Clinical Assessment D.

Question 1

Which orthopedic tests assess for both impingement on a nerve and a blood vessel?

Answer 1

Adsons

Question 2

After performing passive range of motion on a patient’s elbow joint, which of the following findings indicates pathology in the joint?

Answer 2

Pronation empty end feel

Question 3

After performing a deep tendon reflex for the S1 nerve root, the patient’s foot continues to plantar flex as though they are continuously tapping their foot, without stopping or subsiding. What grade will this deep tendon reflex be given?

Answer 3

Grade 5

Question 4

Which dermatome crosses the chest and travels down the anterolateral arm to the wrist?

Answer 4

C5

Question 5

During a gait cycle, there is a stance phase and a swing phase. What would becorrect for a person with no pathology when describing the proper timing between the two phases?

Answer 5

Stance phase occupies 60% of the gait cycle, while swing phase occupies 40% of the gait cycle

Question 6

A patient describes symptoms of carpal tunnel syndrome, however, Phalen’s test and Reverse Phalen’s tests are both negative. What test of the forearm is NOT the most appropriate test to help identify the root cause of the symptoms?

Answer 6

Pinch Grip

Question 7

Which thoracic outlet syndrome test will be positive if the cause of the symptoms is a hypertonic pectoralis minor?

Answer 7

Wrights

Question 8

Which test identifies a lateral meniscus tear in the knee?

Answer 8

McMurrays with medial rotation

Question 9

Which test, if positive, suggests tendinopathy of the supraspinatus muscle?

Answer 9

Empty Can

Question 10

When performing Spurling’s test the patient states they feel a dull local pain on the side of their neck. The pain does not travel or radiate. How is this reaction classified?

Answer 10

This test is negative but notable

Question 11

Which test, if positive, is a contraindication to treatment and require an immediate physician referral? Kendall, Finkelstein, Thompson, Gillets?

Answer 11

Thompson

Question 12

Which of the following special tests, if negative, warrants a referral to a physician and possibly a contraindication to massage treatment? Homans, VA, Valsalva, Swallow

Answer 12

Swallow

Question 13

What is an example of a closed ended questions?

Answer 13

Have you been diagnosed by a Dr?
(Yes or No questions)

Question 14

During a gait assessment, if there is no pathology, the correct sequence of movement starting with heel strike is:

Answer 14

Heel Strike, Flat Foot, Midstance, Heel off, Toe off, midswing

Question 15

While performing the toothpick test the therapist sees that the patient presents with an early deviation C curve to their right side. This most likely indicates that:

Answer 15

The patient has muscle tightness or spasm on the right side

Question 16

Which observation of the upper limb resting neutrally, indicates if a patient has Erb’s palsy?

Answer 16

They have waiters tip deformity

Question 17

What active free glenohumeral range of motion results is most likely to be seen in a person with subacute adhesive capsulitis?

Answer 17

90° of abduction, 60° of external rotation, 45° of internal rotation, 120° of flexion, 55° of extension

Question 18

When performing a gait assessment the therapist notices that the patient has a right-sided high steppage gait and their right foot slaps onto the ground as they bring it down. What clinical impression is indicated by this observation alone?

Answer 18

The patient’s altered gait is possibly due to a sciatic nerve lesion or a common peroneal nerve lesion

Question 19

Prior to performing any special orthopedic tests, what could be an indicator that a patient is most likely experiencing pronator teres syndrome rather than carpal tunnel syndrome?

Answer 19

Wrist movement is compromised

Question 20

The Trendelenburg test evaluates both muscle strength and whether or not the superior gluteal nerve has been compromised. A patient standing on their right leg lifts their left leg, and the left hip drops. This is a positive result which indicates that:

Answer 20

Gluteus Med and Min on the right side is affected

Question 21

With the patient seated and one forearm resting on the table in the pronated position, the therapist places one finger contact on the patient’s fingernail of the 3rd digit. The therapist asks the patient to attempt to extend their 3rd digit while preventing the patient from moving. What is the therapist testing for?

Answer 21

Lateral Epicondylitis
can be call Maudley’s test

Question 22

Which test specifically assesses for an iliopsoas spasm or contracture?

Answer 22

Patrick’s
Fabers
Figure 4

Question 23

While performing a strength test for the tibialis anterior muscle, the patient finds that they are only able to perform dorsiflexion of the foot when they are laying on their side. What grade does this patient get for their strength test?

Answer 23

Grade 2

Question 24

What is the normal scapulothoracic rhythm?

Answer 24

For every 2° of humeral abduction the scapula should move 1°

Question 25

Pain is identified in a patient’s iliofemoral joint upon hip flexion during an active free range of motion assessment. What is the purpose of performing a passive relaxed range of motion assessment?

Answer 25

To identify if the pain is potentially due to non-contractile tissues at the joint

Question 26

When performing passive relaxed range of motion on a patient with suspected piriformis syndrome, which hip movement when they are in a prone position, will relieve their pain if they are positive for the condition?

Answer 26

External Rotation

Question 27

A patient with an acute grade 2 sprain of their right anterior talofibular ligament will likely present with what adaptation to the stance phase?

Answer 27

The right leg will be in the stance phase for 10% of the gait cycle

Question 28

With a patient in the standing position, they are asked to extend their trunk and slide their palm down the back of their leg while the therapist applies downward pressure on the patient’s shoulders. If this test is positive, what is the clinical impression?

Answer 28

Lumbar facet irritation

Question 29

When the rounded rubber portion of the reflex hammer touches the bottom of a patient’s foot, they are unable to identify if the object is dull or sharp, and are barely able to register a sensation at all. What has been demonstrated in this scenario?

Answer 29

A positive L5 dermatome test

Question 30

A patient with noted hyperlordosis on postural assessment will have:

Answer 30

Short erector spinae and iliopsoas muscles, and long abdominals and gluteus maximus muscles

Question 31

An assessment identifies that breast massage is indicated. What information is important to gain during the intake and assessment process?

Answer 31

Onset and frequency of breast pain

Question 32

A patient complains of a dull aching pain in their knee, what structures are more likely involved with this type of pain description?

Answer 32

ligament and joint capsule

Question 33

After the therapist has demonstrated the 3 knuckle test to the patient, what is the order of steps for the test?

Answer 33

Patient: washes hands, places one knuckle between their upper and lower rows of teeth, adds second knuckle, adds third knuckle

Question 34

While performing an assessment of the glenohumeral joint, the therapist places the patient's arm with the elbow flexed to 90°, stabilized against the thorax, and the forearm pronated. The therapist resists supination while the patient laterally rotates their arm against resistance. What test is the examiner most likely performing?

Answer 34

Yergasons

Question 35

During Active Free Range of Motion (AF ROM) of the hand a patient flexes all of their fingers and their thumb, when attempting to open their hand after, the therapist notes that the patient is unable to straighten their pinky and ring fingers. What could this be an indication of?

Answer 35

Ulnar nerve lesion

Question 36

A therapist applies a precise, quick tap to the medial hamstring tendon, which deep tendon reflex are they testing?

Answer 36

L5

Question 37

Why would a therapist use the Rib Motion Test?

Answer 37

to assess for a depressed rib on inhalations

Question 38

A patient arrives for treatment of their headache. They complain of pain in their forehead and point to the frontal area across their forehead. They state that the headache is worse when they bend forward to load the dishwasher. They also say that they are getting over a "head cold" and are still congested, they do not have a fever and have been cleared for massage. What would be an appropriate assessment plan for this patient?

Answer 38

Gentle palpation of the forehead to see if they have any sinus pain that could potentially be causing their headache

Question 39

While performing a passive range of motion assessment for the elbow joint which one of the following would indicate an "abnormal" result?

Answer 39

Extension 10° with tissue approximation

Question 40

Which of the following would be considered full active range of motion for the glenohumeral joint?

Answer 40

Lateral rotation 80-90°, medial rotation 60-100°, and extension 50-60°

Question 41

Which of the following best describes an empty end feel?

Answer 41

A movement that stops or can not be completed due to pain

Question 42

When performing a postural assessment, in the lateral view, where should the plumbline fall?

Answer 42

Slightly anterior to the lateral malleolus, slightly anterior to the midline of the knee, and slightly posterior to the axis of the hip

Question 43

A patient lies supine on the table and the therapist takes the affected leg and brings the patient's knee into no more than 30° flexion. Using the outside hand the therapist stabilizes the patient's femur. With the other hand, the therapist applies an anterior translation of the tibia on the femur. What test is the therapist most likely performing?

Answer 43

Lachmans

Question 44

Which of the following tests can be used to assess for medial epicondylitis? Cozens, maudsleys, mills, reverse mills?

Answer 44

Reverse Mills

Question 45

When using a strength test to assess biceps brachii the therapist notes the grade of contraction as a 4 however the patient complains of pain while performing the test. What could this be an indication of?

Answer 45

1st ir 2nd degree muscle strain

Question 46

When assessing the temporomandibular joint the therapist observes minimal jaw depression during intake and while assessing Range of Motion (ROM). Which of the following orthopedic tests can be used to help confirm the findings?

Answer 46

3 knuckle

Question 47

A therapist asks a patient to bring the tips of the 1st and 2nd digits together and notices that the patient is unable to complete the task and instead touches the finger pads together and not the fingertips. What may be the cause for this?

Answer 47

An indication of anterior interosseous nerve pathology (Pinch Grip test)

Question 48

Which brachial plexus tests is used to assess for compression of the median nerve?

Answer 48

ULTT 1 and ULTT2

Question 49

What is the stance phase of the gait cycle?

Answer 49

The stance phase is 60% of the gait cycle and includes the phases of initial contact, foot flat, single leg stance, heel-off, toe-off

Question 50

A marathon runner comes limping to the first aid tent and states they felt a sharp pain in their ankle and heard a popping sound. The therapist at the tent performs strength tests for gastrocnemius and soleus with a grade of 5 on the unaffected side and 1 on the affected side. What test to rule in the suspected condition should they use next?

Answer 50

Thompson

Question 51

A patient comes to see a therapist for a 1-hour massage therapy treatment in the hopes that they can help with the heaviness and aching they are experiencing in their left shoulder. Postural assessment reveals head-forward carriage and hyperkyphosis. Active Free and Passive Relaxed Range of Motion (ROM) testing of the shoulder reveals some decreased movement. There is a reduction of rotation and lateral flexion of the neck as well as a complaint of pain during Active Free ROM. Which of the following tests would be most appropriate?

Answer 51

Adsons Test

Question 52

A therapist has passively moved their patient's arm in the sagittal plane. Which range of motion did the therapist perform on the patient?

Answer 52

Flexion

Question 53

What is the purpose of range of motion testing?

Answer 53

To assist the therapist in narrowing down the more specific structures involved and specific limitations the patient is experiencing

Question 54

When assessing Active Free Range of Motion (AF ROM) of the temporomandibular joint (TMJ) in a patient with full ROM, what would the therapist expect to see?

Answer 54

Depression of 35-55 mm from neutral

Question 55

When assessing muscle strength the therapist finds the contraction is weak and painful on the affected side. What could this be an indication of?

Answer 55

A severe lesion around the joint possibly due to a fracture

Question 56

In addition to a person displaying a painful facial expression, an antalgic gait may be characterized by which of the following?

Answer 56

More weight placed on the unaffected side results in decreased time in the stance phase of the gait cycle on the affected leg

Question 57

A therapist attempting to assess the C6 myotome would ask their patient to perform which of the following?

Answer 57

Resisted Elbow flexion, wrist extension

Question 57

Which of the following measurements would be considered a wide Q angle for a 25-year-old female?

Answer 57

A Q angle of 20°

Question 58

A patient is seated at the edge of the table with their knees flexed to 90° and their legs relaxed off of the end of the table. Beginning with the unaffected side first and testing bilaterally the therapist sits in front of the patient and places their hand on the top of the patient's foot. The therapist asks the patient to push their foot up towards the ceiling and hold it for 3-5 seconds while the therapist resists by pressing the top of the patient's foot towards the floor. This is done once and then performed on the affected side. What test is the therapist likely performing?

Answer 58

L4 Myotome

Question 59

Which of the following special tests would warrant a referral to a physician if it was negative? Braggards, Swallow, Deep tendon reflex, hoover?

Answer 59

Swallow

Question 60

A therapist instructs a patient to open and close their hand rapidly 4-5 times and then hold the hand in a fist. What test is the therapist likely performing?

Answer 60

Allen Test

Question 61

A patient arrives for treatment of shoulder pain. They inform the therapist that they have been experiencing the pain for a month now and they went to their doctor who diagnosed them with a frozen shoulder. What would be an appropriate assessment plan?

Answer 61

Perform Active Free Range of Motion (AF ROM) followed by Passive Relaxed Range of Motion (PR ROM) and Resisted Isometric Range of Motion (RI ROM)

Question 62

During the patient interview, a patient asks the therapist to be careful when massaging their left thigh as they have been experiencing a slightly painful tingling sensation when their clothing touches the top of their left leg. Which of the following tests should the therapist consider performing?

Answer 62

L2 Dermatome test Bilaterally

Question 63

Which of the following assessment findings may indicate that a patient has pes planus?

Answer 63

Trigger points in peroneus longus and brevis, shortened gastrocnemius and soleus muscles, a valgus orientation of the Achilles tendon, and a positive Feiss Line

Question 64

When performing the talar tilt test, the therapist places the patient's foot in an anatomical position (flexed to 90°). The therapist then brings the foot into inversion, resulting in pain and hypermobility when compared with the unaffected side. What clinical impression would be the most appropriate?

Answer 64

Possible calcaneofibular ligament pathology

Question 65

What are the 4 T's of palpation?

Answer 65

Temp, tone, tenderness, texture

Question 66

The therapist places their hands around the metatarsophalangeal joints of a patient and squeezes tightly in order to see if it recreates the patient's pain. What test is the therapist most likely performing?

Answer 66

Mortons

Question 67

Which muscles would a therapist expect to be tight and lengthened in a patient with hyperkyphosis?

Answer 67

Thoracic erector spinae, infrahyoid and longus capitis