APK - February 1998 Flashcards by Warp Part

The following are procedures to describe the Apley’s scratch test which facilitates range of motion evaluation except:

a. To test abduction and external rotation, the patient reaches behind his head and touches the superior medial angle of the opposite scapula
b. To test abduction and external rotation, place both hands behind the back as high as possible
c. To test internal rotation and adduction, the patient reaches behind his back to touch the inferior angle of the opposite scapula
d. To determine range of internal rotation and adduction, the patient reaches in front of his head and touch the opposite acromion
e. To demonstrate full bilateral abduction, abduct the arms to 90 degrees, keeping elbows straight, and turn palms up in supination and continue abduction until his hands touch over his head

b. To test abduction and external rotation, place both hands behind the back as high as possible

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This type pf traction immobilizes a body part intermittently over an extended period, though direct application of pulling force using adhesive or non adhesive traction tape on other skin traction devices on the patient’s skin

Skin traction
Extremity traction
Skeletal traction
Limb traction
Manual traction

Skin traction

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Common origin of gracilis, adductor brevis and adductor magnus:

Inferior ramus of pubis
Ramus of ischium
Ischial tuberosity
Body of pubis

Inferior ramus of pubis

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“Motor neuron disease” is a rather broad term applied to disorders characterized by the following, EXCEPT:

a. Fasciculation are common and are often found generally before diffuse atrophy is evident
b. These are painless disorders except for muscle cramping, and there are no sensory deficits
c. Onset is often symmetric, with wasting of a hand, arm of shoulder girdle
d. Bulbar involvement may occur early or later and leads to fatal respiratory complications
e. Signs of progressive motor neuron loss with or without the parosis and spasticity of corticospinal tract degeneration

c. Onset is often symmetric, with wasting of a hand, arm of shoulder girdle

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The following statements are true of the collateral ligaments, EXCEPT:

a. Lateral collateral ligament connects the femur and the fibula
b. These ligaments may be easily injured when force is applied to the knee while a person’s leg is extended with his foot firmly planted on the ground
c. Medial collateral ligament connects the femur to the tibia
d. Prevent side-to-side movement by tightening during leg extension
e. The collateral ligaments can tear when the femur is externally rotated on the tibia

The collateral ligaments can tear when the femur is externally rotated on the tibia

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The aponeurotic insertion of the large extensor muscle of the knee largely provides the fibrous capsule for the front and the sides of the joint. In the tendon of this powerful muscle a sesamoid bone developed and became articular. Name this bone:

Tibia
Femoral condyle
Patella
Lateral condyle

Patella

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The vasomotor center is most likely to be found in the:

Cerebral cortex
Carotid sinus
Internal capsule
Spinal cord
Pons and medulla

Pons and medulla

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The following are true of the Rectus Femoris, EXCEPT:

a. The head/s are not distinctly palpable since the muscle disappears proximally in the depression between the sartorius and the tensor fascia latae
b. The head that take origin from the posterior inferior iliac spine is the more commonly avulsed, usually from injuries
c. The only two-joint muscle in the quadriceps group
d. It has a dual origin, a direct, and an indirect head
e. Crosses the hip and the knee joints, acting as a flexor of the hip and an extensor for the knee

The head that take origin from the posterior inferior iliac spine is the more commonly avulsed, usually from injuries

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A solution in water crystalloids and colloids

Plasma
Phagocytes
Blood platelets
Macrophages

Plasma

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In hydrocephalus, the following condition/s is/are true:

a. Blockage of the circulation of the fluid in the subarachnoid space increases the pressure on the outer surface of the brain or spinal cord
b. All of these
c. None of these
d. The cerebrospinal fluid from the ventricles are blocked, leading to the enlargement of the ventricular cavities at the expenses of the brain tissue

All of these

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Nonunion may occur with internal fixation. When this happens, the bone fragments may be stimulated with electrical current. Which of the following statements does not apply?

a. The electrodes may be implanted either by open incision or percutaneously, using a hand drill
b. The electricity applied either through magnetic coils placed on the skin at the fracture site, or through implanted electrodes
c. Electrical bone stimulation substitutes for normal plezoelectric effect, in which mechanical stress on a solid object induces electrical activity
d. A weak current of 20 microamperes is transmitted, because higher level would cause tissue necrosis and a lower level could fall to stimulate osteo genesis
e. In alternating current stimulation of the bone, electronegativity appear to have the same osteoblastic simulating effect

e. In alternating current stimulation of the bone, electronegativity appear to have the same osteoblastic simulating effect

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The following statements are true of the quadriceps, EXCEPT:

a. Small amount of quadriceps activity if the center of gravity line passes behind the knees axis
b. There is no quadriceps activity in bilateral standing in most cases
c. Standing erect is still possible even with bilateral quadriceps paralysis even without braces
d. Keeping the knees slightly flexed minimizes knee collapse during postural sway

Keeping the knees slightly flexed minimizes knee collapse during postural sway

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In this foot deformity, the front part of the foot does not touch the ground:

Pes calcaneus
Pes cavus
Pes Equinus
Pes varus

Pes calcaneus

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Muscles of the digits that have their proximal attachments in the forearm or humerus is classified as:

Intrinsic Muscles
None of these
Extrinsic muscles
Thenar muscles

Extrinsic muscles

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The following statements are true of arthrography, EXCEPT:

a. The visual examination of the joint anteriorly
b. The X-ray examination of a joint following injection of radiopaque dye
c. Most useful in diagnosing conditions of the posterior and middle third of the medial meniscus
c. A strictly diagnostic procedure
d. The only contraindication for this procedure is allergy to an iodine-based dye

d. The only contraindication for this procedure is allergy to an iodine-based dye

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To distinguish between intrinsic muscle tightness and joint capsule contractures, the involved finger is flexed a few degrees at the metacarpophalangeal joint and moving the PIP into flexion. If the joint is now capable of full flexion:

a. There is probably proximal joint capsule contracture
b. The intrinsic are probably tight
c. There is no contracture at the proximal joint capsule
d. None of these applies
e. The intrinsic are probably loose

The intrinsic are probably tight

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If a 15 kilogram force is applied over an area of three square centimeters, the pressure (in kilograms per square centimeter) is equal to:

None of these
5
3
7

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The cell “powerhouse” enables the cell to extract significant amounts of energy from the nutrients and oxygen for cellular functions:

Golgi apparatus
Endoplasmic reticulum
Mitochondria
Lysosomes

Mitochondria

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The following statements apply to crutch-walking down the stairs, non-weight bearing, right lower extremity, EXCEPT:

a. The patient first lowers his crutches to the next step down
b. Instruct the patient to grasp the banister and shift his left crutch to his right hand, the PT stands one step below
c. If using the three-point-and-one gait, he’ll simultaneously lower his right leg and both crutches
d. After lowering his crutches, if using the three-point-and-one gait, lowers his left foot onto the next step, and his other leg follows
e. After lowering his crutches, he lowers his left foot, onto the next step, and his other leg follows

d. After lowering his crutches, if using the three-point-and-one gait, lowers his left foot onto the next step, and his other leg follows

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This lobe of the lateral surface of the hemisphere (approximately the anterior ⅓) is rostral to the central sulcus and above the lateral fissure:

Frontal lobe
Parietal lobe
Occipital lobe
Insular lobe

Frontal lobe

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Subjects treated in PT for knee problems can benefit from a supportive knee appliance. The purposes of knee appliances are as follows: EXCEPT:

a. To change the biomechanics of the knee
b. To pursue a conscientious strength/power maintenance program
c. To protect the surgical procedure during healing of tissues
d. To compensate for decreased internal stabilization with an increased external stabilization system
e. As an adjunct to a thorough rehabilitation program

b. To pursue a conscientious strength/power maintenance program

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Area of skin supplied by one dorsal root:

Myotome
Both of these
Dermatome
None of these

Dermatome

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The Tinel sign is a test designed to:

a. Reproduce the pain of tennis elbow
b. Assess the stability of the medial and lateral collateral ligaments of the elbow
c. Elicit tenderness over a neuroma within a nerve
d. Test the reflex action that is a function of C5
e. Test the deep tendon reflex, a lower motor neuron reflex

c. Elicit tenderness over a neuroma within a nerve

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All of the following statements characterize saltatory conduction of nerve impulse, EXCEPT:

None of these
It is a slow process
Conduction is continuous
Conduction takes place at the Nodes of Ranvier

It is a slow process

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This test flexes the knee into full extension and passively allows it to extend completely with a sharp point. It is designed to evaluate a lack of full knee extension, most often secondary to a torn meniscus, or an intracapsular joint swelling. Distraction test Apprehension test McMurray test “Bounce Home” test Patella Femoral grinding test

“Bounce Home” test

Venous return to the heart may be aided by the following, EXCEPT: Tight elastic stockings Massage A sedentary job Venous valves

A sedentary job

This very strong ligament unites the sustentaculum to the lower edge of the back of the navicular. On its strength and integrity depends on the security of the whole foot. When stretched, the foot may become flat. What is this ligament? Interosseous talocalcaneal ligament Short plantar ligament Plantar calcaneonavicular ligament Deltoid ligament of the ankle

Plantar calcaneonavicular ligament

The following structures pass between the malleoli, EXCEPT: Extensor digitorum longus tendon Extensor hallucis longus tendon Tibialis anterior tendon Posterior tibial artery and tibial nerve Dorsal pedal artery

Posterior tibial artery and tibial nerve

This test is designed to determine the quality of the articulating surfaced of the patella and the trochlear groove of the femur. The subject usually complains of pain or discomfort if the test is positive Apprehension test None of these Knee joint effusion test Patella femoral grinding test Distraction test

Patella femoral grinding test

The rapid exchange of positive and negative ions due to cell’s increase in permeability is termed: Action potential Membrane potential Depolarization Repolarization

Depolarization

Action of the External Abdominal Oblique: a. Unilateral contraction causes side bending and trunk rotation with the opposite shoulder b. Both of these c. Unilateral contraction causes trunk rotation to the opposite side and side bending to the same side d. None of these

c. Unilateral contraction causes trunk rotation to the opposite side and side bending to the same side

In polyneuropathy, the following statements are true, EXCEPT: a. Weakened musculature is often painful when squeezed b. Diminution or loss of tendon stretch reflexes is an early finding c. Clumsiness of the hands and astereognosis appear as sensory deficits increase d. Symptoms are experienced in the feet and legs before the hands and arms e. In most cases, the lower motor neuron lesion is not evident in weakness and atrophy distally

e. In most cases, the lower motor neuron lesion is not evident in weakness and atrophy distally

The following statements apply to the posterior tibial nerve lesions, EXCEPT: a. Sensory loss involves much of the sole and dorsum of the foot b. If high, may result in paralysis of the hamstrings c. Tropic changes may be prominent d. May result in paralysis of the gastrocnemius and soleus muscles, the long flexor of the toes and the intrinsic foot muscles e. Causalgia may appear

a. Sensory loss involves much of the sole and dorsum of the foot

The major cation in the intracellular fluid compartment is: CI Na+ K+ Ca++ Mg++

K+

Administration of any of the following may be expected to result in elevation of mean blood pressure, EXCEPT: Bradykinin All of these Norepinephrine Anglotensin Vasopressin (ADH)

Bradykinin

An Ortolani Click is produced when: a. Both legs are abducted while exerting resisting pressure on the medial aspects of both knees b. You apply traction to the femur and return it to its previous position upon the release of traction c. The femoral head enters and leaves the acetabulum d. You release the abducted leg while the knee is flexed to 90 degrees and keeping the hip joint in neutral e. You gradually distract the head to remove its weight from the neck

The femoral head enters and leaves the acetabular

This type of contractions are quick, jerky reactions responding to a single stimulus, and usually lasts less than a tenth of a second: Fibrillation Tetanic Convulsion Fasciculation Twitch

Twitch

With a proximal or distal extensor reconstruction or a plica excision, postoperative treatment regimen includes the following, EXCEPT: a. Quadriceps femoris setting (5-10 repetitions per hour) is begun along with ankle-circumduction program the day after surgery b. To adhere to the rehabilitation program, a delay of another day may not be allowed even if he feels uncomfortable after surgery c. Walking and weight bearing to tolerance with crutches may be started the day after surgery d. Rehabilitation programs begins the day of surgery e. To promote circulatory benefits in the lower extremity and to prevent phlebitis, ankle circumduction is encouraged

To adhere to the rehabilitation program, a delay of another day may not be allowed even if he feels uncomfortable after surgery

This subjective test increases intrathecal pressure and requires accurate response from the patient: Swallowing test Compression Test Distraction test Adson test Valsalva test

Valsalva test

Triceps brachii may be paralyzed in injury to the: Radial nerve Sixth cervical segment of the spinal cord None of these Both of these

Radial nerve

The following statements may apply to the rotator cuff, EXCEPT: a. Degeneration and tearing of its tendon of insertion results in restriction especially of abduction b. Three of the muscles are palpable at their insertion into the greater tuberosity of the humerus c. The shoulder must be actively extended to rotate it into a palpable position d. The subscapularis is not palpable

The shoulder must be actively extended to rotate it into a palpable position

Arthrokinematically, these types of motions can occur between two surfaces on joint movement: All of these Sliding or Gliding Spinning Rolling or rocking

All of these

To test this structure, the patient’s foot is turned into plantar flexion and inversion. The structure is possibly strained or torn if inversion stares increases pain. What is this structure? Anterior talofibular ligament Posterior talofibular ligament Tibialis anterior tendon Calcaneofibular ligament Tibialis posterior tendon

Anterior talofibular ligament

When the sum of forces acting on the body is balanced, it is said to be in a state of: Terminal velocity Inertia Equilibrium Forced Vector

Equilibrium

This neurologic level outlines a strip down the midline of the posterior thigh and the popliteal fossa, and it is supplied by the posterior femoral cutaneous nerve of the thigh: L3 L4 S1 L2 S2

This procedure tests the integrity of the segmental innervations of the rectus abdominis and the corresponding paraspinal muscles. The patient does a quarter sit-up with arms crossed over the chest. If the umbilical is drawn up, down or to one side, there may be asymmetrical involvement of the anterior abdominal and paraspinal muscles Patrick test Fabere’s Test Beevor’s Sign Valsalva Maneuver Gaeslan’s Sign

Beevor’s Sign

Which of the following ligaments comprise the lateral collateral ligaments of the ankle joint? Anterior talofibular Calcaneofibular None of these Posterior talofibular All of these

All of these

The following are true of the femoral artery, EXCEPT: a. If the common iliac or external iliac artery is partially occluded, the femoral artery pulse may be diminished b. The femoral nerve lies lateral to the femoral artery c. The femoral vein lies medial to the femoral artery and is a clinical site for venous puncture d. Palpable just superior to the inguinal ligament, at a point halfway between the anterior superior iliac spine and the pubic tubercle e. Passes under the inguinal ligament at about its midpoint

Palpable just superior to the inguinal ligament, at a point halfway between the anterior superior iliac spine and the pubic tubercle

The following are true of the femoral triangle, EXCEPT: a. Defined superiorly by the inguinal crease b. Defined posteriorly by the Sartorius muscle ridge c. Defined medially by adductor longus muscle d. With the subject in supine, the soft tissues of the triangle is best examined with the heel of the leg being examines resting upon the opposite knee. e. The floor is formed by portions of the adductor longus, the pectineus and the iliopsoas muscle

Defined posteriorly by the Sartorius muscle ridge

C5, C6 and the lateral cord receive contributions from the: Lower trunk Middle trunk Anterior cord Upper trunk Medial cord

Middle trunk

Hemiplegia or hemiparesis is perhaps the most common physical manifestation of the disease of the brain. The following conditions describe hemiplegia, EXCEPT: a. Subjects may suffer severe hemisensory losses and hemianopsia b. Bilateral mild hemiparesis may pass unnoticed unless Babinski sign is present on both side c. Due in largest part to the vulnerability of the cortex and its radiations the lesions of vascular disease d. Ipsilateral weakness can result even when there is no immediate impingement of the motor cortex and its descending radiations e. Babinski sign is commonly present but the tendon reflexes may be absent, equal to those of the other side or exaggerated

Ipsilateral weakness can result even when there is no immediate impingement of the motor cortex and its descending radiations

Due to their connection with postganglionic neurons, they constrict the pupil and is involved in light and accommodation reflexes: Optic nerve Trochlear nerve Oculomotor nerve Trigeminal nerve

Oculomotor nerve

Apley’s Compression Test is a procedure designed to aid in the diagnosis of a torn meniscus wherein: a. Pain on the medial side indicates a damaged anterior cruciate; pain on the lateral side suggests a lateral meniscus tear b. Pain on the medial aside indicates a damaged medial meniscus; pain on the lateral side suggests a tear of the lateral collateral ligament c. Pain on the medial side indicates a damaged medial meniscus; pain on the lateral side suggests a posterior cruciate tear d. Pain on the medial side indicates a damaged medial collateral ligament; pain on the lateral side suggests lateral meniscus tear. e. Pain on the medial side indicates a damaged medial meniscus; pain on the lateral side suggests a lateral meniscus tear

Pain on the medial side indicates a damaged medial meniscus; pain on the lateral side suggests a lateral meniscus tear

The following statements apply to osteomyelitis, EXCEPT: a. This infection may occur when phylogenic bacteria invade the patient’s injured bone or soft tissue surroundings the bone b. The intramedullary abscess generally forms at the tip of a long bone where it exerts pressure inside the bone c. Accompanied by lowered ESR (erythrocyte sedimentation rate), leukocytosis, and presence of causative organism in wound or blood culture d. Occasionally, the new bone will surround the sequestrum completely in an attempt to heal the area, detaching the sequestrum completely and requires surgical removal

Accompanied by lowered ESR (erythrocyte sedimentation rate), leukocytosis, and presence of causative organism in wound or blood culture

The following statements describe the metatarsal heads, EXCEPT: a. The transverse arch of the forefoot is located immediately behind the metatarsal heads b. An antalgic gait may be created secondary to aseptic neurosis of the second, third or fourth metatarsal heads c. The second metatarsals head is the most common site of disproportionate prominence d. The lateral aspect of the first metatarsal head is also a common site for gout e. The head of the first metatarsal bone and the first metatarsophalangeal joint is the site of hallux valgus.

The lateral aspect of the first metatarsal head is also a common site for gout

The following statements apply in combined anterolateral and anteromedial rotator instability, EXCEPT: a. Result of anterior drawer test is positive with the tibia in the neutral position b. Result of the abduction and abduction and adduction stress tests are positive with the knee in 30 degrees of flexion c. Result of anterior drawer test is positive with the tibia internally rotated d. Posterior cruciate ligament remains intact e. Occurs with tears of the middle third of the medial and lateral capsular ligaments

Result of anterior drawer test is positive with the tibia internally rotated

The following statements describe the Romberg test, EXCEPT: a. The subject stands erect, with feet approximated, looking straight ahead b. Vision, if defective, substitutes substantially for deficits in posterior column and peripheral nerve function c. Assesses the ability to maintain upright posture while standing on only one leg d. When inability to balance well is based on cerebellar disease, vision is less able to correct for the difficulty in maintaining posture and the subject will sway with eyes opened or closed e. Deviation or loss of balance is toward the side of a unilateral lesion of the cerebellum

Assesses the ability to maintain upright posture while standing on only one leg

Carries impulses to the CNS: Efferent fibers Both of these None of these Afferent fibers

Afferent fibers

This muscle can plantarflex the foot regardless of ankle position: Semimembraneous and gracilis Tibialis posterior and peroneus tertius Tibialis anterior and flexor digitorum Gastrocnemius and soleus

Gastrocnemius and soleus

The following statements describe the lateral compartment of the knee, EXCEPT: a. Although the anterior cruciate ligament is an important stabilizer of the knee, whether to repair it after injury is controversial b. Muscular support is provided by the ilio-tibial band and iliotibial tract c. The tension on the bundles of the anterior cruciate ligament is altered as the knee moves from extension to flexion d. The anterior third of the lateral capsule proved little static support e. The insertion of the popliteus muscle reinforces the posterior third of the lateral capsular ligament

The tension on the bundles of the anterior cruciate ligament is altered as the knee moves from extension to flexion

Which of the following examples therapeutically decreases the pressure on a given area? Use of orthotics to increase the force arm length All of these Prescribing a wearing schedule for a prosthesis Use of closed-cell foam shoe inserts for walking

All of these

The following statements are true of the liver, EXCEPT: a. It is in contact with the under surface of the dome of the diaphragm, thus enjoying the protection of the lower ribs b. It is a solid, reddish brown, pliant organ situated mainly on the left side of the body c. It maintains the amount of glucose present in the body at a constant level d. It is the largest organ in the body weighing about one-fiftieth of the total body weight

It is a solid, reddish brown, pliant organ situated mainly on the left side of the body

Postoperative care of acute knee instability repair after hospital discharge include the following, EXCEPT: a. Immobilization is continued for six weeks, during which time the subject is non-weight bearing b. Muscle strength is gained through such techniques as leg raising, terminal knee extension with leg raises or progressive resistance exercises c. When using free weight in progressive resistance exercises, it is extremely important that his foot and weight rest on a surface and not allowed to dangle free with muscles relaxed when the subjects returns to the 90 degrees flexed position d. ROM should be regained passively because passive techniques tend to stretch excessively the healing ligaments and allow residual laxity e. It is important that the subject not externally rotate the involved leg during early weight bearing in order not to pull apart the repaired ligaments

ROM should be regained passively because passive techniques tend to stretch excessively the healing ligaments and allow residual laxity

Signs of meningeal irritation include the following, EXCEPT: a. Kernig sign is elicited when stretching of the lumbar roots consequent to extension of the leg on the thigh produces painful limitation of this movement b. The best sign is a demonstration of stiffness of the neck on flexion, usually accompanied by fever c. In severe meningitis, there may even be a rigid hyper-extension of the neck and back, but generally, it does not limit lateral rotations of the neck d. Probably based on a heightened sensitivity of irritated sensory roots to stretching e. Brudzinski signs is absent when flexion of the knees follows as attempt to flex the neck

Brudzinski signs is absent when flexion of the knees follows as attempt to flex the neck

These tendons work only in unison. By limiting the three, the fourth is also limited. This is demonstrated by flexing the finger at any given distal IP joint - the subject is then unable to accomplish such individual flexion None of these Flexor digitorum superficialis Flexor digitorum profundus Interossel Lumbricals

Flexor digitorum profundus

If the central slip of the extensor digitorum communis tendon is avulsed from its insertion into the base of the middle phalanx, the proximal interphalangeal joint becomes markedly flexed and the distal interphalangeal joint extended. This deformity is called: Heberden’s Mallet finger Boutonniere Swan-neck Trigger finger

Boutonniere

In-hospital postoperative care in acute knee instability repair include the following, EXCEPT: a. Cast change usually on the 5th postoperative day b. Cast immobilization of the knee at about 60 degrees of flexion c. Toe-touch weight bearing crutch walking as tolerated d. Non-weight bearing crutch walking e. Ankle ROM, quadriceps, femoris muscle setting exercises progressing to straight-leg raising exercises

Toe-touch weight bearing crutch walking as tolerated

The axilla is a quadrilateral pyramidal structure through which vessels and nerves pass to the upper extremity. The following statements apply to the axilla, EXCEPT: a. The apex permit the entry of the brachial plexus and axillary artery b. The medial wall is bound by ribs two to six and the overlaying serratus anterior c. The anterior and posterior wall can be palpated when the arm is abducted and extended d. The anterior wall is formed by the pectoralis major and the posterior by the latissimus dorsi e. The lateral wall is defined by the bicipital groove of the humerus

The anterior and posterior wall can be palpated when the arm is abducted and extended

The following statements are true of the knee joint, EXCEPT: a. Limitation by the two-joint rectus femoris muscle decreases knee flexion ROM when the hip is in flexion b. End-feel for extension or hyperextension is firm c. End-feel for passive knee flexion is soft d. It possesses two degrees of freedom and range of flexion is from 120 to 150 degrees

Limitation by the two-joint rectus femoris muscle decreases knee flexion ROM when the hip is in flexion

These muscles extend the arm and are the chief lateral rotators: Subscapularis and Pectoralis Major Infraspinatus and Teres Minor Supraspinatus and Subscapularis Teres Major and Latissimus Dorsi

Infraspinatus and Teres Minor

In the knee, excessive normal forces resulting in overuse syndrome can be caused by the following, EXCEPT: a. High repetition, high load b. Low repetition, high load c. Activity level is greater than the possible physiological repair d. Poor conditioning e. Small biomechanical dysfunction that becomes magnified with high-performance activities

High repetition, high load

Common manifestations of Myasthenia Gravis include the following, EXCEPT: Weakness of extraocular muscles Weakness of bulbar musculature Weakness of neck extension and of shoulder flexion None of these Ptosis

None of these

Which crutch-walking technique would you choose for patients with leg muscle weakness or spasticity, poor muscular coordination or balance, degenerative leg joint disease, or bilateral prosthesis? Swing through three point gait Four-point gait Three point and one gait (partial weight bearing) Two-point gait

Four-point gait

Main venous drainage of the neck Maxillary vein Anterior jugular vein Internal jugular vein Retromandibular vein

Internal jugular vein

Generalities in knee instability are as follows, EXCEPT: a. None of these b. With an isolated tear of the medial compartment ligaments, the result of the abduction stress test is positive at 30 degrees of knee flexion and negative with the knee in full extension c. All of these d. With an intact posterior cruciate ligament, rotator instability - both single and combined - may occur e. With the posterior cruciate ligament ruptured, straight instability may be found

None of these

The following are true of anterolateral rotator instability of the knee, EXCEPT: a. Refers to posterior subluxation of the anterior tibial plate in an internal rotation direction b. Commonly results from a chronic anterior cruciate during weight bearing may cause a severely painful sensation of the knee’s slipping out of place c. Less commonly, it can be a result of an acute tear of the lateral capsule d. Described to a reduction of the tibia upon the femur after subluxation which usually occurs when there is knee flexed from 10-20 degrees and when the iliotibial band lies anterior to the axis of knee rotation.

Refers to posterior subluxation of the anterior tibial plate in an internal rotation direction

The spinous process of the following vertebrae lie above and below the interspace and since they do not overlap each other and mark the actual levels of the vertebral bodies, they make excellent reference points from which to identify other vertebrae: L4 and S1 L4 and L5 L3 and L4 S1 and S2

L4 and L5

The following statements characterize Moro reflex, EXCEPT: a. Absence of the response in the neonate definitely indicates brain disease b. It is normally present from birth until age 3-4 months c. Loss of the reflex previously present is one of the early signs Kernicterus d. Is indicative of a significant cerebral disorder if present beyond six months

Absence of the response in the neonate definitely indicates brain disease

Facilitated diffusion may be described by the following statements, EXCEPT: a. Carrier proteins are involved in the transport of the substance b. The rate of diffusion is faster than simple diffusion c. The direction of diffusion is driven by electrical or concentration gradients d. ATP cleavage is required e. None of these

ATP cleavage is required

Depending on patient size and transfer method, condition and mobility potential, the following are preferred features in wheelchair selection for arthritis patients, EXCEPT: a. Foot and leg rests are swing detachable with heel loops b. Standard type and standard hand rims c. Toggle brakes and fixed back d. Special type with lever brakes e. Fixed or removable armrests

d. Special type with lever brakes

Characteristics of myotonic dystrophy are as follows, EXCEPT: a. General loss of strength and energy are regularly present and slowness of grip release may be evident b. A quick tap on the thenar eminence results in contraction that is abnormally short, and the thumb abducts for several seconds c. Symptoms commonly appear in adulthood, usually in the third and fourth decades d. No sensory or specific reflex changes are seen e. There is prolonged contraction with posture of the hand

A quick tap on the thenar eminence results in contraction that is abnormally short, and the thumb abducts for several seconds

Injury to the tibial collateral, middle one-third medial capsular, and posterior oblique ligaments may be determined by the following test: **(ABDuction/ADDuction)** stress test at **(15/30/45)** degrees of flexion and the **(external/internal)** rotation anterior drawer sign

**ABDuction** stress test at **30 degrees** of flexion and the **EXTERNAL** rotation anterior drawer sign

The following apply to posterolateral rotator instability of the knee, EXCEPT: a. Caused by a momentary anterior subluxation of the lateral tibial plateau on the lateral femoral condyle b. External rotation recurvatum test is positive because there is excessive hyperextension of the tibia on the femur, with excessive external rotation c. The mechanism of injury is usually a direct blow to the knee from an anteromedial direction d. Resultant injury is characterized by a posterolateral drawer sign e. Injury results in a lesion to the arcuate ligament complex, the popliteal tendon, the fibular collateral ligament, and the lateral head of the gastrocnemius

Caused by a momentary anterior subluxation of the lateral tibial plateau on the lateral femoral condyle

Knee appliance selection is based on the following, EXCEPT; a. There must be a definite need b. The particular device chosen must meet the established need c. The appliance must look reasonably attractive even if not comfortable d. The cost must be affordable e. The appliance must be used in a way that might not injure the subject

The appliance must look reasonably attractive even if not comfortable

In the venous system: a. Blood vessels have smaller diameters than their corresponding arteries b. Mean pressures are higher than in the arterial system c. Blood vessels have greater compliance d. All of these are true e. None of these are true

Blood vessels have greater compliance

The patellar tendon of the quadriceps femoris attaches distally on this large roughened area which is anterior on the tibia and below the tibial condyles. This palpable structure is: None of these Crest of the tibia Tuberosity of the tibia Tibiofemoral joint line

Tuberosity of the tibia

Following statements are true of upper motor neurons, EXCEPT: a. Synapse directly on alpha, beta and gamma motor neurons in the spinal cord and cranial nerve nuclei b. Completely contained within the central nervous system c. Provide final direct link with muscles through myoneural junctions d. Synonymous to corticospinal tract

Provide final direct link with muscles through myoneural junctions

In the cranial cavity, this structures act as the outermost covering for the brain, but also as the lining membrane on the inner surfaces of the bones. It also gives valuable support to the brain, the partitions preventing shifting thereby safeguarding the brain against injury. Pia mater Arachnoid mater None of these Dura Mater

Dura Mater

The following are muscles of mastication, EXCEPT: Medial and lateral pterygoid Masseter Temporalis Orbicularis oris

Orbicularis oris

Characteristics of Facioscapulohumeral dystrophy of Landouzy and Dejerine are as follows, EXCEPT: a. Lordosis is exaggerated b. It progresses quickly, resulting in disability years after onset c. Atrophy of the face become severe d. Atrophy and weakness of the shoulder-girdle muscles are prominent e. Usually appears in the second decade of life and in either sex

It progresses quickly, resulting in disability years after onset

The hip-repair surgical procedure involves removal of a bone wedge to shift weight-bearing stresses away from degenerated cartilage onto healthy cartilage. A blade plate may be inserted for secure fixation and early ambulation Arthrodesis Muscle release Displacement osteotomy Femoral prosthesis Double-cup arthroplasty

Displacement osteotomy

The following statements are true of the Levator Scapulae, EXCEPT: a. It raises the medial border of the scapula b. It is supplied by the axillary nerve (C5 and C6) c. It inserts into the medial border of the scapula opposite the supraspinous fossa d. It is supplied by the third and fourth cervical nerves from the dorsal scapular nerve (C5)

It is supplied by the axillary nerve (C5 and C6)

To distinguish between intrinsic muscle tightness and joint capsule contractures, the involved finger is flexed a few degrees at the metacarpophalangeal joint and moving the proximal interphalangeal joint into flexion. If the joint still does not flex completely: a. The intrinsics are probably loose b. There is no contracture at the proximal joint capsule c. There is probably proximal joint capsule contracture d. The intrinsic are probably tight e. None of these applies

There is probably proximal joint capsule contracture

The following are true of the sciatic nerve, EXCEPT: a. Tenderness of the nerve may be due to a herniated disc in lumbar spine, a piriformis muscle spasm or direct trauma to the nerve itself b. Located midway between the greater trochanter and the ischial tuberosity c. Tenderness elicited during palpation of the tuberosity may possibly result from ischial bursitis d. It is covered by the gluteus maximus when the hip is flexed

It is covered by the gluteus maximus when the hip is flexed

The middle trunk of the brachial plexus is formed by the roots of: C6, C7, and T1 C6 and C7 C5 and C6 C5, C6, and C7

C6 and C7

The following statement allow soft tissue palpation of certain structures, EXCEPT: a. The pulse of the brachial artery can be felt directly medial to the biceps tendon b. Have the subject make a fist as resistance is offered to the dorsum of his hand to accentuate the extensor carpi radialis longus and brevis c. If the subject places his closed fist (in supination) under the edge of a table and tries to lift the table, the Brachioradialis tendon and its muscle belly becomes accessible for palpation d. To make the brachioradialis more prominent for palpation, have the subject close his fist, place in neutral position under the edge of a table then lift up against the weight of the table.

If the subject places his closed fist (in supination) under the edge of a table and tries to lift the table, the Brachioradialis tendon and its muscle belly becomes accessible for palpation

This instability occurs with a tear of the posterior cruciate ligament and both the medial and lateral capsular ligaments. The results of the anterior test, in which both condyles are subluxed anteriorly an equal amount with no rotation is positive. Anterior Instability None of these Posterior instability Lateral instability Medial Instability

Anterior Instability

Pronation and supination occurs mainly at this joint: Humero-ulnar joint Humero-radial joint Radio-carpal joint Radio-ulnar joint

Radio-ulnar joint

Fat embolism is a common complication of long-bone fractures or surgery, or multiple fractures. The following statements apply to fat embolism, EXCEPT: a. Does not affect the central nervous system b. If signs and symptoms worsen, the patient may require endotracheal intubation and mechanical ventilation c. Severe cases may lead to coma and death, however, signs and symptoms may remain subtle and undetected d. Signs and symptoms usually occur within 24 to 72 hours following fractures or surgery, but may appear to 7 to 10 days after it e. An accumulation of fat particles (emboli) which obstruct blood flow and cause inflammatory reactions around affected blood vessels

Does not affect the central nervous system

The act of inspiration increase the capacity of the thoracic cage in which principal direction: a. Increase in the transverse diameter due to the ribs swinging outwards b. Increase in the anteroposterior diameter by the sternal body which is hinged at the sternal angle, swinging forwards c. Increase in vertical diameter due to the descent and flattening of the dome of the diaphragm d. All of these movements

All of these movements

This artery enters the upper arm on the medial side of the humerus and is accompanied throughout its course by the median nerve: Ulnar artery Vertebral artery Radial artery Brachial artery

Brachial artery

In apparent leg length discrepancy, the following are true, EXCEPT: a. Poliomyelitis may result in apparent leg length discrepancy b. Apparent shortening may stem from pelvic obliquity or from adduction or flexion deformity in the hip joint c. Measurement is taken from the umbilicus to the medial malleoli of the ankle d. Pelvic obliquity manifests itself as uneven anterior or posterior iliac spines while the patient is standing

Poliomyelitis may result in apparent leg length discrepancy

The shoe is a showcase for certain disorders of the foot. The following are examples, EXCEPT; a. Creases of the forepart of the shoe that are markedly transverse, indicate possible hallux rigidus b. Absence of creases on the forepart of the shoe indicate no toe off c. Shoes of an individual with a drop foot display scuffed toes from scrapping the floor in swing phase d. Shoes of subjects of who toe-in show excessive wear on the lateral border of the sole e. Shoes of individuals with flat feel usually have broken lateral borders due to the prominence of the talar head.

Creases of the forepart of the shoe that are markedly transverse, indicate possible hallux rigidus

The following statements are true of the anatomic snuffbox, EXCEPT: a. The radial border is composed of the abductor pollicis longus and the extensor pollicis brevis tendons b. Any tenderness elicited on the floor of the snuffbox suggest a fracture c. It lies just dorsal and distal to the radial styloid process d. The ulnar border is the extensor pollicis brevis tendon and the floor of the navicular bone e. The terminal branches of the superficial radial nerve are also palpable where they cross the extensor pollicis longus tendon

The ulnar border is the extensor pollicis brevis tendon and the floor of the navicular bone

This connective tissue filament passes through the subarachnoid space to the end of the dura and continues its attachment to the coccyx. It is a caudal continuation of the pia meter. Coccyx Cauda equina Filum terminale Conus medullaris

Filum terminale

Which statement does not apply to the posterolateral drawer sign? a. When the tibia is in external rotation, the sign is positive b. The test is performed in the usual drawer fashion with the knee in 70 to 80 degrees of flexion c. The tibia is internally or externally rotated as well as being positive in neutral position d. Confirms a posterolateral rotator instability of the knee e. The sign is negative if the tibia is in internal rotation because of the intact posterior cruciate ligament

The tibia is internally or externally rotated as well as being positive in neutral position

Abduction and adduction occurs in this plane, and divided the body into front and back Sagittal Plane Horizontal Plane None of these Frontal plane

Frontal plane

Ingestion of extremely small vesicles containing extracellular fluids: None of these Mitosis Pinocytosis Phagocytosis

Pinocytosis

If patients develop gas gangrene, or persistent osteomyelitis, hyperbaric oxygen therapy may be ordered. The following statements apply to hyperbaric oxygen therapy, EXCEPT: a. Administering 100% oxygen at pressures higher than three times of sea level can cause central nervous system toxicity b. Repeated treatment in a multiple chamber may result in complications i.e, pneumothorax, air embolism, CNS, and pulmonary in toxicity c. Provides an oxygen-rich environment to help destroy the anaerobic organism that causes gas gangrene d. Increasing the barometric pressure inside the chamber result in ½ or ⅓ the concentration e. The patient receives 100% oxygen concentration in a specially designed chamber at great than normal atmospheric pressure

Increasing the barometric pressure inside the chamber result in ½ or ⅓ the concentration

Electrical stimulation of the primary somasthetic area will give rise to: Olfactory sensation Cutaneous sensation Visual sensation Auditory sensation Muscle twitch

Cutaneous sensation

Central nervous system toxicities usually precede pulmonary toxicities, and are indicated by apprehension, visual changes, muscular twitches and convulsions. Both statements are true Both statements are false First statement is false, second statement is true First statement is true, second statement is false

Both statements are true

Dysphagia, dysphonia and regurgitation of food into the nose on swallowing is a result of bilateral lesion to this nerve: Glossopharyngeal nerve Hypoglossal nerve Accessory nerve Vagus nerve

Vagus nerve

Which of the following compounds when dissolved in solution produces the greatest osmotic pressure? 100 mM CaCl2 None of these They will generate the same osmotic pressure 100 mM NaCl 100 nM glucose

100 mM CaCl2

Ligament and capsular structures work as a system, interdependent and related to one another. Functional stability is provided by the following factors, EXCEPT: Joint geometry Active restraints generated by the muscles Passive restraints of the ligaments Passive restraints by muscles Joint compressive forces that occur with activity and force the joint together

Passive restraints by muscles

The various physiologic mechanisms of the body strive to achieve constancy of the following characteristic/s of the internal environment All of these Temperature and pH Osmolality Pressure Temperature

All of these

The following statements depict the distribution of some spinal segment and roots, EXCEPT: a. The twelfth thoracic segment is at the groin level b. The third thoracic segment is at nipple level c. The sacral dermatomes innervate the saddle area d. The tenth thoracic segment is at the umbilicus level e. The anterior neck and upper shoulder are innervated by the cervical plexus, largely C4

The third thoracic segment is at nipple level

The following may be observed upon examination of the patient’s lumbar spine, EXCEPT: a. Soft, doughy lipomata appearing as lumps in the area of the low back may be a sign of spina bifida b. Any reddened dislocation may indicate infection, and skin markings may denote underlying neurologic or bone pathology c. Pedunculated tumors indicate the presence of neurofibromatosis and are often accompanied by cafe-u-lait spots which may impinge upon the spinal cord and nerve roots d. An unusual patch of hair on the back may be evidence of some body defect in the spine such as a congenital bony bar e. Gibbus deformity may bone present secondary to a herniated disc

Gibbus deformity may bone present secondary to a herniated disc

Which of the following is true of the Hamstring? All of these None of these They extend the hip and/or flex the knee Rotates the knee joint when the joint is fully extended

They extend the hip and/or flex the knee

This method of bandaging is used to accommodate either increasing or decreasing body part circumstances: Spiral turn Figure-eight turn Circular turn Spiral-reverse turn Recurrent turn

Spiral-reverse turn

The following statements describe the foot’s medial aspect, EXCEPT: a. The sustentaculum tali supports the calcaneus and serves as an attachment for the spring ligament; problems within this anatomic alignment may lead to pes planus b. The first cuneiform bone projects distally nearly half an inch further than the other cuneiform bones and articulates laterally with the cuboid bone c. The medial tubercle of the talus is the point of insertion for the ankle’s medial collateral ligament d. The first metatarsal flares lightly at its base to meet the first cuneiform, articulating in a simple plane joint, providing gliding movement e. The navicular articulates proximally with the talar head and distally with the three cuneiforms

The sustentaculum tali supports the calcaneus and serves as an attachment for the spring ligament; problems within this anatomic alignment may lead to pes planus

The forces at the pelvis in bilateral stance is an example of: Second class lever Fourth class lever First class lever Third class lever

Second class lever

This muscle attaches to the medial border of the scapula and passes under the scapula to attach on the anterolateral border of the first nine ribs: Teres Major Subscapularis Teres Minor Serratus Anterior

Serratus Anterior

Immediately below the sacro-iliac joint, the greater sciatic notch allows which nerve to pass: Sciatic nerve Common peroneal nerve Gluteal nerve Femoral nerve

Sciatic nerve

Complete denervation of the abducens nerve result in the following, EXCEPT: The subject cannot turn the eyes outward beyond the midline Horizontal diplopia Internal strabismus Loss of downward movement ocular movement when the eye is turned toward the nose

Loss of downward movement ocular movement when the eye is turned toward the nose

The cortex is not smooth but is thrown into folds and furrows that markedly increase the total surface area without demanding greater brain volume. Each fold or grounded elevation is known as: Sulcus Hemisphere Gyrus Lobe

Gyrus

The following statements describe the patella, EXCEPT: a. Originally only a sesamoid bone in the quadriceps tendon b. The depth of the patella femoral groove and height of the lateral femoral condyle buttress the patella against lateral dislocation c. The medial patellafemoral ligaments helps prevent its medial displacement d. The chief active stabilizer is the vastus medialis oblique (VMO) muscle e. Passive stabilization is provide by the bony contours of the femoral sulcus and the configuration of the patella as well as by thickenings of the capsule

The medial patellafemoral ligaments helps prevent its medial displacement

Several peripheral nerves have some capacity to repair itself, and axis cylinders sprout from nerve endings at a rate of 1 to 2 mm per day, some going astray. Chance determines whether connections can be reestablished and function restored: Both sentences are false Both sentences are true The first sentence is false, the second sentence is true The first sentence is true, the second sentence is false

Both sentences are true

The following statements apply to micro trauma, EXCEPT: a. May be caused by abnormal forces that occur about the knee, i.e., unaccustomed walking particularly uneven terrain b. May be caused by abnormal biomechanics of the lower extremity kinetic chain, i,e., when excessive compensatory pronation causes excessive medial transverse plane rotations at the knee c. A series of inflammatory reactions to submaximal loading that eventually produces clinical signs and symptoms d. May be caused by excessive normal forces (overuse syndrome) about the knee, i,e., the different biochemical forces that occur during walking, jogging, and running

May be caused by abnormal forces that occur about the knee, i.e., unaccustomed walking particularly uneven terrain

Following are example of Force Couple, EXCEPT: a. Abduction at the glenohumeral joint from the deltoid and supraspinatus contracting together b. None of these c. Abduction and upward rotation of the scapula from the combined forces of the trapezius, serratus anterior d. All of the these

All of the these

Following denervation atrophy, how long before loss of functional return becomes no longer possible: None of these 1-2 years Up to three months 2-3 years

1-2 years

In this maneuver, with the patient in supine, the legs are raised straight two inches from the table and held as long as he can; if he can hold the position for 30 seconds within the pain, intrathecal pathology may be ruled out Gaenslen’s Sign Milgram Test Hoover’s Test Patrick Test Naffziger Test

Milgram Test

The following statements apply to condylar fractures of the knee, EXCEPT: a. Usually there is anterior displacement of the distal fragment caused by the muscular action of the gastrocnemius muscles as well as a reduction of the femoral length by the action of the hamstring and the quadriceps femoris muscle b. Single condylar fracture often occur from severe varus or valgus forces and the fracture line may be vertical and in the sagittal plane or it may be vertical and in the coronal plane c. Prolonged, rigid immobilization is usually unnecessary, but full weight bearing is usually restricted during the three months following the injury d. Supracondylar fractures may be caused by direct trauma or by a torsion stress placed upon the lower extremity e. Femoral condyles are rarely injured, and fractures of the femur may be of the “Y” or “T” type and usually include soft tissue damage

Usually there is anterior displacement of the distal fragment caused by the muscular action of the gastrocnemius muscles as well as a reduction of the femoral length by the action of the hamstring and the quadriceps femoris muscle

Which crutch-walking technique would you choose for patients with spina bifida, paraplegia or myelomeningocele? Two-point gait Four-point gait Swing-through three-point gait Three-point-gait (non-weight-bearing) Three-point-and-one-gait (partial-weight-bearing)

Swing-through three-point gait

The hip-repair surgical procedures replaces the degenerated femoral head with an intramedullary prosthesis: Muscle Release Arthrodesis Femoral Prosthesis Displacement Osteotomy Double-up arthroplasty

Femoral Prosthesis

Projection neurons of the cerebellar cortex whose long axons synapse either on deep nuclei or vestibular nuclei: None of these Stellate cells Purkinje cells Glomeruli

Purkinje cells

The following signs and symptoms generally accompany a fracture, EXCEPT: a. Deformity but no shortening in the injured area b. Decreases of complete loss of muscle power in the injured area c. Localized discoloration and edema d. Presence of grafting sound when testing for ROM during assessment e. Presence of crepitation during skin palpation

Deformity but no shortening in the injured area

This crease lies at the base of the fingers and marks the location of the proximally pulley. Distal palmar crease Hypothenar crease Proximal interphalangeal crease Thenar crease Proximal palmar crease

Proximal palmar crease

This instability occurs with a disruption of all of the lateral compartment capsular ligaments. The iliotibial band may be torn. The posterior cruciate ligament remains intact. The result of the adduction test is positive with the knee at 30 degrees of flexion. Combined anterolateral and posterolateral rotatory instability Combined posterolateral and anteromedial rotator instability None of these Combined anterolateral and anteromedial rotatory instability Anterior instability

Combined anterolateral and posterolateral rotatory instability

The ability to repeatedly execute the same movement over a period of time: Endurance Muscle Tone Motor Control Strength

Endurance

Which of the following statements is true when testing for rigid or supple flat feet? a. While standing on feet and seated, if medial longitudinal arch absent in some positions, subject has flat feet. If present and absent only when he stands, flat feet are supple and correctable with longitudinal arch supports. b. While standing on toes and seated, if medial longitudinal arch is absent in all positions, subject has flat feet. If arch is absent and present only when he stands, flat feet are supple and correctable with longitudinal arch supports. c. While standing on toes, if medial longitudinal arch is absent in all positions, subject has flat feet. If present and absent only when he stands, his flat feet are supple and correctable with longitudinal arch supports d. While standing on toes and seated, if the medial longitudinal arch is absent in all positions, subject has flat feet. If present and absent only when he stands, his flat feet are supple and correctable with longitudinal arch supports e. While standing on toes and seated, if medial longitudinal arch is absent in all positions, subject has flat feet. If arch is present and absent only when he stands, flat feet are supple and correctable with longitudinal arch supports.

While standing on toes and seated, if medial longitudinal arch is absent in all positions, subject has flat feet. If arch is present and absent only when he stands, flat feet are supple and correctable with longitudinal arch supports.

The upper extremity is attached to the trunk only at this joint: Glenohumeral Sternoclavicular Acromio Clavicular Scapulothoracic

Sternoclavicular

During the Stance Phase of Gait, subject may exhibit the following, EXCEPT: a. Subjects with weakness of L5 distribution may have an abductor lurch b. Subject with S1 distribution weakness may have an abductor lurch c. Subject with muscle weakness of S1 and S2 distribution may have a flat foot with no forceful toe-off d. Subject with a L2-L4 distribution weakness may walk with a back knee gait to lock their knees in extension

Subject with S1 distribution weakness may have an abductor lurch

The deltoid is innervated by: Suprascapular nerve (C5, C6) Dorsal Scapular Nerve (C3, C5) Axillary Nerve (C5, C6) Subscapular nerve (C5, C6)

Axillary Nerve (C5, C6)

This piece of equipment is commonly added to the traction equipment overhead framework and when indicated provides the patient with a grasping device that promotes mobility and some independence, expediting daily care: Plain Bar Pulley Bumper Ball Trapeze Spreader Bar

Trapeze

Supplied by the femoral nerve, this neurologic level spans the anterior thigh immediately at and above the knee joint: L4 S1 S2 L3 S2

A patient has been admitted to your hospital with severe lower back pain. The patient will be placed in a pelvic belt for intermittent traction. The following applies to proper pelvic belt application, EXCEPT: a. Although pelvic traction may be applied directly on the skin, it may also be applied over clothing made of cotton (for better traction) and wrinkle-free (to avoid excessive pressure on the skin) b. The patient may be placed in Williams position with hips flexed 30° and knees flexed 30° as part of daily care c. The straps must be parallel to each other and to the patient’s thighs when attached to the traction cords d. The free ends of the belt are wrapped around the hip bone so the iliac crests are covered

The patient may be placed in Williams position with hips flexed 30° and knees flexed 30° as part of daily care

In polyradiculoneuropathy, the following statements are true, EXCEPT: a. In acute post infection polyradiculoneuropathies, the early weakness may be more evident in the girdle musculature b. Hands and feet may become quite sensitive and painful to squeezing, slapping and temperature changes c. Sweating is lost when parasympathetic denervation is complete d. Signs may be somewhat asymmetric

Sweating is lost when parasympathetic denervation is complete

The following are characteristics of the lateral collateral ligament of the ankle joint, EXCEPT: a. The anterior talofibular ligament has a high incidence of sprain because it is the first to undergo stress when the ankle is inverted and plantar flexed b. The posterior talofibular ligament is the strongest of the lateral collateral ligaments, and its primary function is prevent forward slippage of the fibula onto the talus c. The calcanofibular ligament stretches plantarward to its insertion into the lateral wall of the calcaneus d. The peroneous longus and brevis tendons are the primary foot evertors and they assist in plantar flexion e. In severe ankle sprain, the calcaneofibular ligament may be torn, but only after the anterior talofibular ligament has also been born

The peroneous longus and brevis tendons are the primary foot evertors and they assist in plantar flexion

The axillary nerve and radial nerve are second branches of the: Anterior cord Lateral cord Posterior cord None of these Medial cord

Posterior cord

The following statements are true of the Tunnel of Guyon, EXCEPT: a. Site for compression injuries b. A fibro-osseous tunnel on the depression between the pisiform and the hook of the hamate converted by the pisohamate ligament c. Clinically significant because it contains the ulnar nerve and artery d. The area is usually tender if there is pathology present e. The ulnar nerve and artery are distinctly palpable under the layer of soft issue covering the tunnel

The ulnar nerve and artery are distinctly palpable under the layer of soft issue covering the tunnel

The following statements are true of the brachialis, EXCEPT: a. It is an elbow flexor b. It is innervated by Musculocutaneous nerve c. When the forearm is supinated, the brachialis flexes the elbow with little participation from the biceps d. It is proximal attachment is halfway up the shaft of the humerus

When the forearm is supinated, the brachialis flexes the elbow with little participation from the biceps

Injury to the spinal accessory nerve results in the following, EXCEPT: a. Downward and outward rotation of the upper part of the scapula b. Weakness in rotating the head to the opposite side c. Sagging and weakness in shrugging the shoulder d. The tongue deviates to the paralyzed side

The tongue deviates to the paralyzed side

The following statements are true of the Trigeminal Nerve, EXCEPT: a. It branches into three major divisions: Opthalmic, Maxillary and the Mandibular b. It is the sensory nerve of the face, mouth, teeth and nose c. This is also the Sixth cranial nerve d. It is the motor nerve to the four muscles of mastication

This is also the Sixth cranial nerve

The elicitation of a motor response means that the arc is intact and conducting impulses. The absence of a response does not have the converse meaning, since normal or abnormal neural influences may suppress the reflex: First sentence is true, the second sentence is false Both sentence are true First sentence is false, the second sentence is true Both sentence are false

Both sentence are true

Which of the following characterize of the Golgi Tendon Organs: a. They reside within muscle tendons near the point of attachment of the muscle fiber to the tendon b. All of these c. Small bundle of muscle fibers produce tension that stimulate these organs d. These organs discharge nerve impulses that are transmitted over large, rapidly conducting afferent axons to the spinal cord and cerebellum

All of these

A fracture with cord transaction at the C6 level will produce the following, EXCEPT: a. The subject is parasympathetic, ileus appears and the urinary bladder distends b. Breathing is diaphragmatic c. There is complete sensory loss below the C6 or C7 dermatome d. An immediate flaccid paralysis of the trunk and extremities sparing some shoulder movement and flexion at the elbows e. At a later stage, reflexes in this zone will be reduced or absent, whereas those mediated through intact cord segment below will be hyperreflexic

The subject is parasympathetic, ileus appears and the urinary bladder distends

Capillary networks surrounded by cuboidal or columnar epithellum that forms the cerebrospinal fluid: Choroid plexuses Foramina of Luschka Cerebral Aqueduct Interventricular foramina

Choroid plexuses

Which of the following is true in ankle dorsiflexion test? a. If you are able to achieve ankle dorsiflexion when the knee is flexed, the soleus muscle is the limiting factor. If the gastrocs is responsible for the limited motion, the limitation will be the same whether or not the knee is flexed b. If you are able to achieve ankle dorsiflexion when the knee is flexed, the gastrocs muscle is the limiting factor. If the soleus is responsible for the limited motion, the limitation will be the same whether or not the knee is extended c. If you are able to achieve ankle, dorsiflexion when the knee is the limiting factor. If the soleus is responsible for the limited motion, the limitation will be the same whether or not the knee is flexed d. If you are able to achieve ankle dorsiflexion when the knee is extended, the gastro muscle is the limiting factor. If the soleus is responsible for the limited motion, the limitation will be the same whether or not the knee is extended e. If you are able to achieve ankle dorsiflexion when the knee is extended, the gastro muscle is the limiting factor. If the soleus is responsible for the limited motion, the limitation will be the same whether or not knee is flexed

b. If you are able to achieve ankle dorsiflexion when the knee is flexed, the gastrocs muscle is the limiting factor. If the soleus is responsible for the limited motion, the limitation will be the same whether or not the knee is extended

Example of ATP use by the cell: All of these Supply energy for the transport of Na through the cell membrane Supply the energy needed during muscle contraction Promote proteins synthesis by the ribosomes

All of these

The stability of the wrist joint principally depends on: Extrinsic muscles of the hand Capsule Ligaments Intrinsic muscles of the hand

Ligaments

Injury to the Median nerve at the level of the elbow results in the following condition, EXCEPT: a. The ring and little fingers extend b. Making a fist results in the index and middle finger tending to remain straight c. Thenar eminence is flattened and due to paralysis and wasting d. Paralysis of the pronator muscles of the forearm and the long muscles of the wrist and fingers, except the flexor carpi ulnaris and medial half of the flexor digitorum

The ring and little fingers extend

The following statements are true of balanced suspension traction, EXCEPT: a. A hammock or splint, such as a Thomas splint with Pearson attachment is an example of this type of Traction b. The weight that suspends the affected extremity is greater than the weight of the counter traction being applied c. This assembly allows more range of motion than other forms of ration without affecting the line of traction pull d. Most commonly used to support the leg injuries such as femoral fractures with displacement, and nonaligned bone fragments e. This assembly promotes neurovascular integrity by decreasing prolonged pressure on the back of the patient’s leg.

The weight that suspends the affected extremity is greater than the weight of the counter traction being applied

The following is true of the Brachioradialis, EXCEPT: a. It is inserted by a long tendon on the base of the styloid process of the radius b. The nerve supply is via the radial nerve, a terminal branch of the brachial plexus c. It devotes itself entirely to the elbow d. It is a strong flexor of the elbow only with light loads or during slow flexion

It is a strong flexor of the elbow only with light loads or during slow flexion

The following are true of muscle contraction efficiency, EXCEPT: a. Less than 20-25% of input energy to the muscle can be converted into muscle work b. Minimal efficiency is achieved when velocity contraction is about 30% of maximum c. Large amount of maintenance heat are released even though the muscle performed little or not work d. Low efficiency is because about half of nutrient is lost in the formation of ATP

Minimal efficiency is achieved when velocity contraction is about 30% of maximum

The height of a specific vertebrae may be used to determine the following landmarks, EXCEPT: a. C3-level with hyoid bone b. T4-height of the junction between the manubrium and body of sternum c. C4 and C5-level with thyroid cartilage d. All of these

b. T4-height of the junction between the manubrium and body of sternum

The lateral arm and axillary nerve are supplied by neurologic level: C6 C5 C8 T1 C7

An abnormal contraction occurring in denervated muscle fibers after motor neurons have been destroyed, in which individual muscle fibers contract in an unsynchronized manner, producing muscle flutter but no effective movement Tetanic contraction Convulsion Fasciculation Fibrillation Twitch

Fibrillation

External fixation is considered as an alternative for the following reason: a. Internal fixation might increase soft tissue damage because of the surgical procedure involved b. All of these c. Casting probably won’t provide adequate visualization of an open wound or access for treatment of an open fracture d. Bone fragments in comminuted fractures won’t provide adequate anchoring for a pin or plate e. Traction would reduce and immobilize the area securely, but would place the patient at great risk of immobility complications

All of these

The following statements apply to the femoral nerve, EXCEPT: a. Proximal lesions will result in weakness of thigh extension but most prominently loss of knee flexion b. Sensory distribution include the anteromedial thigh and the anteromedial leg to the foot c. Most common syndrome involving this nerve is a painful mononeuritis which occurs in diabetics d. The quadriceps muscle atrophies quickly, the knee jerk is lost early e. Arises from L1 to L4 spinal roots, and innervates the Iliopsoas, Sartorius and quadriceps femoris muscle

Proximal lesions will result in weakness of thigh extension but most prominently loss of knee flexion

Deep somatic pain is transmitted by: C fibers D fibers B fibers A fibers

C fibers

The following statements are true of the ulnar styloid process EXCEPT: a. It articulates with the proximal carpal row to take part in wrist articulation b. It does not extend as far distally and it is more prominent and thicker than its radial counterpart c. The external carpi ulnaris tendon runs through its groove d. In the anatomic position, it is both medially and posteriorly located in the wrist e. It is the most easily palpated when the hand is radially deviated and the tendon is contracted

It articulates with the proximal carpal row to take part in wrist articulation

Upon inspection of the lumbar spine from the side, which of the following observation is NOT TRUE? a. If the spine exhibits an exaggerated curve, the anterior abdominal muscles may be weakened b. Increased lumbar lordosis may also be caused by a fixed flexion deformity of the hip c. An absence of the normal lordosis may suggest paravertebral muscle spasms d. Pelvis obliquity is evident when the two dimples overlying the posterior iliac spine directly above the buttocks lie along the same horizontal plane e. Excessive lordosis occasionally substitutes for true hip extension

Pelvis obliquity is evident when the two dimples overlying the posterior iliac spine directly above the buttocks lie along the same horizontal plane

At the atlanto-occipital joint, the head is balanced by the pull of neck extensor muscles. This is an example of: First class lever Second class lever Third class lever Fourth class lever

First class lever

An example of a synovial pivot joint: a. Glenohumeral joint b. Juncture between the thumb’s metacarpal bone and the wrist’s trapezium c. Joint between the atlas and axis d. Juncture between the radius and carpal bone of the wrist

Joint between the atlas and axis

Which of the following is NOT true of the Temporomandibular joint: a. The center of this movement is near the midpoint of the ramus and not at the joint b. When the mouth is closed, the convex condyle rides forward on to the articular eminence c. As the mouth is opened, the head of the mandible moves forwards and the ankle moves backwards d. The joint can be felt and its movement appreciated by the palpating finger

When the mouth is closed, the convex condyle rides forwards on to the articular eminence

Mean arterial pressure is expected to increase if: None of these Stroke volume increases Calcium-channel blockers are administered Cardiac output decreases There is generalized vasodilatation

Stroke volume increases

Accurate diagnosis forms the cornerstone for any discussion of ligamentous knee problems. The pertinent tests for anteromedial rotatory instability are the: **(ABDuction/ADDuction)** Stress Test at **(30/45)** degrees and the **(External/Internal)** rotation anterior drawer sign

**ABDuction** stress test at **30** degrees of flexion and the **EXTERNAL** rotation anterior drawer sign

The following statements apply to the median nerve, EXCEPT: a. Sensory loss involves the palmar surface of the hand and fingers b. These is conspicuous atrophy of the thenar eminence with flattening of the pal c. Partial injuries are often painful and paresthetic and causalgia may occur d. Interrupt at the elbow produces weakness of wrist flexion with median deviation e. Carries fibers from the C6, C7, C8, & T1 roots

d. Interrupt at the elbow produces weakness of wrist flexion with median deviation

The following characterizes straight anterior knee instability, EXCEPT: a. Injury is sustained while twisting, decelerating of changing direction b. May involve external rotation of the tibia with knee flexed c. May involve forward rotation of the tibia with knee extended or slightly flexed d. Subject usually hears a pop at the time of injury but still able to continue the activity e. Gross swelling develops within 12 hours

Subject usually hears a pop at the time of injury but still able to continue the activity

The following statements describe the medial tubercle of the foot, EXCEPT: a. Gives attachment to the abductor hallucis muscle medially and to the flexor digitorum brevis muscle and the plantar aponeurosis anteriorly b. It lies on the medial plantar surface of the calcaneus c. Heel strike may altogether be avoided during gait when there is pain on the os calcis d. Unlike the lateral tubercle which is weight bearing the medial tubercle of the calcaneus is not e. A heel spur can cause it to become tender to palpation

Unlike the lateral tubercle which is weight bearing the medial tubercle of the calcaneus is not

When a muscle is the principal agent in producing a desired movement, it is said to be a: Antagonist Fixators Prime mover Synergist

Prime mover

If the neck-shaft angle of the femur is less than 125 degrees, this deviation results in decreases leg length and muscle strength due to torque changes from changes in muscle lever arms and length-tension relationships Retroversion Anteversion Coxa vara Coxa valga

Coxa vara

They function in the synthesis of protein cells and are composed of a mixture of ribonucleic acid and proteins: Peroxisomes Ribosomes Glycoproteins Lysosomes

Ribosomes

Sensory perception of pain, may occur in amputated limb as part of a patient’s attempts to cope with loss of his limb: Phantom Pain Acute Pain Superficial Pain Chronic Pain

Phantom Pain

The following statements describe care of meniscal injuries, EXCEPT: a. Subjects with horizontal cleavage tears of the menisci often remain asymptomatic b. Flexion-extension exercises strengthen the quadriceps femoris mechanism c. Subjects with vertical tears of the menisci do not heal, but increased strength and flexibility around the knee may allow continued activities until the appropriate surgical procedure is performed d. Short-arc (terminal extension) or straight-leg raises cannot be substituted if full-arc exercises cause pain

Short-arc (terminal extension) or straight-leg raises cannot be substituted if full-arc exercises cause pain

The following statements describe a biceps reflex response, EXCEPT: a. A deep tendon reflex transmitted to the cord as far as the anterior horn cell and returning to the muscle via the peripheral nerve b. A slight response suggests the neurologic level deficient in its innervations of the biceps c. A decreased response may be caused by a lower motor neuron lesion, e.g. PNI secondary to an herniated cervical disc d. If there is no perceptible response after several attempts, there may be a lesion on the neurologic level anywhere from the root to the innervations of the biceps e. An excessive response may be a result of an upper motor neuron lesion, e.g., CVA

A slight response suggests the neurologic evel deficient in its innervations of the biceps

A common developmental abnormality, it is a partial or complete failure of the posterior neuropore: Ependyma Neural folds Spina bifida Neural groove

Spina bifida

This articulation in the elbow joint permits pronation and supination Proximal Radioulnar Joint Radiohumeral Joint Ulnohumeral Joint None of these

Proximal Radioulnar Joint

The following statements apply to the 7th cranial nerve, EXCEPT: a. Innervates the musculature of the face and the platysma b. The platysma is tested by pulling down the corners of the subject’s mouth c. Minor degrees of unilateral weakness are often best seen at rest or during expressional changes during the conversation and in blinking d. This nerves via its division called the chords tympani conveys the taste from the posterior tongue e. The strength of the frontalis can be estimated by smoothing the wrinkles with the fingers

This nerves via its division called the chords tympani conveys the taste from the posterior tongue

The following statements apply to the sciatic nerve, EXCEPT: a. Innervates the hamstring muscles, the adductor magnus and all the musculature below the knee b. There are two principal division, the posterior tibial and the common peroneal c. Carries fibers from the L4, L5, S1 and S2 roots d. Interruption of the nerve will weaken the extension and adduction of the thigh and paralyze flexion of the knee and all movement below the knee e. Ankle jerk is lost and sensory loss involves and dorsal aspect of the leg and the lateral dorsum and sole of the foot

Ankle jerk is lost and sensory loss involves and dorsal aspect of the leg and the lateral dorsum and sole of the foot

The following positions describe the examination the reflexes, EXCEPT: a. With the subject standing, the hands are placed on hips with arms akimbo, tests for the triceps reflex b. With the subject kneeling, the triceps surae stretch reflex is tested with one hand position on the ball of the foot stretching the muscle slightly and tapping quickly and gently c. With the subject’s feet flat on the floor, hold one hand on the distal thigh and strike the tendon just below patella to test for quadriceps stretch reflex d. In the ankle joint, clonus is elicited by briskly but gently dorsiflexing the ankle increasing pressure against the sole e. Striking the examiner’s thumb on the biceps tendon with the elbow flexed at varied degrees for best response is assumed for biceps stretch reflex

In the ankle joint, clonus is elicited by briskly but gently dorsiflexing the ankle increasing pressure against the sole

The following mechanisms occur in a platelet plug, EXCEPT: Platelets begin to swell when they come in contact with a damaged vascular surface By itself, it can stop blood flow even of the hole in a vessels is large Assume irregular forms They stick to the collagen fibers

By itself, it can stop blood flow even of the hole in a vessels is large

The spinal portion of the cranial nerve innervates the sternomastoid and trapezius muscles Accessory nerve Glossopharyngeal nerve Vagus nerve Hypoglossal nerve

Accessory nerve

The following is true in a nonunion fracture complication, EXCEPT: a. To improve circulation, holes may be drilled near the fracture site and bone grafting may be performed to supply bone tissue b. A pseudarthrosis may form at the fracture site, causing excessive joint mobility c. There may be increased joint motion proximal and distal to the fracture site d. May be treated with an orthotic device in combination with increased activity to improve blood supply to the site d. There may be gradual muscle atrophy, and pain with weight bearing

There may be increased joint motion proximal and distal to the fracture site

The following statements are true in Reduction Click, EXCEPT: a. The test is done by flexing the knee while it is rotated both internally and externally, then rotation and flexing the leg until the meniscus slips back and a characteristic “click” is hear b. This is similar to the McMurray test in that it can also unlock the knee joint and produce the reduction click c. Applicable to those patients having a locked knee due to a torn, dislocated, or “heaped up” meniscus d. The test will unlock the knee caused by a torn meniscus and permit full extension e. The object of the procedure is to reduce the displaced or torn portion of the meniscus by clicking it back into place

The test is done by flexing the knee while it is rotated both internally and externally, then rotation and flexing the leg until the meniscus slips back and a characteristic “click” is hear

This test is used to detect pathology in the hip and sacro-iliac joint. Inguinal pain is a general indication that there is pathology in the hip joint or surrounding muscles Hoover Test Beevor’s Sign Faber Test Gaeslan’s Sign Naffziger Test

Faber Test

The following statements are true when functional deficits are exclusively below a horizontal line at right angle to the spinal neuraxis, EXCEPT: a. Diffuse tract disease may give no clear level b. Suspicion of spinal cord dysfunction is appropriate c. Multiple focal lesions of the cord may give multiple levels d. Diffuse cerebral disease of midline cerebellar (vermis) lesions may produce predominantly sensory dysfunction and ataxia in the lower extremities e. Signs of neuropathy or motor neuron disease can be limited largely to the legs

Diffuse cerebral disease of midline cerebellar (vermis) lesions may produce predominantly sensory dysfunction and ataxia in the lower extremities

The following are type of end feel (according to Cyriax), EXCEPT: Capsular feel Spasm Springy block Bone of muscle

Bone of muscle

A movement disorder resulting from disease of the basal striatum and characterized by jerky, rapid, irregular flow of motions and grimacing movements of the face: Athetosis Chorea None of these Parkinson’s Disease

Chorea

The following describes the medial meniscus, EXCEPT: a. Situated on top of the tibia on the medial plateau b. Its anterior end attaches to the non-articular portion of the top of the tibia, in feat of the anterior cruciate ligament c. Normally there is no specific sulcus between the margin of the meniscus and the joint capsule anywhere along the medial joint line d. Has a firm attachment to the top of the tibia and a less firm one to the femur through the coronary ligament e. The anterior attachment seems to slip under the anterior cruciate ligament, attaching to the bone beneath

The anterior attachment seems to slip under the anterior cruciate ligament, attaching to the bone beneath