Orthapedic assessment Flashcards
Your client complains of tingling in their hand. You have ruled out any cervical or thoracic outlet problems. The client has no reproduction of symptoms with wrist ROM testing. Based on this information, which one of the following orthopedic tests would you perform to help you confirm the source of neurological compression?
Phalen’s test
Pronator teres test
Tinel’s test at the wrist
C7, C8 dermatomal assessment
Pronator teres test
Which of the following is NOT a cause of temporomandibular joint dysfunction?
Imbalances in muscles of mastication
Cranial bone misalignment
Sinus blockage or infection
Nutritional deficiencies
Nutritional deficiencies
Which one of the following pairs of orthopedic tests would you use to differentiate thoracic outlet syndrome from carpal tunnel syndrome?
Adson’s test and Phalen’s test
Wright’s test and Adson’s test
Phalen’s test and Tinel’s test
Adson’s test and Eden’s test
Adson’s test and Phalen’s test
Phalen’s test is performed:
By flexing the wrists, which stretches the structures in the carpal tunnel
By flexing the wrists, which compresses the structures in the carpal tunnel
By extending the wrists, which stretches the structures in the carpal tunnel
By extending the wrists, which compresses the structures in the carpal tunnel
By flexing the wrists, which compresses the structures in the carpal tunnel
Incorrect Response
A client comes to you complaining of dull achy shoulder pain. You find the following on assessment:1. pain in the proximal lateral brachium between 60 - 100active free abduction 2. no pain on passive relaxed abduction and flexion 3. pain in the proximal lateral brachium with the supraspinatus test 4. pain in the proximal lateral brachium with Speed’s testWithout further testing, which of the following structures can be ruled out as the source of the client’s pain?
acromioclavicular joint
subacromial bursa
biceps brachii
supraspinatus
acromioclavicular joint
Apley’s Compression test is an assessment for________________,while Apley’s Distraction test is an assessment for_____________.
collateral ligaments, meniscal injury
meniscal injury, collateral ligaments
cruciate ligaments, collateral ligaments
collateral ligaments, cruciate ligaments
meniscal injury, collateral ligaments
Your client complains about foot pain. You observe the client to have swelling at the medial longitudinal arch, pain with the first few steps after non-weight bearing and paresthesia with compression along the medial aspect of the foot. To rule out vascular damage, which orthopedic test would you perform?
Babinski test
Homan’s sign
Thompson’s test
Morton’s foot structure
Homan’s sign
When testing the stability of the lateral collateral ligament of the knee, one hand stabilizes on the medial side of the knee and the other hand (at the ankle) applies force:
Medially
Laterally
Superiorly
Inferiorly
Medially
When assessing a client’s TMJ, which range of motion finding would not be normal?
Elevation from 35-50mm
Lateral deviation from 8-10 mm
Protrusion from 40-50mm
Retrusion from 3-4mm
Protrusion from 40-50mm
Which one of the follow findings would you expect to find in a client with a lumbar facet irritation?
Positive Valsalva test
Positive Kemp’s test
Positive Slump test
Positive Tinel’s test
Positive Kemp’s test
A C5 deep tendon reflex is elicited by tapping the tendon of:
Biceps femoris
Jaw
Biceps brachii
Triceps brachii
Biceps brachii
You notice that the client has pain at approximately 170° during the painful arc test. Which one of the following problems is indicated by this finding?
Supraspinatus impingement
Subacromial bursa impingement
Acromioclavicular joint compression
Bony block end-feel of shoulder abduction
Acromioclavicular joint compression
Which one of the following tests is used to evaluate the medial menisci of the knee?
Bragards Sign
Anterior drawer test
Posterior drawer test
McConnell’s test
Bragards Sign
Which one of the following spinal cord segments is assesses with the triceps reflex?
C4
C5
C7
C9
C7
Ober’s test assesses:
Shortened biceps femoris
Iliotibial band contracture
Lumbar facet syndrome
Hip joint pathology
Iliotibial band contracture
An abnormally low medial longitudinal arch of the foot is called:
Pes dorsalis
Pes planus
Pes cavus
Pes valgus
Pes planus
Which one of the following spinal cord levels is assessed by striking the medial hamstring tendon with a reflex hammer?
L3
L4
S1
S2
S1
To assess the integrity of the medial ligaments of the ankle, you would perform:
Inversion
Eversion
Dorsiflexion
Plantarflexion
Eversion
Which of the end range movements results in a normal bone to bone endfeel?
Ankle dorsiflexion
Elbow flexion
Ulnar deviation
Knee flexion
Ulnar deviation
Which one of the following tests is used to assess for a space occupying lesion within the spinal canal?
Modified Adson’s test (Halstead test)
Valsalva’s test
Adson’s test
Wright’s test
Valsalva’s test
f sustained passive forced flexion of the wrist provoked tingling and numbness in the palmar surface of the first 3 digits, you would suspect:
Dupuytren’s contracture
Lunate dislocation
Carpal tunnel syndrome
Entrapment of the radial nerve in supinator
Carpal tunnel syndrome
Which one of the following tests is used to evaluate the anterior cruciate ligament of the knee?
Apley’s distraction
Apley’s compression
Anterior drawer test
Posterior drawer test
Anterior drawer test
Which one of the following tests is performed by palpating the client’s radial pulse and hyperabducting the client’s shoulder?
Adson’s test
Eden’s test
Wright’s test
Allen’s test
Wright’s test
Which one of the following tests assesses for trigger points in the scalene muscles?
Adson’s test
Scalene cramp test
Tinels at brachial plexus
Cervical distraction test
Scalene cramp test
Your client injured their knee. You perform a valgus stress test which causes knee pain. Which one of the following structures do you think your client has damaged?
lateral collateral ligament
medial collateral ligament
anterior cruciate
patella
medial collateral ligament
Which one of the following intake questions is effective for helping you determine if a client has tendinits?
Are you on any medications?
What can you tell me about tendinits?
Do you perform any repetitive movements?
Did you happen to see how much I charge for tendinits treatments?
Do you perform any repetitive movements?
During the Trendelenburg Test, while the right leg is weight bearing, the left side of the pelvis drops below level. This indicates:
Weakness of gluteus medius on the left
Weakness of gluteus maximus on the left
Weakness of gluteus medius on the right
Weakness of gluteus maximus on the right
Weakness of gluteus medius on the right
While doing a straight leg raise test, the purpose of dorsiflexing the client’s ankle or flexing the client’s neck is to:
Put tension on the hamstrings
Stretch the gastrocnemius
Add tension to the dura
Traction the femoral nerve
Add tension to the dura
Positioning the hip of the supine patient in flexion, abduction and external rotation you are preparing to do a:
Valsalva test
Thomas test
Faber’s test
Kemp’s test
Faber’s test
Which one of the following tests does NOT assess the menisci of the knee?
Bounce Home test
McMurray’s test
Apley’s compression test
Valgus stress test
Valgus stress test
A client with a genu varum has:
Bowed legs
Knock knees
Hyperextended knees
Locked knees
Bowed legs
Which one of the following problems would be indicated in a client who presents with a “clicking” sound in active range of motion of the knee and who’s knee “locks” in place on occasion?
Muscle problem
Meniscal problem
Nerve problem
No problem
Meniscal problem
Which one of the following assessment sequences is in the correct order?
Postural assessment, orthopaedic assessment, intake questions, palpation
Intake questions, palpation, orthopaedic assessment, postural assessment
Intake questions, postural assessment, orthopaedic assessment, palpation
Orthopaedic assessment, intake questions, postural assessment, palpation
Intake questions, postural assessment, orthopaedic assessment, palpation
Which one of the following statements about range of motion assessment is TRUE?
Passive relaxed ROM assesses the inert structures of a joint.
Active free ROM primarily assesses the contractile elements of a joint.
Active resisted ROM is evaluated by resisting concentric movement of the range.
ROM testing is very general and does not give much information regarding the involved structures.
Passive relaxed ROM assesses the inert structures of a joint.
Which one of the following is a test to determine iliopsoas spasm?
Patricks/Faber
Straight Leg Raise
Braggard’s
Thomas
Patricks/Faber
Gaenslen’s sign is a test for all of the following EXCEPT:
Hip joint
Sacroiliac joints
Lower lumbar nerve root
Rectus femoris contracture
Rectus femoris contracture
The Kendell test assesses:
Hip joint pathology
Lumbar facet syndrome
Shortened biceps femoris
Rectus Femoris Contracture
Rectus Femoris Contracture
Which one of the following statements regarding the rotation of the spine that occurs with scoliosis is TRUE?
Named according to the apex of the curve on the concavity
Rib humping tends to be seen on the concave side
Named according to the apex of the curve on the convexity.
Scoliosis is always a congenital deformity
Named according to the apex of the curve on the convexity
Which one of the following landmarks does a plumb line fall through in the lateral view, when examining a person with correct postural alignment?
mastoid process
spine of scapula
medial malleolus
greater trochanter
greater trochanter
If extension and rotation of the cervical spine caused sharp shooting pain down the upper limb you would suspect:
Facet syndrome
Scalene contracture
Thoracic outlet syndrome
Nerve root compression
Nerve root compression
Which one of the following positions would relieve compression and decrease the pain associated with an acute L4/L5 facet irritation?
Extension and ipsilateral side-bending & rotation
Extension and contralateral side-bending & rotation
Flexion and ipsilateral side-bending & rotation
Flexion and contralateral side-bending & rotation
Flexion and contralateral side-bending & rotation
Which one of the following problems is indicated when pain is relieved by the cervical distraction test?
Fracture
Ligamentous lesion
Nerve root impingement
Vertebral hypermobility
Nerve root impingement
Which one of the following is the first step in the assessment procedure?
Client completes medical history form
Postural assessment
Client intake questions
Range of motion assessment
Client completes medical history form
Which one of the following is always considered to be an abnormal end-feel?
Soft tissue approximation
Soft tissue stretch
Capsular stretch
Springy
Springy
hich one of the following statements regarding ROM is TRUE?
Active free ROM gives the therapist information regarding ligaments and the joint
Passive relaxed ROM gives the therapist information regarding the muscle length
Normally passive relaxed ROM is slightly greater than the active free ROM.
Active resisted testing gives the therapist information about muscle length.
Normally passive relaxed ROM is slightly greater than the active free ROM.
Myotome testing gives the therapist information regarding:
Joints
Sensory innervations from the nerve root
Motor innervation from the nerve root
Muscle tone
Motor innervation from the nerve root
The test that determines if there is an Achilles rupture is:
Thompsons test
Yergasons test
Homans test
Mortons test
Thompsons test
The specific test used to identify tenosynovitis of the tendon sheath of extensor pollicis brevis and abductor pollicis longus is called:
Tinel’s sign
Finklesteins’s test
Phalens test
Cousin’s test
Finklesteins’s test
Allen’s test at the wrist is for:
Tenosynovitis
Carpal tunnel
Blood supply of the radial and ulnar arteries
Blood supply of the median and ulnar arteries
Blood supply of the radial and ulnar arteries
If your client had a positive chovostek test you would have a pathology in what structure?
TMJ disc
Cranial nerve 7
Masseter muscle
Cervical spine nerve roots
Cranial nerve 7
A client comes to you with a callus that develops over the medial side of the head of the metatarsal bone, where the bursa becomes inflamed and excessive bone forms. This is called:
Bakers cyst
Buochards nodes
Bunion
Hallus Valgus
Bunion
The upper limb tension test that places tension on the ulnar nerve is:
ULTT 1
ULTT 2
ULTT 3
ULTT 4
ULTT 4
The posterior rotation of the ilium on the sacrum as seen in a posterior pelvic tilt is:
Nutation
Counternutation
Hyper kyphosis
Sacral angle
Nutation
Which statement regarding leg length testing is TRUE?
A 1-1.5 inch difference is normal
When performing the functional shortening test, the client must square their pelvis
Measurement from umbilicus to medial malleolus is done in functional shortening test
True leg length is due to a contracture somewhere in the spine, pelvis or lower limb.
Measurement from umbilicus to medial malleolus is done in functional shortening test
The sensation of the 5th digit of the foot is innervated by what nerve root:
L3
C8
S1
T2
S1
When performing passive relaxed range of motion on the thoracic spine, which positioning is correct:
Client supine
Client prone
Client standing
Client seated
Client seated
Which special test is used to differentiate dizziness/vertigo caused by articular problems from that caused by vascular problems:
Rombergs
Vertebral Artery
Hautants
Buergers
Hautants
A thoracic spine observation that results from postmenopausal osteoporosis would be:
Round back
Dowagers hump
Humpback
Flatback
Dowagers hump
You have decided to use joint play to assess the lumbar spine vertebral column, this form of assessment can replace findings that you would get in what other assessment:
Passive relaxed range of motion
Active resisted range of motion
Special testing
Gait analysis
Passive relaxed range of motion
Johnny comes to you with some complaints of weakness and numbness & tingling in his right arm. Upon assessment you discover: 1. Weakness in ulnar deviation and thumb extension 2. Altered sensation along the medial arm and forearm including the 4th-5th digit 3. Hyporeflexia in the triceps reflex 4. Pain in his posterior neck, primarily on right side, What condition do you think Johnny may be presenting with:
Ulnar nerve root lesion
Strain to his triceps muscle
Nerve root compression to C8
Pronator teres syndrome
Nerve root compression to C8
When performing the straight leg test, the only version of this test that uses plantar flexion is testing which one of the following nerves:
Common fibular nerve
Sural nerve
Tibial nerve
There is no straight leg raise test with plantar flexion
Common fibular nerve
What is the normal end feel for extension of the hip joint:
Bone to bone
Tissue approximation
Springy
Tissue Stretch
Tissue Stretch
When asking for consent to assess, which of the following IS an appropriate alternative to the assessment you have proposed?
Stretches
Hydrotherapy
Palpation
Relaxation massage
Palpation
ou have now completed your assessment, which of the following steps is next:
Completing treatment
Formulating clinical impression
Formulating treatment plan
Providing homecare to your client
Formulating clinical impression
Symptoms are:
Subjective information, felt by the client
Irrelevant when doing an assessment because they are not measurable
Objective information, therefore consistent regardless of who is doing the assessment
Easily seen and recorded by the examiner
Subjective information, felt by the client
In principle, if resisted action in one direction, passive stretching in the opposite direction, and palpation all provoke a painful response from the client, the most likely site of a lesion would be:
Ligament
Joint capsule
Bone
Musculotendinous
Musculotendinous
A lateral plumb line passing through the external auditory meatus and the greater trochanter of the femur should also pass:
Posterior to the patella
Anterior to the patella
Through the patella
Through the sternum
Posterior to the patella
AR ROM is always done:
Against the therapists resistance
Before passive ROM
To determine the integrity of non-contractile tissues
To reproduce pain
Against the therapists resistance
While doing ROM, you discover that your client has reduced active free range of motion in one direction. You are able to passively move the joint through all ranges of motion in all directions. The most likely cause of restriction is:
Muscle
Ligament
Joint effusion
Joint capsule
Muscle
A client with a grade 2 during Active Resisted testing during ROM has:
Full strength
No muscle function
Ability to contract against gravity but not against resistance
Slight weakness but can still perform against resistance
Ability to contract against gravity but not against resistance
Which one of the following statements regarding postural assessment is FALSE?
You can accurately assess a condition when the client is fully dressed.
You may want to inspect the client’s back to assess muscle tone.
There are no risks of harm, or side effects associated with the assessment.
The client may refuse to continue with the assessment at any time.
You can accurately assess a condition when the client is fully dressed.
Which of the following is NOT a red flag in examination?
Edema
Prolonged fever
Severe night pain
Severe spasm
Edema
Which one of the following pieces of information is NOT gained through postural assessment?
symmetry of the client’s body
orientation of the client in relation to gravity
the amount of movement of a part of the client’s body
predisposing factors contributing to a client’s condition
the amount of movement of a part of the client’s body
Which one of the following sets of landmarks are observed in the posterior view of a postural assessment?
manubrium, xiphoid and umbilicus
spines and inferior angles of the scapulae
ear lobe, acromion, iliac crest
clavicles and acromioclavicular (AC) joint
spines and inferior angles of the scapulae
Which one of the following statements regarding posture is FALSE?
Correct posture is the position in which minimal stress is applied to each joint.
Faulty posture has little affect on the body other than muscular fatigue.
Faulty posture is any position that increases the stress on the joints.
Minimal muscle activity is required to maintain correct posture.
Faulty posture has little affect on the body other than muscular fatigue.
Which one of the following sequences represents the usual progression of ROM testing?
active resisted, passive relaxed, active free
passive relaxed, active free, active resisted
active free, passive relaxed, active resisted
active free, active resisted, passive relaxed
active free, passive relaxed, active resisted
Which one of the following statements regarding gait assessment is TRUE?
Stride length is distance between the contact points of the feet
The pelvis moves both laterally and vertical during walking
As walking speed increases, base width increases
The normal base width is 10-20 cm.
The pelvis moves both laterally and vertical during walking
Which one of the following landmarks is visible from a posterior view postural assessment?
Xiphoid
Scapula
Patella
Greater trochanter
Scapula
In an adult, the centre of gravity is normally located at which one of the following locations?
Anterior to the 2nd sacral segment
Posterior to the pubic symphysis
Posterior to the sacral base
Anterior to the coccyx
Anterior to the 2nd sacral segment
Which one of the following statements comparing the gait pattern of males and females is TRUE?
Stride length is longer in females than in males.
Head movement is less in males than females.
Females typically walk more quickly than do males.
The base of support is narrower in males than in females.
Females typically walk more quickly than do males.
Which one of the following explanations describes why the pelvis moves laterally during gait?
It allows balance to be maintained over the stance leg.
It ensures there is enough momentum to swing the leg.
It allows us to lean away from the swinging limb so that it does not hit the ground.
It serves no functional purpose and occurs solely as a result of the structure of the lower limb.
It allows balance to be maintained over the stance leg.
Which one of the following spinal curves is the last to develop?
Cervical lordosis
Thoracic kyphosis
Lumbar lordosis
Sacral kyphosis
Lumbar lordosis
Which one of the following terms is describes by the number of steps taken in a given period of time?
Stride length
Step length
Cadence
Gait
Cadence
Which one of the following statements regarding postural observation is TRUE?
The client usually keeps their shoes on.
The client should be adequately undressed.
The client is asked to assume their best posture.
You need only observe one lateral view of the client
The client should be adequately undressed.
Which one of the following imbalances may be observed in a lateral view postural assessment?
Elevation of the shoulders
The height of the iliac crest
Hyperextension of the knees
The position of the patellae
Hyperextension of the knees
Which one of the following imbalances may be observed in a posterior view postural assessment?
Levels of the anterior superior iliac spines
Elevation of the shoulders
The degree of pelvic angle
Muscle bulk of the quadriceps muscle
Elevation of the shoulders
The therapist moving the client’s limb with no assistance from the client describes which one of the following types of range of motion (ROM)?
Passive relaxed ROM
Active assisted ROM
Active resisted ROM
Active free ROM
Passive relaxed ROM
When performing special tests, which statement is TRUE:
Therapist must test affected side first
Therapist can diagnose client once a positive test has been found
Clients should be told what a positive result is prior to performing the test
Clients should be told what to expect prior to each movement in the test
Clients should be told what a positive result is prior to performing the test
A 29-year-old client complains of pain and loss of shoulder motion that began insidiously a month ago. The pain worsens with use, and is relieved by rest. Active resisted external rotation of the shoulder increases the pain. The client likely has
rotator cuff tendinitis in the chronic stage of healing
biceps brachii strain in the chronic stage of healing
‘frozen’ shoulder in the chronic stage of healing
osteoarthritis in the late stages
rotator cuff tendinitis in the chronic stage of healing
Which of the following signs or symptoms is likely to be seen with a glenohumeral dislocation?
Step deformity
Sulcus sign
“J” sign
Sag sign
Sulcus sign
When the client presents with hyperextended MCPs and flexed PIPs & DIPs, they have:
Drop hand
Bishops hand
Mallet finger
Claw hand
Claw hand
Normal range of wrist extension is:
80-90 degrees
70-90 degrees
60-80 degrees
40-45 degrees
70-90 degrees
Pain between 170o and 180o of glenohumeral abduction indicates
biceps tendinitis.
subacromial bursitis.
rotator cuff tendinitis.
acromioclavicular pathology.
acromioclavicular pathology.
