Musculoskeletal System Examination Flashcards

During a manual muscle test, a patient can move through full range of motion against gravity but fatigues with minimal resistance. What MMT grade is this?

Answer: Grade 4-

Grade 4- (Fair+) indicates the patient tolerates minimal resistance through full ROM but cannot sustain it against moderate resistance.

A patient presents with pain at the lateral epicondyle that worsens with resisted wrist extension and passive wrist flexion with elbow extended. Which structure is most likely involved?

Answer: Extensor carpi radialis brevis

The extensor carpi radialis brevis (ECRB) is the most commonly affected tendon in lateral epicondylalgia (tennis elbow).

Which special test assesses the integrity of the posterior cruciate ligament (PCL)?

Answer: Posterior drawer test

The posterior drawer test assesses PCL integrity by applying a posterior-directed force to the proximal tibia with the knee at 90° flexion.

A 55-year-old patient has pain with the FABER test, groin pain, and limited hip internal rotation. The most likely diagnosis is:

Answer: Hip osteoarthritis

Limited internal rotation, groin pain, and positive FABER test are classic signs of hip osteoarthritis due to capsular pattern restriction.

When assessing scoliosis with the Adam's forward bend test, a positive result is indicated by:

Answer: Rib hump or paraspinal prominence on one side

A rib hump or paraspinal prominence during forward bending indicates rotational deformity consistent with structural scoliosis.

The Ober test is used to assess tightness of which structure?

Answer: Iliotibial band and tensor fascia latae

The Ober test assesses the flexibility of the iliotibial band (IT band) and tensor fascia latae by observing hip adduction from a side-lying position.

A patient with a C5-C6 disc herniation would MOST likely present with weakness in which movement?

Answer: Wrist extension and elbow flexion

C5-C6 nerve roots innervate the biceps (elbow flexion) and wrist extensors; a herniation at this level typically impairs these movements.

During gait analysis, a patient demonstrates contralateral pelvic drop during single-leg stance. This indicates weakness of which muscle?

Answer: Ipsilateral gluteus medius

Ipsilateral gluteus medius weakness causes the pelvis to drop on the opposite (contralateral) side during single-leg stance, known as a Trendelenburg gait.

Which ligament is tested by the anterior drawer test at the ankle?

Answer: Anterior talofibular ligament

The anterior drawer test at the ankle stresses the anterior talofibular ligament (ATFL), the most commonly injured ankle ligament.

A patient presents with a positive Phalen's test and Tinel's sign at the wrist. Symptoms include numbness in the thumb, index, and middle fingers. This presentation is consistent with:

Answer: Carpal tunnel syndrome

Carpal tunnel syndrome involves median nerve compression at the wrist, producing sensory symptoms in the thumb, index, middle, and radial half of the ring finger.

On joint mobilization grading (Maitland), a Grade III mobilization is BEST described as:

Answer: Large amplitude oscillation into resistance

Maitland Grade III involves large amplitude oscillations that move into tissue resistance and are used for pain management and increasing mobility.

Which of the following findings is MOST consistent with a complete rotator cuff tear rather than tendinopathy?

Answer: Significant weakness with resisted shoulder abduction

Significant weakness with resisted abduction (supraspinatus) is a hallmark of a full-thickness rotator cuff tear, as the muscle-tendon unit is no longer intact.

When measuring passive hip external rotation range of motion in supine, the standard goniometric landmark for the stationary arm is aligned with:

Answer: A horizontal line parallel to the treatment table

For hip rotation in supine, the stationary arm is perpendicular to the floor (vertical), and the moving arm follows the tibial shaft or patella.

A patient has hyperreflexia, clonus, and a positive Babinski sign in the lower extremities. These findings indicate pathology at which level of the nervous system?

Answer: Upper motor neuron (spinal cord or brain)

Hyperreflexia, clonus, and a positive Babinski sign are upper motor neuron signs indicating a lesion in the spinal cord or higher CNS structures.

The capsular pattern of the glenohumeral joint is restriction in which order of movements?

Answer: External rotation > Abduction > Internal rotation

The glenohumeral capsular pattern as described by Cyriax is greatest restriction in external rotation, followed by abduction, then internal rotation.

A patient demonstrates weakness in toe extension (hallux) and foot drop. Which nerve is most likely injured?

Answer: Common peroneal nerve (deep branch)

The deep peroneal (fibular) nerve innervates the tibialis anterior and extensor hallucis longus; injury causes foot drop and inability to extend the great toe.

During the scapular winging test, medial scapular winging during a wall push-up is caused by weakness of which muscle?

Answer: Serratus anterior

Serratus anterior weakness (long thoracic nerve palsy) causes medial scapular winging during pushing activities as the medial border lifts off the thorax.

Which of the following BEST describes the end-feel of a normal elbow extension?

Answer: Hard (bony)

Normal elbow extension has a hard/bony end-feel due to the olecranon process contacting the olecranon fossa, abruptly stopping motion.

Which test differentiates between lumbar spinal stenosis and vascular claudication?

Answer: Bicycle test (van Gelderen's test)

The bicycle test differentiates neurogenic (spinal stenosis) from vascular claudication: symptoms with upright cycling but relief with forward-flexed cycling suggest neurogenic origin.

A patient with SLAP (superior labrum anterior to posterior) tear would most likely test positive on which examination?

Answer: Speed's test and O'Brien's active compression test

Speed's test (resisted shoulder flexion with elbow extended) and O'Brien's test are commonly positive with SLAP lesions involving the biceps anchor.