adjunct 3 final practice

Match the following:

a. Refers pain only when muscle is compressed

b. Can refer pain when the muscle is at rest

c. Highly concentrated pain referral zone

d. Less concentrated pain referral zone

Latent trigger point

Spill over

Active trigger point

Essential zone

Refers pain only when muscle is compressed → Latent trigger point

Can refer pain when the muscle is at rest → Active trigger point

Highly concentrated pain referral zone → Essential zone

Less concentrated pain referral zone → Spill over

Trigger points are predictable but not reproducible.

a. True b. False

b

Chronic trigger points can lead to depression.

a. True b. False

a

Myofascial trigger points can be caused by all EXCEPT:

a. Direct heat over skin

b. Acute sprain

c. Compromised blood flow

d. Direct trauma to a muscle

a

Which examination is the most difficult to elicit & gives the best diagnostic value of myofascial TPs?

a. Twitch response

b. Pain pattern recognition

c. Jump sign

d. Spot tenderness

a

Which will increase the pain of an iliopsoas trigger point?

a. Sitting for long periods of time

b. Passive hip extension

c. Heat on the TP

d. Heat on the referral zone

b

Latent trigger points have all characteristics, EXCEPT:

a. Spontaneously refers pain

b. Always painful when compressed

c. Muscle fatigues easily

d. Hypertonic muscle

a

The progression of an ac,ve trigger point includes all EXCEPT:

a. Increases range of motion

b. Spontaneous recovery

c. Persists without progression

d. Additional TP development

a

9. Trigger point pain can be reduced by applying heat over the reference area. a. True b. False

a

A secondary trigger point becomes active because its muscle is located within the zone of reference of another active TP.

a. True b. False

b

Which is an example of a secondary trigger point (TP)?

a. Infraspinatus TP leading to a flexor carpi radialis TP

b. Iliopsoas TP leading to a soleus TP

c. Supraspinatus TP leading to a teres minor TP

d. Glut max TP leading to a pectineus TP

c

Trigger points can lead to all of the following, EXCEPT:

a. Pain, tingling, & numbness in a dermatomal papern

b. Sweating

c. Increased blood flow to the area

d. Muscle dysfunction

a

The following are typical responses to trigger point therapy, EXCEPT:

a. Increased muscle fibrosis

b. Increased ROM

c. Release of muscle hypertonicity

d. Reduced tenderness

a

Which population is most at risk of ankle sprains?

a. 10–19-year-old athletes

b. 30–50-year-old runners

c. 65–80-year-old weekend warriors

a

Microtears within ligaments in the ankle are classified as:

a. Grade 1 sprain

b. Grade 2 sprain

c. Grade 3 sprain

d. Grade 4 sprain

a

Grade 1 ankle sprains often demonstrate moderate joint laxity upon clinical examination.

a. True b. False

b

Complete tear of a ligament would be classified as a:

a. Grade 3 sprain

b. Grade 3 strain

c. Grade 2 sprain

d. Grade 2 strain

a

What grade ankle sprain places pa,ents in the most likely posi,on to reinjure the same ankle?

a. Grade I & Il

b. Grade Il & III

c. Grade III

a

What is the most common ligament that is sprained in a plantar flexion with inversion ankle sprain?

a. Anterior talofibular ligament

b. Calcaneofibular ligament

c. Deltoid ligament

d. Posterior talofibular ligament

a

What is the most common ligament that is sprained in an eversion ankle sprain?

a. Anterior talofibular ligament

b. Calcaneofibular ligament

c. Deltoid ligament

d. Posterior talofibular ligament

c

The anterior drawer test of the ankle test which of the following structures?

a. ATFL

b. CFL

c. DLC

d. Syndesmosis

a

If a patient has a positive bump test, what other injury is most likely associated with this?

a. Lumbar compression fracture

b. MCL tear

c. Iliopsoas trigger point

d. ATFL sprain

d

Thompson test may not be performed on a patient with a red, hot, & swollen calf because:

a. Risk of a deep vein thrombosis

b. It will increase the patient's pain

c. It can worsen an Achilles tear

d. Risk of infection

a

In regards to the goals of the rehabilitation process of an ankle sprain, gaining range of motion (ROM) of the ankle joint precedes gaining strength.

a. True b. False

a

Syndesmotic injuries can occur in association with an ankle fracture.

a. True b. False

a

What is the mechanism of injury for a syndesmotic injury?

a. External rotation of the foot with respect to the tibia

b. Internal rotation of the foot with plantarflexion of the foot

c. Inversion with plantarflexion of the foot

d. Eversion of the foot

a

27. Which ortho tests is used to evaluate syndesmotic injury?

a. Squeeze test

b. Press test

c. Lachman's test

d. Sag test

a

Which is TRUE regarding perturba,on exercises?

a. It always requires the use of a wobble board

b. It helps to increase range of motion

c. It can be done before achieving active range of motion

d. It helps to train adaptability & proprioception

d

Which is the most efficient for helping pa,ents with chronic ankle instability?

a. Passive range of motion

b. Calf raises

c. Ankle alphabets

d. Balance training

d

Balance training can improve ankle stability & should be incorporated into the rehab protocol.

a. True b. False

a

31. Which would be considered a sensory motor exercise?

a. Marble pick-ups

b. passive ROM movements

c. Calf stretches

d. Ankle alphabet ROM

a

A risk factor for plantar fasciitis is?

a. Obesity

b. Tight shin muscles

c. Wearing cushioned, well-fixng shoes

d. Well-developed strength in the intrinsic foot muscles

a

Custom orthoses can provide short term pain relief from plantar fasciitis.

a. True b. False

a

A Haglund's deformity is associated with?

a. Achilles tendiniits

b. Plantar fasciiits

c. Osteochondral defect

d. Posterior ,bialis tendinopathy

a

Which can mimic chronic hip pain?

a. Disc herniation

b. Infection

c. Tumor

d. All of the options listed

d

Which is an example of an intra-articular hip injury?

a. Internal coxa saltans

b. Gluteal tear

c. Hypertrophic psoas

d. Acetabular labral tear

d

Which condition is considered an intra-articular hip injury?

a. Femoroacetabular impingement

b. Internal coxa saltans

c. Slipped capital femoral epiphysis

d. Piriformis Syndrome

a

What is the most common cause of snapping in the hip?

a. The iliopsoas rubbing over a bony prominence

b. The sartorius rubbing over a bony prominence

c. The rectus femoris rubbing over the ASIS

d. The iliotibial band rubbing over the greater trochanter

a

What population do gluteal tears more often occur in?

a. 10-year-old males

b. 50-year-old females

c. 50-year-old males

d. 20-year-old females

b

Labral tears of the hip will lead to instability & advancement of what other condition?

a. Osteoarthriits in the hip

b. Osteolysis of the femoral head

c. Iliotibial Band syndrome

d. None of these answers are correct

a

Internal snapping of the hip may occur as a result of the IT band rubbing over the greater trochanter.

a. True b. False

b

Extra-ar,cular hip snapping is commonly a result of:

a. None of the options listed

b. Labral tear

c. Chondral damage

d. Loose bodies

a

The meniscus has all the following characteristics except:

a. Cushions the joint

b. Deepens the socket

c. Resists joint lubrication

d. Provides stability

c

The lateral portions of the meniscus are highly vascularized.

a. True b. False

b

The lateral meniscus is apached to:

a. ACL

b. PCL

c. MCL

d. LCL

b

A great way to rehab the meniscus is to do wall sits at 60°

a. True b. False

b

Radial meniscal tears have a more favorable healing poten,al compared to longitudinal meniscal tears.

a. True b. False

b

The medial meniscus is apached to: (select all that apply)

a. ACL

b. PCL

c. MCL

d. LCL

a, c

Simple meniscal tears are more likely to heal than complex meniscal tears.

a. True b. False

a

During weight bearing movements from flexion into extension the femur & tibia are supported primarily by the posterior menisci.

a. True b. False

b

Degenerative meniscal tears have a higher healing rate than traumatic meniscal tears.

a. True b. False

b

18. During weight bearing movements from extension into flexion, the femur & tibia are supported primarily by the anterior menisci.

a. True b. False

b

Which type of meniscal tears often result in locking of the knee (inability to fully straighten the knee)?

a. Longitudinal meniscal tear

b. Traumatic meniscal tear

c. Complex meniscal tear

d. Bucket handle meniscal tear

d

A weak VMO & hip adductor can also increase the Q-angle.

a. True b. False

a

The minimum normal q-angle measurement is:

a. 5°

b. 10°

c. 15°

d. 25°

b

If the tibia medially rotates this allows my knees to come together & increase the Q-angle (close knees = large Q angle)

a. True b. False

a

23. Which will INCREASE the Q-angle?

a. Foot supination (increasing the arch of the foot)

b. Valgus stress on the knee

c. Strengthening of the vastus medialis oblique

d. External rota,on of the hip

b

The ACL contains mechanoreceptors that aid in knee stability.

a. True b. False

a

ACL contains efferent mechanoreceptors that affect the knee's stability.

a. True b. False

b

Which is TRUE regarding the ACL? (select all that apply)

a. Provides posterior stability

b. Provides anterior stability

c. Provides rotational stability

d. ACL tears are least common than PCL tears

b, c

ACL is the most commonly completely disrupted ligament of the knee.

a. True b. False

a

Most sports related ACL injuries are a result of some form of external blow.

a. True b. False

b

The most common ACL tears occur due to:

a. Stretching maneuvers

b. Hyper-Flexion maneuvers

c. Pivoting maneuvers

d. Hyper-Extension maneuvers

c

Which tests the integrity of the ACL?

a. Anterior Drawer Test

b. Lachman Test

c. Apley Test

d. Clarke's Test

a

What is the best orthopedic test to determine an ACL injury?

a. Posterior drawer test

b. Anterior drawer test

c. Lachman’s test

d. McMurray’s test

c

Which 2 tests can determine ACL (anterior) translation?

a. Anterior Drawer Test

b. Lachman Test c. Apley Test

d. Clarke's Test

a, b

Which is the 1st goal of ACL rehab?

a. Open chain exercises

b. Closed chain exercises

c. Initiate quad & hamstrings activity

d. Achieve ROM

d

What would be the first goal of care in an acute ACL rehab protocol?

a. Achieve passive knee extension

b. Quadriceps and hamstrings contraction

c. Performing a squat

d. Codman's exercise

a

The ACL rehabilitation protocol may include having the patient balance on foam pads.

a. True b. False

a

Which ACL rehabilitation protocol is incorrect?

a. Control swelling & pain

b. Early emphasis on obtaining full passive extension

c. Complete reduction of intra-articular inflammation

d. Early initiation of quadriceps & hamstring activity

e. Use of isometric exercises

e

_____ is when full passive mo,on is present but ac,ve terminal knee extension does not occur.

a. Extensor lag

b. Flexor lag

c. Extensor log

d. Flexor log

a

Extensor lag may occur because of edema, pain & redness.

a. True b. False

b

Which statement is correct?

a. If extensor lag is present, joint & muscle stiffness are likely contributors

b. If extensor lag is present, joint stiffness is a likely contributor

c. If extensor lag is present, muscle stiffness is a likely contributor

d. If extensor lag is present, joint & muscle stiffness are not likely contributors

d

AMI is a protective reflex that inhibits quadriceps contraction to prevent further injury to the knee.

a. True b. False

a

if AMI & joint effusion are present the most important goal is to increase both active & Passive ROM as the 1st stage of rehabilitation efforts.

a. True b. False

b

Which is TRUE about AMI?

a. May be observed after knee injury, knee surgery or patients with knee joint arthritis

b. Is a protective reflex inhibition that protects the knee from a strong hamstring contraction

c. AMI allows the quad to fire properly

d. AMI causes a quick rehabilitation

e. AMI is not associated with joint effusion

a

What may lead to decreased knee stability

a. Arthrogenic muscle inhibition

b. Perturbation exercises

c. Isometric muscle contraction

d. Ankle alphabets

a

Persistent AMI can:

a. Decrease in knee stability

b. Increase in knee stability

c. Increase of function or performance

d. Decreases injury

a

Which MOI is correct for PCL injuries:

a. Direct blow to the proximal fibula

b. A fall on the knee with the foot in a dorsiflexed position

c. Hyperextension of the knee > hyperflexion of the knee

d. Combined rotational forces

d

Posterior translation & external rotation is far more severe when both PCL’s tear & posterolateral corner tear is present.

a. True b. False

a

Severe posterolateral corner instability can occur without injury to the PCL, fibular collateral ligament & popliteus.

a. True b. False

b

A combined PCL & collateral complex injury will have varus & valgus laxity in full flexion.

a. True b. False

b

Isolated PCL tear causes varus-valgus laxity & decreased rotation.

a. True b. False

b

PCL tear is best detected at 70-90° of knee flexion a. True b. False

a

The most sensitive PCL orthopedic test is the Posterior Sag Test.

a. True b. False

b

Hamstring strengthening is the foundation of rehabilitation after PCL injury.

a. True b. False

b

Knee hyperflexion may cause:

a. ACL injury

b. PCL injury

c. MCL injury

d. LCL injury

b

Which exercise places the lowest strains on the PCL?

a. Open Kinetic Chain in Extension

b. Open Kinetic Chain in Flexion

c. Closed Kinetic Chain in Extension

d. Closed Kinetic Chain in Flexion

c

Which exercise places the lowest strains on the PCL but results in elevated patello-femoral joint forces?

a. Open Kinetic Chain in Extension

b. Open Kinetic Chain in Flexion

c. Closed Kinetic Chain in Extension

d. Closed Kinetic Chain in Flexion

a

Which is correct for PCL rehabilitation?

a. With open chain activities, there is a tremendous force exerted on the PCL during extension exercises

b. Passive motion can be safely performed through the entire range of flexion & extension.

c. Active closed kinetic chain activities of any kind in passive ROM, should be used cautiously when rehabbing the PCL

d. Closed kine,c chain flexion exercises generate extremely high forces in the PCL & should be avoided altogether.

b

Which is incorrect regarding PCL grade injuries & rehab?

a. Grade 1 injuries: perform non-resisted active motion as tolerated but resisted motion should be limited to a 0-60° flexion arc during the early treatment

b. Grade 2 injuries: perform non-resisted active motion as tolerated but resisted motion should be limited to a 0-60° flexion arc during the early treatment

c. Grade 3 injuries: should be braced in extension & slowly increased

d. Grade 3 injuries: should be braced in flexion & slowly increased (in extension)

d

The MCL apaches to the medial meniscus.

a. True b. False

a

MCL restricts medial rota,on of the ,bia on the femur.

a. True b. False

b

Which is FALSE regarding MCL structure?

a. The fascia inves,ng the sartorius muscle is the 1st layer

b. Capsule of the knee joint & the deep MCL is the 3rd layer

c. Superficial MCL, the medial patellofemoral ligament, & the ligaments of the posteromedial corner of the knee is the 2nd layer

d. Capsule of the knee joint and the meniscofemoral & menisco,bial ligaments composes the 3rd layer

e. All are correct f. None are correct

e

Which MOI for MCL is incorrect?

a. Direct blow to outer aspect of upper leg

b. Direct blow to outer aspect of lower thigh

c. Non-contact external rotation

d. Non-contact internal rotation

d

What test is crucial for evalua,ng an injury to the MCL?

a. Valgus stress test with knee in 20 degrees of flexion

b. Valgus stress test with knee in 30 degrees of flexion

c. Valgus stress test with knee in 20 degrees of extension

d. Valgus stress test with knee in 30 degrees of extension

b

Which DDx is wrong for MCL injuries?

a. Patellar dislocation or subluxation

b. Medial knee contusion

c. Medial meniscal tear

d. Aphyseal fracture in patients who are skeletally immature

e. All are correct

f. None are correct

e

Which indication is incorrect for operative treatments of MCL injuries?

a. A large bony avulsion

b. A concomitant tibial plateau fracture

c. Associated cruciate ligament injury

d. Extra-articular entrapment of the end of the ligament

d

A part of the following statement is incorrect. Find the right word(s) to make the sentence correct: Patient's with a LCL injury may report a popping or tearing sensation.

a. Patients with a MCL injury may report a popping or tearing sensation on the medial aspect of the knee

b. Patients with a meniscus injury may report a popping or tearing sensation throughout the thigh

a

66. LCL attaches to the lateral meniscus.

a. True b. False

b