CATS FINAL Flashcards
(281 cards)
1
Q
Which movements are included in TMJ Assessment?
A
- Depression (opening)
- Elevation (closing)
- Protrusion
- Retrusion
- Lateral Deviation of Mandible
2
Q
What movements can lead to Carpal Tunnel Syndrome and why?
A
- Repetitive strain, wrist or finger flexion and extension
3
Q
Which nerve is affected in Carpal Tunnel Syndrome?
A
- Median
4
Q
What may cause an increase in pressure within the carpal tunnel?
A
- Edema
5
Q
What type of nerve fibres are present in the Median Nerve?
A
- Sensory, Motor, Autonomic
6
Q
What conditions may be confused with Carpal Tunnel Syndrome? And how can they be ruled out?
A
- C6 or C7 nerve root involvement: C6: lateral forearm, thumb and 2nd digit. C7: limited to the 3rd digit and a narrow band down the middle of the Dorsum and volar aspects of the hand just Proximal to the wrist
- Brachial plexus injury: sensory symptoms usually felt along the entire length of the arm, forearm, hand (depends on injury site)
- Median nerve lesion (outside carpal tunnel)
- Cervical nerve root Impingement
- Trigger points
7
Q
Where is the most common site of injury to the ulnar nerve at the elbow?
- Ulnar Nerve Lesion
A
- At the cubital tunnel leading to cubital tunnel syndrome
8
Q
Why are symptoms more likely to occur when the elbow is flexed then when it is extended?
Ulnar Nerve Lesion
A
- Flexion traction’s the nerve
9
Q
What is the “downstream principle”? And what are the functional implications of the principle
A
- Only sensory and/or motor functions distal to the lesion are affected
- Sensory signals arising distal to the lesion do not reach the brain
- Motor signals from the brain do not reach muscles innervated distal to the lesion site
10
Q
What will occur if lumbricals 3 & 4 are affected?
Ulnar Nerve Lesion
A
- Finger extension is unopposed -> MCP joints develop a hyperextension deformity
- Known as a “claw-hand”
11
Q
What are possible signs and symptoms of hemiplegia?
A
- Paresis/complete paralysis of muscles on the affected side
- Compensatory changes to muscles on the unaffected side
- Paresthesia/anesthesia
- Aphasia-speech impairment
- Visual impairment
- Cognitive impairment: long/short term memory, attention, concentration, desicion-making
- Epilepsy - a possibility with any brain lesion
- Emotional and behavioural changes, e.g, aggression, depression
12
Q
What are four types of rib articulation?
Intercostal Neuralgia and Rib Subluxation
A
- Costovertebral
- Costotransverse
- Costochondral
- Sternocostal
13
Q
What are the possible causes of Median & Ulnar Nerve Lesions?
A
- Trauma
- Muscle compression
- Decrease in compartment size
14
Q
What do Median and Ulnar nerves supply?
A
- Motor and sensory Innervation of the forearm and hand
15
Q
What deformities may occur with median and Ulnar nerve lesions?
A
- Median nerve lesion - Ape Hand
- Ulnar nerve lesion - Claw hand
16
Q
A client experiences motor loss of the following movements:
Erb’s Palsy
A
- Glenohumeral joint: abduction, external rotation, and forward flexion
- Elbow joint: Flexion
- Forearm: Supination
17
Q
What other conditions does this shoulder posture make the client susceptible to?
Erb’s Palsy
A
- Adhesive Capsulitis
- Osteoarthritis
- Subluxation
- Dislocation
18
Q
What is a compression syndrome?
A
- A condition arising from pressure exerted upon a Neurovascular bundle by a muscle, or other anatomical structure, causing neurological and/or circulatory signs and symptoms
19
Q
What general manifestations of neurological impairment?
A
- Sensory deficits - Paresthesia, pain, and motor dysfunction - muscle weakness
20
Q
What are general manifestations of vascular impairment?
A
- Ischemia leading to tropic skin changes and muscle spasms
21
Q
What are functions of compartments?
A
- Separate structures
- Link structures that have commonalities
- Facilitate increased force of contraction
- Protection
22
Q
What might cause increased intra-compartmental mass and what can it lead to?
A
- Repetitive use: Walking/running on a hard surface - inflammation/edema/Hypertonicity
- Trauma: Blows, bleeding, contusions - pooling of blood in the compartment
- Not stretching before activity: Muscle strains, inflammation/edema
- Fractures, surgery: Inflammation/edema
- Accumulation of intravenous fluid in the compartment: increased mass
23
Q
What can cause Sciatica
A
- Shortening of the piriformis muscles - overuse, hypertonicity
- Biomechanical dysfunction such as a leg length discrepancies, pelvic obliquity
- Sacroiliac dysfunction - SI joint sprain
24
Q
What would you expect to observe with a client with piriformis syndrome?
A
- Antalgic gait and posture
- Excessive external rotation of the affected leg
- Pelvic obliquity
25
What other conditions may be present if a client complains of pain in the buttock region?
Piriformis Syndrome
- Nerve root irritation, e.g., disc herniation - discussed in future LP’s
- SI Joint Sprain: SI joint dysfunction may lead to a hypertonic/spasmed piriformis causing piriformis syndrome
Assessment determines if SI joint dysfunction is the root cause
SI joint dysfunction is covered in detail in future lectures
- Hip Pathology: A capsular pattern may be present
- Myofascial Trigger Points: MTP’s can mimic a sciatic nerve pain pattern - regions of referred pain include:
- Posterior Iliac crest to the SI joint
- Sacrum
- Buttock
- Posterior and Lateral upper thigh
- Postural Conditions such as hyperlordosis, scoliosis
26
What Palpation you findings would you expect?
| Piriformis Syndrome
- Hypertonicity, spasm, and/or trigger points in the piriformis, gluteals, TFL, lumbar, erectors, quadriceps, hamstrings, psoas
Adhesions, Scar tissue, fibrosis in piriformis and/or gluteals
Pain on palpation of the greater sciatic foramen
27
What is the major role of carbs in the body?
- Energy source
28
What is the major role of fats in the body?
- Long term energy source
29
What is a facet irritation?
- Conditions where inflamed joint capsules cause significant local pain; may affect adjacent nerve roots
30
What structures form the IVD and what are they composed of?
- Central nucleus pulposes: Filled with a gel-like fluid
| - Outer annulus Fibrosus: Series of elastic fibres (annular) surrounding the nucleus pulposes
31
What does the term ‘close-packed’ position of a joint refer to?
- The position where maximal tension is exerted on the articular capsule and ligaments, and joint surfaces are approximated
32
What is the close-packed position of lumbar spine facet joints?
- Extension
33
In which situations would L/S facet joints have an increased weight-bearing role?
- Closed-packed position
| - Lumbar hyperlordosis
34
What is a possible outcome of L/S facet joints placed in the close-packed position for an extended period of time, due to hyperlordosis?
- Excessive compressive force on the joints
- Articular damage and degeneration
- Inflammation of the joint capsule -> Fibrosis -> Capsular restrictions -> Facet irritation -> Gradual degeneration due to altered biomechanics -> OA
35
How might anterior pelvic tilt lead to OA? Which spinal segments are likely to be affected?
- Anterior pelvic tilt -> Increases lumbosacral angle -> Increased shearing stress on lumbosacral joint
- Facet joints and soft tissues in the area ‘carry’ the weight -> Become irritated leading to referral pain from these joints
- Long term irritation -> OA
- Primarily affects L5/S1 joint; superior joints are also affected (increased lumbosacral angle affects the superior spinal segments, e.g., L1/L2, L2/L3, etc. By inducing a lumbar hyperlordosis)
36
What conditions are possible sources of symptoms, when a client presents with low back, or neck pain, with or without neurological symptoms?
- DDD/OA
- Disc Herniation
- Fracture
- Piriformis syndrome (low back)
- Muscle strain
- Trigger points
- TOS (cervical spine)
37
What are types of pelvic dysfunction?
- Anterior tilt, Posterior tilt and Obliquity
38
With a bilateral anterior pelvic tilt, which muscles tend to be tight and short?
- Hip Flexors, low back extensors
39
With a bilateral anterior pelvic tilt what muscles tend to be weak and lengthened?
- Hip Extensors and abdominal muscles
40
With a bilateral posterior pelvic tilt what muscles tend to tight and short?
- Hip Extensors and abdominal muscles
41
With a bilateral posterior pelvic tilt what muscles tend to be weak and lengthened?
- Hip flexors, low back extensors
42
What is pelvic obliquity?
- A condition in which one innominate is rotated forward and the other is rotated backward
43
How can pelvic obliquity, e.g., and anterior right innominate, lead to a functional scoliosis?
- The anterior innominate pulls the sacrum forward on the right into a left rotation, causing rotation of the lumbar spine and subsequent contralateral rotation further up the spine, i.e., in the thoracic spine
44
How might pelvic obliquity, for example, a right Anterior innominate, affects the SI Joints?
- The right anterior innominate pulls the right side of the sacrum forward, i.e., pulls the sacrum into a left rotation
- The right SI joint will be hypomobile
- The left SI joint will be hypermobile
45
What bones articulate to form the SI Joint?
- The sacrum and bony pelvis
46
What muscles have fibrous attachments that blend with the anterior & posterior SI ligaments to increase joint strength?
- QL, Iliacus, Piriformis, Latissimus Dorsi
47
What are the most frequently affected joints?
| Rheumatoid Arthritis
- Knee’s, PIPs, MCPs, small joints in feet
48
Which joints are usually affected first?
| Rheumatoid Arthritis
- Hands and feet - most commonly PIPs
49
What is stress?
- Body’s reaction to a variety of environmental factors; e.g., infections, hard work, may-nutrition, anything that upsets homeostatic balance
- Physical and psychological stimuli that upset us, heat, crowds, difficult relationships, peer pressure
50
What chemicals does the body release in response to stressors?
Adrenaline and cortisol
51
What is your body’s reaction to the presence of adrenaline and cortisol?
- Heart rate increases
- Hot - sweat, hands become clammy
- Breathing changes
- Digestion slows
52
Possible causes of tension headaches?
- Hypertonicity: Muscles of mastication
- Irritation: Structures (TMJ) innervated by CN V - Trigeminal nerve
- Stress on the dura: Sustained from injury to the sacrum, coccyx (fall;kick)
- Hypertonicity/spasm: Upper thoracic and cervical musculature
- Faulty posture: Leading to Hypertonicity and MTPs in over-used, compromised muscles
- Impaired circulation and faulty posture: due to adhesions in T/S and C/S regions, (over-stretched ligaments and joint capsules of facet joints
53
What are Cluster headaches?
- Recurrent, severe
- Location of pain: Orbitotemporal, Unilateral
- Associated with: Ipsilateral photophobia, tearing (lacrimation) & nasal congestion
- Population: More common in males - 5:1
54
What are Fibrositic headaches?
- Location of pain: Centred in the occipital region
- Cause: Fibrositic of occipital muscles
- Associated with: Tender areas in the scalp and lower occipital region
55
Describe Migraine headaches
- Location of pain: Lateral aspect of head, behind eye, usually unilateral
- Types: With and without aura (about 85% are without an aura)
- Prodrome: Both types may be preceded by
- Nausea, photophobia, phonophobia
- Mood changes, alteration in consciousness
- Changes in energy levels
- Autonomic activity
- Food cravings (sugar, other foods)
- Associated with:
- Nausea and vomiting, photophobia
- Motor and/or sensory changes
- Equilibrium disturbances (vertigo)
- Flashing lights, blind spots, double vision
- Hallucinations, unusual taste sensation
- Blanching of the skin in the extremities (skin cold to touch)
56
What is Temporal Arteritis (aka Giant Cell Arteritis)
Temporal Arteritis is a condition (Vasculitis) characterized by inflammation of the temporal arteries and its branches (has been found in other arteries)
57
Cause of headache in Forehead
- Sinusitis
- Muscle spasm
- Trigger points
58
Cause of Headache in side of head
- Migraine
- Temporal Arteritis
- Trigger points
59
Cause of Headache in Occipital region
- Hypertension
- Herniated disc
- Eyestrain
- Trigger points
60
Cause of headache in Parietal region
- Psychological or emotional stress
- Meningitis
- Constipation
- Tumour
61
Cause of Headache in face
- Sinusitis
- Trigeminal neuralgia
- Dental problems
- Tumour
62
Contraindications to MLD & precautions.
- Acute infectious conditions: e.g., sinusitis, influenza - potential spread of infection
- Thrombosis: risk of embolism
- Uncontrolled high blood pressure: excess fluid (circulatory system) May increase BP
- Hemorrhagia: increased bleeding
- Malignancies: Potential spread of cancer - do not do onsite
- Menstruation: May increase bleeding
- Bronchial asthma and allergies: caution - may further congestion chest area
- Post-surgical organ drainage: Check with MD
63
Which muscles provide normal inspiration (no thoracic dysfunction)?
- Primarily the diaphragm and external intercostal muscles
64
Which accessory muscles of respiration may be recruited during forced, or deep inspiration, and what action results?
- Scalenes: Elevate ribs 1 & 2
- SCM: Raises the sternum
- Pectoralis minor: Elevates ribs 3-5 with the scapula fixed
- Upper trapezius: Elevates the scapula
65
Which abdominal muscles are recruited during forced, or laboured expiration?
- Oblique and transverse
66
What other muscles may be hypertonic with chronic respiratory dysfunction, and why?
- Pectoralis Major: Due to poor posture (shoulders forward, anterior head carriage)
- Serratus Anterior/Posterior: Direct attachment to ribs; hypertonicity may restrict rib motion
- Rhomboids: Stretched & hypertonic due to poor posture (Shoulders forward, anterior head carriage)
67
What is Percussion?
- Assesses the amount of air relative to the amount of solid material in the lungs
- Dull, flat sound produced, in prescience of increased amounts of solid material in the lungs, e.g., sputum (normal sound - hollow)
- Sound is hyper-resonant if lungs are hyper-inflated
68
What is Auscultation?
- Performed using a stethoscope, listening to breathing sounds
- Sounds enable therapists to determine the location of congestion
69
Abnormal breathing sounds, include.
| COPD’S
- Crackles, or rales: Fine, discontinuous sounds heard primarily on inspiration
- Wheezing or rhonchi (Active Asthma attacks): High, or low-pitched, noise heard primarily on exhalation; usually due to bronchospasm
70
Indications and contraindications for Postural Drainage
- Postural drainage mobilizes secretions from airways of clients with respiratory dysfunction:
- Client is placed in various positions using gravity to assist drainage
- Mucous moves from peripheral areas of the lungs into the central airways -> out
71
Aims of postural drainage.
| COPD’S
- Prevent accumulation of secretions
| - Remove secretions currently present
72
Contraindications to application of Postural Drainage, include:
COPD’S
- Hemorrhage (excess blood in the sputum)
- Untreated acute conditions such as:
- Severe pulmonary edema
- Congestive heart failure
- Pneumothorax - presence of air in the intrapleural space
- Cardiovascular instability:
- Severe hypertension, or hypotension
- Recent myocardial infarct
- Recent neurosurgery
73
Postural drainage incorporates various techniques, what are they?
COPD’S
- Diaphragmatic breathing
- Double k cough
- Tapotement
- Vibrations
- Shaking
- Rib springing
74
What is CCHF?
- A state in which the heart cannot maintain an output adequate to metabolic needs of tissues and organs, or can only do so at abnormally elevated filling pressures
75
Given the presentation of torticollis, what jts are affected and how?
- Cervical facet jts- compressed on the affected side
- IVDs- compressed on affected side
- TMJ- deviates towards affected side
- Shoulder girdle jts- elevation of the ipsilateral shoulder girdle
76
Which structures are shortened and hypertonic in acquired torticollis, or contracture in congenital torticollis?
```
Anterior:
- SCM, scalenes, platysma
Posterior:
- Levator scap. (ipsilateral one is shortened due to side bending, contralateral one is shortened due to rot’ of neck)
- Splenius captits (as levator scap. Above)
- Splenius cervicis
- Cervical erector spinae mm
- Upper traps
- Suboccipital mm
```
77
What is the relation between distance and the amplification of force?
- The greater the distance the greater the amplification of force
78
What type of joint is the knee?
- Combination of synovial hinge (tibia and femur) and synovial plane (Femur & patella)
79
Why are the supraspinatus & infraspinatus tendons usually more susceptible to poor healing?
- Hypo-vascular; thus the condition is degenerative in nature
80
What Syndromes come from a Median Nerve Lesion?
- Carpal Tunnel Syndrome
| - Pronator Teres Syndrome
81
What Locations are affected by an Ulnar Nerve Lesion?
- Cubital Tunnel
| - Tunnel of Guyon
82
What Locations are affected by a Radial Nerve Lesion?
- Axillary
- Spiral Groove
- Supinator
83
What is Bell’s Palsy?
- A peripheral nerve lesion manifesting as flaccid paralysis
| - Lesion to CN VII - Facial
84
What is Parksinson’s Disease?
- Characterized as alterations in motor functioning resulting in Bradykinesia, rigidity and tremor
85
Postural dysfunctions with Parkinson’s Disease
- Anterior head carriage
| - Hip and Knee flexion
86
What is Cerebral Palsy?
- This non-progressive condition is the result of lesions that occur during the perinatal period, from half-way through pregnancy to 7 days postpartum, and up to 3 years of age
87
What is Thoracic Outlet Syndrome?
- A condition where the brachial plexus and it’s accompanying artery (subclavian or Axillary) and/or vein are compressed between;
- Anterior scalene syndrome: Anterior and middle scalene or by an extra cervical rib
- Pectoralis minor syndrome; coracoid process and pec minor
- Costoclavicular syndrome; clavicle and 1st rib
88
Locations of Common Fibular Nerve Lesions
- Head of Fibula
| - Mid-shaft of Fibula
89
What is Rib Subluxation and Intercostal Neuralgia
- Articular dysfunction of ribs may present as subluxation and/or dislocation
90
What nerve roots are affected in Klumpke’s Paralysis?
- C8, T1
91
What is Erb’s Palsy?
- An upper brachial plexus injury involving injury to C5,C6 nerve roots, usually a result of compression or stretching of the involved nerve roots
92
What is a Tension headache?
- A muscle contraction type of headache, associated with trigger points and other Myofascial pain syndromes
93
What is a migraine?
- Causes are unknown, perhaps a CNS disorder that produces secondary intracranial vasodilation followed by vasoconstriction
94
What is Chronic Bronchitis?
- A condition that results in the production of purulent sputum for at least 3 months in a row over two consecutive years
95
What is Emphysema?
- Disease that causes enlargement of air spaces distal to the terminal bronchioles and destruction of the alveolar walls
96
What is Asthma?
- Chronic inflammatory disorder characterized by bronchospasm (narrowing of the airways in the lungs), which is reversible over time
97
What is Rheumatoid Arthritis?
- Inflammatory, destructive, chronic autoimmune disease of multiple joints and connective tissue throughout the body
98
What is Degenerative Disc Disease?
- Annulus Fibrosis of an IVD degenerates over a long period of time; results in a ‘compressed’ disc
99
Signs and Symptoms of Early DDD
- Dull and achy
- May radiate into Hip, Buttock, Abdomen
- Result of irritation to muscle, tendons, ligaments
- Aggravated by movement
- Affected joints are hypermobile
- Facet irritation
- Muscle Hypertonicity and Spasm in Lumbar, Gluteal and Lower Limb muscles
100
Signs and Symptoms of Late DDD
- Affected joints undergo fibrosis - become hypomobile
- Surrounding joints become hypermobile
- Osteophytes formation
- HT and Spasm in affected muscles
101
What is TMJ Dysfunction?
- Loss of function, or activity in the masticatory system as a result of mechanical occlusion, and/or Myofascial disorders of TMJ
102
What is Hyperkyphosis?
- An increase in the normal thoracic kyphotic curve with protracted scapula and head-forward posture
103
What is Hyperlordosis?
- An increase in the normal lumbar lordotic curve with increased anterior pelvic tilt and hip flexion
- Swayback posture
104
Symptoms of Functional Scoliosis
- Muscle imbalances and shortening
- ROM is reduced away from concave side
- Rib mobility is restricted
- Pain from tight ischemic tissue or over stretched tissue
- Secondary conditions: TOS or Intercostal Neuralgia
105
Symptoms of Structural Scoliosis
- Lateral displacement of nucleus pulposes, vertebral body wedging and possible osteoarthritis
- Facet joint approximation and irritation may occur
- Concave side compression of the posterior disc and intervertebral foramen narrowing with possible nerve root irritation
106
What is Pes Planus?
- A decreased Medial Longitudinal Arch and Pronated hindfoot
107
What is Patellofemoral Syndrome?
- Dysfunction of the Patellofemoral joint
108
What is SI Joint Dysfunction?
- Subluxation, Dislocation or Hypo/Hyper-mobility, may be due to biomechanical dysfunction in L/S, Pelvis or Lower Limb
109
What’s the Difference between ITB Contracture vs. ITB Friction Syndrome?
- ITB Contracture: The TFL tightens the ITB
- ITB Friction Syndrome: Painful inflammation of the Lateral Femoral Condyle resulting in excessive friction caused by an over-tight ITB, Leads to adhesions
110
Possible causes of ITB Contracture/Friction Syndrome
- Excessive Hip or knee flexion, e.g prolonged sitting, or activities such as jogging or cycling
- Postural imbalances, e.g., Plevic Obliquity, Anterior Pelvic Tilt
- Excessive use of one leg
- Prolonged immobilization or bed rest
- Prolonged repetitive activities
111
What is Dupurtren’s Contracture?
- The Palmaris Longus muscle tighten’s the palmar fascia
112
What is Osteoarthritis?
- A group or Chronic, Degenerative conditions that affect joints, specifically the articular cartilage and subchondral bone
113
What is a contusion?
- A crush injury to a muscle, there is damage to the muscle fibres and resultant bleeding into the subcutaneous tissue and skin
114
What is a sprain?
- An overstretch injury to a ligament
115
What is a Strain?
- An overstretch injury to a musculotendinous unit
116
What is Bursitis?
- Inflammation of a Bursa, which is a small, flat sac lined with synovium. A bursa reduces friction, usually between tendons and bones
117
What is Tendonitis?
- Inflammation of a tendon. The dense connective tissue of tendons has a limited blood supply originating from muscles and bones. Blood supply to tendons in compromised in area’s where the tendon is exposed to compression, friction or torsion. When injuries occur, the limited blood supply reduces tissue repair, and prolongs healing
118
What is DeQuervain’s Tenosynovitis?
- Inflammation at a tendon, Abductor pollicis longus and extensor pollicis brevis
119
What does DeQuervain’s Tenosynovitis present with?
- Pain is located over the lateral aspect of the distal radius, may radiate distally, to the thumb or proximally up the radial side of the forearm
- MTP’s, HT, Spasm near elbow, wrist flexors or wrist extensors
- Contracture, Scar tissue, Adhesions are near common tendon sheath of the Abductor Pollicis Longus and Extensor Pollicis Brevis near the radial styloid process
120
What is an Extension whiplash injury?
- Rear impact, damage to anterior C/S, causes strain and spasm to neck flexors
121
What is a Flexion whiplash injury?
- Front impact with damage to posterior C/S, causes strain and spasm to neck extensors
122
What is a side impact whiplash injury?
- Ipsilateral C/S facet compression and nn root impingement
123
What is Frozen Shoulder/Adhesive Capsulitis?
- Painful, significant restriction of active and passive ROM of shoulder, most frequently in abduction and external rotation
- Joint capsule becomes tightened and inflexible
- Adhesions develop within joint capsule
124
What is Ankylosing Spondylitis?
- A form of arthritis that primarily affects the spine, although other joints can become involved. It causes inflammation of the spinal joints that can lead to severe, chronic pain and discomfort
125
What is Plantar Fasciitis?
- An overuse condition resulting in inflammation of the plantar fascia
126
What is Compartment Syndrome?
- The result of an increase in pressure within the fascia compartment of the lower leg, Anterior or Posterior
127
Which statement about cutaneous receptors is TRUE?
A) Pacinian corpuscles detect high frequency vibrations
B) Markell discs detect deep pressure applied during kneading
C) Ruffini corpuscles detect light pressure applied during effleurage
D) Meissner’s corpuscles detect stretch applied during wringing
A) Pacinian corpuscles detect high frequency vibrations
128
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A prolonged contraction in response to a painful stimulus describes which state?
A) Heat cramps
B) Intrinsic muscle spasm
C) Hypertonicity
D) Reflex muscle gaurding
```
D) Reflex muscle gaurding
129
Which statement about fascial clumping is FALSE?
A) Is generally pliable and moves easily
B) Faulty posture tends to cause fascial clumping
C) Ischemia may lead to fascial clumping
D) Found near bony prominences
A) Is generally pliable and moves easily
130
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Which state is described as shortening of an entire structure such as a joint capsule?
A) Scar Tissue
B) Contracture
C) Hypertonicity
D) Adhesions
```
B) Contracture
131
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Which technique is NOT a type of isometric resistance exercise?
A) Multi-angular isometrics
B) Concentric contraction
C) Muscle setting
D) Rhythmic Stabilization
```
B) Concentric contraction
132
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In which direction does the therapist glide the humerus to increase abduction?
A) Superior
B) Inferior
C) Posterior
D) Anterior
```
B) Inferior
133
Which statement about ITB Friction Syndrome is TRUE?
A) It is associated with pain over the lateral femoral condyle during activity
B) It is associated with contracture of the ITB with pain at the medial knee
C) It is associated with contracture of the ITB with pain at the medial knee
D) It is associated with prolonged hypotonicty of the TFL
A) It is associated with pain over the lateral femoral condyle during activity
134
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Which peripheral joint mobilization do you use to increase flexion of the humeroradial joint?
A) Pronation
B) Supination
C) Anterior
D) Posterior
```
C) Anterior
135
Which aim would be the first priority when treating a client with acquired Torticollis?
A) Decrease spasm of the affected SCM
B) Lengthen the muscles on the contralateral side
C) Strengthen the muscles on the Ipsilateral side
D) Lengthen the affected SCM
A) Decrease spasm of the affected SCM
136
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Which peripheral joint mobilization do you use to increase internal rotation of the coxofemoral joint?
A) Inferior
B) Superior
C) Anterior
D) Posterior
```
D) Posterior
137
Which statement about elbow assessment is TRUE?
A) The male carrying angle is usually larger than the female
B) The normal end-feel for elbow flexion is bone-to-bone
C) Swelling of the joint capsule will involve all three joints
D) The ligamentous instability test is performed by passively flexing the elbow
C) Swelling of the joint capsule will involve all three joints
138
What is Diastasis Recti?
A) Tearing of the perineum during delivery
B) Separation of the linea alba
C) Tearing of the rectus abdominis
D) Separation of the internal and external oblique
B) Separation of the linea alba
139
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Pain in the thigh due to dysmenorrhea is usually a result of which state?
A) Hormonal fluctuations
B) Quadriceps muscle hypertonicity
C) Anascara, or systemic edema
D) Visceral referral from the uterus
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D) Visceral referral from the uterus
140
Which observational change is NOT typically associated with pregnancy?
A) Wide stance
B) Increased thoracic kyphosis with associated scapular protraction
C) Hyperextended knees
D) Increased Glenohumeral external rotation
D) Increased Glenohumeral external rotation
141
Which technique/protocol is indicated when treating a woman who is 7 months pregnant and has pregnancy induced hypertension?
A) Grade III sacroiliac joint mobilizations
B) Elevation of legs to reduce edema
C) Strengthening of pubococcygeal and Levator ani muscles
D) Fascial techniques to the lumbar spine and pelvic fascia
C) Strengthening of pubococcygeal and Levator ani muscles
142
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Which approach is contraindicated when treating a healthy pregnant client in the third trimester?
A) Compressions to the lumbar spine
B) Increase venous drainage of the limbs
C) Abdominal massage
D) Increase sacroiliac joint motion
```
D) Increase sacroiliac joint motion
143
```
What are the 2 phases in the classic divisions of gait analysis?
A) Stance phase and swing phase
B) Acceleration and deceleration
C) Heel strike and toe off
D) Mid-stance and mid swing
```
A) Stance phase and swing phase
144
```
At what point in gait is the centre of gravity typically at its lowest point?
A) Mid-swing
B) Foot flat
C) Heel strike
D) Toe off
```
C) Heel strike
145
Which muscle contraction is largely responsible for a soft heel strike?
A) Concentric contraction of the gastrocnemius
B) Concentric contraction of the tibialis anterior
C) Eccentric contraction of the gastrocnemius
D) Eccentric contraction of the tibialis anterior
D) Eccentric contraction of the tibialis anterior
146
```
What Movement begins with the foot and tibia in heel strike and continues to the hip in foot flat?
A) Abduction
B) Adduction
C) Internal rotation
D) External rotation
```
C) Internal rotation
147
```
The change in tension on plantar ligaments throughout the weight-bearing phase of gait is known as the:
A) Steppage gait
B) Windlass effect
C) Loading response
D) Pes Planus
```
B) Windlass effect
148
```
Which joints should flex and/or Dorsiflex during swing leg acceleration forward?
A) Hip and knee
B) Hip, Knee and ankle
C) Ankle and Hip
D) Ankle and Knee
```
B) Hip, Knee and Ankle
149
```
When an individual is unable to hold the foot dorsiflexed to have the foot clear the ground during gait, she or he will excessively flex the knee to compensate. What is this impairment called?
A) Steppage gait
B) Extension gait
C) Foot slap
D) Thumping heel
```
A) Steppage gait
150
```
Which type of ROM testing primarily tests non-moving structures?
A) Active resisted
B) Active assisted
C) Active free
D) Passive relaxed
```
D) Passive relaxed
151
```
Effective initiation and guiding of movement resulting in smooth, accurate and efficient motion is:
A) Cardiopulmonary fitness
B) Coordination
C) Flexibility
D) Balance
```
B) Coordination
152
Which of the following is an example of internal stabilization during resistance exercise?
A) Isometric contraction of an adjacent muscle group
B) Lying or leaning on a firm support surface
C) Pressure applied by the therapist
D) Support provided by equipment
A) Isometric contraction of an adjacent muscle group
153
The difference between muscle setting and multiple angle isometrics is:
A) Muscle setting does not tend to increase strength while multiple angle isometrics may
B) Muscle setting is eccentric while multiple angle is isometric
C) Muscle setting is more appropriate than multiple angle isometrics during the acute stage of severe injuries
D) Muscle setting involves greater resistance than multiple angle isometrics
A) Muscle setting doe not tend to increase strength while multiple angle isometrics may
154
What is advisable when designing a dynamic exercise program?
A) Only isometric contractions of the muscles
B) Concentric and eccentric contractions of the muscles
C) Isometric and Concentric contractions of the muscles
D) Isometric and isotonic contractions of the muscles
B) Concentric and eccentric contractions of the muscles
155
```
What types of tissues does PNF stretching target?
A) Fascia
B) Muscle
C) Muscle and Fascia
D) Muscle and joint capsules
```
B) Muscle
156
What is the difference between static and static progressive stretching?
A) Static stretches are prolonged; static progressive stretches are short duration stretches that are applied, released, then reapplied
B) They are the same, with the target length of the tissue being the only difference
C) Static stretches are held in place; static progressive stretches are a continuous increase in length of the target tissue
D) Static stretches are sustained; static progressive stretches are stretched until relaxed, then stretched further and held until relaxed and so on
D) Static stretches are sustained; static progressive stretches are stretched until relaxed, then stretched further and held until relaxed and so on
157
What are the ankle strategy, weight-shift strategy and hip strategy?
A) Engaging joints other than the knee to make gait most efficient
B) Automatic postural responses to maintain a person’s balance
C) Strengthening regimen’s to improve gait
D) Somatic stretch reflexes mediated by the spinal cord
B) Automatic postural responses to maintain a person’s balance
158
True or False:
| Training in one sport will enhance endurance in other aerobic activities
False
159
```
What is calisthenics?
A) the use of just the body weight in training
B) A type of interval training
C) A type of resistance training
D) A type of circuit training
```
A) The use of just the body weight in training
160
Which statement about shoulder abduction is TRUE?
A) The scapula rotates 20degrees upward before the humerus begins to move
B) The scapula moves approximately twice as much as the humerus
C) The clavicle rotates 30-50degrees in an anterior direction
D) The Humerus rotates laterally during full abduction
D) The humerus rotates laterally during full abduction
161
```
What is the referral pattern for a Pectoralis minor trigger point
A) Anterior deltoid
B) Posterior deltoid
C) Lateral Epicondyle
D) Medial Epicondyle
```
A) Anterior deltoid
162
Which statement about Hawkins-Kennedy test is True?
A) A positive test indicates bicipital tendinitis
B) It is performed by applying resistance to shoulder flexion
C) A positive test indicates Supraspinatus tendinitis
D) A positive test indicates acromioclavicluar dislocation
C) A positive test indicates Supraspinatus tendinitis
163
```
Which factor is the key to designing an effective treatment for a specific tendinitis?
A) Treatment aims
B) Duration of treatment
C) Regional anatomy
D) General contraindications
```
C) Regional anatomy
164
Your, client, a hairdresser, has recently been treated for an acute flare-up of her right Supraspinatus tendinitis. As her symptoms have diminished, your focus is now on resolving the condition and prevention of reoccurrence
Which aim of treatment is appropriate for these goals?
A) Restore good biomechanics
B) Maintain ROM
C) Decrease swelling
D) Increase relaxation
A) Restore good biomechanics
165
```
What is NOT a cause of disuse atrophy?
A) Deficient nutrition
B) Lack of exercise
C) Inadequate blood supply
D) Loss of neural stimulation
```
D) Loss of neural stimulation
166
```
Which manifestation is NOT present, following the recent removal of a cast
A) Decreased muscle strength
B) Increased muscle length
C) Disuse atrophy
D) Contractures
```
B) Increased muscle length
167
Which statement about Glenohumeral dislocations is FALSE?
A) The head of the humerus is usually displaced inferiorly
B) The GH joint is frequently dislocated joint of the shoulder region
C) They present with a step deformity
D) They present with a sulcus sign
C) They present with a step deformity
168
```
Which aim of treatment is beyond the MT scope of practice for treating a client with an acute sternoclavicular dislocation?
A) Decrease inflammation
B) Decreased muscle spasm
C) Reduce the dislocated joint
D) Encourage diaphragmatic breathing
```
C) Reduce the dislocated joint
169
```
Which sign specifically indicates a PNS lesion?
A) Spastic paralysis
B) Abnormal or antalgic gait
C) Increased deep tendon reflexes
D) Decreased deep tendon reflexes
```
D) Decreased deep tendon reflexes
170
```
A client with a common fibular nerve lesion may compensate with excessive ipsilateral ______
A) Hip flexion
B) Dorsiflexion
C) Hip extension
D) Knee extension
```
A) Hip flexion
171
A client, who was in a car accident 2 months ago, describes weakness in the right leg. He explains that when walking he cannot raise his right foot enough to clear the ground. Assessment reveals:
- Limited AF dorsiflexion and Eversion and digit extension
- Weakness with AR dorsiflexion and Eversion and digit extension
- Decreased sensation
Which technique is NOT indicated for treating the client at this time?
A) Mid-range PR ankle ROM
B) AR eccentric exercises for the anterior muscles of the leg
C) Tapping to the muscles of the anterior compartment of the leg
D) Muscle stripping to the posterior compartment muscles of the leg
B) AR eccentric exercises for the anterior muscles of the leg
172
Which statement about multiple sclerosis is TRUE?
A) Treatment is the same for all clients
B) Signs and symptoms are highly predictable
C) There may be large variance in symptom presentation
D) Males are more affected and usually have motor symptoms
C) There may be large variance in symptom presentation
173
```
Which muscle is likely to be hypertonic in a person presenting with upper chest breathing?
A) Abdominal
B) Serratus posterior inferior
C) SCM
D) Internal intercostals
```
C) SCM
174
```
Which is NOT an appropriate aim when treating a client in the early stages of Parkinson’s disease?
A) Minimize hyperkyphosis development
B) Maintain functional rib movement
C) Strengthen intrinsic hand muscles
D) Lengthen scapular retractors
```
D) Lengthen scapular retractors
175
```
Which modality is indicated for treating a client with spasticity?
A) Brief cold towel application
B) AR eccentric exercise
C) Deep moist heat
D) Full PR ROM
```
C) Deep moist heat
176
```
Which upper limb tension test involves elbow flexion and forearm supination?
A) Ulnar
B) Radial
C) Median
D) Musculocutaneous
```
A) Ulnar
177
Which statement about hemiplegia is FALSE?
A) There may be associated cognitive impairment
B) Hemiplegia is a progressive CNS condition
C) Manifests as paralysis to 1/2 of the body
D) May be caused by head trauma
B) Hemiplegia is a progressive CNS condition
178
Which long-term aim of treatment is indicated for a client with hemiplegia
A) Reduce imbalance of the GH joint
B) Strengthen the shoulder adductors
C) Decrease Contractures in the rhomboids
D) Eliminate spasticity in the biceps brachii
A) Reduce imbalance of the GH joint
179
Application of which technique requires caution when treating a client with hemiplegia caused by a CVA?
A) Mid-range PR C/S ROM
B) Muscle stripping to the SCM
C) Strengthening for the wrist extensors
D) Grade II oscillations to the carpal bones
B) Muscle stripping to the SCM
180
```
Which condition may present with slow, writhing, uncontrolled movements of the upper limbs?
A) Parkinson’s disease
B) Multiple sclerosis
C) Cerebral palsy
D) Hemiplegia
```
C) Cerebral palsy
181
```
Which dysfunction is associated with cerebral palsy?
A) Resting tremors
B) Bradykinesia
C) Mid-range PR ROM
D) Rapid shaking of the limbs
```
D) Rapid shaking of the limbs
182
```
Which technique is ineffective for decreasing sympathetic NS firing in a client with cerebral palsy?
A) Slow stroking along the spine
B) Mid-range PR ROM
C) Rhythmic Swedish massage
D) Full body rocking
```
D) Full body rocking
183
Which aim of treatment is NOT indicated when treating a client using a wheelchair due to a spinal cord transection at the T1 level?
A) Maintain health of lower limb joints using PR ROM
B) Decrease tone in the upper limb and pectoral girdle muscles
C) Decrease functional Fascial Contractures in the wrist and hand regions
D) Strengthen the diaphragm through the use of diaphragmatic breathing
C) Decrease functional Fascial Contractures in the wrist and hand regions
184
```
A lesion at which spinal cord level manifests with impairment of primary respiratory function?
A) C5
B) C6
C) C7
D) C8
```
A) C5
185
```
Which muscle of the back can be palpated most medially?
A) Multifidi
B) Spinalis Thoracis
C) Iliocostalis thoracis
D) Longissimus thoracis
```
B) Spinalis thoracis
186
```
Based on visceral referral patterns, where would you apply hydrotherapy to affect the stomach
A) T1-T4
B) T5-T9
C) L1-L2
D) C7-T3
```
B) T5-T9
187
```
Which state is NOT a cause of intercostal neuralgia
A) Rib fracture
B) Lumbar disc herniation
C) Intercostal muscle spasm
D) Thoracic Vertebral Rotation
```
B) Lumbar disc herniation
188
```
When performing mobilization of the 7th rib stuck in an expiration position, the rib is mobilized in which direction?
A) Inferolateral
B) Superolateral
C) Inferomedial
D) Superomedial
```
A) Inferolateral
189
```
Which technique is indicated when treating a client with an acute rib subluxation?
A) Rib springing
B) Clapp’s crawl
C) Deep breathing exercises
D) Grade I joint mobilizations
```
D) Grade I joint mobilizations
190
```
A nervous system lesion that results in loss of motor response, hypotonia and myotome pattern’s is MOST likely the result of injury to which area?
A) Brain
B) Dorsal root
C) Ventral root
D) Spinal nerve
```
C) Ventral root
191
Which description about Trigeminal neuralgia is TRUE?
A) A chronic condition with gradual onset
B) Associated with dull and achy pain
C) Touching affected areas can trigger pain
D) Affects the optic nerve and vision
C) Touching affected areas can trigger pain
192
Which treatment technique is indicated when treating a client suffering from Trigeminal neuralgia in the acute stage?
A) Compressions to the supraorbital margins
B) Stroking along the mandible
C) MLD in the cervical region
D) Pincement to the face
C) MLD in the cervical region
193
```
A lesion of cranial nerve VII at which site will NOT cause Bell’s Palsy?
A) Stylomastoid foramen
B) Submandibular gland
C) Parotid gland
D) Facial gland
```
B) Submandibular gland
194
```
Which is NOT an Idiopathic neurological disorder?
A) Bell’s palsy
B) Poliomyelitis
C) Alzheimer’s disease
D) Parkinson’s disease
```
B) Poliomyelitis
195
Which sign/symptom is unlikely to be seen in a client with Bell’s Palsy?
A) Loss of expressive lines in the fascial skin
B) Bilateral flaccid paralysis of the face
C) Loss of the ability to whistle
D) Contracture of unopposed facial muscles
B) Bilateral flaccid paralysis of the face
196
```
A client complains of pain in the neck and tingling down the arm that began 3 days ago. Dermatomal testing is positive. Myotomal testing and reflexes are unremarkable. Which conclusion is correct?
A) A nerve root is affected
B) A Dorsal Ramus is affected
C) A peripheral nerve is affected
D) There is a latent trigger point
```
A) A nerve root is affected
197
Which statement about the Ulnar nerve is TRUE?
A) It innervates muscles of the lateral aspect of the anterior forearm
B) It innervates Structures in both the anterior brachium and antebrachium
C) It is located between the flexor digitorum Profundus and the flexor carpi Ulnaris
D) It provides sensation to the lateral palm of the hand and one and a half digits
C) It is located between the flexor digitorum Profundus and the flexor carpi Ulnaris
198
```
A diminished Brachioradialis reflex in indicative of a lesion go which nerve root?
A) C4
B) C6
C) C7
D) C8
```
B) C6
199
```
Which nerve may become compressed between the two heads of Pronator Teres?
A) Median
B) Radial
C) Ulnar
D) Posterior Interossei
```
A) Median
200
```
Which condition is unlikely to present with edema?
A) Pregnancy
B) Hypertension
C) Radial nerve lesion
D) Klumpke’s Paralysis
```
C) Radial nerve lesion
201
```
What is a possible cause of a radial nerve lesion at the spiral groove?
A) GH dislocation
B) Humeral fracture
C) Lateral epicondylitis
D) Colle’s fracture
```
B) Humeral fracture
202
Which statements about the radial nerve is TRUE?
A) It innervates the flexors of the arm/forearm
B) ‘Ape hand’ is typical of a radial nerve lesion
C) It may be damaged/compressed at different sites
D) All radial nerve lesions result in the same impairment
C) It may be damaged/compressed at different sites
203
Which exercise would you include when treating a client with muscles affected by a chronic radial nerve lesion?
A) Strengthen the denervated Pronator Teres muscle
B) Strengthen the denervated biceps brachii muscle
C) Stretch the contractured Palmaris longus muscle
D) Stretch the contractured triceps brachii muscle
C) Stretch the contractured palmaris longus muscle
204
```
Which remedial exercise is indicated for treating a client with a radial nerve lesion due to an elbow dislocation in the acute stage of healing
A) PR elbow ROM
B) AR wrist exercises
C) AF shoulder ROM
D) AF elbow ROM
```
C) AF shoulder ROM
205
```
Which nerve lesion most commonly mimics the presentation of Thoracic Outlet Syndromes?
A) Ulnar
B) Radial
C) Erb’s Palsy
D) Axillary
```
A) Ulnar
206
```
Which action is NOT affected when the ulnar nerve is compressed at the cubital tunnel?
A) Adduction of the 5th digit
B) Finger adduction and abduction
C) Abduction of the 5th digit
D) Wrist extension
```
D) Wrist extension
207
```
Which sign/symptom differentiates median from radial nerve lesions?
A) Unopposed Contractures
B) Radiating pain
C) Pronounced edema
D) Paresthesia
```
C) Pronounced edema
208
```
A client complains of difficulty opening jars, and says her hand has diminished grip strength. Which nerve lesion or condition is unlikely to have occurred?
A) Ulnar nerve lesion
B) Median nerve lesion
C) Klumpke’s paralysis
D) C5 nerve root lesion
```
D) C5 nerve root lesion
209
Which statement about a suspected ‘double crush’ syndrome is TRUE?
A) Treatments for carpal tunnel syndrome show the expected improvement
B) Signs/symptoms correlate with more than one possible lesion site
C) Nerve compression is confined between the heads of the Pronator teres
D) Presentation os symptoms clearly implicates a single nerve root
B) Signs/symptoms correlate with more than one possible lesion site
210
Which set of conditions would NOT be considered a double crush injury?
A) Thoracic outlet syndrome and Bell’s palsy
B) Carpal tunnel syndrome and Pronator teres syndrome
C) Piriformis syndrome and compression of the common fibular nerve
D) Cubital tunnel syndrome and ulnar nerve compression in Guyon’s canal
A) Thoracic outlet syndrome and Bell’s Palsy
211
Which client self-care exercise is indicated when treating a client with an incomplete median nerve lesion of moderate severity in the chronic stage of healing?
A) Repetitive wrist extension and elbow supination exercises
B) Thumb extension strengthening using an elastic band
C) Squeezing a rubber ball with the affected hand
D) Muscle setting exercises for the forearm flexors
C) Squeezing a rubber ball with the affected hand
212
```
Which condition does NOT involve structures associated with a cubital tunnel syndrome?
A) Lateral epicondylitis
B) Medial epicondylitis
C) Flexor carpi Ulnaris strain
D) Ulnar collateral ligament sprain
```
A) Lateral epicondylitis
213
```
Which syndrome presents with an ‘ape hand’ deformity?
A) Pronator teres
B) Cubital tunnel
C) Pectoral minor
D) Anterior scalene
```
A) Pronator teres
214
Which statement comparing poly neuropathies and mononeuropathies is TRUE?
A) Mononeuropathies are rarely due to trauma and repetitive strain injuries
B) In general, polyneuropathies are simpler to assess than mononeuropathies
C) Polyneuropathies are usually caused by localized conditions such as trauma
D) Polyneuropathies may be due to immune dysfunction and metabolic diseases
D) Polyneuropathies may be due to immune dysfunction and metabolic diseases
215
A client suffers from chronic cubital tunnel syndrome. Which technique is effective for treating the partially denervated tissues?
A) Frictions to the radial collateral ligament
B) AR ROM of the Hypothenar muscles
C) Stripping to the extensor digitorum
D) AR ROM of the Thenar muscles
B) AR ROM of the Hypothenar muscles
216
```
Klumpke’s paralysis resembles which combined nerve lesion?
A) Ulnar-radial
B) Median-ulnar
C) Median-radial
D) Radial-Axillary
```
B) Median-ulnar
217
Edema in the wrist and hand seen in Klumpke’s paralysis is due to which factor
A) Inflammation caused by the injury
B) Decrease in size of the anterior wrist compartment
C) Vasomotor impairment due to sympathetic involvement
D) The presence of parasympathetic fibres in the affected nerves
C) Vasomotor impairment due to sympathetic involvement
218
Which description is TRUE for both Erb’S palsy and Klumpke’s paralysis?
A) Often due to a tractioning injury
B) Manifest with autonomic dysfunction
C) Present with a ‘waiter’s tip’ deformity
D) Manifest as a combined median-ulnar lesion
A) Often due to a tractioning injury
219
Which dysfunction does NOT manifest with both Erb’s Palsy and Klumpke’s paralysis
A) Loss of muscle function in the upper limb
B) Autonomic nervous system dysfunction
C) Sensory deficits in the upper limb
D) An obvious upper limb deformity
B) Autonomic nervousness system dysfunction
220
```
Erb’s palsy is a disorder predominantly involving which nerve segment?
A) C3-C4
B) C4-C5
C) C5-C6
D) C7-C8
```
C) C5-C6
221
```
A client fell from a roof about 6 weeks ago and broke the fall by grabbing onto a tree branch. He is currently experiencing weakness of elbow flexion, wrist extension and mild sensory loss over the lateral forearm. Which condition is he likely suffering from?
A) Pronator teres syndrome
B) Spiral groove fracture
C) Klumpke’s paralysis
D) Erb’s palsy
```
D) Erb’s palsy
222
```
In a client with Erb’s palsy, which areas present with Contractures
A) Elbow flexors and forearm Supinators
B) Shoulder abductors and extensors
C) Elbow extensors and wrist flexors
D) Wrist extensors and finger flexors
```
C) Elbow extensors and wrist flexors
223
```
A client with Erb’s palsy experiences motor weakness but not loss in which movements?
A) Glenohumeral joint abduction
B) Glenohumeral joint flexion
C) Wrist extension
D) Elbow flexion
```
C) Wrist extension
224
```
With which condition would you apply tapotement, fast petrissage and cold washes to the deltoid and rotator cuff muscles?
A) Bell’s palsy
B) Klumpke’s paralysis
C) Erb’s palsy
D) Pronator teres syndrome
```
C) Erb’s palsy
225
```
Miosis, ptosis and enophthalmos are symptoms of which condition?
A) Reflex Sympathetic dystrophy
B) Horner’s syndrome
C) Erb’s palsy
D) Causalgia
```
B) Horner’s Syndrome
226
```
Which condition is associated with Horner’s Syndrome?
A) Klumpke’s paralysis
B) Poliomyelitis
C) Bell’s palsy
D) Erb’s palsy
```
A) Klumpke’s paralysis
227
Which treatment technique is indicated when treating a client with a C6 nerve root lesion presenting with Paresthesia over the lateral brachium and posterior forearm and decreased wrist extension strength?
A) Concentric exercise for the wrist extensors
B) Pincement to the anterior forearm muscles
C) Passive forced ROM for the wrist extensors
D) Grade III sustained vertebral mobilizations at C4
A) Concentric exercise for the wrist extensors
228
```
A client with damage to the S2 and S3 nerve roots will experience which symptoms?
A) Knee Extension - mild weakness
B) Hip flexion - moderate weakness
C) Anterior thigh - sensory impairment
D) Posterior thigh - sensory impairment
```
D) Posterior thigh - sensory impairment
229
Which statement about the straight leg raise as a treatment technique is FALSE?
A) It may be useful in reducing adhesions in nerve roots of the sacral plexus
B) The client will likely feel a slight temporary increase in signs and symptoms
C) If pain does not decrease after about one minute, technique is stopped
D) The technique can be continued even if client’s pain increases and persists
D) The technique can be continued even if client’s pain increases and persists
230
Which statement about the trendelenburg’s sign is FALSE?
A) When the test is positive the Gluteus Medius is the primary muscle affected
B) A positive sign indicates weak hip abductors of the weight-bearing leg
C) The test is positive if the pelvis of the non-weight bearing leg drops
D) The side being tested is the non-weight bearing limb
D) The side being tested is the non-weight bearing limb
231
When performing a lumbar spine scanning examination what is the correct order of assessment?
A) Neurological examination, ROM, Special tests, joint scan
B) ROM, joint scan, neurological examination, special tests
C) Special tests, neurological examination, ROM, Joint scan
D) Special tests, neurological examination, ROM, joint scan
B) ROM, joint scan, neurological examination, special tests
232
With normal movement of the sacroiliac joints, flexion of the left hip causes _______
A) Left PSIS to move inferiorly
B) Right PSIS to move inferiorly
C) Left Ischial Tuberosity to move superiorly
D) Right Ischial Tuberosity to move superiorly
A) Left PSIS to move inferiorly
233
```
Which set of signs and symptoms is indicative of venous compression?
A) ‘Pink’ skin and slow healing wounds
B) Paresis and Paresthesia
C) Decreased pulse and dry skin
D) ‘Blue’ skin and edema
```
D) ‘Blue’ skin and edema
234
```
What is the average normal pulse rate for adults in beats per minute
A) 40-60
B) 60-80
C) 80-100
D) 100-120
```
B) 60-80
235
Which statement regarding ischemic pain is TRUE?
A) It is typically sharp and ‘shooting’
B) It improves with activity
C) It is specific and local
D) It is accompanied by other cardiovascular signs
D) It is accompanied by other cardiovascular signs
236
```
Which special test is designed to confirm the presence of thrombophlebitis?
A) Buerger’s test
B) Allen’s test
C) Homan’s sign
D) Vertebral artery test
```
C) Homan’s sign
237
Which statement about vasomotor impairment is TRUE?
A) Edema and fragile skin may be a consequence of long-term ischemia
B) Impaired peripheral circulation can be improved with cold washes
C) Warm, puckered and reddish skin is an indication of vasomotor loss
D) Horner’s syndrome is often associated with radial nerve lesions
A) Edema and fragile skin may be a consequence of long-term ischemia
238
Which statement about positional tractioning is true?
A) Positional traction is used to apply traction to a specific joint
B) The therapist rotates the head away from the side to be tractioned
C) Positional traction is used to apply traction to the C/S spine as a whole
D) The therapist side bends the head toward the side to be tractioned
A) Positional traction is used to apply traction to a specific facet
239
Which definition best describes osteoarthritis of the vertebral column?
A) It is a sequestration of the nucleus pulposes due to trauma
B) It is a progressive degeneration of intervertebral discs
C) It is Chronic inflammation of spinal connective tissues
D) It is a gradual degeneration of hyaline cartilage
D) It is a gradual degeneration of hyaline cartilage
240
Which protocol may be contraindicated in the treatment of a client with advanced diabetes?
A) High grade spinal traction’s due to increased possibility of vertebral arch fracture
B) Prone position due to the increased pressure in the abdominal cavity
C) Deep pressure and heat due to peripheral edema and vascular insufficiency
D) Active resisted movements due to increased possibility of a spastic reaction
C) Deep pressure and heat due to peripheral edema and vascular insufficiency
241
```
Disappearance of a radial pulse when the clients neck is rotated ipsilaterally and the shoulder laterally rotated and extended indicates a positive test for which one of the following?
A) Allen’s test
B) Wright’s maneuver
C) Costoclavicular syndrome test
D) Adson’s maneuver
```
D) Adson’s maneuver
242
```
Which structure does NOT compress the brachial plexus?
A) Pectoralis minor
B) Posterior scalene
C) Clavicle
D) Middle scalene
```
B) Posterior scalene
243
A client presents with piriformis syndrome. Which technique will NOT address the root cause of symptoms in the lower limb?
A) Sacroiliac joint mobilizations
B) Heat over the gluteal region
C) Passive angular stretch of the piriformis muscle
D) Muscle stripping in the lumbar spine region
D) Muscle stripping in the lumbar spine region
244
```
In which position does the Adson’s maneuver place the neck and shoulder?
A) Extension/flexion
B) Ipsilateral rotation/extension
C) Contralateral rotation/extension
D) Flexion/hyperabduction
```
B) Ipsilateral rotation/extension
245
```
Sensory Innervation of which area is unaffected with sciatic nerve compression due to piriformis syndrome?
A) Anteromedial thigh
B) Dorsum of the foot
C) Posterior thigh
D) Posterior leg
```
A) Anteromedial thigh
246
```
What nutritional risk factors may lead to the onset of anemia?
A) Excess calories
B) Excess sugar
C) Deficiency of calcium
D) Deficiency of protein
```
D) Deficiency of protein
247
Which statement about facet irritation is FALSE?
A) it is characterized by diffuse pain and joint restriction
B) Pain may refer to other structures
C) Chronic facet irritation exhibits a capsular pattern
D) The onset is usually sudden
D) The onset is usually sudden
248
Which protocol/technique is least likely to reduce compression causing a TOS?
A) Stretching the pectoral and scalene muscles
B) Diaphragmatic breathing to relax the client
C) Joint mobilizations to improve shoulder ROM
D) Remedial exercises to improve a client’s posture
B) Diaphragmatic breathing to relax the client
249
Which statement about the RHPA is TRUE?
A) It is a general act providing rules and regulations for unregulated practitioners
B) It is a specific act pertaining to the practice of massage therapy
C) It is a general act outlining rules of conduct for all health care professionals
D) It is a specific act outlining the rules and consent to treatment for MTs
C) It is a general act outlining rules of conduct for all health care professionals
250
```
When treating clients with DDD what is the main focus of the treatment?
A) Address faulty posture
B) Increase spinal mobility
C) Remove muscle gaurding
D) Decrease inflammation
```
A) Address faulty posture
251
```
Amino acids are associated with which macromolecule?
A) Proteins
B) Starch
C) Carbohydrates
D) Lipids
```
A) Proteins
252
```
The spinous process of S2 is in the same horizontal line with which landmark?
A) PIIS
B) Superior aspect of the coccyx
C) PSIS
D) Superior aspect of iliac crests
```
C) PSIS
253
Which statement about degenerative disc disease is FALSE?
A) Chronic facet irritation may progress to degenerative disc disease
B) DDD may lead to joint instability and possibly disc herniation
C) Annular tears in the nucleus pulposes may lead to localized pain
D) Chronic or repetitive faulty biomechanics and posture may lead to DDD
C) Annular tears in the nucleus pulposes may lead to localized pain
254
Which statement about palpation for spinal mobility in clients which chronic disc herniations is TRUE?
A) Affected vertebrae are usually hypermobile in the late stages
B) Upon palpation you note that the sacroiliac joint is hypermobile
C) Surrounding segments are hypomobile in the later stages
D) Affected vertebrae are usually hypomobile in the late stages
D) Affected vertebrae are usually hypomobile in the late stages
255
Which one of the following statements regarding faulty posture and osteoarthritis is TRUE?
A) Faulty posture may lead to OA, but OA does not cause faulty posture
B) A posterior pelvic tilt causes an increased lumbrosacral angle
C) Anterior head carriage may lead to OA of the cervical spine
D) Pelvic obliquity is unlikely to cause OA in the sacroiliac joints
C) Anterior head carriage may lead to OA of the cervical spine
256
```
In the chronic stage of healing, a disc herniation of which type produces the most severe assessment findings?
A) Protrusion
B) Sequestration
C) Extrusion
D) Prolapse
```
B) Sequestration
257
```
Which one of the following reflexes assesses the Pectoralis major clavicular portion of the shoulder and biceps brachii?
A) C4-C5
B) C7-C8
C) C8-T1
D) C5-C6
```
D) C5-C6
258
```
Which technique would you perform when treating a client in both the acute and chronic stage of facet irritation
A) Positional traction
B) Laminar groove clearing
C) Frictions
D) Muscle stripping
```
A) Positional traction
259
```
In general, the lowest pulse rate measured is seen in _____
A) Children
B) Athletes
C) Adult females
D) Adult males
```
B) Athletes
260
```
Which lumbar spine movement is most likely to increase the pain of a client with a posterior disc herniation in the acute stage?
A) Side bending
B) Extension
C) Rotation
D) Flexion
```
D) Flexion
261
Which statement about vasomotor impairment is FALSE?
A) When vasomotor impairment is present the use of a cold wash is indicated
B) Severe edema and tissue fragility are consequences of vasomotor impairment
C) Median nerve lesions are often associated with vasomotor impairment
D) Cold, pallor and bluish coloured skin is an indication of vasomotor loss
A) When vasomotor impairment is present the use of a cold wash is indicated
262
```
Edema occurring bilaterally is usually NOT caused by which one of the following?
A) Kidney disease
B) Congestive heart failure
C) Inflammation
D) Liver disease
```
C) Inflammation
263
```
Which condition is considered a compartment syndrome?
A) Pectoralis minor syndrome
B) Erb’s palsy
C) Carpal tunnel syndrome
D) Piriformis syndrome
```
C) Carpal tunnel syndrome
264
```
Which muscle should be strengthened in a client with degenerative disc disease of the lumbar spine?
A) Quadratus Lumborum
B) Iliopsoas
C) Abdominal obliques
D) Rectus Femoris
```
C) Abdominal obliques
265
```
The median nerve arises from which spinal root?
A) Medial and lateral (C5-T1)
B) Anterior and Lateral (C5-C8)
C) Medial and Posterior (C8-T1)
D) Lateral and Anterior (C5-C7)
```
A) Medial and Lateral (C5-T1)
266
```
Which condition will NOT cause C2 nerve root irritation?
A) RA of the Atlanta-axial joint
B) OA of the cervical spine
C) C2/C3 disc herniation
D) Whiplash
```
C) C2/C3 disc herniation
267
```
Which findings would NOT be expected in a client with piriformis syndrome?
A) Pain down the posterior thigh and leg
B) Pain in the gluteal region
C) Paresthesia in a dermatomal pattern
D) Decreased AF hip internal rotation
```
C) Paresthesia in a dermatomal pattern
268
```
Which presentation is typical in a client with chronic posterolateral disc herniation at C4/C5 and resultant nerve root irritation
A) A negative distraction test
B) Paresthesia at the lateral neck
C) A decreased triceps reflex
D) Weakness of shoulder abduction
```
D) Weakness of shoulder abduction
269
```
Which special test uses repetitive active free ROM to indicate problems with arterial supply?
A) Kemps test
B) Vertebral artery test
C) Provocative elevation test
D) Homan’s test
```
C) Provocative elevation test
270
```
Where would you palpate a MTP whose referral pattern mimics piriformis syndrome?
A) Piriformis
B) Gluteus Maximus
C) Gluteus Medius
D) Quadratus Lumborum
```
C) Gluteus Medius
271
```
Where a disc protrudes lateral to the nerve root, the client can _____ to relieve the pain
A) Flex the spine
B) Extend the spine
C) Lean ipsilaterally
D) Lean contralaterally
```
D) Lean contralaterally
272
Which capsular pattern of restriction is most likely to appear in a client with adhesive capsulitis of the Glenohumeral joint?
A) Flexion, extension, medial rotation
B) Medial rotation, abduction, lateral rotation
C) Abduction, adduction, lateral rotation
D) Lateral rotation, abduction, medial rotation
D) Lateral rotation, abduction, medial rotation
273
A 29 year old client complains of pain and loss of shoulder movement that began insidiously 3 months ago. The pain worsens with use, and is relieved by rest. Resisted isometric external rotation of the shoulder increases the pain. The client likely has:
A) Rotator cuff tendonitis in CSOH
B) Biceps brachii strain in the CSOH
C) Frozen shoulder in the CSOH
D) Osteoarthritis in the late stages of degeneration
A) Rotator cuff tendonitis in the CSOH
274
```
To increase elevation of the clavicle and allow for full abduction of the arm, the therapist performs a _______ glide at the ______ joint
A) Superior/Acromioclavicular
B) Inferior/Acromioclavicular
C) Superior/Sternoclavicular
D) Inferior/Sternoclavicular
```
D) Inferior/Sternoclavicular
275
```
Which anatomical anomaly does NOT lead to lateral tracking of the patella?
A) Wide pelvis
B) Genu varum
C) Genu valgum
D) Increased ‘Q’ angle
```
B) Genu varum
276
```
What is not a cause of increased intra-compartmental mass with anterior compartment syndrome?
A) Walking/running
B) Rupture of the crural fascia
C) Traumatic blow to lower leg
D) Accumulation of interstitial fluid
```
B) Rupture of the crural fascia
277
```
Which muscle opens the jaw?
A) Masseter
B) Temporalis
C) Medial Pterygoids
D) Lateral Pterygoids
```
D) Lateral Pterygoids
278
```
A client suffered a hyperextension injury to the neck and now experiences TMJ pain. You assess the TMJ and find diminished joint spaces and the teeth are approximated. Spasm in which muscle may cause the phenomenon?
A) Lateral Pterygoid
B) Levator scapula
C) Longus Colli
D) Medial Pterygoid
```
D) Medial Pterygoid
279
Which statement clearly indicates a sub-acute stage of whiplash?
A) An injury that has healed for 1 to 2 months
B) Signs of redness and heat have now subsided
C) AF ROM is severely limited by pain and spasm
D) Client describes sharp, intense and all-over pain
B) Signs of redness and heat have now subsided
280
```
Which pair of muscles causes a persistent headache behind the right eye and top of the head
A) Masseter, trapezius
B) Splenius cervicis, temporalis
C) Splenius cervicis, suboccipitals
D) Levator scapula, lateral pterygoids
```
C) Splenius cervicis, suboccipitals
281
```
Which conditions are systemic disorders?
A) Lupus, facet irritation
B) Rheumatoid arthritis, Ankylosing spondylitis
C) Osteoarthritis, Rheumatoid arthritis
D) Sacroiliac joint dysfunction, lupus
```
B) Rheumatoid arthritis, Ankylosing spondylitis
