LE Ortho Sensitives

During evaluation of a patient, the therapists observes significant posterior trunk lean at initial contact. Which of the following is the most likely muscle that the therapists needs to focus on during the exercise session in order to minimize this gait deviation?

a.     G. medius

b.     G. maximus

c.     Quadriceps

d.     Hamstring

B

During evaluation of a patient, the therapists observes significant posterior trunk lean at initial contact. Which of the following is the most likely muscle that the therapists needs to focus on during the exercise session in order to minimize this gait deviation?

a.     G. medius

b.     G. maximus

c.     Quadriceps

d.     Hamstring

C

Turf toe:

a.     1^st MTP

b.     2^nd MTP

c.     4^th MTP

d.     5^th MTP

A

You have a patient with a knee flexion contracture. Your goal is to increase knee extension by doing stretching exercise. Which of the following doesn’t need to be stretched?

a.     Hamstring muscle

b.     Gastrocnemius muscle

c.     Infra patellar tendon

d.     None of these

C

What is the most active muscle after heel strike to prevent buckling of the knee?

a.     Ankle DF

b.     Gluteus maximus

c.     Trunk extensors

d. Quadriceps femoris

D

After THR, which of the following is correct advice to the patient?

a.     Slowly bend forward then pick up the object from floor

b.     Avoid sitting on high and hard chairs

c.     Used a raised toilet seat

d. None of these

C

You patient suffered from a patellar dislocation. What is the most common direction of dislocation?

a.     Superior

b.     Inferior

c.     Medial

d.     Lateral

e.     Anterior

D

You have patient with an excessive anteversion, what motion of the hip would be limited?

a.     Flexion

b.     Medial rotation

c.     Lateral rotation

d.     Extension

C

A patient point to the lateral aspect of the thigh as the source of pain. This may indicate that the underlying problem may be due to:

a.     RA

b.     Gluteal bursitis

c.     Trochanteric bursitis

d.     Lumbar stenosis

C

A 25 y/o male doing a lot of uphill running is prone to tendinitis of the:

a.     Patellar tendons

b.     Tendon of Achilles

c.     Adductor tendons

d.     Popliteal tendons

B

A 50 y/o female underwent an uncomplicated total knee replacement. What knee flexion ROM would be a realistic goal for her before D/C from the hospital?

a.     0-90 degree

b.     0-60 degree

c.     0-45 degree

d.     0-120 degree

A

A 14 y/o athletic boy has a painful bump in anterior tibial tubercles. HE experiences pain during running and jumping. X-ray findings are normal except for soft tissues swelling over the tubercles. He may be suffering from:

a.     Osgood Schlatter disease

b.     Osteogenesis imperfecta

c.       Sinding Larsen Johansson disease

d.       Osteochondritis dissecans

A

What do you call this foot deformity in which there is a transverse plane deformity with adduction of all of the five metatarsals, which occurs at the tarsometatarsal joint?

a.     Metatarsus adductus

b.     Metatarsus varus

c.     Metatarsus adductovarus

d.     Forefoot adductus

A

Inflammation of the FHL tendon secondary to overuse:

a.     Turf toe

b.     Dancer’s tendinitis

c.     Splay foot

d.     Sever’s disease

B

You have been asked to fabricate a splint for a one-month-old infant with congenital hip dislocation. In what position should the hip be replaced while in the splint?

a.     Flexion and abduction

b.     Flexion and adduction

c.     Extension and adduction

d.     Extension and abduction

A

This condition presents with clicking or popping sound that occurs during running and dancing activities. This is thought to be because of the iliopsoas tendon riding over the greater trochanter or anterior acetabulum. What is this condition?

a.     Subtrochanteric bursitis

b.     Snapping hip syndrome

c.     Ischiogluteal bursitis

d.     Trochanteric bursitis

B

The patient with a torn meniscus of the knee would present with what type of end feel on ROM of the knee?

a.     Springy block

b.     Empty feel

c.     Capsular feel

d.     Bony block

A

Wagner classification stage 1:

a.     Intact skin

b.     Deep with osteomyelitis/abscess

c.     Superficial/Local ulcer

d.     Gangrene of whole foot

C

The 67-year-old male patient came in with a diagnosis of avulsion fracture of the anterior superior iliac spine of the pelvis. What muscle might have caused this fracture?

a.         Iliopsoas

b.         Sartorius

c.           Vastus medialis

d.          Tensor fascia latae

B

Contusion to the ASIS due to direct trauma:

a.     Trochanteric bursitis

b.     ASIS Avulsion fracture
c.     Hip pointer injury

d.     Snapping hip injury

C

The following are presentation of coxa valga:
I. Posterior pelvic rotation
II. Lengthening of the ipsilateral leg
III. ER of hip
IV. Pronated foot

a.     I, II, III

b.     III and IV

c.     I, II, III
d.     IV only

C

The common pain site of plantar fasciitis is at the:

a.     Lateral calcaneus

b.     Lateral talus

c.     Medial talus

d.     medial calcaneus

D

The most commonly damaged bursa in the knee is the:
a.     Medial bursa

b.     Lateral bursa

c.     Deep infrapatellar bursa

d.     Prepatellar bursa

You evaluate your patient who is a runner. He complaints to have posteromedial leg pain while running which he associates with improper foot wear cushioning. The pain subsides with rest. Upon palpation, you noted tenderness of the tibial crest area. What is the BEST diagnosis for this patient?

a.     Achilles tendinitis

b.     Shin splints

c.     Ankle sprain

d.     Retrocalcaneal bursitis

B

Increased distance between the medial malleolus and talus is caused by an injury to the:

a.     Deltoid ligaments

b.     Calcaneofibular ligaments

c.     Anterior talofibular ligaments

d.     Tibiofibular ligaments

A

All are treatments of plantar fasciitis except:

a.     Weight reduction for obese patients

b.     Wear soft heels

c.     Decrease heel size

d.     AOTA

e.     NOTA

E

Flat foot components:

a.     Hindfoot varus, forefoot varus

b.     Hindfoot valgus, forefoot varus

c.     Hindfoot valgus, forefoot valgus

d.     Hind foot varus, forefoot valgus

B

What is the limitation of motion in patients with LCPD?

a.     ABIR

b.     ERABIR

c.     ABER

d.     FABER

A

The least commonly sprained ligament

a.     Posterior talofibular ligament

b.     Anterior talofibular ligament

c.     Calcaneofibular ligament

d.     Spring ligament

A

This is a common clinical feature of Osgood Schlatter’s disease

a.     Pain and swelling on the fibular head

b.     Is self-limiting and ceases at age 15

c.     More common in females

d.     Occurs when growth is slow

B

This is formed when the synovial fluid extends into the popliteal space and becomes exposed in a membrane:

a.     DVT

b.     Lateral meniscitis

c.     Baker’s cyst

d.     Thrombophlebitis

C

Mechanism of injury of the anterior talofibular ligament injury:

a.     DF and INV

b.     DF and EVER

c.     PF and INV

d.     PF and EVER

C

Blount’s disease

a.     Genu valgum

b.     Tibia vara

c.       Tibia valga

d.       Genu recurvatum

B

A basketball player suffered an inversion injury of the ankle 1 day ago upon evaluation the PT noted moderate swelling at the ankle. What can be established at this point?

a.     The patient will not be able to play for the next 2 weeks because of the severity of the injury

b.     The severity of the injury cannot be accurately determined yet

c.     The patient’s affected ankle will be subjected to NWB status for 3 weeks

d.     The patient has 2^nd degree ligamentous injury  

B

When the knee is extended, hip flexion is limited to 60-80 degrees because of passive insufficiency of the?

a.     Gluteus maximus

b.     Iliopsoas

c.     Hamstrings

d.     Rectus femoris

C

A stab wound the popliteal fossa will primarily injure which structure:

a.     Posterior tibial nerve

b.     Popliteus

c.     Common peroneal nerve

d.     Popliteal artery

D

With paralysis of the gastrocsoleus:

a.     In children, a secondary clubfoot deformity is likely to develop

b.     There will be marked difficulty in running and jumping

c.     An AFO should always be prescribed

d.     The deep muscles of the posterior compartment can substitute as plantar flexors in the ankle

B

Meniscal tears in the knee joint usually result from:

a.     Hyperextension

b.     Hyperflexion

c.     Rotation in full extension

d.     Rotation in partial flexion

D

A patient has bilateral quadriceps weakness. The most difficult task for him to do is:

a.     Running

b.     Climbing stairs

c.     Walking at a fast pace

d.     Going downstairs

D

Muscle which compress the sciatic nerve as the nerve passes underneath it:

a.     Rectus femoris

b.     Quadrates femoris

c.     Piriformis

d.     Gluteus maximus

B

Subjects treated in PT for knee problems can benefit from a supportive knee appliance. The purposes of knee appliance are as follows. EXCEPT:

a.     To change the biomechanics of the knee

b.     To pursue a conscientious strength/ power maintenance program

c.     To protect the surgical procedure during healing of tissues

d.     To compensate for decreased internal stabilization with an increased external stabilization system

e.     As an adjunct to a thorough rehabilitation program

B

Postoperative care of acute knee instability repair after hospital discharge include the following except:

a.     Immobilization is continued for six weeks, during which time the subject in NWB

b.     Muscle strength is gained through such techniques as leg raising, terminal knee extension with leg raises or progressive resistance exercises

c.     When using free weight in progressive resistance exercises, it is extremely important that his foot and weight rest on a surface and not allowed to dangle free with muscles relaxed when the subjects returns to the 90 degrees flexed position

d.     ROM should be regained passively because passive techniques tend to stretch excessively the healing ligaments and allow residual laxity

e.     It is important that the subject not externally rotate the involved leg during early weight bearing in order not to pull apart the repaired ligaments

D

In hospital postoperative care in acute knee instability repair include the following except:

a.     Cast change usually on the 5^th postoperative day

b.     Cast immobilization of the knee at about 60 degrees of flexion

c.     Toe-touch weight bearing crutch walking as tolerated

d.     Non- weight bearing crutch walking

e.     Ankle ROM, quadricep femoris muscle setting exercises progressing to straight leg raising exercises

C

In the knee, excessive normal forces resulting in overuse syndrome can be caused by the following except:

a.     High repetition, high load

b.     Low repetition, high load

c.     Activity level is greater than the possible physiological repair

d.     Poor conditioning

e.     Small biomechanical dysfunction that become magnified with high performance activities

A

Generalities of knee instabilities are as follows, except:

a.     None of these

b.     When an isolated tear of the medial compartment ligaments, the result of the abduction stress test is positive at 30 degrees of knee flexion and negative with the knee in full extension

c.     All of these

d.     With an intact posterior cruciate ligament, rotator instability- both single and combined may occur

e.     With the posterior cruciate ligament ruptured, straight instability may be found

A

Injury to the tibial collateral, middle one third medial capsular, and posterior obliques ligaments may be determined by the following test:

a.     Adduction stress test at 45 degrees of flexion and the internal rotation and posterior drawer sign

b.     Abduction stress test sign at 15 degrees of flexion and the external rotation anterior drawer sign

c.     Abduction stress test at 30 degrees of flexion and the external rotation anterior drawer sign

d.     Abduction rotation test at 30 degrees of flexion and the internal rotation anterior drawer sign

e.     Adduction stress test at 45 degrees of flexion and the external rotation anterior drawer sign

C

The following apply to posterolateral rotator instability of the knee, except:

a.     Caused by a momentary anterior subluxation of the lateral tibial plateau on the lateral femoral condyle

b.     External rotational recurvatum test is positive because there is excessive hyperextension of the tibia on the femur, with excessive external rotation

c.     The mechanism of injury is usually a direct blow to the knee from an anteromedial direction

d.     Resultant injury is characterized by a posterolateral drawer sign

e.     Injury results in a lesion to the arcuate ligament complex, the popliteal tendon, the fibular collateral ligament, and the lateral head of the gastrocnemius

A

The hip repair surgical procedure involves removal of a bone wedge to shift weight bearing stresses away from a degenerated cartilage onto healthy cartilage. A blade plate may be inserted for a secure fixation and early ambulation.

a.     Arthrodesis

b.     Muscle release

c.     Displacement osteotomy

d.     Femoral prosthesis

e.     Double cup arthroplasty

C

If the neck shaft angle of the femur is less than 125 degrees, this deviation results in decrease leg length and muscle strength due to torque changes from changes in muscle lever arms and length-tension relationships.

a.     Retroversion

b.     Anteversion

c.     Coxa vara

d.     Coxa valga

C

The following statements describes care of meniscal injuries EXCEPT:

a.     Subjects with horizontal cleavage tears of the menisci often remain asymptomatic

b.     Flexion- extension exercises strengthen the quadriceps femoris mechanism

c.     Subjects with vertical tears of the menisci do not heal, but increased strength and flexibility around the knee may allow continued activities until the appropriate surgical procedure is performed.

d.     Short arc (terminal extension) or straight leg raise exercises is cannot be substituted if full arc exercises cause pain

D

In hospital postoperative care in acute knee instability repair include the following except:

a.     Cast change usually on the 5^th postoperative day

b.     Cast immobilization of the knee at about 60 degrees of flexion

c.     Toe-touch weight bearing crutch walking as tolerated

d.     Non- weight bearing crutch walking

e.     Ankle ROM, quadricep femoris muscle setting exercises progressing to straight leg raising exercises

C

In transferring a patient s/p  (L) THR, what is the correct technique?

a.     To the left to prevent adduction of the left hip with helper supporting the leg

b.     To the right to prevent adduction of the right hip

c.     To the right to prevent adduction of the left hip

d.     To the left to prevent abduction of the right hip

C

The patient is asked to do what specific position to test the right G. medius muscle, trendelenburg’s sign:

a.     Stand on the left leg

b.     Stand on the right leg

c.     Lower the left hip

d.     Lower the right hip

B

A 19 y/o female has a painful knee extension. She has a (+) Clutton’s joint. The probable diagnosis is:

a.     Tuberculosis arthritis

b.     Syphilitic arthritis

c.     Reiter’s syndrome

d.     Septic arthritis of the knee

B

The following rehabilitation principles are followed in post anterior cruciate ligament reconstruction, EXCEPT:

a.     Delay ROM and weight bearing

b.     Avoiding excessive early open chain exercises

c.     Muscle strengthening and conditioning

d.     Incorporation of closed kinetic chain exercises

A

A 50 y/o female underwent an uncomplicated total knee replacement. What knee flexion ROM would be a realistic goal for her before discharge from the hospital?

a.     0-90 degrees

b.     0-45 degrees

c.     0-60 degrees

d.     0-120 degrees

A

Only this avascular necrosis of the navicular bone of the foot is:

a.     Versace’s disease

b.     Scheurmann’s disease

c.     Kohler’s disease

d.     Freiberg’s disease

C

The most common deformity of a spastic lower extremity:

a.     Equinovarus foot

b.     Calcaneovalgus foot

c.     Equinovalgus foot

d.     Calcaneovarus foot

A

The most common cause of lateral knee pain in runners is:

a.     Iliotibial band friction syndrome

b.     Posterior cruciate ligament tear

c.     Lateral retinacular tear

d.     Lateral meniscus tear

A

A 14 y/o basketball player comes to you because of leg pain. He has point tenderness on the middle third of the lower leg. Use of the ultrasound worsened the pain. The most likely has:

a.     Contusion

b.     Stress fracture

c.     Anterior compartment syndrome

d.     Shin splints

C

The cinema sign which is pain of the knee increased on stair climbing and sitting and relief on standing is observed in patients with:

a.     Patellar subluxation

b.     Chondromalacia patella

c.     Patellar discoloration

d.     Osteoarthritis of patella

B

The gait abnormality typical of patients with rheumatoid arthritis is termed apropulsive because of:

a.     Absence of push off

b.     Excessive heel strike

c.     Excessive push off

d.     Absence of heel off

A

On examination of a 6-year-old boy, you noted muscle tightness at both lower extremities. This may indicate:

a.     Myotonia

b.     Fasciculation

c.     Weakness

d.     Generalized hypotonia

A

1.     The shearing stress on the anterior cruciate ligament is:

a.     30 degrees flexion to full extension

b.     60 degrees flexion to full extension

c.     90 degrees flexion to 60 degrees flexion

d.     30 degrees extension to full extension

B

A patient scheduled for a total hip replacement in 3 days is for preoperative instruction. All of the following should be part of the instructions, EXCEPT:

a.     Gait training with appropriate

b.     Basic precautions for early bed mobility

c.     Proper use of abduction pillow for 1-2 weeks postoperative

d.     Deep breathing and coughing exercise

C

An ankle eversion injury will primarily cause:

a.     Bony damage

b.     Tear of anterior talofibular ligament

c.     Tear of medial collateral ligament

d.     Ankle sprain

A

Dynamic factors for patella tracking dysfunction include:

a.     Vastus medialis insufficiency

b.     All of these

c.     Increase in angulation between the quadriceps and patella

d.     A lateral femoral condyle is not sufficiently prominent anteriorly

B

Gait in the elderly is characterized by:

a.     Decreased stride width

b.     Increased cadence

c.     Decreased step length

d.     Increased stride length

C

After an uncomplicated total knee replacement, what knee ROM would be a realistic goal for the patient before discharge from the hospital:

a.     0-60 degrees

b.      0-120 degrees

c.     0-90 degrees

d.     30-90 degrees

C

With a patient prone and knee flexed, you apply a downward force and rotate the leg, knee pain and grinding sensation usually indicates:

a.     Meniscal tears

b.     Chondromalacia patella

c.     Baker’s cyst

d.     Osteoarthritis

A

In acute patellar dislocation, this muscle is usually disrupted or impaired:

a.     Vastus intermedius

b.     Rectus femoris

c.     Vastus lateralis

d.     Vastus medialis

D

Hammer toes are a deformity of metatarsophalangeal joints resulting in:

a.     Flexion of DIP joints

b.     All of these

c.     Flexion of the PIP joints

d.     Extension of the IP joints

C

An athlete with groin pain above the level of the inguinal ligament should be suspected to have:

a.     Hip adductor strain

b.     ASIS avulsion

c.     Pubis fracture

d.     Abdominal fascia strain

B

The SPLATT procedure aims to:

a.     Release and transfer the peroneus longus

b.     Reduce excessive supination at the subtalar joint

c.     Improve the base of support during ambulation

d.     Prevent knee flexion during the gait cycle

B

A degenerative condition starting with irritation and fragmentation of the hyaline cartilage on the patella is:

a.     Chondromalacia patella

b.     Patella baja

c.     Osgood Schlatter disease

d.     Plica syndrome

A

In this foot deformity there is eversion, plantar flexion, and inclination of the calcaneus with abduction of the forefoot:

a.     Pes valgus

b.     Talipes calcaneovalgus

c.     Pes equinovarus

d.     Pes planus

A

Pain in piriformis syndrome is usually reproduced when the extended leg is tested with:

a.     Hip internal rotation

b.     Knee flexion

c.     Hip adduction

d.     Hip external rotation

A

In meralgia paresthetica, there is entrapment of the nerve coming from roots:

a.     L1-L2

b.     L3-L4

c.     L2-L3

d.     L4-L5

C

Which clinical finding is not indicative of ruptured achilles tendon?

a.     Absent achilles reflex

b.     Negative Thompson test

c.     Lack of toe-off during gait

d.     All of these

A high jump athlete complains of pain on the ischial tuberosity. You suspect a tear of the:

a.     Adductor longus

b.     Vastus lateralis

c.     Semitendinosus

d.     Gluteus maximus

C

In medial tibial stress syndrome or shin splints, this is the most commonly affected structure:

a.     Tibialis anterior tendon

b.     Tibialis posterior tendon

c.     Patellar tendon

d.     Semimembranosus tendon

B

Jumper’s knee an overuse syndrome caused by repetitive jumping involves inflammation of the:

a.     All of these

b.     Popliteal tendon

c.     Patellar tendon

d.     Semimembranosus tendon

C

Three weeks after ACL reconstruction and after removal of straight lefT immobilizer the primary concern of the therapist at this stage of the patient’s rehabilitation is to:

a.     Protection of the graft

b.     Increase hamstring length

c.     Prevent ambulation

d.     Increase knee ROM to normal

D

After total hip arthroplasty operation:

a.     Flexion should be limited to 120 degrees

b.     The quadriceps and hip adductors should be contracted isometrically

c.     None of these

d.     Crutches should be used for 4 weeks

C

To improve quality of the gait of a patient with Parkinson’s disease, the patient should be advised to:

a.     Increase forward head posture

b.     Increase trunk rotation

c.     Decrease stride length

d.     Decrease base of support

B

Avascular necrosis of the knee most commonly affects the:

a.     Patella

b.     Fibular head

c.       Tibial tuberosity

d.       Lateral femoral condyle

D

A patient with complete tear of her ligament in her ankle, is classified to have a:

a.     Grade IV sprain

b.     Grade III strain

c.     Grade IV strain

d.     Grade III strain

B

A splay foot result from:

a.     Tight intermetatarsal ligaments

b.     Spasticity of the foot

c.     Weakness of intrinsic foot muscles

d.     Hallux valgus

C

An aquatic program can be valuable for gait training. Which of the following would facilitate a patient shifting his pelvis over the affected leg with an extended hip and trunk?

a.     Marching in place

b.     Ring toss while standing

c.     Flutter kicking in prone

A

Isometric gluteus medius and maximus exercise can increased pain on the arthritic:

a.     Low back

b.     Hip

c.     Knee

d.     Ankle

B

The direction of dislocation of patella is always:

a.     Medial

b.     Lateral

c.     Superior

d.     Inferior

B

The foot type that commonly predisposes to running related injuries include:

a.     All of these

b.     Pronated foot

c.     Cavus foot

d.     Morton’s foot

A

After a total hip arthroplasty, the patient is allowed to?

a.     Pivot on the operated leg during transfers

b.     Sleep on the operated side with a pillow between the legs

c.     Cross the legs

d.     Pick up the objects while seated on the chair

B

Pes cavus is caused by ______.

a.     Inability to supinate the foot

b.     Prolonged supination

c.     Weakness of the gastrocnemius

d.     Prolonged pronation

B

This best describes a teratologic hip

a.     Structural changes in the hip joint have occurred that will require surgery

b.     The femoral head is found completely outside the acetabulum

c.     All of these

d.     The femoral head is partially but not completely outside the acetabulum

B

You determine that a patient is limited in right hip range of motion in a capsular pattern. If you elect to focus on increasing hip flexion, which mobilization technique would be indicated?

a.     Distraction, posterior and inferior glide

b.     Distraction, medial and inferior glide

c.     Distraction, lateral and inferior glide

d.     Distraction, anterior and inferior glide

A

The most frequent side of stress fractures in athletes is the

a.     Femoral neck

b.     Metatarsal

c.     Navicular

d.     Tibia

D

A 65-year-old has hip ankylosis secondary to osteoarthritis. Which gait abnormality do you expect to see in this patient?

a.     Exaggerated movement of the opposite hip

b.     Apparent limp on fast walking

c.     Apparent lack of push off

d.     Sudden buckling of the well knee

A

The gait pattern of a 12-month-old child is characterized by:

a.     Supinated feet

b.     Posterior pelvic tilt

c.     Externally rotated lower extremities

d.     Narrow base of support

C

In patients with post ilizarov external fixation, partial weight bearing may be started at

a.     0-6 weeks

b.     3-6 months

c.     6 weeks to 3 months

d.     More than 6 months

A