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NPTE – MSK exam questions
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NPTE – MSK exam questionswhat is an arthrometer? - ANS - An arthrometer measures joint motion
- The most commonly reported arthrometer in the literature for assessing knee joint motion is the
KT-1000. Its purpose is to objectively evaluate the ACL by quantifying the antero-posterior
displacement of the knee joint
Normal range of intracranial pressure for an adult - ANS 5-15 mmHg
describe spondylolysis and S/S - ANS - a unilateral fx of the pars interarticularis
- occurs frequently in adolescent population from rapid extension movements
- S/S: unilateral back pain, no translation (step-off noted on palpation, pain going into lumbar
extension)
describe spondylolysthesis and S/S - ANS - forward displacement of one vertebra over another as a
result of the fractured pars interarticularis separating
- most likely to occur at spinal segments L4-L5, L5-S1
- S/S: bilateral LBP, translation (step-off deformity) upon palpation
- When running your finger up the spinous processes, if you feel L4 anteriorly displaced relative to
L5, this is called a L5-S1 spondylolisthesis (the level of the slip is one level BELOW the step-off
deformity)
- x-ray/plain radiographs will reveal a non-unified pars interarticularis (decapitated scottie dog)
bilaterally
Describe spondylosis and S/S - ANS - also known as pars interarticularis defect
- stress fracture through the pars interarticularis of the lumbar vertebrae
- insidious onset, typically in the older population, pain with lumbar extension
- "age-related changes"
Describe the Braden scale, the 6 subscales, and scoring - ANS - assesses the risk of pressure ulcer
development
- subscales: mobility, activity, sensory perception, skin moisture, nutritional status, friction/shear
- score ranges from 6-23 (lower score = greater risk for pressure ulcer)
,what movement does the infraspinatus generate? what are tests to assess for infraspinatus
function? - ANS - external/lateral rotation
Tests:
- MMT
- lateral rotation lag sign (to assess the presence of a full-thickness rotator cuff tear AND to test the
integrity of the supraspinatus and infraspinatus tendons
what movement does the latissimus dorsi generate? what are tests to assess for latissimus dorsi
function? - ANS - shoulder extension, with some ADD and medial/internal rotation. it's also active
with scapular depression and protraction.
- MMT in isolation
SCFE (slipped capital femoral epiphysis) - ANS - weak femoral epiphyseal growth plates with
excessive mechanical stress
- adolescents (10-16 y/o), overweight/obese
- gait deviations: lurch gait or trendelenburg
- S/S: leg length discrepancy, knee pain, pain with hip IR, groin pain with anterior impingement test
(FADIR), capsular pattern present
rheumatoid arthritis vs osteoarthritis S/S - ANS - RA: general fatigue, weakness, bilateral
symptomatic joints, most often presenting first in the hands and wrists, morning stiffness, limited
ROM, pain with movement, and low grade fever; smaller peripheral joints initially affected, but
symptoms may progress to larger synovial joints
- OA: often presents in the hands, but is typically unilateral at onset, nor present in multiple joints
(usually just one joint), typically in WB joints, increase in pain and stiffness WITH activity
Reiter syndrome/reactive arthritis and S/S - ANS - a systemic disease/type of arthritis caused by
infection
- pain in multiple joints (ASYMMETRICALLY), presents over several weeks, eye inflammation and
increased frequency or discomfort during urination
- urethritis, conjunctivitis
what does speeds test assess for? - ANS biceps tendon pathology, labral tear, or SLAP (superior
labrum anterior to posterior) type 2 lesion
,what does Hawkins Kennedy assess for? - ANS rotator cuff dysfunction such as impingement,
subacromial bursitis
what can the empty can test assess for - ANS supraspinatis dysfunction such as tendinitis
A patient walks with excessive foot pronation during midstance through toe off (preswing). What is
the MOST likely cause of the patient's gait deviation?
1. Compensated rearfoot varus deformity
2. Compensated forefoot valgus deformity
3. Uncompensated lateral (external) rotation of the tibia
4. Uncompensated pes cavus - ANS 1. CORRECT
2. A compensated forefoot valgus deformity would result in excessive foot supination.
3. Uncompensated lateral (external) rotation of the tibia would result in excessive foot supination.
4. Uncompensated pes cavus would result in excessive foot supination.
A patient exhibits swelling and pain in the medial aspect of the ankle. During examination, the
patient demonstrates rearfoot pronation in standing position and inability to perform a heel raise on
the affected side. The patient demonstrates forefoot abduction when observed from behind. Which
of the following conditions is MOST likely present?
1. Eversion ankle sprain
2. Retrocalcaneal bursitis
3. Tarsal tunnel syndrome
4. Posterior tibial tendon dysfunction - ANS 1. Although pain and swelling occur about the medial
ankle in a patient who has an eversion ankle sprain, the patient would demonstrate pain with
eversion stress. Also, the patient would relate this pain to a specific traumatic event. The patient
would also not necessarily have rearfoot pronation and forefoot abduction.
2. In retrocalcaneal bursitis, the pain is behind the ankle posterior to the talus, but there is no pain
with resistive testing
, 3. Although pain occurs in the medial aspect of the ankle with tarsal tunnel syndrome, this condition
is associated with paresthesias, which are not reported by the patient in the stem
4. CORRECT - The main function of the tibialis posterior is to plantar flex and invert the foot as well
as support the medial arch. The tendon courses under the medial malleolus, causing pain and
inflammation in this area when the tendon is dysfunctional. With a heel raise, the tendon becomes
stressed due to its actions of plantar flexion and inversion. Finally, a finding of the "too many toes
sign," which is the hallmark sign of this diagnosis, is due to forefoot abduction and hindfoot valgus.
how does hip flexor tightness/tightness in the iliopsoas affect one's posture? - ANS the patient
would have a tendency to stand with hyperlordosis
A patient reports pain in response to palpation of the anteromedial knee below the joint line. In
addition, the patient reports pain with active knee flexion, passive knee extension, and valgus stress.
Which of the following structures is the MOST likely source of the pain?
1. Pes anserine
2. Patellar tendon
3. Medial meniscus
4. Popliteus tendon - ANS 1. CORRECT - The pes anserine is medial and just distal to knee joint line.
The semitendinosus and sartorius attach here, would be stretched with extension and valgus, and
are involved in knee flexion.
2. The patellar tendon is located on the anterior knee and would not be painful with passive knee
extension
3. Medial meniscus injury would be painful with palpation on the joint line
4. The popliteus tendon is located in the posterior knee
A patient is referred to a physical therapist for treatment of chronic neck pain. During the
examination, the therapist notices that the patient has a marked ulnar drift in both hands at the
MCP joints. Which of the following treatments should the therapist perform?
1. Cervical stabilization exercises with the patient in good postural alignment
2. Gentle cervical mobilization for 8 minutes
3. Intermittent cervical traction at 8% of the patient's body weight for 10 minutes
4. Moist hot pack on the patient's cervical spine with the patient in sitting position for 15 minutes -
ANS 1. CORRECT - Marked ulnar drift is a hallmark sign of rheumatoid arthritis. Because cervical
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