NMS II exam 1 practice questions

When evaluating hip groin and thigh pain, what ROM is the first to go

Internal rotation

The average angle of the neck of the femur at birth is 160 degrees, to adulthood the average is ____________degrees

120

Increases to 2.4-2.6x body weight when standing on 1 leg

Articular cartilage

What leg is being tested in trendelenberg's test

The leg the patient is standing on

MC in elderly women, with history of fall onto the hip

Hip fractures

MCC of hip fracture

Osteoporosis

Patient is young and active with insidious pain often anterior and deep pain with ROM changing end-range restriction and pain with flexion and internal rotation

Stress fracture

T/F: posterior dislocation is 90% of sports related hip dislocations

True

Major force applied to flexed, adducted hip would cause

A. Posterior hip dislocation

B. Anterior hip dislocation

Posterior hip dislocation

Major force applied to extended, external rotation of the hip would cause:

A. Posterior hip dislocation

B. Anterior hip dislocation

Anterior hip dislocation

To manage traumatic hip dislocations, relocation is done with _________ in the hospital

Anesthesia

What presents in overweight children, or a child that may only have knee pain

Slipped capital epiphysis

T/F: a person w OA has low back pain

True

Patient usually 40-60 years old and may occasionally cause pain radiating to low back, lateral thigh, and knee

Subtrochanteric bursitis

Subtrochanteric bursitis can be tested by what 2 tests:

Patrick Faber test

Ober's test

Patient reports sitting for long period of time on hard surfaces or during horseback riding that causes a reffered pain down the back of the leg, mimicking sciatica is known as

Ischial bursitis

An 8 year old girl was riding her horse and presented with diffuse pain and inflammation, which test should be performed

SLR

Patrick test

Occurs in children less than 10 years old, that complains of acute or gradual pain in the inguinal area with difficulty bearing weight, causing decreased and tender ROM especially internal rotation. What is the diagnosis

Transient Synovitis

Patient may have LBP due to altered gait due to limited hip extension, what is the diagnosis:

Osteoarthritis of the hip

What two orthos are used for OA of the hip

Scouring test

Laguerre's test

Patient is often an athlete that feels a sudden pop or pull after a forceful knee extension, they have increased pain with resisted knee flexion what would the diagnosis be:

Hamstring Strain

Patient reports sudden pulling/pain in anterior thigh which causes pain with active extension of the knee, what is the diagnosis:

Quadriceps Strain

Failure to plantar flex in Thompson test, indicates which pathology?

Achilles Rupture

Nerve root to big toe

L5

Nerve root - eversion

L4

What test assesses for hip pathology?

Patrick's Test

T/F: Thomas test tests the iliopsoas contraction in flexion

True

DDX: for ITB syndrome with female athlete triad

Stress fracture

Eating disorders, menstrual irregularities, osteopenia/osteoporosis

Female athlete triad - stress fracture

Hyperextension trauma of the knee joint results in:

ACL tear or patellar dislocation

Hyper flexion trauma of the knee joint results in:

PCL tear

Sudden deceleration trauma of the knee joint results in:

ACL tear

Valgus force [no rotation] trauma of the knee joint often seen in a football tackle results in:

MCL tear

Valgus force w rotation [foot fixed] trauma of the knee joint results in:

ACL MCL menisci [terrible triad]

The terrible triad consists of

ACL

MCL

Meniscus

Soccer player gets bow to the tibia from behind causing instant pain. Anterior drawers test reveals a 2mm translation. What structure did he damage

Crucial ligaments

Collateral ligaments

Meniscus

Ortho Tests for ACL

Lachman's test in acute setting

Anterior drawer test

Degree of joint instability mild, <5 mm of translation is what grade

Grade 1

Degree of joint instability moderate 5-10 mm translation

Grade 2

Degree of joint instability severe, >10 mm translation

Grade 3

Varus stress test is testing which ligament

Lateral

Best ortho for ACL

Lachman's

Swelling developing over several hours, clicking/popping/locking involved

Meniscus tears

Orthos for meniscus tear

Mcmurrays

Apleys compression

Bounce home

Tbessalys

Medial side stress test

Valgus

T/F: Soft tissues on medial side of knee offer more stability than the lateral side

True

Medial side

Stability

Lateral side

Mobility

Rectus femoris pull and alignment of pattar tendon

Q-angle

Bowed legs is involved in

Genu varum

Q angle>15 degrees, "knock knees"

Genu Valgus

Beyond 5 degrees, "back knee" pain w squatting

Genu recurvatum

Anterior knee pain, pain worse going down steps

Patellofemoral arthralgia

Patellofemoral arthralgia causes underlying predispositions, mostly:

Pronation

Ortho used to evaluate swelling of Patellofemoral arthralgia

Patellar ballotement test

Patellar tracking with weak VMO and tight IT, and hyper pronation will:

Increase q angle

Tenderness and swelling around tibial tuberosity, usually young athlete involved in running/jumping activities

Osgood-Schlatter disease

T/F: osgood-schlatter rarely develops bilaterally

True

Insidious anterior knee pain, limp, locks/swelling; lateral portion medial femoral condole

Osteochondritis dissecans

14-year old male athlete w insidious onset of anterior knee pain with a limp, his knee occasionally locks and swells, the lateral portion of the medial femoral condyle is affected. This is known as:

Osteochondritis dissecans

When performing ober's test and the leg fails to descend smoothly, this would be A positive test, and would indicate what:

TFL or ITB

Biceps femoris is ________ mover of flexion

Prime

The tibial branch of the sciatic nerve to the long head of the biceps femoris is what roots

L4-S1

The peroneal branch to the short head of biceps femoris is what roots

L4-S2

What is mcmurray's sign testing?

Meniscus

Patient has a meniscal tear, what is the best test

Bounce home test

An older patient with leg pain after walking a few minutes that gets relief with rest

Intermittent claudication

DDX of canal stenosis

Bicycle test

What is a good test for Achilles tendinitis for a patient with pain in Achilles tendon following jumping or running

Thompson test

Pressure on leg compartments, exercise induced, tarsal tunnel syndrome, deep peroneal n, Tinel's test; pain subsides hours after work out

Compartment syndrome

Most commonly exercise induced

Compartment syndrome

What compartment is the deep personal nerve, tib and toe extensors in

Anterior compartment

What compartment are the toe flexors in

Deep posterior

What compartment would have tingling btw the 1st and 2nd toes

Lateral

What does the posterior drawer sign of the ankle test

Deltoid

You take a reflex hammer to the tarsal tunnel inferior to the medial maleolus, which nerve are you test

Posterior tibial nerve

Assesses for metatarsalgia or the possibility of Morton's neuromas

Morton's test

A patient that wears high heels a lot, what test might you want to perform

Morton's test

T/F: Plantar fasciitis is caused by either supination and pronation

True

What type of sprain/grade would it be for a mild limp, but no bruising

Mild sprain - grade 1

A patient has pain and a palpable mass btw the 2nd and 3rd toes, this patient also wears high heels often

Morton's neuroma

Sharp heel pain radiating along the bottom of the foot with pain worse in the morning - heel spur formation may be seen in x ray

Plantar fasciitis

T/F: meniscus swelling develops immediately

False

Your patient complains of low back pain that is worse at night, especially when they roll over in bed. If they remain in one position, the pain doesn't seem to worsen. What is the most likely diagnosis?

A. Tendinitis

B. Cancer

C. Bursitis

D. Mechanical Low Back Pain

Mechanical low back pain

Which of the following conditions would most likely present with complaints of joint instability?

A. Tendinitis

B. Muscle Sprain

C. Bursitis

D. Ligament Sprain

Ligament sprain

Which is not a common complaint associated with Bursitis?

A. Pain increases with compression

B. Empty end feel with ROM

C. Constant pain aggravated by activity

D. Intermittent pain that is relieved by lying on the affected side

Intermittent pain that is relieved by lying on the affected side

Which of the following motions is not a part of the capsular pattern of the hip?

A. Flexion

B. Abduction

C. Medial (internal) Rotation

D. Extension

Extension

Trendelenburg's Test assesses for a weakness in what motion?

A. Hip flexion

B. Hip adduction

C. Hip Extension

D. Hip Abduction

Hip abduction

What is the best imaging modality for a stress fracture of the hip?

A. Bone scan

B. MRI

C. X-ray

Bone scan

What condition of the hip is a Salter-Harris Type I fracture?

A. Stress fracture

B. Intracapsular fracture

C. Leg Calve Perthes Disease

D. Slipped Capital Femoral Epiphysis

Slipped capital femoral epiphysis

Your patient has osteoarthritis of the hip. What range of motion is affected first?

A. Extension

B. Abduction

C. Flexion

D. Medial (internal) Rotation

Medial (internal) rotation

Which is not a component of the Terrible Triad?

A. ACL

B. MCL

C. Meniscus

D. Iliotibial Band

Iliotibial band

Which is the least likely cause of a "Pop" occurring during knee trauma that results in a Terrible Triad?

A. Fracture

B. ACL rupture

C. Joint cavitation from stretch

D. ITB bruise

ITB bruise

Which condition presents with the most swelling in the acute setting?

A. ACL rupture

B. MCL sprain

C. Meniscus tear

ACL rupture

Which orthopedic test is not designed to detect a meniscal tear?

A. McMurray's test

B. Thessaly test

C. Leli's test

D. Bounce home test

Leli's Test

When is pulsed ultrasound most effective in the treatment of a medial collateral ligament sprain?

A. Anytime within the first 2 months

B. Pulsed US is not effective for an MCL sprain

C. At anytime during the treatment cycle

D. Within the first 4 weeks

Within the first 4 weeks

According to the text, which is not a complication of a hip fracture?

A. Hemoglobinopathies

B. Osteomyelitis

C. Thromboembolic disease

D. Osteonecrosis

Hemoglobinopathies

Your patient has snapping of the hip and localizes the symptoms to the lateral hip. What structure is most likely involved?

A. Iliotibial band

B. Iliopsoas Muscle

C. Adductor muscles

D. Biceps femoris

Iliotibial band

What anatomical structure of the lower extremity is most likely to experience a contusion and Myositis Ossificans?

A. Iliotibial band

B. Tensor fascial Lata

C. Hamstring muscles

D. Quadriceps muscles

Quadriceps muscles

Which statement is true concerning Traumatic Hip Dislocations

A. Most common direction of dislocation is anterior.

B. Relocation is not possible without anesthesia.

C. Perform Anvil Test to confirm your suspicions before taking x-rays.

D. The patient's ability to bear weight is not affected.

Relocation is not possible without anesthesia