ATC Clinical Assessment 5 — Questions and Answers
Question 1: A football lineman presents with weakness of shoulder abduction, external rotation, and elbow flexion following a direct blow to the neck. Which structure is MOST likely involved?
- Cervical spinal cord
- Upper brachial plexus (Erb's point) (Correct answer)
- Lower brachial plexus (Klumpke's palsy)
- Axillary nerve only
Correct answer: Upper brachial plexus (Erb's point)
Upper brachial plexus injuries (C5–C6, Erb's point) present with weakness of shoulder abduction/external rotation and elbow flexion, the 'waiter's tip' posture.
Question 2: Which postural deviation is characterized by excessive anterior pelvic tilt, increased lumbar lordosis, and hip flexor tightness?
- Flat back posture
- Sway back posture
- Lower crossed syndrome (Correct answer)
- Kyphosis-lordosis posture
Correct answer: Lower crossed syndrome
Lower crossed syndrome (Janda) involves tight hip flexors and lumbar extensors paired with inhibited deep abdominals and gluteals, resulting in anterior pelvic tilt.
Question 3: An athlete with a suspected femoral neck stress fracture is assessed using the fulcrum test. A positive finding is:
- Lateral hip pain with passive straight-leg raise
- Apprehension or pain when a fulcrum force is applied to the mid-femur (Correct answer)
- Groin pain with resisted hip external rotation
- Pain at the ASIS with palpation
Correct answer: Apprehension or pain when a fulcrum force is applied to the mid-femur
The fulcrum test applies a bending force across the femoral shaft; pain or apprehension localizing to the femoral neck region suggests a stress fracture.
Question 4: Which assessment finding would MOST concern an athletic trainer evaluating an athlete with low back pain, suggesting possible cauda equina syndrome requiring immediate referral?
- Unilateral hamstring tightness
- Bilateral saddle anesthesia and loss of bowel/bladder control (Correct answer)
- Positive straight-leg raise at 60°
- Tenderness over L4-L5 spinous process
Correct answer: Bilateral saddle anesthesia and loss of bowel/bladder control
Cauda equina syndrome is a surgical emergency characterized by bilateral saddle anesthesia and bowel/bladder dysfunction due to compression of the cauda equina nerve roots.
Question 5: During an exertional heat illness evaluation, which finding distinguishes exertional heat stroke from heat exhaustion?
- Profuse sweating
- Core temperature above 40°C (104°F) with CNS dysfunction (Correct answer)
- Muscle cramps and weakness
- Normal mental status with fatigue
Correct answer: Core temperature above 40°C (104°F) with CNS dysfunction
Exertional heat stroke is defined by a rectal temperature >40°C combined with central nervous system dysfunction (confusion, altered consciousness), distinguishing it from heat exhaustion.
Question 6: The Phalen test is used to assess for which condition?
- Thoracic outlet syndrome
- Carpal tunnel syndrome (Correct answer)
- Guyon's canal syndrome
- Triangular fibrocartilage complex tear
Correct answer: Carpal tunnel syndrome
The Phalen test (wrist held in maximum flexion for 60 seconds) increases carpal tunnel pressure and reproduces symptoms (numbness, tingling in median nerve distribution) in carpal tunnel syndrome.
Question 7: A positive Noble compression test is diagnostic for:
- Lateral meniscus tear
- Iliotibial band syndrome (Correct answer)
- Lateral compartment syndrome
- Proximal tibiofibular joint instability
Correct answer: Iliotibial band syndrome
The Noble compression test applies direct pressure over the lateral femoral epicondyle at approximately 30° of knee flexion, reproducing pain in iliotibial band syndrome.
ATC Clinical Assessment 5
A football lineman presents with weakness of shoulder abduction, external rotation, and elbow flexion following a direct blow to the neck.
Which structure is MOST likely involved?