Orthopedic Physical Assesment Flashcards
60 to 90 degrees of forward flexion and 60 to 120 degrees of horizontal adduction of the shoulder would allow which activity of daily living?
Select one:
a. Wash opposite shoulder
b. Put something on a shelf
c. Tuck in shirt
d. Eat
a. Wash opposite shoulder
Complete range of motion against gravity with moderate resistance would be given an approximate grade of
Select one:
a. 5+ or normal
b. 2 or poor
c. 3 or fair
d. 4 or good
d. 4 or good
Complete range of motion against gravity would be given an approximate grade of
Select one:
a. 5+ or normal
b. 3 or fair
c. 2 or poor
d. 4 or good
b. 3 or fair
Determination of a capsular pattern of restriction can only be achieved if the joint is taken to
Select one:
a. the end of the available range
b. anywhere in the available range
c. the midrange
d. the inner range
a. the end of the available range
Determining the number of repetitions a client can sit in a chair and return to standing, is part of functional testing of
Select one:
a. the knee
b. the hip
c. the ankle
d. the toes
b. the hip
During the midstance stage of the gait cycle, if there is pain in the foot or ankle, a possible reason is
Select one:
a. weak gluteus medius
b. osteoarthritis
c. short foot plantar flexors
d. L4 nerve root lesion
b. osteoarthritis
During the intitial contact stage of the gait cycle, if the trunk lurches forward with increased lordosis, a possible reason is
Select one:
a. knee extensors are weak
b. short foot plantar flexors
c. foot dorsifexors are weak
d. hip extensors are weak
d. hip extensors are weak
If foot dorsiflexors are weak during the initial and midswing stages of the gait cyle, a possible sign is
Select one:
a. heel pain
b. foot drop
c. knee snaps out excessively
d. push off from lateral aspect of foot
b. foot drop
If hip adductors are weak during the preswing stage of the gait cycle, a possible sign is
Select one:
a. foot drop
b. knee snaps out excessively
c. hip and leg rotation
d. knee buckles
c. hip and leg rotation
Muscle weakness may be caused by
Select one:
a. upper motor neuron lesion
b. a nerve root lesion
c. any of these reasons
d. tendon pathology
c. any of these reasons
Normal end feel for elbow extension is
Select one:
a. tissue stretch
b. soft tissue approximation
c. soft capsular
d. bone to bone or bony
d. bone to bone or bony
Osteophyte formation may cause a joint to have a
Select one:
a. bone to bone or bony endfeel
b. early muscle spasm endfeel
c. empty endfeel
d. hard capsular endfeel
a. bone to bone or bony endfeel
Respiratory rate of 30, heart rate of 130, diastolic blood pressure of 48, systolic blood pressure of 80 are normal results for
Select one:
a. newborn
b. adult
c. adolescent
d. toddler
d. toddler
Results of range of motion testing that are strong and painful, indicates
Select one:
a. a local lesion of the muscle or tendon
b. no lesion of the contractile unit
c. rupture of a muscle
d. fracture
a. a local lesion of the muscle or tendon
Results of range of motion testing that are weak and painfree, indicates
Select one:
a. local lesion of muscle or tendon
b. rupture of a muscle or its tendon and or nerve involvement
c. fracture
d. no lesion in contractile tissue
b. rupture of a muscle or its tendon and or nerve involvement
Which of the following is not necessary to perform an adequate client interview?
Select one:
a. use of formal medical jargon to demonstrate the therapists knowledge
b. development of rapport with the client
c. speaking at a level the client will understand
d. demonstrating empathy, caring, and interest in the client
a. use of formal medical jargon to demonstrate the therapists knowledge
The range of motion necessary at the shoulder to perform the activity of eating is
Select one:
a. 70 to 100 degrees of horizontal adduction and 45 to 60 degrees of abduction
b. 10 to 15 degrees of horizontal adduction, 110 to 125 degrees of forward flexion, and 90 degrees of lateral rotation
c. 70 to 100 degrees of horizontal adduction, 45 to 60 degrees of abduction, and 90 degrees of medial rotation
d. 60 to 90 degrees of forward flexion and 60 to 120 degrees of horizontal adduction
a. 70 to 100 degrees of horizontal adduction and 45 to 60 degrees of abduction
To achieve a functionally poor result for wrist flexion, a client would be able to lift a maximum of
Select one:
a. 3 to 4 pounds
b. less than one pound
c. 5 or more pounds
d. 1 to 2 pounds
d. 1 to 2 pounds
Which of the following is an example of an open-ended question?
Select one:
a. how is your pain altered during activities?
b. does your pain hurt worst during the day or the night?
c. do you take narcotic medications?
d. does this increase your pain?
a. how is your pain altered during activities?
What are the main reasons for performing an orthopedic assessment?
Select one:
a. to determine a course of treatment
b. to determine whether the client has an orthopedic condition
c. to determine if the client should be referred to another health care provider
d. all of the above
d. all of the above
What are the main reasons for performing an interview?
Select one:
a. to gather information as it relates to the chief complaint
b. to determine whether the client has an orthopedic condition
c. to determine if the client should be referred to another health care provider
d. all of the above
d. all of the above
Radicular pain is most likely associated with what condition?
Select one:
a. nerve root compression
b. both muscle and joint injury
c. muscle injury
d. joint injury
a. nerve root compression
If the client indicates they have pain, what is the most logical question to ask next?
Select one:
a. has there been a trauma
b. what is the clients occupation
c. are they on medication
d. what is the nature of the pain
a. has there been a trauma
Radicular pain may also be accompanied by what other signs or symptoms?
Select one:
a. bright, well localized pain
b. deep somatic pain
c. paresthesia and muscle weakness
d. diffuse pain
c. paresthesia and muscle weakness
Cutaneous pain is usually the result of what cause?
Select one:
a. pain from joint injury
b. pain from periosteal injury
c. superficial tissue damage
d. pain from muscle injury
c. superficial tissue damage
At the end of the interview, what conclusion does the therapist form?
Select one:
a. they will make a diagnosis and proceed with a treatment
b. an educated idea of what the client may have that forms the starting point for further testing to confirm or rule out this idea
c. they know exactly what the client suffers from, but has to confirm it with an orthopedic test
d. they know exactly what the client suffers from
b. an educated idea of what the client may have that forms the starting point for further testing to confirm or rule out this idea
What is the starting reference point for the plumb line in the lateral view of a postural observation?
Select one:
a. just posterior to lateral malleolus
b. greater trochanter
c. external auditory meatus
d. just anterior to lateral malleolus
d. just anterior to lateral malleolus
While looking at the anterior posture, the therapist notices that the clients head laterally flexes to the left side. This may be the result of what condition?
Select one:
a. hypertonic (shortened) right lateral neck flexors and hypertonic (shortened) left upper trapezius
b. hypertonic (shortened) left lateral neck flexors and hypertonic (shortened) left lower trapezius
c. hypertonic (shortened) left lateral neck flexors and hypertonic (shortened) left upper trapezius
d. hypertonic (shortened) right lateral neck flexors and hypertonic (shortened) right upper trapezius
c. hypertonic (shortened) left lateral neck flexors and hypertonic (shortened) left upper trapezius
While looking at the lateral posture, the therapist notices that the client has an increased lumbar (lordotic) curve. This may result in what other finding?
Select one:
a. posterior pelvic tilt and hypertonic (shortened) hip flexors
b. anterior pelvic tilt and hypertonic (shortened) hamstrings
c. posterior pelvic tilt and hypertonic (shortened) hamstrings
d. anterior pelvic tilt and hypertonic (shortened) hip flexors
d. anterior pelvic tilt and hypertonic (shortened) hip flexors
Once a postural observation has been completed, the therapist will have a good understanding of what parameters?
Select one:
a. whether to work on the client or refer them to another health care provider
b. structural musculoskeletal imbalances
c. functional musculoskeletal imbalances
d. structural and functional musculoskeletal imbalances
d. structural and functional musculoskeletal imbalances
The gait cycle is divided into
Select one:
a. anterior, lateral and posterior cycles
b. painful and not painful steps
c. step length and stride length
d. a stance phase and a swing phase
d. a stance phase and a swing phase
What does the term antalgic gait mean?
Select one:
a. a way of moving that indicates muscle wasting
b. a way of moving that the client assumes in order to relieve pain
c. a way of moving that indicates peripheral nerve damage
d. a way of moving that indicates central nervous system damage
b. a way of moving that the client assumes in order to relieve pain
The therapist notes that the client has an ataxic gait. This is most likely due to
Select one:
a. nerve damage
b. muscle imbalance
c. joint dysfunction
d. all of the above
a. nerve damage
Observing for full ease of movement describes which range of motion?
Select one:
a. active resisted (AR)
b. passive relaxed (PR)
c. active assisted (AA)
d. active free (AF)
d. active free (AF)
Boggy, ropy, firm, and adhesions are terms used to describe what state of tissue?
Select one:
a. pain
b. texture
c. tone
d. age
b. texture
Active resisted (AR) ROM testing is held for how long?
Select one:
a. 5 seconds isometrically
b. 5 seconds isotonically
c. 10 seconds isotonically
d. 10 seconds isometrically
a. 5 seconds isometrically
ROM testing with overpressure describes which range of motion?
Select one:
a. active free (AF)
b. active resisted (AR)
c. passive relaxed (PR)
d. active assisted (AA)
c. passive relaxed (PR)
To determine the location of muscle pain, the best range of motion testing is
Select one:
a. active free (AF)
b. passive relaxed (PR)
c. active assisted (AA)
d. active isometric resisted (AR)
d. active isometric resisted (AR)
To determine the integrity of noncontractile tissue surrounding a joint, the best range of motion testing is
Select one:
a. active isometric resisted (AR)
b. active assisted (AA)
c. passive relaxed (PR)
d. active free (AF)
c. passive relaxed (PR)
To determine the integrity of contractile and noncontractile tissue surrounding a joint, the best range of motion testing is
Select one:
a. active isometric resisted (AR)
b. passive relaxed (PR)
c. active assisted (AA)
d. active free (AF)
d. active free (AF)
The therapist notes the following range of motion results: AF (ROM) is painful and restricted, PR (ROM) is painless and full range, AR (ROM) is painful and strong. The type of tissue most likely involved is
Select one:
a. nerve tissue
b. contractile and noncontractile tissue
c. noncontractile tissue
d. contractile tissue
d. contractile tissue
The therapist notes the following range of motion results: AF (ROM) is painful and restricted, PR (ROM) is restricted with empty end feel, AR (ROM) is painless and strong. The type of tissue most likely involved is
Select one:
a. contractile and noncontractile tissue
b. nerve tissue
c. contractile tissue
d. noncontractile tissue
d. noncontractile tissue
The therapist notes the following range of motion results: AF (ROM) is painful and restricted, PR (ROM) is restricted with empty end-feel, AR (ROM) is painful and weak. The type of tissue likely involved is
Select one:
a. nerve tissue
b. contractile and noncontractile tissue
c. contractile tissue
d. noncontractile tissue
b. contractile and noncontractile tissue
The therapist notes the following range of motion results: AF (ROM) is painless and restricted, PR (ROM) is full with normal endfeel, AR (ROM) is painless and weak. There is no history of tendonopathy or rupture. The type of tissue likely involved is
Select one:
a. nerve tissue
b. contractile and noncontractile tissue
c. contractile tissue
d. noncontractile tissue
a. nerve tissue
Dermatome, myotome, and deep tendon reflex testing is performed to rule out what conditions?
Select one:
a. peripheral and nerve root dysfunction
b. nerve root dysfunction
c. source of pain
d. peripheral nerve dysfunction
b. nerve root dysfunction
Which part of neurological testing only gives information about the motor pathway?
Select one:
a. myotome testing
b. dermatome testing
c. deep tendon reflexes
d. all of the above
a. myotome testing
What responses are measured in myotome testing?
Select one:
a. numbness and tingling
b. weakness and pain
c. relative weakness
d. pain
c. relative weakness
Which part of neurological testing only gives information about the sensory pathway?
Select one:
a. dermatome testing
b. myotome testing
c. deep tendon reflexes
d. all of the above
a. dermatome testing
Which part of neurological testing gives information about the sensory and motor pathways?
Select one:
a. deep tendon reflexes
b. dermatome testing
c. myotome testing
d. none of the above
a. deep tendon reflexes
The therapist notes the following dermatome testing result: stroking around low back and hips to ASIS is different from the right side to the left side. What nerve root is most likely affected?
Select one:
a. L3
b. L1 L2
c. L2
d. L1
d. L1
The therapist notes the following myotome testing result: resisted neck flexion is weak. What nerve root is likely affected?
Select one:
a. C2
b. C1 C2
c. C1
d. C3
b. C1 C2
The clinical impression consists of which points?
Select one:
a. 5 points: summary of signs and symptoms, chief complaint, stage of healing, possible condition, possible cause
b. 5 points: summary of signs and symptoms, location, stage of healing, possible condition, possible cause
c. 6 points: summary of signs and symptoms, location, stage of healing, possible condition, possible cause, treatment plan
d. 5 points: summary of signs and symptoms, location, client’s pain level, diagnosis, possible cause
b. 5 points: summary of signs and symptoms, location, stage of healing, possible condition, possible cause
What is the purpose of orthopedic testing?
Select one:
a. to recreate the clients symptoms
b. to confirm the index of suspicion
c. to rule out the index of suspicion
d. all of the above
d. all of the above
What factors determine the range of motion of a healthy joint?
Select one:
a. amount of range of motion movements a person performs
b. shape of the joint and the soft tissue surrounding it
c. amount of stretching a person performs
d. amount of strengthening a person performs
b. shape of the joint and the soft tissue surrounding it
What is the difference in reasoning, if any, for performing active free, passive relaxed and active resisted movements in an ORTHOPEDIC ASSESSMENT and performing active free, active assisted and passive relaxed movements in REMEDIAL EXERCISE?
Select one:
a. there is no difference in reasoning
b. all answers are correct
c. during an orthopedic assessment the movements are done as a test and during remedial exercise the movements are done as a treatment
d. during an orthopedic assessment the movements are done as a treatment and during remedial exercise the movements are done as a test
c. during an orthopedic assessment the movements are done as a test and during remedial exercise the movements are done as a treatment
Which of the following are ways to LENGTHEN soft tissue when treating injured tissue?
Select one:
a. active inhibition, passive stretching,
b. active free movement in the unrestricted range
c. isotonic contractions
d. passive relaxed movement in the unrestricted range
a. active inhibition, passive stretching
What is the term for the distance that a muscle can shorten from the point of maximum lengthening to the point of maximum contraction?
Select one:
a. outer range
b. mid range
c. functional excursion
d. inner range
c. functional excursion
Which of the following are range of motion techniques to MAINTAIN joint range, proprioception and joint health when treating injured tissue?
Select one:
a. passive stretching in the restricted range
b. active free, active assisted and passive relaxed range of motion
c. isotonic contractions
d. active free, passive relaxed and active resisited range of motion movements
b. active free, active assisted and passive relaxed range of motion
In the early stages of joint injury, which technique is not appropriate?
Select one:
a. active free ROM in the painfree range
b. passive relaxed ROM
c. active resisted isometric painfree strengthening to muscles crossing the injured joint
d. passive relaxed ROM to joints proximal and distal to injured joint
b. passive relaxed ROM
Stabilizing the muscles crossing a joint is generally used in which type of injury?
Select one:
a. fracture
b. nerve
c. joint injury
d. muscle injury
c. joint injury
In general terms, what is the goal of techniques for remedial exercise treatments for acute or severe injury?
Select one:
a. increase proprioception
b. restore movement and strength
c. increase movement and strength
d. maintain movement and strength
d. maintain movement and strength
What is the general rule before beginning a remedial exercise program to increase strength?
Select one:
a. client should regain as much range of motion as possible before starting to increase strength
b. client should begin to increase strength in the acute stage of a severe injury
c. client should begin to increase strength in the acute stage of injury
d. client should begin strengthening exercises before stretching exercises
a. client should regain as much range of motion as possible before starting to increase strength
Which of the following stretching techniques is usually held for 15-30 seconds?
Select one:
a. contract relax
b. passive stretching
c. hold relax
d. active inhibition
b. passive stretching
Which type of tissue is most affected by active inhibition techniques?
Select one:
a. contractile
b. ligaments
c. non contractile
d. joint capsules
a. contractile
What critera must be met before active inhibition techniques are effective?
Select one:
a. tissue stretch must be held for at least 15-30 seconds
b. muscle must be completely relaxed throughout the whole exercise
c. muscle contraction must be held for at least 15-30 seconds
d. muscle to be stretched must be normally innervated and under clients control
d. muscle to be stretched must be normally innervated and under clients control
Which of the following are ways to strengthen muscles when treating injured tissue?
Select one:
a. resistance exercise
b. eccentric contractions
c. concentric contractions
d. all of the above
d. all of the above
Of the following, which type of strengthening exercise is usually started first?
Select one:
a. isometric contractions
b. eccentric contractions
c. isotonic contractions
d. concentric contractions
a. isometric contractions
Generally stated, the typical progression for remedial exercise is
Select one:
a. 1. increase and restore range of motion with stretching techniques, 2. maintain range of motion with various movements, 3. increase and restore strength with strengthening techniques
b. 1. maintain range of motion with various movements, 2. increase and restore strength with strengthening techniques, 3. increase and restore range of motion with stretching techniques
c. 1. increase and restore strength with strengthening techniques, 2. increase and restore range of motion with stretching techniques, 3. maintain range of motion with various movements,
d. 1. maintain range of motion with various movements, 2. increase and restore range of motion with stretching techniques, 3. increase and restore strength with strengthening techniques
d. 1. maintain range of motion with various movements, 2. increase and restore range of motion with stretching techniques, 3. increase and restore strength with strengthening techniques
- External auditory meatus __normal
- Acromion process __normal
- Greater trochanter __normal
- Anterior to head of fibula __normal
- Just anterior to lateral malleolus __normal
- Anterior greater trochanter, anterior pelvic tilt, hyperlordosis, hyperkyphosis, head forward
Hyperextended knees, greater trochanter anterior to plumb line, posterior pelvic tilt, flat back, head forward
Loss of normal lordosis with pelvis in posterior tilt, hip joint hyper extended, knee joints hyperextended, increased flexion to upper thoracic spine (hyperkyphosis), forward head posture
Hip flexors
Hamstrings
Hyperextended knees
A is normal
A. anterior tilt, B. lengthens and inhibits hamstrings, C. shortens quadriceps
Head laterally flexed to right (right ear lower), left SCM overdeveloped, uneven clavicles, right shoulder lower (or left higher), more negative arm space on right, right hip more externally rotated, right knee more externally rotated, right foot more externally rotated
Body left of centre throughout, head laterally tilted right (right ear lower), right shoulder lower, inferior angles of scapula uneven, more negative space left arm
Hyperlordosis
B is in the correct place
C is in the correct place
Hyperkyphosis
- Loss of normal lordosis with pelvis in posterior tilt, hip joint hyperextended, knee joints hyperextended, increased flexion to upper thoracic spine (hyperkyphosis), forward head posture; 2. Lengthened; 3. shortened
