AA2 - Midterm
c) 3 (10-15sec holds) *4 would be 15-20sec holds
A client was able to perform trunk extension in prone and cleared the sternum from the table and held for 12 seconds with arms at the side. The best grade to be given for this would be... a) 5 b) 4 c) 3 d) 2
a) 5
A client was able to perform trunk extension in prone and cleared the sternum from the table and held for 21 seconds with arms behind head. The best grade to be given for this would be... a) 5 b) 4 c) 3 d) 2
C) ~80º
A normal Thomas Test would have what degree of knee flexion? A) >80º B) <80º C) ~80º D) >90º E) <90º
b) ischial tuberosity
A physical therapist is examining a patient in side-lying with the gluteus maximus moved superiorly. The PT is palpating greater trochanter & palming the butt right under gluteus maximus. this bony prominence you are most likely on is? a) femur b) ischial tuberosity c) PSIS d) iliac crest
d) Gluteus Medius
A physical therapist is examining a patient in side-lying. The PT is palpating mid-line between the iliac crest and greater trochanter. The patient is asked to perform hip abduction and the therapist confirms they are most likely on the ______ muscle when they can palpate muscle contraction with this motion. a) Piriformis b) Biceps Femoris c) TFL d) Gluteus Medius
c. psoas major
A physical therapist is examining a patient in supine hookline in the region between the umbilicus & ASIS about 2/3 of the way. The PT is palpating a firm muscle belly & has the patient lift knee off the table towards the chest (hip flexion). This muscle you are most likely on is? a. iliopsoas b. iliacus c. psoas major d. psoas minor
b. iliacus
A physical therapist is examining a patient in supine hookline in the region of ASIS & iliac crest sinking into the fossa. The PT is palpating a firm muscle belly & has the patient lift knee off the table towards the chest (hip flexion). This muscle you are most likely on is? a. iliopsoas b. iliacus c. psoas major d. psoas minor
Lateral midline of pelvis/midpoint between ASIS and PSIS
A therapist is measuring hip flexion with a goniometer. What is the correct alignment for the stationary arm?
b) 115º in Hip Flexion
According to AAOS standards, which of the following goniometric findings might indicate an abnormal finding for a joint? a) 80º in SLR b) 115º in Hip Flexion c) 45º in Hip External Rotation d) 30º in Hip Adduction
b. False.
According to the course textbook, when using the method for fingertip-to-floor to measure thoracolumbar flexion, stabilization is required at the pelvis to prevent anterior tilting of the pelvis. a. True b. False.
b) 16-45º From table
As a PT, you are testing lower abdominal strength on a client. Which of the following degree measurements would receive a 4/5 muscle grade when the patient was unable to hold the position and the pelvis started to tilt during the testing procedure? a) 0-15º from table b) 16-45º From table c) 46-75º From Table d) Unable to hold pelvis in neutral
d) Active insufficiency of the hamstrings
Bending the knee in prone during hip extension allows the gluteus maximus to primarily extend the hip. This also helps the therapist to isolate recruitment of other muscles in performing this motion by causing: a) Passive insufficiency of the hamstrings b) Active insufficiency of the gluteus maximus c) Passive insufficiency of the gluteus maximus d) Active insufficiency of the hamstrings
firm except hip flexion can be soft
End-feels mostly are all ___
a. normal
For MLT, a normal value for muscle flexibility & extensibility can be considered: a. normal b. limited c. excessive d. abnormal
A) Posterior thigh does NOT touch the table D) Knee can be flexed as many degrees beyond 80º as the hip is flexed
For the Thomas Test, what is an indicator the 1-joint muscles are tight? (choose all that apply) A) Posterior thigh does NOT touch the table B) Hip ER C) Lateral deviation of the Patella D) Knee can be flexed as many degrees beyond 80º as the hip is flexed
c. patient has a tight ilipsoas
If you are performing a Thomas test and find that the leg is unable to reach the table despite straightening the knee, you presume: a. patient has a tight rectus femoris b. patient has a tight hamstring c. patient has a tight ilipsoas d. patient has a tight gluteus maximus
a. patient has a tight rectus femoris
If you are performing a Thomas test and patient's hip is flexed and knee is flexed not to 80º degrees extension, you presume: a. patient has a tight rectus femoris b. patient has a tight hamstring c. patient has a tight ilipsoas d. patient has a tight gluteus maximus
b. False
The L4 spinous process is smaller than L5. a. True b. False
a. IT band/TFL
The Obers test is used to test for tightness in which structure? a. IT band/TFL b. sartorius c. gracilis d. rectus femoris
a. L4
The iliac crest is level with which vertebrae on a typical spine? a. L4 b. L5 c. S1 d. S2
d) Rectus Femoris
The modified Ober test may be considered to be used instead of the Ober test when a patient has tightness in the following muscle? a) Gluteus Maximus b) TFL c) Piriformis d) Rectus Femoris
Position: standing, neutral spine Stabilize: pelvis @ approx ASIS & PSIS Commands: pt to nod head into cervical flexion, round shoulders, reach fingers to the floor End-feel=firm Landmarks T1 & S2 ~10cm normal Compensations: hip hinge (flexion), knee flexion
Thoracolumbar flexion goni tape measure
a. lift torso off table
To confirm palpation of the erector spinae, have the patient: a. lift torso off table b. hike ipsilateral hip c. lift ipsilateral leg d. do pelvis elevation
c. EXT
To confirm palpation of the gluteus maximus, have the hamstrings in active insufficiency before having patient lift into hip: a. IR b. ER c. EXT d. FLEX
a. IR/ER
To confirm palpation of the greater trochanter, have the patient flex the knee to 90º and PT passively move the hip into: a. IR/ER b. ABD/ADD c. FLEX/EXT
c. lift ipsilateral leg d. lift contralateral leg
To confirm palpation of the multifidus, have the patient: a. lift torso off table b. hike ipsilateral hip c. lift ipsilateral leg d. lift contralateral leg
a. resist hip ER
To confirm palpation of the piriformis, have the patient: a. resist hip ER b. resist hip IR c. resist hip EXT d. resist hip FLEX
c) Weakness in gluteus maximus
Valid reasons that you would perform the alternate gluteus maximus MMT test position (prone over edge of table) versus the standard test position include the following EXCEPT: a) Tightness of one joint hip flexors b) Tightness of 2 joint hip flexors c) Weakness in gluteus maximus d) Weakness in erector spinae
B) Greater trochanteric bursitis
What condition is tightness of the ITB or TFl associated with? A) Golfer's Knee B) Greater trochanteric bursitis C) LCL pathology D) Yo momma
d. femoral artery
What do you palpate inside the femoral triangle? a. inguinal ligament b. profunda femoris artery c. obturator artery d. femoral artery
B) leg dropped anywhere from 0-10º degrees of the horizontal
What is a normal TFL length indicated by the Ober Test? A) leg dropped just before the horizontal B) leg dropped anywhere from 0-10º degrees of the horizontal C) leg does not drop past test starting point D) patient can hold leg against gravity
c. sartorius, inguinal ligament, adductor longus
What muscles make up the femoral triangle? a. tensor fascia lata, sartorius, rectus femoris b. tensor fascia lata, inguinal ligament, sartorius c. sartorius, inguinal ligament, adductor longus d. sartorius, inguinal ligament, gracilis
b. patient unable to keep the knee extended at 80 degrees of hip flexion
What would be a positive finding for the straight leg raise? a. patient unable to keep the knee extended at 90 degrees of hip flexion b. patient unable to keep the knee extended at 80 degrees of hip flexion c. patient unable to dorsiflex past 80 degrees of hip flexion d. patient unable to flex the knee at 80 degrees of hip flexion
B) Thigh flat on table and the knee is <80º degrees flexed
What would be an indication that the 2 joint hip flexors are tight and the 1 joint flexor is normal? A) Thigh flat on table and the knee is >80º degrees flexed B) Thigh flat on table and the knee is <80º degrees flexed C) Thigh not flat on the table, the knee is at ~80º D) LB and sacrum are not on the table and the knee is ~80º
a. hip extension, knee extension, hip internal rotation
When performing MMT on your patient and testing the sartorious muscle, you would produce a force into... a. hip extension, knee extension, hip internal rotation b. hip flexion, knee extension, hip internal rotation c. hip extension, knee flexion, hip internal rotation a. hip extension, knee extension, hip external rotation
A) 0cm on the tip of the middle finger
When performing fingertip to floor, what cm marking is on the middle finger? A) 0cm on the tip of the middle finger B) 1cm on the base of the MCP C) 0cm on the base of the MCP D) 1cm on the tip of the middle finger
D) 80º degrees of hip flexion with knee fully extended
When using the SLR test, what would indicate normal length of the hamstrings? A) ~80º degrees of hip flexion B) >80º degrees of hip flexion with knee fully extended C) <80º degrees of hip flexion D) 80º degrees of hip flexion with knee fully extended
C) on the hip, force downward and upward
Where is the stabilization force for the Ober Test? A) on the hip, downward and lateral B) on the greater trochanter, downward and lateral C) on the hip, force downward and upward D) on the greater trochanter, downward and upward
d. TFL/ITB
Which muscle would be indicated tight in the Thomas test of these were your findings: Hip flexed, Hip Abd, Hip IR, Knee Extension, Tibia ER? a. iliopsoas b. rectus femoris c. sartorius d. TFL/ITB e. pectineus
c. sartorius
Which muscle would be indicated tight in the Thomas test of these were your findings: LB and sacrum flat-posterior thigh on table, Hip Add, Hip flexed, Hip ER, Knee flexed, & Tibia IR? a. iliopsoas b. rectus femoris c. sartorius d. TFL/ITB e. pectineus
b. rectus femoris
Which muscle would be indicated tight in the Thomas test of these were your findings: hip flexed, knee extension (knee flexion past 80º)? a. iliopsoas b. rectus femoris c. sartorius d. TFL/ITB e. pectineus
a) Sartorius
While performing the Thomas test, while moving the hip towards neutral (0º degrees) of hip abduction/adduction, it is noted that the knee moves into increased flexion. This could indicate tightness in which of the following muscle? a) Sartorius b) Rectus Femoris c) TFL d) Iliopsoas
b) Sacral Sulcus
You are working as a therapist on a client who has low back pain. You identify both PSIS's with one thumb on each structure. You move just medial to both of the PSIS's with your thumbs and you come off of the superior and medial edge of both PSIS and feel an indentation. You are palpating the following structure(s): a) S2 Spinous process b) Sacral Sulcus c) ASIS d) Coccyx
a) S2 Spinous process
You are working as a therapist on a client who has low back pain. You identify both PSIS's with one thumb on each structure. You move just medial to both of the PSIS's with your thumbs and you move to the midpoint between the 2 PSIS's and feel a bony prominence. You are palpating the following structure(s): a) S2 Spinous process b) Sacral Sulcus c) PSIS d) PIIS
c) PSIS
You are working as a therapist on a client who has low back pain. You identify iliac crest and move posteriorly & inferiorly & find 2 dimples (bony divets) in the back. You are palpating the following structure(s): a) S2 Spinous process b) Sacral Sulcus c) PSIS d) PIIS
a) 12th rib
You are working as a therapist on a client who has low back pain. You identify posterior part of iliac crest and move superiorly & medially & find a bony prominence. You are palpating the following structure(s): a) 12th rib b) multifidi c) PSIS d) L4
a) Quadratus Lumborum
You are working as a therapist to assess a patient who is complaining of low back pain. The patient is side-lying and you are palpating the posterior back above the iliac crest. You are now in an area in the lateral mid-lumbar region. Your patient complains of tenderness. You as the patient to bring the hip up in a superior direction (hip hike) and the patient confirms this area is tender. You are most likely palpating the: a) Quadratus Lumborum b) Gluteus medius c) Spinalis d) Rectus abdominis
c) TFL
client complains of lateral hip pain & has gluteus medius tendinopathy. you palpate slightly inferior & posterior to ASIS & have the patient perform hip Abd, hip flexion, hip IR in order to confirm you are most likely on the: a) Sartorius b) gluteus medius c) TFL d) Iliopsoas
a. iliopsoas
you are palpating a muscle belly medial to the sartorius tendon & inferior to ASIS confirming with hip flexion. what muscle are you on? a. iliopsoas b. iliacus c. psoas major d. psoas minor
b) 4
you perform strength testing of upper abs and patient is in supine hookline. they cleared the scapula from the table as they lift up from the table and held for 17 seconds with arms crossed over chest. The best grade to be given for this would be... a) 5 b) 4 c) 3 d) 2
distal aspect of leg pushing into ADD, and EXT
You have a patient who is performing MMT for TFL. Where is your direction of force?
a. supine
For hip rotators MMT what is a gravity minimized position? a. supine b. sideline c. prone
a. 2
Lower abs measurement of MMT 90º-76º degrees is: a. 2 b. 1 c. 4 d. 3
d. marked weakness
Performing an MMT of lower back extensors, the patient drops down to the bed from starting point, it would be measured as: a. normal b. slight weakness c. moderate weakness d. marked weakness
C ( Gluteus medius)
When walking sideways (in frontal plane) with a theraband wrapped around the ankles, which muscle is the primary mover? (Kendall page 433) A. Gemellus inferior B. Sartorius C. Gluteus medius D. Adductor longus
C (47-66 degrees-----Depends on dimensions of stairs but approximately 47-66 degrees)
How much hip flexion is necessary for ascending the stairs? (NW p. 294) a. 111-120 degrees b. 102-112 degrees c. 47-66 degrees d. 32-45 degrees
b. 0-20º
The norm for hip extension is: a. 0-10º b. 0-20º c. 0-30º d. 0-50º
a. 0-45º
The norm for hip external rotation is: a. 0-45º b. 0-50º c. 0-70º d. 0-80º
c. 0-120º
The norm for hip flexion is: a. 0-180º b. 0-100º c. 0-120º d. 0-150º
a. 0-45º
The norm for hip internal rotation is: a. 0-45º b. 0-50º c. 0-70º d. 0-80º
c) tight TFL
Therapist finds resistance pushing hip into ER than IR during thomas test. This would be assessed as: a) tight Sartorius b) tight gluteus medius c) tight TFL d) tight Iliopsoas
C (Obers test )
Which of the following test would be the best test to assess TFL tightness? [ Kendall Pages 392-393] a) Thomas test b) Elys test c) Obers test d) Straight Leg Raises
E (A & C -- Swimming & Running)
A patient presents with tight hip flexors and you decide stretch them out by performing a Thomas test stretch. What activity/activities is this most likely to help with? (Lab Manual page 10) a. Swimming b. Doing sit ups at the gym c. Running d. Performing a stoop lift to get luggage out of a car e. A and C
a) Hip internal rotation
A therapist has a patient sitting at the edge of a table which is the standardized position for assessing a particular hip motion. The patient demonstrates elevation of the pelvis (hip hiking) as well as ipsilateral side-bending of the trunk. The therapist would best determine that this is most likely a compensation for which motion? a) Hip internal rotation b) Hip external rotation c) Hip abduction d) Hip adduction
c) Perform the test in supine (gravity eliminated)
A therapist is assessing hip adduction in the standard position. However, the patient is unable to lift the leg up off of the table and does not have pain. PROM of the same motion demonstrates that the patient has normal expected range for this motion and does not have pain. The therapist would do the following: (Choose the BEST answer) a) Refer the patient to a neurologist b) Perform a special test of the hip c) Perform the test in supine d) Grade the patient as a 3-
a. Tight Rectus Femoris
If the examiner discovers a firm muscular end feel when measuring the knee flexion range of motion, what muscle could be the limiting factor? a. Tight Rectus Femoris b. Tight biceps femoris c. Weak Semimembranosis d. Weak Adductor Magnus
d. 4
Lower abs measurement of MMT 15º degrees: a. 5 b. 2 c. 3 d. 4
d. 5
Lower abs measurement of MMT 15º-0º degrees is: a. 3 b. 3+ c. 4+ d. 5
c. 3
Lower abs measurement of MMT 45º degrees: a. 1 b. 2 c. 3 d. 4
a. 4
Lower abs measurement of MMT 45º-16º degrees: a. 4+ b. 3+ c. 5 d. 3
c. moderate weakness
Performing an MMT of lower back extensors, the patient drops halfway from starting point, it would be measured as: a. normal b. slight weakness c. moderate weakness d. marked weakness
D (93 degrees--It requires a mean range of 90-95 degrees, D is within this range)
Rising from a chair requires approximately how much knee flexion? (NW p. 333) a. 80 Degrees b. 120 Degrees c. 73 Degrees d. 93 Degrees
c. imaginary line between acromion processes
The movement arm for thoracolumbar rotation goniometer measurement is: a. nose b. iliac crest c. imaginary line between acromion processes d. ASIS
b. 0-45º
The norm for hip abduction is: a. 0-30º b. 0-45º c. 0-60º d. 0-80º
c. 0-30º
The norm for hip adduction is: a. 0-10º b. 0-20º c. 0-30º d. 0-40º
d. iliac crests
The stationary arm for thoracolumbar rotation goniometer measurement is: a. PSIS b. ASIS c. AIIS d. iliac crests
A (Ipsilateral pelvis; imaginary line extending from one ASIS to the other)
To accurately measure hip adduction, placement of the stabilizing hand and proximal arm of goniometer should be where? a. Ipsilateral pelvis; imaginary line extending from one ASIS to the other b. Contralateral pelvis; imaginary line extending from one ASIS to the other c. Ipsilateral pelvis; midline of the patella d. Contralateral pelvis; midline of the patella
A (prone and sitting)
What two positions are likely when measuring hip external rotation? a. prone and sitting b. prone and supine c. supine and sitting d. on side of plinth and sitting
A) you stop the test immediately and record the data gathered
What do you do when you notice a patient compensating on an MMT? A) you stop the test immediately and record the data gathered B) you continue the test and note how much the patient is compensating C) you stop the test immediately and try again D) you continue the test and then try again later to see if they are still compensating
C) 2
What grade would you give a patient who was only able to hold a posterior pelvic tilt in the lower abdominals MMT? A) 0 B) 1 C) 2 D) 3
c. hip extension internal rotation and abduction
What is close packed position of the hip? a. hip extension, internal rotation, and adduction b. hip extension external rotation and abduction c. hip extension internal rotation and abduction d. none of the above
b. 35 degrees
What is normal thoracolumbar lateral flexion ROM according to the AAOS? a. 30º degrees b. 35º degrees c. 20º degrees d. 40º degrees
b. Goniometer d. Fingertip-to-floor
What is the best measurement to take of thoracolumbar lateral flexion that is relative to person's body structure? a. Fingertip-to-thigh b. Goniometer c. Inclinometer d. Fingertip-to-floor
C) Have the patient curl their upper chest up
What is the first step for doing an MMT of the upper abdominal muscles? A) Passively put the patient into the testing position B) Have the patient place their arms across their chest C) Have the patient curl their upper chest up D) Have an assistant brace the patient's legs
a. iliopsoas e. pectineus
What muscles are our 1 joint hip flexors? (choose all that apply) a. iliopsoas b. rectus femoris c. sartorius d. TFL e. pectineus
b. rectus femoris c. sartorius d. TFL
What muscles are our 2 joint hip flexors? (choose all that apply) a. iliopsoas b. rectus femoris c. sartorius d. TFL e. pectineus
A (TFL tightness)
When completing a Thomas test and you observe hip abduction, hip IR, and lateral patella glide, this would suggest what? a. TFL tightness b. Sartorius Tightness c. Tight Soleus d. Tight Adductor longus
B (sartorius)
When doing the Thomas Test, you observe that the patient's hip is slightly flexed, externally rotated, and abducted with the knee in slight flexion. Which muscle is tight? a. Rectus Femoris b. Sartorius c. Tensor Fascia Latae d. Biceps Femori
straight down towards floor on distal femur
You have a patient who is performing MMT for hip flexors. What direction is your force?
B (Tensor Fascia Lata)
A 16-year-old ballerina dancer arrived to your PT clinic with complaints of muscular pain in her leg. You noted she has trouble with hip abduction, flexion, and internal rotation. Which muscle is most likely affected? a. Sartorius b. Tensor Fascia Lata c. Rectus Femoris d. Semitendinosus
C (Distal Hamstring length test)
The common name for Popliteal Angle test is: (NW p. 326) a. Thomas test b. Obers test c. Distal Hamstring length test d. IR/ER hip test
A (Knee flexed and internally rotated)
Which of these correctly tests the MMT for hip internal rotators? (Kendall p. 429) a. Knee flexed and internally rotated b. Knee flexed and externally rotated c. Knee extended and internally rotated d. Knee extended and externally rotated
B (Patient will have trouble climbing the stairs to the second floor of their house.)
While performing a Straight Leg Test with a patient, you measure the angle of hip flexion to be 45 degrees. Which of your patient's daily activities will be most affected? (p. 294 NW) a. Patient will have difficulty walking their dog around the neighborhood. b. Patient will have trouble climbing the stairs to the second floor of their house. c. Patient will have trouble throwing a ball with their daughter. d. Patient will have trouble doing butt kicks in their exercise program.
D) you internally rotate the leg to create a ligamentous lock
For the quadratus lumborum MMT which of the following is true? A) you grip the testing leg on the proximal tib/fib B) this test is graded 0-5 C) you externally rotate the leg to create a ligamentous lock D) you internally rotate the leg to create a ligamentous lock
B (Foot drop)
If there was damage to the sciatic nerve, what could occur? a. Loss of knee extension b. Foot drop c. Loss of hip flexion d. Loss of blood flow to the knee
B (Tibial external rotation)
In full knee extension, what rotation is referred to as the screw-home mechanism? (NW p. 316) a. Tibial internal rotation b. Tibial external rotation c. Femoral abduction d. Femoral external rotation
C (Firm, Annulus fibrosis)
In lateral thoracolumbar flexion, what end feel is experienced? A. Firm, Supraspinous ligaments B. Hard, Transverse processes C. Firm, Annulus fibrosis D. Soft, Quadratus Lumborum
C (Internal rotation and flexion)
In non-weight bearing, the popliteus muscle does what movements of the tibia? (Kendall p. 416) a. flexion and external rotation b. External rotation and extension c. Internal rotation and flexion d. extension and internal rotation
C (Patient prone with Goniometer Fulcrum: Anterior aspect of Patella, Proximal Arm: Perpendicular to floor, Distal Arm: Tibial crest midway between two malleoli)
A patient comes in and appears to have limited external rotation of the hip. You decide to take goniometric measurements but your patient is unable to sit due to a sacral ulcer. How would you take the measurement? a. Pt. seated on a cushion with Goniometer Fulcrum: Anterior aspect of Patella, Proximal Arm: Perpendicular to floor, Distal Arm: Tibial crest midway between two malleoli b. Patient supine with Goniometer. Fulcrum: Anterior aspect of Patella, Proximal Arm: Perpendicular to floor, Distal Arm: Tibial crest midway between two malleoli c. Patient prone with Goniometer Fulcrum: Anterior aspect of Patella, Proximal Arm: Perpendicular to floor, Distal Arm: Tibial crest midway between two malleoli d. Patient prone with Goniometer Fulcrum: Tibial Tuberosity, Proximal Arm: Parallel to floor, Distal Arm: 1st Metatarsal
B (Semitendinosus--because the question describes the insertion of the semitendinosus {pes anserine} and the SLR confirms a problem in the hamstrings versus the adductor muscles)
A patient comes to see you for pain in their leg. When asked exactly where, they said "my pain is right below my knee cap and on the front/inner side, as well as spreading to the back of my leg". You do a SLR test during your examination and find that the hamstrings muscle length is short (the hamstrings are tight). Which hamstring muscle is mostly affected? a. Semimembranosus b. Semitendinosus c. Biceps Femoris d. Gracilis
C (120 degrees)
According to AAOS, what is the normal range for hip flexion? a. 100 degrees b. 110 degrees c. 120 degrees d. 130 degrees
B (Sartorius)
After completion of a Thomas test, the patient's femur is externally rotated, flexed off the table, and abducted. What muscle is shortened? (Lab manual p.17 MLT of Hip and Knee) A) rectus femoris B) sartorius C) biceps femoris D) illiopsoas
C (During a straight leg raise)
During MLT's when is it appropriate to use a pillow? a. It is never appropriate b. During an ober test c. During a straight leg raise d. During a Thomas test
a. supine
For hip abductors MMT what is a gravity minimized position? a. supine b. sideline c. prone
b. sideline
For ilipsoas MMT & hip flexor group what is a gravity minimized position? a. supine b. sideline c. prone
B (Anterior shoulder)
For ilipsoas MMT where does the therapist apply counterpressure? a. the scapula b. anterior shoulder c. opposite leg d. the humerus
b. 2
Lower abs measurement of MMT 75º degrees: a. 1 b. 2 c. 3 d. 4
A. 3+
Lower abs measurement of MMT 75º-46º degrees: a. 3+ b. 2 c. 1 d. 3-
a. 1
Lower abs measurement of MMT 90º degrees can't hold: a. 1 b. 2 c. 3 d. 4
C (20 degrees)
What is normal hip extension ROM according to the AAOS? a. 30º degrees b. 40º degrees c. 20º degrees d. 10º degrees
B (Firm, Posterior Joint capsule)
What is the normal end-feel for knee extension? a. Hard, Patella on Femur b. Firm, Posterior Joint capsule c. Soft, Quadriceps Femoris blocking patella d. Firm, Hamstring tightness
C (Medial Rotation)
What motion has significant marked restriction in the hip when a capsular pattern is developed? a. Lateral Rotation b. Adduction c. Medial Rotation d. Both A and B
d. lift pelvis & holds 10-20 seconds
When performing MMT of lateral flexors, what is 5/5 grade? (end test when pelvis drops) a. unable to lift pelvis straight with spine b. lift pelvis but can not hold <5 seconds c. lift pelvis & holds 5-9 seconds d. lift pelvis & holds 10-20 seconds
B. 4
When performing a lower abdominal leg lowering MMT, the patient's pelvis begins to tilt anteriorly at about 50º degrees from the vertical start position. What grade is appropriate? (Kendall p. 212) a. 5 b. 4 c. 4- d. 4+
A) it puts the two joint muscles on active insufficiency
When performing an MMT for the hip flexors, which is true regarding the one joint hip flexor? A) it puts the two joint muscles on active insufficiency B) it puts the one joint muscle on active insufficiency C) it creates a passive insufficiency in the two joint muscles D) it creates a passive insufficiency in the one joint muscles
C (Tight Sartorius muscle)
When performing the Thomas Test, a finding of the hip being externally rotated, abducted, and flexed would indicate what? a. Tight Tensor Fascia Latae muscle b. Tight Rectus Femoris muscle c. Tight Sartorius muscle d. Tight Iliotibial Band
C (iliopsoas)
When performing the Thomas Test, the patient's right knee is flexed and held in their arms, and their left hip is slightly flexed with their knee flexed to about 80 degrees. What muscle needs to be stretched to improve their test performance in the future based on this description? (Kendall p. 377-380) a. sartorius b. quadriceps femoris c. iliopsoas d. biceps femoris
B (Rectus Femoris and Gracilis)
When performing the Thomas test, your patient's contralateral leg did not touch the plinth and was also rotated internally rotated. What muscles could possibly be tight in this situation? A. adductor magnus and semitendinosus B. Rectus Femoris and Gracilis C. Sartorius and Tensor Fasciae Latae D. Rectus Femoris only
B ( Sitting and legs hanging off the plinth; no resistance)
When testing the popliteus muscle, what is the proper positioning of the patient and what direction of resistance is applied? (Kendall p.416) a. Supine and knee in 0° flexion; resistance into adduction b. Sitting and legs hanging off the plinth; no resistance c. Sitting and legs hanging off the plinth; resistance into external rotation d. Prone with knee flexed to 90°; no resistance
A (Hip Extension, hip adduction, hip medial rotation, and knee extension)
When testing the strength of the sartorius what direction of resistance should be applied to the lower leg? a) Hip Extension, hip adduction, hip medial rotation, and knee extension b) Hip Flexion, Hip abduction, hip internal rotation, and knee flexion c) Hip extension, hip adduction, hip internal rotation, knee flexion d) Hip extension, hip abduction, hip medial rotation, knee extension
D) Quadratus Lumborum because you are testing in gravity eliminated position
Which of the following MMTs is graded as strong or weak and why? A) Back Extensors because you are testing against gravity B) Quadratus Lumborum because you are testing against gravity C) Back Extensors because you are testing in gravity eliminated position D) Quadratus Lumborum because you are testing in gravity eliminated position
A) Adduction
Which of the following actions cannot be performed by the gluteus medius muscle? a.) Adduction b.) Abduction c.) Internal rotation d.) Flexion
C) An anterior pelvic tilt
Which of the following can cause a limitation for thoracolumbar extension? A) Tight quadriceps femoris muscles B) A posterior pelvic tilt C) An anterior pelvic tilt D) Tight rectus abdominis muscles
B) A posterior pelvic tilt
Which of the following can cause a limitation for thoracolumbar flexion? A) Tight quadriceps femoris muscles B) A posterior pelvic tilt C) An anterior pelvic tilt D) Tight rectus abdominis muscles
B ( Pt supine, fulcrum aligned with the greater trochanter, stationary arm along the lateral midline of the pelvis, movable arm in line with the lateral midline of the femur.)
Which of the following describes the proper set up for using the goniometer to measure hip flexion? (p. 258 Norkin and White) a. Pt is standing, fulcrum is aligned with the greater trochanter, stationary arm along the lateral midline of the pelvis, movable arm in line with lateral midline of the femur. b. Pt supine, fulcrum aligned with the greater trochanter, stationary arm along the lateral midline of the pelvis, movable arm in line with the lateral midline of the femur. c. Pt supine, fulcrum in line with the lateral aspect of the iliac crest, stationary arm along the lateral midline of the pelvis, movable arm in line with the lateral aspect of the femur. d. Pt supine, fulcrum in line with the lateral aspect of the greater trochanter, stationary arm along the lateral midline of the thorax, movable arm in line with the lateral aspect of the femur.
B (Reduced tension on the patella)
Which of the following is a benefit of the modified ober test? (NW p. 287) a. Increased tension on the medial aspect of the knee b. Reduced tension on the patella c. Involvement of the rectus femoris muscle d. Reduced strain on the lateral aspect of the knee
A. the patient uses the wall to stabilize themselves
Which of the following is a compensation for Thoracolumbar lateral flexion? A. the patient uses the wall to stabilize themselves B. the patient brought their ear on the testing side to their same side shoulder C. the patient extends their arm so their finger tips are pointing to the floor D. the patient's same side iliac crest moves up
C) they are all AROM so there is no end feel
Which of the following is true for all of the thoracolumbar motions measurement? A) they are all AROM so there is an end feel B) they are all PROM so there is an end feel C) they are all AROM so there is no end feel D) they are all PROM so there is no end feel
C) the therapist has the patient actively go into the testing position so the hip flexors are not recruited
Which of the following is true regarding the upper abdominals MMT? A) the therapist passively puts the patient into the testing position to recruit the hip flexors B) the therapist has the patient actively go into the testing position to recruit the hip flexors C) the therapist has the patient actively go into the testing position so the hip flexors are not recruited D) the therapist passively puts the patient into the testing position so the hip flexors are not recruited
C. The patient needs to segmentally move into flexion
Which of the following is true regarding using a tape measurer to measure Thoracolumbar flexion? A. It is measured from C7 to S2 B. You conform the tape to the patient's back C. The patient needs to segmentally move into flexion D. It is measured from T1 to the PIIS
B) they move into an anterior pelvic tilt
Which of the following would be a compensation to look for when a patient is performing a lower abdominals MMT? A) they raise their head B) they move into an anterior pelvic tilt C) they move into a posterior pelvic tilt D) they straighten their knees
B (soft)
Which of the following would be considered a normal end-feel for hip flexion? a. firm b. soft c. hard d. empty
A (The pelvis drops down on the left side)
Which of the following would be expected in a patient as they support their weight on their right leg when they have a weak right gluteus medius? a. The pelvis drops down on the left side b. The pelvis drops down on the right side c. The pelvis will not be affected d. They will have a significant anterior pelvic tilt
b. Knee flexed and externally rotated
Which of these correctly tests the MMT for hip external rotators? a. Knee flexed and internally rotated b. Knee flexed and externally rotated c. Knee extended and internally rotated d. Knee extended and externally rotated
B ( Patient will have trouble climbing the stairs to the second floor of their house.)
While performing a Straight Leg Test with a patient, you measure the angle of hip flexion to be 45 degrees. Which of your patient's daily activities will be most affected? (p. 294 Norking and White) a. Patient will have difficulty walking their dog around the neighborhood. b. Patient will have trouble climbing the stairs to the second floor of their house. c. Patient will have trouble throwing a ball with their daughter. d. Patient will have trouble doing butt kicks in their exercise program.
A (IT band/TFL)
While performing the Ober test the PT was not able to passively bring the patients' leg 10˚ below the horizon. During the therapy session the PT should focus on stretching which muscle? a.) IT band/TFL b.) Glut max c.) Sartorius d.) Quad
A (10º degrees below the horizontal)
With the Modified Ober Test, the TFL would be considered to have normal length at what position? (Kendall page 392) A. 10º degrees below the horizontal B. At the horizontal C. 10 degrees above the horizontal D. At the horizontal or 10 degrees below the horizontal
B (Firm. Due to capsule, ligament, tensor fasciae latae muscles, gluteus medius, and gluteus minimus.-----Endfeel firm due to tension in the superior (lateral) joint capsule and the superior band of the iliofemoral ligament. Hip abductor muscles also contribute to this firm endfeel.)
You are doing a goniometric measurement on patients hip adductors. End feel is found to be normal. What is end feel and what contributes to this? (NW p. 264) a. Firm. Due to capsule, ligament, adductor longus, adductor brevis, and adductor magnus. b. Firm. Due to capsule, ligament, tensor fasciae latae muscles, gluteus medius, and gluteus minimus. c. Hard. Due to capsule and bone to bone contact. d. Soft. Due to soft tissue approximation of testing leg making contact with non-testing leg. Cannot move farther.
A (Have pt. perform iliopsoas test supine)
You are performing Iliopsoas MMT and see that your patient is extending their trunk. What is your next move? a. Have pt. perform iliopsoas test supine b. Record strength with their compensations c. Move on to strengthening d. MLT iliopsoas
hip ER using sartorius, hip IR using TFL, posterior pelvic tilt, trunk hip flexion
You are performing Iliopsoas MMT in seated & ask patient to lift knee high towards their chest. What are some compensations?
A (Lateral rotation and abduction --The Sartorius muscle flexes, laterally rotates, and abducts the hip joint. It also flexes, and assists in medial rotation of the knee joint)
You are performing Thomas Test and your patient has tight sartorius. What position will the hip be resting in during this test? (NW p. 276) a. Lateral rotation and abduction b. Medial rotation and abduction c. Lateral rotation and adduction d. Medial rotation and adduction
B (Weakness of the hamstrings, the ankle is dorsiflexing to elongate the gastroc to make it a more effective knee flexor)
You are performing an MMT for gross hamstring strength of a patient. While applying pressure, you determine the patient's strength to be a 4- by the amount of resistance they are providing. However, you feel they are somewhat shaky for a 4- grade, and you then notice that the ankle is dorsiflexed while the patient is resisting. What could the ankle dorsiflexion indicate? (Kendall p. 417) A. Tension of the hamstrings can cause ankle dorsiflexion as a kinetic chain response, it is normal B. Weakness of the hamstrings, the ankle is dorsiflexing to elongate the gastroc to make it a more effective knee flexor C. Tightness of the hamstrings causing the ankle to dorsiflex D. Weakness of the hamstrings, causing the tibialis anterior to attempt to compensate by dorsiflexing the ankle
b. 4
You are performing an MMT of the oblique abdominals and the patient is able to lift off the table to 45º degrees with arms crossed in chest, what grade do you give? a. 5 b. 4 c. 3+ d. 3
c. 3+
You are performing an MMT of the oblique abdominals and the patient is able to lift off the table to 45º degrees with arms extended forward, what grade do you give? a. 5 b. 4 c. 3+ d. 3
c. 3
You are performing an MMT of the oblique abdominals and the patient is only able to lift scapulae off the table with arms extended forward, what grade do you give? a. 2+ b. 3- c. 3 d. 3+
knee past the umbilicus, normal end-feel, asymptomatic, symmetry
You are performing piriformis MLT. What is normal?
b. 60º hip flexion, hip IR until end-feel, hip ADD
You are performing piriformis MLT. What is position is your patient in? a. 90º hip flexion, hip IR until end-feel, hip ADD b. 60º hip flexion, hip IR until end-feel, hip ADD c. 80º hip flexion, hip IR until end-feel, hip ADD
D (tight hip flexors, passively flex non-test leg and place a pillow under knee)
You are testing a patient's hamstring length using the straight leg raise test. You have the patient fully extend and actively raise their leg, the test demonstrates hamstring shortness. You observe the patient and notice that their lower back is not flat on the plinth. What could be the cause of this, and what factors would you change regarding the test position to ensure a true test result? A. tight hamstrings, have the patient flatten their back B. tight hip flexors, have the patient flex their non-test leg and place their foot flat on the plinth C. tight hamstrings, test is positive and no changes are needed D. tight hip flexors, passively flex non-test leg and place a pillow under knee
d. 4
You decide to perform an oblique trunk flexors MMT. patient arms are at the side in supine. You ask them to reach to one side clearing both scapulas off the table. Patient is able to hold 15-20 seconds, what grade is this? a. 5 b. 2 c. 3 d. 4
C. Supine with testing leg off side of table, hip slightly extended, abducted, and slight external rotation
You have a patient who is performing MMT for Gluteus Medius posterior fibers. What is the gravity eliminated position for this test? (Kendall p. 433) a. Side lying, hip slightly extended, abducted, and slight external rotation b. Prone, hip slightly extended, abducted, and slight external rotation c. Supine with testing leg off side of table, hip slightly extended, abducted, and slight external rotation d. Standing, hip slightly extended, abducted, and slight external rotation
a. slight ADD, slight hip FLEX toward opposite foot
You have a patient who is performing MMT for gluteus medius. What direction is your force? a. slight ADD, slight hip FLEX toward opposite foot b. straight ADD toward table c. straight ADD, slight hip EXT
b. sideline, hip slight ext, knee & foot pointing towards ceiling & lift up
You have a patient who is performing MMT for gluteus medius. What is the patient position for this test? a. sideline, knee & foot pointing straight in front & lift up b. sideline, hip slight ext, knee & foot pointing towards ceiling & lift up c. sideline, knee & foot point down towards table & lift up
c. straight ADD, slight hip EXT
You have a patient who is performing MMT for gluteus minimus. What direction is your force? a. slight ADD, slight hip FLEX toward opposite foot b. straight ADD toward table c. straight ADD, slight hip EXT
b. push down at the femoral epicondyle
You have a patient who is performing MMT for hip ADDuctors. What direction is your force? a. push down at the ankle b. push down at the femoral epicondyle c. push down at the knee
a. sideline, knee & foot pointing straight in front & lift up
You have a patient who is performing MMT for hip abductors group. What is the patient position for this test? a. sideline, knee & foot pointing straight in front & lift up b. sideline, knee & foot pointing towards ceiling & lift up c. sideline, knee & foot point down towards table & lift up
a. popliteal fossa and push down towards table
You have a patient who is performing MMT for hip extensors. What direction is your force? a. popliteal fossa and push down towards table b. push down at the knee c. push down at the ankle
anterolateral side of distal femur pushing toward opposite foot (knee extension) & underneath distal leg pulling ankle into extension
You have a patient who is performing MMT for sartorius. Where is your direction of force?
A (Ober test)
You would like to test a patients tensor fascia lata and ilioibial band length. What is the best test to perform on them? (NW p. 283) a. Ober Test b. Thomas Test c. SLR d. Hip adduction test
C) 3+
Your patient comes into the clinic complaining of back pain. You decide to do a lower abdominals MMT to see if a muscle imbalance is causing their pain. You measure their hip flexion as 63 degrees. What grade would you give them? A) 3- B) 3 C) 3+ D) 2+
B) patient has slight weakness
Your patient comes into the clinic complaining of back pain. You decided to do an MMT for the back extensor muscles. After having the patient move through the motion 3x, you passively place them into the testing position. After 2 seconds of the test your patient drops an inch towards the table but then completes the remaining 3 seconds. Which of the following would you record in your records? A) patient is normal B) patient has slight weakness C) patient has moderate weakness D) patient has marked weakness
A) the right external obliques and the left internal obliques
Your patient comes into the clinic complaining of feeling weak in daily activities and off balance. You decide to perform an oblique trunk flexors MMT. You instruct the patient to turn to their right side. Which muscles are being tested? A) the right external obliques and the left internal obliques B) the left external obliques and the right internal obliques C) the left internal and external obliques D) the right internal and external obliques
A) keeping the knee straight reduces patellar compression since the pt is already complaining of pain
Your patient comes into the clinic complaining of pain in their right knee on the lateral side. You decided to preform an Modified Ober Test. What is the correct rationale for choosing the Modified Ober Test and not the Ober Test? A) keeping the knee straight reduces patellar compression since the pt is already complaining of pain B) bending the knee reduces patellar compression since the pt is already complaining of pain C) keeping the knee straight increases patellar compression and your patient is reporting pain D) keeping the knee bent increases patellar compression and your patient is reporting pain
A) increased lumbar lordosis
Your patient enters the clinic complaining of pain. You decided to perform the Ober Test. While performing the test, your patient shows signs of tight quariceps femoris. Which of the following would indicate this? A) increased lumbar lordosis B) the leg staying above 10º degrees of abduction C) increased patellar compression D) weak MCL
C (Weakness of the back extensors )
Your patient is unable to get into the correct position to test gluteus maximus, but has 4/5 strength when tested using the modified gluteus maximus MMT. According to Kendall, which of the following is a possible explanation for your patient's inability to get reach the initial testing position? a. Weakness of the hip flexors b. Tightness of the hamstrings c. Weakness of the back extensors d. Weakness of the hip extensors