Studied by 1 personA patient with a below knee prosthesis has a short stump and, therefore, her quadriceps are not very strong. As she goes from a sitting position to a standing position, you notice that she leans very far forward with her trunk compared to a normal sit to stand motion. What is a good biomechanical explanation for this?
Her forward trunk lean brings her Center of Gravity action line closer to the knee joint, reducing the resistance she must overcome.
Which of the following statements about the Physiological cross-sectional area (PCSA) is/are NOT true?
The PCSA of a fusiform muscle is going to be at a non-perpendicular angle to the tendon
Maximal tension in the muscle is produced when the muscle fiber...
Is lengthened
During eccentric muscle activation
Muscle produces an active force while elongating
The left subclavian artery arises from
Aortic Arch
The dorsalis pedis artery is one of the major branches of the
Anterior tibial artery
Which of the following statements is NOT true about the Venous pump?
When skeletal muscle contracts it increases in length and decreases in girth
The cerebrospinal fluid (CSF) is located
Between the arachnoid membrane and the pia mater
The lateral spinothalamic tracts
Carry pain and temperature signals from the muscles to the brain
The blood flow to the front of the spinal spinal chord is supplied by the ________ artery and supplies _____ of the spinal chord. While the back of the spinal chord is supplied by the _________ artery and supplies the other _____ of the spinal chord.
anterior spinal, 2/3, posterior spinal, 1/3
A ball and socket joint
Has Triplanar motion
In a third-class lever
Always has a mechanical dis-advantage
The superficial inguinal lymph nodes are located around the
great saphenous vein
Which of the following structures in innervated by the parasympathetic nervous system?
Internal organs
Autonomic dysreflexia occurs with spinal cord injury
Above T6
Muscles that are considered to cooperate with each other during a particular movement are said to be
Synergists
The posterior tibial artery can be palpated at the
Posterior aspect of medial malleolus
A patient with a spinal cord injury is able to feel touch and pain sensation at proximal phalanx of the little finger, but not over the medial epicondyle of humerus. Which is the lowest intact level of the spinal cord?
C8
In an injury below the L2 spinal segment, leaving the L1 spinal myotome intact, which of the following muscle groups will still be functional?
Hip flexors
The spinal cord extends from the base of the skull to which vertebral level
L1
Which of the following statements about the Upper Motor Neuron (UMN) is NOT true?
The axons of UMN are located in the cerebral cortex
A Lower Motor Neuron lesion results in
Hypotonia and lost deep tendon reflexes
With a complete spinal cord injury
There is loss of sensation, paralysis and hypotonia at the level of injury
Normal arthrokinematics of the humeroulnar joint (convex humerus/concave ulnar) during a push-up could be described as:
moving convex surface on a stationary concave surface → rolling and gliding occurs in opposite directions
Which of the following statements is correct, concerning the downward phase (lowering portion) of a pull-up?
Elbows are extending, biceps are eccentrically contracting
A patient is prone (laying on stomach) and doing an active hip extension against gravity with the knee flexed. As they near the end of ROM, the exercise becomes difficult for them because,
of active insufficiency of the hamstrings and passive insufficiency of the rectus femoris
To maximally stretch the Soleus, which of the following positions should be used?
knee flexion combined with ankle dorsiflexion
Maximum lengthening (stretching) of the gastrocnemius requires:
Knee extension combined with ankle dorsiflexion
A patient is lying on his back as shown in the figure to the left. He is flexing his shoulder from position a through f and then slowly extending back to position a again. At what point in this exercise is the resistance the greatest?
Position b
At what point in this exercise is the resistance the least or near zero?
Position e
As the weight is slowly lowered from position e to position a, what muscle group is active, and what type of contractions are occurring:
Flexors eccentrically
As the weight is slowly moved from position e to position f, what muscle group is active, and what type of contractions are occurring:
Extensors eccentrically
Which myotome is associated with the C6 nerve root?
Wrist extensors
Which spinal segment dermatome is associated with the medial epicondyle of the femur and what is it's correlating myotome?
L3, knee extension
If a person is experiencing ataxia, which portion of the brain stem is the common site of injury?
Cerebellum
Are pennate muscles stronger than fusiform muscles and why?
Yes, because they have more fibers per cross-sectional area.
Identify the order of the meninges from superficial to deep:
Dura mater, arachnoid mater, and pia mater
Which of the following statements is NOT true about the blood supply of the brain?
The basilar artery arises from the external carotid arteries
During a squat the hip, knee and ankle all flex. This motion occurs in the ______ plane about a ______ axis.
sagittal, medial/lateral
Which of the vessels does not derive from the femoral vein?
Internal iliac
The _________ muscle increases 1st ray _______ during terminal stance to increase MTP extension.
Peroneus longus, plantarflexion
Maximum lengthening (stretching) of the gastrocnemius requires:
Knee extension combined with ankle dorsiflexion
Excessive anterior motion of the tibia relative to the femur is most likely a sign of
Injury to the anterior cruciate ligament
Excessive knee flexion during standing posture may be caused by each of the following, EXCEPT
Tightness/spasticity of the plantar flexors
During terminal stance your midtarsal joint axis are ________ allowing for a ______ midfoot.
crossing, rigid
A large Q angle can result in
An increase in joint forces between the lateral patella and the patellar groove on the femur
Excessive anterior motion of the tibia relative to the femur is most likely a sign of:
Injury to the anterior cruciate ligament
A knee brace for medial knee compartment osteoarthritis would need to provide what type of force?
A force toward genu valgum
As a compensation for paralysis of the knee extensors, a person might stand in:
Excessive anterior trunk lean and knee hyper-extension
Muscles which can internally rotate the lower leg relative to the femur include all except:
Biceps femoris
What factors contribute to a large patellofemoral joint force?
High quadriceps force
In a patient with genu varum, you would expect that there would be:
Increased compressive forces on the medial side of the joint and increased tensile forces in the lateral collateral ligament
A shorter transfemoral amputation may cause weakness of the ________ muscle group and contracture of the ________ muscle group leading to a lateral trunk lean to the ________ side during ambulation.
Adductors, Abductors, Prosthetic
Your patient fell from the ladder at home and complains that she is now feeling some knee instability when walking upstairs. She says that the knee seems to give away posteriorly. You suspect of an injury of which ligament of the knee?
PCL
You are testing the strength of the soleus muscle. In what position should you position the knee joint to decrease the effect of the gastrocnemius?
Flexion
When performing a lachman's test, the knee should be in ______ degrees of flexion. The femur should _______ move and the tibia should _______ move during applied forces.
20-30, not, anteriorly
Assume that a patient has a gastrocnemius. You measured dorsiflexion ROM once with the knee flexed and again with the knee extended fully. What would you expect to find?
Greater dorsiflexion with the knee flexed
During initial contact/weight acceptance the foot goes into some ________ to create a ______ foot.
pronation, flexible
How is the lateral malleoli positioned in relationship to the medial malleoli?
More posterior and lower
With your foot on the floor, what happens with the tibia as you pronate the foot?
Internally rotates
Going from standing on one's toes to a foot-flat position in a controlled manner involves what type of muscle contraction?
Eccentric contraction of plantar flexors
MTP extension can be limited by
Tightness of the plantar fascia
Medial plantar and Lateral plantar are branches of
Tibial nerve
The ligament most likely to be injured at the ankle joint when the ankle is forcefully inverted when in a plantar flexed position is the:
Anterior talofibular ligament
With the foot planted on the floor, pronation of the subtalar joint has which of the following movements:
Calcaneal eversion on the talus, talar adduction and plantar flexion on the calcaneus
A patient excessively pronates during weight bearing and is complaining of pain posterior to the medial malleolus and along the medial side of the leg. This may be due to tendonitis of the tendon of the:
Tibialis posterior
The sensory innervation of the deep peroneal nerve is
Between the first and second toes
A patient is prone and doing an active hip extension against gravity with the knee flexed. As she nears the end of ROM, the exercise becomes difficult for her because,
of active insufficiency of the hamstrings and passive insufficiency of the rectus femoris
You are attempting to test the strength of the gluteus maximus. To do this, in what position should you place the knee to decrease the contribution of the hamstrings as a hip extensor?
In full flexion
When the angle of inclination is greater than the normal 125 degrees, which of the following is correct in regard to hip ROM?
Increased abduction ROM and Decreased adduction ROM
The femoral nerve innervates the following muscles, EXCEPT
Quadratus lumborum
Anteversion at the hip may result in:
Increased hip internal rotation during walking
The ACL attaches from the _______ tibial plateau to the _______ femoral condyle.
anteromedial, posterolateral
Muscles which can internally rotate the lower leg relative to the femur include all except:
Biceps femoris
If a person was going from a standing to sitting position, the femur would have to _______ rotate to unlock the screw home mechanism in the knee and allow for knee flexion.
Externally
During a Trendelenburg test, the patient is unable to hold her pelvis level when standing on one leg. This is an indication of
Weakness of the stance side hip abductors
During standing posture, bilateral tightness of the hip flexors needs excessive activity in
Plantar flexors
Which of the following test is useful to differentiate between contracture/tightness of the iliopsoas and the rectus femoris?
Modified Thomas test
What kind of hip abductors activation occurs during a one legged stance when the pelvis is allowed to drop in a controlled manner on the opposite side
Eccentric to control upward motion of pelvis on stance side
Assuming that the hip and trunk extensors were innervated, the individual assumes the following positions with quadriceps paralysis,
All of the options are correct: Knee in hyper-extension, Slight trunk flexion to assist with getting the action line of the GRF anterior to the knee joint, Passive stretch of the posterior portion of the joint capsule & ligaments of the knee
Tightness of the hamstrings and abdominal muscles may result in what postural deviation?
Increased posterior pelvic tilt
All of these muscles have direct muscular branches from the lumbosacral plexus,
Adductor longus
In order to isolate the tendon of the Biceps femoris muscle, the leg is placed in the following position
External rotation
To stretch the iliopsoas, one should:
Extend the hip and extend the knee
Which of the following statements about the Physiological cross-sectional area (PCSA) is/are true?
All of the above: The PCSA of the whole muscle reflects the amount of active proteins available to generate active force., In order to measure the PCSA of a pennate muscle accurately, the cross-section must be made perpendicular to each of the muscle fibers., The PCSA of a fusiform muscle is determined by dividing its overall volume by its length
The finger flexors are able to exert more grip strength with the wrist in slight extension than with the wrist flexed, due to the
insufficiency of the finger flexors and insufficiency of the finger extensors. Active, Passive
Which of the following is NOT a synovial joint?
Distal tibiofibular joint
The left subclavian artery arises from
Aortic Arch
The lateral spinothalamic tracts
Carry pain and temperature signals from the muscles to the brain
Normal arthrokinematics of the humeroulnar joint during a push-up could be described as:
moving convex surface on a stationary concave surface → rolling and gliding occurs in opposite directions
Flexion and extension of the knee occurs in the _______ plane along the _______ axis.
sagittal, medial/lateral
What is the position that best describes the position of the upper limbs of the child shown in the image?
Lt. Shoulder extension, Lt. elbow extension, Lt. wrist flexion
Which of the following is NOT a synovial joint?
Distal tibiofibular joint
A close-packed position of a joint is one in which
All of the options: Little joint "play" is possible, Ligaments hold joint surfaces tightly together, Joint surfaces are maximally congruent
Maximum lengthening (stretching) of the gastrocnemius requires:
Knee extension combined with ankle dorsiflexion
If the concave proximal tibia is fixed to the ground when standing and the convex distal femur is moving during a squat what type of kinematic chain is this and is the roll/slide of the femur in the same or opposite direction?
closed, opposite
Muscles that are considered to cooperate with each other during a particular movement are said to be
Synergists
The contractile elements of the skeletal system are
Sarcomeres
A patient is trying to flex their hip with their knee straight (tightening the rectus femoris -agonist- over the hip joint and knee joint). What would you expect to occur regarding active vs. passive insufficiency? Select all of the answers that apply:
Passive insufficiency of the hip extensors due to excess lengthening, Active insufficiency of the rectus femoris due to excess shortening
Pennate muscles
Have relatively larger capability for generating higher force
Note
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