Final Fundamentals CLASS 2020
The most common cause of injury to the anterior cruciate ligament is a lateral blow to the knee. This may be associated with the "unholy triad or terrible triad" whereby which structures are torn? (1/1 Points) A) ACL, MCL and medial meniscus B) ACL, PCL, and LCL C) ACL, lateral meniscus and LCL D) ACL, IT band and popliteus muscle
A) ACL, MCL and medial meniscus
During the subacute stage of soft tissue healing after injury and repair of the flexor tendons of the hand or forearm, each of the following is an important intervention EXCEPT: A. Scar management with pressure on the scar. B. Tendon-gliding exercises. C. Gentle prolonged stretch. D. Progressive resistance exercise.
D. Progressive resistance exercise.
Your patient had a total hip replacement 3 days ago and will be discharged from the hospital tomorrow. Your home instructions should include, but are not limited to, each of the following EXCEPT: (1/1 Points) A) Avoid moving the hip past midline when moving in bed; do not cross your legs. B) Perform ankle-pumping exercises on a regular basis throughout the day with the legs elevated. C) Perform assisted, progressing to active, ROM exercises of the hip and knee within protected ranges. D) Whenever possible, perform transfers or turn with your walker toward the operated side.
D.) Whenever possible, perform transfers or turn with your walker toward the operated side.
Which of the following is required to improve successful Total Ankle Arthroplasty for arthritis of the ankle? (1/1 Points) A) The patient who has high physical demands B) The patient must have sufficient ligament integrity for stability C) Vascular supply should be poor D) A bony deformity that cannot be corrected passively
B) The patient must have sufficient ligament integrity for stability
According to Neer's classification of rotator cuff disease, which of the following stages is seen most often in patients 25 to 40 years of age and characterized by tendonitis or bursitis but not a rotator cuff tendon rupture? (1/1 Points) A. Stage I B. Stage II C. Stage III D. Stage IV
B. Stage II
You are modifying a home exercise program for a patient recovering from an episode of medial epicondylitis. Pain and inflammation are reduced; however there is pain that is present at the end range of motion and with tissue resistance. What phase of tissue healing is this? (1/1 Points) A. Acute stage B. Subacute stage C. Chronic stage D. None
B. Subacute stage
Shoulder instability associated with a tear of the proximal attachment of the long head of the bicep tendon and recurrent anterior instability of the glenohumeral joint BEST describes: (1/1 Points) A. Adhesive capsulitis B. Superior Labrum Extending Anterior to Posterior (SLAP Lesion) C. Rotator Cuff Impingement Syndrome D. Shoulder osteoarthritis
B. Superior Labrum Extending Anterior to Posterior (SLAP Lesion)
A PTA instructs a patient in a home stretching program that includes the pictured stretch. The MOST likely structure targeted is which muscle? (1/1 Points) A) Gluteus medius B) Iliotibial band C) Piriformis D) Rectus femoris
C) Piriformis
Which of the following surgical approaches for conventional total hip arthroplasty is associated with the highest risk of postoperative hip dislocation if the hip flexes (passively or actively) beyond 80° to 90° during the early postoperative weeks? (1/1 Points) A) Lateral B) Anterolateral C) Posterolateral D) Superior approach
C) Posterolateral
A PTA instructs a patient in a lower extremity stretching exercise depicted in this image. After observing the patient complete the stretch, the PTA places a bolster under the patient's right distal femur and asks them to repeat the stretching procedure. This modification is designed to enhance the stretch on which muscle? (1/1 Points) A) Gluteus medius B) Iliotibial band C) Rectus femoris D) Vastus medialis
C) Rectus femoris
A PTA instructs a patient positioned in supine to bring her left leg towards her chest and maintain the position. Assuming the PTA observes the reaction, shown in the image, what muscle would MOST likely have insufficient length? (1/1 Points) A) Iliopsoas B) Quadratus lumborum C) Rectus femoris D) Sartorius
C) Rectus femoris
A PTA instructs a patient in soft tissue mobilization using a foam roller as shown in the image. This therapeutic technique may be MOST beneficial for a patient diagnosed with which diagnosis? (1/1 Points) A) Iliolumbar syndrome B) Iliotibial band syndrome C) Piriformis syndrome D) Trochanteric bursitis
B) Iliotibial band syndrome
All of the following are appropriate nonoperative interventions for ankle arthritis EXCEPT which intervention: (1/1 Points) A) Orthotics B) Physical Therapy C) Activity modification D) High impact loading
D) High impact loading
A PTA instructs a patient in a self-stretching activity using the FABER position. This position would be MOST useful to stretch which muscles? (1/1 Points) A) Hip abductors B) Hip flexors C) Hip external rotators D) Hip internal rotators
D) Hip internal rotators
A PTA works to improve ROM of a patient who has undergone total hip arthroplasty using the posterolateral approach. The patient is having difficulty reaching their feet to don and doff their shoes independently. Which of the following motions should be emphasized to achieve improved independence with this skill? (1/1 Points) A) Hip flexion B) Hip medial (internal) rotation C) Knee extension D) Hip lateral (external) rotation
D) Hip lateral (external) rotation
The medial meniscus is firmly attached to several other structures of the knee, increasing the likelihood for medial meniscus tears. These structures include all of the following in the knee EXCEPT: (1/1 Points) A) Joint capsule B) MCL C) ACL and PCL D) IT band
D) IT band
Your patient reports a sudden onset of severe pain yesterday in the (L) posterior thigh while sprinting. Today he is unable to fully extend his (L) knee while walking because of pain. Which of the following interventions is most appropriate to use when initiating therapy TODAY? (1/1 Points) A) Passive knee flexion/extension within the pain-free range with the hip flexed to 90° B) Passive knee flexion/extension within the pain-free range with the hip positioned in 0° extension C) Active knee flexion but no passive or active extension D) Submaximal resisted knee flexion in the prone-lying position
) Passive knee flexion/extension within the pain-free range with the hip positioned in 0° extension
John is a 25-year-old active athlete and outdoorsman who suffered a severe lateral ankle injury 5 years ago, resulting in progressive subtalar arthritis, pain, and instability of the ankle and hindfoot. His quality of life and ability to work are now restricted owing to the pain and instability despite repeated sessions in therapy. The surgical procedure of choice for John is most likely: (1/1 Points) A) Arthrodesis (fusion). B) Total ankle arthroplasty. C) Brostrom procedure. D) Watson-Jones procedure.
A) Arthrodesis (fusion).
Each of the following is an expected improvement after TAA for advanced arthritis EXCEPT: (1/1 Points) A) Increased mediolateral stability of the ankle. B) Alleviation of pain. C) Sufficient range of motion (ROM) of the ankle for functional activities. D) Decreased joint deformity.
A) Increased mediolateral stability of the ankle.
Assuming a capsular restriction, to increase abduction or flexion of the hip, the direction of an appropriate mobilization glide would be: A) Inferior B) Compression C) Anterior D) Superior
A) Inferior
This is a condition where pain is experienced along the plantar aspect of the heel. Pain may be present for more than 6 months. The patient may experience pain getting out of bed in the morning, upon standing after sitting for longer than 1 hour, and after playing a sport. The mostly likely disorder causing these symptoms is: (1/1 Points) A) Plantar fasciitis. B) Calcaneal bursitis. C) Achilles tendinitis. D) Posterior tibialis tendinitis.
A) Plantar fasciitis.
Because the line of gravity falls anterior to the axis of the ankle in standing, a dorsiflexion movement or tendency is created. Which muscle counteracts or opposes this movement by pulling on the tibia posterior to keep us from falling forward during postural sway? (1/1 Points) A) Soleus B) Popliteus C) Anterior tibialis (tibialis anterior) D) Extensor hallicus longus
A) Soleus
Proximal factors of the hip and pelvis can cause patellofemoral pathologies. All of the following are considered proximal factors that may cause patellofemoral dysfunction EXCEPT: (1/1 Points) A) Strong hip abductors and external rotators B) Genu valgum C) Tight lateral retinaculum D) External tibial torsion
A) Strong hip abductors and external rotators
Following a severe, third-degree (grade 3) inversion sprain, your patient complains of pain just distal and lateral to the knee joint. The pain is likely the result of: (1/1 Points) A) Subluxation of the proximal tibiofibular joint. B) Tear of the lateral collateral ligament. C) Tear of the lateral head of the gastrocnemius. D) Referred pain from gait deviations due to sore ankle joints and ligaments.
A) Subluxation of the proximal tibiofibular joint.
A patient is limited in passive ankle dorsiflexion when the knee is extended but is not limited when the knee is flexed. The MOST logical explanation for this is: (1/1 Points) A) The gastrocnemius is responsible for the limitation B) The soleus is responsible for the limitation C) The popliteus is responsible for the limitation D) The gastrocnemius AND soleus are both responsible for the limitation
A) The gastrocnemius is responsible for the limitation
Which of the following special tests may be used to confirm or rule out a rupture of the Achilles tendon during a patient's physical examination? (1/1 Points) A) Thompson test B) Anterior drawer of the ankle C) Talar tilt test D) Test for Homan's sign
A) Thompson test
The hamstrings have the ability to pull posterior on the tibia to participate in knee extension in a closed chain scenario: (1/1 Points) A) True B) False
A) True
5) A patient with hip flexor tightness may cause a pelvic rotation requiring stretching to hip flexors and which other muscles (based on the pelvic rotation that tight hip flexors create)? (0/1 Points) A) Trunk extensors stretching due to increased lordosis B) Trunk flexors (abdominals) stretching due to decreased lordosis C) Hip extensors (hamstrings) stretching due to decreased lordosis D) Hip adductors stretching due to pelvic lateral tilting
A) Trunk extensors stretching due to increased lordosis
A PTA attempts to assess the motor component of the axillary nerve by conducting a resistive test. Which muscle would be the MOST appropriate to test? (1/1 Points) A. Teres minor B. Teres major C. Subscapularis D. Supraspinatus
A. Teres minor
Pendulum (Codman's) exercises (with NO WEIGHT) are thought to be effective: (1/1 Points) A. As a grade II oscillation technique to inhibit pain and maintain mobility. B. Because they are always used for strengthening exercises. C. To stretch the shoulder musculature and increase range of motion (ROM) when a patient does not have antigravity control of shoulder movement. D. As a grade III distraction technique to increase ROM when mobility of the scapula is normal but there is chronic stiffness of the glenohumeral joint.
A. As a grade II oscillation technique to inhibit pain and maintain mobility.
You are educating your patient about returning to functional activities following a radial head resection with an implant. What should you tell her about returning to high-demand, high-impact activities? A. Avoid these activities on a permanent basis. B. Because she had a radial head implant, she may return to these activities after 6 months. C. She may return to heavy lifting after 6 months, but not high-impact (tennis or golf) activities because of the ballistic force these activities create. D. She should have had a TEA if she wanted to return to these activities.
A. Avoid these activities on a permanent basis.
When a period of continuous immobilization of the elbow is required after trauma or surgery, the elbow often is positioned in only a moderate amount of flexion (20°to 30°) rather than 90° of flexion. This position is selected to: (1/1 Points) A. Decrease the risk of ulnar neuropathy from compression of the ulnar nerve in the cubital tunnel. B. Decrease the risk of radial neuropathy from compression of the radial nerve in the cubital tunnel. C. Decrease the risk of median nerve neuropathy from compression in the cubital tunnel. D. Decrease the risk of overstretching the lateral collateral ligament complex of the elbow that could cause posterior translation of the radial head.
A. Decrease the risk of ulnar neuropathy from compression of the ulnar nerve in the cubital tunnel.
Tennis elbow may involve which muscle? A. Extensor carpi radialis brevis. B. Flexor carpi radialis C. Pronator teres. D. Flexor carpi ulnaris
A. Extensor carpi radialis brevis.
A 45-year old sustained a traumatic injury to his right shoulder while playing basketball one week ago. The patient presents with pain, inflammation, and muscle spasm throughout the shoulder. The MOST appropriate interventions is: (1/1 Points) A. Grade I and II joint mobilization B. Bent over row with a hand weight C. Door way pectoralis stretching D. PNF without resistance
A. Grade I and II joint mobilization
A patient with mallet finger admits to being noncompliant with recommended splinting regimen. The patient was instructed to wear the prescribed splint continuously for 6 weeks. Which impairment would be MOST likely based on this scenario? A. Inability to fully extend the distal interphalangeal joint B. Inability to fully flex the distal interphalangeal joint C. Inability to fully extend the proximal interphalangeal joint D. Inability to fully flex the proximal interphalangeal joint
A. Inability to fully extend the distal interphalangeal joint
Your patient has an "extensor lag" of the MP joints. What does this suggest? A. It is possible to extend the MP joint passively through the full range of extension, but full active MP extension is not possible, owing to weakness of the extensor digitorum. B. Posterior (dorsal) sliding of the proximal phalanx on the head of the metacarpal is restricted. C. Full passive MP extension is not possible. D. It is possible to extend the MP joint passively through the full range of extension, but full active MP extension is not possible, owing to weakness of the lumbricales.
A. It is possible to extend the MP joint passively through the full range of extension, but full active MP extension is not possible, owing to weakness of the extensor digitorum.
A closed procedure that is performed when little to no progress in range of motion is achieved in order to break adhesions. This procedure creates an inflammatory reaction and the joint is treated as an acute lesion. Name the procedure. A. Manipulation under anesthesia B. Capsular shrinking C. Shoulder arthroscopy D. Total Shoulder Replacement
A. Manipulation under anesthesia
Which of the following is LEAST appropriate after arthroplasty of the wrist? (0/1 Points) A. Manual stretching techniques to restore full ROM of the wrist during the final phase of rehabilitation B. Active wrist flexion/extension (greater emphasis on extension) and forearm pronation/supination (greater emphasis on supination) as soon as the immobilization device can be removed for exercise C. Low-intensity (about 1 lb) dynamic resistance exercises of the wrist and hand during the intermediate and late phases of rehabilitation D. Use of the hand for light functional activities at about 3 months postoperatively
A. Manual stretching techniques to restore full ROM of the wrist during the final phase of rehabilitation
A PTA instructs a patient to perform the stretch shown in the image. This type of stretch would MOST likely be used to stretch the: (1/1 Points) A. Pectoralis major and minor B. Triceps C. Middle trapezius D. Upper traps
A. Pectoralis major and minor
Which of the following is an indication for carpometacarpal (CMC) arthroplasty of the thumb? (1/1 Points) A. RA B. carpal tunnel syndrome C. myositis ossificans D. Schwann Neck Deformity
A. RA
Injury to the Long Thoracic Nerve may result in which postural abnormality? (1/1 Points) A. Scapular winging B. Head forward posture C. Reduced cervical lordosis D. Increased kyphosis
A. Scapular winging
A patient diagnosed with a partial tear of the infraspinatus. Which muscle group would be MOST seriously affected by this injury? (1/1 Points) A. Shoulder lateral rotators (external rotators) B. Shoulder medial rotators (internal rotators) C. Shoulder abductors D. Shoulder adductors
A. Shoulder lateral rotators (external rotators)
You notice several deformities, including hyperextension of the proximal interphalangeal (PIP) joints and flexion of the distal interphalangeal (DIP) joints of digits 2, 3, and 4 in your patient with RA. This deformity is called: A. Swan-neck deformity. B. Heberden's deformity. C. Boutonnière deformity. D. Saddleback deformity.
A. Swan-neck deformity.
Which muscles prevent impingement of the subacromial structures by opposing the upward translation of the deltoid during elevation? (1/1 Points) A. The rotator cuff because the supraspinatus compresses the humeral head into the glenoid fossa and the infraspinatus and teres minor cause a downward translation of the humeral head B. The biceps and triceps complex because they balance the anterior and posterior sagittal movements of flexion and extension of the shoulder C. The pectoralis minor because it tilts the scapula anteriorly to create less subacromial space D. The subclavian muscle because it depresses the clavicle
A. The rotator cuff because the supraspinatus compresses the humeral head into the glenoid fossa and the infraspinatus and teres minor cause a downward translation of the humeral head
Effective shoulder flexion (elevation) depends on sufficient strength to the scapular upward rotators. Which scapular muscles contribute to scapular upward rotation to achieve this? (1/1 Points) A. Upper traps, lower traps, and serratus anterior B. Deltoid and supraspinatus C. Rhomboids and levator scapula D. Thoracic extension and axial extension of the cervical spine.
A. Upper traps, lower traps, and serratus anterior
Of the following contributing factors, which is classified as an intrinsic factor in rotator cuff disease affecting the suprahumeral (AKA subacromial) space? (0/1 Points) A. Vascular changes in the rotator cuff tendons B. Hypertrophic degenerative changes of the acromioclavicular joint C. The shape of the acromion D. Increased thoracic extension
A. Vascular changes in the rotator cuff tendons
An athlete is referred to physical therapy after being diagnosed with apophysitis of the ischial tuberosity. Which mechanism of injury in MOST consistent with this condition? (1/1 Points) A) A soccer player kicking a soccer ball B) A runner competing in hurdles C) A tennis player rapidly changing direction D) A sprinter coming out of the starting blocks
B) A runner competing in hurdles
A patient is a male, in his 5th decade of life who was playing softball and was trying to stretch a double hitter into a triple by suddenly accelerating to reach 3rd base. He felt a sudden pain and had a distinctive pop. He demonstrates pain approximately 4 cm proximal to the calcaneus. What condition is he likely suffering from? (1/1 Points) A) Fracture of the tibia. B) Achilles tendon rupture. C) Plantaris rupture. D) Syndesmosis injury.
B) Achilles tendon rupture.
A PTA works with a patient diagnosed with patellofemoral syndrome. As part of the physical therapy session the PTA measures the patient's Q angle. Which three bony landmarks are used to measure the Q angle? (1/1 Points) A) Anterior superior iliac spine, superior border of the patella, tibial tubercle B) Anterior superior iliac spine, midpoint of the patella, tibial tubercle C) Anterior superior iliac spine, inferior border of the patella, midpoint of the patella tendon D) Greater trochanter, midpoint of the patella, tibial tubercle
B) Anterior superior iliac spine, midpoint of the patella, tibial tubercle
Which one of the following ligaments of the ankle is most frequently stressed with an inversion sprain? (1/1 Points) A) Posterior talofibular B) Anterior talofibular C) Calcaneofibular D) Deltoid
B) Anterior talofibular
After checking the iliac crest height, greater trochanter height, head of the fibula and medial malleolus, a patient's left leg appears shorter than his right. What related possible foot deformity should you look for while still in standing? (1/1 Points) A) Excessive right foot pronation compared with the left B) Excessive left foot pronation compared with the right C) Excessive left foot supination compared with the right D) Hallux valgus on the right
B) Excessive left foot pronation compared with the right
When there is lateral pelvic tilting, what hip motion occurs on the side of the pelvis that is elevated? (1/1 Points) A) Hip abduction B) Hip adduction C) Hip extension D) Hip flexion
B) Hip adduction
Because the function of the piriformis changes past 90 degrees of hip flexion, the position for stretching the piriformis when the hip is in greater than 90 degrees of flexion is the following position: (1/1 Points) A) Hip flexion and internal rotation B) Hip flexion and external rotation C) Hip extension and internal rotation D) Hip extension and external rotation
B) Hip flexion and external rotation
All of the following conditions are considered indications for arthrodesis of the ankle EXCEPT: (1/1 Points) A) Debilitating pain with weightbearing B) Hypomobility C) Ankle deformities causing abnormal loading D) Necrosis of the talus
B) Hypomobility
Why is a knee immobilizer sometimes used to help a patient adhere to total hip arthroplasty precautions? (1/1 Points) A) It helps to prevent the knee from flexing which is a hip precaution B) It prevents the hip from flexing beyond 90 degrees by passive insufficiency due to positioning of the hip extensor two-joint muscle (hamstrings) C) It keeps the legs from crossing midline D) It prevents excessive internal rotation/twisting with weightbearing of the involved hip
B) It prevents the hip from flexing beyond 90 degrees by passive insufficiency due to positioning of the hip extensor two-joint muscle (hamstrings)
Controlled motion and return to function for the patient with patellofemoral dysfunction would NOT typically include: (1/1 Points) A) Stretching the TFL and IT band B) Lateral glide of the patella C) Patella taping for medial glide of the patella in the femoral groove D) Shoe inserts to prevent foot pronation
B) Lateral glide of the patella
There is an interdependence of leg and foot motions such that supination of the foot results in what motion: (1/1 Points) A) Medial rotation of the tibia B) Lateral rotation of the tibia C) Flexion of the great toe D) Extension of the lateral foot
B) Lateral rotation of the tibia
What motion occurs with the screw-home mechanism when the leg is in a CLOSED CHAIN or weight bearing position? (1/1 Points) A) Lateral rotation of the tibia on the femur B) Medial rotation of the femur on the tibia C) Lateral rotation of the femur on the tibia D) Medial rotation of the tibia on the femur
B) Medial rotation of the femur on the tibia
This procedure involves creating small fractures of subchondral bone in the area of the chondral lesion to stimulate growth of fibrocartilage to replace the damaged hyaline cartilage: (1/1 Points) A) Capsulorrhaphy B) Microfracture procedure C) Total hip arthroplasty D) Repair of an acetabulum labral tear
B) Microfracture procedure
A surgical procedure for a repair of a chondral defect of the medial femoral condyle involves the following: harvesting multiple plugs of intact articular cartilage along with some subchondral bone of the patient's own tissue from a donor site (typically a nonweight-bearing portion of the joint surface) and implanting the plugs (using a press fit) into the site forming a bone-to-bone graft. This procedure is called: (1/1 Points) A) Autologous chondrocyte implantation. B) Mosaicplasty. C) Microfracture. D) Debridement and lavage.
B) Mosaicplasty.
Your patient has a known joint effusion or joint swelling. What position allows for the knee joint capsule to have the greatest amount of extensibility and thus be the most comfortable for the patient? (1/1 Points) A) Place the knee in a fully extended position flat on mat B) Place the knee in 25 degrees of flexion with a bolster or towel C) Place the knee in a fully flexed position D) Place the lower extremity in a figure 4 position
B) Place the knee in 25 degrees of flexion with a bolster or towel
A patient rehabilitating from knee surgery exhibits significant weakness in the involved extremity. During the most recent therapy session the patient was able to complete an independent straight leg raise as shown. What muscle is emphasized in this exercise? (1/1 Points) A) Vastus medialis B) Rectus femoris C) Vastus lateralis D) Sartorius
B) Rectus femoris
When there is pelvic rotation, what hip motion occurs in each hip when the pelvis is rotating to the right? (1/1 Points) A) Left hip internal rotation and right hip external rotation B) Right hip internal rotation and left hip external rotation C) Left hip and right hip external rotation D) Left hip and right hip internal rotation
B) Right hip internal rotation and left hip external rotation
In a closed chain position, the ankle joint (talocrural joint) arthrokinematic glide occurs in (1/1 Points) A) Opposite direction from as osteokinematic motion B) Same direction as the osteokinematic motion
B) Same direction as the osteokinematic motion
Dominance of the TFL over the gluteus medius due to gluteus medius weakness may lead to valgus in weight bearing, increased Q-angle, lateral knee pain or patellofemoral pain due to the following reason: (1/1 Points) A) The TFL adducts the femur and can strain the knee B) The TFL attaches to the iliotibial band and increases tension to the band as it dominates the gluteus medius. This can lead to valgus stresses at the knee due to insertion on the lateral tibial condyle. C) The TFL causes hip extension and can cause the knee to go into hyperextension which causes medial knee stress D) The TFL externally rotates the hip and makes the leg longer which places a stress on the medial knee
B) The TFL attaches to the iliotibial band and increases tension to the band as it dominates the gluteus medius. This can lead to valgus stresses at the knee due to insertion on the lateral tibial condyle.
Rehabilitation progression in ACL reconstruction is criterion-based and not time based. Why is this? (1/1 Points) A) Patients receiving ACL reconstruction are all athletes and can handle accelerated rehab B) Today's technology (using bone plugs and strong grafts) allows for strong fixation allowing for accelerated rehab which is not as dependent on stages of healing as normal tissue healing by scar formation C) It is easier for the PT and PTA to follow this type of protocol D) Criterion-based progression is best when going through the stages of tissue healing
B) Today's technology (using bone plugs and strong grafts) allows for strong fixation allowing for accelerated rehab which is not as dependent on stages of healing as normal tissue healing by scar formation
6) Weakness to the hip abductors (gluteus medius) and hip external rotators may cause the hip to adduct and internally rotate causing what type of stress at the knee which may lead to patellofemoral pain and anterior cruciate ligament stress? (1/1 Points) A) Varus stress B) Valgus stress C) Anteversion D) Retroversion
B) Valgus stress
The clinical prediction rule for the diagnosis of osteoarthritis of the hip developed by Sutlive and colleagues includes consideration of all of the following variables EXCEPT: (1/1 Points) A) Self-reported squatting aggravates symptoms. B) Walking more than one block causes groin and anterior thigh pain. C) Passive internal rotation is less than or equal to 25°. D) Scour test with adduction causes lateral hip or groin pain.
B) Walking more than one block causes groin and anterior thigh pain.
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
B. Bankart repair
Your patient sustained a laceration of the palmar aspect of the fingers in zone II ("no-man's land") of the hand. The patient subsequently underwent a repair of the lacerated tissues. During the subacute (moderate protection) phase of healing, it is critical to: (1/1 Points) A. Keep the fingers immobile because there is poor circulation and therefore poor healing in this area. B. Begin tendon-gliding exercises to minimize the formation of range-limiting adhesions. C. Initiate maximum-level resistance exercises of the extrinsic flexors to regain normal strength of the injured muscle-tendon unit. D. Limit exercise to passive ROM to protect the healing tendons.
B. Begin tendon-gliding exercises to minimize the formation of range-limiting adhesions.
A patient reports feeling tenderness and sensitivity to pressure in the area of the hand consistent with marking in the image. This subjective finding is MOST consistent with: (1/1 Points) A. Carpal tunnel B. Dupuytren's Contracture C. de Quervain's disease D. ulnar nerve entrapment
B. Dupuytren's Contracture
During active ROM exercises, which of the following structures is most elongated with full active extension and ulnar deviation of the wrist if the fingers remain relaxed? A. Flexor carpi ulnaris B. Flexor carpi radialis C. Flexor digitorum profundus D. Flexor digitorum superficialis
B. Flexor carpi radialis
"Place-and-hold" exercises are: A. A form of dynamic exercises in which the patient actively moves through a series of hand positions to prevent tendon adhesions. B. Gentle muscle setting (isometric/static) exercises used during the early phase of rehabilitation after, for example, a tendon repair, whereby an involved finger is placed passively in a particular position (by the therapist or by the patient using the sound hand); the patient then is asked to try actively to hold the position without assistance. C. A form of isometric exercise in which the therapist places a finger in a particular position and then asks the patient to hold the position as manual resistance is applied to the contracting muscle. D. A form of stretching exercise in which a patient is asked to perform an isometric contraction of a muscle-tendon unit against low-intensity resistance followed by relaxation and elongation of that muscle.
B. Gentle muscle setting (isometric/static) exercises used during the early phase of rehabilitation after, for example, a tendon repair, whereby an involved finger is placed passively in a particular position (by the therapist or by the patient using the sound hand); the patient then is asked to try actively to hold the position without assistance.
Which of the following is true about myositis ossificans in the elbow region? A. The muscle most often affected in the elbow region is the biceps brachii. B. Passive extension is more limited than flexion. C. After the acute inflammatory period, heterotopic bone is laid down within muscle fibers and within the joint. D. The muscle should be stretched and massaged regularly to prevent a contracture.
B. Passive extension is more limited than flexion.
Which of the following describes an arthroscopic subacromial decompression procedure? A. A traumatic full thickness rotator cuff tear repair with open repair technique. B. Surgical procedure that involves resection of the anterior acromial protuberance and contouring of the undersurface of the remaining acromion. It frequently involves a clavicular resection as well. C. It is indicated for a patient with secondary impingement syndrome due to glenohumeral joint hypermobility/instability. D. It is the first treatment of choice, even over conservative physical therapy management of shoulder impingement syndrome.
B. Surgical procedure that involves resection of the anterior acromial protuberance and contouring of the undersurface of the remaining acromion. It frequently involves a clavicular resection as well.
The patella acts to improve efficiency of the quadriceps tendon. The greatest amount of leverage the quadriceps generate is moving from _____to _____ degrees of flexion (moving towards extension). (1/1 Points) A) 90 to 45 B) 45 to 60 C) 60 to 30 D) 30 to 15
C) 60 to 30
Identify the common forefoot deformity where the proximal phalanx of the great toe shifts laterally toward the second toe, eventually leading to shifting of the great toe laterally. This may cause the metatarsal head to become inflamed and the bone will hypertrophy. This deformity is also known as a bunion. (1/1 Points) A) Hallux limitus/hallux rigidus B) Claw toe (MTP hyperextension and IP flexion and hammer toe C) Hallux valgus D) Dorsal subluxation or dislocation of the proximal phalanges on the metatarsal heads 2
C) Hallux valgus
Anterior pelvic tilting results in what motion of the hip and lumbar spine? (1/1 Points) A) Hip extension and increased lumbar extension B) Hip extension and decreased lumbar extension C) Hip flexion and increased lumbar extension D) Hip flexion and decreased lumbar extension
C) Hip flexion and increased lumbar extension
Compression forces on the patella in the femoral groove increase under all of the following conditions EXCEPT: (0/1 Points) A) Squatting B) In open chain as the knee moves from extension to flexion beginning at 30 degrees C) In a fully extended knee D) As the Q-angle increases
C) In a fully extended knee
Patients who undergo meniscal repair are likely to have tears in which part of the meniscus due to a greater likelihood for healing? (1/1 Points) A) Inner 1/3 B) Middle 1/3 C) Outer 1/3 D) Posterior half
C) Outer 1/3
A PTA positions a patient in prone to measure passive knee flexion. Range of motion may be limited in this position due to: (1/1 Points) A) Active insufficiency of the knee extensors B) Active insufficiency of the knee flexors C) Passive insufficiency of the knee extensors D) Passive insufficiency of the knee flexors
C) Passive insufficiency of the knee extensors
A quadriceps lag may be described as: (1/1 Points) A) Patient has full active knee extension but exhibits increased time to peak torque when knee extensors are evaluated on an isokinetic dynamometer. B) Patient has full passive knee flexion but limited passive knee extension. C) Patient cannot actively extend the knee to full extension even though there is full passive knee extension. D) Another term for knee extension contracture.
C) Patient cannot actively extend the knee to full extension even though there is full passive knee extension.
Your patient has regained normal strength (5/5) and ROM during rehabilitation following a traumatic injury that severely stressed several ligaments and joints of the ankle (he DID NOT have surgery). He continues to have poor control while walking on gravel or other uneven surfaces. To address this problem, your exercise program should focus on: (1/1 Points) A) Strengthening exercises for the invertor and evertor muscles of the ankle using elastic resistance. B) Stretching the invertor and evertor muscles of the ankle. C) Performing progressive balance training with closed-chain disturbed balance activities on a rocker/balance board. D) Practicing walking on uneven surfaces while wearing a custom-made ankle/foot orthosis that controls inversion and eversion.
C) Performing progressive balance training with closed-chain disturbed balance activities on a rocker/balance board.
Each of the following is true about surgical repair/reconstruction of the lateral ligament complex of the ankle and postoperative management EXCEPT: (1/1 Points) A) The most common procedure is a direct repair and imbrication of the torn ligaments through an open surgical approach. B) After reconstruction of the lateral ligaments that includes a tendon autograft and tendon transposition (often the peroneus brevis tendon) to reinforce the lateral aspect of the ankle, there may be some permanent loss of full ankle inversion postoperatively. C) The ankle is immobilized in plantarflexion and slight inversion for 4 to 6 weeks postoperatively; therefore, the patient must remain nonweight bearing on the operated lower extremity during the period of immobilization to prevent rupture of the repair site. D) It is usually permissible to remove the ankle immobilizer by about 4 to 6 weeks postoperatively to begin active ROM exercises of the ankle.
C) The ankle is immobilized in plantarflexion and slight inversion for 4 to 6 weeks postoperatively; therefore, the patient must remain nonweight bearing on the operated lower extremity during the period of immobilization to prevent rupture of the repair site.
Which of the following is a true statement about glenohumeral arthroplasty? A. Hemiarthroplasty is most often performed using an arthroscopic approach. B. The primary indication for glenohumeral arthroplasty is limited mobility of the shoulder. C. A reverse total shoulder arthroplasty (rTSA) is an appropriate procedure for a patient with marked instability of the glenohumeral joint and a rotator cuff that is not repairable. D. For adequate exposure of the joint during surgery, the muscle that routinely must be released (and reattached prior to closure) is the anterior deltoid.
C. A reverse total shoulder arthroplasty (rTSA) is an appropriate procedure for a patient with marked instability of the glenohumeral joint and a rotator cuff that is not repairable.
Each of the following is true regarding management of the patient with RA of the hands EXCEPT: A. Progressive resistance exercise is contraindicated so long as there are signs of inflammation. B. Principles of joint protection and energy conservation are integral components of patient education to reduce deforming forces on involved joints and reduce excessive fatigue. C. Application of an orthosis should be avoided in the rheumatoid hand because it promotes loss of joint mobility. D. With MP joint deformities, forceful pinch and grip exercises are contraindicated.
C. Application of an orthosis should be avoided in the rheumatoid hand because it promotes loss of joint mobility.
A PTA is instructing the patient in a traditional bench press using free weights. Which modification would be the MOST beneficial to limit the amount of stress placed on the anterior capsule of the shoulder? (1/1 Points) A. Grasp the bar with both forearms in supinated with the hands wider than shoulder width apart B. Ensure that the elbows lock fully at the end of the upward movement C. Ensure that the bar does not contact the chest during the downward movement in order to prevent and anterior glide D. Attempt to raise the head off the bench during the upward movement of the exercise.
C. Ensure that the bar does not contact the chest during the downward movement in order to prevent and anterior glide
Of the following activities, which is the MOST appropriate choice for developing stability of the scapulothoracic joint? A. Flex and extend the elbow with a 3# hand weight in open chain position. B. Have the patient perform a corner stretch for the pectoralis major. C. Have the patient stand, face a wall, place the hands on the wall, and lean into the wall as the therapist applies alternating rhythmic resistance against the shoulders. D. Perform PROM of the shoulder in supine for shoulder flexion, abduction and external roation.
C. Have the patient stand, face a wall, place the hands on the wall, and lean into the wall as the therapist applies alternating rhythmic resistance against the shoulders.
A patient with a suspected scaphoid fracture is referred to PT. Which clinical signs is MOST indicative of a scaphoid fracture? A. Localized edema along the dorsum of the hand B. Crepitus with AROM C. Localized bony tenderness in the anatomic snuff box D. Pain with resisted wrist extension
C. Localized bony tenderness in the anatomic snuff box
Results of numerous outcome studies have demonstrated that the most predictable outcome after shoulder arthroplasty is: (1/1 Points) A. Increased active shoulder ROM. B. Increased shoulder-joint stability. C. Pain relief. D. Improved function of the rotator cuff mechanism.
C. Pain relief.
What is the biomechanical cause of a Boutonnière deformity? A. Overstretching of the volar plate (palmar plate) and bowstringing of the lateral bands of the extensor hood mechanism B. Volar displacement of the extensor carpi ulnaris tendon, causing a flexion force at the wrist joint C. Rupture of the central band (central slip) of the extensor hood mechanism, causing the lateral bands to slip in a volar direction at the PIP joint D. Overstretching or rupture of the collateral ligaments of the metacarpophalangeal (MP) joints
C. Rupture of the central band (central slip) of the extensor hood mechanism, causing the lateral bands to slip in a volar direction at the PIP joint
Why is shoulder girdle function safer when in "scaption" (i.e. elevation of the shoulder occurs in the plane of the scapula, 30 degrees from the frontal plane)? Pick the one that does not apply. (1/- Points) A. These movements are more functional B. No further external rotation of the humerus is required to clear the greater tubercle from the acromion - less risk for impingement C. There is less tension on the joint capsule D. This position makes the patient work twice as hard
C. There is less tension on the joint capsule
Each of the following is true about flexor tendon-gliding exercises EXCEPT: A. Maintain or develop free gliding between the FDS and FDP tendons. B. To perform these exercises, the patient actively moves the fingers into five different positions. C. To perform these exercises, the therapist passively moves the patient's fingers into five different positions in a particular sequence. D. Maintain or develop free gliding between the FDS and FDP tendons and adjacent bones.
C. To perform these exercises, the therapist passively moves the patient's fingers into five different positions in a particular sequence.
Which procedure is generally indicated for patients with RA, late stage elbow arthritis, nonunion fractures or elbow instability? A. Synovectomy B. Excision of the radial head coupled with prosthetic implant C. Total elbow arthroplasty D. Arthrodesis of the elbow
C. Total elbow arthroplasty
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? A. Have the patient assume a prone-lying position with the shoulder in 90° abduction, the upper arm supported on the table, and the elbow flexed to 90° B. Have the patient assume the supine position with the shoulder flexed to 90° and the elbow flexed so the handheld weight touches the opposite shoulder. C. 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. D. While the patient is in a standing position and the hips are flexed to 90 degrees, begin with the shoulder in hyperextension.
C. 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.
A surgical approach to a knee replacement where only the medial or lateral joint surface is replaced is called what kind of knee replacement? (1/1 Points) A) Axial compartmental B) Bicompartmental C) Tricompartmental D) Unicompartmental
D) Unicompartmental
The PTA reviews a patient history for a female diagnosed with adhesive capsulitis of the shoulder. Given the capsular pattern of the should, which functional limitation would be most difficult? A. Reaching across her body B. Reaching into her back hip pocket C. Performing a push-up D. Combing her hair
D. Combing her hair
Mr. Smith underwent a repair of a torn biceps brachii 2 days ago. During PROM exercises, which combination of motions should you avoid at end range to protect (not disrupt) the healing tissue in this phase of healing (think maximal stretching of 2 joint muscle)? (1/1 Points) A. Elbow extension, shoulder extension, forearm supination B. Elbow extension, shoulder flexion, forearm pronation C. Elbow extension, shoulder flexion, forearm supination D. Elbow extension, shoulder extension, forearm pronation
D. Elbow extension, shoulder extension, forearm pronation
The PTA decides stretching of the long head of the triceps brachii is needed to improve PROM of elbow flexion. Which positioning of the arm meets this objective? (1/1 Points) A. Elbow extension and shoulder extension B. Elbow extension and shoulder flexion C. Elbow flexion and shoulder extension D. Elbow flexion and shoulder flexion
D. Elbow flexion and shoulder flexion
For the same patient in #31, 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: A. Flex and ulnarly deviate the wrist and flex the fingers while the elbow is extended and the forearm is pronated. B. Flex and radially deviate the wrist and flex the fingers while the elbow is extended and the forearm is supinated. C. Extend and ulnarly deviate the wrist and extend the fingers while the elbow is extended and the forearm is pronated. D. Extend and radially deviate the wrist and extend the fingers while the elbow is extended and the forearm is supinated.
D. Extend and radially deviate the wrist and extend the fingers while the elbow is extended and the forearm is supinated.
Your patient is in stage 2, the "freezing" stage, of adhesive capsulitis. 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? (1/1 Points) A. Low-intensity progressive resistance exercise, mobilization with movement techniques, and manual stretching of the shoulder and scapular stabilization exercises with progressive weight bearing through the upper extremity B. Grade III joint-mobilization techniques, self-stretching, and strengthening exercises C. Gentle weight bearing on the involved upper extremity to develop scapular control and active ROM of the shoulder (e.g., wand and wall-climbing exercises) D. 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
D. 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
Which scenario below would cause the PTA to suspect a systemic cause of shoulder pain (pain is not from the shoulder but from something else happening in the body like a pathology)? A. Pain present for years B. Pain alleviated with use of ice C. Pain aggravated by cervical rotation D. Pain remains unrelieved with rest
D. Pain remains unrelieved with rest
Muscles that typically are shortened in patients with increased thoracic kyphosis; forward head; and protracted, forward tilted scapula are the: A. Trunk extensors B. Scapular retractors C. Scapular depressors D. Pectoralis muscles
D. Pectoralis muscles
