PCE Musculoskeletal Physiotherapy and Manual Therapy 1 — Questions and Answers
Question 1: A patient presents with a positive Empty Can (Jobe's) test. Which structure is most likely injured?
- Infraspinatus
- Supraspinatus (Correct answer)
- Subscapularis
- Teres minor
Correct answer: Supraspinatus
The Empty Can test isolates the supraspinatus by placing the shoulder in 90° abduction, 30° horizontal adduction, and internal rotation, making supraspinatus pathology the primary finding.
Question 2: Which special test has the highest specificity for diagnosing an anterior cruciate ligament (ACL) tear?
- Anterior drawer test
- Lachman test
- McMurray's test
- Pivot shift test (Correct answer)
Correct answer: Pivot shift test
The pivot shift test has the highest specificity (~98%) for ACL tears because it reproduces the rotational instability pattern unique to ACL deficiency during weight-bearing.
Question 3: Using the Maitland grading system, which grade is MOST appropriate for treating an acute, highly irritable cervical condition?
- Grade I (Correct answer)
- Grade III
- Grade IV
- Grade V
Correct answer: Grade I
Grade I (small amplitude oscillations at the beginning of range) is appropriate for acute, irritable conditions to provide pain relief without provoking symptoms.
Question 4: Which of the following is an absolute contraindication to cervical spine high-velocity manipulation?
- Degenerative disc disease at C5-C6
- Vertebral artery insufficiency (Correct answer)
- Acute torticollis
- Cervicogenic headache
Correct answer: Vertebral artery insufficiency
Vertebral artery insufficiency is an absolute contraindication to cervical manipulation due to the risk of vertebrobasilar stroke from compromised blood flow.
Question 5: Which muscle is most commonly involved in lateral epicondylitis (tennis elbow)?
- Extensor carpi ulnaris
- Extensor carpi radialis brevis (Correct answer)
- Extensor digitorum communis
- Brachioradialis
Correct answer: Extensor carpi radialis brevis
The extensor carpi radialis brevis (ECRB) is most commonly affected in lateral epicondylitis due to its anatomical position and the high tensile loads it bears during repetitive gripping.
Question 6: Which best describes the coupled motion pattern of the lumbar spine during lateral flexion?
- Ipsilateral rotation in the upper lumbar spine
- Contralateral rotation throughout the lumbar spine (Correct answer)
- No coupled rotation occurs in the lumbar spine
- Ipsilateral rotation throughout the lumbar spine
Correct answer: Contralateral rotation throughout the lumbar spine
In the lumbar spine, lateral flexion is coupled with contralateral rotation — when the spine bends left, the spinous processes rotate to the right.
Question 7: A patient has a positive Finkelstein test. Which diagnosis does this indicate?
- Carpal tunnel syndrome
- De Quervain's tenosynovitis (Correct answer)
- Trigger finger
- Dupuytren's contracture
Correct answer: De Quervain's tenosynovitis
Finkelstein's test (ulnar deviation with thumb tucked in fist) specifically stresses the abductor pollicis longus and extensor pollicis brevis tendons, confirming De Quervain's tenosynovitis when painful.
PCE Musculoskeletal Physiotherapy and Manual Therapy 1
A patient presents with a positive Empty Can (Jobe's) test.
Which structure is most likely injured?