Variadas 11

Question 1

A patient exhibits pain and sensory loss in the posterior leg, calf and dorsal foot.
Extension of the hallux is poor, however the Achilles reflex is normal. What spinal level would you expect to be involved?

A. L4
B. L5
C. S1
D. S2

Answer 1

B

The Achilles reflex originates in the S1 and S2 nerve root

Question 2

A patient scheduled for total hip replacement surgery is referred to physical therapy for. preoperative instruction. All of the following should be incorporated into the preoperative session except?

A. deep breathing and coughing exercises

B. gait training with an appropriate assistive device

C. basic precautions for eary bed mobility

D. proper use of an adduction pillow

Answer 2

D

Question 3

A 26 year old male involved in a motorcycle accident sustains a T10 vertebral fracture.
The patient’s physician attempts to restrict forward thoracic flexion by using an externally applied device. Which of the following would be the most appropriate selection?

A. Minerva cervical thoracic orthosis

B. Philadelphia collar

C.stemal-occipital-mandibular immobilizer

D. thoracolumbar-sacral-orthosis

Answer 3

D

Question 4

A therapist evaluates a patient diagnosed with an Achilles tendon injury. Which clinical finding is not indicative of a ruptured Achilles tendon?

A. negative Thompson test
B. absent Achilles reflex
C. lack of toe off during gait
D. a palpable defect in the musculotendinous unit

Answer 4

A

Question 5

A physical therapist evaluates a patient’s hip range of motion. Which patter of limitation is typically considered to be a capsular pattern?

A. gross limitation of flexion, abduction and intemal rotation

B. gross limitation of flexion, adduction and external rotation

C. gross limitation of extension, abduction and extemal rotation

D. gross limitation of extension, adduction and internal rotation

Answer 5

A

Question 6

A therapist provides exercise guidelines for a group of expectant mothers. Relative contraindications for exercise during pregnancy include all of the following except

A.diabetes

В.thyroid disease

C. history of precipitous labor

D. mild hypotension

Answer 6

D

Question 7

A patient diagnosed with pure athetoid cerebral palsy would most likely demonstrate

A. disturbed sense of balance and faulty depth perception

B. hypertonicity, contractures and clonus

C. slow involuntary uncontrolled movements

D. severe intention tremor

Answer 7

C

Question 8

A physical therapist instructs a patient to move her lower teeth forward in relation to the upper teeth. This motion is termed

A. protrusion
B. retrusion
C. lateral deviation
D. occlusal position

Answer 8

A

Question 9

A CVA patient positioned in supine with legs flexed and arms clasped around his knees gently rocks back and forth. Expected therapeutic outcomes include all of the following except

A. decreased extensor spasticity in the lower extremities

В.inhibition of flexor spasticity in the upper extremities

C. protraction of the scapula

D. facilitation of extensor tone in the trunk

Answer 9

D

Question 10

178. What muscle controls the posilion of the ankle joint at heel strike?

A. eccentric contraction of the anterior tibialis

B. eccentric contraction of the gastroc-soleus

C. concentric contraction of the anterior tibialis

D. concentric contraction of the gastroc-soleus

Answer 10

A

Question 11

Proper technique is essential when mobilizing a joint. Which of the following statements about mobilization is not true?

A. one joint at a time is moved in one direction

B. a joint is mobilized in the closed packed position

С.commence with grade | distraction when possible

D. the patient and the extremity to be treated should be placed in a comfortable position

Answer 11

B

Question 12

The most appropriate goal when treating a patient receiving workers’ compensation
is

A. requiring attendance at scheduled physical therapy sessions

B.maintaining a formal patient/herapist relationship

C.attempting to satisfy the needs of the insurance provider

D. building confidence in the patient’s physical capabilities and control over the future

Answer 12

D

Question 13

A 25 y.o male arrived at an outpatient clinic with chief complaints of R hip and medial knee pain. He denies any traumatic incident or episode leading to his pain and is not certain of how his pain began.

Q1) The physiotherapist performed a thorough evaluation and noticed that the pain in the hip is contributed from R groin. The therapist is very knowledgeable of nerves distributed to skin particularly over the medial femoral triangle. Which of the following nerves is MOST likely associated with the scenario?

A) Genitofemoral

B) Subcostal

C) Ilio-inguinal

D) Lateral cutaneous nerve of thigh

Answer 13

Answer is C

Ilio-inguinal nerve as it supplies skin over medial femoral triangle.

Genitofemoral supplies skin over the lateral part of the femoral triangle and also supplies anterior labia majora.

Subcostal nerve supplies skin at the hip region inferior to anterior part of iliac crest and anterior to greater trochanter.

Lateral cutaneous nerve of thigh supplies skin on anterior and lateral aspects of thigh.

Question 14

A 25 y.o male arrived at an outpatient clinic with chief complaints of R hip and medial knee pain. He denies any traumatic incident or episode leading to his pain and is not certain of how his pain began.

Q2) Upon further assessment, the physiotherapist performed a 90-90 SLR test on R LE as the test was positive. The therapist assesses a patient’s gait on level surfaces and suspects possible deviation.

Which of the following is TRUE regarding this patient’s deviation?

A) Decrease step length on left side

B) Increase step length on right side as test result was negative

C) Increase stride length as test result was negative

D) Decrease step length on right side

Answer 14

Answer is D

Rationale:
decrease step length on the right side as the biceps femoris long head, semitendinosus and semimembranosus are exhibiting muscular tightness (90-90 deg SLR test) and acts as a hip extensor.

This would also affect the runner stride length in terms of decreasing the step length and also decrease his speed.

Question 15

A basketball player presents to the physiotherapist after sustaining an injury. The ankle was forced into inversion while plantar flexed upon landing on a teammate’s foot after a spike at the basketball.

Based on the history mentioned above about the athlete, which ligament is most likely injured?

A. Calcaneofibular
B. Anterior talofibular
C. Anterior tibiofibular
D. Tibio-calcaneal

Answer 15

B

Iversion + pf

Question 16

A basketball player presents to the physiotherapist after sustaining an injury. The ankle was forced into inversion while plantar flexed upon landing on a teammate’s foot after a spike at the basketball.

You have been asked to tape the ankle prophylactically before a basketball game to prevent ankle sprain. In what position should the ankle be slightly positioned in before taping to provide the most protection?

A. Inversion, plantarflexion, adduction
B. Eversion, dorsiflexion, abduction
C. Eversion, plantarflexion, adduction
D. Inversion, dorsiflexion, abduction

Answer 16

B

Tape in the opposite direction from the mechanism of injury

Question 17

A 32-year-old male patient arrived at an outpatient clinic with R heel pain during activity. Upon, examination, the Physiotherapist noted the patient’s calcaneus is moving into eversion after heel strike. The PT would like to provide an orthotic that could help relieve pain. Which of the following orthotic would most likely benefit this patient?

A.Cushion heel
В.Rearfoot Varus post (medial wedge)
C.Rearfoot Valgus post (lateral wedge)
D. Forefoot (lateral wedge)

Answer 17

B

Question 18

) A patient presents with pain in the right ankle which started after the patient tripped while playing football. During assessment, which type of end feel is to be expected with left ankle dorsiflexion in absence of any pathological finding?

A. Soft tissue approximation
B. Tissue stretch
C. Bone-to-bone
D. Empty

Answer 18

B

Question 19

The PT then performs the following test: “Squeezing the calf in prone position” on a patient and notes that there is no response. PT can move the ankle in ROM passively. Which of the following is the most appropriate conclusion based on this finding?

A. Normal finding. All ligaments and tendons intact
B. 1st degree strain of tibiofibular ligament
C. 3rd degree strain of the Achilles tendon
D. Excessive tightness of the soleus muscle

Answer 19

C
Normal response: ankle goes to PF
Test is positive for achilles tendon strain in there is no movement with the test

Question 20

You are examining a patient’s knee and observe the following findings: tenderness along the facets of the patella; crepitus with knee flexion; an alteration in the Q-angle; pain with squatting. Which of the following would likely be your provisional diagnosis?

A. Patellofemoral syndrome
B. Osteoarthritis of the tibia femoral joint
C. Osgood-Schlatter’s disease
D. Adaptive shortening of the iliotibial band

Answer 20

A

Question 21

A 30 y.o. a female, who is a lab assistant by occupation, presents with a history of lower back pain and occasional neck pain since the last few months. She mentions having a h/o lesion to her dorsal scapular nerve in the past.

Q1) Which of the following muscles will the therapist NOT expect to be affected?

A) Levator Scapulae
B) Rhomboid major
C) Teres minor
D) Rhomboid minor

Answer 21

C

The dorsal scapular nerve supplies the Levator scapulae
Rhomboid major and minor;
Teres minor is supplied by the axillary nerve.

Question 22

A 30 y.o. a female, who is a lab assistant by occupation, presents with a history of lower back pain and occasional neck pain since the last few months. She mentions having a h/o lesion to her dorsal scapular nerve in the past.

On evaluation the physiotherapist documents the presence of lordotic posture.

Which of the following statements would be MOST APPROPRIATE regarding postural deformities?

A) Short and strong lumbar erector spinae, upper trapezius with weak and elongated upper erector spinae and anterior abdominals

B) Short and strong upper erector spinae, hip flexors with elongated and weak lumbar erector spinae and middle and lower trapezius

C) Short and strong pectoralis major and minor and hip flexors with weak and elongated upper trapezius and lumbar erector spinae

D) Short and strong hip flexors and lower and middle trapezius with elongated and weak anterior abdominals and pectoralis major

Answer 22

A

With lordotic posture:Weak and elongated- Anterior abdominals, small muscles of lumbar spine (multifidus, rotators), lower and middle trapezius. upper (thoracic and cervical) erector spinae, hyoid muscles

Muscles commonly short and strong-Lumbar erector spine, hip flexors, upper trapezius, pectoralis major and minor, levator scapulae, sternocleidomastoid, scalenes, suboccipital muscles

Question 23

A PT has recently started training a 40 year old male with right hemiplegia for sit to stand transfers.
Which of the following strategies does not generate forward momentum and needs to be discouraged?

A)Pushing-off with both hands on the support surface.

B)Moving shoulders forward by clasping hands with elbows extended.

C)Flexing the trunk to shift the weight forward.

D)Placing the feet well behind to generate forward momentum.

Answer 23

A

A patient with stroke typically demonstrates decreased forward movement and momentum. Focus should be laid on using strategies to generate forward momentum.

Pushing off with both hands on support surface is not effective in forward weight shift and should be discouraged.

Flexion at the trunk shifts the body mass forward.

Placing feet behind allows dorsiflexors to assist forward rotation.

Moving shoulders forward with clasped hands helps in forward weight shift to stand up.

Question 24

A physical therapist is evaluating a patient with burn injuries on the right upper body. The skin on her forearm is reddish-white with presence of blanching and slow capillary refill. There are several broken blisters and the skin surface is wet.

On sensory testing, the patient is found to be sensitive to pressure, however she is insensitive to light touch and soft pinprick.
There is marked edema throughout the extremity.

The Physical Therapist should document this type burn as a:

A)Deep partial thickness
B)Subdermal
C)Superficial partial thickness
D)Epidermal

Answer 24

A

The patient presentation is suggestive of a deep partial thickness burn. With deep partial thickness burn, the skin appears waxy white with broken blisters. Deep partial thickness burns are sensitive to pressure but insensitive to light touch and there will be marked edema with a slow capillary refill.

Subdermal burns look charred in appearance. It will be evident that subcutaneous tissue is involved with muscle damage and neurological involvement.

Incorrect: Superficial partial thickness wounds appear bright pink or red with blanching and brisk capillary refill is present. The blisters are intact and the wound is typically moist. The wound will be sensitive to change in temperature and light touch.

There is presence of moderate edema.
Incorrect: Epidermal wounds are characterized by pink or red color with no blisters. The wound is typically dry and there is minimal edema.

Question 25

A Basketball player suffered a complete achillies tendon rupture after landing abruptly on the right foot. After undergoing a tendon repair surgery, the patient started experiencing numbness at the foot after damage to the sural nerve.

Where would you expect the numbness to be present?

A) Medial border of the foot
B) Dorsal aspect of the foot between the 1st and 2nd toe
C) Lateral border of the foot
D) Posterior to the medial malleolus

Answer 25

C

Lateral border of the

A patient after a TA tendon repair can commonly have sensory disturbances over the lateral border of the repaired extremity.
This occurs due to the involvement of Sural nerve and is a very common complication following the repair alongside infections and adhesions.

Incorrect options
A - Medial border is related to saphenous nerve or L4 dermatome/ medial plantar
B - This is deep peroneal nerve

Question 26

A 60 year old male complaints of chronic shoulder pain with limited ROM. He is diagnosed as shoulder osteoarthritis with cuff arthropathy. He has undergone Reverse total shoulder arthroplasty (TSA) and is currently in phase 1 of rehabilitation.

Q1. Which of the following is NOT an indication of Reverse

A) Severe Osteoarthritis of shoulder
B) Rotator cuff arthropathy
C) Axillary nerve palsy
D) Irreparable Rotator cuff tear

Answer 26

Correct answer: C

Axillary nerve palsy is a contraindication for reverse
TSA since deltoid is necessary for shoulder function post
reverse TSA.

Incorrect Answers:
A,B & D - These are indications for reverse TSA.

Question 27

A 60 year old male complaints of chronic shoulder pain with limited ROM. He is diagnosed as shoulder osteoarthritis with cuff arthropathy. He has undergone Reverse total shoulder arthroplasty (TSA) and is currently in phase 1 of rehabilitation.

Q2.Which of the following is appropriate for this patient currently?

A) Shoulder sling worn compulsorily
B) No GH extension past neutral
C) Isotonics for scapulothoracic muscles and deltoid
D) Can lift 2-5 lb weight

Answer 27

Correct Answer: B

No Gleunohumeral extension past neutral is allowed till weeks postoperatively.

Incorrect Answers:
A-Sling is not compulsory unless rotator cuff is repaired. It is only worn when shoulder is unsupported or in crowded places.
C - Only light, NWB isometrics of ST and deltoid muscles with shoulder in scapular plane is allowed in phase 1.
D- Lifting is limited to Ilb (cup of coffee or glass of water) till 6 weeks.

Question 28

A 68 y.o patient has been admitted to the hospital for complaints of reporting interrupted sleep, increased swelling of the feet, and shortness of breath.

Q1) The patient’s heart rate is 120 bpm and respiratory rate, 28 breaths/minute. Auscultation reveals crackles in both lung bases. The therapist should suspect:

A) acute congestive heart failure.
B) pneumonia in bilateral lower lobes.
C) atelectasis.
D) renal failure

Answer 28

Answer is A

These signs and symptoms are consistent with congestive heart failure.

Question 29

A 68 y.o patient has been admitted to the hospital for complaints of reporting interrupted sleep, increased swelling of the feet, and shortness of breath.

Q2) Patient has been treated in hospital and is getting better under care.
Which of the following clinical characteristics would be MOST important to monitor as part of the home program?

A) Blood pressure and fatigue level
B) Heart rate and cough productivity
C) Presence of cyanosis and diaphoresis
D) Presence of shortness of breath and dependent edema

Answer 29

Answer is D

Rationale:
An increase in fatigue is a symptom of heart failure exacerbation; blood pressure changes are not. A productive cough is a symptom of heart failure; heart rate changes are not.

Cyanosis is a symptom of heart failure; diaphoresis is not. Shortness of breath and dependent edema are symptoms of heart failure exacerbation.

Question 30

. After evaluating the respiratory status of a 06 spinal cord injured patient, which of the following clinical findings would you expect to be true?

A: partial innervation of the diaphragm
B: full epigastric rise in supine
C:a ventilator is required for assisted breathing
D:normal ventilatory reserve

Answer 30

B

Question 31

A therapist is examining a stroke patient. The patient records indicate a lesion in the left middle cerebral artery affecting the frontal lobe.

Which of the following sign/symptom should the therapist expect to find in this patient?

1Visual agnosia
2Horner’s syndrome
3Non-Fluent Aphasia
4 Fluent Aphasia

Answer 31

Non fluent Aphasia or Broca’s Aphasia occurs due to the lesion of the premotor area of the left frontal lobe.

Fluent aphasia/ Wernicke’s aphasia occurs due to the lesion of auditory association cortex in the left lateral temporal lobe.

Visual agnosia occurs due to the lesion in the occipital lobe.

Horner’s syndrome occurs due to the lesion of descending sympathetic fibers.

Question 32

A PT is training a patient with right hemiplegia for postural control in transfers. The patient is able to maintain prone on elbows position and the PT plans to progress him to more challenging postures.

What is the correct sequence of progression the PT should use to improve his balance and posture?

A)Prone on elbows >quadruped-»side-sitting >half kneeling >kneeling.

B)Prone on elbows>side sitting quadruped >kneeling >half kneeling.

C)Prone on elbows >quadruped »side sitting >kneeling >half kneeling.

D) Prone on elbows>side sitting >quadruped >half kneeling »kneeling.

Answer 32

C

Rationale: Prone on elbows» quadruped →side sitting >kneeling >half kneeling is the correct sequence of increasing difficulty to maintain balance. The PT has to challenge the patient with increasingly difficult positions, which concentrate on specific body segments.

Question 33

Scarlet who is 40 years old presented to the clinic with multiple sclerosis which was diagnosed by the neurologist 2 years ago. The disease is characterized by continuous worsening of the disease from onset without distinct relapses. The patient stated she has an adverse reaction to heat which exacerbates her symptoms. The patient is wheelchair bound due to decreased functional strength in the lower extremity. The most common symptoms are visual changes, fatigue, decreased strength and spasticity. Scarlet can dorsiflex the left foot through a partial range of motion against gravity.

Q1) According to the symptoms mentioned above, which of the following is the most appropriate category of this condition?

A) Progressive relapsing multiple sclerosis
B) Benign multiple sclerosis
C) Relapsing remitting multiple sclerosis
D) Primary progressive multiple sclerosis

Answer 33

D

Option a) Progressive relapsing MS: characterized by progressive disease course from onset, with clear, acute relapses that may or may not resolve with full recovery.

Option b) Benign MS: Characterized by mild disease in which patients remain fully functional in all neurological systems 15 years after disease onset.

Option c) Relapsing-remitting MS: Characterized by relapses with either full recovery or some remaining neurological sign/symptoms and residual deficit upon recovery.

Option d) Primary progressive multiple sclerosis:
Characterized by diseases progression from onset, without distinct relapses.

Question 34

Scarlet who is 40 years old presented to the clinic with multiple sclerosis which was diagnosed by the neurologist 2 years ago. The disease is characterized by continuous worsening of the disease from onset without distinct relapses. The patient stated she has an adverse reaction to heat which exacerbates her symptoms. The patient is wheelchair bound due to decreased functional strength in the lower extremity. The most common symptoms are visual changes, fatigue, decreased strength and spasticity. Scarlet can dorsiflex the left foot through a partial range of motion against gravity.

Q2) During examination, the therapist noticed that the patient has left foot drop which has some sensory loss as well. Patient reported pins and needles in the left foot as well. Upon touching the patient’s foot, the patient reported hypersensitivity to minor sensory stimuli. Burning pain has also been reported in the foot. What would be the most appropriate treatment plan for Scarlet
A) Ankle foot orthosis and hydrotherapy
B) Regular stretching and exercises
C) Knee ankle foot orthosis and hydrotherapy
D) Massage and ankle foot orthosis

Answer 34

B

AFO and KAFO is contraindicated is patient severe spasticity, edema and decreased function strength of LE. AFO is used to prevent the foot drop when walking. The patient is already wheelchair bound and decreased functional strength which is mentioned in the stem. So, we can rule out option a,c and d. Regular stretching may help with the pain and AAROM can help to prevent stiffness and maintain ROM/strength. In the stem it is mentioned that the patient has grade 2+.

Question 35

A 40 year old female patient who is in the relapse phase of multiple sclerosis visited the outpatient PT department. The patient reports feeling out of balance when walking, unsteady in activities and trembling of hand when reaching out for an object. On examination, the patient is unable to perform finger to nose test.
Which area of her brain can you suspect to be having new lesions?

1)Dorsal column medial lemniscus.
2Pyramidal tracts.
3)Basal ganglia.
4)Cerebellum.

Answer 35

4

The Patient seems to be having new lesions in the cerebellum. The symptoms reported like ataxia, dyssynergia, intention tremor are important features of cerebellar pathology.
Basal ganglia pathology has main features of resting tremors and rigidity. Lesion in pyramidal tracts would cause difficulty in motor tasks and spasticity. Lesions in the DCML cause sensory issues.

Question 36

A 50 year old male resides alone and is an elementary school teacher. At the conclusion of eight weeks of rehabilitation for a recent CVA, the patient has good strength in the lower extremity except trace to poor strength in the right ankle joint. The patient’s sensation is severely impaired for deep pressure, light touch, and sharp stimuli. The patient has severe fluctuating edema at the ankle. The most appropriate orthosis for this patient is
A. metal upright ankle-foot orthosis
B. polypropylene solid ankle-foot orthosis
C.prefabricated posterior leaf orthosis
D. metal upright knee-ankle foot orthosis

Answer 36

A

Question 37

Which of the following symptoms is not indicative of chronic bronchitis?
A. long term irritation of the trachea and bronchi
В.increased mucus production
C. decreased vital capacity
D. often a result of an allergic reaction

Answer 37

D

Question 38

A patient with a left above knee amputation ambulates in physical therapy. The therapist observes that the patient vaults with left swing phase and occasionally circumducts the involved leg. The most likely cause of the gait deviation is:
A. the prosthesis is too short
B.the prosthesis is long
C. Weak plantarflexors on the right
D. there is decreased toe-out on the left

Answer 38

B

Question 39

Assuming normal development, which activity would typically not occur prior to nine months?
A. rolling from prone to supine
B. sitting independently
C. cruising
D. creeping( Baby may be rocking back and forth on tummy towards items of interest)

Answer 39

C

Question 40

A 47 year old male uses a straight cane during gait activities. The patient is four weeks status post left total hip replacement and is full weightbearing on the left. As he begins to make a 180 degree turn, the most important reminder is
A. you should turn away from the affected side
В.you should tum towards the affected side
C. it does not matter which way you turn if you are full weightbearing
D. keep the cane in front of you

Answer 40

A

Question 41

A degenerative process beginning with irritation and fragmentation of the hyaline cartilage on the patella is termed?
A. Osgood-Schlatter disease
В.retropatellar syndrome
C. chondromalacia patella
D.plica syndrome

Answer 41

C

Question 42

A sensory evaluation reveals light touch impairment to the anterolateral thigh, lateral calf, and sole of the foot. The corresponding dermatomes should be recorded as.
A. L2, 14, S3
B. L1, L3, L5
C. L2, L5, S1
D. L1, L4, S1

Answer 42

C

Question 43

Facilitation of muscle tone is performed through all of the following except

A. approximation
B. prolonged stretching
C. vibration
D. Icing

Answer 43

B

Question 44

A treatment program is designed to include late moming sessions involving aggressive stretching, moderate exercise, energy conservation and stress management techniques.
This program would be most appropriate for which diagnosis?
A. Guillain-Barre syndrome
B. myasthenia gravis
C. Osgood-Schlatter disease
D. mulliple sclerosis

Answer 44

D

Question 45

In an above knee prosthesis, a quadrilateral socket absorbs the majority of the body’s weight on the _ wall?

А.posterior
В.anterior
C.lateral
D. medial

Answer 45

A

Question 46

What a positive Hoffmann’s sign suggests?

Answer 46

A positive Hoffmann’s sign is suggestive of corticospinal tract dysfunction localized to the cervical segments of the spinal cord.

Question 47

What a Homans sign suggests?

Answer 47

Homans sign: Discomfort in the calf muscles on forced dorsiflexion of the foot with the knee straight has been a time-honored sign of DVT.

Question 48

The stability of the transverse ligament should be cleared for all patients with which diagnosis?
A. Downs syndrome
B. Cerebral Palsy
C. Parkinsons
D. Diabetes mellitus I|

Answer 48

A

Children with Downs are low tone and hyper extensible. It is the hypermobility that puts their transverse lig at risk.

All patients with Downs over the age of 3 and RA (not listed here) should be tested with the Sharps Purser test to rule out instability in the AO joint. CP is more commonly spastic which puts them more at risk for contractures.

Question 49

Martha is a 93 year old woman with advanced dementia.
She is physically able to walk but forgets to get out of bed unless cued. What is she at risk for?

A. Skin break down, respiratory complications, disease progression

B Respiratory complications, disease progression, declining physical function

C. Skin break down, urinary tract infections, declining physical function

D. Disease progression, urinary tract infections, declining physical function

Answer 49

C

Increased immobility in bed leads to skin breakdown due to potential pressure wounds, respiratory complications due to decreased tidal volume and secretion clearance, UTIs due to either wearing soiled briefs, or using a catheter.

Question 50

What is the physiological ‘normal’ opening for the jaw?
A. 42mm
B. Two finger height
C. Three finger height
D. Four finger height
E. 52mm

Answer 50

C

jaw opening depends on body size so it is best determined by the three finger rule. Note a jaw opening of less than 2 fingers is considered a positive sign for TMD