APK - August 1998 Flashcards by Warp Part

The following apply to anteromedial rotatory instability of the knee except

a. Anterior subluxation of the medial tibial condyle occurs with anteromedial rotatory subluxation
b. May be accentuated by a tear of the anterior cruciate ligament
c. Occurs with tears of the medial and lateral compartment ligaments
d. Result of abduction stress test is positive with the knee at 30 degrees of flexion as is the result of the anterior drawer test with the tibia externally rotated
e. Occurs with a tear of the medial compartment ligaments, including the posterior oblique ligament

c. Occurs with tears of the medial and lateral compartment ligaments

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The following statements characterize vibration syndrome, EXCEPT:

a. Common symptoms include intermittent numbness and tingling in the fingers
b. Exposure to cold with not trigger vasospasm in the fingers
c. There is recurrent episode of finger blanching due to complete closure of digital arteries
d. Condition is caused in part by forceful gripping prolonged use of vibrating tools
e. Also referred to as white finger or Reynaud’s phenomenon

b. Exposure to cold with not trigger vasospasm in the fingers

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Patellofemoral pain (PFP) is a prominent knee complaint. The following describes the mechanism most widely thought to cause PFP, EXCEPT:

a. Abnormal patellar tracking which can lead to excessive strain on both prepatellar retinacular supports and the articular cartilage
b. The vastus lateralis is hypothesized to contract simultaneously as the vastus medialis oblique muscle rather than earlier
c. Asynchronous timing of vastus muscle contraction has been postulated to contribute to patellar instability
d. A hypothesis suggests that there is an imbalance between the primary dynamic patellar stabilizers, resulting in lateral tracking and malalignment
e. The lateral pull of the vastus lateralis muscle is not adequately counteracted by the medial pull of the vastus medialis oblique muscle

b. The vastus lateralis is hypothesized to contract simultaneously as the vastus medialis oblique muscle rather than earlier

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Continuous standing, particularly on a hard surface, can cause fatigue and stress on the back, legs, and feet. Improvements in workstation design include the following, EXCEPT:

a. Opportunities to change positions, move around, or alternate between sitting or standing
b. Feet must remain flat on the floor
c. Provide cushioned in soles
d. Provide anti-fatigue mats or other floor materials which provides cushioning
e. Provide stools or sit-lean stands

b. Feet must remain flat on the floor

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This is the most common method for lifting and allows full use of good body mechanics principles. To perform the lift, the individual should establish a wide base of support and straddle the object with one foot slightly ahead of the other:

Golfer’s lift
Diagonal lift
Tripod lift
Power lift
Deep squat lift

Diagonal lift

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Which hip-repair surgical procedure is indicated for pain in early stages of degenerative joint disease before motion has been lost?

Double-cup arthroplasty
Femoral prosthesis
Muscle release
Arthrodesis
Displacement Osteotomy

Displacement Osteotomy

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Following are true of macro-trauma, EXCEPT:

a. Results injuries repetitive injury
b. Direct injuries result in a joint-closing (compression) type of injury
c. Results from an injury of a magnitude that causes immediate clinical signs and symptoms
d. Indirect macro-traumatic mechanisms include joint distraction and rotation or transmitted torque
e. A single-incident injury manifested by strain or sprain or contusion

a. Results injuries repetitive injury

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The following statements describe true leg length discrepancy, EXCEPT:

a. To determine true leg length discrepancy, measure the distance from the anterior superior iliac spines to the medial malleolus of the ankles
b. With the subjects in supine with knees flexed to 90 degrees and feet flat on the table, if one knee appears higher than the other, the femur of that extremity is longer
c. With the subject in supine with knees flexed to 90 degrees and feet flat on the table, if one knee projects further anteriorly than the other, the femur of the extremity is longer
d. A fracture that crossed the epiphyseal plate during childhood may result in true leg length discrepancy
e. Measurement begins at the slight concavity must below the anterior superior iliac spine

b. With the subjects in supine with knees flexed to 90 degrees and feet flat on the table, if one knee appears higher than the other, the femur of that extremity is longer

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The following statements apply to alveolar dead space, EXCEPT:

a. All of these
b. A condition that occurs when blood flow is blocked by a pulmonary embolus
c. Selected alveoli are replaced with scar tissue, decreasing ventilation to areas with normal perfusion
d. A result of vascular abnormalities
e. The volume of gas in alveoli that is ventilated but poorly perfused or under-perfused

c. Selected alveoli are replaced with scar tissue, decreasing ventilation to areas with normal perfusion

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Molecules or ions are moved uphill against an electrical or pressure gradient across cell membranes in a process called:

Osmosis
Active transport
None of these
Diffusion

Active transport

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The following statements describe Parkinson’s Disease, EXCEPT:

a. It affects mostly the elderly
b. Bradykinesia and rigidity are characteristics of the disease
c. It is due to the degeneration of the dopaminergic neurons
d. Its clinical manifestations include tremors
e. It can be completely reversed by giving L-dopa

e. It can be completely reversed by giving L-dopa

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The following statements apply to halo skeletal traction, EXCEPT:

a. This is applied to reduce or immobilize stable cervical fractures of dislocations
b. The halo is a metal ring that is secured around the patient’s head by four pins, two anterior and two posterior
c. None of these
d. Permitting mobility is an advantage of halo traction over other forms, reducing respiratory and circulatory problems and muscle atrophy
e. Because of the pins penetrate the skull only about ⅛+. Skin incisions and drill holes are not necessary, reducing the risk of infection

c. None of these

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Rupture of this ligament shows that the tibia can be pulled excessively forward on the femur:

Posterior Cruciate Ligament
Medial Collateral Ligament
Lateral Collateral Ligament
Anterior Cruciate Ligament

Anterior Cruciate Ligament

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The goal of postural regulation is to stabilize the head with respect to the vertical. The following statements describe this stabilization concept, EXCEPT:

a. None of these
b. Predetermined response appears to be formed through experience with self-initiated goal-directed activity
c. Meter input is used primarily for “knowledge of response” to make appropriate adjustments in subsequent anticipatory postural actions
d. Geocentric frame of reference enable anticipation or prediction of center of force displacements that are induced by voluntary motion
e. Corrections of head position occur in advance of a voluntary change in body position

c. Meter input is used primarily for “knowledge of response” to make appropriate adjustments in subsequent anticipatory postural actions

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The following statements are true in supracondylar and condylar fracture, EXCEPT:

a. Traction is treatment of choice
b. Traction is not indicated in this type of fracture
c. For transverse or oblique fractures, and other fractures that aren’t complex, internal fixation may be used
d. Rod, nail, plate or screws may be used as internal fixation device
e. Internal fixation carries risk of damage to the sciatic or popliteal artery

b. Traction is not indicated in this type of fracture

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This type of muscle has a great stabilizing component:

Spurt
Isotonic
Isometric
Shunt
Concentric

Shunt

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The following describe the 6-minute walk test (6MW), EXCEPT:

a. The patient is encouraged to cover as much as possible le over a flat, measure coursed in 6 minutes
b. Used to assess exercise tolerance in patients with pulmonary disease
c. Supplemental oxygen is administered as needed to maintain oxygen saturation above a prescribed level (usually 88%-90%)
d. The patient is allowed to stop and rest as needed, but the clock is not stopped
e. It is essential not to repeat the 6MW and report the better effort

e. It is essential not to repeat the 6MW and report the better effort

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The following statements apply to mononeuropathy, EXCEPT:

a. Multiple single-nerve paresis are often due to disseminated vasculitis and infarction of nerve trunks
b. Refers to a dysfunction of a single nerve, not several nerves that are separately involved without general affliction of the peripheral nervous system
c. May be caused by primary “neuritis” related to viral infection
d. Examples include the paralysis of the facial nerve and of the ninth-tenth cranial nerve complex
e. Etiology is usually vascular occlusive disease or vasculitis, trauma of some kind, of impingement

b. Refers to a dysfunction of a single nerve, not several nerves that are separately involved without general affliction of the peripheral nervous system

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Waddell’s nonorganic signs assess a patient’s pain behavior in response to certain maneuvers. Which of the following signs indicate a positive simulation test?

a. Cogwheeling of many muscle groups that cannot be explained on a neurological basis
b. Marked improvement of straight leg raising of distraction as compared with formal testing
c. Back pain is reported with the first 30 degrees when the pelvis and shoulders are passively rotated in the same plane as the patient stands
d. Deep tenderness left over a wide area, not localized to structure
e. Disproportionate verbalization, facial expression, muscle tension and tremor

c. Back pain is reported with the first 30 degrees when the pelvis and shoulders are passively rotated in the same plane as the patient stands

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The following statements apply to Percussion and Vibration, EXCEPT:

a. Recommended for patients with impaired cognition or poor coughing ability
b. Recommended for the patient who is intubated and mechanically ventilated
c. Used to enhance mucociliary clearance from both central and peripheral airways
d. The exact mechanism of action of chest percussion is unknown, but there is some evidence that physical stimulation alters airflow and is associated with the release of pulmonary chemical mediators
e. Alterations in airway diameter and airflow may increase the viscosity of mucus, making percussion more effective in mobilizing secretions that are adherent to the bronchial walls

e. Alterations in airway diameter and airflow may increase the viscosity of mucus, making percussion more effective in mobilizing secretions that are adherent to the bronchial walls

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Arterial blood pressure increases with:

Decreased angiotensin
Increase bradykinin
Decreased Aldosterone
Increased carbon dioxide

Increased carbon dioxide

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The McKenzie system is a commonly used method of examining and treating patients who have low back pain. McKenzie has defined the following, EXCEPT:

a. The lateral shift is considered to be clinically relevant when a single-glide test does not alter the location or intensity of the pain reported by the patient
b. If the lateral shift is determined to be clinically relevant, then the lateral shift must be corrected prior to the use of other treatment procedures or the symptoms may worsen
c. The progress of lateral shifts is determined during the postural examination
d. The use of a two-step procedure is used to determine when clinically relevant lateral shifts are present
e. A lateral shift is a lateral displacement of the patient’s trunk in relation to the pelvis

a. The lateral shift is considered to be clinically relevant when a single-glide test does not alter the location or intensity of the pain reported by the patient

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Taste impulses from the anterior ⅔ of the tongue are transmitted via:

Trigeminal nerve
Oculomotor nerve
Glossopharyngeal nerve
Facial nerve
Vagus nerve

Facial nerve

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This lifting technique allows the individual to conveniently bring the item close to the body before completing the lift. One foot is placed behind the front portion of the object, and drop slowly to the other knee. This lift should be avoided by those with knee problems:

Power lift
Diagonal lift
Deep squat lift
Tripod lift
Partial squat lift

Tripod lift

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Tumor located at the premotor cortex will give rise to: Incoordination of the contralateral side Paralysis of the contralateral side Tremors of the ipsilateral side Spasticity of the ipsilateral side Paralysis of the ipsilateral side

Incoordination of the contralateral side

The following statements characterize flexion in the lumbar spine, EXCEPT: a. Flexion in the low back produces kyphosis b. Involves relaxation of the anterior longitudinal ligament and stretching of the supraspinal and interspinal ligaments the ligamentum flavum and the posterior longitudinal c. To test, the subject bends as far forward as he can with knees straight, and try to touch the toes d. There is no reversal of the normal lordosis during flexion, the low back merely flattens out e. Limited by the size of the vertebral bodies

a. Flexion in the low back produces kyphosis

Subjects who have meniscectomies follow the following program, EXCEPT: a. Flexion-to-extension exercises are used when there is a partial ROM with very little swelling or discomfort in or about the knee b. Resistance is kept low but is raised as the subject becomes able to handle the resistance with good exercise technique c. Subjects with arthroscopic meniscectomies are started on a much more vigorous exercise program much earlier d. Hamstring stretching exercises and flexion exercises are begun about 10 days after surgery e. Subjects are allowed to begin straight-leg-raise exercises at day one and progress to about eight sets of 10 repetitions in a very short period of time

a. Flexion-to-extension exercises are used when there is a partial ROM with very little swelling or discomfort in or about the knee

This test makes it possible to determine whether or not the radial and ulnar arteries are supplying the hand to their full capacities: Bunnel-Littler Test Tinel test None of these Allen test Retinacular test

Allen test

Innervates the lateral rectus eye muscle: Trigeminal nerve Trochlear nerve Oculomotor nerve Abducens nerve

Abducens nerve

Inhibitive ankle-foot orthosis are used in children with spastic cerebral palsy for the following reasons, EXCEPT: a. Inhibit or decrease abnormal reflexes in the lower extremity by protecting the foot from tactile-induced reflexes b. Normalize movement of trunk, pelvis and lower extremity in standing and during gait c. Decrease spasticity by prolonged stretch and pressure on the tendons of the triceps surae muscle and too flexors d. Change in bony alignment of the foot and ankle e. Prevent excessive ankle plantar flexion and improve lower extremity muscle timing

d. Change in bony alignment of the foot and ankle

The following statements describe electrical stimulation (ES) in the treatment of chronic wounds, EXCEPT: a. ES involves the application of low-level, therapeutic dose of electricity directly into the wound b. Eliminates many microorganism that might otherwise inhibit or prevent healing c. ES is not an alternative treatment for a wound that has shown only slow or minimal improvement d. ES is the first alternative treatment for a wound that has not responded to traditional care e. Promotes healing by enhancing tissue proliferation and repair

c. ES is not an alternative treatment for a wound that has shown only slow or minimal improvement

In lateral epicondylitis, repetitive stress may result in injury to the following muscles: a. All of these b. Proximal attachments of the extensor radialis brevis c. Extensor Carpi Radialis Longus d. Extensor Digitorum

b. Proximal attachments of the extensor radialis brevis

Cardiopulmonary manifestation of spinal cord injury include the following, EXCEPT: a. Dysrhythmias can be precipitated by hypoxemia in the absence of primary heart disease b. Normal-position included change in respiratory functional can be accentuated with changes in body position c. Hemodynamically unstable initially due to the effects of spinal shock and hypotension d. Inspiratory and expiratory capacities are decreased e. Residual volume and ventilation of the lung bases are diminished

e. Residual volume and ventilation of the lung bases are diminished

In cardiac transplantation, postoperative cardiovascular physiology is dramatically affected by the following, EXCEPT: None of these Immunosuppression Donor-recipient size mismatch Denervation Rejection

None of these

Forward bending is a complex movement of combined lumbar and hip motion, and many of the tasks that occur during everyday activities require trunk flexion. The following statements apply to this movement, EXCEPT: a. Stretching short hamstring may affect lumbar motion during forward bending b. Excessive lumbar motion decreases tensile loads on the spine c. Short hamstring muscles, because of their attachment to the posterior leg and to the ischial tuberosity, may limit hip flexion ROM d. LBP could result from excessive lumbar motion due to their influence on lumbopelvic rhythm during forward bending e. Restricted hip motion is coupled with excessive lumbar motion

b. Excessive lumbar motion decreases tensile loads on the spine

The only two muscles inserted into the back part of the sclera: Superior Oblique and Inferior Oblique Superior Rectus and Medial Rectus None of these Lateral Rectus and Inferior Rectus

Superior Oblique and Inferior Oblique

In getting a laminectomy patient out of bed, the following procedures are observed, EXCEPT: a. Raise herself to a standing position by pushing against the bed with her palm, reminding to keep the back straight and to look straight ahead b. The incision site need not be splinted c. Help lower herself slowly into a chair, keeping the back straight; make sure the knees are elevated to hip level or slightly higher to avoid stress on the lumbar spine d. Raise the head of the bed to low Fowler’s position e. Raise herself into sitting position by pushing against the mattress with her upper hand as she swings her legs over the side of the head

c. Help lower herself slowly into a chair, keeping the back straight; make sure the knees are elevated to hip level or slightly higher to avoid stress on the lumbar spine

In radial nerve paralysis, the following happens, EXCEPT: a. Extension in drop-wrist position is due to tendon action, not active contraction b. Wrist drop develops c. Grip strength may be good if the wrist is supported in extension by means of a splint d. The wrist can be actively extended or stabilized for effective grasp

d. The wrist can be actively extended or stabilized for effective grasp

The following statements are true of the Stance Phase of gait, EXCEPT: a. A spike of bone protruding from the medial tubercle on the plantar surface of the os calcis may cause the subject to avoid heel strike completely b. If the gluteus maximus is weakened, the subject must thrust his thorax posteriorly to maintain hip extension c. A flatfooted or calcaneal gait can result from the weakness of the gastrocnemius, soleus and flexor hallucis longus d. Problems in stance phase can cause the subject to walk with an antalgic gait e. A weakened gluteus medius forces the subject to lurch forward to the uninvolved side to place the center of gravity over the hip

e. A weakened gluteus medius forces the subject to lurch forward to the uninvolved side to place the center of gravity over the hip

On a full-term, healthy newborn infant, gentle rubbing on one cheek elicits a response that deviates his mouth to that side. This is called: Asymmetric Tonic Neck reflex Moro Reflex Symmetric Tonic Neck Reflex Rooting Reflex Sucking Reflex

Rooting Reflex

The following statements apply to the ulnar nerve, EXCEPT: a. Innervates the hypothenar, all interossei, two medial lumbricals, the adductor pollicis and part of the flexor pollicis brevis via its deep palmar branch in the hand b. Innervates the flexor carpi ulnaris and the flexor digitorum profundus to the 4th and 5th digits in the forearm c. Carries fibers from the C8 and T1 roots d. In early or minimal lesions of the ulnar nerve, there is atrophy of the first dorsal interosseus and sensory loss distally in the fifth digit e. Paralysis causes the grip to be fairly weak but finger abduction and adduction will be nearly lost

e. Paralysis causes the grip to be fairly weak but finger abduction and adduction will be nearly lost

If the distal insertion of the extensor digitorum communis has been torn away from the distal phalanx an attendant avulsion of a bone fragment, a bony excrescence become palpable on the dorsal surface of the distal interphalangeal joint. This deformity is known as: Mallet finger Swan-neck Trigger thumb Heberden’s Boutonniere

Mallet finger

In a workplace, an issue closely related to heights is difficulty with reaches. Following are some recommendation to improve on material handling ergonomics problem, EXCEPT: Increase dimensions of the work surface Smaller lot sizes Tilt the work surface Provide containers with removable sides Provide cut-outs in the work surface

Increase dimensions of the work surface

The nerve most likely to be injured in wrist slashing is: Median nerve Ulnar nerve Radio-ulnar nerve Musculocutaneous nerve Radial nerve

Median nerve

There is a greater frequency of tears of the medial semilunar cartilage, a common athletic injury. This is due to: a. The medial meniscus which is fixed to the tibia front and back by its two horns as well as around its periphery b. The posterior cruciate ligament which is attached to the tibia so far back as to allow some of its fibers to arise from the back of the bone below the upper surface c. Tightness of the medial coronary ligament of the knee that prevents back-and-forth movements of the medial d. None of the above

c. Tightness of the medial coronary ligament of the knee that prevents back-and-forth movements of the medial

The most important joint in the upper extremity for spatial placement is: Sternoclavicular joint Shoulder joint Claviculohumeral joint Elbow joint Wrist joint

Shoulder joint

The following statements are true of the triquetrum, EXCEPT: a. Formed within the flexor ulnaris tendon b. It lies under the pisiform c. Lies just distal to the ulnar styloid process, in the proximal row c. Third highest of all the carpal bones in incidence of fracture d. Palpated by radially deviating the hand

a. Formed within the flexor ulnaris tendon

The major modifiable risk factors for the development and progression of coronary artery disease include the following, EXCEPT: Habitual smoking Hypertension Physical activity Habitual Smoking Hypercholesterolemia

Physical activity

In a normal electrocardiogram, this wave is caused by potentials generated as the ventricles depolarize: T wave QRS complex Q wave P wave

QRS complex

The following statements describe Osteochondritis Dissecans, EXCEPT: a. Usually a history of intermittent nonspecific knee pain, usually related to some form of exertion b. Symptoms include acute episodes of locking, giving way, or joint effusion when a fragment becomes detached and falls into the joint c. Treatment may include debridement with femoral condyle drilling to increase the vascularity in the subchrondral bone to help form a new articular surface d. Commonly has a lesion of the articular surface of the femoral condyles e. Most common location of separation is the medial aspect of the anterior margin of the medial femoral condyle

e. Most common location of separation is the medial aspect of the anterior margin of the medial femoral condyle

Excessive inversion stress is the most common cause of ankle injury because: a. The talus can be forced to invert father than it can evert b. None of these c. The ligamentous thickenings on the lateral side of the joint are separate, and therefore not as strong as the deltoid d. All of these e. The medial malleolus is shorter than the lateral malleolus

d. All of these

The following statements apply to the 11th cranial nerve, EXCEPT: a. Lifting the shoulders up toward the ear then resisting the movement from above tests the trapezius b. This combined motor and sensory nerve innervates the sternocleidomastoid and the upper portion of the trapezius muscles c. Testing the function of the 11th nerve also tests for involvement of functions by motor neuron disease and dystrophy d. Testing the function of the 11th nerve will detect weakness of either central or peripheral nuclei of origin e. The nuclei of origin of the various parts of this nerve are not adjacent and differential paresis may occur from central nuclear lesions

b. This combined motor and sensory nerve innervates the sternocleidomastoid and the upper portion of the trapezius muscles

Transfer training after open reduction internal fixation are as follows, EXCEPT: a. If the lower extremities are too weak or painful to be lifted as transfer progresses, wheelchair leg rests are fully elevated to maintain a long sitting position with the knees extended b. The subject is instructed to push with the arms on the supporting surface in order to raise the hips and begin moving to the transfer surface c. Depending on the comfort and ease of the transfer, transfer training may be accomplished with or without a sliding board d. Subjects do not practice wheelchair mobility e. Legs are pulled along with the hips as subjects move

d. Subjects do not practice wheelchair mobility

The upper eyelids normally cover 1-2 mm of the superior margin of the cornea in forward gaze. Ptosis of the upper lid is an abnormality which may be due to which condition? Edema due to infection, trauma or venous stasis All of these Horner’s syndrome Third-nerve paresis Myasthenia gravis

All of these

A spot within a muscle, ligament, tendon or periosteal tissue, that elicits a localized rather than referred pain to adjacent areas upon sustained stimulation: Tender point Stimulation point Acupuncture point Trigger point Motor point

Tender point

Supplied by the femoral nerve, this neurologic level crosses the anterior portion of the middle of the thigh: L2 L1 L4 L3 S1

If the cardiac output is 7.2 L/min and the heart rate is 80 bpm, then the stroke volume is: 70 ml 100 ml 90 ml 80 ml 60 ml

90 ml

This anatomical area involves the highest percentage of symptoms among physical therapists reporting musculoskeletal symptoms: Wrist/hands Neck Shoulders Low back Upper back

Low back

The neurological basis for sexual dysfunction in men with spinal cord injury (SCI) are as follows, EXCEPT: a. The parasympathetic spinal outflow originating from the S-2 to S-4 spinal segments is primarily responsible for mediating reflexogenic erection b. The T-10 to S-2 spinal segments contain the reflex arc that receives sensory afferents from the genitals c. The neural output from the hypothalamus to the sexual organs courses in the anterolateral columns to terminate in the intermediolateral cell columns of T-10 to L-3 d. In men, the sympathetic output is primarily responsible for regulating ejaculation and psychogenic component of penile erection e. Supraspinal component of the motor pathways descends with the corticospinal tracts to the S-2 to S-4 segments of the sacral cord

b. The T-10 to S-2 spinal segments contain the reflex arc that receives sensory afferents from the genitals

Due to the difference in length of the moment arms used by the hip abductor (HA) muscles and body weight, the HA muscles must produce this force to that of body weight to ensure frontal-plane equilibrium: About twice Five times About four times Three times Equal

About twice

Following are measurable determinants of gait, EXCEPT: a. The knee should remain flexed during all components of stance phase b. The body’s center of gravity lies two inches in front of the second sacral vertebrae and oscillates no more than two inches in a vertical direction c. The pelvis and trunk shift laterally approximately one inch to the weight-bearing side d. During the swing phase, the pelvis rotates 40 degrees forward e. The width of the base should not be more than two to four inches from heel to heel

a. The knee should remain flexed during all components of stance phase

The following muscles arise from the medial epicondyle of the humerus and bounds the medial side of the antecubital fossa: a. Flexor Carpi Radialis, Palmaris Longus and Flexor Carpi Ulnaris b. Flexor Digitorum Sublimis, Flexor Digitorum Profundus and Flexor Pollicis Longus c. None of these d. Pronator Teres, Palmaris Longus, and Flexor Digitorum Superficialis

a. Flexor Carpi Radialis, Palmaris Longus and Flexor Carpi Ulnaris

A cardiac cycle is from the beginning of one heartbeat to the beginning of the next. Each cycle is initiated by Atrioventricular node Purkinje fibers Sinoatrial node Atrioventricular bundle

Sinoatrial node

Paralysis of the left gluteus maximus is compensated for during the stance phase by: a. Increased ankle plantarflexion of the affected extremity b. Hyperextension of the spine c. External tibial torsion at heel strike d. Maintenance of knee flexion of affected extremity

b. Hyperextension of the spine

In root compression syndrome, the following statements are true, EXCEPT: a. Paresthesia are common and are usually experienced distally, in the hand or foot b. Stretch reflexes whose arcs are largely or entirely incorporated in the involved root will be exaggerated c. Pain in the segment distribution of a root is the hallmark of these syndrome d. Weakness and atrophy in the corresponding myotomal distribution result from prolonged or severe root compression e. Findings to confirm the syndrome are those which relate spinal movement to the radiating pain

b. Stretch reflexes whose arcs are largely or entirely incorporated in the involved root will be exaggerated

The following statements describe care of knee extension mechanism injuries, EXCEPT: a. When using stationary bike, resistance should be kept low and a steady pace of about 20 mph maintained b. Running is encouraged because the biomechanical forces of running put great stress upon the extensor mechanism c. Flexion-to-extension motions or heavy resistance may aggravate these type of injuries d. Resistance for straight-leg-raises is kept to an upper limit of 6.8 kg e. Hamstring stretching is useful in preventing over-compressions of the patella against the underlying bony surface

b. Running is encouraged because the biomechanical forces of running put great stress upon the extensor mechanism

Persistent asymmetry of the Moro reflex suggest the following, EXCEPT: Hemiparesis Fracture of the clavicle Injury to the brachial plexus Hemiplegia Fracture of the humerus

Hemiplegia

The following statements described the Hassis Infant Neuromotor Test (HINT), EXCEPT: a. Asks the infant’s parent or caregiver to assess how the infant moves and plays b. Aimed at identifying early motor deficits and early signs of cognitive delay in infants at risk c. Spans an age range of 3 to 12 months d. Designed to examine differences in motor behavior, specifically posture and antigravity control e. Was developed to provide a reliable and valid neuromotor screening tool for early identification of neurodevelopment handicaps in high-risk infants

d. Designed to examine differences in motor behavior, specifically posture and antigravity control

This test refers either to the elicitation of pain from tapping for neuromotor on the end of a cut nerve or to the provocation of pain on the leading edge of a regenerating nerve. In the knee, testing concerns the area around the medial side of the tibial tubercle: McMurray Test Tinel Test Distraction Test Apprehension Test Bounce Home Test

Tinel Test

Which of the following processes in early ambulation after fixation does not apply? a. To bring the patient to a chair from a standing position, flex your knees and hips and slowly lower her into the chair, elevating the patient’s legs on a stool for comfort and to reduce swelling b. To assist the patient into a standing position, move in close and grasp the patient under her arms, allowing the patient to hold you around your neck c. Obtain a straight-backed, relatively high chair with arms, and place it close to the bed, on the patient’s unaffected side d. To bring the patient back to into bed from a chair, slide the chair so its braced against the bed, have the patient bend forward from the hips and flex the knee of the unaffected leg at a 90 angle e. To bring your patient to a sitting position on the bed, first raise the head of the bed to 30°, have the unaffected leg flexed at a right angle, and the affected leg partially flexed

b. To assist the patient into a standing position, move in close and grasp the patient under her arms, allowing the patient to hold you around your neck

All of the following statements are true, EXCEPT: a. Nerve impulses are propagated by the continuous progression of the action potential along the length of the fiber in myelinated fibers b. Nerves with large axons have lower stimulus thresholds for development of an action potential than do nerves with smaller axons c. Nerves with large-diameter axons have greater conduction velocities than do nerves with smaller diameter axons d. Conduction velocity is also substantially greater in myelinated axons than in unmyelinated axons

a. Nerve impulses are propagated by the continuous progression of the action potential along the length of the fiber in myelinated fibers

The following statements are true of the total knee replacement, EXCEPT a. May be used for a knee with varus/valgus deformity greater than 40 degrees b. Prosthesis life is estimated at 25 years c. Performed to relieve severe pain, joint contracture, and swelling in a patient who would otherwise be ambulatory d. May be used for a knee with flexion contracture greater than 60 degrees e. In most cases, it works best for older patients

b. Prosthesis life is estimated at 25 years

Depending on patient size and transfer method, condition and mobility potential, the following are preferred features in wheelchair selection for a hemiplegic, EXCEPT: a. Fixed armrests and foot-and-leg rests are swing-detachable with heel loops b. Motorized type with reclining back c. Back with head extension and foot-and-leg rests are elevating d. Standard type with standard handrims e. Extension brakes and fixed back

b. Motorized type with reclining back

Stimulation of the anterior hypothalamus causes all of the following, EXCEPT: Sweating Cutaneous vasodilatation Increased respiration Shivering

Shivering

Home exercise program following open reduction internal fixation include the following, EXCEPT: a. Basic ROM and strengthening exercises to prevent contracture and reduce atrophy while non ambulatory b. Subject’s full weight bearing status may be achieved at 3 months post surgery c. Subjects perform isometric exercises, ROM exercises, and upper extremity exercise until fatigued d. Even as pain increases or weakness develops, full active ROM must be performed

d. Even as pain increases or weakness develops, full active ROM must be performed

Decreases vascular resistance by decreasing catecholamine mediated vasoconstriction of peripheral vasculature: Alpha-adrenergic blockers Diuretics Angiotensin-converting (ACE) enzyme inhibitors Calcium channel blockers Beta-adrenergic blockers

Alpha-adrenergic blockers

The following statements are true of the primary dorsiflexor of the foot, EXCEPT: a. The extensor digitorum longus tendon is perceptible on the dorsum of the foot, crossing in front of the ankle mortise and fanning out to insert, by slips into the dorsal surfaces of the middle and distal phalanges of the four lateral toes b. The tendon of the extensor hallucis longus is perceptible to its insertion at the proximal end of the distal phalanx of the great toe c. The primary dorsiflexor of the foot lie in the anterior tibial compartment and share a common innervations, the deep peroneal nerve d. The muscle belly of the extensor digitorum brevis can be palpated where it bulges out from the sinus tarsi and therefore can be isolated for muscle testing e. The tendon of the tibialis anterior can be seen where it crosses the anteromedial portion of the ankle joint

d. The muscle belly of the extensor digitorum brevis can be palpated where it bulges out from the sinus tarsi and therefore can be isolated for muscle testing

The following statements apply to cane selection, EXCEPT: a. To determine proper sizing, ask patient to stand with the cane’s tip 4” (10cm) to the side of his foot, the cane should extend from the floor to his hip joint b. A rubber tip keeps the cane from slipping and helps prevent accident c. As the cane is held, the elbow should be flexed at a 45 degree angle d. As the cane is held, the elbow should be flexed at a 30 degree angle e. If he has poor balance, he’ll probably need a broad-based cane

c. As the cane is held, the elbow should be flexed at a 45 degree angle

When applied, second class levers can be: a. Levers that operate at a mechanical disadvantage but one of speed b. Levers that work at a mechanical advantage c. Levers of stability and speed d. All of these

b. Levers that work at a mechanical advantage

Electrical bone stimulation is indicated to treat fracture non-unions. Contraindications include the following, EXCEPT: a. An active systemic infection b. Paget’s disease c. Non-pathologic fracture d. A congenital or developmental condition, i.e., osteogenesis imperfects e. Pseudarthrosis

c. Non-pathologic fracture

Atrial depolarization is represented in the ECG as the: ST interval P wave PR interval QRS complex T wave

P wave

An area routinely addressed in fitness tests is flexibility, and the sit-and-reach test (SRT) is typically used. The following statements characterize SRT, EXCEPT: a. It evaluated flexibility of the low back and hamstring muscles b. The subject being tested leans forward in a long-sitting position c. Passing scores are given when subjects can reach at least 4 cm beyond their toes d. A score given is based on the most distant point reached by both hands on a standardized box e. It is an important test because decreased flexibility is thought to contribute to the development of low back pain

c. Passing scores are given when subjects can reach at least 4 cm beyond their toes

This tendon can be isolated by holding the subject’s fingers in extension and flexing the finger in question at the IP joint, if the finger can be flexed at the specified joint, the tendon is intact: Interossei Flexor digitorum profundus Lumbricals Flexor digitorum superficialis None of these

Flexor digitorum superficialis

When the patient is able to make two breaths in order to complete counting aloud to 15, the Ventilatory Index Scale is: 0 1 2 4 3

Knees with ligamentous repair follow the following program, EXCEPT: a. Excessive quadriceps femoris muscle activity can cause the tibia to become subluxed anteriorly and stretch the repaired tissues b. Immobilized for at least six weeks c. Gait is partial weight bearing with crutches d. The very complicated anteromedial, anterolateral and posterolateral surgeries requires an especially slow progression e. Quadriceps femoris setting and ankle ROM is initiated at day one

c. Gait is partial weight bearing with crutches

As part of an overall ergonomic program, a variety of administrative practices can be used effectively, but must not be used instead of considering engineering improvements. Following are some accepted recommendations, EXCEPT: Subdivision of labor Exercise Workload reduction Job rotation Work/Rest schedule

Exercise

To create electrical neutrality, the major intracellular cation is balanced intracellularly by which anions? C1 - HCO - 3 HPO - 4 Organic anions KMnO4

Organic anions

The following statements characterize harness-supported treadmill ambulation, EXCEPT: a. Minimized load to healing tissues and conserves energy during exercise b. Increases an individual's effective body weight by given amount using a supporting harness c. It can reduce pain and skin breakdown during the initial phases of prosthetic use d. Counterbrace system accommodates the rise and fall of the body during treadmill ambulation e. Facilitates the expression of a more normal gait

b. Increases an individual's effective body weight by given amount using a supporting harness

A frame of reference for balance and head control that gives information about body position with respect to the environment: Geosynchronous Egocentric Ecocentric Exocentric Proprioceptive

Exocentric

The distal carpal consists of the following, EXCEPT: Hamate Navicular Capitate Trapezium Trapezoid

Navicular

The following statements characterize intracranial hyperextension, (IC), EXCEPT: a. A good indicator of a bad prognosis in persons with head trauma, and subarachnoid and intracerebral hemorrhage b. Commonly observed in person with serious injuries and diseases of the central nervous system c. Ventricular drainage and controlled hyperventilation could decrease ICP d. Exercise will not increase ICP e. A patient’s head may be elevated and stimulation of the sympathetic nervous system is avoided to prevent further increases in ICP

d. Exercise will not increase ICP

This reflex, with a C6 component, primarily indicates the neurologic integrity of C5: Triceps reflex Biceps reflex Flexor reflex Brachioradialis reflex Symmetric tonic neck reflex

Biceps reflex

Normal cardiac rhythm is: 40-70 bpm 30-60 bpm 120-150 bpm 60-90 bpm 100 - 130 bpm

60-90 bpm

Any bodily movement produced by skeletal muscles that results in increased energy expenditure: Physical activity Training Exercise Performance Physical fitness

Physical activity

The stability and integrity of the transverse arch is maintained by: Hypothenar and thenar muscles Extrinsic muscles of the hands Interossei and lumbricals Tendons Ligaments

Hypothenar and thenar muscles

The following muscle chiefly flex the distal interphalangeal joint: Lumbricals Flexor Digitorum Profundus and Flexor Pollicis Longus None of these Flexor Digitorum Superficialis and Flexor Carpi Ulnaris

Flexor Digitorum Profundus and Flexor Pollicis Longus

This transport mechanism exist in all cell bodies and maintains the sodium and potassium concentration differences across the cell membrane; it also established a negative electrical potential inside the cells: Sodium-potassium pump Calcium pump Sodium counter-transport Active transport

Sodium-potassium pump

Cardiac dysfunction results in the following, EXCEPT: Excessive fatigue Chest pain Changes in electrocardiographic activity or heart sounds Dyspnea Decreased or absent peripheral pulses

Decreased or absent peripheral pulses

During isovolumetric contraction phase: a. The aortic and tricuspid valves are closed b. The aortic valve is open while the pulmonic valve is closed c. The mitral valve is open but the tricuspid valve is closed d. The mitral valve is open while the aortic valve is closed e. The mitral and aortic valves are closed

e. The mitral and aortic valves are closed

The following steps describe the increased cardiopulmonary activity in response to various levels of physical activity, EXCEPT: a. During exercise, CO is increased because of increase in both stroke volume and heart rate, with stroke volume reaching its maximal level at approximately 40% of maximal oxygen consumption b. When ventilation occurs, the muscles contract creating a negative pressure within the thorax allowing air to move inward from the mouth to various lung parts c. Because of regional differences in the distribution of both ventilation and perfusion, the possibility exists to have areas of the lungs that are well ventilated but underperfused, but not vice versa d. In myocardial ischemia, the ability to adequately fill the left ventricle may be impaired and patients may experience dyspnea or signs and symptoms of decreased CO. e. At rest, the primary muscles of respiration are the diaphragm, scalene and parasternal intercostals

c. Because of regional differences in the distribution of both ventilation and perfusion, the possibility exists to have areas of the lungs that are well ventilated but underperfused, but not vice versa

Which is true of the following examples of anatomic pulleys? a. In quadriceps and patellar tendons, where the direction of pull is changed as the knee flexes and improves the force arm distance due to the interposed patella b. All of these c. In the leg, where tendons of the peroneal and long toe flexor descend distally on the posterior aspect of the legs and go behind and around the malleoli to form attachments in the foot and toes. d. In the palmar side of the phalanges, when the flexor digitorum profundus and superficialis contract, their tendons rise for the joint axes and are held down by seven pulley-like loops that deflects the tendon with movement.

b. All of these

These cardinal signs characterized inflammation, EXCEPT: Edema Rubor Pain Heat No disturbance of function

No disturbance of function

Which of the following is true of the flexor digitorum superficialis? a. Both of the superficialis and profundus act to clench the fist b. All of these c. The chief joint that it flexes is the proximal interphalangeal joint d. It is supplied by the median nerve

b. All of these

The following statements are true of laminectomy, EXCEPT: a. Involved a surgical removal of a portion of the lamina b. Spinal fusion may be performed along with laminectomy for additional vertebral stability c. The protruding disc fragments are removed to relieve pressure on the nerve root d. Spinal fusion can only be performed in laminectomy e. In laminectomy with spinal fusion, the spine is reinforced by using bone chips or inserting a metallic rod, screw or plate

d. Spinal fusion can only be performed in laminectomy

An Ober Test is positive if: a. There is to-and-for motion of the greater trochanter b. The hip does not extend fully when one leg is flexed and the other is fully extended c. The subject arches his back to reform the lumbar lordosis when he lowers his leg d. The thigh remains abducted when the leg is released e. The thigh drops to the adducted position when the leg is released

d. The thigh remains abducted when the leg is released

The following statements are true of the heart, EXCEPT: a. It lies behind the body of the sternum and in front of the middle four thoracic vertebrae (T5, T6, T7, and T8) b. During development, the heart undergoes rotation so that its right side is carried backwards and its left side forwards c. It is about the size of a clenched fist and occupies a central position in the thoracic cavity d. The right ventricle occupies most of the anterior surfaces and forms all but the extremities of the inferior border

b. During development, the heart undergoes rotation so that its right side is carried backwards and its left side forwards

The following statements describe Parkinson’s Disease, EXCEPT: a. Functional limitations in bed mobility, transfers, and gait may become severely disabling as the disease progresses b. Results from neurotransmitter imbalances associated with degeneration of the substantia nigra c. Mobility of the neck, torso, and extremities is lost d. The primary impairments typically are rigidity, bradykinesia, tremor and postural instability e. Presents stooped, flexed posture, characterized by excessive lumbar kyphosis and loss of thoracic lordosis

e. Presents stooped, flexed posture, characterized by excessive lumbar kyphosis and loss of thoracic lordosis

The following statements are true of the Swing Phase of gait, EXCEPT: a. The ankle dorsiflexors are active during the entire swing phase to clear the ground by holding the ankle neutral b. The knee reaches its maximum degree of flexion approximately 65 degrees between toe-off and midswing c. Steppage gait occurs when the ankle dorsiflexor do not work properly d. If the subject has poor quadriceps strength, he may rotate the pelvis posteriorly in an exaggerated motion to provide forward thrust for the leg e. If the hamstrings are weak, heel strike may be excessively harsh and the may hyperextend

d. If the subject has poor quadriceps strength, he may rotate the pelvis posteriorly in an exaggerated motion to provide forward thrust for the leg

The following statements are true of erythrocytes, EXCEPT: a. They are produced in red bone marrow and in the spleen and other lymphoid tissues b. A mature red cell is completely filled with hemoglobin, a high specialized compound of protein and iron c. These are formed in bone marrow where they pass through several stages before reaching maturity d. The life of an erythrocyte is about four months, and four million new cells every second of every minute must be produced

a. They are produced in red bone marrow and in the spleen and other lymphoid tissues

The following statements apply to the common peroneal nerve, EXCEPT: a. Subject is able to walk on his toes and Achilles reflex is preserved b. Interruption of the nerve results in loss of dorsiflexion of ankle and toes and in loss of eversion of the foot c. There is foot drop with hypotonia and atrophy of muscle but not sensory loss d. Received fibers from the L4, L5, S1, and S2 roots e. There is varying sensory loss along the lateral aspect of the dorsum of the foot

c. There is foot drop with hypotonia and atrophy of muscle but not sensory loss

To test this nerve, the subject protrudes the tongue and moves it from side to side: Hypoglossal nerve Vagus nerve Spinal accessory nerve Glossopharyngeal nerve

Hypoglossal nerve

Which of the following pain intervention techniques apply to the gate control theory directly? a. Stimulus produced analgesia and prefrontal lobotomy b. Placebo treatment and aspirin c. Acupuncture and hypnosis d. Paracetamol e. Transcutaneous electrical nerve stimulation and whirlpool bath

e. Transcutaneous electrical nerve stimulation and whirlpool bath

The following describes the “Q” angle, EXCEPT: a. The acute angle formed by the triceps femoris tendon and the ligamentum patellae b. An increased in the “Q” angle above 15 degrees may increase the tendency for lateral patellar malposition c. An increased “Q” angle associated with another deficiency of the extensor mechanism may allow the patella to sublux more easily d. The second line is drawn from the center of the patella to the center of the anterior-superior iliac spine on the pelvis e. Determined by drawing one line from the middle of the patella to the center of the tibial tubercle

a. The acute angle formed by the triceps femoris tendon and the ligamentum patellae

Fracture of a long bone, i.e. a femur may cause traumatic hemorrhage even if the break is closed. Which of the following statements does not apply: a. Blood loss may eventually cause hypovolemic shock b. None of these c. Within 24-48 hours, as much as 1 to 2 liters (2 to 4 units) of blood may accumulate in the patient’s thigh d. Increasing ecchymosis of his injury e. Laboratory tests may show decreased hemoglobin and hematocrit

b. None of these

Thrombus formation in the legs, particularly in patients following surgery may be prevented in the following manner, EXCEPT: a. Gentle mobilization and modified exercises after thrombi have resolved b. Increase movement and activity to negate sequelae of restricted mobility and recumbency on oxygen transport c. Specially designed stockings in conjunction with pneumatic compression devices to stimulate the normal action of the muscle pump in the leg d. Stockings that are applied with uniform pressure along the leg, and removed frequently for 10 minute periods are reapplied e. Compression stockings to prevent peripheral blood pooling and augment venous return

b. Increase movement and activity to negate sequelae of restricted mobility and recumbency on oxygen transport

Despite the presence of third cranial nerve paralysis, upon examination it was determined that the eyes is able to rotate inward, indicating that the superior oblique muscle is intact. This indicates: All of these Cranial nerve II is only partially denervated None of these Cranial nerve IV is intact Cranial nerve IV is also denervated

Cranial nerve IV is intact

This muscle is active in foot inversion if accompanied by dorsiflexion: Extensor hallucis longus Tibialis anterior Tibialis posterior Extensor digitorum longus

Tibialis anterior

The product of heart rate and stroke volume: Cardiac output (in liters per minute) Ventilation Breathing Tidal volume Metabolic rate

Cardiac output (in liters per minute)

Transcutaneous electrical nerve stimulation has been used for pain management over the years. Conventional TENS has the following properties, EXCEPT: a. Uses intensities below the motor threshold b. Uses relatively low pulse frequencies (50-100 pulses per second) c. Used relatively short pulse durations (2-50 microseconds) d. Stimulates large-diameter fibers e. Stimulates superficial cutaneous nerve fibers

b. Uses relatively low pulse frequencies (50-100 pulses per second)

A dome shaped bump that lies in the occipital region on the midline and marks the center of the superior nuchal line: Lanula None of these Cricoid tubercle Cricoid ring Inion

Inion

When other forms of reconstructive hip surgery have failed, and the patient still suffers incapacitating pain, a total hip replacement may be performed. The following statements are true, EXCEPT: a. It is contraindicated on patients with history bone infection b. A young patient won’t receive total hip replacement, because the prosthesis lifespan is uncertain c. The prosthesis is considered total because the both joint components are replaced d. After total hip replacement, no activities are prohibited e. The procedure usually restores joint movement and stability, allowing the patient to ambulate without severe pain

d. After total hip replacement, no activities are prohibited

Functional limitations observed in patients with cerebellar dysfunction may include in the following, EXCEPT: Hypertonicity Gait ataxia Fatigability and weakness Dyssynergia Postural instability

Hypertonicity

In this lifting technique, the individual squats in front of the object with the feet and knee approximately shoulder width apart, this should only be used when lifting small, light, items or when insufficient space is provided. This lift should be avoided by those with knee problems: Power lift Tripod lift Deep squat lift Diagonal lift Golfer’s lift

Deep squat lift

Which of the following statements is true in forefoot adduction correction test? a. If forefoot can be fully corrected to less than neutral, foot will probably not correct itself, and cast correction is necessary b. If forefoot can only be partially corrected to neutral or less, foot will still correct itself and cast correction is not necessary c. If you can manually correct adduction and abduct forefoot greater than the neutral position, no treatment is necessary as foot will partially correct itself d. If forefoot can be fully corrected to neutral or greater, foot will probably not correct itself, and cast correction is not necessary e. If you can manually correct adduction and abduct forefoot beyond neutral position, no treatment is necessary as foot will partially correct itself

a. If forefoot can be fully corrected to less than neutral, foot will probably not correct itself, and cast correction is necessary

The following statements are true of breathing exercises, EXCEPT: a. Indicated during mechanical ventilation b. Indicated in the ICU setting for patients with neuromuscular disease c. Benefit includes increased tidal volume, improved thoracic cage mobility and increased inspiratory capacity d. Used when thoracic excursion is decreased as a result of retained secretions or pain e. May be used during weaning from mechanical ventilation

a. Indicated during mechanical ventilation

Characteristic of patellofemoral pain syndrome include the following, EXCEPT: a. Can be used for malalignment of the lower extremity b. Most frequently recommended treatment is exercise c. Surgical treatment is rarely indicated d. Pain results in decreased force by knee extensors e. Consists of anterior knee pain excluding intra-articular pathology, peripatellar tendinitis and bursitis

a. Can be used for malalignment of the lower extremity

The following statements characterize extension in the lumbar spine, EXCEPT: a. To test, the subject is instructed to bend backward as far as he can, using the examiner’s hand on the posterior superior iliac spine as fulcrum b. Increase in lumbar lordosis is resisted by the rectus abdominis muscles c. Stretches the anterior longitudinal ligament and relaxes the posterior ligaments d. When testing extensions, the examiner must not assist the subject manually by pushing gently on his chest e. Motored by the intrinsic muscles of the back

d. When testing extensions, the examiner must not assist the subject manually by pushing gently on his chest

Among health care workers, the job-factor described that has the highest problematic percentage for the development of work-related musculoskeletal disorders is: a. Performing the same tasks over and over b. Reaching or working away from your body c. Lifting or transferring dependent patients d. Bending or twisting your back in an awkward way e. Working in the same positions in long periods

c. Lifting or transferring dependent patients

From the frontal plane, the neck of the femur has an anterior angle of 13 to 15 degrees. A decrease in this angle, a factor in out-toeing during walking, is called: Coxa Vara Coxa valga Retroversion Anteversion

Retroversion

The bones and associated ligaments of the foot form arches: All of these Medial longitudinal arch Transverse arch Lateral longitudinal arch

All of these

This test was developed to assist in diagnosing posterior meniscal tear by causing a palpable or audible “click” within the joint: McMurray Test “Bounce Home” Test Apley’s Compression Test Distraction Test Reduction Test

McMurray Test

The following statements apply to lower lumbar root compression, EXCEPT: a. Atrophy of the gastrocnemius may be seen b. Severe foot drop is unlikely, but toe drop is common with atrophy of the anterior compartment c. Percussion by fist or hammer over the lower lumbar segments may aggravate pain in the thigh or leg d. Ankle jerk reflex is commonly diminished or absent in S1 root impingement but may be normal in L5 root syndromes e. Test of straight-leg-raising frequently shows marked limitation in range of thigh flexion on the good side

e. Test of straight-leg-raising frequently shows marked limitation in range of thigh flexion on the good side

The following statements describe the patellar reflex, EXCEPT: a. While the reflex may be significantly diminished, it is rarely totally absent b. A deep tendon reflex mediated through nerves emanating from L2, L3, and L4 neurologic levels c. To test, the subject sits on a chair with one leg dangling over his knee d. Even if the L4 nerve root is pathologically involved, the reflex may still be present e. For clinical application, the patellar reflex is to be considered an L4 reflex

c. To test, the subject sits on a chair with one leg dangling over his knee

In the jaw reflex involving the masseter and temporalis muscles, this cranial nerve mediates the reflex are: Facial Accessory Hypoglossal Glossopharyngeal Trigeminal

Trigeminal

After total hip surgery, for the next 3 months, the following must be observed as part of the patient’s home care, EXCEPT: a. Keep the affected leg facing front at all times whether sitting, lying or walking b. Legs must not be crossed legs whether lying, sitting or standing c. Place a pillow between the legs when lying in unaffected side, with the affected leg uppermost d. Patient may reach down to the end of the bed to pull covers e. Never turning hip or knee inward or outward

d. Patient may reach down to the end of the bed to pull covers

A form of tendon inflammation that occurs when a muscle/tendon unit is repeatedly tensed: Epicondylitis De Quervain’s disease Tendinitis Stenosing tenosynovitis Tenosynovitis

Tendinitis

The following relationships are true of the low back, EXCEPT: a. Lumbar lordosis is unrelated of hip and trunk flexibilities b. Longer abdominal muscles and shorter erector spinae muscles are associated with an increased lumbar curve c. Individuals with exaggerated lumbar curvature while standing tend to have short hamstrings, rotating the pelvis posteriorly, resulting in concurrent reduction of lumbar lordosis d. There is no correlation among hip extension ROM, standing pelvic tilt, standing lumbar lordosis and abdominal muscle performance variables e. The length of the hamstring muscles are negatively related to the lumbar curve

c. Individuals with exaggerated lumbar curvature while standing tend to have short hamstrings, rotating the pelvis posteriorly, resulting in concurrent reduction of lumbar lordosis

The following applies to resisted movement testing, EXCEPT: a. Performed to determine the status of the contractile unit and its segmental innervations from the spinal cord b. Considered to be specific in evaluating the status of the contractile unit c. While it primarily assesses the contractile unit, it causes some joint compression that may lead to inappropriate conclusions d. Performed in the shortened, midrange, and stretched position for total evaluation of the contractile unit e. Performing in shortened position prevents excessive compression or distraction of noncontractile structures

e. Performing in shortened position prevents excessive compression or distraction of noncontractile structures

Within the depression between the medial malleolus’ posterior aspect and the Achilles tendon lie several soft tissue structures, EXCEPT: Flexor hallucis longus tendon Flexor digitorum longus tendon Posterior tibial artery and tibial nerve Tibialis posterior tendon Tibialis anterior tendon

Tibialis anterior tendon

Some of the eight basic techniques which can be used to safely perform most lifting tasks include the following. EXCEPT: Golfer's lift Diagonal lift Tripod lift Full squat lift Deep squat lift

Full squat lift

The following are effects of cardiac transplantation on cardiovascular and pulmonary variables, EXCEPT: a. The peak heart rate achieved during maximal exercise is markedly lower in cardiac transplant patients than in age-matched subjects thereby limiting the usefulness of exercise prescriptions based on target heart rate b. Peak systolic blood pressure of cardiac transplant recipient is less than that of individuals without, but diastolic blood pressure is not much different c. Resting stroke volume of patients following cardiac transplantation is less than that of individuals without, but diastolic blood pressure is not much different d. At rest, cardiac recipients exhibit lower heart rates than do individuals without cardiac transplants due to the loss of vagal tone associated with the surgical procedure e. Oxygen consumption at anaerobic threshold is markedly lower than that of individuals without cardiac transplants, partially due to skeletal muscle weakness

d. At rest, cardiac recipients exhibit lower heart rates than do individuals without cardiac transplants due to the loss of vagal tone associated with the surgical procedure

Epidemiological studies have established some risk factors for work-related low back pain and include the following, EXCEPT: a. Vibration b. Movements into inner ranges of motion such as stretching or reaching heavy-materials handling c. Prolonged posture of sitting or standing d. Requirements of lifting, pushing, pulling, bending and twisting e. Repetitious work, poor management employee relations and new employment status

b. Movements into inner ranges of motion such as stretching or reaching heavy-materials handling

Type of contraction when the muscle shortens but the tension remains constant: Isometric None of these Isotonic Isokinetic

Isotonic

In this knee instability, the mechanism of injury is a forcible blow against the front of the tibia with the leg externally rotated and planted in a varus position: Anterolateral rotatory instability Combined rotatory instability Anteromedial rotatory instability Posterolateral rotatory instability Straight lateral instability

Posterolateral rotatory instability

The following are true of the types of breathing exercises, EXCEPT: a. Use of a flutter valve, the forced-expiration technique and autogenic drainage are beneficial in patients with cystic fibrosis, although efficacy has not been determined b. Following coronary artery bypass of gall-bladder surgery, breathing exercises offer no advantage over early patient mobilization c. Incentive spirometry is no more advantageous or cost-effective than instruction in deep breathing and coughing d. Diaphragmatic breathing and lateral costal and segmental coastal and segmental costal expansion exercises are used most often post-operatively e. Inspiratory muscle training and resistive diaphragmatic breathing exercises are not beneficial in weaning the patient with chronic obstructive pulmonary disease

e. Inspiratory muscle training and resistive diaphragmatic breathing exercises are not beneficial in weaning the patient with chronic obstructive pulmonary disease

The Babinski sign is the single most important sign in neurology. The following statements apply to Babinski sign, EXCEPT: a. The normal response is flexion with adduction of the toes b. When the sign is absent, then the system is diseased c. When present after age 12-16 months, it indicates dysfunction of the corticospinal motor system d. About one second is an appropriate time for the stimulus e. The abnormal response is dorsiflexion of the great toe and fanning of the others with withdrawal at the knee and hip

b. When the sign is absent, then the system is diseased

A patient requires skin traction using a cervical head halter. The following applies to proper head halter application, EXCEPT: a. The patient’s head may be elevated 20 deg for patient comfort b. If any adjustment to the straps is necessary, the anterior straps must be adjusted first, then the posterior c. The back of the halter is positioned beneath the head, aligning the sides in order not to cover the patient’s ears d. A head halter is contraindicated for extended use for it can cause skin irritation e. To avoid zygomatic nerve damage, the straps leading to the sidepiece should be loose over the patient’s check

b. If any adjustment to the straps is necessary, the anterior straps must be adjusted first, then the posterior

The following are characteristics of Myasthenia Gravis, EXCEPT: a. Involvement is often selective and asymmetric b. There is weakness and excessive fatigability of muscle c. Dysfunction arises from imperfect neuromuscular transmission d. The degree of paresis does not vary during the day e. Incidence is highest in young women and elderly men

d. The degree of paresis does not vary during the day

Daylight and color vision is dependent on the integrity of the: Ganglion cells Amacrine cells Rod receptors Ossicular chain Cone receptors

Cone receptors

The perpendicular distance from the pivot point to the line of action of the weight is called the: Lever Arm Mechanical Advantage Force Arm Weight Arm

Weight Arm

The following conditions can result from excessive and repetitive end-range motions, excessive force, and stretching leading to chronic soft tissue inflammation, muscle spasm and postural imbalance, EXCEPT: Repetitive sprain injuries None of these Cumulative trauma disorders Repetitive strain injuries Repetitive motion injuries

Repetitive sprain injuries

Gastric emptying is mainly the function of the: Pylorus None of these Distal body Fundus Proximal body

Pylorus

The following are characteristics of “fasciculations”, EXCEPT: a. Refers to low-voltage potentials which results from independent contractions of single, denervated muscle b. Especially prominent in and characteristics of chronic, progressive, motor neuron disease c. When infrequent and not accompanied by atrophy, are not necessarily evidence of progressive disease d. A result of almost any disorder of a motor neuron resulting in spontaneous, irregular, recurrent contraction e. Occasionally occurs in otherwise normal subjects

a. Refers to low-voltage potentials which results from independent contractions of single, denervated muscle

Stroke volume is expected to increase if: After load increases Myocardial contractility decreases Myocardial elasticity decreases Pre-load increases None of these

Pre-load increases

The following describe patellar misalignment, EXCEPT: a. May be either permanent or recurrent b. Release of the tight lateral restraining structures that cause excessive pressure and patellar subluxation (lateral release) may correct the problem c. Eventual outcome of many cases of chronic patellar medial alignment is patellofemoral arthrosis d. Vastus medialis advancement with tightening of lax medial restrains (medial roofing) may treat the problem e. Correction of the varus angle of the patellar tendon (distal realignment) may help resolve the problem

e. Correction of the varus angle of the patellar tendon (distal realignment) may help resolve the problem

If the blood pressure reading is 150/90 the mean blood pressure is: 100 mm Hg 135 mm Hg 120 mm Hg 110 mm Hg 115 mm Hg

110 mm Hg

So that fibers conveying impulse from a visual field accompany one another to the same cortical center, fibers from each retina cross behind the eyeball in what is known as: Visual path Optic chiasm Macula Lutea Optic Tract

Optic chiasm

A combination of the four primary movements in which flexion, abduction, extension and adduction succeed one another: Circumduction Lateral rotation in the horizontal or transverse plane Medial rotation on the coronal plane Adduction in the coronal or frontal plane

Circumduction

In anterolateral rotatory instability of the knee, healing requires: a. Six to eight weeks of cast immobilization with the knee flexed 90 degrees and leg maximally externally rotated b. Four to five weeks of cylinder cast immobilization of the knee at about 60 degrees of flexion c. None of these d. A long leg cast over a bulky compressive dressing with the knee positioned 60-70 degrees of flexion and the tibia is internally rotated on the femur for five to eight weeks e. Cast immobilization with the knee flexed at 60-70 degrees and the tibia internally rotated to prevent the posterolateral subluxation of the tibia for six to eight weeks

a. Six to eight weeks of cast immobilization with the knee flexed 90 degrees and leg maximally externally rotated

As part of an overall ergonomics program, a variety of administrative practices can be used effectively, but must not be used instead of considering engineering improvements. Following are some accepted recommendations, EXCEPT: Work/Rest schedule Exercise Job rotation Workload reduction Subdivision of labor

Exercise

Rapid, unpredictable jerks of a muscle or a part: Chorea Myoclonus Hyperkinesia Tremor Athetosis

Chorea

Management following open reduction internal fixation of the pelvis include the following, EXCEPT: a. Time frame for meeting these goals varied from four to eight weeks depending on the subject’s medical status b. Physical therapy is initiated to begin transfer and exercise training with the subjects c. Subjects are expected to be able to perform a home exercise program prior to hospital discharge d. Subjects are maintained on bed rest for 1 to 2 days e. Short-term goals include independence with transfer and wheelchair mobility

a. Time frame for meeting these goals varied from four to eight weeks depending on the subject’s medical status

The attachments of this structure can be palpated and identified by placing the index finger on the lateral epicondyle of the femur and middle finger on head of the fibula: Lateral collateral ligament None of these Medial meniscus Medial collateral ligament

Lateral collateral ligament

Following statements are true of the corticospinal or pyramid tract, EXCEPT: a. Concerned with skilled movements of the distal muscles of the limb b. About ⅓ of the axons in the pyramidal tract arise form the primary motor cortex in areas 4 and 6 c. About 90% of the tracts decussate to the opposite side at the lower level of the medulla d. The fibers arise from the neurons in the ventral part of area 4 on the lateral surface of the hemisphere and from area 8

d. The fibers arise from the neurons in the ventral part of area 4 on the lateral surface of the hemisphere and from area 8

Included among the types of irregular bone are the following: Sesamoid Wormian None of these Carpals Sesamoid and wormian

None of these

Main determinant of cardiac output: Left ventricle and diastolic pressure Blood present in the aorta Efficiency of systolic contraction Venous pressure

Efficiency of systolic contraction

The muscles of expression, including the Buccinator is supplied by: Seventh cranial nerve Ninth cranial nerve Fifth cranial nerve Third cranial nerve

Seventh cranial nerve

Characteristics findings in the diagnosis of benign paroxysmal positional vertigo includes the following, EXCEPT: a. A latency of 1 or more seconds after the head is moved into the provoking position before the onset of the vertigo and nystagmus b. Continued nystagmus and a recurrence of vertigo when the person returns to a sitting position c. Decreased intensity of the vertigo with repeated movement of the person into the provoking position d. Characteristic nystagmus e. A gradual reduction in the vertigo and nystagmus with a duration of less than 60 seconds

b. Continued nystagmus and a recurrence of vertigo when the person returns to a sitting position

The following describe the lateral meniscus, EXCEPT: a. There is an area of no point attachment to the tibia from under the anterior cruciate ligament to the anterior margin of the tibia b. May move anteriorly-posteriorly as the condyle does c. The lateral meniscus is much less secure than the medial d. Because of its shape, it is much more of movement by the lateral femoral condyle over the lateral plateau of the tibia e. Has considerably less mobility than medial meniscus and by its shape and countour tends to be controlled much more by the femoral condyle

e. Has considerably less mobility than medial meniscus and by its shape and countour tends to be controlled much more by the femoral condyle

The most common inhibitory neurotransmitter in the cerebral cortex is: Dopamine Noradrenaline Glycine GABA None of the above

GABA

The following assumptions on mechanical pain threshold (MPTh) are true, EXCEPT: a. MPThs are perceived differently by male subjects than female subjects b. Women have lower MPThs than do men c. MPThs do not differ in different body regions d. There is no gender difference in MPTh with pressure applied at the top of the index finger proximal to the nail e. There is positive correlation between age and MPTh

c. MPThs do not differ in different body regions

The following statements are true of herniated disc, EXCEPT: a. The most common areas of herniated disc are L4 to L5 and L5 to S1 interfaces b. Only about 5% of disc herniation occur in the cervical area c. It is caused by strain, degenerative joint disease, or trauma which may force all of part of the nucleus pulposus through the disc’s weakened of torn outer ring d. Disc herniation does not cause loss of sensation of motor function in the area innervated by the compressed nerve root e. Symptoms include low back pain, sometimes accompanied by muscle spasms which may radiate to the buttocks, legs and feet

d. Disc herniation does not cause loss of sensation of motor function in the area innervated by the compressed nerve root

The anterior cruciate ligament is: Slack when the knee is flexed, taut when the knee is fully extended None of these Taut when the knee is flexed, slack when the knee is fully extended Taut when knee is flexed or fully extended Slack when knee is flexed or fully extended

Slack when the knee is flexed, taut when the knee is fully extended

Which eye muscles are contracting when the subject is looking downward and to the left: Left superior rectus and right inferior oblique Right inferior rectus and left superior oblique Right superior rectus and left inferior oblique Left inferior rectus and right superior oblique

Left inferior rectus and right superior oblique

The normal value of hematocrit for men is: 50% 45% 30% 25% 35%

45%

Metacarpophalangeal and interphalangeal joint extension is primarily the action of: Interossei and lumbricals Extensor digitorum communis Extensor digitorum, lumbricals and interossei Extensor carpi ulnaris and extensor carpi radialis

Extensor digitorum communis

The angle formed by the tendons of the quadriceps and ligamentum catella with the center of the patella: Q-Angle None of these Genu Varum Genu Valgum

Q-Angle

The following statements are true of the hinged type of total knee prosthesis, EXCEPT: a. Rotation places a great stress on the prosthesis/bone interfaces which will eventually loosen b. Indicated for completely destroyed knee joint c. Includes a hinge, which functions on one axis, and the hinged pieces are continually articulated d. Patient must have functioning ligaments in the knee e. Long, thin intermedullary portions hold the prosthesis in place, without the aid of methyl methacrylate

d. Patient must have functioning ligaments in the knee

The following statements characterize percussion in chest PT, EXCEPT: a. For patients with rib and sternal fracture, controlled mechanical ventilation may even stabilize the fracture site by minimizing negative intrathoracic pressure b. Used during both the inspiratory and expiratory phases or respiration c. Pneumothorax and hemothorax that develop as a result of the initial injury is considered a contraindicated to percussion d. Not indicated for the spontaneously breathing with rib fractures who is responding to breathing exercises and assistive coughing techniques e. Fast percussion (240 cycles/min) demonstrated the greatest sputum production, although slow percussion (6-12 cycles/min) was more effective than no percussion f. None of the above

c. Pneumothorax and hemothorax that develop as a result of the initial injury is considered a contraindicated to percussion

Postoperative complications in cardiac transplantation include the following, EXCEPT: Weight loss Transplant Vasculopathy Cyclosporine related hypertension Rejection Infection

Weight loss

Sodium ions can diffuse inward across the cell membrane in which condition: a. Sensory nerve endings in the skin are excited from mechanical pressure b. Signals between muscle cells in the heart and intestine are transmitted through electrical currents c. All of these d. In the brain, signals from one neuron to the next are transmitted by mechanical neurotransmitters

c. All of these

The following statements describe the extensor mechanism of the knee, EXCEPT: a. The infrapatellar and prepatellar bursae are subject to inflammation caused by trauma and by overuse b. The patellofemoral and patellotibial ligaments (thickenings in the extensor retinaculum that covers the anterior portion of the knee), stabilize the patella c. Because of the synovial membrane of the knee is large, it obtains support from the articularis genu during movements of the knee d. The direction of pull exerted on the patella by the muscles provides for a great amount of dynamic instability of the patella e. The patella is a critical component because its location allows greater mechanical advantage for knee extension

d. The direction of pull exerted on the patella by the muscles provides for a great amount of dynamic instability of the patella

The following statements allow soft tissue palpation of certain structures, EXCEPT a. The flexor carpi radialis may be palpated radial to the Palmaris longus proximally toward its origin at the medial epicondyle when making a tight first and then to radially deviate and flex the wrist b. The wrist flexors may be palpated as a unit and individually as you move from their origin at the medial epicondyle and supracondylar line down the forearm and toward the wrist c. The ulnar nerve may be palpated as it is rolled gently under the index and middle fingers in the sulcus between the medial epicondyle and the olecranon process d. The medial collateral ligament, a basic stabilizer of the humeroulnar articulation, rises from the medial epicondyle and extends to the medial margin of the ulna’s trochlear notch may be palpated directly e. To facilitate palpation of the triceps, the subject may lean on the table where it will stand out on the posterior aspect of the arm

d. The medial collateral ligament, a basic stabilizer of the humeroulnar articulation, rises from the medial epicondyle and extends to the medial margin of the ulna’s trochlear notch may be palpated directly

Just proximal to the capitates, this is the most often dislocated as well as the second most often fractured bone in the wrist? Capitate Lunate Hamate Navicular Base of third metacarpal

Lunate

Following spinal cord injury (SCI), myths as to whether men can biologically father children abound. The following statements are true of male fertility following SCI, EXCEPT: a. High immotile sperm count is caused by lifestyle factors (such as elevated scrotal temperature, or ejaculation frequency) b. Immotile sperm count may be due to factors within the seminal plasma c. Semen can be obtained from almost all men with SCI through the use of vibratory or electrical stimulation d. Most men with SCI experience impairments in erectile and ejaculatory functions e. While their ejaculated often have normal sperm counts, more immotile sperm are found than men

a. High immotile sperm count is caused by lifestyle factors (such as elevated scrotal temperature, or ejaculation frequency)

Which of the following statements is true of the Na+/K+ATPase pump? All of these It is an example of an ionic channel It pumps sodium out and potassium in It is an example of facilitated diffusion It is an example of facilitated osmosis

It pumps sodium out and potassium in

The following are causes of cardiac muscle dysfunction, EXCEPT: Pulmonary embolus Hypotension Renal insufficiency Spinal cord injury Cardiomyopathy

Hypotension

The following are actions of the upper fibers of the Trapezius, EXCEPT: Maintain shoulder level When fatigued, allow the shoulder to droop Shrug the shoulders Retract the scapula

Retract the scapula

In Moro reflex, when the infant is held in supine and the head is gently, but abruptly, allowed to drop in partial hyperextension, the following response is observed, EXCEPT: a. The legs flex slightly b. Deviates his mouth to a lateral side c. The hips abduct but to a lesser degree than the arms d. The arms return forward over the body in a clasping maneuver e. The arms briskly abduct and extend while hands open

b. Deviates his mouth to a lateral side

The sinu-atrial node is the normal pacemaker in the human heart because: It has the highest intrinsic rate of automaticity It receives both sympathetic and parasympathetic innervations It is far from the ventricles It is located near the entry to the right atrium It is located near the entry to the right ventricle

It has the highest intrinsic rate of automaticity

The following statements are true of the hips, EXCEPT: a. The combination of an observed shortened extremities, external hip rotation, and pain movement strongly suggests a fractured hip b. The ischial tuberosity is easily palpable if the hip is flexed as the gluteus maximus moves laterally c. A line drawn across the top of the iliac crest crosses the spine between the spinous processes of L4 and L5 d. Due to the overhang of the ilium and the obstruction of supporting ligaments, the sacroiliac joint is not palpable e. The center of the sacroiliac joint, at S2, is crossed by an imaginary line drawn between the posterior superior iliac spines

b. The ischial tuberosity is easily palpable if the hip is flexed as the gluteus maximus moves laterally

A patient with long thoracic nerve injury will have the most difficulty in: Folding blanket Reaching at shoulder level Combing his hair Washing his face Eating

Combing his hair

Sensation to the middle finger is supplied by neurologic level: C8 C5 C7 T1 C6

Decrease in lumbar lordosis results in: Downward tilt of pelvis Forward tilt of pelvis Backward tilt of pelvis No change in pelvic tilt

Backward tilt of pelvis

While use of submaximal contraction recruits slow twitch fibers which selectively atrophies post anterior cruciate ligament injuries, it is still used to do the following, EXCEPT: a. To provide neurophysiological patterning and prevent reflex dissociation b. To decrease synovial fluid lubrication c. To decrease stresses on patella-femoral joint and articular cartilage d. To provide gradual stress to ligament to stimulate collagen formation and alignment during maturation e. To control initial muscle contractions in the short arc ROM

b. To decrease synovial fluid lubrication

The following conditions apply to chondromalacia patella, EXCEPT: a. Calliet describes second degree chondromalcia as erosion of the cartilage to subchondral bone and possible involvement of the posterior femoral cartilage b. Surgical intervention with debridement, realignment, or patellectomy may be necessary as the condition progresses c. A common degenerative condition involving a softening of the patella’s articular surface d. Quadriceps femoris muscle wasting, particularly of the oblique fibers of the vastus medialis, is common e. Intermittent pain is attributed to the quadriceps femoris muscles as they pull the tender patella tightly against the trochlear surface of the femur

a. Calliet describes second degree chondromalcia as erosion of the cartilage to subchondral bone and possible involvement of the posterior femoral cartilage

Repeated use of body mechanics is a major cause of back injuries. Some of the common mistakes include the following, EXCEPT: Insufficient strength Handling the load too far Using fast but not jerking motion Lifting with the back bent forward and the legs straight Bending and twisting at the same time

Using fast but not jerking motion

The following statements apply to the radial nerve, EXCEPT: a. Extension of the distal phalanges, which appears to be absent in wrist drop, will be found to be possible if ulnar and median nerves are intact b. Classically paralyzed by ischemia from pressure in the drunken and comatose and also in lead poisoning c. Abduction and adduction of fingers are not weakened d. Partly mediates flexion and supination at the elbow through innervations of the brachioradialis muscle e. A “finger drop” may result when a penetrating injury of the dorsal forearm spares branches that mediate dorsiflexion of the wr5ist but sever the posterior interosseous branch that mediates extension of the thumb and fingers

c. Abduction and adduction of fingers are not weakened

Neuromuscular electrical stimulation has been used: a. Directly on the spastic muscle to produce a reciprocal relaxation effect b. On the antagonist to the spastic muscle to fatigue them and directly on the spastic muscle produce a reciprocal relaxation effect c. On the antagonist to the spastic muscle to fatigue them and directly on the spastic muscle produce a reciprocal relaxation effect d. Directly on both the antagonist to the spastic muscle and the spastic muscle to produce a reciprocal relaxation effect e. On both the antagonist to the spastic muscle and the spastic muscle

b. On the antagonist to the spastic muscle to fatigue them and directly on the spastic muscle produce a reciprocal relaxation effect

Lesion of the seventh cranial nerve at the stylomastoid foramen results in the following condition, EXCEPT: a. Can still close the eye on the side of the paralysis b. Bell’s palsy c. The buccinators is paralyzed, and the cheek puff out during expiration d. Total paralysis of facial expression muscles on that side

a. Can still close the eye on the side of the paralysis