Musculoskeletal pathology 1
Which condition would be the most likely to be treated with a heel lift? Achilles tendonitis hallux rigidus metatarsalgia pes cavus
Correct Answer: Achilles tendonitis A heel lift can be used to treat Achilles tendonitis since it serves to reduce traction and promote healing of the Achilles tendon.
Which of the following special tests is used to identify the presence of a biceps tendon rupture? Neer impingement test empty can test Roos test Ludington's test
Correct Answer: Ludington's test A positive Ludington's test is indicated by absence of movement in the biceps tendon and may be indicative of a rupture of the long head of the biceps.
Which of the following special tests may be used to help confirm a suspected diagnosis of bicipital tendonitis? apprehension test empty can test Hawkins-Kennedy test Speed's test
Correct Answer: Speed's test Special tests such as Speed's test and Yergason's test may be useful to confirm a diagnosis of bicipital tendonitis. Speed's test is performed with the patient positioned in sitting or standing with the elbow extended and the forearm supinated. The therapist places one hand over the bicipital groove and the other hand on the volar surface of the forearm. The therapist resists active shoulder flexion. A positive test is indicated by pain or tenderness in the bicipital groove region.
A person with an anterior cruciate ligament deficiency, who elects not to have surgical reconstruction, could probably expect to reach what minimal functional level? able to participate in all sports without restrictions able to participate in light recreational sports cannot play any type of sport problems with normal walking
Correct Answer: able to participate in light recreational sports Patients with anterior cruciate ligament insufficiency can typically participate in light recreational sports, although may experience periodic instability. Participation in all sports without restrictions would greatly increase the probability of frequent episodes of instability.
Immediate and severe swelling following a knee injury would most likely indicate damage to the: meniscus posterior cruciate ligament medial collateral ligament anterior cruciate ligament
Correct Answer: anterior cruciate ligament The medial inferior genicular artery runs through the anterior cruciate ligament (ACL). As a result, tearing of the ACL often produces hemarthrosis of the knee joint.
What medical condition would likely result in a decreased percentage of the femoral head being within the acetabulum? acetabular labral tear ankylosing spondylitis femoroacetabular impingement congenital hip dysplasia
Correct Answer: congenital hip dysplasia Congenital hip dysplasia, also known as developmental dysplasia, is a condition characterized by malalignment of the femoral head within the acetabulum. The condition develops during the last trimester in utero and often results in a decreased percentage of the femoral head being within the acetabulum.
Which structure would be necessary to palpate with a suspected Colles' fracture? scaphoid distal ulna fifth metacarpal distal radius
Correct Answer: distal radius A Colles' fracture is a fracture of the distal radius with dorsal displacement of the fractured segment. The most common mechanism of injury is a fall on an outstretched hand.
The majority of congenital limb deficiencies are caused by: genetics infection maternal drug exposure inadequate blood supply
Correct Answer: genetics The majority of congenital limb deficiencies are idiopathic or genetic in origin. The remaining options represent possible etiologies for congenital limb deficiencies, but they are not as common as genetics.
What stage of idiopathic frozen shoulder is most likely to present with intact rotator cuff strength and night pain? stage 1 stage 2 stage 3 stage 4
Correct Answer: stage 1 Stage 1 is characterized by the gradual onset of pain with decreased movement and night pain. The patient typically presents with a loss of external rotation motion with intact rotator cuff strength. The duration of this stage is usually less than three months.
Congenital torticollis is caused by a unilateral contracture of which muscle? levator scapulae middle scalene sternocleidomastoid trapezius
Correct Answer: sternocleidomastoid Congenital torticollis, also known as wry neck, is characterized by a unilateral contracture of the sternocleidomastoid muscle. The condition is most often identified in the first two months of life. The cause is unknown, however, it may be associated with malpositioning in utero or birth trauma.
Unequal limb length in a newborn may be indicative of: torticollis fetal alcohol syndrome congenital hip dislocation spina bifida
Correct Answer: congenital hip dislocation The physical examination of the newborn should include assessment of the back, hips, buttocks, and anus. Unequal leg length, asymmetrical gluteal folds, and a click in the hips can be indicative of congenital hip dislocation.
What is the goal of therapeutic intervention associated with developmental dysplasia of the hip? internal fixation enlarging and deepening the acetabulum replacing the femoral head compensating for a leg length discrepancy
Correct Answer: enlarging and deepening the acetabulum Developmental dysplasia of the hip is characterized by malalignment of the femoral head in the acetabulum. Enlarging and deepening the acetabulum can allow for a more stable articulation between the two structures. If conservative treatment for this condition is not successful, surgical management may be indicated.
What is the typical clinical presentation of a child with congenital torticollis? lateral cervical flexion and rotation to the same side as the contracture lateral cervical flexion and rotation to the opposite side of the contracture lateral cervical flexion to the same side as the contracture and rotation to the opposite side lateral cervical flexion to the opposite side as the contracture and rotation to the same side
Correct Answer: lateral cervical flexion to the same side as the contracture and rotation to the opposite side Congenital torticollis, also known as wry neck, is characterized by a unilateral contracture of the sternocleidomastoid muscle. The clinical presentation includes lateral cervical flexion to the same side as the contracture, rotation toward the opposite side, and facial asymmetries.
The "unhappy triad" refers to an injury to all of the following except: anterior cruciate ligament lateral collateral ligament medial collateral ligament medial meniscus
Correct Answer: lateral collateral ligament An "unhappy triad" refers to an injury affecting the anterior cruciate ligament, medial meniscus, and medial collateral ligament. Damage to this combination of structures is commonly referred to as the "terrible triad" or "unhappy triad."
A child with right torticollis would most likely present with plagiocephaly in the area of the: right frontal bone left frontal bone left occipitoparietal bone right occipitoparietal bone
Correct Answer: left occipitoparietal bone Right torticollis results from shortening of the right sternocleidomastoid causing the head to bend to the right and rotate to the left. With the child lying supine, pressure is placed on the left occipitoparietal bone.
Which clinical finding is not indicative of a ruptured Achilles tendon? negative Thompson test absent Achilles reflex lack of toe off during gait inability to actively plantar flex the ankle
Correct Answer: negative Thompson test A ruptured Achilles tendon would most likely produce a positive Thompson test. The Thompson test is designed to assess the integrity of the Achilles tendon by squeezing the muscle belly of the gastrocnemius and soleus muscles. The patient is positioned in prone with the feet extended over the edge of a table. A positive test is indicated by the absence of plantar flexion and may be indicative of a ruptured Achilles tendon.
Where does a patient with Achilles tendonitis typically experience the most pain and swelling? in the popliteal fossa posterior to the knee immediately proximal to the ball of the foot proximal to the insertion on the calcaneus throughout the muscle belly of the gastrocnemius
Correct Answer: proximal to the insertion on the calcaneus A patient with Achilles tendonitis will typically experience a gradual onset of pain and swelling localized 2-3 centimeters above the tendon's insertion on the calcaneus. Morning stiffness or pain at the start of activity are also classic signs associated with Achilles tendonitis.
What mechanism of injury is commonly associated with this structure? twisting on a planted foot compression force valgus force excessive posterior force
Correct Answer: twisting on a planted foot The anterior cruciate ligament (ACL) is a commonly injured ligament in the knee. The most common mechanism of injury is twisting on a planted foot.