to create a counternutation movement

Question 26

This condition is increased with walking and with spinal extension, but is less painful with walking uphill. decreases with sitting, lying down, bending forwards while leaning on a shopping cart or in flexed spinal positions.

Answer 26

Neurogenic claudication

Question 27

During PPIVM testing for lumbar flexion, normal motion is determined by?

Answer 27

separation of the lumbar spinous processes

Question 28

(T/F) The sign of the buttock is positive when performing the passive SLR test, hip flexion does not reach 15 deg of hip flexion.

Answer 28

False

Question 29

Which of the following tests would you perform on your patient to help you rule out a lumbar stenosis from a vascular claudication? slumped sitting test timed up and go test bike test SLR test combination of the SLR and slumped sitting test

Answer 29

Bike test

Question 30

(T/F) An unexplained weight loss of 5% or more over a period of 4 wks should be a red flag.

Answer 30

True

Question 31

(T/F) Your patient reports low back pain and presents with full lumbar AROM and PROM without limitations and you are unable to reproduce the patient's symptoms is considered a yellow flag.

Answer 31

False

Question 32

(T/F) The outer half of the IVD is innervated by the sinuvertebral nerve

Answer 32

True

Question 33

The following findings are reported after assessing lumbar Transverse Process (P) positions during physical examination of a patient with low back pain: L4 TP palpation in neutral: Posterior in the right side L4 TP palpation in flexion: Symmetrical L4 TP palpation in extension: More posterior in the right side You suspect?

Answer 33

L4 facet on the left is unable to extend

Question 34

(T/F) Your patient with LBP is 70 yrs old, they can be considered a red flag just due to their age.

Answer 34

True

Question 35

You perform the ipsilateral weight bearing kinetic test (Stork Test), a positive test finding for the right SIJ dysfunction would be?

Answer 35

the PSIS on the right does not move during the test

Question 36

You have your patient perform heel walking, you are checking?

Answer 36

key muscle testing for L4 innervation level

Question 37

What exercise is MOST appropriate for a patient with Grade I spondylolisthesis?

Answer 37

Any bottom-up flexion exercise

Question 38

The following findings are reported after assessing lumbar Transverse Process (TP) positions during physical examination of a patient with low back pain: L4 TP palpation in neutral: symmetrical L4 TP palpation in flexion: more posterior on the right side L4 TP palpation in extension: symmetrical Which of the following motion restrictions are expected in L5 segment? facet of L4 on the right is unable to flex facet of L4 on the right is unable to extend facet of L4 on the left is unable to flex facet of L4 on the left is unable to extend

Answer 38

facet of L4 on the right is unable to flex

Question 39

(T/F) An anterior pelvic tilt decreases lumbar lordosis.

Answer 39

False

Question 40

In the prone instability test, the test is positive if?

Answer 40

there is a reduction of the patient's symptoms when the patient raises their feet off the floor while the therapist is performing a central PA glide

Question 41

(T/F) Ankylosing spondylitis is a chronic rheumatoid disorder that is usually progressive, resulting in full anklylosing of the SIJ's.

Answer 41

True

Question 42

Which of the following test would you perform on your patient to help you rule in a lumbar spinal stenosis? timed up and go test 2 stage treadmill test slump sitting test combination of positive results for an SLR and slumped sitting test none of the above

Answer 42

2 stage treadmill test

Question 43

You have your patient perform 10 toe raises (standing plantaflexion), you are checking?

Answer 43

key muscle testing for S1-S2 innervation level

Question 44

When performing the passive physiological intervertebral mobility tests for lumbar flexion, the therapist palpates?

Answer 44

movement the interspinous spaces between the spinous processes during the passive movement

Question 45

Form closure and force closure provide stability to the SIJ, form closure is provided by the?

Answer 45

the joint itself, the ligaments and the capsule of the joint

Question 46

Which is the most correct statement regarding AROM testing in the lumbar spine?

Answer 46

the clinician should observe not only the quantity, but the quality of the AROM

Question 47

(T/F) You find a hypermobility in lumbar flexion while performing PPIVM testing. This finding is enough for you to conclude that your patient is demonstrating a lumbar instability.

Answer 47

False

Question 48

(T/F) This condition is a bony defect of the pars interarticularis of the spine.

Answer 48

spondylosis

Question 49

(T/F) In the McKenzie classification system, the postural syndrome, patient symptoms are not generally affected by mechanical maneuvers performed by the clinician or the patient.

Answer 49

True

Question 50

This increases with intersegmental injury and intervertebral disc degeneration and is considered to be an important measure of spinal stability, it is?

Answer 50

the neutral zone

Question 51

Your patient has been referred by her MD to you for right SIJ dysfunction, which of the following is the most correct statement regarding her pain presentation?

Answer 51

she reports pain in an area medial and also inferior to the right PSIS

Question 52

Your 88 yr old male patient, reports low back pain and LE symptoms into the top of their right foot during walking. You suspect from this statement your patient could have which condition?

Answer 52

lateral foraminal stenosis in the lumbar spine on the right

Question 53

You perform positional testing for the L4 segment and found that the TVP were symmetrical in neutral, flexion, and extension when compared to L3 and L5, which of the following is the most correct statement? this patient has a facet dysfunction this patient probably does not have facet dysfunction this segment could be rotated right this segment could be rotated left

Answer 53

this patient probably does not have facet dysfunction

Question 54

You are going to perform a PAIVM movement test for flexion of L3 on L4, you would?

Answer 54

perform a PA glide in the prone position on the SP of L3

Question 55

Your patient presents with a lateral mechanical shift to the left, your patient self-treatment for his HEP to correct this mechanical shift could be?

Answer 55

in standing, have the patient perform self-shift correction by the patient moving their pelvis to the left

Question 56

A diffuse and throbbing pain into the legs, not position related, and is induced by walking and subsides shortly after rest. These symptoms are associated with which of the following pathologies? Nerve root involvement Dural Involvement Visceral involvement Vascular involvement

Answer 56

Vascular involvement

Question 57

Which of the following statements regarding 5th lumbar nerve root compression is most correct? A) one may find weakness in the ankle dorsiflexors B) one may find weakness in the extensor hallucis C) one may find weakness in the hip abductor muscles D) one may find weakness in the fibularis/ peroneals B, C and D are most correct A, C and D are most correct

Answer 57

B, C and D are most correct

Question 58

Which is the most correct answer? The McKenzie method of mechanical diagnosis and therapy is described as _?_ system of examination and treatment which is based on the patient's pain level system of examination and treatment which is based on an individual's symptomatic and mechanical response to movement and positions system of examination and treatment based on an individual's neurological weakness system and treatment based on MRI findings system and treatment based on Passive Physiological inter-vertebral joint mobility findings.

Answer 58

system of examination and treatment which is based on an individual's symptomatic and mechanical response to movement and positions

Question 59

Spondylolisthesis is characterized according to three factors, they are?

Answer 59

Etiology, direction of slippage, grade of slippage

Question 60

In the McKenzie method of mechanical diagnosis and therapy, which of the following statements are most correct? during the exam and treatment, the patient's pain responses to movements directs the movements or positions of choice for the therapist for treatment during the exam and treatment, movement loss directs the movements or positions of choice for the therapist for treatment during the exam and treatment, peripheralization and centralization of the patient's most distal symptoms directs the movements or positions of choice for the therapist for treatment during the exam and treatment, centralization and peripheralization of patient's symptoms is only used during the examination only and is not important during the treatment program

Answer 60

during the exam and treatment, peripheralization and centralization of the patient's most distal symptoms directs the movements or positions of choice for the therapist for treatment

Question 61

A principle axis of motion of the SIJ is called the oblique axis. The right oblique axis is considered to be?

Answer 61

from the right sacral sulcus/sacral base to the left ILA

Question 62

Which of the following statements is most correct? A) Testing muscle stretch reflex of the hamstring muscles tests the L5 innervation level B) Testing the muscle stretch reflex of the semimembranosus tests the L5, S1 innervation level C) Testing the muscle stretch reflex of the bicep femoris tests the S1-52 innervation level D) Testing the muscle stretch reflex of the semimembranosus test the $1-2 innervation level b and c are correct c and d are correct

Answer 62

b and c are correct

Question 63

In the McKenzie method, patients are classified into which main category/categories?

Answer 63

postural, dysfunction, derangement

Question 64

You are going to perform a PAIVM test for flexion of L4 on L5, you would?

Answer 64

perform a PA glide on the SP of L4 in the prone position

Question 65

(T/F) Side bending PPIVM for side bending right, of L4 on L5 in lumbar spine can only be performed on the patient in side lying.

Answer 65

False

Question 66

Which of the following is the best answer. Which signs or symptoms would you expect to find in a patient who has cauda equina syndrome? numbness in the lateral side of their foot reports of bladder and bowel dysfunction inability to dorsi flex the ankle none of the above A and C are the best answers

Answer 66

reports of bladder and bowel dysfunction

Question 67

You are going to perform a PAIVM for L4 extension on L5, you would?

Answer 67

perform a PA glide on the TVP of L5 in the prone position

Question 68

This muscle is the primary dynamic stabilizer of the hip joint in the frontal plane

Answer 68

glute med.

Question 69

This muscle is an external rotator of the hip at 60 deg of hip flexion and reverses its muscle action to an internal rotator at 90 deg of hip flexion.

Answer 69

piriformis

Question 70

This condition is a contusion to the iliac crest.

Answer 70

hip pointer

Question 71

Excessive external rotation of the hip may indicate?

Answer 71

hip retroversion

Question 72

This ligament of the hip is also called the Y ligament of Bigelow

Answer 72

iliofemoral ligament

Question 73

An ischial apophyseal injury commonly occurs in this age group.

Answer 73

13-16 yrs of age

Question 74

Which nerve innervates the glut max muscle?

Answer 74

tibial division of the sciatic nerve

Question 75

This test is used to measure hip anteversion/retroversion

Answer 75

Craig's test

Question 76

The superior portion of the glut max acts as a __?__ during gait

Answer 76

hip abductor

Question 77

This is a term for all disorders that cause chronic pain in the region of the pubic tubercle and the structures that attach to the pubic bone

Answer 77

Athletic pubalgia

Question 78

This condition, IT band friction syndrome, is the most common overuse condition of the knee. Which of the following listed below are at risk for developing IT band friction syndrome? long distance runners 20-40 mi. per week runners who train on cambered roads runners who train on hilly terrains A and B all of the above

Answer 78

ALL TRUE long distance runners 20-40 mi. per week runners who train on cambered roads runners who train on hilly terrains

Question 79

This term is used to describe an apophysitis of the tibial tubercle

Answer 79

Osgood-Schlatter disease

Question 80

You observe one of the JV basketball players while jumping and landing from a jump during practice. You notice that her jumps and lands with a stiff knee vertical jumping-landing strategy. You suspect he has which condition?

Answer 80

Jumper's knee

Question 81

The KT1000 arthrometer is used to measure?

Answer 81

Anterior laxity in patient's with an ACL injury

Question 82

Microfracture, autologous osteochondral mosaicplasty, and osteochondral autograft transfer are used as reparative techniques for which conditions?

Answer 82

Articular cartilage injuries

Question 83

The maneuver performed in a duck walk/Childress sign, is similar to which test listed below?

Answer 83

McMurray test

Question 84

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a self administered questionnaire that evaluates three dimensions, they are?

Answer 84

pain, stiffness, and physical function

Question 85

At this knee flexion angle, the patella is most constrained by the walls of the trochlea groove

Answer 85

20-30 degrees

Question 86

During knee flexion, the femur? rolls anteriorly and glides posteriorly glides anteriorly and rolls anteriorly rolls posteriorly and glides posteriorly rolls posteriorly and glides anteriorly

Answer 86

rolls posteriorly and glides anteriorly

Question 87

The biceps femoris is a two headed muscle, the shorter head arises from the inferomedial facet of the tibial tuberosity

Answer 87

False

Question 88

This term is used to describe a hyperextension sprain of the 1st MTP joint with an axial load to the heel while in ankle plantar flexion

Answer 88

Turf toe

Question 89

With your patient in a supine position, you grasp the foot around the metatarsal heads and squeeze the heads together. the reproduction of pain with this maneuver indicates?

Answer 89

the presence of a neuroma or a stress fx

Question 90

The tibialis posterior muscle produces the motion of __?__ in a plantar flexed position

Answer 90

inversion

Question 91

(T/F) You are testing muscle strength of the ankle plantar flexors, usually, clinician strength is sufficient to overcome ankle plantar flexor force, and eliminates the need for weight bearing assessment of ankle plantar flexor strength.

Answer 91

False

Question 92

(T/F) The cuboid is located in the medial midfoot

Answer 92

False

Question 93

This deformity refers to an abnormal prominence of he posterior superior lateral border of the calcaneus

Answer 93

Haglund's deformity

Question 94

Entrapment of this nerve in the LE could reproduce burning on the medial aspect of the knee pain and could be confused with Pes Anserine bursitis.

Answer 94

saphenous nerve

Question 95

The talocrural joint is the synovial articulation between _?_

Answer 95

the articulating facets of the tibiofibular mortise and the facets of the talus

Question 96

(T/F) The primary function of the ATFL is to resist posterior displacement of the talus relative to the ankle mortise

Answer 96

False

Question 97

During weight bearing, the tibia __?__ with pronation and __?__ with supination.

Answer 97

IR and ER