UE/Spine Therex Textbook Questions

To strengthen the elbow extensors in a closed chain, you have the patient perform push-ups, using body weight as the source of resistance. Which of the following variations of push-ups provides the greatest amount of resistance to the elbow extensors?

Bilateral push-ups while in a fully prone position on the floor with weight on the hands and toes

Which of the following PROM exercises provides the most flexion of the lumbar spine?

Double KTC

Your patient exhibits a forward head posture and excessive thoracic kyphosis. Considering the muscles that typically are weak with this faulty posture, which of the following muscles of the shoulder girdle are most important to strengthen? A. Pectoralis minor and levator scapulae B. Serratus anterior and levator scapulae C. Upper and lower trapezius and serratus anterior D. Upper and lower trapezius and pectoralis minor

Upper and lower trapezius and serratus anterior

To effectively stretch the scalene muscles on the left, the patient:

Axially extends the neck, side bends to the right, and rotates to the left.

Pendulum (Codman's) exercises are used most effectively:

As a grade II oscillation technique to inhibit pain and maintain mobility.

During ROM of the cervical spine

Avoid grasping the jaw

Which of the following surgical procedures is performed for recurrent anterior instability or dislocation of the glenohumeral joint and involves reattachment and repair of the capsulolabral complex to the anterior rim of the glenoid? A. Anterior capsular shift B. Bankart repair C. Hill-Sachs repair D. SLAP lesion repair

Bankart repair

Rhythmic stabilization exercises are important in a spinal rehabilitation program because they:

Develop postural muscle response to external disturbances.

You are modifying a home exercise program for a patient recovering from an episode of medial epicondylitis. Although pain has subsided, there is evidence of mild limitation of motion and pain when the involved muscle-tendon unit is placed on a stretch and overpressure is applied at the end of the available ROM. To fully lengthen the muscle-tendon unit typically involved in medial epicondylitis, have the patient perform a self-stretch by using the opposite hand to:

Extend and radially deviate the wrist and extend the fingers while the elbow is extended and the forearm is supinated.

4. You are developing an exercise program for a patient who has adhesive capsulitis of the right shoulder. You have determined that the signs and symptoms identified during your examination are consistent with stage 2, the "freezing" stage, of this disorder. In addition to maintaining mobility of joints distal to the shoulder, which of the following interventions for the shoulder is most appropriate at this time?

Grades I and II joint distraction and gliding techniques, pendulum exercises, passive or active-assistive ROM within pain-free ranges, and muscle setting exercises for shoulder musculature

For effective shoulder function, each of the following is necessary except: A. Appropriate movement and stability of the scapula. B. Greater mobility in the external rotators than the internal rotators. C. A balance in strength of the external and internal rotators. D. Thoracic extension and axial extension of the cervical spine.

Greater mobility in the external rotators than the internal rotators.

You place your patient's wrist in a splint because he is experiencing an acute episode of lateral epicondylitis. Which of the following is the least appropriate intervention while the inflamed soft tissue is healing? A. Have the patient wear a splint to immobilize the wrist continuously for at least 2 weeks or until there is no pain. B. Have the patient remove the splint several times each day and perform active or self-assisted ROM of the wrist within pain-free ranges. C. Have the patient remove the splint several times a day and perform gentle muscle-setting exercises, elongating the involved muscle-tendon unit slightly after each contraction but not beyond the pain-free ranges. D. Apply cross-fiber massage at the site of the lesion.

Have the patient wear a splint to immobilize the wrist continuously for at least 2 weeks or until there is no pain.

One day following onset of pain and muscle guarding in the low back region, your patient stands with lumbar flexion and a sciatic scoliosis. Repeated flexion tests increase pain into the buttock. Repeated extension done after side gliding increases the pain in the midback and decreases the pain in the buttock. You begin treatment by:

Having the patient lie prone and attempting passive extension with press-ups or prone propping maneuvers after side gliding the thorax.

All of the following statements are true about functional position (bias) of the spine except: A. The functional position may change as tissues heal and the individual gains mobility and strength. B. If there is an extension bias, it means there is a disk lesion. C. A person with a nonweight-bearing bias is sensitive to the effects of gravity and feels greatest relief when lying down. D. The functional position is not a static position but a range wherein nontraumatic or safe activity can occur.

If there is an extension bias, it means there is a disk lesion.

Of the following choices, the most effective way to stretch tight lumbar extensor muscles is: A. In supine, pull both thighs to the chest until the sacrum is lifted off the mat. B. In long sitting, reach both hands toward the feet as far as possible. C. While standing, bend over and touch the toes. D. In prone, perform press-ups.

In supine, pull both thighs to the chest until the sacrum is lifted off the mat.

Fundamental techniques that every patient with spinal impairments should learn before progressing to basic and advanced training exercises include:

Kinesthetic awareness of safe spinal positions and movement, activation of deep segmental muscles, and global muscle control of spinal posture when moving the extremities or moving from one position to another.

The decision to utilize dynamic exercises in the later stages of a spinal rehabilitation program should be based on:

Patient demonstrating effective deep segmental and global stabilization techniques.

Muscles that typically are shortened in patients with increased thoracic kyphosis; forward head; and protracted, forward tilted scapula are the:

Pectoralis minor, subscapularis, and levator scapulae.

Your patient describes frequent headaches, especially when working at her computer, which get progressively worse during the day. The following limitations in motion are noted: capital flexion, lower cervical extension, cervical side bending, and lateral rotation of the shoulders. Use of a pressure cuff to test control of capital flexion shows the ability to maintain an increase in pressure of 8 mm Hg for 3 seconds. She is not able to lie prone and perform axial extension by lifting her forehead off the table. All of the following would be appropriate methods for initiating your interventions except: A. Gentle manual traction to the suboccipital region followed by passive capital flexion to increase flexibility. B. Training of deep cervical flexors to maintain capital flexion for 10-second holds, using a pressure cuff for feedback. C. Prone-lying axial extension with the head over the end of the table, holding for 10 seconds at a time. D. Supine lying with a foam roller placed longitudinally under the spine and head, allowing the shoulders to roll outward into external rotation.

Prone-lying axial extension with the head over the end of the table, holding for 10 seconds at a time.

Your patient describes posterior cervical pain and headaches that get progressively worse throughout each workday. She is a computer programmer, plays tennis on the weekends, and is an aerobic walker in the evenings. Your evaluation reveals a person who is physically fit with well-balanced flexibility and strength. Your treatment emphasis will be:

Teaching tension-reducing postures and modification of chair, desk, and computer heights.

For a patient to be able to learn good body mechanics for lifting:

The patient must be able to maintain a neutral spinal posture against the force being lifted.

Anterior-posterior pelvic tilt exercises are used:

To perform range of motion (ROM) of the lumbar spine.

The quadratus lumborum is an important stabilizer of the spine in which planes of motion?

Transverse and frontal

Which of the following is an inappropriate component of an exercise program 1 to 3 weeks postoperatively for a patient without preoperative rotator cuff deficiency who underwent total shoulder replacement?

Wand exercises for active-assistive shoulder extension (combined with internal rotation) by placing the wand behind the back and sliding it up the back

You are treating a patient who sustained an anterior dislocation of the glenohumeral joint. When it is permissible for the patient to begin self-assisted or active ROM of the involved shoulder within pain-free ranges, which of the following exercises places the most stress on the anterior aspect of the capsule at the end range of external rotation, therefore posing the greatest risk of re-dislocating the involved shoulder?

Wand exercises while lying in the supine position with both shoulders abducted to 90° (upper arms supported on the treatment table) and both elbows flexed to 90°

Using a handheld weight as the source of resistance, which of the following positions to strengthen the elbow extensors begins with the long head of the triceps brachii fully lengthened?

With the patient standing or sitting in a chair, begin with the elbow fully flexed and the arm elevated overhead and stabilized to maintain the shoulder in as much flexion as possible.