Knee
A PTA observes the posture of a 16-year-old distance runner. The therapist identifies excessive genu valgum. Which of the following would be the most probable associated finding? A. decreased Q angle B. posterior pelvic tilt C. excessive subtalar pronation D. ipsilateral pelvic rotation
C. excessive subtalar pronation
A physical therapist assistant reviews the medical record of a patient rehabilitating from a total knee replacement. One of the entries in the medical record indicates the presence of a 15 degree extension lag at the knee. Which of the following goniometric readings would be most consistent with this condition? A. 15-100 degrees AROM; 0-100 degrees PROM B. 15-100 degrees PROM; 0-100 degrees AROM C. 15-120 degrees PROM; 15-135 degrees AROM D. 15-135 degrees AROM; 15-135 degrees PROM
A. 15-100 degrees AROM; 0-100 degrees PROM
A physical therapist assistant employed by a home health agency visits a patient status post total knee arthroplasty. The patient was discharged from the hospital yesterday and according to the medical record had an unremarkable recovery. The physician orders include the use of a continuous passive motion machine. The MOST appropriate rate of motion would be: A. 2 cycles per minute B. 4 cycles per minute C. 6 cycles per minute D. 8 cycles per minute
A. 2 cycles per minute
A therapist examines a patient diagnosed with an acute posterior cruciate ligament sprain. The mechanism of injury for the posterior cruciate ligament is: A. A forceful landing on the anterior tibia with the knee hyperflexed B. An anteriorly directed force applied to the tibia when the foot is fixed C. A valgus force applied to the knee when the foot is fixed D. Hyperextension, medial rotation of the leg with lateral rotation of the body
A. A forceful landing on the anterior tibia with the knee hyperflexed
A patient two months status post total knee replacement is referred to physical therapy for range of motion and strengthening exercises. Which treatment technique would be inappropriate for this patient? A. Active stretching using the contract-relax technique B. Joint mobilizations to increase joint play C. Exercise on a stationary bicycle against mild resistance D. Performing SLR's, SAQ's, and knee flexion exercises using ankle weights
A. Active stretching using the contract-relax technique
A college soccer player sustained a hyperextension knee injury when kicking the ball. The patient was taken to the emergency room of a local hospital and was diagnosed with "knee sprain". He was sent to physical therapy the next day for aggressive rehabilitation. As part of the examination to determine the type of treatment plan to implement, the therapist conducted the test shown in the figure. Based on the test picture, the therapist is examining the integrity of the: A. Anterior cruciate ligament B. Posterior cruciate ligament C. Medial meniscus D. Iliotibial band
A. Anterior cruciate ligament
Documentation from an orthopedic surgeon's report indicates that a patient sustained damage to several structures that provide anterolateral stability to the knee. Which of the following structures would most likely be involved? A. Anterior cruciate ligament, lateral collateral ligament, iliotibial band B. Anterior cruciate ligament, posterior oblique ligament, iliotibial band C. Anterior cruciate ligament, medial collateral ligament, medial meniscus D. Posterior cruciate ligament, lateral collateral ligament, biceps femoris tendon
A. Anterior cruciate ligament, lateral collateral ligament, iliotibial band
When trying to palpate the popliteal pulse the therapist should place their palpation fingers in which of the following areas: A. Between the two heads of the gastrocnemius muscle B. Just behind the fibular head and the lateral hamstring muscle C. Just anterior to the pes anserine muscles D. Between the gastrocnemius and soleus muscle
A. Between the two heads of the gastrocnemius muscle
A physical therapist assistant palpates along the lateral portion of the hamstring musculature to the tendinous attachment on the fibular head. The muscle should be identified as the: A. Biceps femoris B. Gracilis C. Sartorius D. Semitendinosus
A. Biceps femoris
A physical therapist assistant is preparing to treat a patient with an injury to the posterior knee that crushed the tibial nerve. The PT examination identifies both motor and sensory involvement. You would expect the patient to present with: A. Decrease tone of the ankle plantarflexors and invertors and paresthesia of the posterior calf and plantar surface of the foot B. Increased muscle tone and spasticity of the knee flexors, as well as anesthesia over the posterior thigh area C. Increase muscle tone and spasticity of the plantarflexors and invertors of the ankle, as well as anesthesia over the posterior calf and plantar surface of the foot D. Decrease muscle tone of the knee flexors, as well as paresthesia of the posterior thigh and knee
A. Decrease tone of the ankle plantarflexors and invertors and paresthesia of the posterior calf and plantar surface of the foot
A 10 y/o boy who plays catcher on his baseball team complains of bilateral knee pain which is exacerbated with forceful quadriceps contraction. He has also noticed pain and swelling at the distal attachment of the patellar tendon. Effective early intervention should include: A. Decreased loading of the knee by the quadriceps femoris muscle B. Modalities to decrease inflammation C. AROM exercises to prevent contracture D. Casting followed by decreased loading of the knee
A. Decreased loading of the knee by the quadriceps femoris muscle
A patient status post medial meniscus repair is referred to physical therapy. Which of the following would be the responsibility of the physician post-operatively? A. Determine weight bearing status B. Specify the parameters for superficial modality application C. Specify the frequency and duration of range of motion exercises D. Select an appropriate resistive exercise program
A. Determine weight bearing status
A patient status post medial meniscus repair is referred to physical therapy. Which of the following would be the responsibility of the physician post-operatively? A. Determine weightbearing status B. Specify the parameters for superficial modality application C. Specify the frequency and duration of range of motion exercises D. Select an appropriate resistive exercise program
A. Determine weightbearing status
As the result of blunt trauma to the quadriceps femoris muscle, a patient experiences loss of knee function. Early PT interventions should stress: A. Gentle AROM exercises in weight bearing B. Aggressive soft tissue stretching to remove blood which has accumulated in soft tissues C. Aggressive open-chain strengthening of the quads to regain normal lower extremity strength D. Gentle PROM exercises in non-weightbearing to regain normal knee motion
A. Gentle AROM exercises in weight bearing
A physical therapist assistant performs graded oscillation techniques in an attempt to reduce a patient's knee pain. Which grades of oscillation would be the most appropriate based on the stated objective? A. I, II B. I, III C. II, III D. III, IV
A. I, II
A physical therapist and physical therapist assistant jointly determine that a patient rehabilitating from an anterior cruciate ligament reconstruction is not ready to return to athletic competition. Which of the following best supports the therapists' decision? A. Inability to complete a functional progression B. A 20 percent quadriceps peak torque deficit at 60 degrees per second C. Trace effusion in the knee after a therapy session D. A 5 degree limitation in knee flexion
A. Inability to complete a functional progression
Which of the following special tests would help determine if a patient had a partial tear or rupture of the anterior cruciate ligament? A. Lachman's test B. Valgus stress test C. McMurray's test D. Apley's distraction test
A. Lachman's test
Which of the following special tests is used to test the integrity of the meniscii of the knee joint? A. McMurray's test B. Apley's distraction test C. Valgus stress test D. Lachman's test
A. McMurray's test
A patient is referred to physical therapy 24 hours after a total knee replacement. What exercise would be the most appropriate to begin treatment? A. Quadriceps sets B. Short arc quads C. Standing leg curls D. Straight leg raises
A. Quadriceps sets
The "Q-angle" is best described by which of the following? A. The angle of the quadriceps pull on the tibial tuberosity B. Another way of measuring the angle of inclination C. Another way of measuring the angle of torsion D. The angle of the neck of the femur in the transverse plane
A. The angle of the quadriceps pull on the tibial tuberosity
A fourteen-year-old girl complains of sub-patellar pain after participation in an aerobic exercise program for two weeks. The physical therapist's examination shows a large Q angle, pain with palpation at the inferior pole of the patella, and mild swelling at both knees. Physical therapy intervention should promote: A. Vastus medialis muscle strengthening B. Lateral patellar tracking C. Vastus lateralis strengthening D. Hamstring strengthening
A. Vastus medialis muscle strengthening
During gait training, a patient leans his body weight forward from heel strike through midstance. This maneuver is probably a compensatory motion resulting from: A. Weak knee extensors B. Weak hip flexors C. Tight hip extensors D. Weak hip extensors
A. Weak knee extensors
A physically active 27 y/o male receives pre-operative instruction prior to anterior cruciate ligament reconstruction. The patient's past medical history includes a medial meniscectomy of the contralateral knee 8 months ago. The most likely functional level of the patient following rehabilitation is: A. able to return to previous functional level B. able to participate in light recreational activities C. able to participate in all recreational activities D. able to return to recreational and competitive athletic activities with a derotation brace
A. able to return to previous functional level
A physically active 27-year-old male receives preoperative instruction prior to anterior cruciate ligament reconstruction. The patient's past medical history includes a medial meniscectomy of the contralateral knee eight months ago. The most likely functional level of the patient following rehabilitation is: A. able to return to previous functional level B. able to participate in light recreational activities C. able to participate in all recreational activities D. able to return to recreational and competitive athletic activities with a derotation brace
A. able to return to previous functional level
A physician instructs a 26-year-old male to utilize a knee derotation brace for all athletic activities. Which condition would most warrant the use of the derotation brace? A. anterior cruciate ligament insufficiency B. medial meniscus repair C. anterior cruciate ligament reconstruction D. posterior cruciate ligament reconstruction
A. anterior cruciate ligament insufficiency
A physical therapist assistant attempts to select assistive device for a 46-year-old female that is partial weight bearing on the right lower extremity. Which of the following assistive devices permits weight bearing and requires the patient to exhibit significant coordination? A. axillary cruches B. bilateral canes C. single cane D. walker
A. axillary cruches
A physical therapist assistant implements an exercise program consisting of closed-chain activities for a patient rehabilitating from a medial meniscus repair. An appropriate closed-chain exercise to include in the rehabilitation program is: A. bilateral mini-squats in standing B. submaximal velocity spectrum isokinetic exercise C. short-arc terminal knee extension D. prone leg curls with a two pound cuff weight
A. bilateral mini-squats in standing
A physical therapist assistant treats a 36-year-old male status post knee surgery. The therapist performs goniometric measurements to quantify the extent of the patient's extension lag. Which of the following would not provide a plausible rationale for the extension lag? A. bony obstruction B. muscle weakness C. inhibition by pain D. patient apprehension
A. bony obstruction
A patient status post open knee meniscectomy is referred to physical therapy for neuromuscular electrical stimulation. The most beneficial frequency of treatment to promote strengthening is: A. three times per week B. one time per week C. two times per week D. once every two weeks
A. three times per week
A patient recovering in the hospital from a total knee replacement works with a physical therapist assistant. Assuming an uncomplicated recovery, how much knee range of motion is anticipated prior to discharge? A. 0-50 degrees B. 0-90 degrees C. 15-90 degrees D. 15-105 degrees
B. 0-90 degrees
After correctly measuring the patient's Q-angle, you find that it equals 18°. The normal range of the Q-angle for men with the knee extended is: A. 11-13° B. 13-15° C. 16-18° D. 18-20°
B. 13-15°
A physical therapist assistant works with a 16-year old male diagnosed with left knee anterior cruciate ligament insufficiency. During the session a Lachman's test is performed. Ideally, the therapist should perform the test with the knee in: A. Complete extension B. 20-30 degrees flexion C. 30-40 degrees flexion D. 40-50 degrees flexion
B. 20-30 degrees flexion
A patient diagnosed with infrapatellar tendonitis completes a series of functional activities. After completing the activities the physical therapist assistant instructs the patient to use ice massage over the anterior surface of the knee. The MOST appropriate treatment time is: A. 3-5 minutes B. 5-10 minutes C. 10-15 minutes D. 15-20 minutes
B. 5-10 minutes
A physical therapist assistant treats a patient diagnosed with an acute posterior cruciate sprain. The most common mechanism of injury for the posterior cruciate is: A. An anteriorly directed force applied to the tibia when the foot is fixed B. A forceful landing on the anterior tibia with the knee hyperflexed C. A valgus force applied to the knee when the foot is fixed D. Hyperextension and medial rotation of the leg with lateral rotation of the body
B. A forceful landing on the anterior tibia with the knee hyperflexed
Which of the following structures should be used when measuring the Q-Angle? A. Apex of the patella, Base of the patella and the tibial tuberosity B. ASIS, Center of the patella, and the tibial tuberosity C. ASIS, Apex of the patella, and the tibial tuberosity D. Apex of the patella, center of the patella, and base of the patella
B. ASIS, Center of the patella, and the tibial tuberosity
The Q-Angle is utilized as a measure to determine the amount of force on the patella. Which three bony landmarks are used to measure the Q-angle? A. ASIS, Superior border of the patella, Tibial tubercle B. ASIS, Midpoint of the patella, Tibial tubercle C. ASIS, Inferior border of the patella, Mid-point of the patella D. Greater trochanter, Midpoint of the patella, Superior border of the patellar tendon
B. ASIS, Midpoint of the patella, Tibial tubercle
A patient is receiving physical therapy following an ACL repair. After 4 weeks of treatment the patient still complains of pain and instability even though he reports he has been faithful with his home exercise program and wearing his orthosis. The original referral was for 7 to 8 weeks of physical therapy. The therapist's BEST course of action is to: A. Recommend to the Pt. that he get a second medical opinion as the surgery seems unsuccessful B. Discontinue the treatment; and discuss the situation with the supervising physical therapist C. Complete the full 8 weeks of treatment and carefully document his lack of improvement to ensure full insurance coverage D. Re-examine the patient and implement a modified therapy program
B. Discontinue the treatment; and discuss the situation with the supervising physical therapist
A physical therapist assistant observes a physical therapist perform joint mobilizations on a patient rehabilitating from a knee fracture. The large amplitude movement is directed parallel to the joint surfaces and is designed to increase periarticular extensibility. This type of mobilization best describes: A. Grade III Traction B. Grade III Glide C. Grade IV Traction D. Grade IV Glide
B. Grade III Glide
Which of the following best describes a patient 6 weeks following a total medial menisectomy? A. Decreased joint play and rehab should focus on stretching & joint mobs to regain lost motion B. Increased joint play and rehab should focus on increasing muscle tone & joint stability C. Decreased knee extension and rehab is focused on hamstring stretches & anterior tibial glides D. Decreased knee flexion and rehab should focus on quad stretches &posterior tibial glides
B. Increased joint play and rehab should focus on increasing muscle tone & joint stability
The primary physical therapist asks you to perform patellar joint mobilizations on a patient 5 weeks s/p knee surgery. If the primary goal was to assist in gaining limited knee flexion the direction of the mobilization should be placed in which of the following directions? A. Superior B. Inferior C. Medial D. Lateral
B. Inferior
When treating a post-op ACL reconstruction patient and you are educating them on the strength of their ACL graft 12 weeks following their surgery, which of the following best represents what you should tell them? A. It is at its weakest at 12 weeks post/op B. It has less than 50% of its original strength C. It has approximately 75% of its original strength D. It is now at approximately 100% of its full strength
B. It has less than 50% of its original strength
A physical therapist assistant works with a patient diagnosed with piriformis syndrome. Weakness would most likely be noted with which of the following resisted motions? A. Knee extension B. Knee flexion C. Hip flexion D. Hip adduction
B. Knee flexion
The gastrocnemius performs which of the following functions in the open and closed kinetic chain? A. Perform knee flexion in the OKC and knee flexion in the CKC B. Knee flexion in the OKC and knee extension in the CKC C. Knee extension in the OKC and knee extension in the CKC D. Knee extension in the OKC and knee flexion in the CKC
B. Knee flexion in the OKC and knee extension in the CKC
The hamstrings perform which of the following functions in the open and closed kinetic chain? A. Knee flexion in the OKC and knee flexion in the CKC B. Knee flexion in the OKC and knee extension in the CKC C. Knee extension in the OKC and knee extension in the CKC D. Knee extension in the OKC and knee flexion in the CKC
B. Knee flexion in the OKC and knee extension in the CKC
A physical therapist assistant uses iontophoresis over the anterior knee of patient with patellar tendonitis. Assuming the established goal is to reduce the patient's present pain level, the MOST appropriate solution to utilize is: A. Acetic acid B. Lidocaine C. Sodium chloride D. Zinc oxide
B. Lidocaine
A 23 year-old male has sustained a left quadriceps femoris strain while playing recreational volleyball two weeks ago. The supervising physical therapist has instructed you to begin a stretching program to promote a functional gain in range of motion. The patient has noted pain and discomfort with knee flexion greater than 80 degrees. The most appropriate treatment program for this patient would be: A. Moist heat followed immediately by ballistic stretching B. Moist heat followed immediately by static stretching C. Cryotherapy followed immediately by ballistic stretching D. Cryotherapy followed immediately by static stretching
B. Moist heat followed immediately by static stretching
A patient demonstrates quadriceps weakness (4-/5) and difficulty descending stairs. The BEST intervention to regain functional strength in the quadriceps is: A. Isokinetic exercise, at 36 degrees/second B. Partial squats progressing to lunges C. Progressive resistance exercises, 70% 1 RM, 3 sets of 10 D. Maximum isometric exercise, at 45 and 90 degrees of knee extension
B. Partial squats progressing to lunges
A patient with patellar tracking dysfunction is referred to physical therapy. A note from the examination indicates diminished vastus medialis obliquus activity. The most appropriate method to selectively train the vastus medialis obliquus is: A. Short arc terminal extension with manual resistance B. Quadriceps setting exercises and biofeedback C. Straight leg raises with leg weights D. Multiple angle isometric exercises
B. Quadriceps setting exercises and biofeedback
Following surgery, a patient has effusion of the right knee joint and is unable to initiate quadriceps setting exercises. To facilitate the exercise, the best method to use would be: A. Transcutaneous nerve stimulation to the thigh B. Quick icing to the quadriceps muscle C. Joint approximation at the knee D. Firm pressure on the patellar tendon
B. Quick icing to the quadriceps muscle
A PTA reviews an exercise program for a patient rehabilitating from ACL reconstruction. Which of the following treatment options would place the least amount of stress on the reconstructed ligament? A. Walking B. Stationary cycling C. Slow running on a level surface D. Fast running on a level surface
B. Stationary cycling
A physical therapist assistant positions a patient in prone on a plinth and passively flexes their knee. As the knee flexes, the patient's hip on the same side also begins to flex. This clinical finding is most indicative of a: A. Tight iliopsoas B. Tight rectus femoris C. Tight tensor fasciae latae D. Tight hamstrings
B. Tight rectus femoris
An injury at the knee joint that involves the meniscus, MCL and ACL is also known as... A. Genu Valgum injury B. Unhappy or terrible triad C. Miserable malalignment D. Bayonet sign
B. Unhappy or terrible triad
A physical therapist assistant works with a patient with an injury to the femoral nerve, this patient would be affected most during which of the following functional activities? A. Walking up-hill and up-stairs B. Walking down-hill and down-stairs C. Walking up-hill and down-stairs D. Walking down-hill and up-stairs
B. Walking down-hill and down-stairs
A patient is treated in physical therapy after injuring his hamstrings. The medical chart describes the injury as an avulsion fracture of the ischial tuberosity. This injury usually results from: A. forceful extension of the hip with an extended knee B. forceful flexion of the hip with an extended knee C. forceful extension of the hip with a flexed knee D. forceful flexion of the hip with a flexed knee
B. forceful flexion of the hip with an extended knee
A patient rehabilitating from a motor vehicle accident completes a series of closed kinetic chain exercises. One of the exercises requires the patient to perform a mini-squat in an erect position the center of gravity placed directly over the knee joint. If the physical therapist assistant modifies the activity by asking the patient to move the buttocks posteriorly in relation to the knees, what muscle group is the therapist attempting to emphasize? A. knee extensors B. hip extensors C. knee flexors D. hip flexors
B. hip extensors
A patient scheduled for posterior cruciate ligament reconstruction in two weeks is seen in physical therapy. The patient has diminished quadriceps strength and walks with a noticeable limp. The involved knee has mild edema and a 15 degree flexion contracture. The most appropriate treatment priority is: A. improve quadriceps strength B. improve range of motion C. improve fluidity of gait D. reduce edema
B. improve range of motion
A patient is referred to physical therapy after sustaining a lower extremity injury. The physical therapist assistant identifies several postural abnormalities including genu varum. Which of the following motions or postures is not often correlated with genu varum? A. excessive hip abduction B. lateral patellar subluxation C. ipsilateral hip lateral rotation D. medial tibial torsion
B. lateral patellar subluxation
A physical therapist assistant completes a posture screening and a gross range of motion test on a patient referred to therapy with patella tendonitis. The therapist determines that the patient has extremely limited lower extremity flexibility, most notably in the hip flexors. What common structural deformity is often associated with tight hip flexors? A. scoliosis B. lordosis C. kyphosis D. spondylosis
B. lordosis
A patient eight days status post anterior cruciate ligament reconstruction using a patellar tendon autograft is referred to physical therapy. Which of the following exercises would be the most appropriate based on the patient's post-operative status? A. limited range isokinetics at 30 degrees per second B. mini-squats in standing C. unilateral leg press D. active knee extension in short sitting
B. mini-squats in standing
Measuring passive knee flexion in prone (A) and in supine (B) would likely result in decreased ROM in prone (A) due to: A. active insufficiency of the knee extensors B. passive insufficiency of the knee extensors C. active insufficiency of the knee flexors D. passive insufficiency of the knee flexors
B. passive insufficiency of the knee extensors
A patient rehabilitating form a knee injury completes an isokinetic test. The patient produces 88 ft/lbs of torque with the hamstring at 120° per second. Assuming normal quadriceps/ hamstrings ratio, which of the following MOST accurately reflects the predicted quadriceps value? A. 67 ft/lbs B. 109 ft/lbs C. 136 ft/lbs D. 183 ft/lbs
C. 136 ft/lbs
A physical therapist assistant works with a patient diagnosed with patellar femoral pain syndrome. During the session the therapist elects to measure the patient's Q angle. Which three bony landmarks are used to measure the Q angle? A. Anterior superior iliac spine, superior border of the patella, tibial tubercle B. Greater trochanter, midpoint of the patella, superior border of the patella tendon C. Anterior superior iliac spine, midpoint of the patella, tibial tubercle D. Anterior superior iliac spine, inferior border of the patella, midpoint of the patella tendon
C. Anterior superior iliac spine, midpoint of the patella, tibial tubercle
A physical therapist assistant completes a series of special tests designed to assess the ligamentous integrity of a patient's knee. After completing the tests, the therapist is unsure if the laxity is normal or if it is indicative of a ligamentous injury. The most appropriate step to gather more information is to: A. Quantify the millimeters of laxity and compare the values with established norms B. Contact the physician and suggest a referral for magnetic resonance imaging C. Directly compare the laxity in the involved knee to the laxity in the uninvolved knee D. Identify special tests that can offer more information on the ligamentous integrity of the knee
C. Directly compare the laxity in the involved knee to the laxity in the uninvolved knee
Good hamstring strength and control will help prevent... A. Excessive anterior tibial glide during knee flexion B. Excessive posterior tibial glide during knee flexion C. Excessive anterior tibial glide during knee extension D. Excessive posterior tibial glide during knee extension
C. Excessive anterior tibial glide during knee extension
If a patient presented with a tight gastroc/soleus complex which of the following resting postures of the knee would they most likely present with in standing? A. Genu varus B. Genu valgus C. Genu recurvatum D. Slightly flexed knee
C. Genu recurvatum
A 28 y/o male diagnosed with a medial meniscus injury is referred to physical therapy following arthroscopy surgery. During the treatment session the physical therapist assistant identifies decreased range of motion in the involved knee. This objective finding is best termed a/an: A. Pathology B. Functional limitation C. Impairment D. Disability
C. Impairment
A seventeen year-old healthy female athlete is being treated for tendonitis of the right patellar tendon. The supervising PT believes that it is time to enhance her strength by introducing appropriate therapeutic exercises. The exercise principle that would most likely promote rapid strength development would be to: A. Increase the size of the muscle belly through repeated bouts of exercise B. Begin repeated bouts of sub-maximal isometric exercise C. Increase the recruitment of motor units through increased resistance D. Instruct the athlete to ingest greater amounts of protein in her diet
C. Increase the recruitment of motor units through increased resistance
A 16 y/o high school track participant returns to physical therapy after a physician appointment. The patient indicates the MRI revealed a tear in the medial meniscus of the left knee. As you look back on the initial examination, which of the following special tests would you expect to have been positive? A. Lachman B. Pivot shift C. McMurray D. Apprehension
C. McMurray
A patient explains to a physical therapist assistant that she was instructed to bear up to five pounds of weight on her involved extremity. The patient's weight bearing status would be BEST described as: A. Non-weight bearing B. Toe touch weight bearing C. Partial weight bearing D. Weight bearing as tolerated
C. Partial weight bearing
Which of the following muscles has its primary job to unlock the knee joint from its closed pack position to initiate knee flexion? A. Pes anserine muscles B. Biceps femoris C. Popliteus D. VMO
C. Popliteus
A physical therapist assistant obtains a gross measurement of hamstring length by passively extending the lower extremity of patient in short sitting. The MOST common substitution to exaggerate hamstring length is: A. Weight shift to the contralateral side B. Anterior rotation of the pelvis C. Posterior rotation of the pelvis D. Hiking of the contralateral hip
C. Posterior rotation of the pelvis
A patient with iliotibial band friction syndrome is seen in physical therapy for instruction in stretching of the iliotibial band and tensor fascia latae. The most appropriate way to teach this stretch is to position the patient: A. Sidelying on the involved side with the upper leg supported while the patient flexes, adducts and externally rotates the involved hip B. Supine while the patient extends, abducts and internally rotates the involved hip C. Sidelying on the uninvolved side while the patient extends, internally rotates and adducts the involved hip D. Standing with legs adducted, flexing and laterally rotating the trunk towards the involved side
C. Sidelying on the uninvolved side while the patient extends, internally rotates and adducts the involved hip
A patient diagnosed with left patellofemoral pain is referred to physical therapy. The patient reports the onset of pain in the left knee when she runs for more than six miles, physical examination of the left knee reveals mild edema along the medial joint line, diminished patella medial glide, and mild vastus medialis atrophy. The MOST appropriate treatment option is A. Medial patella glide and squats to 90 degrees knee flexion with hip adduction. B. Open chain knee extension in short sitting C. Squats to 30 degrees knee flexion and medial patella glides D. Phonophoresis and retro- walking on a treadmill.
C. Squats to 30 degrees knee flexion and medial patella glides
A patient two weeks s/p ACL reconstruction using a patellar tendon autograft is referred to physical therapy. The supervising physical therapist indicates that the patient's rehabilitation program should avoid activities that place shearing stress on the reconstructed ligament. Which exercise would be the least desirable to include in the exercise program? A. Straight leg raises in supine from 0-60 degrees of hip flexion B. Standing hamstrings curls from 0-90 degrees of knee flexion C. Supine short arc quadriceps exercises using a bolster D. Gravity assisted knee extension in supine
C. Supine short arc quadriceps exercises using a bolster
A PTA is treating a 47 y/o female with diminished lower extremity ROM due to tight hamstrings. As part of the treatment program, the therapist attempts to identify an appropriate active exercise technique to improve ROM. Which objective finding would result in contract-relax being an undesirable treatment option? A. The limitation of movement is greater than 50% of the normal available range B. The limitation of movement involves multiple planes C. The limitation of movement is accompanied by pain D. The limitation of movement occurs in a non-capsular pattern
C. The limitation of movement is accompanied by pain
A physical therapist assistant prepares a patient education program for an individual with chronic venous insufficiency. Which of the following would NOT be appropriate to include in the patient education program? A. Wear shoes that accommodate to the size and shape of your feet B. Observe your skin daily for breakdown C. Wear your compression stockings only at night D. Keep your feet elevated as much as possible throughout the day
C. Wear your compression stockings only at night
A patient successfully completes ten anterior lunges. The physical therapist assistant would like to modify the activity to maximally challenge the patient in the sagittal plane. Which of the following modifications would be the most appropriate? A. anterior lunge with concurrent bilateral elbow flexion to 45° with five pound weights B. anterior lunge with concurrent unilateral shoulder flexion to 90° with a five pound weight C. anterior lunge with concurrent bilateral shoulder flexion to 90° with five pound weights D. anterior lunge with concurrent bilateral shoulder abduction to 45° with five pound weights
C. anterior lunge with concurrent bilateral shoulder flexion to 90° with five pound weights
A 67 y/o female status post total knee arthroplasty due to severe degenerative joint disease is referred to physical therapy. During the examination the patient reports to the therapist that she has significant difficulty negotiating stairs. How much knee range of motion would be required to perform this activity? A. approximately 0-60 degrees of knee flexion B. approximately 0-110 degrees of knee flexion C. approximately 0-90 degrees of knee flexion D. approximately 0-125 degrees of knee flexion
C. approximately 0-90 degrees of knee flexion
A patient diagnosed with chronic osteoarthritis of his right knee and is referred to physical therapy. The patient reports his current pain as a 4 on a visual analog scale ranging from 0-10. The MOST appropriate goal when addressing the patient's pain is: A. prevent pain B. control pain C. manage pain D. alleviate pain
C. manage pain
A PTA is treating a patient status post knee surgery. The patient is presently using a straight leg immobilizer that maintains the knee in an extended posistion. The decision to discontinue the knee immobilizer would be MOST influenced by the patient's: A. edema B. active range of motion C. quadriceps control D. pain
C. quadriceps control
A 13 y/o girl discusses the possibility of anterior cruciate ligament reconstruction with an orthopedic surgeon. She injured her knee while playing soccer and is concerned about the future impact of the injury on her athletic career. Which of the following factors would have the greatest influence on her candidacy for surgery? A. anthropometric measurements B. hamstrings/quadriceps strength ratio C. skeletal maturity D. somatotype
C. skeletal maturity
A PTA is required to train a 71 y/o patient to ascend and descend stairs. The patient presents with a fractured left tibia and is weight bearing as tolerated. There is moderate weakness in the involved lower extremity secondary to the fracture. The most appropriate instructions are: A. "One step at a time, right foot first to ascend and to descend the stairs" B. "Step over step slowly" C. "One step at a time, left foot first to ascend and to descend the stairs" D. "One step at a time, right foot first to ascend the stairs and left foot first to descend the stairs"
D. "One step at a time, right foot first to ascend the stairs and left foot first to descend the stairs"
A patient with anterior cruciate ligament insufficiency, who elects not to have surgical reconstruction, could probably expect to reach which minimal functional level? A. Able to participate in all sports B. Cannot play any type of sport C. Problems with normal walking D. Able to participate in light recreational sports
D. Able to participate in light recreational sports
Following a total knee replacement [TKR], continuous passive motion [CPM] is initiated. One of the main objectives in using CPM in this case is to facilitate: A. Active knee extension B. Passive knee flexion C. Passive knee extension D. Active knee flexion
D. Active knee flexion
Which of the following special tests would likely be positive in a patient with patellofemoral pain syndrome? A. Clarks Sign B. Lateral pull test C. Increased Q-angle D. All of the above
D. All of the above
Which of the following would be a possible cause for a lateral tracking patella? A. Tight IT band and lateral retinaculum B. Weak abductors C. Poor functioning VMO D. All of the above
D. All of the above
Which of the following would be a possible cause for an exaggerated Q-angle? A. Excessive femoral anteversion B. Excessive tibial torsion C. Excessive Genu valgus D. All of the above
D. All of the above
A therapist is treating a patient status post left knee replacement with goals of general conditioning and independence for household mobility. Which component of the patient's treatment program would be the most appropriate to delegate to a physical therapy aide? A. Stair training B. Progressive gait training with a straight cane C. Patient education regarding the surgical procedure D. Ambulation with a walker for endurance
D. Ambulation with a walker for endurance
A patient demonstrates a deficit in terminal knee extension following knee surgery due to capsular tightness. To assist the patient in gaining this last 10-15 degrees of knee extension you should perform which of the following? A. Pure posterior glides B. Posterior glides with medial rotation C. Anterior glides D. Anterior glides with lateral rotation
D. Anterior glides with lateral rotation
A physical therapist assistant is trying to palpate Gerdy's tubercle at the knee. This structure is located in which of the following areas? A. Posterior lateral aspect of the distal femur B. Anterior medial aspect of the proximal tibia C. Anterior lateral aspect of the distal femur D. Anterior lateral aspect of the proximal tibia
D. Anterior lateral aspect of the proximal tibia
A physician reduces a comminuted tibia fracture using an external fixation device. Which stage of bone healing is associated with the termination of external fixation? A. Hematoma formation B. Cellular proliferation C. Callus formation D. Clinical union
D. Clinical union
A college soccer player sustained a hyperextension knee injury when kicking the ball with his other lower extremity. The patient was taken to the emergency room of a local hospital and was diagnosed with "knee sprain". He was sent to physical therapy the next day for aggressive rehabilitation. As part of the examination to determine the type of treatment plan to implement, the therapist conducts the test shown in the figure (Page 621). The type of exercise that is indicated in the acute phase of treatment if a positive test is found includes: A. Agility exercises B. Open-chain terminal knee extension exercises C. Plyometric functional exercises D. Closed chain terminal knee extension exercises
D. Closed chain terminal knee extension exercises
A patient sustained a valgus stress to his left knee while skiing. Special tests found a positive McMurray's and Lachman's test. He has been sent to physical therapy for conservative treatment. The sub-acute phase of physical therapy intervention should emphasize: A. Open-chain strengthening of the quadriceps femoris and hip adductors to inhibit anterior translation of the tibia on the femur. B. Closed-chain functional strengthening of the quadriceps femoris and hip abductors to promote regaining terminal knee extension. C. Open-chain exercises of the hip extensors and hamstrings to inhibit anterior translation of the femur on the tibia. D. Closed-chain functional strengthening of the quadriceps femoris and hamstrings emphasizing regaining terminal knee extension.
D. Closed-chain functional strengthening of the quadriceps femoris and hamstrings emphasizing regaining terminal knee extension.
A severe injury to the lower branches of the femoral nerve would have the most effect when the patient is walking: A. Upstairs B. Up an incline C. On uneven terrain D. Downstairs
D. Downstairs
A PTA observes genu recurvatum during ambulation in a patient with hemiplegia. The patient has been using a posterior leaf spring (PLS) orthosis since discharge from subacute rehab 4 weeks ago. The therapist has previously administered Fugl-Meyer Assessment of Physical Performance and determined the lower extremity score to be 22 (out of a possible 34) with strong synergies in the lower extremity and no out-of-synergy movement. The most likely cause of this deviation is: A. Hip flexor weakness B. Dorsiflexor spasticity C. Hamstring weakness D. Extensor spasticity
D. Extensor spasticity
A college volleyball player complains of moderate pain resulting from a left hamstring strain four weeks ago. The focal point of pain and tightness is noted where a hematoma developed initially. The specific massage technique that would be MOST beneficial in this case is: A. Stroking B. Kneading C. Tapotement D. Friction
D. Friction
An 18 y/o female basketball player is undergoing rehabilitation post left knee ACL reconstruction. The orthopedic surgeon used a bone-patellar tendon-bone graft and has ordered that an accelerated rehabilitation protocol be utilized to restore function to the athlete's lower extremities. The best description of a positive impact utilizing closed chain kinetic exercises as part of an accelerated rehabilitation protocol is promoting: A. Long axis distraction of the joint B. Functional movement in only the cardinal planes of motion C. Shear forces at the articular level D. Functional recruitment of motor units
D. Functional recruitment of motor units
A PTA assesses the strength of selected lower extremity muscles on a patient rehabilitating from a knee injury. The pictured test would be most effective to assess the strength of the: A. Hip abductors B. Hip adductors C. Hip medial rotators D. Hip lateral rotators
D. Hip lateral rotators
A 10 y/o boy with hemophilia fell and injured himself while skateboarding. He was admitted to a pediatric acute care facility and a therapist sees him that afternoon. Examination reveals a hemarthrosis in his left knee. The BEST initial intervention for this patient is: A. Instruct the patient in crutch use to protect the joint and assist in early return to walking B. A pool program to maintain ROM and strength while he is non-weightbearing C. A hot pack for the knee, splint and instruction in non-weightbearing exercises D. Ice, elevation and a splint for the limb
D. Ice, elevation and a splint for the limb
A physical therapist assistant works with a patient diagnosed with anterior cruciate ligament insufficiency. The physician referral specifies closed kinematic chain rehabilitation. Which exercise would NOT be appropriate based on the physician order? A. Exercise on a stair machine B. Limited squats to 45 degrees C. Walking backwards on a treadmill D. Isokinetic knee extension and flexion
D. Isokinetic knee extension and flexion
A patient with osteoarthritis in the right knee is referred to physical therapy. Examination reveals moderate inflammation in the involved knee and significant muscle weakness particularly in the quadriceps. The patient rates the intensity of pain in the knee as a 4 on a scale of 0 to 10. The most appropriate activity to address the muscle impairment is: A. Straight leg raises with ankle weights B. Limited range active knee extension in short sitting C. Avoid strengthening exercises until the patient is pain free D. Isometric quadriceps contraction
D. Isometric quadriceps contraction
A physical therapist assistant classifies a patient's end-feel as soft after completing a specific passive movement. Which of the following joint motions would typically produce a soft end-feel? A. Hip flexion with the knee extended B. Elbow extension C. Forearm supination D. Knee flexion
D. Knee flexion
A 16 year-old female was sent to physical therapy with a diagnosis of anterior knee pain. Positive findings include Pes planus, lateral tibial torsion and genu valgum. The position the femur will be in is excessive: A. Abduction B. Lateral rotation C. Retroversion D. Medial rotation
D. Medial rotation
A physical therapist assistant performs girth measurements on a patient rehabilitating from knee surgery. The therapist takes the measurements 5cm and 10cm above the superior pole of the patella with the patient in supine. The girth measurements are recorded as 32cm and 37cm on the right and 34cm and 40cm on the left. Which of the following conclusions can be made regarding the strength of the patient's quadriceps? A. The right quadriceps will be capable of producing a greater force than the left B. The left quadriceps will be capable of producing a greater force than the right C. The right and left quadriceps will be capable of producing equal force D. Not enough information is given
D. Not enough information is given
A patient with left knee degenerative joint disease c/o knee pain of two months duration. He has been followed by outpatient PT for 3 weeks. The patient feels his condition is worsening as pain has increased during weight bearing activities and he can no longer fully extend his left knee. Re-examination findings include: increased swelling, decreased knee AROM into extension, and an antalgic gait. The PTA should: A. Continue therapy for another week to ensure that all interventions have been attempted and then return the patient to the referring physician. B. Continue physical therapy for another two weeks because there is uncertainty if the patient understands or is complying with the home exercise program. C. Tell the patient to see an orthopedic surgeon for possible immediate surgical intervention. D. Notify the primary physical therapist as to the ineffective treatment and document.
D. Notify the primary physical therapist as to the ineffective treatment and document.
During functional activities the primary function of the vastus medialis obliquus (VMO) is to perform... A. Knee flexion B. Knee extension C. Medial rotation of the tibia D. Patellar stabilization
D. Patellar stabilization
A Cho-Pat Straps are commonly prescribed for patients with which of the following conditions at the knee joint? A. ACL injuries B. MCL injuries C. Lateral tracking patella D. Patellar tendinitis
D. Patellar tendinitis
A program that consisted of stretching the lateral retinaculum, IT band and vastus lateralis as well as strengthening the VMO, medial hamstrings and hip abductors would be most appropriate for which of the following conditions? A. ACL or MCL tear B. Groin strain or hamstring strain C. LCP or Osgood Schlatter's disease D. Patellofemoral syndrome or miserable malalignment syndrome
D. Patellofemoral syndrome or miserable malalignment syndrome
If a patient has knee range of motion "5 degrees to 90 degrees", it could be interpreted that: A. Knee can be completely flexed but cannot completely extend B. Patient has adequate functional range of motion at the knee C. Patient can completely extend the knee but cannot completely flex it D. Patient has limited knee motion
D. Patient has limited knee motion
A patient is rehabilitating from a grade I medial collateral ligament injury questions the therapist about his expected functional activity level following rehabilitation. The most accurate predictor of the patient's expected functional activity level is the: A. Patient's age and past medical history B. Patient's previous functional activity level C. Duration of physical therapy services D. Patient's compliance with the established HEP
D. Patient's compliance with the established HEP
You are manually stretching a patient's hamstring muscle in the supine position by performing a passive straight leg raise. The therapeutic goal is to improve long-term flexibility of the hamstring muscle. The physiological changes that you are trying to produce are: A. Elastic changes in the musculotendinous components B. Elastic changes in the ligamentous components C. Plastic changes in the ligamentous components D. Plastic changes in the musculotendinous components
D. Plastic changes in the musculotendinous components
A patient is sitting on the edge of a mat with her right knee in extension. As the knee is slowly flexed, the activity occurring is the result of the: A. Quadriceps performing a concentric contraction B. Hamstrings performing a concentric contraction C. Hamstrings performing an eccentric contraction D. Quadriceps performing an eccentric contraction
D. Quadriceps performing an eccentric contraction
A patient diagnosed with an anterior cruciate ligament injury is referred to physical therapy. During a treatment session, the patient asks the physical therapist assistant why the physician would order x-rays after already diagnosing the ligament injury. The primary purpose for ordering the radiographs would be to: A. Confirm the physician's diagnosis B. Check for possible meniscal involvement C. Assess the patient's skeletal maturity D. Rule out the possibility of a fracture
D. Rule out the possibility of a fracture
A physical therapist assistant palpates along the medial portion of the hamstring musculature. The most prominent tendon palpated during resisted knee flexion would be: A. Biceps femoris B. Gracilis C. Sartorius D. Semitendinosus
D. Semitendinosus
A physical therapist assistant observing a patient complete a leg curl exercise notices two prominent tendons visible on the posterior surface of the patient's left knee. The visible tendons are most likely associated with the: A. Semimembranosus and semitendinosus muscles B. Popliteus and semitendinosus muscles C. Semimembranosus and biceps femoris muscles D. Semitendinosus and biceps femoris muscles
D. Semitendinosus and biceps femoris muscles
A patient that presents with clinical hip anteversion would most likely present with which of the following postures of the knees and feet? A. Frog eyed patella with a toeing in posture B. Frog eyed patella with a toeing out posture C. Squinting patella with a toeing out posture D. Squinting patella with a toeing in posture
D. Squinting patella with a toeing in posture
A patient 2 weeks post anterior cruciate ligament reconstruction using a patellar tendon autograft is referred to physical therapy. The supervising physical therapist indicates that the patient's rehabilitation program should avoid activities that place shearing stress on the reconstructed ligament. Which exercise would be the least desirable to include in the exercise program? A. Straight leg raises in supine from 0-60 degrees of hip flexion B. Standing hamstrings curls from 0-90 degrees of knee flexion C. Gravity assisted knee extension in supine D. Supine short arc quadriceps exercises using a bolster
D. Supine short arc quadriceps exercises using a bolster
A PTA provides pre-operative instruction for a patient scheduled for anterior cruciate ligament reconstructive surgery. During the treatment session, the patient expresses to the therapist a sincere fear of dying during surgery. The therapist's most appropriate response would be: A. This surgery is done many times every day B. I have never had a patient die yet C. You will be back to athletics before you know it D. Surgery can be a very frightening thought
D. Surgery can be a very frightening thought
A physical therapist assistant treats a 47-year-old female with diminished lower extremity range of motion due to hamstrings tightness. As part of the treatment program, the therapist attempts to identify an appropriate active exercise technique to improve range of motion. Which objective finding would result in contract-relax being an undesirable treatment option? A. The limitation of movement is greater than 50% of the normal available range B. The limitation of movement involves multiple planes C. The limitation of movement occurs in a non-capsular pattern D. The limitation of movement is accompanied by pain
D. The limitation of movement is accompanied by pain
A PTA completes a selected resistive test on a patient. The patient reports feeling pain during the test, however, strength is normal. Which of the following conclusions is most likely? A. capsular or ligamentous laxity B. a complete rupture of the muscle or tendon C. intermittent claudication may be present D. a minor lesion of the muscle or tendon
D. a minor lesion of the muscle or tendon
A physician instructs a 26-year-old male to utilize a knee derotation brace for all athletic activities. Which condition would most warrant the use of the derotation brace? A. medial meniscus repair B. anterior cruciate ligament reconstruction C. posterior cruciate ligament reconstruction D. anterior cruciate ligament insufficiency
D. anterior cruciate ligament insufficiency
A PTA participates in a research study that examines the effect of HVPC electrical stimulation on edema following arthroscopic knee surgery. The most appropriate method to collect data is: A. anthropometric measurements B. goniometric measurements C. volumetric measurements D. circumferential measurements
D. circumferential measurements
A patient two days status post arthroscopy of the knee completes a quadriceps setting exercise while lying supine on a mat table. During the exercise the patient begins to experience severe pain. The most appropriate physical therapist assistant action is: A. have the patient perform the exercise in sidelying B. have the patient flex the knee prior to initiating the exercise C. place a pillow under the ankle D. discontinue the exercise
D. discontinue the exercise
An athlete is forced to contemplate knee surgery after spraining the anterior cruciate ligament while playing soccer. Which situation would provide the most direct support for an anterior cruciate ligament reconstruction? A. grade III ACL sprain and grade I PCL injury B. grade III ACL sprain with a lateral meniscus tear C. grade II ACL sprain with a medial meniscus tear D. functional instability
D. functional instability
A physical therapist assistant works with a patient diagnosed with anterior cruciate ligament insufficiency. The physician referral specifies closed kinematic chain rehabilitation. Which exercise would not be appropriate based on the physician order? A. exercise on a stair machine B. limited squats to 45 degrees C. walking backwards on a treadmill D. isokinetic knee extension and flexion
D. isokinetic knee extension and flexion
A physician completes a physical examination on a 16-year old male who injured his knee while playing in a soccer contest yesterday. The physician's preliminary diagnosis is a grade III anterior cruciate ligament injury with probable meniscal involvement. Which of the following diagnostic tools would best confirm the preliminary diagnosis? A. bone scan B. myelogram C. x-rays D. magnetic resonance imaging
D. magnetic resonance imaging
A 13 y/o female presents with patellofemoral syndrome. During the examination you ask your patient to extend her knee, while she is sitting with her legs over the examination table. You recall that during this motion the patella is moving from a position in which... A. the medial and lateral facets are in contact with the femur to a position of no facet contact B. the odd and lateral facets are in contact with the femur to a position of no facet contact C. the odd and medial facets are in contact with the femur to a position of no facet contact D. the odd, lateral and medial facets are in contact with the femur to a position of no facet contact
D. the odd, lateral and medial facets are in contact with the femur to a position of no facet contact
