- What is the most common pathological “mass” to occur in the wrist joint?
A) Madelung’s deformity
B) Ganglion cyst
C) Heterotopic ossification
D) Giant cell tumor of tendon sheath
- What is the final (last) phase of sports rehabilitation?
A) Sports/task-specific activities
C) Restoring range of motion (ROM)
- In patients younger than 20 years who have had a shoulder dislocation, what is the rate of
- What portion of the clavicle is most commonly fractured?
A) Distal 1/3
B) Middle 1/3
C) Proximal 1/3
D) Distal 1/3 and proximal 1/3 fractures are equally most common
- Thomas’ test is used to assess:
A) Lumbar lordosis
B) Hip flexion contracture
C) Sacroiliac joint dysfunction
D) Iliotibial band contracture
- Rupture of the terminal extensor tendon of the distal phalanx causing loss of active extension is
A) Mallet finger
B) Jersey finger
C) Trigger finger
D) Coach’s finger or jammed finger
- The test of choice when looking for labral pathology is:
B) CT scan
D) Magnetic resonance (MR) arthrogram
- Which splint is appropriate for De Quervain’s tenosynovitis?
A) Nocturnal wrist splint
B) Thumb spica splint
C) Dynamic extension splint
D) Flexor tendon splint
- The popliteus muscle performs an important action of unlocking by:
A) Internally rotating the femur on the tibia during an open chain movement
B) Externally rotating the tibia on the femur during an open chain movement
C) Externally rotating the femur on the tibia during a closed chain movement
D) Internally rotating the tibia on the femur during a closed chain movement
- A newborn is holding his head with his chin rotated toward the left and the ear approximating
the right shoulder. Which muscle is primarily implicated?
A) Left cervical paraspinal
B) Right cervical paraspinal
C) Left sternocleidomastoid
D) Right sternocleidomastoid
- Mechanisms proposed for superior labrum anterior to posterior (SLAP) lesions include:
A) Falling on an outstretched arm
B) Underhand throwing motion
C) Repetitive overhead reaching
D) Repetitive resistant elbow extension
- Which portion of the humerus is most commonly affected in osteochondritis dessicans?
B) Medial epicondyle
C) Lateral epicondyle
D) Greater tubercle
- Shoulder extension involves the use of all of the following muscles except:
A) Pectoralis major, sternocostal portion
B) Teres major
C) Biceps brachii
D) Posterior deltoid
- Medial winging of the scapula is caused by which of the following nerve injuries?
A) Weakness of serratus anterior due to spinal accessory nerve injury
B) Trapezius weakness due to long thoracic nerve injury
C) Serratus anterior weakness due to long thoracic nerve injury
D) Trapezius weakness due to spinal accessory nerve injury
- Which is the most common site for compartment syndrome?
A) Anterior compartment of the lower leg
B) Superfi cial posterior compartment of the lower leg
C) Lateral compartment of the lower leg
D) Deep posterior compartment of the lower leg
- Which statement is true regarding medial tibial stress syndrome (MTSS or shin splints)?
A) This is a type of overuse injury that results from chronic traction on the periosteum at the
periosteal-fascial junction along the anterolateral border of the tibia
B) The main predisposing factor is hyper supination
C) Patient should continue normal activity
D) Pain may improve with exercise but worsens afterward
- Most patients with a grade II ankle sprain will present with:
A) Pain in the ankle with no ligamentous injury
B) Mild sprain of the anterior talofibular ligament and negative ankle drawer test
C) Disruption of the anterior talofibular ligament, sprain of the calcaneofibular ligament, and
positive ankle drawer test
D) Disruption of the anterior talofibular ligament, the calcaneofibular ligament, and the lateral ligament complex, with a positive ankle drawer test
- Which test is the most specific test to diagnose an anterior cruciate ligament (ACL) tear?
A) Pivot shift
B) Lachman test
C) Anterior drawer sign
D) Ege’s test
- Which ligament is affected in Gamekeeper’s thumb?
A) Tear of the ulnar collateral ligament of the thumb metacarpophalangeal (MCP)
B) Rupture of the fl exor digitorum profundus (FDP) tendon
C) Rupture of the extensor tendon from the distal phalanx
D) Tear of the triangular fi brocartilage complex
- Which activity will most likely aggravate patellofemoral pain syndrome?
B) Climbing stairs
C) Stationary cycling
Physiotherapy Musculoskeletal MCQs Ques & Ans -3
Physiotherapy Musculoskeletal MCQs Ques & Ans -3 41 to 60 Questions and Answers
- B) The most common “mass” to occur in the wrist is a ganglion cyst. It is essentially a “ballooning-out” of the joint lining and the fluid inside is synovial fluid. Ganglion cysts most commonly occur on the dorsal aspect of the wrist (usually from the scapholunate joint). On physical examination, the cyst may transilluminate. They can be evaluated by MRI, while x-rays will often be normal. Observational management is indicated for asymptomatic cases. If the cysts interfere with activity, aspiration may be warranted. Ganglion cysts tend to recur at a rate of 20%, while recurrence rate drops to less than 10% following excision.
- A) Sports rehabilitation can be categorized into five phases: (1) resolving the pain and inflammation, (2) restoring range of motion, (3) strengthening, (4) proprioceptive training, and (5) sports/task-specific activities. Immobilization is generally avoided as it can limit range of motion (which can cause contractures and atrophy).
- D) Approximately 90% of patients under 20 years of age will dislocate their shoulder again after a prior dislocation. Individuals age 20 to 40 years old carry a moderate risk of dislocation and there is an approximate 10% rate for dislocation in patients over 40 years.
- B) Clavicle fractures are one of the most common bony injuries. The most common location is the middle 1/3 (80%), 15% occur in the distal 1/3, and 5% occur in the proximal 1/3.
- B) Thomas’ test is used to assess for a hip flexion contracture. With the patient supine, fl ex one hip to obliterate the lumbar lordosis. The angle between the affected thigh and the table reveals the fixed flexion contracture of the hip. Ober’s test is used to assess for an iliotibial band contracture.
- A) Mallet finger is usually caused by forced flexion of the distal phalangeal joint. Jersey finger is avulsion of the flexor digitorum profundus from the distal phalanx. It usually occurs in the fourth finger. Trigger finger is thickening of the proximal portion of the flexor tendon sheath which may cause the finger to get “stuck” in flexion. Coach’s finger is an interphalangeal dislocation that usually dislocates dorsally.
- D) MR arthrogram is the test of choice when evaluating for labral pathology.
- B) De Quervain’s tenosynovitis is a condition in which inflammation causes thickening and stenosis of the synovial sheath surrounding the first dorsal compartment of the wrist. This produces pain with tendon movement. On examination, there may be appreciable thickening of the fibrous sheath and Finkelstein’s test will be positive. Nonoperative management is indicated in most cases. Splinting with a thumb spica splint is applied such that pinching is possible. Steroid injection can help for symptomatic relief, and surgery may be indicated for decompression in refractory cases.
- C) During the last 20° of extension of the knee, the femur slightly internally rotates on the tibia to lock the knee joint in place in the closed chain, or the tibia slightly externally rotates on femur in the open chain, which is also called the screw-home mechanism. In the closed chain, the popliteus can externally rotate the femur to unlock the knee for flexion.
- D) Congenital torticollis occurs in approximately 1 per 250 live births, with 75% involving the right side. The most common cause is fibrosis of the sternocleidomastoid. The presence of a cervical hemivertebra is less common. On physical examination, a nontender enlargement in the sternocleidomastoid is noted
- A) SLAP lesions occur as a result of falling on an outstretched arm causing a traction and compression injury related to the fall. Overhead throwing motion in the deceleration phase can also cause a SLAP lesion by causing traction on the superior labrum by the biceps muscle. The cocking phase of the overhead throw causes a torsional peeling-back stress to the glenoid labrum leading to a SLAP lesion.
- A) Osteochondritis dessicans is characterized by fragmentation of the bone and cartilage overlying the capitellum in the elbow. This condition often occurs in teenage boys involved in throwing sports because of the valgus stress on the elbow. It is often mistakenly confused with Panner’s disease, which has more to do with a circulatory problem affecting the bone in the elbow and occurs in children 5 to 12 years of age.
- D) Shoulder extension involves the use of the posterior deltoid, latissimus dorsi, teres major, long head of triceps, and sternocostal portion of the pectoralis major.
- C) Choices (A) and (B) are paired with the incorrect nerves. Choice (D) is responsible for lateral winging of the scapula.
- A) The most common site of compartment syndrome is the lower leg. The anterior compartment is the most frequently affected, followed by the lateral compartment and the deep posterior compartment.
- D) MTSS, also known as shin splints, is a common type of overuse injury that results from chronic traction on the periosteum at the periosteal-fascial junction along the posteromedial border of the tibia. The main predisposing factor is hyper pronation. Pain may improve with exercise but may worsen afterward. Rest is the first priority in management of MTSS. Return to activity should be gradual.
- C) It is important to rule out a fracture of the fibula and/or the fifth metatarsal. Mild sprain of the anterior talofibular ligament and negative ankle drawer test is considered a grade I ankle sprain. Disruption of the anterior talofibular ligament, the calcaneofibular ligament, and the lateral ligament complex with positive ankle drawer test is considered a grade III ankle sprain.
- A) The pivot shift test is the most specific test to diagnose an ACL tear. Under anesthesia, the specificity approaches 100%. Lachman’s test is usually considered the most sensitive test for an ACL tear. Ege’s test is used for diagnosis of a meniscal injury.
- A) Gamekeeper’s thumb is an injury to the ulnar collateral ligament of the thumb-MCP joint resulting in joint instability. Usually, the mechanism of injury is a forced radial deviation of the thumb or from a ski pole injury. Patients may describe pain and decreased grip strength at this location. There may be appreciable laxity of the MCP. A palpable mass at the location of the ulnar collateral ligament is called a Stener lesion, where the adductor pollicis aponeurosis falls under the torn collateral ligament.
- B) The patellofemoral joint is under high levels of compression during stair climbing owing to significantly increased quadriceps activity.
Physiotherapy Musculoskeletal MCQs Ques & Ans -3
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