MSK (SEM exam)

Question 1

Tibialis posterior muscle is best palpated:

Answer 1

posterior to the medial malleolus

Question 2

Which of the following is the MOST affected lateral collateral ligament of the ankle in a low ankle inversion sprain?

Anterior talofibular ligament
Posterior talofibular ligament Calcaneofibular ligame

Answer 2

Anterior talofibular ligament

Question 3

A patient with complain of posterior heel pain is referred for PT evaluation and treatment. Which of the following finding/s is/are likely pertinent positive in this patient?

Decreased ankle dorsiflexion ROM
Decreased ankle dorsiflexion strength
None of these
Reported pain at plantar surface only at initial weight bearing after periods of rest

Answer 3

Decreased ankle dorsiflexion ROM

Question 4

Which of the following is considered as the strongest lateral collateral ligament of the ankle?

Calcaneofibular ligament
Posterior talofibular ligament
Anterior talofibular ligament

Answer 4

Posterior talofibular ligament

Question 5

The varus stress test of the ankle assesses the integrity of all of the following ligaments EXCEPT:

tibiofibular ligament
posterior talofibular ligament
posterior calcaneofibular ligament
anterior talofibular ligament

Answer 5

posterior calcaneofibular ligament

Question 6

True of patellofemoral pain:

All are true

All are not true

Pain or apprehension with superior-inferior glide and tilt maneuvers of the patella also supports the diagnosis

A mainstay of clinical diagnosis is tenderness to palpation under the medial and lateral aspects of the patella

Localized to the anterior knee, or even say that the pain is “below the kneecap”

Answer 6

A mainstay of clinical diagnosis is tenderness to palpation under the medial and lateral aspects of the patella

Question 7

Patellofemoral forces can be minimized during quadriceps strengthening by perform­ing closed kinetic chain strengthening exercises between:

30 degrees and 60 degrees of flexion
90 degrees and 120 degrees of flexion
60 degrees and 90 degrees of flexion
0 degrees and 30 degrees of flexion

Answer 7

0 degrees and 30 degrees of flexion

Question 8

rozen shoulder is more common in women than men. It is most frequently seen in individuals between 40 to 60 years of age.

Both statements are false.
Only the first statement is true.
Only the second statement is true.
Both statements are true.

Answer 8

Both statements are true.

Question 9

Which of the following is NOT true regarding Achilles tendon tenosynovitis?

There may be presence of noticeable swelling on the Achilles tendon area
May be a precursor to tendon rupture
None of the given choices
Acute local tenderness may be present on the area
During walking, a pad may be placed on the metatarsal heads to elevate the forefoot and lessen the excursion of the heel

Answer 9

During walking, a pad may be placed on the metatarsal heads to elevate the forefoot and lessen the excursion of the heel

Question 10

The radiograph of the patient with osteoarthritis shows moderate osteophytes and joint space narrowing and some sclerosis. What is the Kellgren and Lawrence grade of the patient?

III
IV
II
I

Answer 10

III

Question 11

If a patient is able to localize a point of maximum pain concerning a jumper’s knee, it is usually felt at:

Mediolateral side of patella
Inferior pole of patella
Underneath the patella
Superior pole of patella

Answer 11

Inferior pole of patella

Question 12

Which of the following etiologies and levels of amputation presents with the MOST metabolic requirements for ambulation using a prosthesis?

Traumatic transfemoral
Vascular transtibial
Vascular transfemoral
Traumatic transtibial

Answer 12

Vascular transfemoral

Question 13

The following are possible clinical manifestations of OA EXCEPT:

Increased risk for falls
Pseudolaxity of medial collateral ligament
Flexion deformity of knee
Protrusio acetabuli

Answer 13

Protrusio acetabuli

Question 14

A patient complains of (L) hip pain which is aggravated by weight bearing. Based on the BMI, patient is obese and suspected to have an osteoarthtitis. Which of the following motions would most likely to elicit pain?

Hip IR >15 deg
Hip ER < 15 deg
Hip flexion <115 with hip ER > 15 deg
Hip IR <15 with hip extension <15 deg

Answer 14

Hip IR >15 deg

Question 15

Which muscle group should be emphasized when training a patient with cervical spondylosis using postural exercises?

All of these
Deep Cervical Flexors
Capital Extensors
Scapular Retractors

Answer 15

All of these

Question 16

A patient who underwent a minimally invasive THA with anterior approach will present which of the following features?

Required to adhere to abduction precautions.
Disrupted abductor mechanism causing Trendelenburg gait.
Extended period of non-weight bearing status.
All involved muscles are intact and were retracted only during procedure.

Answer 16

All involved muscles are intact and were retracted only during procedure.

Question 17

Postural retraining in adhesive capsulitis should focus on:

Reducing kyphosis
Neither
Both
Preventing forward humeral positioning

Answer 17

Both

Question 18

Upon interview to a 2 weeks post-THA posterior approach patient, evaluation revealed that patient’s home environment compose mostly with low wood chairs. How will this finding affect the patient’s recovery?

Neither of the component of sit-to-stand from a low chair will cause dislocation since all soft tissues around the hip joint have healed sufficiently
At risk for anterior dislocation, particularly when rising from low chair as it impose higher load at the hip joint.
At risk for posterior dislocation, particularly when rising from low chair as it impose higher load at the hip joint.
Both component of sit-to-stand from a low chair will cause anterior dislocation

Answer 18

At risk for posterior dislocation, particularly when rising from low chair as it impose higher load at the hip joint.

Question 19

Which of the following predisposes a patient to have a jumper’s knee?
Correct Answer

Both of these

Lacks adequate ankle dorsiflexion

Inadequate activation of lumbar and hip extensors

None of these

Answer 19

Both of these

Question 20

Lasting up to 3 months presenting with pain with shoulder movements but no sig­nificant glenohumeral joint ROM restriction when exam­ined under anesthesia best describes:

stage 4
stage 1
stage 2
stage 3

Answer 20

stage 1

Question 21

For patients who will be fitted with conventional body-powered AE prosthesis, it is important that the patient is able to isolate muscle contraction to these KEY motions, EXCEPT:

Shoulder protraction
Shoulder abduction
Shoulder internal rotation
Shoulder flexion

Answer 21

Shoulder internal rotation

Question 22

After applying an axial compression to a patient’s head while the neck is laterally flexed to the right, the patient complained of a sharp, shooting pain that coursed through his right upper extremity during the maneuver. In this situation, the therapist can conclude that the patient most likely has a/an:

Intervertebral foramen affectation
Muscle Spasms
Peripheral Nerve Injury
Normal response to the test

Answer 22

Intervertebral foramen affectation

Question 23

A unilateral above-knee amputee in the prosthetic training phase who scores 40 in the Amputee Mobility Predictor tool is assigned which functional level and what does this signify?

K3: Has ability or potential for ambulation with variable cadence and ability to traverse most environmental barriers; community ambulator
K1: Has ability or potential to ambulate or transfer using prosthesis; limited and unlimited household ambulator
K0: No ability or potential to ambulate or transfer safely with or without assistance
K2: Has ability or potential for ambulation with ability to traverse low-level environmental barriers such as curbs, stairs, and uneven surfaces; limited community ambulator
K4: Has ability or potential for ambulation exceeding basic ambulation skills, typically involving high-impact activities

Answer 23

K3: Has ability or potential for ambulation with variable cadence and ability to traverse most environmental barriers; community ambulator

Question 24

Which of the following is INCORRECT about rotator cuff injury?

Calcific tendonitis is a risk factor for cuff tears
MRI with T2- weighted images is highly specific for full thickness tear.
The injury may be traumatic or degenerative in nature and injury to tendon of insertion leads to abduction limitation.
None of these

Answer 24

None of these

Question 25

Which of the following test should be done to determine if there is rotator cuff injury?

Ludington’s Test
Active Compression Test of O’Brien
Drop arm test
Lippman’s Test

Answer 25

Drop arm test

Question 26

The PT was performing a test on his patient. The patient was asked to stand on one leg and to extend the spine while balancing on other leg. What test is being performed and its possible interpretation?

Hoover Test : Neurogenic Claudication
Stork Standing Lumbar Extension Test : Spondylolisthesis
Pheasant Test : (+) Lumbar Instability
Quadrant Extension Test : (+) Joint dysfunction

Answer 26

Stork Standing Lumbar Extension Test : Spondylolisthesis

Question 27

According to Waddell, the following signs and symptoms may be indicative of a more serious pathology in the lumbar spine in relation to low back pain, EXCEPT:

Unexpected weight loss

Violent trauma

Constant, progressive, nonmechanical pain

None of the given choices

Systemic illness

Answer 27

None of the given choices

Question 28

Patient instructions for isometric exercises include the following, EXCEPT:

maintain the contraction for no more than 6 seconds
not contract more than two muscle groups at a time
all are appropriate instructions
avoid maximal effort because it is neither necessary nor desirable
exhale during the contraction and inhale during a similar time period of relaxation

Answer 28

all are appropriate instructions

Question 29

A patient with L3 spondylolisthesis was being given patient education as part of PT program. The physical therapist warns the patient of the following activity that may increase load in the spine. Which of the ff would give the most stress in the spine?

Sit ups with knees bent
Bilateral SLR
Active back hyperextension
Isometric contraction of abdominals

Answer 29

Sit ups with knees bent

Question 30

This type of trabecular system resists bending and shearing forces in the vertebral body:

Horizontal trabeculae

All of these

Vertical trabeculae

Fan shaped trabeculae

Answer 30

Fan shaped trabeculae

Question 31

The following spine structures belong to the weight-bearing Anterior Pillar, EXCEPT:

Intervertebral discs

Anterior longitudinal ligament

Vertebral body

Facet joints

Answer 31

Facet joints

Question 32

What happens to the superior vertebra over the adjacent vertebra during spinal flexion?

anterior tilting and gliding of the superior vertebra causing narrowing of foramen and separation of spinous process

posterior tilting and gliding of the superior vertebra causing narrowing of foramen and approximation of spinous process

posterior tilting and gliding of the superior vertebra causing widening of foramen and separation of spinous process

anterior tilting and gliding of the superior vertebra causing widening of foramen and separation of spinous process

Answer 32

anterior tilting and gliding of the superior vertebra causing widening of foramen and separation of spinous process

Question 33

A 88/M with a dx Lumbar Compression Fx 20 Senile Osteoporosis was referred to physical therapy for management. The following management principles is/are applicable for this patient, EXCEPT?

Progressive resistance training should not be performed
Moderate activity such as brisk walking for 30 minutes or 20 minutes of vigorous activity such as running is acceptable
Using a weighted vest during exercise to improve bone mass density
Trunk flexion exercises, such as supine curl-ups, as well as the use of sitting abdominal machines should be avoided

Answer 33

Progressive resistance training should not be performed

Question 34

A female patient was referred to physical therapy for evaluation and treatment. While the Military Brace Test is being performed, reproduction of patient’s symptoms was observed. Which of the following should be further evaluated?

Mobility of clavicle and first rib

None of these

Tightness of pectoralis minor

You Answered

Tightness of scalene muscle

Answer 34

Mobility of clavicle and first rib

Question 35

A 28 y/o Tennis player px was diagnosed with acute lateral epicondylitis on the right elbow was referred to PT for treatment. Which of the following intervention is appropriate in controlling the pain of the px?

Ice massage using ice cup x 10 minutes

Contrast bath x 15 minutes

Continuous Ultrasound using 3 Mhz x 1.0 W/cm2 x 5 minutes

Pulse Ultrasound using 1 Mhz x 1.5W/cm2 x 5 minutes

Answer 35

Ice massage using ice cup x 10 minutes

Question 36

Which of the following exercises can improve patient’s dynamic neuromuscular control of ankle and foot?

pick up small objects from floor such as marble or dice
making ankle motions using a rocker board with the patient sitting
instruct patient to “draw” alphabets using his feet in long sitting
patient attempting to raise the MLA while keeping the forefoot and hindfoot on the floor
all of these

Answer 36

all of these

Question 37

According to Heel Pain Committee of the Americal College of Foot and Ankle Surgeons, complaints of posterior heel pain is most likely due to?

Plantar fasciitis
Plantar fasciosis
Heel spurs
Achilles tendinitis

Answer 37

Heel spurs

Question 38

Treatment protocols for patellofemoral pain include:

  Patellofemoral taping 
  Activity modification 
  All are usual principles for musculoskeletal rehabilitation 
  Strengthening weak muscles 
  Stretching tight structures

Answer 38

All are usual principles for musculoskeletal rehabilitation

Question 39

A therapist decides to apply mobilization with movement to increase dorsiflexion on a patient who has stiffness of the talocrucal joint following removal of a short leg cast. In this situation, how should the therapist position the patient for proper application of the technique?

Prone
Standing
Supine
Sidelying

Answer 39

Standing

Question 40

Which of the following ligaments is/are most likely affected if the patient is diagnosed with high ankle inversion sprain?

I

Anterior talofibular ligament

II

Posterior talofibular ligament

III

Calcaneofibular ligament

IV

Inferior tibiofibular ligament

  I, II, III are correct 
  I and III are correct 
  Only IV is correct 
  All are correct 
  II and IV are correct

Answer 40

Only IV is correct; Inferior tibiofibular ligament

Question 41

Which instruction should not be included when teaching a patient with a tibial fracture on the left how to perform sit-to-stand from a chair with armrests while using axillary crutches?

Place one hand on the arm rest and the other on the handpiece of both crutches.
Position the right foot more posteriorly than the left.
None, all are appropriate for this skill
Grasp both handpieces of the crutches using the right hand.

Answer 41

Grasp both handpieces of the crutches using the right hand.

Question 42

During a re-evaluation, a patient with a tibial fracture tells the therapist that he hasn’t been able to comply with the non-weight-bearing restriction at home- occasionally using the affected extremity to bear some weight when moving about at home. The most appropriate therapist response in this scenario is to:

Proceed with the treatment session and include proper assistive device use.

Do not treat the patient and refer the patient for an x-ray.

Examine the patient’s static and dynamic balance to confirm his claim.

Assure the patient that that is alright so long as no pain is felt when bearing weight.

Answer 42

Do not treat the patient and refer the patient for an x-ray.

Question 43

A 60 y/o retired employee sustained a femoral neck fracture on the L after a fall. Pt is referred for rehabilitation S/P joint replacement 1 month ago.

The patient is indicated for gait training, to promote full weight bearing over the affected LE. Which of the following assistive devices would be MOST appropriate for the intended goal?

Axillary Crutches

Quad Cane

Forearm Crutches

Walker

Answer 43

Quad Cane

Question 44

A patient with trans-tibial amputation 2o to PVD is referred for PT Evaluation. As part of the objective evaluation for readiness to use a LE prosthetic device, the therapist measured muscle strength via MMT. Which of the following would be MOST pertinent to perform to determine proper use of the prosthetic device?

In the sidelying position, ask the patient to lift the top LE, applying resistance over the lateral distal femur

In sitting dangling position, ask the patient to straighten the knee, while applying downward force on the anterior distal stump

You Answered

In the prone position, ask the patient to lift his thigh off the plinth, applying force over the posterior thigh

In the prone position, ask the patient to bend his knee while applying force over the posterior distal stump

Answer 44

In sitting dangling position, ask the patient to straighten the knee, while applying downward force on the anterior distal stump

Question 45

A patient with trans-tibial amputation is referred for gait training with a prosthetic device. Which of the following exercises is NOT appropriate to target weight bearing on the prosthetic device?

Stepping Activities with the unaffected LE
Weight Shifting Anterior-Posterior in bilateral stance
Weight Shifting Side-Side in bilateral stance
Stepping Activities with the Prosthesis
All of these are appropriate for the goal indicated

Answer 45

All of these are appropriate for the goal indicated

Question 46

Patient who underwent THA has higher risk of having dislocation if with following factors:

Reason of surgery is due to femoral neck fracture.
Proper and suitable size of femoral head component.
No known chronic inflammatory disease in PMHx.
Procedure done using lateral approach.

Answer 46

Reason of surgery is due to femoral neck fracture.

Question 47

A patient with cervical neck pain is being instructed to perform cervical stabilization exercises with limb loading. In this case, which of the following maneuvers would this patient find the most difficult?

Shoulder flexion to 90 deg while in supine
Shoulder flexion to end-range while in supine
Shoulder external rotations with arms at the side in supine
Shoulder abduction with external rotation to end range in supine

Answer 47

Shoulder abduction with external rotation to end range in supine

Question 48

When using a transhumeral (ie. AE) prosthesis, the terminal device of a body-powered prosthesis can be operated via shoulder flexion or biscapular abduction if the elbow joint is:

Locked
Either locked or unlocked will work
Unlocked

Answer 48

Locked

Question 49

Which of the following is TRUE regarding “voluntary closing” terminal devices used for conventional body-powered UE prostheses…?

Wearer actively opens the device using a cable system
Terminal device is closed at rest
Terminal device is open at rest
All of these are true

Answer 49

Terminal device is open at rest

Question 50

A 70-year-old patient with osteoarthritis has difficulty with balance when ambulating at home. The patient reported recurrent falls in the last month. What is the initial priority of home PT?

Gait training with quad cane to ensure safety
Installing lights throughout the house and keeping them lit all the time.
Strength training of LE to improve balance.
Ambulation training on different surfaces in home.
All of the given choices

Answer 50

Gait training with quad cane to ensure safety

Question 51

Which of the following finding/s is/are required to achieve prior to progressing moderate protection phase after a traditional THA?

All of these

Able to ambulate pain-free without assistive device.

Independent in all aspect of ADLs.

Can bear full weight on the operated extremity without pain and with a fully extended knee.

Answer 51

Can bear full weight on the operated extremity without pain and with a fully extended knee.

Question 52

The following are pertinent findings in the past medical history of adhesive capsulitis patients EXCEPT:

  Previous trauma 
  Uncontrolled hypertension 
  Inflammatory arthritis 
  Thyroid disease 
  Diabetes mellitus

Answer 52

Uncontrolled hypertension

Question 53

Considering the cause of a patient’s amputation to be PVD, which of the following will be the MOST Appropriate Preventive Goal for the identified problem?

(+) Superficial Sensory Deficit: Pt will constantly perform skin checks on the LE
(+) Diminished Dorsalis Pedis Pulse: Pt will demonstrate a grade 4+ pulse over dorsalis pedis
Decreased Endurance: Pt will have ↑ distance ambulated on 6 MWT with RPE of 15
(+) Edema: Pt will exhibit ↓ limb circumference by 2 cm

Answer 53

(+) Superficial Sensory Deficit: Pt will constantly perform skin checks on the LE