Full Question & Answer Text (for Search Engines)
Question 1:
Which of the following regimens is recommended for maintenance of cadiorespiratory fitness:
Options:
- 30 to 60 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate
- 30 to 60 minutes of exercise 7 days per week at 20% to 50% of maximum heart rate
- 90 to 120 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate
- 30 to 60 minutes of exercise 1 day per week at 60% to 90% of maximum heart rate
- 15 to 20 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate
Correct Answer: 30 to 60 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate
Explanation:
Current recommendations for maintenance of cardiorespiratory fitness include 30 to 60 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate.
Question 2:
All of the following muscles act in scapular retraction except:
Options:
- Trapezius
- Rhomboideus major
- Rhomboideus minor
- Levator scapulae
- Pectoralis minor
Correct Answer: Pectoralis minor
Explanation:
The trapezius, rhomboids, and levator scapulae all provide some degree of scapular retraction. The pectoralis minor is a scapular protractor.
Question 3:
A 20-year-old male distance runner complains of pain on the lateral aspect of his knee that reliably occurs 3 miles into his run and eventually causes him to terminate his run. The pain is made worse by running downhill. He recalls no injury to his knee and has noticed no swelling. What is the most likely diagnosis:
Options:
- Lateral meniscus tear
- Lateral collateral ligament sprain
- Iliotibial band tendinitis
- Lateral parapatellar plica
- Exertional compartment syndrome
Correct Answer: Iliotibial band tendinitis
Explanation:
Iliotibial band tendinitis is the most common cause of lateral knee pain in runners. It generally occurs a few miles into a run and is exacerbated with downhill running. Iliotibial band tendinitis generally responds to nonoperative treatment consisting of stretching and nonsteroidal anti- inflammatory drugs but may require a corticosteroid injection or, rarely, surgical treatment.
Question 4:
Outcome following arthroscopic treatment of superior labrum anterior to posterior (SLAP) lesions is most affected by which of the following factors:
Options:
- Patient gender
- Level of sports participation
- Participation in overhead sports
- Dominance of involved arm
- Time to return to activity following surgery
Correct Answer: Participation in overhead sports
Explanation:
Kim and colleagues reported on the results of 34 patients who underwent arthroscopic treatment of SLAP lesions and discovered that results were good in all patients, but individuals who participated in overhead sports did not have outcomes as good as those not participating in these types of activities.
Question 5:
Inversion injury of a plantarflexed foot results in disruption of the anterolateral capsuloligamentous structures in a sequential fashion. Which of the following is the order in which this disruption occurs:
Options:
- Anterolateral joint capsule, anterior talofibular ligament, calcaneofibular ligament
- Anterior talofibular ligament, anterolateral joint capsule, calcaneofibular ligament
- Anterolateral joint capsule, calcaneofibular ligament, anterior talofibular ligament
- Calcaneofibular ligament, anterior talofibular ligament, anterolateral joint capsule
- Calcaneofibular ligament, anterolateral joint capsule, anterior talofibular ligament
Correct Answer: Anterolateral joint capsule, anterior talofibular ligament, calcaneofibular ligament
Explanation:
Inversion injury to the plantarflexed foot results in a predictable, sequential pattern of injury. Injury is initiated anteriorly with disruption of the anterolateral joint capsule and progresses posteriorly to the anterior talofibular ligament and ultimately to the calcaneofibular ligament.
Question 6:
When treating recurrent inversion ankle sprains, physiotherapy should be directed at strengthening of which muscle or muscle group:
Options:
- Gastrosoleus
- Tibialis anterior
- Tibialis posterior
- Peroneals
- Flexor digitorum longus
Correct Answer: Peroneals
Explanation:
The peroneals provide dynamic resistance to inversion of the ankle. Therapy programs designed for treating lateral ankle instability must attempt to maximize the function of these dynamic stabilizers.
Question 7:
All of the following are either primary or secondary stabilizers of the knee to posterior translation except:
Options:
- Posterior cruciate ligament
- Anterior cruciate ligament
- Medial collateral ligament
- Lateral collateral ligament
- Posterolateral corner
Correct Answer: Anterior cruciate ligament
Explanation:
The posterior cruciate ligament is the primary stabilizer to posterior translation of the knee. Secondary stabilizers include the medial and lateral collateral ligaments and the posterolateral corner.
Question 8:
Which of the following most accurately describes the location of the tibial attachment of the posterior cruciate ligament:
Options:
- At the level of the tibial plateau
- 0 mm to 5 mm inferior to the level of the tibial plateau
- 5 mm to 10 mm inferior to the level of the tibial plateau
- 10 mm to 15 mm inferior to the level of the tibial plateau
- 15 mm to 20 mm inferior to the level of the tibial plateau
Correct Answer: 10 mm to 15 mm inferior to the level of the tibial plateau
Explanation:
The tibial attachment of the posterior cruciate ligament is usually 10 mm to 15 mm inferior to the joint line. Reconstructions of the posterior cruciate ligament should attempt to replicate this tibial attachment site.
Question 9:
Which of the following is the most accurate clinical examination tool in detecting disruption of the posterior cruciate ligament:
Options:
- Posterior drawer test
- Quadriceps active drawer test
- Posterior sag test
- Reverse pivot shift test
- Reverse Lachman test
Correct Answer: Posterior drawer test
Explanation:
The posterior drawer test is the most accurate method of clinically diagnosing posterior cruciate ligament disruption. Although the quadriceps active drawer test and the posterior sag test are useful, their reported accuracy is less than that of the posterior drawer test. The reverse pivot shift test evaluates posterolateral corner injuries.
Question 10:
Completely lacerated muscles recover ____% of their strength and ___% of their ability to shorten:
Options:
- 50, 80
- 25, 25
- 10, 90
- 90, 10
- 90, 90
Correct Answer: 50, 80
Explanation:
Completely lacerated muscles recover 50% of their strength and 80% of their ability to shorten. Complete laceration is uncommon and is seen more often after trauma than after athletic accidents.
Question 11:
Muscles at increased risk for injury include:
Options:
- Muscles that cross a single joint and act concentrically.
- Muscles that cross a single joint and act eccentrically.
- Muscles that cross two joints and act concentrically.
- Muscles that cross two joints and act eccentrically.
- Muscle injury is independent of the number of joints crossed and type of contraction.
Correct Answer: Muscles that cross a single joint and act concentrically.
Explanation:
Muscles that cross two joints and that are acting in an eccentric fashion are at increased risk for injury. Frequently injured muscles also have a high percentage of type II (fast twitch) fibers.
Question 12:
Histology 7 days after muscle strain will most likely reveal:
Options:
- Inflammatory reaction
- Fibrous tissue replacing the inflammatory reaction
- C omplete muscle regeneration
- No reaction
- Acute hemorrhage
Correct Answer: Inflammatory reaction
Explanation:
Inflammatory reaction is seen after 2 days. At 1 week, the inflammatory reaction is replaced by fibrous tissue, and some muscle regeneration may be evident. Muscle strains and tears heal through scarring with minimal replacement with normal muscle tissue.
Question 13:
The initial treatment after a muscle strain includes:
Options:
- Rest, heat, and elevation
- Ice, rest, and aggressive stretching
- Heat, rest, and aggressive stretching
- Ice, elevation, and aggressive stretching
- Ice, rest, and elevation
Correct Answer: Ice, rest, and aggressive stretching
Explanation:
The usual initial treatment after a muscle strain involves rest, ice, compression, and elevation (RIC E). Although gentle range of motion exercises can be instituted as tolerated, aggressive stretching may cause further hemorrhage and muscle injury.
Question 14:
Which of the following are important in prevention of muscle injury:
Options:
- Improved muscle endurance
- Inflexibility
- Minimal warm up
- Decreased muscle tone
- Rapid muscle fatigue
Correct Answer: Improved muscle endurance
Explanation:
Factors that decrease muscle injury include adequate warm up; a strong, flexible muscle; and improved muscle endurance. Fatigued muscles have diminished load to failure, total deformation, and energy to absorption prior to failure.
Question 15:
Fatigued muscles are characterized as having:
Options:
- Lower propensity for injury
- Greater flexibility
- Diminished energy to absorption
- Less flexibility
- Increased muscle tone
Correct Answer: Diminished energy to absorption
Explanation:
Factors that decrease muscle injury include adequate warm up; a strong, flexible muscle; and improved muscle endurance. Fatigued muscles have diminished load to failure, total deformation, and energy to absorption prior to failure.
Question 16:
Reported hamstring strength deficit by isokinetic testing after complete proximal rupture is approximately:
Options:
- 10%
- 20%
- 60%
- 90%
- No deficit
Correct Answer: 60%
Explanation:
In a series of 12 patients with complete or near complete proximal hamstring ruptures, the mean strength deficit measured 61% for the hamstring and 23% for the quadriceps musculature.
Question 17:
Which of the following activities is associated with proximal hamstring ruptures:
Options:
- High jumping
- Skating
- Water skiing
- Swimming
- Basketball
Correct Answer: Water skiing
Explanation:
Water skiing is associated with proximal hamstring ruptures in both novice and experienced skiers. The mechanisms, however, are reported to be different depending on the level of skier. The novice skier typically sustains the injury while trying to get up on one or two skis from a submerged position, whereas the injury is typically the result of a fall in an experienced skier.
Question 18:
Patients with symptomatic chronic proximal hamstring ruptures typically complain of:
Options:
- Anterior thigh cramping with running
- Difficulty decelerating the leg during running
- Difficulty ascending stairs
- Difficulty descending stairs
- Difficulty accelerating the leg during running
Correct Answer: Difficulty decelerating the leg during running
Explanation:
Patients typically complain of a pulling sensation or cramping in the posterior thigh with vigorous activity. In addition, they may describe difficulty controlling the leg, which has been attributed to the impaired deceleration of the thigh as a result of the complete rupture.
Question 19:
The recommended treatment of a complete proximal hamstring rupture with 4-cm retraction in a young athletic adult is:
Options:
- Nonoperative rehabilitation
- Nonoperative rehabilitation followed by surgical repair if there is continued disability
- Surgical reattachment of the proximal hamstrings
- No rehabilitation or surgery is indicated
- C omplete proximal hamstring ruptures have not been reported
Correct Answer: Surgical reattachment of the proximal hamstrings
Explanation:
Patients with disability secondary to chronic complete proximal hamstring ruptures have been increasingly identified. Because of the reports of continued weakness and poor leg control, more authors are recommending acute repair of these injuries. Chronic repairs are reported to be much more difficult although good results are reported.
Question 20:
When comparing operative to nonoperative treatment of Achilles tendon ruptures, the major difference in outcome reported in the literature is:
Options:
- Return to full activity
- Plantarflexion strength
- Rerupture rate
- Ultimate range of motion
- There are no reported differences in results.
Correct Answer: Rerupture rate
Explanation:
In a review of the literature, the rerupture rate after nonoperatively treated Achilles tendon ruptures was 13.4% compared to 1.4% for operative treatment. A prospective randomized study also substantiated these findings. Although the number of patients returning to full sporting activity and plantarflexion strength measurements was higher in the operative group, the differences were not as marked as the rerupture rate.
