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INSTANT DOWNLOAD COMPLETE TEST BANK WITH ANSWERS

 

 

Fundamental Orthopedic Management For the Physical Therapist Assistant 4th Edition By Robert Manske –  Test Bank

 

 

Sample  Questions

 

Chapter 03: Differential Diagnosis and Emergent Conditions

 

MULTIPLE CHOICE

 

  1. The process of providing a label that correlates specific signs and symptoms to an identifiable disease or disorder is:
a. evaluation.
b. diagnosis.
c. consideration.
d. prognosis.

 

 

ANS:  B

Multiple sources have used this definition of diagnosis.

 

REF:   P. 38

 

  1. The process of comparing and contrasting patient data points with the goal of appropriate exclusion and inclusion that terminate with the development of intervention strategies is:
a. examination.
b. prognosis.
c. intervention.
d. differential diagnosis.

 

 

ANS:  D

Examination is the use of tests and measures to screen the patient. Prognosis is the prediction of outcomes. Intervention is the action taken by the physical therapist (PT) or physical therapist assistant (PTA) to resolve the patient’s problem. Differential diagnosis is the process of using patient data to develop intervention strategies.

 

REF:   P. 39

 

  1. What is the term for a comprehensive screening of the patient that includes specific tests and measures?
a. Examination
b. Prognosis
c. Intervention
d. Differential diagnosis

 

 

ANS:  A

Examination is the use of tests and measures to screen the patient. Prognosis is the prediction of outcomes. Intervention is the action taken by the PT or PTA to resolve the patient’s problem. Differential diagnosis is the process of using patient data to develop intervention strategies.

 

REF:   P. 39

 

  1. What is the term for a prediction of the outcome of the physical therapy episode of care with the establishment of a plan of care (POC)?
a. Examination
b. Prognosis
c. Intervention
d. Differential diagnosis

 

 

ANS:  B

Examination is the use of tests and measures to screen the patient. Prognosis is the prediction of outcomes. Intervention is the action taken by the PT or PTA to resolve the patient’s problem. Differential diagnosis is the process of using patient data to develop intervention strategies.

 

REF:   P. 41

 

  1. Which of the following is not a minimum skill for a PTA?
a. Collect data on patient’s current condition and compare results to previously collected data
b. Communicate to the PT when there are significant changes in patient status
c. Develop the POC
d. Use clinical problem solving skills to determine if the patient is safe and comfortable with the intervention

 

 

ANS:  C

The PT is responsible for the development of the POC. The PTA is expected to have all of the other skills listed (see Table 3-1).

 

REF:   P. 42

 

  1. The PTA is expected to have which of the following basic assessment skills?
a. Assessment of range of motion
b. Ability to do manual muscle testing
c. Proficiency in anthropometric measurement
d. All of the above

 

 

ANS:  D

The PTA is expected to be competent in all of the above skills.

 

REF:   P. 43

 

  1. Which type of diagnosis emphasizes the influence of a disease or disorder on the patient’s functional status at the system level and on the interrelationship between the system and the patient as a whole?
a. Physical therapy diagnosis
b. Medical diagnosis
c. Nursing diagnosis
d. Functional diagnosis

 

 

ANS:  A

A medical diagnosis labels a disease or disorder on a cellular, tissue, or organ level. A physical therapy diagnosis emphasizes the impact of the disorder on the patient’s functional status.

 

REF:   P. 41

 

  1. Which of the following is not true about vital signs?
a. They provide an objective overview of the patient’s cardiopulmonary function
b. They may be influenced by exercise, disease, stress, and age
c. Baseline vital signs data should be obtained prior to initiation of a POC
d. During an episode of care, vital signs are no longer measured or useful

 

 

ANS:  D

Vital signs should be measured periodically during care. Altered vital signs may indicate an adverse response to care and must be evaluated.

 

REF:   P. 48

 

  1. What percentage of patients undergoing orthopedic surgery develops an infection?
a. 1%
b. 2-5%
c. 10%
d. 12-15%

 

 

ANS:  B

Two to five percent of patients undergoing orthopedic surgery develop an infection.

 

REF:   P. 48

 

  1. The signs and symptoms of redness, edema, pain, and increased skin temperature may indicate:
a. inflammation or infection.
b. infection only.
c. inflammation only.
d. a prognosis.

 

 

ANS:  A

Both inflammation and infection may be indicated by redness, edema, pain, and increased skin temperature. The health care team needs to evaluate these signs and symptoms to determine if infection is present.

 

REF:   P. 48

 

  1. An abnormal response to musculoskeletal trauma that involves the excessive collection of red and white blood cells and fibrin resulting in a partial or complete occlusion of a vessel is:
a. inflammation.
b. tumor.
c. venous thrombosis.
d. tachycardia.

 

 

ANS:  C

Venous thrombosis is caused when an excessive collection of white and red blood cells and fibrin occlude a blood vessel. If a deep vessel is involved, the thrombosis is referred to as a deep vein thrombosis (DVT).

 

REF:   P. 48

 

  1. DVT usually occurs in which location?
a. Upper extremities
b. Lower extremities
c. Head and neck region
d. Lungs

 

 

ANS:  B

Approximately 90% of DVTs occur in the lower extremities.

 

REF:   P. 48

 

  1. What is a chronic swelling of an area that leads to the involvement of an entire extremity?
a. Thrombosis
b. Myocardial infarction
c. Orthostatic hypertension
d. Lymphedema

 

 

ANS:  D

A chronic swelling of an area that leads to the involvement of the entire extremity is a lymphedema. A common type of lymphedema is secondary lymphedema, which is a direct result of obstruction or damage to the lymphatic system.

 

REF:   P. 51

 

  1. A fall in blood pressure associated with position changes from lying to sitting or sitting to standing is:
a. syncope.
b. orthostatic hypotension.
c. orthostatic hypertension.
d. lymphedema.

 

 

ANS:  B

Orthostatic hypotension is defined as a fall in systolic blood pressure of 20 mm Hg or more and a 10 mm Hg decrease in diastolic blood pressure when the patient moves from a lying position to a sitting or standing position or from sitting to standing.

 

REF:   P. 51

 

  1. What is a dysfunction that is a result of a reduction in the quality or quantity of erythrocytes and results in oxygen deficiency?
a. Anemia
b. Syncope
c. Pulmonary embolism
d. Hypertension

 

 

ANS:  A

Anemia is a dysfunction that is a direct result of a reduction in the quality or quantity of erythrocytes. The resultant oxygen deficiency can lead to multi-tissue and organ disturbances that further impair the individuals healing capacity and overall functional capabilities.

 

REF:   P. 52

 

  1. A common problem, especially among elderly patients, to the pulmonary system that is an inflammation of lung tissue that creates excessive fluids resulting in difficulty breathing is:
a. pulmonary embolism.
b. lymphedema.
c. pneumonia.
d. lung cancer.

 

 

ANS:  C

The elderly are particularly susceptible to pulmonary dysfunction or disease, such as pneumonia. Pneumonia is an inflammation of lung tissue that results in excessive fluid accumulation. This then creates breathing difficulties.

 

REF:   P. 52

 

  1. Which of the following statements is not true about asthma?
a. Asthma primarily inflames the bronchial blood vessels
b. Asthma is associated with response to allergens, infectious agents, or pollution
c. Asthma may be triggered by exercise
d. Asthma may cause a “panting” breathing pattern with a nonproductive, hacking cough

 

 

ANS:  A

Asthma affects the bronchial airways, not the bronchial blood vessels. All of the other statements are true about asthma.

 

REF:   P. 52

 

  1. When evaluating a patient with low-back pain, who also has experienced unexplained recent weight loss, night pain, and inability to obtain a comfortable position, the health care team should investigate for:
a. spinal muscle spasm.
b. spinal tumor or cancer.
c. pulmonary embolism.
d. osteomyelitis.

 

 

ANS:  B

Recent weight loss, night pain, and inability to obtain a comfortable position are possible indications of tumor or cancer. None of the other answers are associated with these three signs or symptoms.

 

REF:   P. 53

 

  1. Spinal compression fractures are not associated with which of the following?
a. Trauma
b. Osteoporosis
c. Steroid use
d. Infection

 

 

ANS:  D

Spinal fractures are usually caused by trauma. Both osteoporosis and steroid use can weaken bone and inert tissue that may contribute to spinal fracture. Infection is not normally associated with spinal fracture.

 

REF:   P. 53

 

  1. Obesity, eating red meat, cigarette smoking, and alcohol consumption are risk factors for:
a. pulmonary embolism.
b. colon cancer.
c. spinal fracture.
d. asthma.

 

 

ANS:  B

Risk factors for colon cancer include obesity, eating red mean, cigarette smoking, and alcohol consumption.

 

REF:   P. 54

 

Chapter 07: Balance and Coordination

 

MULTIPLE CHOICE

 

  1. Select the term that is defined as the ability to maintain the center of mass over the base of support.
a. Coordination
b. Neuromuscular control
c. Proprioception
d. Balance

 

 

ANS:  D

Balance is often defined as the ability to maintain the center of mass over the base of support.

 

REF:   P. 125

 

  1. Select the term that is defined as the ability to produce patterns of body and limb motions in the context of environmental objects and events.
a. Coordination
b. Neuromuscular control
c. Proprioception
d. Balance

 

 

ANS:  A

Coordination is the ability to produce patterns of body and limb motions in the context of environmental objects and events.

 

REF:   P. 126

 

  1. What term is defined as the perception of knowing joint position, movement, and movement resistance?
a. Coordination
b. Neuromuscular control
c. Proprioception
d. Balance

 

 

ANS:  C

Essential to joint positions is sufficient sensory (afferent) information regarding joint position, movement (kinesthesia), and movement resistance, or tension. The afferent information contributing to these three elements is called proprioception. Proprioception is vital for neuromuscular control.

 

REF:   P. 126

 

  1. Where are mechanoreceptors located?
a. Muscle
b. Tendon
c. Ligament
d. All of the above

 

 

ANS:  D

Mechanoreceptors are the sensory receptors that are responsible for converting mechanical events (movement or tension) into neural signals that can be conveyed to the central nervous system.

 

REF:   P. 127

 

  1. Muscle spindles convey information regarding:
a. nutrients delivered to the muscle.
b. muscle length and rate of length change.
c. muscle tension.
d. the balance of the body.

 

 

ANS:  B

Muscle spindles are responsible for conveying information regarding muscle length and rate of length changes.

 

REF:   P. 127

 

  1. Which of the following mechanoreceptors is responsible for conveying information regarding muscle tension?
a. Golgi tendon organs
b. Ruffini receptors
c. Pacinian corpuscles
d. Free nerve endings

 

 

ANS:  A

Golgi tendon organs, located across a musculotendinous junction, are responsible for conveying information regarding muscle tension.

 

REF:   P. 127

 

  1. Balance tests and balance treatment activities use the same movements. How does the physical therapist assistant challenge the patient and test different aspects of the postural control system?
a. By counting the number of repetitions within a given time frame
b. By counting the time the patient can maintain a certain balance activity
c. By manipulating the conditions in which the balance tasks are conducted
d. There is no way to change balance tests; they are designed to measure all aspects of the postural control system

 

 

ANS:  C

Different aspects of the postural control system may be more selectively challenged by manipulating the conditions in which balance tasks are conducted. For example, having a patient stand with the eyes closed heightens his or her reliance on somatosensory and vestibular information.

 

REF:   P. 127

 

  1. Which of the following are included in a comprehensive balance assessment and training?
a. Progressive tasks of incremental difficulty
b. Static stance with varying bases of support
c. Progressive tasks with unexpected perturbations
d. All of the above

 

 

ANS:  D

Comprehensive balance assessment and training frequently call for a progressive battery of specific tasks of incremental difficulty and should include not only static stances with varying bases of support and support-surface characteristics, but also tasks that involve voluntary movement and unexpected perturbations with task completion.

 

REF:   P. 128

 

  1. Which of the following descriptions of coordination tests applies to the finger-to-nose test?
a. A static position test in which the arms are held horizontal or the knees extended
b. A reciprocal motion test in which the patient is asked to receive and deliver a ball
c. A reciprocal motion test in which the patient alternately touches the tip of each finger with the tip of the thumb
d. A reciprocal motion test in which the patient touches the tip of the index finger to the tip of the nose

 

 

ANS:  D

The finger-to-nose coordination test involves having the patient touch the tip of the index finger to the tip of the nose.

 

REF:   P. 127

 

  1. Which of the following is involved in coordination?
a. Sensory organs
b. Muscle function
c. Central nervous system centers
d. All of the above

 

 

ANS:  D

Coordination involves multiple elements, including sensory organs, muscle function, and central nervous system centers.

 

REF:   P. 127

 

  1. When planning a progressive balance training plan for your postoperative patient, where would you begin with activities?
a. The tasks and drills begin and progress according to the abilities of the patient
b. The tasks and drills are established two levels above what the patient can perform to challenge his balance and coordination
c. The tasks and drills are initiated a level below what the patient can perform and progress as the patient progresses
d. The tasks and drills are established based on the diagnosis and followed on a set time schedule

 

 

ANS:  A

Tasks and drills are initiated and progress according to the abilities and desired goals of the patient.

 

REF:   P. 128

 

  1. Which of the following exercises is NOT a closed kinetic chain (CKC) exercise?
a. Double- and single-leg squats on stable and unstable surfaces
b. Forward and backward gait
c. Sidestepping and heel-to-toe walking
d. Reaching for an object placed outside of the patient’s reach

 

 

ANS:  D

Progressively challenging tasks and CKC exercises stimulate a patient’s ability to safely and accurately negotiate obstacles. Such exercises include the double- and single-leg squats, forward and backward gait, sidestepping, and heel-to-toe walking.

 

REF:   P. 131

 

  1. For which training tasks would a wobble board be used?
a. Balance training for the lower extremities
b. Coordination training for the upper extremities
c. Proprioceptive training for the upper extremities
d. Flexibility training for the lower extremities

 

 

ANS:  A

The wobble board, or balance board, is a portable and affordable device. It is used in balance training for lower extremities.

 

REF:   P. 131

 

  1. Which training exercise would be most appropriate for the glenohumeral joint of a gymnast?
a. Double- and single-leg squats on stable and unstable surfaces
b. Forward and backward gait walking
c. Medicine balls and physioballs
d. Stretching exercises that emphasize the spine and hips

 

 

ANS:  C

Global stability of the glenohumeral joint can be enhanced effectively with the use of medicine balls and physioballs (Fig. 7-10, B1 and B2).

 

REF:   P. 132

 

  1. A critical safety component in all balance and proprioception activities is the patient’s ability to demonstrate which of the following?
a. Increased range of motion (ROM)
b. Improved strength
c. Steady gait
d. Protective reactions

 

 

ANS:  D

Close observation of the patient’s protective reactions during loss of balance is a critical component of all balance tests and training activities.

 

REF:   P. 128

 

  1. Which of the following factors does NOT contribute to balance dysfunction?
a. ROM
b. Coordination
c. Perception
d. CKC exercises

 

 

ANS:  D

Duncan identified several factors that may significantly contribute to balance dysfunction: perception, behavior, ROM, biomechanical alignment, weakness, synergistic organization strategy, coordination, and adaptability.

 

REF:   P. 130

 

  1. Which of the following is not a sensory source that a patient relies on for balance?
a. Vision
b. Proprioceptive
c. Somatosensory
d. Vestibular

 

 

ANS:  B

A patient relies on visual, somatosensory, and vestibular senses. By observing changes in the amount of sway or using a forceplate to quantify sway, the clinician can determine which of these sensory sources a patient relies on for balance as well as the degree to which the patient can adapt reliance on the remaining senses during situations of intersensory conflict.

 

REF:   P. 129

 

  1. Why is balance training and proprioceptive training needed for upper extremities?
a. Many household chores involve the repetitive use of arms and shoulders to lift, pull, and carry
b. Surgery, injury, and immobilization lead to significant alterations in proprioception
c. Many workers use their arms and shoulders in their jobs with vigorous weight bearing
d. All of the above

 

 

ANS:  D

All of the listed items are reasons why balance training and proprioceptive training are needed for the upper extremities.

 

REF:   P. 132

 

  1. In progressive balancing exercises, which of the following exercises would come first?
a. Seated: eyes open, then eyes closed
b. Single-leg standing: eyes open, then eyes closed
c. Minitrampoline: double-leg standing
d. Balance board

 

 

ANS:  A

Progressive balancing exercises are in Box 7-2. Seated: eyes open, then eyes closed comes first.

 

REF:   P. 128

 

  1. In progressive balancing exercises, which of the following exercises would come last?
a. Seated: eyes open, then eyes closed
b. Single-leg standing: eyes open, then eyes closed
c. Minitrampoline: double-leg standing
d. Balance board

 

 

ANS:  D

Progressive balancing exercises are in Box 7-2. The balance board activities would come last in this list.

 

REF:   P. 128

 

Chapter 17: Orthopedic Management of the Ankle, Foot, and Toes

 

MULTIPLE CHOICE

 

  1. Which of the following injuries are among the most common sports and orthopedic injuries?
a. Fractures of the ankle
b. Ankle sprains
c. Cartilage tears in the ankle
d. Twisted ankles

 

 

ANS:  B

Inversion ankle sprains are among the most common sports and orthopedic injuries.

 

REF:   P. 271

 

  1. Which position is the ankle most likely in just before an injury?
a. Full weight bearing
b. Partial weight bearing
c. Non–weight bearing
d. All of the above

 

 

ANS:  C

Most commonly, ankle sprains occur with the foot in an unloaded or non–weight-bearing position before injury.

 

REF:   P. 272

 

  1. Using Leach’s classification model, which of the following would be classified as second-degree ankle sprain?
a. A completely torn single ligament
b. Completely torn anterior talofibular and fibulocalcaneal ligaments
c. Torn anterior and posterior talofibular and fibulocalcaneal ligaments
d. None of the above

 

 

ANS:  B

According to Leach’s classification, a second-degree ankle sprain is a double ligament rupture. Both the anterior talofibular ligament and the fibulocalcaneal ligaments are completely torn.

 

REF:   P. 272

 

  1. Using Leach’s classification model, which of the following would be classified as a first-degree ankle sprain?
a. A completely torn single ligament
b. Completely torn anterior talofibular and fibulocalcaneal ligaments
c. Torn anterior and posterior talofibular and fibulocalcaneal ligaments
d. None of the above

 

 

ANS:  A

According to Leach’s classification, a first-degree sprain is a single ligament rupture.

 

REF:   P. 272

 

  1. Which of the following interventions is used in the initial management phase of an acute inversion ankle sprain?
a. No weight bearing
b. Partial weight bearing
c. Weight bearing as tolerated
d. Plyometrics

 

 

ANS:  C

In the initial phase, rest, ice, compression, and elevation (RICE) is done along with weight bearing as tolerated.

 

REF:   P. 274

 

  1. Which of the following interventions is the most effective means to reducing swelling?
a. Elevation and compression
b. Application of ice and maximum protection
c. Casting and ice applications
d. Elevation and casting

 

 

ANS:  A

Elevation and compression are the most effective means to reduce swelling. Elasticized wraps and elevation of the limb are the interventions.

 

REF:   P. 274

 

  1. Which of the following interventions are to be avoided during the maximum protection phase?
a. Isometric exercises
b. Active range of motion (ROM) exercises—plantar flexion and inversion
c. Active ROM exercises—dorsiflexion and eversion
d. General fitness exercises

 

 

ANS:  B

Active ROM exercise might cause unwanted stress that would disrupt the normal healing process. Plantar flexion or inversion should not be done in the maximum protection phase.

 

REF:   P. 274

 

  1. When does the moderate protection phase begin?
a. When the swelling is gone and the patient is pain-free
b. When the patient can run short distances with moderate pain
c. When the patient can bear weight without crutches but with some pain
d. When the pain level decreases to a moderate amount

 

 

ANS:  C

The moderate protection phase can begin when the patient can bear weight on the injured limb without crutches, perform all ROM and isometric exercises without undue pain, and control the swelling.

 

REF:   P. 274

 

  1. How many weeks should an ankle brace be used for running activities after an injury?
a. 6-8
b. 8-12
c. 12-26
d. 26-52

 

 

ANS:  D

Maturation of the injured ligaments can take as long as 6-12 months. Therefore it is critical to encourage patient compliance with the use of either tape or a semirigid brace during all running activities.

 

REF:   P. 275

 

  1. A skier’s ankle is forced into dorsiflexion and the structures supporting the ankle are injured. Which injury has likely occurred and which test would be diagnostic for the injury?
a. Deltoid ligament sprain; X-ray
b. High ankle sprain; squeeze test
c. Inversion ankle sprain; talar tilt test
d. Grade III ankle sprain; talar tilt test

 

 

ANS:  B

High ankle sprains or ankle syndesmosis injuries occur in skiing, football, soccer, and other sports activities when the ankle is forced into dorsiflexion or rotation with the foot in a weight-bearing position. Diagnostic testing includes external rotation and squeeze tests, as well as diagnostic imaging.

 

REF:   P. 277

 

  1. Select the ankle complication that results in laxity of the ankle ligaments.
a. Functional instability
b. Mechanical instability
c. Lifestyle instability
d. General instability

 

 

ANS:  B

Mechanical instability is defined as laxity of the ankle ligaments.

 

REF:   P. 277

 

  1. Select the ankle complication that results in the patient feeling that the ankle joint is giving way without affecting ligament laxity.
a. Functional instability
b. Mechanical instability
c. Lifestyle instability
d. General instability

 

 

ANS:  A

Functional instability refers to a subjective feeling of giving way without affecting ligament laxity.

 

REF:   P. 278

 

  1. A subluxing peroneal tendon injury can be acute or chronic. How does this type of injury occur?
a. Plantar flexion, inversion, and adduction of the foot and ankle
b. Fracture in the medial or lateral malleolus
c. Dorsiflexion or rotation with the foot in a weight-bearing position
d. Passive dorsiflexion with the foot slightly everted

 

 

ANS:  D

Subluxing peroneal tendon injuries occur with passive dorsiflexion with the foot slightly everted.

 

REF:   P. 278

 

  1. Inversion ankle sprains occur frequently. How?
a. Plantar flexion, inversion, and adduction of the foot and ankle
b. Fracture in the medial or lateral malleolus
c. Dorsiflexion or rotation with the foot in a weight-bearing position
d. Passive dorsiflexion with the foot slightly everted

 

 

ANS:  A

Inversion ankle sprains occur with plantar flexion, inversion, and adduction of the foot and ankle.

 

REF:   P. 272

 

  1. Surgical repair procedures such as bone block, rerouting, periosteal flaps, groove deepening, and tendon slings are done for which type of ankle injury?
a. Acute subluxing peroneal tendons
b. Third-degree sprains
c. Chronic subluxing peroneal tendons
d. Achilles tendinopathy

 

 

ANS:  C

There are five basic types of surgical repair procedures for correction of chronic subluxing peroneal tendons: bone block, rerouting, periosteal flaps, groove deepening, and tendon slings.

 

REF:   P. 279

 

  1. An athlete enters the emergency room complaining of localized pain at the midportion, distal third, and insertion on the calcaneus. What do you suspect?
a. Subluxing peroneal tendon
b. Acute ankle sprain
c. Lateral ligament injury
d. Achilles tendinopathy

 

 

ANS:  D

The primary feature of Achilles tendinopathy is localized pain at the midportion, distal third, and insertion on the calcaneus.

 

REF:   P. 280

 

  1. Which of the following exercises for Achilles tendinopathy are safe without any evidence of adverse effects?
a. Ballistic motions
b. Vigorous exercises that stretch the Achilles
c. Standing cord stretches that bounce the Achilles tendon
d. Daily eccentric training exercises

 

 

ANS:  D

Daily eccentric training for Achilles tendinopathy is a safe activity without any evidence of adverse effects in either midportion or insertional Achilles tendinopathy.

 

REF:   P. 281

 

  1. Which of the following repairs have better success rates and a significant increase in ultimate recovery of strength, power, and endurance after an Achilles tendon rupture?
a. Nonoperative treatment with casting for at least 8 weeks
b. Surgical repair of the tendon
c. Immediate initiation of physical therapy with light casting
d. None of the above

 

 

ANS:  B

Surgically repaired Achilles tendons have a much lower rate of rerupture and there is a significant increase in the ultimate recovery of muscular strength, power, and endurance.

 

REF:   P. 282

 

  1. Why is acute elevated intracompartmental pressure in the lower leg considered a medical emergency?
a. The fracture has not been realigned and the patient’s pain continues to be extreme until the fracture is aligned.
b. Ischemia and reduced neuromuscular function can result in permanent damage if left 12 or more hours.
c. Ischemia results in continued swelling.
d. None of the above

 

 

ANS:  B

Elevated intracompartmental pressure within the lower leg can result in permanent damage. The physical therapist assistant should immediately report suspected compartmental syndrome.

 

REF:   P. 284

 

  1. What is the treatment for acute compartment syndrome?
a. Rest, ice, compression, and elevation (RICE)
b. Elevation and compression
c. Fasciotomy
d. Rest, heat, and pain relievers

 

 

ANS:  C

Treatment for acute compartmental syndrome is a surgical procedure called fasciotomy. For chronic compartment syndrome, rest, antiinflammatories, stretching, and strengthening of the involved muscles and foot orthotic devices may be ordered.

 

REF:   P. 284

Chapter 27: Musculoskeletal-Related Dysfunctions of the Pelvic Floor

 

MULTIPLE CHOICE

 

  1. What is a condition in which there is an inability to coordinate the necessary muscles of the abdominal wall and the pelvic floor to urinate or defecate?
a. Animus
b. Abdominal pelvic dyssynergia
c. Chronic pelvic pain
d. Constipation

 

 

ANS:  B

Abdominal pelvic dyssynergia is a condition in which there is an inability of the patient to coordinate the necessary muscles of the abdominal wall and the pelvic floor to urinate or defecate.

 

REF:   P. 542

 

  1. What is the term for a muscle spasm of the anal sphincter that causes rectal pain that restricts the anal canal?
a. Anismus
b. Bladder sphincter dyssynergia
c. Coccydynia
d. Constipation

 

 

ANS:  A

Anismus is a muscle spasm of the anal sphincter that causes rectal or anal pain that restricts the anal opening.

 

REF:   P. 541

 

  1. What is the term for a prolapse of the bladder?
a. Cystocele
b. Enterocele
c. Piriformis syndrome
d. Sciatica

 

 

ANS:  A

Cystocele is a prolapse of the bladder.

 

REF:   P. 541

 

  1. What is the common name for voluntary pelvic floor contractions or exercises?
a. Levator ani stretches
b. Dyspareunia
c. Kegel exercises
d. Isometrics

 

 

ANS:  C

Kegel exercises are voluntary pelvic floor contractions or exercises, named after Dr. Arnold Kegel.

 

REF:   P. 543

 

  1. The pelvic floor is bordered by the pubic symphysis and pubic rami anteriorly, the ischial tuberosities and acetabulum laterally, and the _______ and _______ posteriorly.
a. coccyx, levator ani muscle
b. anterior ligament, posterior ligament
c. bladder, vagina
d. sacrum, coccyx

 

 

ANS:  D

The pelvic floor is bordered by the pubic symphysis and pubic rami anteriorly, the ischial tuberosities and acetabulum laterally, and the sacrum and coccyx posteriorly.

 

REF:   P. 536

 

  1. How many layers of musculature are in the pelvic floor?
a. 3
b. 6
c. 10
d. 12

 

 

ANS:  A

The pelvic floor consists of three layers of musculature, commonly categorized into the urogenital triangle, the deep urogenital triangle, and the anal triangle.

 

REF:   P. 536

 

  1. Which muscle is NOT in the deepest layer of muscles of the pelvic floor?
a. Levator ani
b. Coccygeus
c. Piriformis
d. Bulbocavernosus

 

 

ANS:  D

The deepest layer of muscles of the pelvic floor consists of the levator ani muscles (pubococcygeus and illiococcygeus), the coccygeus, and the piriformis and obturator internis muscles.

 

REF:   P. 537

 

  1. How many layers of fascia are in the pelvic floor?
a. 1
b. 2
c. 3
d. 5

 

 

ANS:  B

The pelvic floor consists of two continuous layers of fascia, the parietal pelvic fascia and the visceral pelvic fascia.

 

REF:   P. 537

 

  1. Which of the following is not considered a function of the pelvic floor?
a. Maintain urinary and fecal continence
b. Support the upper and lower extremities
c. Aid in sexual appreciation
d. Support the bony pelvis

 

 

ANS:  B

The pelvic floor supports the internal abdominopelvic organs, maintains urinary and fecal continence, aids in sexual appreciation, and supports the bony pelvis. It does not support the upper and lower extremities.

 

REF:   P. 538

 

  1. The levator ani muscle can stretch almost 260% of its resting length. What function relies on this extremely large stretch ratio?
a. Vaginal childbirth delivery
b. Defecation
c. Diaphragmatic breathing
d. Ambulation

 

 

ANS:  A

The levator ani has been shown to stretch up to almost 260% of its resting length to accommodate for vaginal delivery.

 

REF:   P. 538

 

  1. The pelvic floor musculature may become dysfunctional for many reasons, including:
a. childbirth.
b. surgery.
c. skeletal malalignment.
d. All of the above

 

 

ANS:  D

The pelvic floor musculature may become dysfunctional due to many causes, including childbirth, surgery, trauma, pain, and skeletal malalignment.

 

REF:   P. 538

 

  1. Urinary continence is maintained when which of the following is true?
a. Sphincteric pressure around the anus exceeds that of the contracting detrusor muscle of the bladder and intraabdominal pressure
b. Sphincteric and detrusor muscle pressure around the urethra exceed intraabdominal pressure
c. Sphincteric pressure around the urethra exceeds that of the contracting detrusor muscle of the bladder and intraabdominal pressure
d. Sphincteric pressure around the urethra is less than that of the contracting detrusor muscle of the bladder and intraabdominal pressure

 

 

ANS:  C

Urinary continence is maintained when sphincteric pressure around the urethra exceeds that of the contracting detrusor muscle of the bladder and intraabdominal pressure.

 

REF:   P. 539

 

  1. An anatomical support deficit of the pelvic viscera that may result from a series of long-term failures of the supporting and suspension mechanisms of the uterus and vaginal wall is:
a. pelvic organ prolapse (POP).
b. bladder sphincter dyssynergia.
c. abdominal pelvic dyssynergia.
d. all of the above.

 

 

ANS:  A

POP is defined as an anatomical support deficit of the pelvic viscera. It may result from a series of long-term failures of the supporting and suspension mechanisms of the uterus and vaginal wall.

 

REF:   P. 539

 

  1. Which of the following is true about POP?
a. It decreases with age and number of given births
b. It increases with age and number of given births
c. It increases with number of given births, but age is not a factor
d. It increases with age, but number of given births is not a factor

 

 

ANS:  B

POP increases significantly with age and with the number of given births.

 

REF:   P. 539

 

  1. What type of pelvic floor dysfunction is characterized by pelvic floor muscles being in a state of increased tension or prolonged state of contraction with the inability to relax?
a. Supportive
b. Incoordination
c. Hypertonic
d. Visceral

 

 

ANS:  C

A hypertonic pelvic floor dysfunction is characterized by pelvic floor muscles being in a state of increased tension or prolonged state of contraction with the inability to relax.

 

REF:   P. 541

 

  1. What is the term for a muscle spasm of the anal sphincter that causes sharp rectal pain that lasts from seconds to 30 minutes and frequently occurs in the middle of the night?
a. Coccydynia
b. Proctalgia fugax
c. Levator ani syndrome
d. Nonrelaxing puborectalis

 

 

ANS:  B

Proctalgia fugax is the term for a muscle spasm of the anal sphincter that causes sharp rectal pain that lasts from seconds to 30 minutes and frequently occurs in the middle of the night.

 

REF:   P. 541

 

  1. Dysparenunia is the term for pain during or after:
a. defecation.
b. urination.
c. sexual intercourse.
d. vaginal childbirth.

 

 

ANS:  C

Dyspareunia is pain before, during, and after sexual intercourse. The majority of causes of dyspareunia are directly or indirectly related to hypertonus of the pelvic floor.

 

REF:   P. 542

 

  1. What type of pelvic floor dysfunction involves an inability to coordinate the muscles of the abdominal wall and the pelvic floor necessary to urinate or defecate?
a. Hypertonic
b. Visceral
c. Supportive
d. Incoordination

 

 

ANS:  D

Incoordination dysfunction involves an inability to coordinate the muscles of the abdominal wall and the pelvic floor necessary to urinate or defecate. This is described as abdominal pelvic dyssynergia, bladder sphincter dyssynergia, or pelvic floor dyssynergia.

 

REF:   P. 542

 

  1. Another name for interstitial cystitis (IC) is:
a. painful bladder syndrome.
b. levator ani syndrome.
c. dyspareunia.
d. vulvodynia.

 

 

ANS:  A

IC is also known as painful bladder syndrome.

 

REF:   P. 542

 

  1. What is a commonly used scale for assessment of the pelvic floor in order to determine an appropriate exercise prescription?
a. Cambridge scale
b. PELVIC Scale
c. PERFECT Scale
d. POWER Scale

 

 

ANS:  C

The PERFECT Scale is used for assessment of the pelvic floor. PERFECT is an acronym for Power (P), Endurance (E), Repetitions (R), Fast contractions (F), and Every contraction timed (ECT).

 

REF:   P. 543