MSK: Midterm Assignments and Quiz Questions Flashcards
1
Q
The understanding of genomics has led to the identification of ________, which describes how an individual’s characteristics are a result of their genotype interacting with the environment.
A
Phenotypes
2
Q
__________ is defined as progressive and detectable but unrecognized decline in physical function in older adults.
A
Preclinical disability
3
Q
_________ involves the reduction of muscle mass and/or function as well as the impairment of the muscle’s capacity to regenerate.
A
Sarcopenia
4
Q
What is true for musculoskeletal system and aging?
A
All of the above
-Skeletal muscle of older people is more easily damaged with the loading that occurs during training compared with skeletal muscle of younger adults.
-Aging collagen increased cross-links between molecules, increasing the mechanical stability of collagen but also contributing to increased tissue stiffness.
-Tendons exhibit a lower metabolic activity associated with aging that has implications for injury and healing in the aging population.
5
Q
___________ fractures occur as a result of forceful heel strike during prolonged marching or running. ___________ reactions occur as a result of muscle pull and can become more serious if displacement occurs.
A
Compressive stress; Distractive stress
6
Q
In a ________, the fracture line is at a right angle to the long axis of the bone; this fracture is usually produced by shearing force.
A
transverse fracture
7
Q
Which of the following is the risk factor for fractures?
A
All of the above
-Eating disorder
-Leg-length discrepancy
-Radiation treatment
8
Q
When compared to a young adult, which of the following statements is true for an older adult?
A
Decreased ability of articular cartilage to hold water.
9
Q
Which of the following can be a specific risk factor for stress or fatigue fracture?
A
Genu valgum
10
Q
__________ are the most common osteoporosis-related fractures. The incidence increases with age and with decreasing bone density.
A
Vertebral compression fractures
11
Q
Which of the following is generally the first diagnostic study to be done following the clinical examination on a patient with musculoskeletal disorder?
A
X-ray
12
Q
Which of the following substances has the highest radiodensity?
A
Bone
13
Q
Which of the following is nonoperative treatment for vertebral compression fractures?
A
Bracing or assistive devices
14
Q
A PT treats a 38 y/o male patient with fibula fracture 2 weeks ago. The patient complains of numbness and severe muscle pain in his lower leg since this morning. The PT identifies a significant swelling on patient’s lower leg and suspects there is a development of compartmental syndrome. Which of the following actions is the best?
A
Contact patient’s physician and seek immediate medical attention.
15
Q
Which of the following complications of fractures requires immediate medical attention?
A
Fat embolism
16
Q
What is true about magnetic resonance imaging (MRI)?
A
Its primary use is to identify and characterize soft tissue injuries and pathological conditions.
17
Q
What is true for the musculoskeletal system in the aging population?
A
Joint proprioception declines
18
Q
If the bone is broken into more than two fragments, it is called ______.
A
Comminuted fracture
19
Q
Which of the following can affect the bone remodeling process?
A
All of the above
-parathyroid hormone levels
-mechanical stress
-calcium and phosphate levels in extra cellular fluid
20
Q
Which of the following is true for vertebral compression fractures (VCF)?
A
The incidence increases with age and with decreasing bone density
21
Q
What type of fracture is the most common in track and field athletes, distance runners, and soldiers in training?
A
Stress or fatigue fracture
22
Q
_____ occurs in the growth centers of children and adolescents, located in the long bones
A
Epiphyseal fracture
23
Q
Which of the following is true for the etiology of fracture?
A
Bone loss is accelerated for women during and after menopause
24
Q
Which of the following can be a specific risk factor for stress or fatigue fracture?
A
A wide pelvis.
25
Which of the following is true for chondrolysis?
The process of rapid cartilage degeneration is associated with anterior cruciate ligament reconstruction.
26
What is true for osteoarthritis (OA)?
Muscle weakness in anyone can also cause joint changes leading to OA, such as occurs with prolonged immobilization.
27
What is true for rheumatoid arthritis (RA)?
Although the cause remains unknown, recent advances in molecular techniques have allowed for identification of distinct cell subtypes, surface markers, and products that may initiate and propagate the inflammatory and destructive components of the disease.
28
Which of the following clinical manifestations can occur due to the progressive loss of cartilage on osteoarthritis (OA)?
All of the above
-Bony overgrowth
-Muscle weakness and atrophy
-Inflammation develops
29
Which of the following is true about the joint stiffness on osteoarthritis (OA)?
Stiffness over the joint involved for a short duration can occur after periods of inactivity, including sitting and sleeping.
30
Slowing the progression of the osteoarthritis (OA) with a combination of _______ and _______ is the current best method to treat or prevent OA.
drug; behavioral interventions
31
Which of the following is true when describing osteoarthritis (OA)?
Patient with minor radiographic degenerative changes may experience severe, intense pain.
32
What is true about rheumatoid factors?
Rheumatoid factors are autoantibodies that react with immunoglobulin antibodies found in the blood.
33
Which of the following is extraarticular rheumatoid arthritis (RA) manifestation?
Pulmonary effusions
34
Which of the following is considered as negative predictor for healing of fracture?
All of the above
-Diabetes mellitus
-Certain medications such as calcium channel blockers
-Vascular insufficiency
35
Which of the following complications of fractures requires immediate medical attention?
Fat embolism
36
Which of the following is true for vertebral compression fractures (VCF)?
Pain tends to be worse with spinal extension
37
Physicians specializing in radiology and interpreting medical images are called ______.
Radiologists
38
The process of fracture healing can be broken down into five stages:
1. hematoma formation
2. cellular proliferation
3. callous formation
4. ossification
5. consolidation and remodeling
39
Which of the following substances has the lowest radiographic density?
Metal
40
Which of the following is characteristic of the rheumatoid factor-positive subtype of polyarticular juvenile idiopathic arthritis (JIA)?
Presence of subcutaneous nodules
41
Which treatment is commonly used to manage polyarticular JIA and prevent disease progression?
DMARDs such as methotrexate (MTX)
42
Which of the following is a common feature of spondyloarthropathies (SpAs)?
Chronic inflammation of the axial skeleton and sacroiliac joints
43
Which of the following is an essential aspect of managing Ankylosing Spondylitis, as it requires significant cooperation and lifestyle adjustments from patients?
Compliance with the exercise program
44
The pathogenesis of ankylosing spondylitis (AS) is primarily marked by chronic inflammation at the site where the ligaments, tendons, and synovium attach to the bone, known as the __________.
Enthesis
45
Which of the following best describes the primary characteristic of Diffuse Idiopathic Skeletal Hyperostosis (DISH)?
Ossification of the anterior longitudinal ligament of the spine
46
In addition to dry eyes and dry mouth, Sjögren syndrome may also cause ________, which can lead to difficulties in chewing, swallowing, and speaking.
Xerostomia
47
Which of the following statements about Psoriatic Arthritis is TRUE?
Psoriatic arthritis has a high predilection for the distal interphalangeal joints of the hands.
48
Which of the following statements about Reactive Arthritis is TRUE?
Sacroiliac joint involvement occurs in 10% of acute cases and 30% of chronic cases.
49
Which of the following is true about Reiter Syndrome?
The classic triad of symptoms in Reiter syndrome includes urethritis, conjunctivitis, and arthritis.
50
Which of the following is true about the clinical manifestations and progression of gout?
The first metatarsophalangeal joint is the most common site for the first gout attack, which is usually monarticular and characterized by sudden onset of pain.
51
Which of the following is true regarding Osteochondritis Dissecans (OCD)?
The subcondoral bone is affected, and it is a disorder of at least one ossification site characterized by necrosis followed by recalcification
52
The term ___________ refers to the death of bone and bone marrow cellular components as a result of loss of blood supply in the absence of infection.
Osteonecrosis
53
Which of the following statements about Legg-Calvé-Perthes disease clinical manifestations is true?
Pinpoint tenderness over the hip capsule is a characteristic feature of the disease.
54
Which of the following is mentioned as a potential cause of Osgood-Schlatter disease?
Repetitive stress on the quadriceps muscle
55
Which of the following is true?
A person with rheumatoid arthritis usually develops small vessel vasculitis
56
What is true for osteoarthritis (OA)?
The overall prevalence of OA is expected to increase dramatically over the next 20 years as the population ages
57
What is true about rheumatoid factors?
On the pathogenesis of rheumatoid arthritis, it is hypothesized that the interaction between rheumatoid factor and the immunoglobulin triggers events that initiate an inflammatory reaction
58
Which of the following is musculoskeletal manifestation of rheumatoid arthritis (RA)?
Joint contracture
59
Pannus formation is a hallmark feature of which condition?
Rheumatoid arthritis
60
Which of the following is TRUE about Dislocations?
Most often occur at the glenohumeral joint.
61
Which of the following is true about strains?
Strains refer to stretching or tearing of the musculotendinous unit; they may be full or partial tears.
62
Which of the following is true for the clinical manifestations of muscle contusion?
Bruising with intact skin may result in local pain, edema, increased local tissue temperature, ecchymosis, hypermobility or instability, and loss of function.
63
Which of the following is true regarding compartment syndrome?
All of the above
-It may be caused by fractures, severe contusions, crush injuries, excessive skeletal traction, and reperfusion injuries and trauma.
-Nerves, muscles, and vessels in the compartment may be compromised.
-It may result in the loss of the involved limb.
64
What is a hallmark sign of Heterotropic Ossification?
A progressive loss of ROM at a time when posttraumatic inflammation should be resolving
65
Which of the following is true for Heterotopic Ossification (HO)?
The sites affected most often include the hip, elbow, knee, shoulder, and TMJ.
66
Which of these clinical manifestations is most common in connective tissue diseases?
Polyarthralgia
67
A patient recently diagnosed with polymyalgia rheumatica may experience which of the following clinical manifestations?
Bilateral shoulder and hip pain with morning stiffness.
68
What is a critical symptom of rhabdomyolysis that warrants immediate medical attention?
A change in urine color (tea or cola-colored).
69
Which of the following can cause rhabdomyolysis?
Excessive physical exertion
70
A physical therapist is visiting a patient in the ICU who has been hospitalized for an extended period. Which muscle group is most likely to be weak in this patient, considering the diagnosis of critical illness myopathy (CIM)?
Proximal lower limb muscles
71
Which of the following is a hereditary myopathy?
Muscular dystrophy
72
What are the primary criteria for identifying Trigger Points (TrPs)?
Presence of a taut band, presence of a TrP, and referred pain
73
What is the most broadly accepted definition of trigger points (TrPs) in the context of myofascial pain syndrome (MPS)?
Trigger points are hyperirritable spots in a taut band of skeletal muscle that are painful on compression, stretch, overload, or contraction of the tissue, usually responding with referred pain perceived distant from the spot.
74
Which of the following steps is essential during physical examination of trigger points (TrPs)?
Performing palpation to identify taut bands and further assess for the presence of TrPs.
75
Which of the following is true regarding the under activity of the pelvic floor muscles?
Birth related trauma is the most common factor in the activity of pelvic floor muscles.
76
What is the correct order of pelvic floor muscles (PFMs) from superficial to deep?
Superficial transverse perineal muscles, sphincter urethra, puborectalis
77
A 35-year-old female presents to an outpatient physical therapy clinic with complaints of urinary incontinence and pelvic pressure. She reports a history of childbirth, along with a sedentary lifestyle, which has contributed to muscle weakness. The patient also mentions occasional pelvic pain and has a history of mild anxiety. She has been advised by her doctor to seek physical therapy intervention for pelvic floor muscle weakness and dysfunction. During the evaluation, the physical therapist observed signs of underactivity of the pelvic floor muscles, including difficulty engaging the muscles during a pelvic floor contraction test. What would be the most appropriate initial PT intervention for this patient?
Biofeedback, pelvic floor muscle strengthening exercises, and vaginal weights.
78
Which statement is true about subluxation?
It is a partial disruption of the anatomic relationship within a joint
79
Which of the following tendon injuries reflects more of a chronic condition, with minimal or no inflammatory process detected histologically?
Tendinosis/tendinopathy
80
Which of the following is most likely to cause Heterotopic Ossification?
Total Hip Arthroplasty
81
Which demographic group is predominantly affected by overlap connective tissue disease (OCTD)?
Adult females
82
Which of the following diseases is related to giant cell arteritis?
Polymyalgia Rheumatica (PMR)
83
Which of the following can cause rhabdomyolysis?
Crush injury
84
Which of the following is a common clinical manifestation of critical illness myopathy (CIM)?
Progressive proximal muscle weakness, particularly in the lower limbs
85
Which of the following is a comorbidity for myofascial pain syndrome that can be addressed with contemporary methods, such as pharmacologic intervention?
Poor sleep hygiene
86
Which of the following factors can contribute to pelvic floor dysfunction?
All of the above
-Abdominal or pelvic surgery
-psychogenic origin
-pain related to rectal hemorrhoids
87
Which of the following is associated with urinary incontinence and pelvic organ prolapse?
Under activity of the pelvic floor muscles
88
An individual with a herniated disc positive imaging study on cervical spine will always present symptoms in the clinic.
False
89
Disc ______ occurs when the nucleus pulposus bulges into the annulus fibrosis and the disc margin extends beyond the endplates of adjacent vertebral levels.
Bulge
90
Which of the following clinical presentations can be expected to see on a patient with cervical degenerative disc disease (DDD)?
All of the above
-Annular tears
-Nuclear disc material degradation
-Osteophyte on vertebral body
91
Which of the following is TRUE on thoracic disc pathology?
Pain can be nonspecific.
92
Which of the following can be the sign or symptom of thoracic disc pathology?
All of the above
-Pain on midback and lower back.
-Positive slump test
-Spinal cord compression symptoms.
93
Which of the following are the contributing factors for cervical facet dysfunction?
Occupations that require repetitive activities of the neck.
94
Which of the following statements is TRUE for primary facet pathology?
Primary facet pathology is common for bone spurs to intrude into the zygapophyseal joint.
95
A PT treats a patient with the diagnosis of cervical facet arthropathy. Which of the following activities would typically make patient’s symptoms better?
Positions that involve an “opening” pattern of the cervical spine.
96
Which of the following may cause cervical muscle strain?
All of the above
-Poor posture of neck
-Having head or neck in prolonged position
-Weak neck muscle strength
97
Which of the following pathologies might be related to cervical radiculopathy?
All of the above
-Spondylosis
-Disc herniation
-Facet dysfunction
98
You are evaluating a 32 y/o male patient with diagnosis of left cervical radiculopathy. If the patient presents limited active ROM on right lateral bending (away from the side of discomfort) because he is trying not to aggravate his symptom of tingling in his left arm, which of the following tissues on his neck might most likely be involved besides the nerve?
Disc
99
_____________ is generally the result of daily wear and tear in combination with various injuries sustained throughout life that cause the breakdown of healthy tissue.
Cervical degenerative joint disease
100
Which of the following can be a typically imaging finding on a patient with degenerative joint disease on cervical spine?
Narrowing of the joint space
101
Which of the following activities can be an aggravating factor in a patient with cervical spondylosis?
Ipsilateral side flexion and rotation of neck
102
Which of the following can be the cause of whiplash-associated disorders?
All of the above
-Child abuse
-Quick, sudden motions of the neck
-Motor vehicle accidents
103
Which of the following would be the most common symptom in a person with whiplash injury?
Neck pain and shoulder pain
104
Which of the following is an example of functional scoliosis?
Protective scoliosis secondary to a lumbar disc herniation
105
Which type of scoliosis has the highest risk for poor outcomes?
Juvenile idiopathic scoliosis
106
Some individuals with cervical disc pathology can be asymptomatic, but their imaging studies show degenerative changes within the cervical spine
True
107
Disc _____ occurs when the nucleus pulposus breaks past the outer lamina of the annulus fibrosis and into the space beyond.
Extrusion
108
Which of the following activities may increase patient's symptoms of neck pain due to the change in disc pressure?
Sneezing
109
Which of the following statements is true for cervical facet dysfunction?
A history of trauma to the neck in the past may account for some of the abnormal mechanics and subsequent wear and tear at the facet joint
110
A PT treats a patient with the diagnosis of cervical facet arthroplasty, and the patient has neck pain on the left side. Looking in specific directions involving a "closing" pattern would typically aggravate patient's symptoms
True
111
A patient who received anterior cervical discectomy and fusion may develop joint hypomobility at the fusion level, but hypermobility in the segments above and below
True
112
A 52 y/o male was recently diagnosed with cervical degenerative disc disease. What signs and symptoms may the patient present in the clinic?
All of the above
-diffuse and vague pain over the cervical spine
-limited range of motion on cervical spine
-refer pain extends down the arm past the AC joint
113
Numbness and/or tingling in the arm or hand is one of the common symptoms for cervical radiculopathy
True
114
The use of seatbelts has decreased the number of fatalities due to motor vehicle accidents, and with the increased usage of seatbelts, there has been a decrease in severe forms of whiplash injuries
False
115
Poor sitting posture can contribute to cervical muscle strain
True
116
Which of the following is true for lumbar disc pathology?
Patient may experience dull and deep pain on lower back but hard to be localized
117
Which of the following might be the most effective intervention to a patient with chronic low back pain for more than one year due to degenerative joint disease?
Provide patient education on mechanism of injury and good body mechanics.
118
A physical therapist has been treating a 62-year-old male with spondylolisthesis for three months. However, the patient recently developed pain radiating to buttock, posterior thigh, and lower leg. Which of the following actions should the therapist do?
Refer the patient to see a physician.
119
A DPT student is assessing the standing posture on a 28-year-old female with low back pain due to lumbar stenosis. The clinical instructor reminds the student to check if the patient may have lower crossed syndrome. Which of the following clinical magnifications might be relevant to lower crossed syndrome?
Weak gluteus maximus and abdominals
120
Which of the following patient populations may receive the most benefit from lumbar extension-based exercises?
Lumbar disc protrusion
121
Which of the following activities may cause lumbar disc herniation?
Bearing down for a bowel movement
122
Which of the following movements may aggravate the symptoms in the patient with lumbar degenerative joint disease?
The movement that causes more joint compression
123
Which of the following may cause lumber spine interforaminal stenosis?
Bone spurs
124
125
A 45-year-old male is in your clinic 3 days after onset of acute low back pain with left lower extremity pain into posterior thigh to knee. It is his second episode of this condition in the past 6 months. Which of the following pathologies can be the patient’s medical diagnosis on his referral?
Lumbar degenerative joint disease (spondylosis) with radiculopathy.
126
What is true for lumbar radiculopathy?
The pain due to lumbar radiculopathy can be described as sharp, shooting, or burning.
127
Most people with soft tissue injuries in the lower back will recover within _______ .
1 to 2 months
128
_______ is a fracture at the region of the pars interarticularis. It usually occurs at the fifth lumbar vertebra and next most frequently at the fourth lumbar vertebra.
Spondylolysis
129
Obesity can be a contributing factor of ____________.
All of the above
-lumbar ligament strain/sprain
-lumbar degenerative joint disease
-lumbar muscle strain
130
Which of the following is true for sacroiliac joint pathology?
The gold standard for verifying sacroiliac articulation as the source of pain is the use of intraarticular anesthetic injections.
131
Mrs. Johnson, a 78-year-old retired teacher, presents to the outpatient PT clinic with lower back pain that began two weeks ago. She reports that the pain started after a weekend spent gardening, where she spent hours bending over to pull weeds and lifting heavy bags of soil. Mrs. Johnson also experiences stiffness in her lower back, particularly in the mornings. Based on Mrs. Johnson's history of activity, which of the following factors is most likely contributing to her lumbar muscle strain?
Spending long periods bending and lifting while gardening without breaks.
132
A physical therapist is evaluating a 78-year-old woman with degenerative joint disease of the lumbar spine. Which activities may help ease her symptoms?
Lying down with knees flexed or flexion-based activities
133
A physical therapist is evaluating a 63-year-old male with lumbar radiculopathy. The patient asks the PT about the reasons for his condition. Which of the following pieces of information is clinically relevant as a contributing factor?
All of the above
-The patient rarely engages in physical activity or exercise
-The patient is a metro bus driver
-The patient was informed that his left leg is slightly longer than his right leg
