Musculoskeletal - Lafayette (104 question)
What value best represents normal hip flexion range of motion? A. 90 B. 120 C. 150 D. 180
Correct Answer: 120 Normal hip flexion range of motion is 0-120. Normal hip extension range of motion is 0-30 degrees.
Which value best represents normal elbow flexion range of motion? A. 100 degree B. 130 degree C. 150 degree D. 180 degree
Correct Answer: 150 degrees Normal elbow flexion range of motion is 0-150 degrees. Elbow extension past 0 degrees (neutral) would be considered abnormal.
A Lachman test should be performed with the knee in which of the following positions? A. 5-10 degree of flexion B. 10-20 degree of flexion C. 20-30 degree of flexion D. 30-40 degree of flexion
Correct Answer: 20-30 degrees of flexion The Lachman test is designed to assess the integrity of the anterior cruciate ligament. It is typically performed with the patient in a supine position and the knee flexed 20-30 degrees. A positive test is indicated by excessive anterior translation of the tibia on the femur.
Which value best represents normal thoracolumbar extension range of motion? A. 25 degrees B. 45 degrees C. 65 degrees D. 85 degrees
Correct Answer: 25 degrees Normal thoracolumbar extension range of motion is 0-25 degrees. Normal thoracolumbar flexion range of motion is 0-80 degrees.
When assessing a patient's ability to open their mouth fully, what distance between the top and bottom rows of teeth is considered functional? A. 10 millimeters B. 15 millimeters C. 20 millimeters D. 25 millimeters
Correct Answer: 25 millimeters Range of motion of the temporomandibular joint can be assessed by measuring the distance between the two rows of teeth after the patient fully opens their mouth. Normal range of motion is 35-55 millimeters, although only 25-35 millimeters of opening is needed for everyday activities.
Which value best represents normal wrist ulnar deviation range of motion? A. 30 degree B. 50 degree C. 70 degree D. 90 degree
Correct Answer: 30 degrees Normal wrist ulnar deviation range of motion is 0-30 degrees. Normal wrist radial deviation is 0-20 degrees.
What percentage of shoulder complex abduction occurs at the scapulothoracic articulation? A. 20% B. 33% C. 67% D. 80%
Correct Answer: 33 percent The shoulder complex consists of motion available from the glenohumeral joint and the scapulothoracic articulation. The glenohumeral joint and the scapulothoracic articulation contribute to shoulder complex range of motion in roughly a 2:1 ratio. As a result, the glenohumeral joint contributes approximately 120 degrees (67%) of shoulder complex abduction and the scapulothoracic articulation contributes approximately 60 degrees (33%).
Maximal tension on the S1 nerve root occurs in which range during a straight leg raise test? A. 0-35 degree B. 35-70 degree C. 70-90 degree D. 90-100 degree
Correct Answer: 35-70 degrees Slack in the sciatic nerve is taken up in the first 35 degrees of movement and no further deformation occurs after about 70 degrees. This results in maximal tension during a straight leg raise from 35-70 degrees.
Which value is most representative of normal depression of the mandible? A. 20 millimeters B. 40 millimeters C. 60 millimeters D. 80 millimeters
Correct Answer: 40 millimeters Depression of the mandible (i.e., mouth opening) is measured by asking a patient to open their mouth slowly and as far as possible without pain. Normal depression of the mandible is 35-55 millimeters.
At what angle of knee flexion is the quadriceps femoris capable of producing a maximum force contraction? A. 15 degree B. 45 degree C. 90 degree D. 135 degree
Correct Answer: 45 degrees The range of 30-70 degrees of knee flexion is consistent with the maximum force production of the quadriceps femoris. As a result, many functional tasks occur with the knee positioned within this range.
How much extension of the first metatarsophalangeal joint would be necessary for a patient to stand on tiptoe? A. 10 degrees B. 30 degrees C. 40 degrees D. 55 degrees
Correct Answer: 55 degrees Standing on tiptoe requires a patient to possess full plantar flexion range of motion and a minimum of 55 degrees of extension at the first metatarsophalangeal joint.
Which value best represents normal shoulder extension range of motion? A. 60 degrees B. 80 degrees C. 100 degrees D. 120 degrees
Correct Answer: 60 degrees Normal shoulder extension range of motion is 0-60 degrees. Normal shoulder flexion and abduction are both 0-180 degrees.
Which value best represents normal forearm pronation range of motion? A. 20 degrees B. 40 degrees C. 60 degrees D. 80 degrees
Correct Answer: 80 degrees Normal forearm pronation range of motion is 0-80 degrees. Normal forearm supination range of motion is also 0-80 degrees.
When measuring shoulder medial rotation with a goniometer, what is the proper positioning of the shoulder and elbow? A. 45 degrees of elbow flexion, 90 degrees of shoulder abduction B. 90 degrees of elbow flexion, 45 degrees of shoulder abduction C. 45 degrees of elbow flexion, 45 degrees of shoulder abduction D. 90 degrees of elbow flexion, 90 degrees of shoulder abduction
Correct Answer: 90 degrees of elbow flexion, 90 degrees of shoulder abduction When measuring shoulder medial rotation with a goniometer, proper positioning includes 90 degrees of elbow flexion and 90 degrees of shoulder abduction. The axis should be placed over the olecranon process, the stationary arm should be parallel or perpendicular to the floor, and the moveable arm should be aligned with the ulna using the ulnar styloid process as a reference.
Where does the majority of rotation occur in the cervical spine? A. C1-C2 B. C3-C4 C. C5-C6 D. C7-C8
Correct Answer: C1-C2 C1 is termed the atlas and C2 is termed the axis. C2 has a superior projection called the dens that articulates with the anterior arch of the atlas forming the atlantoaxial joint. The majority of rotation of the skull on the spinal column occurs at the atlantoaxial joint.
When measuring lateral cervical flexion using a goniometer, which vertebrae serves as the axis? A. C5 B. C6 C. C7 D. T1
Correct Answer: C7 When measuring cervical lateral flexion using a goniometer, the axis should be placed over the C7 vertebrae. The stationary arm should be aligned with the spinous processes of the thoracic vertebrae so that the arm is perpendicular to the ground. The moveable arm should be aligned along the dorsal midline of the head using the occipital protuberance for reference.
Which of the following tests would be used to assess the rectus femoris? A. Freiberg test B. Pace abduction test C. Ely test D. piriformis test
Correct Answer: Ely's test Ely's test is performed with the patient in prone. A positive test is indicated by spontaneous hip flexion occurring simultaneously with knee flexion and may be indicative of a rectus femoris contracture.
Which special test is not designed to identify a contracture or muscle tightness? A. Elys test B. Fromment sign C. piriformis test D. tripod sign
Correct Answer: Fromment's sign Froment's sign is designed to identify the presence of neurological dysfunction, specifically ulnar nerve compromise or paralysis.
What special test is being performed if the therapist flexes the patient's shoulder to 90 degrees, flexes the elbow to 90 degrees, and medially rotates the arm? A. Yergason test B. supraspinatus test C. Neer impingement test D. Hawkins Kennedy impingement test
Correct Answer: Hawkins-Kennedy impingement test The Hawkins-Kennedy impingement test is performed by flexing the patient's shoulder to 90 degrees, flexing the elbow to 90 degrees, and medially rotating the arm. This movement pushes the supraspinatus tendon against the coracoacromial ligament and the coracoid process. Pain indicates a positive test for supraspinatus tendinitis or impingement.
The prone knee bend test places maximal tension on which nerve root? A. L1 B. L3 C. L5 D. S1
Correct Answer: L3 The prone knee bend is a test for neural tension and involves flexion of the hip and knee in a prone position. The test stresses the femoral nerve and the L2-L4 nerve roots.
Which of the following special tests would be used to assess pain occurring at 60-120 degrees of shoulder flexion? A. Neer test B. empty can test C. crossover test D. Yergason test
Correct Answer: Neer test The Neer test is a test for subacromial impingement and is associated with a painful arc. A positive test is indicated by a facial grimace or pain.
The capitate carpal bone is used as a landmark for which goniometric measure? A. radial deviation B. wrist flexion C. pronation D. carpometacarpal flexion
Correct Answer: radial deviation The capitate is the anatomical landmark used to align the axis of the goniometer when measuring radial and ulnar deviation using a goniometer. The capitate is the most central and largest of the carpal bones.
Which orthopedic special test would be performed with the patient in sidelying? A. Lachman test B. McMurray test C. Yeoman test D. Ober test
Correct Answer: Ober's test Ober's test is performed with the patient in sidelying. The therapist abducts and extends the patient's top leg and then slowly lowers the leg to assess for tensor fasciae latae tightness. A positive finding would be the inability of the leg to reach the level of the table.
Which of the following special tests would only be administered to infants? A. Finkelstein test B. Froment sign C. Ortolani Test D. Murphy sign
Correct Answer: Ortolani's test During Ortolani's test the patient lies supine with the hips flexed to 90 degrees. The therapist abducts the patient's hips and gentle pressure is applied to the greater trochanters until resistance is felt at approximately 30 degrees. A positive test is indicated by a click or a clunk and may be indicative of a dislocation being reduced.
Which of the following describes a test for thoracic outlet syndrome performed by opening and closing the hands for three minutes in shoulder abduction and lateral rotation? A. Roos B. Adson C. Allen D. Phalen
Correct Answer: Roos Thoracic outlet syndrome is a group of disorders that occur when the neurovascular bundle in the thoracic outlet becomes compromised. A positive Roos test is indicated by an inability to maintain the test position, weakness of the upper extremities, sensory loss or ischemic pain.
When measuring lateral trunk flexion using a goniometer, the axis of the goniometer should be placed directly over the spinous process of which vertebrae? A. L1 B. L3 C. L5 D. S2
Correct Answer: S2 When measuring lateral flexion of the trunk using a goniometer the axis should be placed over S2, the stationary arm should be perpendicular to the ground and the movable arm should be placed in line with the posterior aspect of the spinous process of T1.
Which principle of strength training states that improvements in strength will be specific to the training method that is employed? A. overload principle B. SAID principle C. reversibility principle D. transfer of training principle
Correct Answer: SAID principle The specific adaptation to imposed demands (SAID) principle states that the adaptive effects of training, such as improvement of strength, power, and endurance, are highly specific to the training method that is employed. The principle is an extension of Wolff's law, which states that body systems adapt over time to the stresses placed on them.
Which orthopedic special test would be performed with the patient positioned in sitting? A. ober test B. tripod sign C. elys test D. Thomas Test
Correct Answer: Tripod sign The Tripod sign special test begins with the patient positioned in sitting with the knees flexed to 90 degrees over the edge of the table. The therapist passively extends one knee. A positive test is indicated by tightness in the hamstrings or extension of the trunk in order to limit the effect of the tight hamstrings.
The anterior apprehension test for the shoulder places the joint in which position? A. extension and lateral rotation B. horizontal adduction and medial rotation C. abduction and lateral rotation D. adduction and lateral rotation
Correct Answer: abduction and lateral rotation The anterior apprehension test places the shoulder in a position of compromise for an anterior shoulder instability/dislocation (i.e., abduction, lateral rotation).
What would a positive Thompson test reveal when the calf is squeezed? A. absence of plantar flexion B. slightly diminished plantar flexion C. absence of dorsiflexion D. slightly diminished dorsiflexion
Correct Answer: absence of plantar flexion The Thompson test is designed to assess the integrity of the Achilles tendon by squeezing the muscle belly of the gastrocnemius and soleus muscles. The patient is positioned in prone with the feet extended over the edge of a table. A positive test is indicated by the absence of plantar flexion and may be indicative of a ruptured Achilles tendon.
Which of the following terms describes the prime mover of a joint? A. synergist B. fixator C. antagonist D. agonist
Correct Answer: agonist An agonist is a synonym for a primary mover of a joint. A prime mover actively contracts and produces the intended movement. The agonist is not always the muscle that is shortening. In a bicep curl, the biceps is the agonist when it contracts concentrically causing elbow flexion. It is also the agonist when it eccentrically contracts as the elbow joint moves into extension.
Which range of motion measurement would typically be performed with the patient positioned in sitting and the knee flexed to 90 degrees? A. knee extension B. knee flexion C. ankle dorsiflexion D. ankle inversion
Correct Answer: ankle dorsiflexion Ankle dorsiflexion requires the axis of the goniometer to be aligned over the lateral aspect of the lateral malleolus. The moving arm is parallel with the lateral aspect of the fifth metatarsal and the stationary arm is aligned along the lateral midline of the fibula using the head of the fibula for reference.
Which of the following terms describes a muscle that opposes the action of a prime mover? A. synergist B. fixator C. antagonist D. agonist
Correct Answer: antagonist An antagonist is a muscle that opposes the action of the prime mover. As the prime mover contracts the antagonist progressively relaxes, allowing for a smooth and coordinated movement. Antagonists may also be required to slow down the movement and project the joint from injury.
True leg length measurements are taken from what two anatomical landmarks? A. anterior superior iliac spine, medial malleoli B anterior superior iliac spine, lateral malleoli C. iliac crest, medial malleoli D. iliac crest, lateral malleoli
Correct Answer: anterior superior iliac spine, medial malleoli True leg length measurements are obtained by using a tape measure from the distal point of the anterior superior iliac spines to the distal point of the medial malleoli. The patient should be positioned in supine with the hips and knees extended with the legs 15 to 20 centimeters apart.
Which goniometric measurement uses the external auditory meatus as a landmark? A. cervical flexion B. cervical lateral flexion C. temporomandibular depression D. temporomandibular retrustion
Correct Answer: cervical flexion When measuring cervical flexion, the axis of the goniometer is aligned over the external auditory meatus. The stationary arm is aligned perpendicular or parallel to the ground. The moveable arm is aligned with the base of the nares.
Which of the following terms describes the application of force over a specified distance? A. work B. power C. torque D. acceleration
Correct Answer: work Work results when a force acts on an object and moves it some distance. The formula to determine work is force multiplied by distance (W=FxD).
A positive foraminal compression (Spurling) test is most indicative of: A. atlantoaxial instability B. cervical radiculitis C. vertebral artery compromise D. thoracic outlet syndrome
Correct Answer: cervical radiculitis Spurling test is considered positive if pain radiates into the arm toward which the cervical spine is laterally flexed during compression. Radiating pain is caused by pressure on the nerve root (cervical radiculitis).
Which term is most consistent with a mid-radius fracture that is in several different pieces? A. Salter-Harris Fracture B. segmented fracture C. Jones fracture D. comminuted fracture
Correct Answer: comminuted fracture A comminuted fracture refers to a fracture that breaks into fragments at the site of injury. The fragments may be in the form of several different pieces, splintered pieces or crushed pieces.
a fracture in which the bone protrudes through the skin is referred to as which type of fracture A. comminuted fracture B. simple fracture C. compound fracture D. stress fracture
Correct Answer: compound fracture A compound fracture describes a break in a bone that protrudes through the skin. Because of the amount of force required to cause this type of fracture, patients often have additional injuries which require immediate medical treatment.
What type of fracture is most commonly associated with osteoporosis? A. compound B. compression C. greenstick D. avulsion
Correct Answer: compression Patients with osteoporosis are at an increased risk for compression fractures. Fractures typically occur secondary to the vertebral bodies assuming a wedged shape structure and an increased kyphosis of the thoracic spine.
When administering Ludington's test, the patient is asked to: A. extend the elbow B. flex the shoulder C. contract the biceps brachii D. contract the triceps brachii
Correct Answer: contract the biceps brachii Ludington's test requires the patient to clasp both hands behind the head with the fingers interlocked. The patient is then asked to alternately contract and relax the biceps muscles. A positive test is indicated by absence of movement in the biceps tendon and may be indicative of a rupture of the long head of the biceps.
A positive Finkelstein's test may be indicative of? A. ulnar nerve compromise B. ulnar collateral ligament instability C. carpal tunnel syndrome D. de Quervain disease
Correct Answer: de Quervain's disease A positive Finkelstein's test may be indicative of tenosynovitis of the thumb (de Quervain's disease). The patient is asked to make a fist with the thumb tucked inside the fingers. The therapist stabilizes the patient's forearm and ulnarly deviates the wrist. A positive test is indicated by pain over the abductor pollicis longus and extensor pollicis brevis tendons at the wrist.
What would be the most appropriate method to decrease stress on the patella during a squat exercise? A. decrease the depth of the squat B. widen the base of support C. increase the speed of the squat D. exhale during the downward portion of the squat
Correct Answer: decrease the depth of the squat Decreasing the depth of the squat will reduce the external torque on the knee, which will reduce the pressure placed on the patella.
Which functional activity would require the greatest amount of dorsiflexion range of motion? A. gait on level surfaces B. gait on a treadmill with a 3.0 percent grade C. ascending stairs D. descending stairs
Correct Answer: descending stairs Descending stairs requires nearly 20 degrees of dorsiflexion. The remaining activities require significantly less dorsiflexion range of motion.
Which of the following forms of stretching is most appropriate for the period prior to engaging in an athletic activity? A. static B. dynamic C. ballistic D. proprioceptive neuromuscular facilitation
Correct Answer: dynamic Static, ballistic, and proprioceptive neuromuscular facilitation forms of stretching have been shown in multiple studies to either decrease performance, strength, and/or power. Dynamic stretching has not been shown to have the same detrimental effects on performance as the other options and conversely, has been shown to improve performance in several athletic activities.
Which of the following types of contraction has the potential for the highest force production? A. eccentric B. isotonic C. isometric D. concentric
Correct Answer: eccentric An eccentric contraction occurs when the muscle lengthens while developing tension. This type of contraction involves dynamic loading of a muscle beyond its typical force producing capacity.
Which term is used to describe an increase in fluid within the joint capsule? A. effusion B. tenosynovitis C. edema D. bursitis
Correct Answer: effusion Effusion is used to describe an increase in fluid within a joint capsule. Edema is characterized by an increase in fluid outside of the joint capsule. Tenosynovitis and bursitis are inflammatory conditions usually caused by repetitive activities.
Which type of fracture would most likely utilize an intramedullary rod to provide fixation? A. acetabulum B. femur C. fibula D. calcaneus
Correct Answer: femur An intramedullary rod is often used as a form of fixation for a femur fracture. Advantages of this type of fixation include smaller incision, minimal soft tissue damage during surgery, and enhanced stability for early weight bearing.
What bone when fractured is often associated with the use of skeletal traction? A. femur B. humerus C. tibia D. fibula
Correct Answer: femur Balanced suspension traction requires pins, screws, and wires to be surgically inserted into bone for the purpose of applying a traction force using an externally applied weight. This type of traction is most often utilized with a comminuted fracture of the femur.
When measuring ankle plantar flexion using a goniometer, what structure should the moveable arm be aligned with? A. tibia B. calcaneus C. fifth metatarsal D. first metatarsal
Correct Answer: fifth metatarsal When measuring ankle plantar flexion using a goniometer, the moveable arm should be aligned parallel to the lateral aspect of the fifth metatarsal. The axis should be placed over the lateral malleolus. The stationary arm should be aligned with the lateral midline of the fibula using the head of the fibula for reference.
An inclinometer would be most useful when conducting a formal measurement of: A. balance B. strength C. range of motion D. sensation
Correct Answer: range of motion An inclinometer is a device that is utilized to measure the angle of inclination with respect to gravity. The inclinometer is placed directly on the surface of the patient's skin and the patient is then instructed to move through their available range of motion. The inclinometer quantifies the amount of movement based on the starting and ending value.
Which of the following terms describes a muscle that stabilizes the origin of a prime mover at one joint to increase the effectiveness of another muscle at another joint? A. synergist B. fixator C. antagonist D. agonist
Correct Answer: fixator A fixator is a muscle that stabilizes the origin of the agonist and the joint that the origin spans to allow the agonist to function most effectively. A fixator is a stabilizer in one part of the body during movement in another part of the body. In the bicep curl the fixator would be the rotator cuff muscles.
When performing the Bunnel-Littler test, what is done to rule out capsular restriction? A. flex the metacarpophalangeal joint B. extend the metacarpophalangeal joint C. flex the wrist D. extend the wrist
Correct Answer: flex the metacarpophalangeal joint When performing the Bunnel-Littler test, the metacarpophalangeal (MCP) joint is flexed followed by the proximal interphalangeal (PIP) joint to rule out a capsular restriction of the involved digit. If the range of motion is unrestricted at both joints, the capsule is likely unaffected. The test begins with the MCP in slight extension. If the PIP joint does not flex with the MCP joint extended, there may be a tight intrinsic muscle or capsular tightness.
Which term describes two muscles on opposite sides of a joint that act synergistically to produce a shared motion? A. cocontraction B. force couple C. antagonist group D. synergist
Correct Answer: force couple A force couple is a term used in mechanics to describe two force vectors on opposite sides of an axis that create a collective moment. An example of this in the human body is the serratus anterior and upper trapezius muscles during shoulder abduction.
Which goniometric measurement would require stabilization of the distal end of the humerus to prevent medial rotation and abduction of the humerus? A. forearm pronation B. forearm supination C. wrist flexion D. wrist extension
Correct Answer: forearm pronation Failure to prevent medial rotation and abduction of the humerus when measuring forearm pronation will result in an exaggerated forearm pronation range of motion value. Normal forearm pronation is 80 degrees.
Placing the goniometer axis lateral to the ulnar styloid process would be most appropriate to measure which movement? A. elbow flexion B. forearm pronation C. wrist extension D. wrist flexion
Correct Answer: forearm pronation Forearm pronation is measured with the patient in sitting with the elbow flexed to 90 degrees. The axis of the goniometer is positioned lateral to the ulnar styloid process.
Which of the following is a common type of fracture in children? A. spiral fracture B. compound fracture C. greenstick fracture D. avulsion fracture
Correct Answer: greenstick fracture Greenstick fractures are common in children since the bones have not fully developed and therefore are less rigid and brittle.
Which of the following activities is most likely to increase an individual's bone mineral density at the hips and spine? A. baseball B. swimming C. gymnastics D. golf
Correct Answer: gymnastics Research indicates that high-impact loading exercises for the lower body, such as gymnastics, volleyball or basketball, selectively increase bone mineral density at the hips and spine as compared to low-impact activities. Bone mineral density is regulated by what is known as "specificity of loading". Specificity of loading states that increases in bone mineral density will occur only at sites of the body that are exposed to the minimal essential strain threshold needed to spur bone growth.
The Barlow test is used to test the stability of which joint? A. shoulder B. hip C. knee D. ankle
Correct Answer: hip The Barlow test can be used to detect congenital hip dysplasia. This condition, also known as developmental dysplasia, is characterized by malalignment of the femoral head within the acetabulum. A positive Barlow test is indicated by a click or a clunk and may be indicative of a hip dislocation being reduced.
Which goniometric measurement would require stabilization of the pelvis to prevent anterior tilting? A. hip flexion B. hip extension C. hip medial rotation D. hip abduction
Correct Answer: hip extension Failure to prevent the pelvis from anterior tilting when measuring hip extension will result in an exaggerated hip extension range of motion value. Normal hip extension range of motion is 30 degrees.
When quantifying hip range of motion using a goniometer, which movement requires the axis of the goniometer to be placed directly over the greater trochanter of the hip? A. hip abduction B. hip adduction C. hip extension D. hip external rotation
Correct Answer: hip extension When measuring hip extension with a goniometer, the axis of the goniometer is placed over the lateral aspect of the hip joint using the greater trochanter of the femur for reference. Normal hip extension range of motion is 0-30 degrees.
Which goniometric measurement would require stabilization of the distal end of the femur? A. hip flexion B. hip extension C. hip abduction D. hip medial rotation
Correct Answer: hip medial rotation Failure to stabilize the distal end of the femur when measuring hip medial rotation will result in an exaggerated hip medial rotation range of motion value. Normal hip medial rotation range of motion is 45 degrees.
A muscle contraction in which the muscle shortens or lengthens while resisting a constant load is known as: A. isometric B. concentric C. isokinetic D. isotonic
Correct Answer: isotonic An isotonic contraction occurs when the muscle shortens or lengthens while resisting a constant load. Performing dumbbell curls would be an example of an isotonic contraction.
When measuring knee flexion using a goniometer, what structure should the axis be placed over? A. medial femoral epicondyle B. lateral femoral epicondyle C. tibial plateau D. inferior pole of the patella
Correct Answer: lateral femoral epicondyle When measuring knee flexion using a goniometer, the axis should be placed over the lateral femoral epicondyle. The stationary arm should be aligned with the lateral midline of the femur using the greater trochanter for reference. The moveable arm should be aligned with the lateral midline of the fibula using the lateral malleolus and fibular head for reference.
Temporarily diminished blood flow to the working muscles during a set of a resistance exercise, which then increases during the rest period following the completion of the set is known as: A. reactive hyperemia B. vascular claudication C. hyperperfusion D. erythema
Correct Answer: reactive hyperemia Muscular contractions greater than approximately 20% of the maximal voluntary contraction impede blood flow during a set, however, blood flow increases during the rest period after the set has been completed. This is known as reactive hyperemia and is a potent stimulus for muscle growth.
Which of the following is the most appropriate instruction to provide to a patient who is performing a sidelying hip abduction strengthening exercise? A. lie on your side with the affected leg on the bottom B. bend your top knee slightly to improve your balance C. lift your top leg straight up without allowing the leg to come forward D. hold your breath while performing the exercise
Correct Answer: lift your top leg straight up without allowing the leg to come forward The patient should be instructed to lie on their side with the affected leg on top and the bottom knee bent slightly to provide balance and stability during the exercise. The top leg should be lifted straight up and not allowed to drift forward or backward. The patient should be instructed to breathe throughout the entire exercise.
Which of the following is an indication for soft tissue stretching? A. limited motion due to a bony block B. recent fracture with incomplete bony union C. limited motion due to shortening of opposing tissues at a joint D. hypermobility at a joint
Correct Answer: limited motion due to shortening of opposing tissues at a joint Limited range of motion at a joint due to shortening of opposing tissues is an indication for stretching the affected soft tissue. The other answer options are all contraindications for stretching soft tissue.
What form of stretching is considered the safest and most significant for long-term plastic changes in soft tissue? A. low-intensity, short duration B. high intensity, short duration C. low intensity, long duration D. high intensity, long duration
Correct Answer: low-intensity, long duration A lower intensity of stretch lessens the amount of soft tissue damage and post-exercise soreness compared to high intensity. A low intensity with a long duration allows for permanent deformation of the tissues after the stress is released.
When administering the empty can test, the patient is asked to: A. maintain 90 degrees of glenohumeral flexion and medial rotation against resistance B. slowly lower their arm from an abducted position C. adduct and medially rotate their arm D. actively open and close their hand with their shoulders and elbows flexed to 90 degrees
Correct Answer: maintain 90 degrees of glenohumeral flexion and medial rotation against resistance The empty can test requires the patient to maintain a position of 90 degrees of shoulder flexion and medial rotation against a downward force applied to the distal forearm. Inability to maintain the position or pain may be indicative of a supraspinatus tear.
Phalen's test assesses which nerve? A. ulnar B. musculoskeletal C. radial D. median
Correct Answer: median A positive Phalen's test is indicated by tingling in the thumb, index finger, middle finger, and lateral half of the ring finger. A positive test may be indicative of carpal tunnel syndrome due to median nerve compression.
What muscles are emphasized in a standing row exercise with the arms parallel with the floor using a cable system? A. anterior deltoid and pectoralis major B. infraspinatus and teres minor C. middle trapezius and rhomboid D. upper trapezius and latissimus dorsi
Correct Answer: middle trapezius and rhomboids The standing row exercise requires the patient to start with the arms extended grasping the handles of the cable system. The patient then pulls the cables toward their body while retracting the shoulders and scapulae.
When measuring ankle inversion using a goniometer, where should the axis be placed? A. mid shaft of the anterior tibia B. over the navicular C. anterior medial malleolus D. midway between the malleoli
Correct Answer: midway between the malleoli When measuring ankle inversion using a goniometer, the axis should be placed on the anterior aspect of the ankle midway between the malleoli. The stationary arm should be aligned with the anterior midline of the lower leg using the tibial tuberosity for reference. The moveable arm should be aligned with the anterior midline of the second metatarsal.
Measurement of range of motion at the temporomandibular joint is most often recorded in: A. degrees B. millimeters C. inches D. feet
Correct Answer: millimeters The temporomandibular joint is the articulation between the mandible, the articular disk, and the temporal bone of the skull. Motion at the temporomandibular joint is typically quantified in millimeters based on the relative position change of designated anatomical landmarks associated with the mouth.
Which of the following terms describes muscle pain? A. arthrodynia B. myalgia C. arthroplasty D. myelomalacia
Correct Answer: myalgia Myalgia is a term used to describe pain in a muscle or a group of muscles. Arthrodynia is a term used to describe joint pain, while the other options options do not refer to pain directly.
The ability of an individual to use greater resistance with an exercise during their second session as compared to their first session is most likely due to which of the following? A. neuromuscular adaption B. muscle hypertrophy C. increases in muscle fiber strength D. muscular atrophy
Correct Answer: neuromuscular adaptation The most immediate response to resistance training is an increase in the amount of motor units activated during a particular movement. Muscular hypertrophy and true muscular strength gains take approximately four weeks or more to be realized.
Which term refers to abnormal healing of a bone fracture resulting in a fibrous union or pseudarthrosis? A. delayed union B. malunion C. nonunion D. cancellous
Correct Answer: nonunion Nonunion results in a fibrous union, which may be caused by complications such as infection or inadequate fixation. A fracture that heals in an unsuitable position is termed a malunion and a fracture that takes longer than normal to heal is termed a delayed union. Cancellous bone or "spongy bone" is found at the end of long bones, as well as in the pelvis, ribs, skull, and vertebrae.
Which of the following conditions would not be a contraindication to passive range of motion? A. vertebral basilar insufficiency B. cauda equina lesion C. fracture D. osteoporosis
Correct Answer: osteoporosis Passive range of motion should be performed with caution on a patient with osteoporosis, but should be avoided with patients showing signs and symptoms of vertebral basilar insufficiency, cauda equina lesion, and fracture.
Which exercise would be appropriately classified as a closed chain exercise? A. wall squats B. knee extension in short sitting C. sidelying hip abduction D. supine straight leg raise
Correct Answer: wall squats A closed chain exercise occurs when the distal body segment is fixed, while an open chain exercise occurs when the distal body segment moves freely. When performing a wall squat, the feet are fixed to the floor while the ankles, knees, and hips move through a range of motion.
When measuring metacarpophalangeal flexion of the fingers using a goniometer, where should the stationary arm be placed? A. parallel to the floor B. over the dorsal midline of the metacarpal C. over the dorsal midline of the radius D. over the dorsal midline of the phalanx
Correct Answer: over the dorsal midline of the metacarpal When measuring metacarpophalangeal flexion of the fingers using a goniometer, the stationary arm should be placed over the dorsal midline of the metacarpal. The axis should be placed over the dorsal aspect of the metacarpophalangeal joint. The moveable arm should be aligned over the dorsal midline of the proximal phalanx.
Which strengthening principle states that in order to increase strength, the load placed on a muscle must be greater than those normally incurred? A. overload B. spcificity C. reversibility D. periodization
Correct Answer: overload The overload principle states that in order for strengthening to take place, the load placed on the muscle must be greater than the load normally incurred. Increasing the amount of weight that a patient used with a particular exercise would be an example of adherence to the overload principle.
Which of the following would indicate a positive medial epicondylitis test? A. pain B. numbness C. radiculopathy D. diminished radial pulse
Correct Answer: pain A positive medial epicondylitis test would be indicated by pain in the medial epicondyle region. The therapist palpates the medial epicondyle and supinates the patient's forearm, extends the wrist, and extends the elbow. A positive test may be indicative of medial epicondylitis.
When measuring carpometacarpal flexion of the thumb using a goniometer, where should the axis be placed? A. proximal interphalangeal joint of the first digit B. over the scaphoid bone C. lateral aspect of the radial styloid process D. palmar aspect of the first carpometacarpal joint
Correct Answer: palmar aspect of the first carpometacarpal joint When measuring carpometacarpal flexion of the thumb using a goniometer, the axis should be placed over the palmar aspect of the first carpometacarpal joint. The stationary arm should be aligned with ventral midline of the radius using the ventral surface of the radial head and radial styloid process for reference. The moveable arm should be aligned with the ventral midline of the first metacarpal.
When measuring medial rotation of the hip using a goniometer, what structure should the axis be placed over? A. patella B. anterior superior iliac spine C. center of the acetabulum D. anterior inferior iliac spine
Correct Answer: patella When measuring medial rotation of the hip using a goniometer, the axis should be placed over the patella. The stationary arm should be placed perpendicular to the floor or parallel to the supporting surface. The moveable arm should be aligned with the anterior midline of the lower leg using the crest of the tibia and a point midway between the two malleoli for reference.
When performing the Hoover test, what patient action is required after the therapist grasps each calcaneus? A. perform a straight leg raise B. perform a bridge C. actively abduct the hip D. dorsiflex the ankle
Correct Answer: perform a straight leg raise The Hoover test is performed by the therapist grasping each calcaneus and then asking the patient to perform a straight leg raise. A positive test would result if the therapist was unable to detect pressure from the patient's contralateral heel into their hand as the opposing leg performs the straight leg raise. The test is designed to identify if the patient is malingering.
New bone formation in response to resistance training occurs primarily in which area of the bone? A. periosteum B. endosteum C. epiphysis D. undefined
Correct Answer: periosteum Bone formation occurs with resistance training due to the body's response to mechanical loading. Forces against the longitudinal axis of bone cause the bone to bend. This bending of the bone signals the body that there is weakness in the areas that experience the greatest amount of deformation. The body responds through the application of new bone cells (osteoblasts) in the periosteum of those areas of the bone experiencing the greatest amount of deformation.
When measuring lateral rotation of the shoulder using a goniometer, where should the stationary arm be placed? A. perpendicular to the floor B. midline of the ulna C. the midline of the thorax D. lateral humerus
Correct Answer: perpendicular to the floor When measuring lateral rotation of the shoulder using a goniometer, the stationary arm should be placed perpendicular or parallel to the floor. The axis should be placed over the olecranon process and the moveable arm should be aligned with the ulna using the ulnar styloid process as a reference.
When measuring subtalar inversion using a goniometer, where should the stationary arm be placed? A. posterior midline of the lower leg B. anterior midline of the lower leg C. posterior midline of the calcaneus D. along the second metatarsal
Correct Answer: posterior midline of the lower leg When measuring subtalar inversion using a goniometer, the stationary arm should be aligned with the posterior midline of the lower leg. The axis should be placed at the posterior aspect of the ankle midway between the malleoli. The moveable arm should be aligned with the posterior midline of the calcaneus.
Which of the following does not test for an anterior cruciate ligament injury? A. lateral pivot shift test B. Lachman test C. posterior sag sign D. anterior drawer test
Correct Answer: posterior sag sign A positive posterior sag test is used to identify a posterior cruciate ligament injury. The patient is supine with the hips and knees flexed to 90 degrees and legs supported at the calves by the clinician. The clinician attempts to identify changes in the contour of the tibial tuberosity between the involved and uninvolved sides.
Which test of the lumbar spine involves overpressure in lumbar extension while the patient laterally flexes and rotates to the side of pain? A. Ober test B. quadrant test of the lumbar spine C. Milgram test D. Yeoman test
Correct Answer: quadrant test of the lumbar spine Lumbar extension, lateral flexion, and rotation causes maximum narrowing of the intervertebral foramen and stress on the facet joint to the side on which the rotation occurs.
Which artery does the examiner palpate while performing the costoclavicular syndrome test? A. ulnar B. radial C. carotid D. temporal
Correct Answer: radial The examiner palpates the radial artery when performing the costoclavicular syndrome test. The examiner then assists the patient to assume a military posture. A positive test is indicated by an absent or diminished radial pulse and may be indicative of thoracic outlet syndrome caused by compression of the subclavian artery between the first rib and the clavicle.
When performing Speed's test, what is the role of the examiner? A. passively abduct the shoulder B. resist active shoulder flexion C. passively medially rotate the shoulder D. resist active elbow flexion
Correct Answer: resist active shoulder flexion When performing Speed's test, the therapist should resist active shoulder flexion. The patient is positioned in sitting or standing with the elbow extended and the forearm supinated. The therapist places one hand over the bicipital groove and the other hand on the volar surface of the forearm. A positive test is indicated by pain or tenderness in the bicipital groove region and may be indicative of bicipital tendonitis.
The carpal bone that is most frequently fractured is the: A. pisiform B. lunate C. trapezium D. scaphoid
Correct Answer: scaphoid The scaphoid links the proximal and distal carpal rows and helps provide stability to the wrist. A scaphoid fracture can occur as a result of a fall on an outstretched hand. This injury can be serious due to the potential for avascular necrosis.
Which shoulder motion is being measured if the patient is supine with the fulcrum of the goniometer on the acromial process, the stationary arm on the midaxillary line of the thorax, and the moveable arm on the lateral midline of the humerus? A. shoulder extension B. shoulder abduction C. shoulder adduction D. shoulder flexion
Correct Answer: shoulder flexion The described process is consistent with the goniometric techniques used to measure shoulder flexion. Normal shoulder flexion range of motion is 180 degrees.
Which term describes a partial rupture or tear of a ligament? A. sprain B. strain C. avulsion D. contusion
Correct Answer: sprain A sprain is an acute injury involving a ligament. A strain is an injury involving the musculotendinous unit that involves a muscle, tendon or their attachments to bone.
Which of the following terms describes an incomplete or partial dislocation of joint surfaces? A. dislocation B. sprain C. strain D. subluxation
Correct Answer: subluxation A subluxation occurs when a joint begins to dislocate, however, the joint surfaces do not completely lose contact. A subluxation can occur from an acute injury, such as trauma, or from generalized joint laxity.
Which of the following would be the best indicator that the amount of weight used is excessive in a progressive resistive exercise? A. red flushed color in the face B. substitute motion are required C. increase in measured respiratory rate D. increase in systolic blood pressure
Correct Answer: substitute motions are required An excessive amount of weight often requires a patient to use a variety of substitutions to successfully complete a progressive resistive exercise. The use of substitutions can jeopardize patient safety and in many cases can be avoided by decreasing the amount of resistance used.
When performing Yergason's test, how is the patient asked to actively move against resistance? A. supinate the forearm and medially rotate the shoulder B. pronate the forearm and medially rotate the shoulder C. supinate the forearm and laterally rotate the shoulder D. pronate the forearm and laterally rotate the shoulder
Correct Answer: supinate the forearm and laterally rotate the shoulder When performing Yergason's test, the patient is asked to actively supinate the forearm and laterally rotate the shoulder against resistance. The therapist places one hand on the patient's forearm and the other hand over the bicipital groove. A positive test is indicated by pain or tenderness in the bicipital groove and may be indicative of bicipital tendonitis.
What is the correct sequence of joint type from least to most mobile? A. synarthorosis, diarthrosis, amphiarthrosis B. synarthrosis, amphiarthrosis, diarthrosis C. diarthrosis, amphiarthrosis, synarthrosis D. diarthrosis, synarthrosis, amphiarthrosis
Correct Answer: synarthrosis, amphiarthrosis, diarthrosis Synarthrosis joints are nearly immobile, amphiarthrosis are slightly moveable, and diarthrosis joints are freely moveable.
When measuring cervical rotation using a goniometer, what serves as a reference point for the stationary arm? A. the external occipital protuberance B. the bridge of the nose C. the spinous processes of the thoracic vertebrae D. the acromial processes
Correct Answer: the acromial processes When measuring cervical rotation using a goniometer, the stationary arm is aligned parallel to an imaginary line between the two acromial processes. The axis should be placed over the center of the cranial aspect of the head. The moveable arm should be aligned with the tip of the nose or if using a tongue depressor, align the goniometer parallel with the tongue depressor.
What is the most distal bony landmark used when measuring Q angle? A. anterior superior iliac spine B. medial condyle of the tibia C. midpoint of the patella D. tibial tubercle
Correct Answer: tibial tubercle Q angle refers to the degree of angulation present when measuring from the midpatella to the anterior superior iliac spine and to the tibial tubercle. A normal Q angle measured in supine with the knee straight is 13 degrees for a male and 18 degrees for a female. An excessive Q angle can lead to pathology and abnormal tracking.
A fracture that occurs at a right angle to the long axis of the bone and is usually produced by a shearing force is best termed a/an: A. oblique fracture B. transverse fracture C. spiral fracture D. comminuted fracture
Correct Answer: transverse fracture A transverse fracture occurs at a right angle to the long axis of the bone. Fractures heal in varying time frames based upon age, comorbidities, and fracture site. Normal average healing times range from 3 weeks for the phalanges to 12 weeks for the femur.
When measuring wrist flexion using a goniometer, which carpal bone serves as the axis? A. pisiform B. capitate C. scaphoid D. triquetrum
Correct Answer: triquetrum When measuring wrist flexion using a goniometer, the axis should be placed over the triquetrum. The stationary arm should be aligned with the lateral midline of the ulna using the olecranon and ulnar styloid process for reference, and the moveable arm should be placed along the lateral midline of the fifth metacarpal.
An upper limb tension test that combines the motions of shoulder depression, abduction, external rotation, wrist and finger extension, forearm pronation, and elbow flexion tests which peripheral nerve? A. ulnar nerve B. median nerve C. radial nerve D. musculocutaneous nerve
Correct Answer: ulnar nerve The upper limb tension test of the ulnar nerve utilizing the described motions stresses the C8 and T1 nerve roots specifically.
Which goniometric measurement would require a patient to be positioned in sitting? A. wrist extension B. elbow extension C. knee flexion D. hip flexion
Correct Answer: wrist extension Measuring wrist extension with a goniometer requires the patient to be positioned in sitting with the patient's arm supported on a surface with the shoulder abducted to 90 degrees and the elbow flexed to 90 degrees. The axis of the goniometer is positioned on the lateral aspect of the wrist over the triquetrum. The stationary arm is aligned with the lateral midline of the ulna using the olecranon and ulnar styloid process for reference. The moveable arm is aligned with the lateral midline of the fifth metacarpal.
