NPTE-PT Musculoskeletal System Examination 3 — Questions and Answers
Question 1: During gait analysis, a patient demonstrates contralateral pelvic drop during single-leg stance. This indicates weakness of which muscle?
- Contralateral gluteus medius
- Ipsilateral gluteus medius (Correct answer)
- Ipsilateral quadratus lumborum
- Contralateral piriformis
Correct 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.
Question 2: Which ligament is tested by the anterior drawer test at the ankle?
- Calcaneofibular ligament
- Posterior talofibular ligament
- Anterior talofibular ligament (Correct answer)
- Deltoid ligament
Correct answer: Anterior talofibular ligament
The anterior drawer test at the ankle stresses the anterior talofibular ligament (ATFL), the most commonly injured ankle ligament.
Question 3: 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:
- Ulnar nerve entrapment at Guyon's canal
- Carpal tunnel syndrome (Correct answer)
- Cubital tunnel syndrome
- C6 radiculopathy
Correct 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.
Question 4: On joint mobilization grading (Maitland), a Grade III mobilization is BEST described as:
- Small amplitude oscillation at the beginning of range
- Large amplitude oscillation into resistance (Correct answer)
- Small amplitude movement into end-range
- Large amplitude movement up to but not into resistance
Correct 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.
Question 5: Which of the following findings is MOST consistent with a complete rotator cuff tear rather than tendinopathy?
- Painful arc between 60-120 degrees
- Positive Neer sign with pain
- Significant weakness with resisted shoulder abduction (Correct answer)
- Positive Hawkins-Kennedy test
Correct 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.
Question 6: When measuring passive hip external rotation range of motion in supine, the standard goniometric landmark for the stationary arm is aligned with:
- The anterior superior iliac spine
- A vertical line through the patella
- A horizontal line parallel to the treatment table (Correct answer)
- The greater trochanter
Correct 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.
Question 7: 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?
- Peripheral nerve
- Nerve root (radiculopathy)
- Upper motor neuron (spinal cord or brain) (Correct answer)
- Lower motor neuron
Correct 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.
NPTE-PT Musculoskeletal System Examination 3
During gait analysis, a patient demonstrates contralateral pelvic drop during single-leg stance.
This indicates weakness of which muscle?