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Question 1

What direction of disc herniation is contraindicated for spinal traction?

Answer 1

Posteromedial disc herniation

Question 2

What age is the most common presentation for Rotator Cuff Tendinitis?

Answer 2

25-40 yo. (Neer’s Stage 2)

Question 3

Where is the location of pain for pt’s with supraspinatus tendinitis?

Answer 3

Lateral pain at the midhumerus

Question 4

Which of the ff is not part of the restrictions in pt’s. with rotator cuff tears?

a. Avoid provocative maneuvers or exercises that cause discomfort, includes both offending ROM exercises and strengthening exercises
b. ROM exercises and muscle strengthening exercises should begin with the arm in more than 90 deg. of abduction
c. Avoid abduction-rotation
d. Avoid empty-can exercises

Answer 4

b. ROM exercises and muscle strengthening exercises should begin with the arm in more than 90 deg. of abduction (start ROM below 90 deg. first to avoid pain)

Question 5

What does “tenosyno” in the term tenosynovitis mean?

Answer 5

Tendon sheath

Question 6

What is the etiology for adhesive capsulitis?

Answer 6

No known etiology (Idiopathic)

Question 7

What is the most frequent musculoskeletal problem of diabetic patients?

Answer 7

Adhesive capsulitis

Question 8

The loss of passive ___ is the single most important finding on PE for Adhesive capsulitis and helps to differentiate adhesive capsulitis from a rotator cuff problem.

a. Abduction
b. Adduction
c. ER
d. IR

Answer 8

c. ER

Question 9

What are the reasons why the shoulder is commonly dislocated?

Answer 9

Shallow glenoid cavity, very redundant capsule (loose capsule; unstable), lax ligaments, wide range of motion (unstable)

Question 10

Weakness of the subscapularis may result into what direction of subluxation?

Answer 10

Anterior subluxation

Question 11

Weakness of the supraspinatus may results into what direction of subluxation?

Answer 11

Inferior subluxation

Question 12

What is the most active muscle extending the wrist in gripping; prevent active and passive insufficiency?

Answer 12

ECRB

Question 13

The instruction that is considered to be incorrect for a subject diagnosed with lateral epicondylitis is:

a. To avoid pain in lifting, lift with both UE on supination (palm up)
b. Modify activity by avoiding grasping heavy objects in pronation
c. Use counterforce brace. The band is placed 2 fingerbreadths proximal to the painful area of the lateral epicondyle
d. Tennis players may reduce the racquet string tension, change the size of the grip (usually to a larger grip) and change to a better dampening racquet.

Answer 13

c. Use counterforce brace. The band is places 2 fingerbreadths proximal to the painful area of the lateral epicondyle

Distal to the lateral epicondyle

Question 14

What is the most common direction of disc herniation?

Answer 14

Posterolateral direction

Question 15

What type of arthritis is more common in C1-C2 joints? (OA or RA)

Answer 15

RA

upper cervical spine is more commonly affected and OA is for lower cervical spine

Question 16

what is the hallmark for Rheumatoid Arthritis?

Answer 16

Synovitis and Fatigue

Question 17

What is the hallmark for Osteoarthritis?

Answer 17

Cartilage degeneration

Question 18

What are the functional range of motion of shoulder?

Answer 18

30-45 deg of shoulder flexion, 10 deg of shoulder internal rotation

Question 19

What is the functional range of motion of the hip?

Answer 19

20-30 deg of hip flexion

Question 20

What kind of heating modalities may be used for patients with RA?

Answer 20

HMP (superficial heating modalities)

Question 21

What is the functional range of knee flexion for stair climbing?

Answer 21

100 deg knee flexion

Question 22

What is a common deformity of Kohler’s disease?

Answer 22

Flatfoot deformity

Question 23

What is the most common hip fracture seen in elderly population which is caused by a twisting motion during weight bearing?

Answer 23

Subcapital fracture

Question 24

What stage of progression do symptoms generally begin in children with LCPD?

Answer 24

Revascularization phase (Stage 3)

Question 25

What hip fx is often associated with a posterior dislocation of the hip?

Answer 25

Acetabular Fracture

Question 26

Affectation of the ulnar nerve will lead to what type of hand deformity?

Answer 26

Claw hand deformity (intrinsic muscle)

Question 27

Affectation of the median nerve will lead to what type of hand deformity?

Answer 27

Ape hand

Question 28

Affectation of the radial nerve will lead to what type of hand deformity?

Answer 28

Wrist drop

Question 29

Anterior wedging of the vertebrae will lead to what type of posture?

Answer 29

Kyphosis

Question 30

What is the specific structure affected in kids with Legg Calve Perthes Disease?

Answer 30

Femoral head

Question 31

What is the position of the hip when using a brace or plaster cast for LCPD?

Answer 31

Hip internal rotation and abduction; to place the femoral head inside the socket?

Question 32

What is the adult counterpart of LCPD or avascular necrosis of the femoral head?

Answer 32

Chandler's disease

Question 33

What are the limitation of motions in the hip for Chandler's disease and LCPD?

Answer 33

Hip IR and Abduction

Question 34

What is the typical muscle imbalance of the ACL tear?

Answer 34

Strong quadriceps and weak hamstrings

Question 35

What is the first affected structure/s in a varus/ valgus contact with rotation?

Answer 35

Collateral and cruciate ligaments

Question 36

MOI: Non contact, quickly turning one way with tibia rotated in opposite direction What is the possible diagnosis or affectation given the MOI?

Answer 36

Patellar dislocation or subluxation

Question 37

MOI: Noncontact deceleration What is the possible diagnosis or affectation given the MOI?

Answer 37

ACL tear

Question 38

MOI: Forced medial rotation of the tibia What is the possible diagnosis or affectation given the MOI?

Answer 38

Lateral meniscal injury

Question 39

MOI: Forced medial rotation of the femur What is the possible diagnosis or affectation given the MOI?

Answer 39

Medial meniscal injury

Question 40

What is the grandfather special test for meniscus injury?

Answer 40

McMurray's test

Question 41

Where is the location of pain in pt's with Legg-Perthes disease?

Answer 41

Pain on groin, medial thigh, knee

Question 42

What are the internal rotators of the shoulder?

Answer 42

Latissimus dorsi, Subscapularis and Teres Major

Question 43

Which among the ff conditions have bilateral affectation? Leg-Calve-Perthes Osgood Schlatter SCFE

Answer 43

Osgood Schlatter SCFE LCPD (unilateral)

Question 44

What type of knee injuries produce rapid effusion (intracapsular or extracapsular)?

Answer 44

Intracapsular

Question 45

What is the strongest ligament of the hip?

Answer 45

Iliofemoral ligament (Y-ligament of Bigelow)

Question 46

What is the strongest ligament of the ankle?

Answer 46

Medial collateral ligament (Deltoid ligament)

Question 47

What is the most common direction of hip dislocation?

Answer 47

Posterior hip dislocation

Question 48

What is the most common type of meniscal tears?

Answer 48

Buckle-handle type

Question 49

How long does it take to replace necrotic trabeculae with a healthy new bone?

Answer 49

2-3 years

Question 50

What types of children are commonly affected with SCFE?

Answer 50

Obese or tall & thin children

Question 51

What age range are commonly affected with SCFE?

Answer 51

10-16 years old

Question 52

Where is the location of pain for pt's with Slipping Capital Femoral Epiphysis?

Answer 52

Pain in the anterior aspect of the hip

Question 53

What are the mechanism of injury for a lateral patellar dislocation/ subluxation?

Answer 53

Valgus and ER of the tibia

Question 54

What types of rotatory instability may involve later patellar dislocation?

Answer 54

Anteromedial, posteromedial, posterolateral instability

Question 55

MOI: Flexion-varus, medial rotation of tibia What is the possible diagnosis or affectation given the MOI?

Answer 55

Anterolateral instability

Question 56

In a patient with SCFE, how is moderate classification defined?

Answer 56

Moderate: displacement of 1/3 to 1/2 of the diameter of the femoral neck

Question 57

In meniscal tears what type of position does the knee assume?

Answer 57

Knee flexion (d/t joint effusion and loose capsule)

Question 58

True or False. The rotation of the tibia for special tests and palpation is opposite.

Answer 58

True Palpation: IR tibia - medial meniscus McMurray: ER tibia - medial meniscus

Question 59

What is the diagnostic tool for meniscal injury/ ligamentous tears?

Answer 59

MRI

Question 60

What special test may be done for MCL sprain?

Answer 60

Valgus stress at 0 deg and 30 deg test

Question 61

How many degrees of knee flexion should be avoided in PCL injury?

Answer 61

45 deg of knee flexion

Question 62

What muscle should be focused in PCL rehabilitation?

Answer 62

Quadriceps

Question 63

If the Q angle is >20 deg what could occur?

Answer 63

Lateral patellar tracking (Genu valgum)

Question 64

Which is more common to subluxation (Patella Alta or Patella Baja)?

Answer 64

Patella Alta

Question 65

What do you call the avascular necrosis of the navicular bone?

Answer 65

Kohler's disease

Question 66

What is the difference between Hammer toes, Mallet toes and Claw toes?

Answer 66

Hammer toes - PIP flexion and MTP extension Mallet toes - DIP flexion only Claw toes - PIP & DIP flexion and MTP hyperextension

Question 67

What is Sever's or Haglund's disease?

Answer 67

Calcaneal apophysitis or epiphysisits

Question 68

What treatment can we do for Sever's disease?

Answer 68

Raise the heel of the shoe | Well-padded UCBL insert

Question 69

Among the 4 compartment syndromes which is usually more affected?

Answer 69

Anterior compartment - Deep peroneal nerve - Anterior tibial a. and v.

Question 70

What range of shoulder abduction is most painful for rotator cuff tendinitis?

Answer 70

60-90 deg. of shoulder abduction

Question 71

How is Neer's stage 3 of supraspinatus tendinitis defined?

Answer 71

Neer's stage 3: Tendon degeneration, tendon rupture and presence of bony changes Stage 2: Fibrosis and thickening of the subacromial bursa

Question 72

What is the typical muscle imbalance in rotator cuff tendinitis?

Answer 72

Strong deltoid | Weak rotator cuff mm.

Question 73

Which of the disease will have an improvement in ROM after injection of lidocaine? (Rotator cuff tendinitis or Adhesive capsulitis)

Answer 73

Rotator cuff tendinitis

Question 74

True or False. Tendinitis will present with evident swelling.

Answer 74

False. Tendinitis will present with no apparent swelling but calcific tendinitis has evident swelling.

Question 75

What special test is most sensitive for bicipital tenosynovitis and how is it done?

Answer 75

``` Speed's test - Neutral -ER and supinated (most painful) - IR and pronated (+) pain = SLAP type II ```

Question 76

What motion should be avoided with shoulder dislocation?

Answer 76

Shoulder abduction

Question 77

What joint is the most frequently dislocated joint in children?

Answer 77

Elbow joint

Question 78

What do you call the disease that is a compartment syndrome secondary to pressure that produces muscle ischemia in the forearm?

Answer 78

Volkmann's Ischemic Contracture

Question 79

What is the typical hand deformity of Volkmann's Ischemic Contracture?

Answer 79

Wrist and finger flexion

Question 80

What is the difference between Bankart lesion and Hill sachs lesion?

Answer 80

Bankart lesion: tearing of the labrum | Hill-Sachs lesion: stripping of the periosteum and capsule

Question 81

What program do you give to patients with Reflex Sympathetic Dystrophy (RSD)

Answer 81

Stress loading program

Question 82

Avascular necrosis of the lunate

Answer 82

Kienbock's disease

Question 83

What muscles should you strengthen in TOS?

Answer 83

Trapezius and levator scapulae | - Scapular elevation

Question 84

What trunk of the brachial plexus is commonly affected in neurogenic TOS?

Answer 84

Middle and Inferior trunk of the brachial plexus (ulnar nerve C8-T1)

Question 85

What are the method of measurement for lateral curvature in scoliosis?

Answer 85

Cobb method | Risser-Ferguson method

Question 86

What is considered as a normal curvature of the spine?

Answer 86

<10 deg.

Question 87

What degree of lateral curvature may have cardiopulmonary changes and decreased life expectancy in sever scoliosis?

Answer 87

60-70 deg. above

Question 88

How do you define the Nash Moe scale grade 3 in scoliosis rotational deformity?

Answer 88

Only one pedicle is seen and it is in midline

Question 89

What spinal brace will you recommend to a patient with an apical vertebrae above T6?

Answer 89

Milwaukee Brace Boston brace (apical: below T8)

Question 90

Besides scoliosis what other conditions are indicated for Boston brace?

Answer 90

Spondylolisthesis and Muscular dystrophy

Question 91

What is the most effective form of treatment for adolescent kyphosis?

Answer 91

Milwaukee brace

Question 92

What is the most common classification of Spondylolysis?

Answer 92

Isthmic

Question 93

On X-ray what view can best reveal the scottie dog sign?

Answer 93

Oblique view (lumbar posterior)

Question 94

In the Meyerding's classification how will you define stage 2?

Answer 94

Stage 2: Slipping less than 1/2 (26-50%)

Question 95

True or False. The heart is often displace to the left side of the chest in Pectus excavatum.

Answer 95

True

Question 96

What muscles should be strengthened with spinal stenosis?

Answer 96

Abdominal strengthening