Anatomy Final

A 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