Orthopedic Physical Assesment

Question 1

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

Answer 1

a. Wash opposite shoulder

Question 2

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

Answer 2

d. 4 or good

Question 3

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

Answer 3

b. 3 or fair

Question 4

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

Answer 4

a. the end of the available range

Question 5

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

Answer 5

b. the hip

Question 6

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

Answer 6

b. osteoarthritis

Question 6

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

Answer 6

d. hip extensors are weak

Question 7

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

Answer 7

b. foot drop

Question 8

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

Answer 8

c. hip and leg rotation

Question 9

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

Answer 9

c. any of these reasons

Question 10

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

Answer 10

d. bone to bone or bony

Question 11

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

Answer 11

a. bone to bone or bony endfeel

Question 12

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

Answer 12

d. toddler

Question 13

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

Answer 13

a. a local lesion of the muscle or tendon

Question 14

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

Answer 14

b. rupture of a muscle or its tendon and or nerve involvement

Question 15

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

Answer 15

a. use of formal medical jargon to demonstrate the therapists knowledge

Question 16

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

Answer 16

a. 70 to 100 degrees of horizontal adduction and 45 to 60 degrees of abduction

Question 17

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

Answer 17

d. 1 to 2 pounds

Question 18

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?

Answer 18

a. how is your pain altered during activities?

Question 19

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

Answer 19

d. all of the above

Question 20

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

Answer 20

d. all of the above

Question 21

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

Answer 21

a. nerve root compression

Question 21

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

Answer 21

a. has there been a trauma

Question 22

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

Answer 22

c. paresthesia and muscle weakness

Question 23

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

Answer 23

c. superficial tissue damage

Question 24

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

Answer 24

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

Question 25

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

Answer 25

d. just anterior to lateral malleolus

Question 26

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

Answer 26

c. hypertonic (shortened) left lateral neck flexors and hypertonic (shortened) left upper trapezius

Question 27

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

Answer 27

d. anterior pelvic tilt and hypertonic (shortened) hip flexors

Question 28

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

Answer 28

d. structural and functional musculoskeletal imbalances

Question 29

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

Answer 29

d. a stance phase and a swing phase

Question 30

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

Answer 30

b. a way of moving that the client assumes in order to relieve pain

Question 31

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

Answer 31

a. nerve damage

Question 31

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)

Answer 31

d. active free (AF)

Question 32

Boggy, ropy, firm, and adhesions are terms used to describe what state of tissue?

Select one:
a. pain
b. texture
c. tone
d. age

Answer 32

b. texture

Question 33

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

Answer 33

a. 5 seconds isometrically

Question 33

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)

Answer 33

c. passive relaxed (PR)

Question 34

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)

Answer 34

d. active isometric resisted (AR)

Question 35

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)

Answer 35

c. passive relaxed (PR)

Question 36

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)

Answer 36

d. active free (AF)

Question 37

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

Answer 37

d. contractile tissue

Question 38

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

Answer 38

d. noncontractile tissue

Question 39

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

Answer 39

b. contractile and noncontractile tissue

Question 40

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

Answer 40

a. nerve tissue

Question 41

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

Answer 41

b. nerve root dysfunction

Question 42

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

Answer 42

a. myotome testing

Question 42

What responses are measured in myotome testing?

Select one:
a. numbness and tingling
b. weakness and pain
c. relative weakness
d. pain

Answer 42

c. relative weakness

Question 43

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

Answer 43

a. dermatome testing

Question 44

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

Answer 44

a. deep tendon reflexes

Question 45

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

Answer 45

d. L1

Question 46

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

Answer 46

b. C1 C2

Question 47

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

Answer 47

b. 5 points: summary of signs and symptoms, location, stage of healing, possible condition, possible cause

Question 48

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

Answer 48

d. all of the above

Question 49

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

Answer 49

b. shape of the joint and the soft tissue surrounding it

Question 50

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

Answer 50

c. during an orthopedic assessment the movements are done as a test and during remedial exercise the movements are done as a treatment

Question 51

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

Answer 51

a. active inhibition, passive stretching

Question 52

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

Answer 52

c. functional excursion

Question 53

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

Answer 53

b. active free, active assisted and passive relaxed range of motion

Question 54

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

Answer 54

b. passive relaxed ROM

Question 55

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

Answer 55

c. joint injury

Question 56

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

Answer 56

d. maintain movement and strength

Question 57

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

Answer 57

a. client should regain as much range of motion as possible before starting to increase strength

Question 58

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

Answer 58

b. passive stretching

Question 59

Which type of tissue is most affected by active inhibition techniques?

Select one:
a. contractile
b. ligaments
c. non contractile
d. joint capsules

Answer 59

a. contractile

Question 60

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

Answer 60

d. muscle to be stretched must be normally innervated and under clients control

Question 61

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

Answer 61

d. all of the above

Question 62

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

Answer 62

a. isometric contractions

Question 63

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

Answer 63

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

Question 64

Answer 64

1. External auditory meatus __normal
2. Acromion process __normal
3. Greater trochanter __normal
4. Anterior to head of fibula __normal
5. Just anterior to lateral malleolus __normal

Question 65

Answer 65

3. Anterior greater trochanter, anterior pelvic tilt, hyperlordosis, hyperkyphosis, head forward

Question 66

Answer 66

Hyperextended knees, greater trochanter anterior to plumb line, posterior pelvic tilt, flat back, head forward

Question 67

Answer 67

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

Question 68

Answer 68

Hip flexors

Question 69

Answer 69

Hamstrings

Question 70

Answer 70

Hyperextended knees

Question 71

Answer 71

A is normal

Question 72

Answer 72

A. anterior tilt, B. lengthens and inhibits hamstrings, C. shortens quadriceps

Question 73

Answer 73

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

Question 74

Answer 74

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

Question 75

Answer 75

Hyperlordosis

Question 76

Answer 76

B is in the correct place

Question 77

Answer 77

C is in the correct place

Question 78

Answer 78

Hyperkyphosis

Question 79

Answer 79

1. 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