Musculoskeletal

Question 1

What is a reverse muscle action

Answer 1

This occurs when a muscle takes on a different role/action because the muscle’s origin now moves towards a fixed insertion, whereas a typical muscle will move from insertion point to origin.

Question 2

List a regular and a reverse muscle action exercise for the following muscle groups:

biceps brachii
middle deltoid
latissimus dorsi

Answer 2

biceps brachii - normal bicep curls, reverse pull ups
middle deltoid - normal shoulder abduction, reverse isometric sh. abduction
latissimus dorsi - normal lat pull downs, reverse push ups

Question 3

Fill this table out to be able to identify the main differences between RA and OA

Answer 3

Question 4

Your patient is an avid runner and comes into the clinic and complains of dull pain on the medial side of the shin that extends greater than 5cm. Her pain is present at the beginning of the working and during cool down, but goes away during exercise. You suspect

A. Shin splints
B. Stress fracture
C. Anterior compartment syndrome

Answer 4

shin splints

Question 5

If a patient has shin splints, they will have limited mobility secondary to tightness in the anterior/posterior compartment

Answer 5

posterior; gastroc, soleus, posterior tib.

Question 6

Your patient is an avid runner and comes into the clinic and complains of deep point tender pain that is less than 5cm in length and the pain is present at rest, especially at night. You suspect

A. Shin splints
B. Stress fracture
C. Anterior compartment syndrome

Answer 6

B. stress fracture

Question 7

Your patient is an avid runner and comes into the clinic and complains of extreme pain in the front of her left lower leg. She describes the pain as numb, tight, and worsens with stretching. You suspect

A. Shin splints
B. Stress fracture
C. Anterior compartment syndrome

Answer 7

anterior compartment syndrome - this is a medical emergency that

Question 8

You suspect your patient is experiencing anterior compartment syndrome. You palpate her pedal pulse and expect to find they are normal, absent, or diminished

Answer 8

absent or diminished, it will be hard to find.

Question 9

Fill this table out in regards to shoulder pathologies and special tests.

Answer 9

Question 10

Fill this table out in regards to shoulder pathologies and special tests.

Answer 10

Question 11

Your pt is recovering from a surgical repaired SLAP lesion. What ROM restrictions would you expect immediately post-op

Answer 11

passive rom only, no active
shoulder flexion limited to 30 degrees per week, so at 90 degrees by week 3 or 4
0-15 degrees ER, 45 IR week 1-2
15-30 degrees ER,, 60 IR week 3-4

Question 12

True or False:

Active elbow supination/pronation is appropiate for your pt who is 4 weeks post-op SLAP repair

Answer 12

false, avoid active biceps contraction for six weeks

shoulder extension with elbow extension should be avoided for 6 weeks as well

Question 13

What is spondylolisthesis and what spinal segments does it occur at

Answer 13

a forward displacement of one vertebra over another. This occurs mainly at L4-L5, L5-S1

Question 14

What is the meyerding scale

Answer 14

used to scale spondylolisthesis, 5 grades.
1. less than 25%
2. 25-49%
3. 50-74%
4. 75-99%
5. 100+%

Question 15

What is the step off sign in regards to spondylolisthesis

Answer 15

a palpable anterior displacement of a spinous process relative to the level below

for example, if you feel L4 anteriorly displaced relative to L5, this is called a L5-S1 spondylolisthesis

Question 16

what bones articulate at the first CMC joint

Answer 16

trapezium and first metacarpal

Question 17

State the correct information for flexion and extension of the first CMC joint

1. plane of motion
2. arthrokinematics motion

Answer 17

flexion and extension occur in the frontal plane. A concave moves on convex, so roll and glide into the same direction

example, during flexion there is a medial/ulnar roll and medial glide

Question 18

State the correct information for abduction and adduction of the first CMC joint

1. plane of motion
2. arthrokinematics motion

Answer 18

abduction and adduction occur in the sagittal plane. a convex joint moves on a concave joint, so roll and glide occur in opposite directions

For example, there is a volar/palmar roll and dorsal glide during abduction

and a dorsal/posterior roll and palmar glide during adduction

Question 19

what is normal ROM for opening of the TMJ

Answer 19

35-55 millimeters

Question 20

What is the bite down test or cotton roll test and how is it performed?

Answer 20

this is used to determine the origin of the patient’s jaw pain - muscular or joint

a tongue depressor or cotton roll is placed in between the teeth and the pt bites down.

If the pain is on the same side of the cotton roll, muscle is the cause.
If the pain is on the opposite side, the joint is the cause.

Question 21

How should a pt descend a curb in a wheelchair going backward

Answer 21

backup so that the wheels are close to the edge, lean forward, then roll backwards down the curb slowly until the front wheels are down

Question 22

How should a pt ascend a curb in a wheelchair

Answer 22

pop a wheelie by bringing the wheelchair close to the curb then quickly pulling back to an abrupt stop to bring the front wheels up

Question 23

How should a patient ascend stairs with a walker

Answer 23

the walker is placed on the opposite side of handrail. The closed
side of the walker is placed closest to the body. The front feet of
the walker are placed on the step above and the rear feet are on placed on the step where the patient is standing. The patient ascends with the sound limb first, then lifts the affected lower extremity. The walker is then advanced to the
next step.

Question 24

How should a pt descend stairs with a walker

Answer 24

the
front feet of the walker are placed one step below, and the rear feet are placed at the level the patient is
standing. The weaker lower extremity descends first, then the patient steps down with the strongest
lower extremity. The walker follows and the process is repeated. The patient is instructed to grasp onto the
rear hand grip or the midpoint of the horizontal bar of the walker during this transfer.

Question 25

What artery supplies the cerebellum, brainstem, and occipital lobes

Answer 25

vertebrobasilar artery

Question 26

How can you tell if your patient is experiencing vertebrobasilar insufficiency

Answer 26

The 5 D’s And 3 N’s

drop attacks, dysartria, dysphagia, diplopia, dizziness
ataxic gait
nystagmus, nausea, numbness

Question 27

How would a PT test for VBI

Answer 27

with the quadrant test - pt is supine and head is passively extended and side bended, then rotated towards the same side for thirty seconds to test the contralateral artery