Quiz 6: Musculoskeletal Examination

Why is it important to obtain information about the patient's current symptoms and functional abilities? A)It allows the patient to verbalize symptoms in order to see progress from session to session. B)It helps the therapist establish a baseline so that the effectiveness of the interventions can be evaluated. C)It allows the therapist time to listen to the patient and reduces the number of questions as the exam continues. D)It helps the patient understand the rehabilitation process better.

Which of the following questions would be BEST to obtain an unbiased answer from the patient regarding pain? A)Is your left knee painful? B)How severely does your back hurt? C)Is the pain stabbing or throbbing? D)Where are your symptoms located?

Which answer BEST describes the type of information that should be obtained about the patient's symptoms? A)The onset,location,quality,and behavior of the symptoms B)How many times the patient has experienced the same symptoms C)The frequency,duration,and intensity of the symptoms D)Whether the patient has been able to alter the symptoms

How will an understanding about the onset of symptoms help the therapist? A)It will allow the therapist to determine what structures might be involved based on the mechanism of injury. B)It will allow the therapist to determine what structures might be involved based on the location of the symptoms. C)It will allow the therapist to determine what structures might be involved based on the description of the symptoms. D)It will allow the therapist to determine what structures might be involved based on the positions that alter the symptoms.

What is one of the easiest methods for documenting the severity of the pain? A)McGill-Melzack Pain Questionnaire B)A body chart filled in by the patient C)Palpation of the area of symptoms D)A numerical pain rating scale

How will an understanding of the behavior of the symptoms help the therapist? A)It will allow the therapist to determine what structures might be involved based on the mechanism of injury. B)It will allow the therapist to determine if the symptoms are more or less severe than those experienced by patients with the same diagnosis. C)It will allow the therapist to determine a diagnosis and the treatment interventions that might be most effective. D)It will allow the therapist to determine how the symptoms began and where each type of symptom is located on the body.

The therapist asks the patient at the initial evaluation to describe pain symptoms over the last 48 hours.The patient reports that pain has been decreasing slightly.At the next visit,the therapist asks the same question,and the patient reports that pain has remained the same since the last intervention.What might this indicate about the intervention? A)The intervention was effective because it stopped the patient's pain. B)The intervention was ineffective because it did not reduce the patient's pain. C)The intervention was effective because it stabilized the patient's condition. D)The intervention was ineffective because made the patient's pain worse.

Why is it important to obtain information about the patient's past and current medical conditions? A)The therapist needs to know if the patient has a complete understanding of his condition. B)Some medical conditions can present as musculoskeletal conditions. C)The patient's family needs to be informed if there are any gaps in their understanding. D)Medical conditions must be documented in the record for full reimbursement by payors.

The patient informs the therapist that she has 15 steps in her home that lead to the only bedroom and bathroom.Why is this important for the therapist to know? A)The therapist will have to speak to family members about modifying the house. B)The therapist may ask another clinician to see the patient to maintain their privacy. C)The therapist will need to perform a full home evaluation to know what the stairs look like. D)The therapist can include training with an appropriate device in stair-climbing.

A patient tells the therapist at the end of the examination that he wants to be able to return to hiking.How can the therapist use this information? A)The therapist can use the patient's goal to help establish the plan of care. B)The therapist can not use this information because the patient's goal is not realistic. C)The therapist will document this as the only goal for the patient. D)The therapist will allow the patient to verbalize the goals so he feels better.

After the therapist completes the interview,what should be the next step in the examination? A)Palpation of the area where the symptoms are severe B)Observation of posture and performance of functional tasks C)Performance of special musculoskeletal tests D)Assessment of muscle strength and integrity

When performing a gross examination of posture from the anterior view,what landmarks can the therapist use? A)Acromion processes and patellae B)Greater trochanters and gluteal folds C)Malleoli and angle of the scapula D)Iliac crests and spine

During inspection of the soft tissue,the therapist notes a blue discoloration of the skin and nail beds.What does this tell the therapist? A)Cyanosis usually indicates a lack of oxygen and excessive carbon dioxide in the superficial blood vessels. B)Pallor usually indicates a decrease in blood flow or blood hemoglobin secondary to anemia or shock. C)Erythema usually indicates increased blood flow and inflammation in a localized area of the body. D)Clubbing usually indicates chronic hypoxia associated with cardiovascular or respiratory disease.

During inspection of the soft tissue,the therapist notes redness of the skin over the lateral aspect of the knee.What does this tell the therapist? A)Cyanosis usually indicates a lack of oxygen and excessive carbon dioxide in the superficial blood vessels. B)Pallor usually indicates a decrease in blood flow or blood hemoglobin secondary to anemia or shock. C)Erythema usually indicates increased blood flow and inflammation in a localized area of the body. D)Clubbing usually indicates chronic hypoxia associated with cardiovascular or respiratory disease.

During inspection of the soft tissue,the therapist notes rounding of the soft tissue of the distal fingers.What does this tell the therapist? A)Cyanosis usually indicates a lack of oxygen and excessive carbon dioxide in the superficial blood vessels. B)Pallor usually indicates a decrease in blood flow or blood hemoglobin secondary to anemia or shock. C)Erythema usually indicates increased blood flow and inflammation in a localized area of the body. D)Clubbing usually indicates chronic hypoxia associated with cardiovascular or respiratory disease.

Which of the following should be assessed first and will help direct the rest of the examination of range of motion (ROM)? A)Passive ROM B)Active-assisted ROM C)Active ROM D)Gravity-eliminated ROM

What should the therapist remember when assessing passive range of motion (ROM)? A)Pain during PROM is due to damage to contractile tissues. B)PROM is not affected by muscle strength. C)PROM encourages nonparticipation by the patient. D)The ROM available during AROM is greater than PROM.

When evaluating a patient's wrist flexion,the therapist notes a gradual increase in resistance toward the end of the motion.How would this best be described? A)Soft end-feel B)Hard end-feel C)Empty end-feel D)Firm end-feel

When evaluating a patient's knee extension the therapist notes an abrupt stop of the motion.How would this best be described? A)Soft end-feel B)Hard end-feel C)Empty end-feel D)Firm end-feel

When evaluating a patient's shoulder extension the therapist notes a rubbery-like resistance toward the end of the motion.How would this best be described? A)Soft end-feel B)Hard end-feel C)Empty end-feel D)Firm end-feel

When evaluating a patient's hip flexion the patient tells the therapist to stop and the therapist is unable to passively move the patient to the end of the range of motion.How would this best be described? A)Soft end-feel B)Hard end-feel C)Empty end-feel D)Firm end-feel

A patient presents with a capsular pattern of the shoulder.What might cause this? A)Tendonitis B)Muscle weakness C)Hypermobility of the joint D)Synovial inflammation

What are important characteristics of noncapsular patterns of restricted motion? A)Loss of flexion is proportional to loss of abduction and extension. B)Usually caused by conditions not involving the entire joint capsule. C)Significant inflammation prevents all movement of the joint. D)Hypermobility of abduction causes instability of the joint.

What information can a therapist learn from an assessment of accessory joint movement? A)The full range of motion available for a specific joint B)The patient's specific limitations of pain C)How well a muscle tolerates a stretched position D)How well specific joint structures tolerate stress

A patient presents with pain during active shoulder flexion and resisted isometric testing of shoulder flexion.The patient does not report pain with passive shoulder flexion.What would be the most likely involved structures causing the patient's pain? A)Ligaments supporting the shoulder B)Muscles responsible for shoulder flexion C)Joint capsule of the shoulder D)Muscles responsible for shoulder extension

What is the correct procedure for performing resisted isometric testing? A)Position the joint at end range of motion and provide resistance. B)Provide resistance while the patient moves through the range of motion. C)Position the joint at mid-range of motion and provide resistance. D)Provide resistance at the first ¼ and last ¼ of the range of motion.

What is the correct procedure for performing a break test for muscle strength of a one-joint muscle? A)The patient holds a joint position at end range of motion and the therapist gradually provides resistance and overpowers the patient. B)The therapist provides a constant amount of resistance while the patient moves through the range of motion. C)The patient holds a joint position at mid-range and the therapist rapidly provides resistance and overpowers the patient. D)The therapist provides a gradually increasing amount of resistance at the first ¼ and last ¼ of the range of motion.

How would a therapist grade the muscle of a patient who is able to move through the full available range of motion,against gravity,with no resistance? A)5/5 or Normal B)4/5 or Good C)3/5 or Fair D)2/5 or Poor

How would a therapist grade the muscle of a patient who is able to perform shoulder flexion through the full available range of motion,against gravity,with strong resistance? A)5/5 or Normal B)4/5 or Good C)3/5 or Fair D)2/5 or Poor

How would a therapist grade the muscle of a patient who is able to perform hip flexion through the full available range of motion,in a sidelying position,with no resistance? A)5/5 or Normal B)4/5 or Good C)3/5 or Fair D)2/5 or Poor

What does isokinetic dynamometry measure? A)It measures the length of the muscle and its ability to contract at that length. B)It measures the ability of the muscle to hold a contraction over time. C)It measures the torque and range of motion as a function of time. D)It measures the weakness at specific points in the range of motion.

What does an apprehension test evaluate? A)Ligamentous tightness B)Ligamentous instability C)Muscle length D)Patient fear of movement

A patient presents to the physical therapist after injuring the R shoulder during a fall.The shoulder is hot to the touch,swollen,and painful with movement.The patient is unable to tolerate any resistance to movement.In what stage of tissue healing is this patient? A)Acute stage B)Subacute stage C)Chronic stage D)Cannot determine

A patient presents to the physical therapist after injuring the R shoulder during a fall.The shoulder does not appear swollen or warm with palpation.The patient reports pain at the end range of motion and with moderate resistance to movement.In what stage of tissue healing is this patient? A)Acute B)Subacute C)Chronic D)Cannot determine