Musculoskeletal System

A physical therapist is observing a 67-year-old female patient walk, and immediately notes a forward trunk lean. A LIKELY contributing cause for this deviation is: A. Excessive Ankle Dorsiflexion B. Quadriceps Spasticity C. Ankle Plantar Flexion Weakness D. Ankle Plantar Flexion Contracture

D. Ankle Plantar Flexion Contracture

On examining a patient with a decreased trunk side bending to the left, the PT finds a closing restriction between L2-L3 vertebrae. What is the MOST appropriate intervention to improve the restriction? A. Apply PA glide on L2 transverse process on the right side B. Apply PA glide on L4 transverse process on the right side C. Apply PA glide on L4 transverse process on the left side D. Apply PA glide on L3 transverse process on the left side

D. Apply PA glide on L3 transverse process on the left side You need to IMPROVE the closing restriction (you're not trying to open it up).

A patient has limited RR caused by L thoracic facet joint capsular tightness at T6-7. What arthrokinematic glide would MOST effectively improve RR in sitting? a. sup/ant glide on R T7 TP b. sup/ant glide on L T7 TP c. sup/ant glide on L T6 TP d. sup/ant glide on R T6 TP

c. sup/ant glide on L T6 TP a. sup/ant glide on R T7 TP (this improves LR at T7-8) b. sup/ant glide on L T7 TP (this improves RR at T7-8) c. sup/ant glide on L T6 TP d. sup/ant glide on R T6 TP (this improves L rotation)

A physical therapist prepares to treat a patient currently undergoing active treatment for an osteosarcoma. Which statement BEST describes this condition? 1.a malignant growth affecting the long bones 2.a malignant growth affecting the flat bones 3.a benign growth affecting the long bones 4.a benign growth affecting the flat bones

1.a malignant growth affecting the long bones

While examining a patient diagnosed with Achilles tendonitis, a physical therapist notes that the foot and ankle appear to be pronated. Which motions combine to create pronation in a non-weight bearing foot? 1.abduction, dorsiflexion, eversion 2.adduction, dorsiflexion, inversion 3.abduction, plantar flexion, eversion 4.adduction, plantar flexion, inversion

1.abduction, dorsiflexion, eversion SIIP PEED For NWB

A patient presents with ape hand deformity secondary to a peripheral nerve injury. Which of the following findings would MOST likely be noted on examination? 1.decreased strength with thumb opposition 2. fixed flexion of the metacarpophalangeal joints 3. fixed hyperextension of the metacarpophalangeal joints 4.wasting of the hypothenar eminence

1.decreased strength with thumb opposition

A physical therapist grades a patient's ankle strength as 4+/5 for the dorsiflexors and a 3+/5 for the plantar flexors. Assuming that the patient demonstrates no compensation for the muscular impairments, which deviation is MOST likely during the foot flat to midstance phase of gait? 1.excessive dorsiflexion 2.foot maintained in plantar flexion 3.inadequate toe off 4.decreased knee flexion

1.excessive dorsiflexion During the foot flat to midstance phase of gait, the gastroc and soleus function eccentrically to oppose the DF moment at the ankle and control the advancement of the tibia. Weakness of these muscles would result in excessive DF during this phase of gait. Inadequate toe off would also occur, but in the later portion of the midstance phase.

A physical therapist examines the foot of a 17-year-old female referred to physical therapy with lower leg pain. After placing the foot in subtalar neutral, the therapist determines that the medial border of the foot along the first metatarsal is higher than the lateral border of the foot along the fifth metatarsal. This position would MOST appropriately be documented as: 1.forefoot varus 2.forefoot valgus 3.rearfoot varus 4.rearfoot valgus

1.forefoot varus Patients with low arches in WB often exhibit forefoot varus w/ the subtalar joint in a neutral position.

A physical therapist identifies a limitation in movement after performing a straight leg raise test on a patient in supine. The therapist then passively flexes the patient's knee on the test leg, but is unable to gain any additional hip flexion range of motion. The MOST likely diagnosis is: 1.gluteal bursitis 2.hamstrings strain 3.sciatic nerve pathology 4.trochanteric bursitis

1.gluteal bursitis The sign of the buttock test is used to determine if a patient's buttock pain has its origin in the buttock or is referred pain from the hip, sciatic nerve, or hamstring muscles. Do a SLR to limitation. Then flex the knee. If the amount of hip flexion does not increase, this is a buttock pathology like gluteal bursitis. Hamstring strain would lead to more hip flexion with the addition of knee flexion.

A physical therapist prepares to treat a patient two days following total hip arthroplasty using a posterolateral surgical approach. Which muscle experiences the GREATEST trauma with this surgical procedure? 1.gluteus maximus 2.gluteus medius 3.piriformis 4.vastus lateralis

1.gluteus maximus 1. Access to the hip using a posterolateral surgical approach occurs by spitting the gluteus maximus muscle in line with the muscle fibers. This type of surgical approach penetrates the posterior capsule resulting in potential post op joint instability. In order to prevent dislocation fo the femoral head component, the patient should avoid excessive hip flexion greater than 90 deg, hip adduction, and hip medial rotation. The glute med and vastus lateralis remain largely functional during a posterolateral functional approach. The piriformis muscle is released from its insertion on the greater troch during a THA using a postlat approach, however it is later reattached.

A physical therapist works on weight shifting activities with a patient sitting over the edge of a mat table with their feet positioned on the floor. The therapist facilitates an anterior weight shift through facilitation of the pelvis. What pattern of activity would be required for the patient to maintain an upright posture? 1.spinal extension resulting from concentric contraction of the spinal extensors 2.spinal flexion resulting from concentric contraction of the spinal flexors 3.spinal extension resulting from eccentric contraction of the spinal extensors 4.spinal flexion resulting from eccentric contraction of the spinal flexors

1.spinal extension resulting from concentric contraction of the spinal extensors

A patient successfully completes ten anterior lunges. The physical therapist 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? 1.anterior lunge with concurrent bilateral elbow flexion to 45 degrees with five pound weights 2.anterior lunge with concurrent bilateral shoulder flexion to 90 degrees with five pound weights 3.anterior lunge with concurrent unilateral shoulder flexion to 90 degrees with a five pound weight 4.anterior lunge with concurrent bilateral shoulder abduction to 45 degrees with five pound weights

2. anterior lunge with concurrent bilateral shoulder flexion to 90 degrees with five pound weights

3. A physical therapist treats a patient with right medial epicondylitis. When positioning the patient's ulnohumeral joint in the loose packed position, the therapist should allow for: 1.full extension 2.70 degrees flexion, 10 degrees supination 3.70 degrees flexion, 35 degrees supination 4.full extension, full supination

2.70 degrees flexion, 10 degrees supination When looking at 3, this is the correct placement for loose pack of the proximal radioulnar joint. This is not correct for ulnohumeral.

A physical therapist treats a patient with a peroneal tendon subluxation. To observe the subluxation, the therapist positions the patient in a prone position with the knee flexed to 90 degrees. Which action would be the MOST appropriate to reproduce the subluxation? 1.active ankle plantar flexion and inversion 2.active ankle dorsiflexion and eversion 3.passive ankle plantar flexion and inversion 4.passive ankle dorsiflexion and eversion

2.active ankle dorsiflexion and eversion Peroneal tendon subluxation occurs when the peroneus longus and/ or peroneus brevis displace from the retromalleolar groove with loading. Active DF and ev reproduces this. PF or circumduction may also be useful.

A physical therapist examines a patient diagnosed with patellofemoral syndrome. As part of the examination the therapist elects to measure the patient's Q angle. Which three bony landmarks are used to measure the Q angle? 1.anterior superior iliac spine, superior border of the patella, tibial tubercle 2.anterior superior iliac spine, midpoint of the patella, tibial tubercle 3.anterior superior iliac spine, inferior border of the patella, midpoint of the patella tendon 4.greater trochanter, midpoint of the patella, tibial tubercle

2.anterior superior iliac spine, midpoint of the patella, tibial tubercle

A physical therapist performs the talar tilt test on a 22-year-old female rehabilitating from an inversion ankle sprain. Which ligament does the talar tilt test examine? 1.anterior talotibial 2.calcaneofibular 3.deltoid 4.posterior talotibial

2.calcaneofibular The CFL is a round cord that passes post/inf from the tip of the lateral malleolus to the lateral surface of the calcaneus. The integrity of the lig can be assessed using the talar tilt test.

A patient with a transtibial amputation is performing gait training. After 15 minutes of training, the patellar tendon bearing prosthesis is removed and the skin is inspected. Redness is noted on multiple areas of the residual limb. Which area of redness would be the GREATEST concern? 1.patellar tendon 2.fibular shaft 3.gastrocnemius muscle 4.distal anterior tibia

4.distal anterior tibia

A patient with a transtibial amputation ambulates in the physical therapy gym. The patient exhibits an extended knee throughout early stance phase on the prosthetic side. The MOST appropriate action to resolve the patient's difficulty is: 1.plantar flex the foot 2.soften the heel wedge 3.move the foot anteriorly 4.dorsiflex the foot

4.dorsiflex the foot

Patient is a 8 weeks post op case of Achilles tendon repair. Patient has recently started discontinuing the CAM boot and unable to bear weight with complains of pain with weight bearing. The PT should FIRST emphasize: A. Stretching of posterior compartment muscles in standing B. Heel lift C. Continue with CAM boot D. Notify the doctor

B. Heel lift

A physical therapist works with a patient with left-sided hemiparesis on half kneeling with the L leg bent forward and the R leg resting on the mat. As the therapist facilitates an anteriorly directed weight shift of the pt's hips, the patient shifts weight onto the left lower extremity through: 1.concentric activity of the left quadriceps and soleus 2.eccentric activity of the left quadriceps and soleus 3.concentric activity of the right quadriceps and soleus 4.eccentric activity of the right quadriceps and soleus

2.eccentric activity of the left quadriceps and soleus A patient positioned in half kneeling would use eccentric control of the L quadriceps and soleus when weight shifting anteriorly. This activity also reinforces right hip extension with knee flexion and proximal control of the posterior extremity.

A physical therapist treats a patient wearing a shoe that incorporates a rocker bottom. This type of modification would be the MOST beneficial for a patient diagnosed with: 1.Achilles tendonitis 2.hallux rigidus 3.plantar fasciitis 4.posterior tibial tendonitis

2.hallux rigidus

A physical therapist treats a patient diagnosed with posterior tibial tendon dysfunction. When observing the posterior aspect of the patient's lower leg and ankle in standing, the MOST probable finding is: 1.forefoot adduction 2.hindfoot valgus 3.hypertrophy of the gastrocnemius 4.swelling in the lateral ankle region

2.hindfoot valgus

A physical therapist observes that a patient has difficulty controlling the affected lower extremity during the loading response. This phase is characterized by: 1.increased quadriceps activity and increased hamstrings activity 2.increased quadriceps activity and decreased hamstrings activity 3.decreased quadriceps activity and increased hamstrings activity 4.decreased quadriceps activity and decreased hamstrings activity

2.increased quadriceps activity and decreased hamstrings activity The loading response requires increased quad activity to limit the rate of knee flexion. Hamstrings activity is decreased but the muscles are no longer needed to prevent knee hyperextension.

A physical therapist completes a series of resistive movements on a patient with a lower extremity injury. The patient denies pain initially, but complains of increasing pain after performing a number of repetitions. This scenario is MOST consistent with: 1.complete rupture of a tendon 2.intermittent claudication 3.ligamentous laxity 4.emotional hypersensitivity

2.intermittent claudication Intermittent claudication occurs as a result of insufficient blood supply and ischemia in active muscles. Symptoms most commonly include pain and cramping in muscles distal to the occluded vessel. Pain tends to progressively worsen with increasing activity. SB Exam 2 Question 52

A patient involved in a motor vehicle accident sustains a proximal fibula fracture. The fracture damaged the motor component of the common peroneal nerve. Ankle dorsiflexion and eversion are tested as 2/5. The MOST appropriate intervention to assist the patient with activities of daily living would be: 1.electrical stimulation 2.orthosis 3.exercise program 4.aquatic program

2.orthosis Why not 3? Exercise is appropriate, but would not provide the same magnitude of benefit as the orthosis when performing ADLs.

A two-year-old with T10 spina bifida receives physical therapy for gait training. Initially, the preferred method to teach a child how to maintain standing is with the use of: 1.bilateral hip-knee-ankle-foot orthoses (HKAFO) and forearm crutches 2.parapodium and the parallel bars 3.bilateral knee-ankle-foot orthoses (KAFO) and the parallel bars 4.bilateral ankle-foot orthoses (AFO) and the parallel bars

2.parapodium and the parallel bars The parapodium is a HKAFO with a thoracolumbar orthosis that supports the trunk and lower extremities. It has a large base of support and is used with or without an AD. This would be ideal with a patient w/ T10 spina bifida to initiate standing within the parallel bars.

A physical therapist examines a patient with a suspected lesion of the common fibular nerve. Which objective finding would be the MOST useful to rule out the possibility of a sciatic nerve lesion? 1.inability to actively dorsiflex the foot 2.preservation of the Achilles reflex 3.presence of a steppage gait 4.weakness of the quadriceps muscle

2.preservation of the Achilles reflex Absence of the Achilles reflex is characteristic of a tibial nerve or sciatic nerve injury. Preservation of the Achilles reflex means that a sciatic nerve injury could still be present through the common fibular nerve could still be affected since this nerve is not responsible for the Achilles reflex.

A physical therapist examines a patient with a suspected injury to the thoracodorsal nerve. Which objective finding would be consistent with this injury? 1.shoulder medial rotation weakness 2.shoulder extension weakness 3.paralysis of the rhomboids 4.paralysis of the diaphragm

2.shoulder extension weakness The latissimus dorsi is innervated by the thoracodorsal nerve. Weakness of the latissimus dorsi would produce impaired strength during shoulder extension resistive testing despite the fact that several other muscles also function to extend the shoulder. These muscles include the posterior deltoid and teres major.

A physical therapist employed in a subacute rehabilitation facility works on community re-integration prior to discharging a 72-year-old patient to their home. Which aspect of gait should be focused on during training to ensure the patient's ability to safely cross the street? 1.step length 2.velocity 3.cadence 4.heel strike

2.velocity

A patient experiences a proximal humerus fracture that is non-displaced. Which clinical finding would provide the BEST support for the patient being cleared to perform active-assisted exercise? 1.hematoma formation 2.diminished pain 3.callus formation 4.remodeling

3. callus formation Callus formation is one of the first indications that healing has occurred. The presence of a callus identified through diagnostic imaging allows the patient to progress to active assisted exercise.

A physical therapist examines a patient with multidirectional instability of the shoulder. Which position would be the MOST appropriate when assessing posterior instability of the shoulder? 1.abduction to 90 degrees with neutral rotation 2.abduction to 90 degrees with full external rotation 3. flexion to 90 degrees with full internal rotation 4.arm at the side in neutral rotation

3. flexion to 90 degrees with full internal rotation These motions move the humeral head posteriorly in the joint and place stress on the posterior capsule. During the jerk test, the patient is placed in this position and the therapist applies an axial load through the elbow in a posterior direction. The therapist can then horizontally adduct the shoulder to place further stress on the posterior capsule.

A physical therapist determines that a patient's cadence is 120 steps per minute. How long would it take the patient to complete 120 full strides? 1.30 seconds 2.60 seconds 3.120 seconds 4.240 seconds

3.120 seconds A period of 120 seconds would be necessary to complete 120 strides since the patient can currently complete 120 steps in 60 seconds.

A 16-year-old female walks with a toe-in gait. Which objective finding would MOST likely contribute to this type of gait deviation? 1.15 degree Q angle 2.20 degree Q angle 3.18 degrees femoral anteversion 4.7 degrees femoral anteversion

3.18 degrees femoral anteversion 8-15 deg anteversion is normal.

A physical therapist treats a patient with several injuries impacting the upper extremity including mallet finger. The therapist notes that the affected finger is immobilized using a static splint. Which position of the finger would be MOST essential when splinting? 1.5 degrees of flexion at the distal interphalangeal joint 2.5 degrees of flexion at the proximal interphalangeal joint 3.5 degrees of hyperextension at the distal interphalangeal joint 4.5 degrees of hyperextension at the proximal interphalangeal joint

3.5 degrees of hyperextension at the distal interphalangeal joint Mallet finger is injury to the EDL at the DIP. The injury most often occurs when the finger is abruptly forced into flexion at the DIP. Splinting in 5 degrees of hyperextension allows the extensor tendon to heal in an optimal position without becoming excessively lengthening.

A physical therapist observes a patient complete a standing arm curl with a dumbbell using the starting and ending positions shown in the image. Which scenario would produce the MOST power? 1.a 2 pound dumbbell lifted in two seconds 2.a 2 pound dumbbell lifted in three seconds 3.a 4 pound dumbbell lifted in one second 4.a 4 pound dumbbell lifted in four seconds

3.a 4 pound dumbbell lifted in one second Power is calculated as the amount of work divided by the time needed to perform the work. A 4 lb dumbbell lifted in one second would produce the greatest amount of power since the weight lifted is the heaviest of the presented options and the amount of time to complete the repetition (i.e. one second) is the shortest.

A physical therapist participates in a research study that examines body composition as a function of aerobic exercise and diet. Which method of data collection would provide the physical therapist with the MOST valid measurement of body composition? 1.anthropometric measurements 2.bioelectrical impedance 3.hydrostatic weighing 4.skinfold measurements

3.hydrostatic weighing

A physical therapist observes the gait of a child with spastic cerebral palsy. The therapist notes that the child exhibits excessive lordosis during ambulation. Which surgical procedure would BEST address this postural deformity? 1.hamstring tendon lengthening 2.adductor longus tendon lengthening 3.iliopsoas tendon lengthening 4.lumbar laminectomy

3.iliopsoas tendon lengthening SB Exam 2 Question 51

A 48-year-old female patient is referred to physical therapy after being diagnosed with patellofemoral pain syndrome. As part of the session, the patient describes a number of exercises that she was instructed to perform by her personal trainer. Which exercise would likely be the MOST problematic? 1.terminal knee extension in standing 2.mini-squats from 0-30 degrees of knee flexion 3.long arc quads from 0-45 degrees of knee flexion 4.quadriceps setting in terminal knee extension in supine

3.long arc quads from 0-45 degrees of knee flexion Forces in open chain activities are their lowest at 90 deg of flexion. The forces increase as the knee moves closer to full extension. Therefore, this is not recommended.

An entry in a patient's medical record indicates that the patient has recently received viscosupplementation. This type of procedure is MOST commonly performed to treat: 1.arrhythmias 2.bursitis 3.osteoarthritis 4.spasticity

3.osteoarthritis

A physically active 19-year-old 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 eight months ago. The MOST likely functional level of the patient following rehabilitation is: 1.able to participate in light recreational activities 2.able to participate in all recreational activities 3.able to return to recreational and competitive athletic activities with a derotation brace 4.able to return to previous functional level

4.able to return to previous functional level A physically active, young patient should return to his previous functional level within 6-12 months following ACL reconstruction.

A patient recently visited a podiatrist and was told to purchase a heel lift for one of their shoes. Which condition would be LEAST likely to benefit from the use of the heel lift? 1.true leg length discrepancy 2.Achilles tendonitis 3.Achilles tendon repair 4.calcaneal bone spur

4.calcaneal bone spur

A physical therapist reads a recent entry in a patient's medical record that indicates aspiration was performed in the elbow region. This scenario is MOST commonly associated with: 1.dorsal ganglion cyst 2.lateral epicondylitis 3.medial epicondylitis 4.olecranon bursitis

4.olecranon bursitis Olecranon bursitis is characterized by pain, redness, and swelling around the olecranon caused by inflammation of the elbow's bursa. Aspirating the excess bursa's fluid is often performed to relieve the inflammation and prevent further accumulation of fluid. An excessive amount of fluid in this region can inhibit range of motion and functional use of the elbow. The aspirated fluid is often cultured and evaluated for crystals to rule out infection or gout.

A 16-year-old male patient sprained his thumb in a volleyball game five weeks ago and continues to have decreased range of motion with carpometacarpal abduction. What joint mobilization technique would the therapist use to increase carpometacarpal abduction? 1.medial glide of the first metacarpal on the trapezium 2.lateral glide of the first metacarpal on the trapezium 3.anterior glide of the first metacarpal on the trapezium 4.posterior glide of the first metacarpal on the trapezium

4.posterior glide of the first metacarpal on the trapezium A posterior glide of the metacarpal would be used to increase carpometacarpal abduction. In this plane, a convex surface is moving on a concave surface, so the glide (i.e. posterior) will occur in the opposite direction to the osteokinematic motion of abduction (i.e. anterior).

A physical therapist applies passive overpressure to the spine of a patient referred to physical therapy with back pain. The patient reports back and leg symptoms with extension overpressure, however, he denies the presence of symptoms with flexion. This finding is MOST consistent with: 1.lumbar disk lesion 2.lumbar muscle strain 3.sacroiliac joint sprain 4.spinal stenosis

4.spinal stenosis

A physical therapist examines a patient diagnosed with carpal tunnel syndrome. As part of the examination the therapist assesses end-feel. The therapist classifies the end-feel associated with wrist extension as firm. The MOST logical explanation is: 1.tension in the dorsal radiocarpal ligament and the dorsal joint capsule 2.contact between the ulna and the carpal bones 3.contact between the radius and the carpal bones 4.tension in the palmar radiocarpal ligament and the palmar joint capsule

4.tension in the palmar radiocarpal ligament and the palmar joint capsule

A physical therapist examines a 36-year-old female referred to physical therapy after experiencing back pain two weeks ago. The patient identifies the majority of pain in the buttock and lateral thigh and denies any referred pain down the posterior leg. Presently she rates the pain as a "3" on a 0-10 scale, however, indicates that the pain is a "6" or a "7" during activity or at night. This description MOST closely resembles: 1.sacroiliitis 2.iliolumbar syndrome 3.piriformis syndrome 4.trochanteric bursitis

4.trochanteric bursitis Trochanteric bursitis is the inflammation of the bursa that protects the structures that cross the posterior portion of the greater trochanter. The patient is often extremely sensitive to palpation over the bursa and may experience lateral thigh pain that is exacerbated by activity or periods of prolonged rest.

A physical therapist discusses the plan of care for a 61-year-old male diagnosed with spinal stenosis with the referring physician. During the discussion the physician shows the therapist a picture of the patient's spine obtained through computed tomography. What color would vertebrae appear when using this imaging technique? 1.black 2.light gray 3.dark gray 4.white

4.white The greater the density, the whiter the image. CSF: black soft tissue structures: gray vertebrae: white

A patient presents to the clinic with history of burns on the right hip and thigh region causing tight hip flexors. What gait abnormality is MOST likely to be demonstrated by the patient? A. A shorter step length with the left lower extremity B. A shorter step length with the right lower extremity C. Backward lean during stance phase on left lower extremity D. Lateral lean during swing phase on right lower extremity

A. A shorter step length with the left lower extremity Limits hip extension on the R side, so L side has to shorten in step length. Now if the question said tight R hip extensors, this would stop more forward hip flexion of the R side, making B the correct answer.

A patient underwent surgical repair of a SLAP lesion 10 days ago. Which of the following interventions is LEAST appropriate at this time? A. Active isometric contraction of the biceps B. Passive humeral rotation with shoulder in scapular plane C. Pendulum exercises D. Active isometric contraction of the triceps

A. Active isometric contraction of the biceps Actively, doing a biceps should be AVOIDED.

A PT notices that a patient is experiencing early toe-off during terminal stance in gait. Which of the following identifies a likely cause, AND an appropriate intervention to address that cause? A. Hip flexion contracture, prolonged stretch B. Hip adductor weakness, progressive strengthening C. Gastrocnemius weakness, ultrasound D. Great toe flexion weakness, progressive strengthening

A. Hip flexion contracture, prolonged stretch

A client presents to an outpatient clinic with chief complaint of neck pain. PT decides to address the left opening restriction between C3-C4 vertebrae. The MOST appropriate treatment would include: A. PA glide on left C3 vertebrae B. PA glide on right C3 vertebrae C. PA glide on left C4 vertebrae D. PA glide on right C4 vertebrae

A. PA glide on left C3 vertebrae You want to open the restriction.

During the examination, the patient reports increased pain while standing. Pain is alleviated with lumbar flexion and sitting. Which special test will be positive to confirm the diagnosis shown in the picture ? A. Stork standing test B. Gillet Test C. Van Gelderen bicycle test D. Quadrant Test

A. Stork standing test For spondylolisthesis Test position: Subject stands on one leg with sole of NWB foot resting on medial aspect of knee of WB limb. Action: Maintain balance on one leg and perform slight lumbar extension. Bilateral testing. Positive finding: Pain at pars interarticularis B. For SI joint C. For stenosis D. For facet

A 39 year old comes to an outpatient clinic complaining of neck problems. Which of the following exercise combinations is MOST appropriate for a patient who has a forward head posture? A. Strengthen the deep cervical flexors and stretch the sternocleidomastoids and upper cervical extensors. B. Strengthen the deep cervical flexors and sternocleidomastoids and stretch the upper cervical extensors. C. Strengthen the cervical extensors and stretch the sternocleidomastoids and deep cervical flexors. D. Strengthen the cervical extensors and sternocleidomastoids and stretch the deep cervical flexors.

A. Strengthen the deep cervical flexors and stretch the sternocleidomastoids and upper cervical extensors.

A 74-year-old retired contractor walks to the treatment room with a prominent backward lean, when he is in stance on the left lower extremity. From this observation, you hypothesize that the MOST LIKELY cause is: A. Weak hip extensors on the left during stance phase B. Weak hip flexors on the left during stance phase C. Weak hip extensors on the right during swing phase D. Weak hip flexors on the right during swing phase

A. Weak hip extensors on the left during stance phase TIGHTNESS VS. WEAKNESS Contracture will DECREASE the ROM of OPP motion Ex. hip flexion contracture will lead to dec hip extension Weakness will DECREASE the ROM of SAME motion Ex. weakness of hip flexors will cause dec in step length

A 12 year-old girl has a structural right thoracic idiopathic scoliosis. The clinical features you would expect to find include a high: A. right shoulder, a prominent right scapula and a left hip that protrudes B. left shoulder, a prominent left scapula and a right hip that protrudes C. right shoulder, a prominent left scapula and a right hip that protrudes D. left shoulder, a prominent right scapula and a left hip that protrudes

A. right shoulder, a prominent right scapula and a left hip that protrudes

A young adult underwent right Achilles tendon repair 6 weeks ago and is now able to fully weight bear. The PT is giving him advice on proper shoe modification. Which of the following would be BEST for the patient to utilize? A. Normal shoes B. Shoes with 1- 1.5 cm heel lift C. Shoes with lower than the regular heel D. Shoes with 5 cm heel lift

Avoid stretching the gastroc. B. Shoes with 1- 1.5 cm heel lift

The patient complains of painful rotation on right L2 which is relieved on rotating to left. What is the MOST appropriate intervention for this patient? A. Apply PA glide on L2 transverse process on the right side B. Apply PA glide on L3 transverse process on the right side C. Apply PA glide on L2 transverse process on the left side D. Apply PA glide on L4 transverse process on the left side

B. Apply PA glide on L3 transverse process on the right side You want to close L3 on the right.

A physical therapist is treating a pediatric patient with cerebral palsy. The patient is seen in standing with a toe- in posture. Which of the following postural strategies most accurately correlates with the observed foot position? A. Internal tibial torsion, increased femoral retroversion B. Internal tibial torsion, increased femoral anteversion C. External tibial torsion, increased femoral retroversion D. External tibial torsion, increased femoral anteversion

B. Internal tibial torsion, increased femoral anteversion

A 74-year-old retired contractor walks to the treatment room. Patient presents with backward trunk lean during the swing phase of gait. What is the MOST likely cause and associated movement pattern seen? A. Ipsilateral gluteus maximus weakness B. Ipsilateral hip flexor weakness C. Ipsilateral gluteus medius weakness D. Ipsilateral vastus medialis muscle weakness

B. Ipsilateral hip flexor weakness you thought A? Well now we have to look at the SWING, not STANCE phase of gait.

A patient fractured the right mid tibia 3 months ago. After cast removal a severe foot drop was noted. The patient wants to try electrical stimulation orthotic substitution. The PT would set up the FES to contract the appropriate muscles during? A. Late stance at push-off B. Mid swing C. Early stance at foot-flat D. Late stance at toe-off

B. Mid swing Problem - foot drop Solution - FES orthotic substitution Phase - They need to be able to clear the ground. They need FES to work during mid swing.

A patient that is eight days status post ACL reconstruction (patellar tendon autograft) is being examined by a physical therapist. What is the MOST appropriate exercise to implement into the patient's home exercise program? A. Leg press on operated side B. Mini squats C. Limited range isokinetic at 30 degrees D. Active knee extension in short sitting

B. Mini squats

When analyzing the patient's gait, the PT observes a collapse of the medial arch and over-pronation during stance phase. Which muscle would you strengthen to support the medial arch, and also assist in decelerating pronation during stance? A. Anterior Tibialis B. Posterior Tibialis C. Peroneus Brevis D. Abductor Hallucis Brevis

B. Posterior Tibialis

A 21 year old male works as a cashier at a gas station. He is having trouble giving cash back to a customer. According to role and slide mechanism, during right forearm pronation at the proximal radioulnar joint, the PT should do the following to the radial head: A. Roll and slide posteriorly B. Roll anteriorly and slide posteriorly C. Roll and slide anteriorly D. Roll posteriorly and slide anteriorly

B. Roll anteriorly and slide posteriorly Proximal RU joint is CV-CC. (PPP - posterior, pronation, proximal RU)

A PT examines the gait of a 62-year-old male patient. The patient exhibits right early heel off during stance phase of gait. Which of the following impairments is MOST likely associated with this finding? A. Shortening of the hamstrings B. Shortening of the gastrocnemius C. Weakness of the tibialis anterior D. Weakness of the iliopsoas

B. Shortening of the gastrocnemius

A 39 year old comes to an outpatient clinic complaining of hip problems. The PT notices the left hip dropping during right mid stance. The MOST appropriate treatment for this impairment would be: A. Stand on right leg and abduct the left leg B. Stand on left leg and abduct the right leg C. Stand on right leg and flex the right leg D. Stand on left leg and flex the right leg The MOST LIKELY cause of this impairment can be the injury of what nerve?

B. Stand on left leg and abduct the right leg The R glute med is weakness, so it should be the R sup gluteal nerve. What could also be weak? The L adductors. So the L obturator nerve.

A PT needs to check the walking gait of a stroke patient and decides to record a video in slow motion. The 3 hamstring muscles contract eccentrically during which phase of gait cycle? A. Initial Swing B. Terminal Swing C. Midstance D. Terminal Stance

B. Terminal Swing

Nadine assesses her pt's HS strength in the sitting position and standing positions. The PT finds that the pt's strength is significantly better in sitting when compared to the standing position. Which of the following is the MOST likely reason for the diminished end range knee flexion strength in standing? A. active insufficiency of the quadriceps B. active insufficiency of the hamstrings C. passive insufficiency of the quadriceps D. passive insufficiency of the hamstrings

B. active insufficiency of the hamstrings WE'RE TALKING ABOUT THE HAMSTRINGS STRENGTH NOT QUADS. A. Don't think about A! B. HSs extend the hip and flex the knee. HSs are too short in standing and are unable to generate enough force. This is CORRECT. C. We're trying to look for strength, not ROM. This would be the right answer if we were looking for diminished knee flexion ROM in standing. D. In standing, the HS is shortened, NOT LENGTHENED.

Which of the following joint mobilization techniques is MOST appropriate for a patient with limited wrist flexion range of motion? A. Radial glide of the proximal carpal row on the radius B. Ulnar glide of the proximal carpal row on the ulna C. Dorsal glide of the proximal carpal row on the radius D. Volar glide of the proximal carpal row on the radius

C. Dorsal glide of the proximal carpal row on the radius

Active insufficiency of right iliopsoas will be caused by? A. Hip extension and right lateral flexion of the trunk B. Hip extension and left lateral flexion of the trunk C. Hip flexion and right lateral flexion of the trunk D. Hip flexion and left lateral flexion of the trunk

C. Hip flexion and right lateral flexion of the trunk

A physical therapist observes a leg length discrepancy. Which of the following gait deviations is MOST likely seen by the therapist? A. Increased dorsiflexion of the short limb during swing and increased plantar flexion of the long limb during stance B. Decreased knee flexion and increased dorsiflexion of the long limb during stance and increased dorsiflexion of the short limb during swing C. Increased dorsiflexion with early heel rise of the long limb at heel off and increased plantar flexion of the short limb during stance D. Increased plantar flexion of the long limb at heel strike and decreased knee flexion of the short limb during heel off

C. Increased dorsiflexion with early heel rise of the long limb at heel off and increased plantar flexion of the short limb during stance

While evaluating the gait cycle of a 68 year old male patient, the PT observes right pelvic hike during the swing phase of the right gait cycle. Which of the following condition is MOST likely to cause the problem? A. Lack of left hip flexion B. Excessive right knee flexion C. Lack of right ankle dorsiflexion D. Right ankle plantar flexor weakness

C. Lack of right ankle dorsiflexion

Following major surgery of the left hip, a patient ambulates with a R hip drop. As part of the intervention, the PT opts to include FES to help improve the gait pattern. Stimulation should be initiated for the: A. Right abductors during swing on the right. B. Right abductors during stance on the right. C. Left abductors during stance on the left. D. Left abductors during swing on the left.

C. Left abductors during stance on the left. Problem - right pelvis drop Solution - FES Opp (Lt) abductors weak.

A patient who underwent anterior approach total hip arthroplasty for right hip is being discharged from hospital. Which of the following should the patient NOT do in order to avoid dislocation? A. Patient should sit in a high chair as long as hips are at a higher level than your knees B. Patient should not sit on the floor with their legs crossed C. Patient should tie their shoelaces by sitting on a chair with right ankle on the left knee D. Patient should not cross their right leg in adduction towards the left leg while standing

C. Patient should tie their shoelaces by sitting on a chair

A 58 year old male underwent a total hip arthroplasty on the left side using a postero-lateral approach. The PT is working on a gait training program for the patient. The therapist should instruct the patient to hold the crutch or cane in the: A. Left hand to decrease activity in the left hip abductors. B. Left hand to facilitate activity in the left hip abductors. C. Right hand to decrease activity in the left hip abductors. D. Right hand to facilitate activity in the left hip abductors.

C. Right hand to decrease activity in the left hip abductors.

A 58 year old male underwent a total hip arthroplasty on the left side using a postero-lateral approach. The PT is working on a gait training program for the patient. The therapist should instruct the patient to hold the crutch or cane in the: A. Left hand to decrease activity in the left hip abductors. B. Left hand to facilitate activity in the left hip abductors. C. Right hand to decrease activity in the left hip abductors. D. Right hand to facilitate activity in the left hip abductors.

C. Right hand to decrease activity in the left hip abductors.

A patient presents with limited mouth opening of 25 mm due to pain. There is no complain of clicking sound or mouth deviation when he opens his mouth. The patient is unable to completely close his mouth with teeth clenched together. What is the MOST likely diagnosis? A. Hypomobility B. Disc displacement with reduction C. Synovitis D. Capsulitis

C. Synovitis Hypomobility - limited mouth opening, no pain Disc displacement w/ reduction - clicking sounds Synovitis - limited mouth opening d/t pain, no clicking, no mouth deviation Capsulitis - causes mouth deviation

A 74 year old contractor has a prominent forward lean when he is in stance on the right lower extremity. From this observation, PT would hypothesize that the MOST LIKELY cause is: A. Weak hip extensors on the left B. Weak hip flexors on the left C. Weak knee extensors on the right D. Weak knee flexors on the right

C. Weak knee extensors on the right A forward trunk lean puts the center of gravity in front of the knee for stability

A 54-year-old female patient is seen by a PT for gait training. The patient performs excessive hip flexion while ascending a ramp. Which of the following should the PT focus FIRST on mobilizing? A. Anterior glide on hip joint B. Posterior glide on hip joint C. Anterior glide on ankle joint D. Posterior glide on ankle joint

D. Posterior glide on ankle joint Posterior glide for DF

A PT is testing the active shoulder range of motion of a 45 year old female patient. The PT asks the patient to move the shoulder to full medial/internal rotation. During medial rotation at the shoulder joint (GH joint), the humerus will slide: A. Anteriorly B. Superiorly C. Inferiorly D. Posteriorly

D. Posteriorly

A 13-year-old girl has been diagnosed with structural idiopathic scoliosis. The physical therapist notices a left thoracic, right lumbar structural scoliosis. Which postural deviation would be expected in this patient: A. The body of the thoracic vertebrae rotated to the right B. High right shoulder C. Spinous processes of thoracic spine rotated to the left D. Posteriorly protruding left scapulae

D. Posteriorly protruding left scapulae A. it would be to the left B. this would be for R scoliosis C. the SPs would rotate to the right

The student is having difficulty swiping upwards with their thumb as shown in the picture. What is the BEST mobilization to improve the thumb range of motion? A. Dorsal glide at the CMC joint B. Volar glide at the CMC joint C. Ulnar glide at the CMC joint D. Radial glide at the CMC joint

D. Radial glide at the CMC joint

A patient complains of lack of grip strength. PT notices that the patient has a stronger grip with wrist in extension, but the grip strength decreases as the patient starts flexing the wrist. What is the MOST appropriate intervention to improve the ROM? A. Stretch the flexor digitorum and strengthen extensor digitorum B. Strengthen extensor digitorum and put a flexion splint C. Stretch flexor digitorum and extensor digitorum D. Stretch extensor digitorum and strengthen flexor digitorum

D. Stretch extensor digitorum and strengthen flexor digitorum There was passive insufficiency of the extensors and active insufficiency of the flexors.

A 36 year old patient experiences limitation with left side bending and left rotation at the C5-6 junction. What is the MOST appropriate intervention? A. Apply PA glide at left C5 B. Apply AP glide at left C5 C. Apply PA glide at right C5 D. Apply PA glide at right C6

We want to do a PA glide at left C6, but no option. SO look on the right side. Open on the right side, so right C5. C. Apply PA glide at right C5

Yael presents to PT status post right femoral neck fx w/ an ORIF. During the gait assessment, the patient demonstrates a diminished backward rotation of the pelvis on the right when compared w/ the left. Which of the following findings will MOST likely accompany this clinical picture? a. excessive plantarflexion during midstance on the right b. lengthened step length on the left c. shortened step length on the right d. diminished left trunk rotation

d. diminished left trunk rotation When do we need post pelvic tilt of the pelvis? DURING TERMINAL STANCE. So we're trying to find what would limit TERMINAL STANCE on the right leg. A. for if you want to clear the opp limb during vaulting B. The L leg during a R leg terminal stance would be at swing. If you cant bring the R leg back very far, this would lead to a shortened step length on the L during swing phase. C. R step length would be normal because L terminal stance is normal, making R step length to be normal. D. When the R leg is in terminal stance, the trunk rotates to the L, and vice versa. SO THIS MAKES SENSE.