Joint Mobs Review
What is Brian Mulligan's main theory for why his techniques work? A. Correct minor positional faults B. Improve accessory motion C. Improve joint play D. Desensitize the nervous system E. None of the above
A. Correct minor positional faults
In what direction does the proximal fibula move during ankle dorsiflexion? A. Superior and posterior B. Superior and anterior C. Inferior and posterior D. Inferior and anterior E. None of the above
A. Superior and posterior
In what direction is the glide performed during MWM? A. Lateral B. Medial C. Distraction D. Both a and b E. All of the above
E. All of the above
According to the convex-concave rule, what accessory motion is necessary for full pain free shoulder external rotation? A. Anterior glide B. Posterior glide C. Inferior glide D. Distraction E. Compression
A. Anterior glide
What is compression primarily used for in joint mobilization? A. Assess the irritability of a joint B. Assess joint play of a joint C. Assess accessory motion of a joint D. Both b and c E. None of the above
A. Assess the irritability of a joint
How many reps and sets does Brian Mulligan recommend on the first visit? A. 6 reps, 3 sets B. 10 reps, 3 sets C. 6 reps, 1 set D. 10 reps, 1 set E. None of the above
A. 6 reps, 3 sets
What is the loose pack position of the ankle? A. 10 degrees of plantarflexion B. 10 degrees of dorsiflexion C. 20 degrees of plantarflexion D. 20 degrees of dorsiflexion E. None of the above
A. 10 degrees of plantarflexion
What is the purpose of keeping your arms close to your body when performing short axis inferior hip glides? A. Directs the line of force inferiorly B. Keeps your body warm C. Secures the patients leg D. Prevents excessive neuro tension E. None of the above
A. Directs the line of force inferiorly
According to the convex rule when performing wrist curls at the gym in what direction will the proximal row of carpal bones glide? A. Dorsal B. Ventral C. Lateral D. There is no glide E. None of the above
A. Dorsal
Which of the following are epidemiological findings associated with Tempromandibular Dysfunction (TMD)? A. Females > males B. Males > females C. 30-40% of the population D. Both b and c E. All of the above
A. Females > males
What type of motion predominantly occurs at the OA joint? A. Flexion and extension B. Sidebending C. Rotation D. Both a and b E. None of the above
A. Flexion and extension
How do you reduce a Nursemaid's elbow? A. Fully extend, supinate, and then flex the elbow B. Fully flex, pronate, and then extend the elbow C. Fully extend, pronate, and then flex the elbow D. Fully flex, supinate, and then extend the elbow E. None of the above
A. Fully extend, supinate, and then flex the elbow
What grade of oscillation mobilization is sometimes referred to as bending the bee's knees? A. Grade I B. Grade II C. Grade III D. Grade IV E. Grade V
A. Grade I
What is performed in conjunction with a talocrural anterior glide mobilization? A. Grade I distraction B. Grade II distraction C. Grade III distraction D. Grade IV distraction E. None of the above
A. Grade I distraction
Which grades of oscillations are generally used for pain inhibition vs improving mobility? A. Grades I and II B. Grade III and V C. Grades V and IV D. Both a and b E. Both b and c
A. Grades I and II
What is the term for increased joint play with extended, empty, very soft, end-feel? A. Hypermobility B. Hypomobility C. Guarding D. Boney block E. None of the above
A. Hypermobility
Performing an inferior patella glide will improve what osteokinematic motion? A. Knee flexion B. Knee extension C. Ankle dorsiflexion D. Ankle plantarflexion E. None of the above
A. Knee flexion
What physiologic motion does tibiofemoral posterior glide improve? A. Knee flexion B. Knee extension C. Knee flexion and extension D. Ankle dorsiflexion E. All of the above
A. Knee flexion
What muscle guides the disc by rolling it forward? A. Lateral pterygoid B. Medial pterygoid C. Masseter D. Both a and c E. None of the above
A. Lateral pterygoid
If the right L4/L5 facet is unable to upglide, what will the therapist observe? A. Limited forward bending B. Deviation to the left when forward bending C. Limited backward bending D. Limited right sidebending E. None of the above
A. Limited forward bending
What physiological changes occurs when connective tissue is immobilized? A. Loss of water B. Greater collagen inter fiber distance C. Greater tensile strength of collagen D. Both a and b E. None of the above
A. Loss of water
What are the four branches of physical therapy first described by Mary McMillan? A. Manipulation to muscle and joint, therapeutic exercise, electrotherapy, and hydrotherapy B. Manipulation to muscle and joint, therapeutic exercise, ultrasound, and hydrotherapy C. Manipulation to muscle and joint, therapeutic exercise, electrotherapy, and motor learning D. Namely-manipulation to muscle and joint, posture, electrotherapy, and hydrotherapy E. None of the above
A. Manipulation to muscle and joint, therapeutic exercise, electrotherapy, and hydrotherapy
What subtalar joint glide will improve eversion? A. Medial glide B. Lateral glide C. Anterior glide D. Posterior glide E. None of the above
A. Medial glide
What does Brian Mulligan expect if there is pain free overpressure at the symptomatic joint after the application of a MWM technique? A. Optimal recovery B. Limited range of motion C. Loss of joint play D. Poor prognosis E. None of the above
A. Optimal recovery
When performing the Mulligan shoulder elevation technique, in what direction is the GH joint glide? A. Posterior and lateral B. Posterior and medial C. Anterior and lateral D. Anterior and medial E. None of the above
A. Posterior and lateral
What talocrural glide will improve ankle dorsiflexion? A. Posterior glide B. Anterior glide C. Lateral Glide D. Medial Glide E. All of the abov
A. Posterior glide
What is the purpose of placing the mobilizing hand as close to the joint as possible? A. Prevent joint torque B. Prevent joint glide C. Prevent joint play D. Both a and b E. None of the above
A. Prevent joint torque
Which of the following are mechanical effects of HVLA thrust manipulation? A. Release an entrapped meniscus B. Release of endorphins C. Stimulate GTO's D. Placebo E. None of the above
A. Release an entrapped meniscus
When performing the lumbar mobilization and pressing the spinous process from right to left, what facet joint will gap? A. Right B. Left C. Both D. None of the above E. All of the above
A. Right
What are the two primary motions at the TMJ? A. Rotation followed by anterior translation B. Rotation followed by posterior translation C. Rotation followed by medial deviation D. Rotation followed by lateral deviation E. None of the above
A. Rotation followed by anterior translation
What position is the patients arm held in when performing a posterior glide manipulation of the glenohumeral joint? A. Shoulder flexed to 85 degrees and elbow fully flexed B. Shoulder flexed to 45 degrees and elbow fully extended C. Shoulder flexed to 85 degrees and elbow fully extended D. Shoulder flexed to 45 degrees and elbow fully flexed E. Anatomical position
A. Shoulder flexed to 85 degrees and elbow fully flexed
What is the loose pack position for the radiocarpal joint? A. Slight Flexion B. Slight Extension C. Slight Radial Deviation D. Slight Ulnar Deviation E. None of the above
A. Slight Flexion
What are differences between Maitland and Kaltenborn techniques and the Mulligan Concept of MWM? A. There is no system of grading the force and amount of movement in the Mulligan Concept as there is for Maitland and Kaltenborn techniques B. There is no system of grading the force and amount of movement in the Maitland and Kaltenborn techniques as there is in the Mulligan Concept C. The Mulligan Concept utilizes accessory motion glides and Maitland and Kaltenborn techniques do not D. Both a and c E. All of the above
A. There is no system of grading the force and amount of movement in the Mulligan Concept as there is for Maitland and Kaltenborn techniques
What is the loose-packed position of the knee? A. 10 degrees of knee flexion B. 25 degrees of knee flexion C. 70 degrees of knee flexion D. 90 degrees of knee flexion E. Full extension
B. 25 degrees of knee flexion
How many reps and sets of MWM does Mulligan recommend performing on the first visit? A. 8-10 reps, 3-5 sets B. 6 reps, 3 sets C. 10-12 rep, 3 sets D. 3-4 reps, 3 -5 sets E. None of the above
B. 6 reps, 3 sets
When distracting the humeroulnar joint, what position is the elbow held in? A. 90 degrees of flexion and full supination B. 70 degrees of flexion and 10 degrees supination C. 90 degrees of flexion and 10 degrees supination D. 70 degrees of flexion and full supination E. None of the above
B. 70 degrees of flexion and 10 degrees supination
When performing HVLA thrust manipulation of the talocrural joint, which of the following are important in the set up? A. Have the patient's foot at least 16" off the table B. Adjust the table height so that your elbows are parallel with the floor C. Externally rotate the patients hip so that the foot is slightly everted D. Place a bolster under the patients knee to keep it flexed E. All of the above
B. Adjust the table height so that your elbows are parallel with the floor
What hip mobilization would be most beneficial for someone who has low back pain and sits for a living? A. Posterior glide B. Anterior glide C. Short axis Inferior glide D. Long axis inferior glide E. None of the above
B. Anterior glide
What anatomical structure is contacted on the cervical spine when performing lateral glides? A. Spinous process B. Articular pillar C. Transverse process D. Lamina E. Mammillary process
B. Articular pillar
What term did Maitland and later Mulligan use to describe a task that a patient had difficulty completing due to pain or joint stiffness? A. Compatible sign B. Comparable sign C. Commensurate sign D. Collateral sign E. None of the above
B. Comparable sign
Where is the treatment plane of the joint located? A. Convex bone B. Concave bone C. Either the convex or concave bone depending on body position D. Both b and c E. None of the above
B. Concave bone
When performing the Mulligan technique to improve shoulder flexion, what is the purpose of the belt? A. Glide the GH joint posterior B. Distract the GH joint C. Stabilize the scapula D. Glide the GH joint anterior E. None of the above
B. Distract the GH joint
In which direction does the capitate typically sublux? A. Palmer B. Dorsal C. Medial D. Lateral E. None of the above
B. Dorsal
What direction is the force applied in a cuboid whip manipulation? A. Dorsal medial B. Dorsal lateral C. Plantar medial D. Plantar lateral E. None of the above
B. Dorsal lateral
What specific motion will hip distraction improve? A. Abduction B. Flexion C. Internal rotation D. Adduction E. None of the above
B. Flexion
Who first introduced the convex-concave rule? A. John Mennell B. Freddy Kaltenborn C. James Cyriax D. Geoffrey Maitland E. Stanley Paris
B. Freddy Kaltenborn
What is the loose packed position for the humeroradial joint? A. 30 degrees of flexion and 10 degrees of supination B. Full extension and full supination C. 30 degrees of flexion and full supination D. Full extension and full pronation E. None of the above
B. Full extension and full supination
What does Brian Mulligan recommend if the accessory motion produces an immediate increase in pain? A. Continue with less force B. Glide in the opposite direction C. Change the angle D. Distract the joint E. None of the above
B. Glide in the opposite direction
What grade of sustained stretch is used to evaluate joint irritability? A. Grade I B. Grade II C. Grade III D. Grade IV
B. Grade II
Which of the following are characteristics of osteokinematic motion? A. Not under voluntary control B. Gross movements of bones at joints C. Measured with joint glide D. Unable to measure with a goniometer E. All of the above
B. Gross movements of bones at joints
What is the 1st step in the Mulligan Concept? A. Apply passive accessory motion to the joint B. Identify one or more comparable signs C. Bunch the skin an distract the joint D. Apply effleurage to the area to be treated E. None of the above
B. Identify one or more comparable signs
What is the most commonly cited successful accessory motion used in MWM for the extremities? A. Medial glide B. Lateral glide C. Distraction D. Medial rotation E. Lateral rotation
B. Lateral glide
Which of the following techniques would be the most effective for a patient having wrist pain when performing pushups? A. Medial glide of the carpal proximal row with elbow on table B. Lateral glide of the carpal proximal row with hand weightbearing on table C. Medial glide of the carpal proximal row with hand weightbearing on table D. Lateral glide of the carpal proximal row with elbow on table E. None of the above
B. Lateral glide of the carpal proximal row with hand weightbearing on table
If the therapist encounter resistance when gliding the cervical spine from right to left, what are the two possibilities for the restriction? A. Right upglide and left downglide B. Left upglide and right downglide C. Right downglide and left downglide D. Left upglide and right upglide E. None of the above
B. Left upglide and right downglide
What two researchers promoted disc herniations as a source of low back pain? A. Costello and Winslow B. Mixter and Barr C. Ghormley and Jones D. Rolf and Still E. None of the above
B. Mixter and Barr
What does the acronym PILL stand for? A. Posterior, inferior, lateral, long B. Pain free, instant, long lasting C. Posterior, instant, lateral, less D. Pain free, inferior, long lasting E. None of the above
B. Pain free, instant, long lasting
Which of the following are components of long axis hip distraction mobilization? A. Abduction 30 deg, external rotation 30 deg, and slight flexion B. Placing the hands above the malleoli C. Knee in 30 degrees of knee flexion D. Both b and c E. All of the above
B. Placing the hands above the malleoli
In which direction does the occiput slide during forward bending? A. Anterior B. Posterior C. Lateral D. Inferior E. Superior
B. Posterior
Which of the following mobilization techniques can be specifically used to improve radial deviation of the wrist? A. Radiocarpal Radial Glide B. Radiocarpal Ulnar Glide C. Radiocarpal Palmer Glide D. Radiocarpal Dorsal Glide E. None of the above
B. Radiocarpal Ulnar Glide
What primary motion occurs in the inferior compartment of the TMJ? A. Glide B. Rotation C. Translation D. Compression E. None of the above
B. Rotation
How does HVLA thrust manipulation cause inhibition of surrounding muscles? A. Stimulated type I mechanoreceptors B. Stimulates the Golgi Tendon Organ C. Stimulates the adrenal glands D. Stimulates A beta nerve fibers E. All of the above
B. Stimulates the Golgi Tendon Organ
What type of glide is applied when performing MWM? A. Oscillatory B. Sustained C. Thrust D. Both a and b E. None of the above
B. Sustained
What causes the popping sound when a joint is gapped? A. Bones going back into place B. Synovial fluid converted to a gas C. Rupture of a fluid filled bursa D. Meniscus being relocated E. All of the above
B. Synovial fluid converted to a gas
What is a grade II sustained stretch used for? A. Unweight the joint surfaces for glide mobilizations B. Test the irritability of the joint C. Stretch the joint capsule D. Inhibit pain E. None of the above
B. Test the irritability of the joint
What is produced when the mobilizing hand is distal to the joint space? A. Distraction B. Torque C. Glide D. Both a and c E. None of the above
B. Torque
Which of the following mobilization techniques can be used to improve thumb abduction? A. Trapeziometacarpal Palmer Glide B. Trapeziometacarpal Dorsal glide C. Trapeziometacarpal Radial Glide D. Trapeziometacarpal Ulnar Glide E. None of the above
B. Trapeziometacarpal Dorsal glide
When treating a joint hypomobility how much of the slack should be taken up? A. Up to the anatomical barrier B. Up to the restrictive barrier C. Up to the physiologic barrier D. Both a and c E. All of the above
B. Up to the restrictive barrier
What is characteristic of a hypermobile end-feel? A. Soft resistance just before the usual end feel B. Very soft and empty at the end of the range C. Harsh stop before the expected end range D. More elastic and softer at the end range E. None of the above
B. Very soft and empty at the end of the range
What is the capsular pattern for the shoulder? A. IR-ABD-XR B. XR-ABD-IR C. ABD-XR-IR D. ABD-IR-XR E. None of the above
B. XR-ABD-IR
At what point in the stress-strain curve is stress equal to strain? A. Elastic region B. Yield point C. Plastic region D. Failure point E. None of the above
B. Yield point
What nerve root impingement would produce thumb numbness? A. C4 B. C5 C. C6 D. C7 E. C8
C. C6
What grade represents normal accessory motion? A. 1 B. 2 C. 3 D. 4 E. 5
C. 3
At what angle are the typical cervical facet joint oriented in the frontal plane? A. 25 B. 35 C. 45 D. 55 E. 65
C. 45
When performing the glenohumeral distraction manipulation where does the therapist place their hands? A. Just above the wrist B. Just below the elbow C. Around the proximal humerus D. On the scapula E. None of the above
C. Around the proximal humerus
Who developed the manual therapy concept of mobilization with movement? A. Stanley Paris B. Robin McKenzie C. Brian Mulligan D. Geoffrey Maitland E. None of the above
C. Brian Mulligan
A small disc herniation between C3 and C4 would affect what nerve root? A. C2 B. C3 C. C4 D. Both a and b E. Both b and c
C. C4
What country did physiotherapy originate? A. Australia B. Sweden C. England D. France E. Germany
C. England
When assessing joint play, what three variables are measured? A. Excursion, overpressure, pain B. Physiologic range of motion, over pressure, pain C. Excursion, end-feel, pain D. Physiologic range of motion, crepitus, pain E. None of the above
C. Excursion, end-feel, pain
How can a therapist differentiate between and upglide and downglide restriction? A. Push a little harder at end range B. Introduce slight rotation C. Flex or extend the neck D. Palpate while performing the glide E. None of the above
C. Flex or extend the neck
What type of grip is used when performing a radiohumeral distraction mobilization? A. Power grip B. Batters grip C. Golfers grip D. Vice grip E. None of the above
C. Golfers grip
In order to prevent joint irritation what is applied prior to glide mobilization? A. Massage lotion B. Grade II distraction C. Grade I distraction D. Grade III oscillations E. None of the above
C. Grade I distraction
Which of the following are examples of jaw parafunction? A. Singing B. Laughing C. Grinding D. Coughing E. All of the above
C. Grinding
When performing a MWM for ankle dorsiflexion where are the two contact points? A. Hand on the tibia and fibula and the belt on the talus B. Hand on the calcaneus and the belt on the tibia and fibula C. Hand on the talus and belt on the tibia and fibula D. Hand on the tibia and fibula and the belt on the calcaneus E. None of the above
C. Hand on the talus and belt on the tibia and fibula
How did Andrew Taylor Still discover Osteopathy? A. He manipulated a man's neck that restored his hearing B. He fell off a horse and broke his back C. He fell asleep with his head wedged between the roots of an oak tree D. He became ill with meningitis E. None of the above
C. He fell asleep with his head wedged between the roots of an oak tree
Which of the following mobilization techniques can be used to improve forearm pronation? A. Proximal radioulnar anterior glides B. Humeroulnar distraction C. Humeroradial distraction D. All of the above E. None of the above
C. Humeroradial distraction
What governing body ultimately determines if a physical therapist can perform HVLA thrust manipulation? A. APTA B. Federation of State Boards of Physical Therapy C. Individual state boards D. IFOMPT E. None of the above
C. Individual state boards
What osteokinematic motion will a hip posterior glide mobilization improve? A. Extension B. Abduction C. Internal rotation D. External rotation E. None of the above
C. Internal rotation
Who first introduced the concept of the joint end-feel? A. John Mennell B. Freddy Kaltenborn C. James Cyriax D. Geoffrey Maitland E. Stanley Paris
C. James Cyriax
What is the main difference between Kaltenborn technique and Maitland technique? A. Maitland is more concerned with accessory motion loss and Kaltenborn is more concerned with symptoms B. Kaltenborn technique was developed in Australia and Maitland technique in Norway C. Kaltenborn is more concerned with accessory motion loss and Maitland is more concerned with symptoms D. Both b and c E. None of the above
C. Kaltenborn is more concerned with accessory motion loss and Maitland is more concerned with symptoms
A moderate posterior lateral disc herniation between L4 and L5 will compress what nerve root? A. L2 B. L3 C. L4 D. L5 E. None the above
C. L4
How does the 100th monkey effect apply to manual therapy? A. It takes 100 monkeys to build a community B. Monkeys are the founders of manual therapy C. Manual therapy techniques spread once the tipping point is reached D. Manual therapy techniques require the dexterity of monkeys E. All of the above
C. Manual therapy techniques spread once the tipping point is reached
What cells cause increased tissue permeability after an injury that results in a joint becoming hot, red, and swollen? A. Leukocytes B. Fibroblasts C. Mast D. Macrophages E. None of the above
C. Mast
What nerve directly innervates the cervical facet joints? A. Cranial nerve IV B. Dorsal rami C. Medial branch of the dorsal rami D. Lateral branch of the dorsal rami E. Both a and c
C. Medial branch of the dorsal rami
Where is the manipulating hand placed when performing the HVLA thrust manipulation technique to improve knee flexion? A. Medial femur B. Lateral femur C. Medial tibia D. Lateral tibia E. None of the above
C. Medial tibia
Which of the following are components of the anterior glide hip mobilization? A. Patient is supine B. The patient is supine in the hooklying position C. Patients knee is pinned or supported by the practitioner D. Both a and c E. None of the above
C. Patients knee is pinned or supported by the practitioner
In which direction does distraction occur? A. Parallel to the treatment plane B. Oblique to the treatment plane C. Perpendicular to the treatment plane D. Both a and b E. None of the above
C. Perpendicular to the treatment plane
Which of the following interventions are not in the scope of practice for an Osteopaths in the United Kingdom? A. HVLA thrust manipulation B. Muscle energy technique C. Prescribing pharmaceuticals D. Myofascial release E. None of the above
C. Prescribing pharmaceuticals
Which of the following are effects of HVLA thrust manipulation? A. Release entrapped blood vessels B. Increase insulin levels C. Snap periarticular adhesions D. Stimulate adrenal glands E. Both b and c
C. Snap periarticular adhesions
What step in assessing and treating accessory motion has similarities to cutting a 2x4 piece of wood in a vice grip? A. Positioning the joint in the loos pack position B. Using a mobilization wedge C. Stabilizing the proximal bone D. Bunching up the skin E. Applying a Grade I distraction prior to the glide
C. Stabilizing the proximal bone
What occurs arthrokinematically when the knee extends during open chain movement? A. The tibia glides posterior and rolls anterior B. The tibia glides anterior and rolls posterior C. The tibia glides anterior and rolls anterior D. The tibia glides posterior and rolls posterior E. None of the above
C. The tibia glides anterior and rolls anterior
In the Mulligan "Tennis Elbow" technique, where is the force applied with the practitioners hand at the elbow? A. Through the Radius B. Through the Ulna C. Through the Humerus D. Through the treatment strap E. None of the above
C. Through the Humerus
What primary motion occurs in the superior compartment of the TMJ? A. Glide B. Rotation C. Translation D. Compression E. None of the above
C. Translation
Which of the following mobilization techniques can be used to improve thumb extension? A. Trapeziometacarpal Palmer Glide B. Trapeziometacarpal Dorsal glide C. Trapeziometacarpal Radial Glide D. Trapeziometacarpal Ulnar Glide E. None of the above
C. Trapeziometacarpal Radial Glide
Why are cervical disc herniations not as common in the cervical spine as they are in the lumbar spine? A. Greater axial load B. Greater amount of water than collagen C. Uncinate processes D. Both a and b E. All of the above
C. Uncinate processes
What is the best reference when assessing joint mobility? A. The amount of osteokinematic motion available B. Experience with other patients and body types C. Pain level D. Comparing to the contralateral side E. None of the above
D. Comparing to the contralateral side
What position is the hip placed in when performing a long axis inferior glide hip HVLA manipulation? A. 30 deg IR, 30 deg XR, 15 deg flex B. 30 deg XR, 15 deg IR, 15 deg flex C. 30 deg ABD, 30 deg XR, 15 deg ext D. 30 deg ABD, 30 deg flex, 15 deg XR E. None of the above
D. 30 deg ABD, 30 deg flex, 15 deg XR
What is the loose pack position for the glenohumeral joint? A. 30 Abduction, 55 Flexion, slight XR B. 55 Abduction, 30 Flexion, slight IR C. 30 Flexion, 55 Flexion, 30 XR D. 55 Abduction, 30 Flexion, slight XR E. None of the above
D. 55 Abduction, 30 Flexion, slight XR
How can a medial or lateral tibiofemoral glide improve knee flexion and extension? A. Corrects a minor position fault B. Relieves pain C. Stretches the joint capsule D. All of the above E. None of the above
D. All of the above
Mobilization with movement utilizes which principles? A. Maitland B. McKenzie C. Kaltenborn D. All of the above E. None of the above
D. All of the above
Which of the following are true according to the concave rule? A. Convex surface is stationary and concave surface moves B. Glide is in the same direction as the osteokinematic movement C. Glide and roll are in the same direction D. All of the above E. None of the above
D. All of the above
What variable is most important to control when performing a HVLA thrust manipulation? A. Joint plane B. Stabilization of the proximal bone C. Having the patient relax D. Amplitude E. Taking up the slack
D. Amplitude
In what position does the patient rest their arm when performing the proximal radioulnar posterior and anterior glides? A. Straight with their hand pronated B. Bent with their hand resting on the chest C. Straight with their hand supinated D. Bent with their hand resting on the ASIS E. None of the above
D. Bent with their hand resting on the ASIS
How can the clinician make the proximal tibiofibular post glide mobilization more comfortable for the patient? A. Contour the hand to the bone B. Ask for feedback from the patient and adjust hand placement C. Use their forearm instead of their hand D. Both a and b E. All of the above
D. Both a and b
How does MWM work to desensitize the nervous system? A. Can produce immediate pain-free change in comparable sign B. May reduce negative beliefs and expectations C. Remind a patient of a painful past experience D. Both a and b E. All of the above
D. Both a and b
How does the therapist take up the slack when performing a thoracic mobilization? A. Sinks into the tissue B. Twist both hands in a clockwise direction C. Apply a small amount of emollient D. Both a and b E. All of the above
D. Both a and b
If the patient experiences a slight decrease in pain when performing the MWM what should the therapist do? A. Adjust the amount of force B. Change the direction of force C. Perform a different technique D. Both a and b E. None of the above
D. Both a and b
In the Mckenzie method what is Directional Preference? A. During the assessment the therapist determines what movement direction reduces the patients symptoms B. Exercise prescription is based upon the movement direction that reduces the patients symptoms C. Symptoms migrate into the midline of the body D. Both a and b E. All of the above
D. Both a and b
Limited hip extension may contribute to which of the following conditions? A. Lumbar facet joint synovitis B. Knee OA C. Rotator cuff impingement D. Both a and b E. All of the above
D. Both a and b
What causes spur to form around the vertebral endplates? A. Sharpy fibers B. Tension C. Nucleus pulposus D. Both a and b E. All of the above
D. Both a and b
What does Brian Mulligan recommend if there is not complete resolution of symptoms when introducing the accessory motion? A. Increase or decrease the force B. Change the angle C. Apply over pressure D. Both a and b E. All of the above
D. Both a and b
What is another name for accessory motion? A. Joint play B. Arthrokinematic motion C. Physiologic motion D. Both a and b E. Both a and c
D. Both a and b
What is the goal of the Mill's technique for tennis elbow? A. Distract and stretch the capsule of the humeroradial joint B. Break adhesions in the ECRB C. Distract and stretch the capsule of the humerolulnar joint D. Both a and b E. All of the above
D. Both a and b
What mobilizations will improve great toe extension? A. Distraction B. Dorsal glide C. Plantar Glide D. Both a and b E. Both a and c
D. Both a and b
What motions improve with subtalar joint distraction? A. Inversion B. Eversion C. Plantarflexion D. Both a and b E. All of the above
D. Both a and b
What motions will improve with talocrural distraction? A. Plantarflexion B. Dorsiflexion C. Inversion D. Both a and b E. All of the above
D. Both a and b
When performing a medial tibiofemoral glide, where is the mobilizing hand placed? A. Close to the joint line B. On the lateral aspect of the tibia C. On the medial aspect of the tibia D. Both a and b E. Both a and c
D. Both a and b
Which of the following are characteristics of arthrokinematic motion? A. Necessary for full osteokinematic motion B. Include roll, glide, and spin C. Are observable D. Both a and b E. All of the above
D. Both a and b
Which of the following are contraindications to cervical mobilization? A. Osteoporosis B. Double vision C. Rotator cuff surgery D. Both a and b E. All of the above
D. Both a and b
Which of the following manipulations will cause a joint cavitation? A. Talocrural distraction B. Mill's technique C. Glenohumeral posterior glide D. Both a and b E. Both b and c
D. Both a and b
Which of the following mobilization techniques can be used to improve radiocarpal extension? A. Radiocarpal Distraction B. Radiocarpal Palmer Glide C. Radiocarpal Dorsal Glide D. Both a and b E. Both a and c
D. Both a and b
Which of the following practitioners can perform HVLA thrust manipulation? A. Chiropractors B. Osteopaths C. Massage Therapists D. Both a and b E. All of the above
D. Both a and b
Why is the Royal Central Institute of Gymnastics (RCIG) so important to the history of physical therapy in the US? A. It's where Edgar Cyriax, physiotherapist, trained before he went to work with James Mennell at St Thomas Hospital in London B. Many of the principles in Mary McMillan's physical therapy textbook originated from the RCIG C. David Daniel Palmer created Chiropractic based on the philosophy of Per Henrick Ling D. Both a and b E. All of the above
D. Both a and b
How do you locate the navicular bone? A. Medial aspect of the foot B. Lateral aspect of the foot C. Navicular tuberosity D. Both a and c E. Both b and c
D. Both a and c
If a joint is painful when performing a mobilization, what adjustments can be made? A. Make sure the glide is parallel with the treatment plane B. Make sure a grade III distraction is applied C. Make sure the proximal bone is sufficiently stabilized D. Both a and c E. Both a and b
D. Both a and c
What accessory motion should be addressed if a patient has limited knee extension? A. Anterior tibiofemoral glide B. Posterior tibiofemoral glide C. Superior patella glide D. Both a and c E. Both b and c
D. Both a and c
What bones articulate with the cuboid? A. Calcaneus B. Talus C. 5th metatarsal D. Both a and c E. All of the above
D. Both a and c
Which of the following are appropriate terms for a physical therapist to use when describing HVLA techniques? A. Thrust B. Adjustment C. Grade V Mobilization D. Both a and c E. All of the above
D. Both a and c
Which of the following is an appropriate term for a physical therapist to use when documenting manipulation? A. HVLA thrust manipulation B. Grade 5 manipulation C. Adjustment D. Both and b E. None of the above
D. Both and b
What is the main function of the lumbar multifidi muscles? A. Prime movers B. Provide stiffness to the lumbar spine C. Proprioception D. Both b and c E. Both a and b
D. Both b and c
Which of the following are true according to the convex rule? A. The convex surface is stationary and the concave surface moves B. Glide is in the opposite direction to roll C. Glide is in the opposite direction of the osteokinematic motion D. Both b and c E. Botha a and b
D. Both b and c
Which of the following statements is true according to the convex rule? A. Glide and roll are in the same direction B. Glide and roll are in opposite directions C. Roll is always in the same direction as physiological motion D. Both b and c E. Both a and c
D. Both b and c
Which region of the body carries the greatest risk for injury when performing an HVLA thrust manipulation? A. Shoulder B. Lumbar spine C. Hip D. Cervical spine E. None of the above
D. Cervical spine
What component of manipulation is the most important for patient safety? A. Producing sufficient speed B. Stabilizing the proximal bone C. Being close to the joint axis D. Controlling the amplitude E. Having the patient relax
D. Controlling the amplitude
What soft tissue techniques can be used to improve elbow extension? A. Cross friction massage of rotator cuff B. IASTM of the carpal tunnel C. Glide cupping of the triceps D. Crossed hand MFR of the biceps E. None of the above
D. Crossed hand MFR of the biceps
What ligament holds the dens directly to the anterior arch of the atlas? A. PLL B. Apical C. Alar D. Cruciate E. None of the above
D. Cruciate
What three variables are assessed and documented with joint mobility testing? A. Swelling, excursion, and pain B. Excursion, tone, and end-feel C. End-feel, bony blocks, and pain D. Excursion, pain, and end-feel E. End-feel, pain, and resistance
D. Excursion, pain, and end-feel
What did Hippocrates recommend after joint manipulation? A. Hot baths B. Leaches C. Massage D. Exercise E. None of the above
D. Exercise
Who first introduced graded oscillations for mobilizing joints? A. John Mennell B. Freddy Kaltenborn C. James Cyriax D. Geoffrey Maitland E. Stanley Paris
D. Geoffrey Maitland
Which of the following mobilizations can be used to improve joint mobility? A. Grd II oscillations B. Grd I distraction C. Grd II distraction D. Grd III oscillations E. None of the above
D. Grd III oscillations
In what direction should you mobilize the clavicle if there is a limitation with shoulder abduction? A. Anterior B. Posterior C. Superior D. Inferior E. None of the above
D. Inferior
What muscles can "hold" a lumbar facet joint closed? A. Multifidi B. Semi spinalis C. Iliocostalis D. Intertransversarii E. None of the above
D. Intertransversarii
Where does the therapist position their thumb during the Mill's manipulation? A. Olecranon process B. Shaft of the radius C. ECRB D. Radial head E. None of the above
D. Radial head
How can you instruct a patient to find the resting position of the TMJ? A. Sit with good posture and retract jaw B. Sit with good posture and hum C. Sit with good posture and clench teeth D. Sit with good posture and place tong on roof of mouth E. None of the above
D. Sit with good posture and place tong on roof of mouth
What is the average mouth opening in millimeters? A. 80mm B. 70 mm C. 60mm D. 50mm E. 40mm
E. 40mm
How can the accessory glide be applied in MWM? A. Manually B. With a treatment belt C. Applying Sports tape D. Using Theraband E. All of the above
E. All of the above
If the patient experiences improvement in pain and ROM with PIP flexion of the index finger after application of a MWM technique, what could they do as a home program? A. Manually apply a lateral glide while flexing and extending their finger B. Apply tape to create a lateral glide with functional activities C. Have their partner apply a lateral glide while they flexing and extending their finger D. Both a and b E. All of the above
E. All of the above
In the typical cervical vertebra (C2-C7) what occurs with sidebending right? A. The right facet downglides B. The left facet upglides C. Rotation and sidebending are coupled to the same side D. The spinous process deviates to the left E. All of the above
E. All of the above
In which of the following situations would you NOT perform grade III or V oscillatory joint mobilizations? A. On a patient that you do not know the medical history B. On a patient who has osteoporosis C. On a patient who has been taking prednisone to control symptoms of an autoimmune disease D. Both a and b E. All of the above
E. All of the above
What can you do prior to assessing joint mobility to relax spastic muscles? A. Limb rocking B. Apply moist heat C. Trigger point therapy D. Effleurage E. All of the above
E. All of the above
What conditions might respond favorably to Hip distraction HVLA thrust manipulation? A. Hip OA B. FAI C. Stiff hip D. Both a and c E. All of the above
E. All of the above
What does it mean if a patient does not have any additional motion with overpressure? A. There may be a loss of arthrokinematics motion B. There may be a loss of accessory motion C. There may be a loss of joint play D. Both b and c E. All of the above
E. All of the above
What factors limit osteokinematic motion? A. Pain B. Swelling C. Joint capsule shortening D. Both a and c E. All of the above
E. All of the above
What is a "Comparable Sign"? A. A subjective complaint B. An activity that causes pain C. A limitation in ROM during a functional activity D. Something that is re-measured after a MWM intervention E. All of the above
E. All of the above
What is it called when the distal segment is moved perpendicular to the treatment plane? A. Distraction B. Traction C. Joint Play D. Accessory Motion E. All of the above
E. All of the above
What is the purpose of performing overpressure when evaluating osteokinematic motion? A. Determine if accessory motion may be contributing to the loss of osteokinematic motion B. Determine if the patient has capsular tightness C. Determine if there is a loss of joint play D. Both b and c E. All of the above
E. All of the above
What is the purpose of placing a towel under the distal femur when a patient is sitting on the edge of the table and the therapist is performing tibiofemoral distraction? A. Keep the femur parallel to the table B. Secure the distal femur C. Ensure that the joint plane remains constant D. Both a and b E. All of the above
E. All of the above
What is the therapist feeling for when performing a thoracic spring test? A. Resistance to movement B. Increased movement C. Pain D. Both a and b E. All of the above
E. All of the above
What structures make up the temporomandibular joint? A. Condyle of the mandible B. Synovial capsule C. Articular disc D. Both a and c E. All of the above
E. All of the above
What's the difference between and osteopathic physician and a medical physician? A. Their initials DO and MD B. DO's follow a more holistic philosophy C. DO's learn some manual manipulation techniques D. Both a and c E. All of the above
E. All of the above
When is a joint considered hypomobile? A. Hard stop before the expected end range B. No bounce or element of creep at end range C. Excursion is less than the contralateral side D. Both a and c E. All of the above
E. All of the above
Which of the following are absolute contraindications to HVLA thrust manipulation? A. Patient apprehension B. Osteoporosis C. Positive pre-manipulative hold D. Both B and c E. All of the above
E. All of the above
Which of the following are common symptoms of TMD? A. Jaw pain with opening and closing B. Earache C. Facial pain D. Both a and c E. All of the above
E. All of the above
Which of the following are components of a lumbar facet joint? A. Joint space B. Synovial fluid C. Articular disc D. Both a and b E. All of the above
E. All of the above
Which of the following are components of the thoracic spring test? A. Stand with a staggard base of support B. Adjust the table to approximately knee height C. Contact the spinous processes D. Transfer body weight directly over the patient E. All of the above
E. All of the above
Which of the following are considered constitutional symptoms? A. Fatigue B. Night sweats C. Fever D. Both a and b E. All of the above
E. All of the above
Which of the following are indications for joint mobilization? A. Pain relief B. Decrease muscle guarding C. Increase joint mobility D. Improve joint nutrition E. All of the above
E. All of the above
Which of the following are true about normal end-feel? A. Normal end-feel is between R1 and R2 B. Normal end-feel is a firm stop with an element of creep C. Normal end-feel begins at the physiological barrier D. Both b and c E. All of the above
E. All of the above
Which of the following is a contraindication for manipulating the thoracic spine? A. Osteoporosis B. Neurogenic radiating pain along the ribs C. History of breast cancer D. Both a and c E. All of the above
E. All of the above
Why are disc herniation more common in the lumbar spine? A. Hourglass shape of the PLL B. Outer annulus only resists 50% rotation in one direction C. Higher compressive load D. Both and c E. All of the above
E. All of the above
Why does Brian Mulligan believe his techniques are very safe? A. They are applied without symptoms B. A small amount of force is required to achieve an improvement C. The patient is actively participating D. Both a and c E. All of the above
E. All of the above
Why is MWM a patient centered approach? A. The patient chooses the comparable sign B. The patient actively performs the motion C. The patient applies over pressure D. The patient provides feedback E. All of the above
E. All of the above
Why is it important to apply a grade I distraction prior to performing a lateral or medial glide of the humeroulnar joint? A. Unweight the joint surfaces B. Reduce irritability to the joint C. Make the patient more comfortable D. Both b and c E. All of the above
E. All of the above
Why would you decide to perform an HVLA thrust manipulation to the talocrural joint vs just mobilizing with a grade IV oscillation? A. The patient has a positive expectation for manipulation B. There was no improvement with mobilization C. There are no contraindications to HVLA thrust D. Both b and c E. All of the above
E. All of the above
What are characteristics of the loose pack position? A. Intra-capsular space is the greatest B. Joint surfaces pressure is the highest C. Lower joint irritability D. Both b and c E. Both a and c
E. Both a and c
What is the function of the temporalis muscle? A. Close jaw B. Medially deviate C. Laterally deviate D. Both and b E. Both a and c
E. Both a and c
What motions do medial and lateral humeroulnar glides improve? A. Elbow flexion B. Forearm supination C. Elbow extension D. Forearm pronation E. Both a and c
E. Both a and c
Which of the following mobilization techniques can be used to improve elbow flexion? A. Humeroulnar distraction B. Humeroradial posterior glide C. Humeroradial anterior glide D. Both a and b E. Both a and c
E. Both a and c
Which of the following mobilization techniques can be used to improve metacarpal phalangeal flexion? A. MCP Distraction B. MCP Dorsal Glide C. MCP Palmer Glide D. Both a and b E. Both a and c
E. Both a and c
Why is the vertebral artery at risk with upper cervical manipulation? A. It makes a sharp angle after exiting the transverse foramen of C1 B. Mostly sidebending occurs between C1 and C2 and the artery becomes taught C. Mostly rotation occurs between C1 and C2 and the artery becomes taught D. Both a and b E. Both a and c
E. Both a and c
At what angle to the treatment plane is traction performed? A. Perpendicular B. 45 degrees C. Parallel D. 90 degree E. Both a and d
E. Both a and d
What is the purpose of securing the patient ankle between the therapist lower legs when performing a tibiofemoral posterior glide? A. Make the patient feel secure B. Apply a Grd I distraction C. Hold the leg in the loose pack position D. Both a and b E. Both b and c
E. Both b and c
A limitation in shoulder flexion can be improved with what glenohumeral mobilization? A. Anterior glide B. Posterior glide C. Inferior glide D. Distraction E. Both b and d
E. Both b and d
What grades of mobilization are most appropriate for treating limitations in joint mobility? A. Grade II Oscillations B. Grade IV Oscillations C. Grade I Sustained Stretch D. Grade III Sustained Stretch E. Both b and d
E. Both b and d
What are key points when performing hip distraction with a mobilization belt? A. Counterforce on the pelvis B. Belt positioned mid femur C. Apply Grd I distraction D. Patient applies over pressure E. None of the above
E. None of the above
What is a grade IV mobilization? A. Small oscillations at the beginning of the range B. Large oscillation into the middle of the range C. Large oscillations at the beginning of the range D. Small oscillations in the middle of the range E. None of the above
E. None of the above
What is the contact point for the TMJ distraction mobilization? A. Mastoid process B. Zygomatic arch C. Occipital condyles D. Sternocleidomastoid E. None of the above
E. None of the above
What is the difference between a grade IV oscillation and a grade V manipulation? A. The grade V engages the restrictive barrier and the grade IV does not B. The grade IV has a large amplitude and the grade V has a small amplitude C. The grade V is a sustained hold and the grade IV is an oscillation D. The grade IV is performed at the physiological barrier and the grade V at the anatomical barrier E. None of the above
E. None of the above
Which of the following are components of the cervical lateral glide? A. Patient lies prone B. Patients head is in slight extension C. Therapist contacts the spinous process of the superior segment D. Slight rotation is introduced E. None of the above
E. None of the above
Which of the following would be an absolute contraindication to performing a HVLA hip manipulation? A. Patient is over 50 years old B. Patient has a history of diabetes C. Patients asks for a hip manipulation D. Patient has no health insurance E. None of the above
E. None of the above
Who was the first person to describe, in writing, the use of manipulation to restore function to the human body? A. Maitland B. Kaltenborn C. Cyriax D. Paris E. None of the above
E. None of the above
