OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for G, Exams of Nursing

Download OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for G and more Exams Nursing in PDF only on Docsity! OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 1 | 65 What is characteristic of a migraine HA? - ✓✓✓PRIMARY HA…. -pulsating/pounding -unilateral in nature -4-72 hrs -nausea is associated -light/noise sensitivity also activity increases HA 4/5 present + LR 24 which significant shifts post-test probability of the dx being present American College of Radiology would recommend what imaging modality for migraines - ✓✓✓CT without IV contrast - for sudden onset, severe HA If you perform a manip to C1-2, where do you expect the cavitation to occur? - ✓✓✓multiple audible pops bilaterally at C1-2 If the Sharp Purser is (+) - why are you still skeptical about instability? - ✓✓✓test is only diagnostic for subjects with RA -specific test for transverse ligament, however it's only been validated in subjects with RA and Down's Syndrome; also it may be dangerous to perform the test after a traumatic MOI ?? Pt is referred to you with mechanical neck pain and they test (+) for flexion rotation test at C1-2, what intervention is best for most immediate relief? - ✓✓✓C1-2 manip and upper thoracic manipulation manip is superior to mobs for short term effects for mechanical neck pain T/F: there is no increased risk to the VBI for chiro vs PCP - ✓✓✓TRUE What are 3 types of people who have an increased risk for upper cervical instability? - ✓✓✓RA Down's hx of Cervical Spine Trauma Is the VBI test validated? - ✓✓✓NO, a neg test doesn't not r/o dissection and can be dangerous within itself OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 2 | 65 What is the most commonly affected CN if a pt has an Internal Carotid Artery Dissection? - ✓✓✓Hypoglossal! CN 12 What is associated with Alar Ligament Instability? - ✓✓✓Neck Tongue Syndrome what a pt rotates their head they may experience numbness along half of their tongue (+) Sharp Purser= transverse ligament compromise in pt's with RA, Downs or post trauma Horners Syndrome = common after internal carotid artery dissection Cervical Flexion Rotation Test = used for CGH identification VBI = 5D's 3 N's hindbrain TIA, Wallenberg When preparing to perform a cervical manip, what's the purpose of the pre-manip hold? - ✓✓✓assess pt's comfort and response to position Pt after MVA with neck pain, she flexes her neck and has increased paresthesia into her hands and feet, what's the next step? - ✓✓✓appropriate answers: cervical collar refer to ER refer for imaging Sharp Purser is not appropriate What spinal segments do NOT have an intervertebral disc? - ✓✓✓between occiput and first cervical vertebrae between the 1st and 2nd cervical vertebrae What ligament prevents the dens of the axis from pressing on the during active cervical flexion and is commonly compromised during trauma? - ✓✓✓Transverse - prevents anterior movement of C1 on C2 Where are the joints of Luschka located? - ✓✓✓c-spine C3-7 and these jts are commonly assoc with degenerative spine conditions and cervical radiculopathy What part of the cervical intervertebral discs is the weakest? - ✓✓✓posterior; the annulus fibrosis is thick anteriorly but thin and weak posteriorly OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 5 | 65 pt has R lateral cervical foramen narrowing at C5-6 resulting from radiculopathy, upon observing their posture at IE, what is the most likely position of the pt's head to avoid reproduction of their radiculopathy? - ✓✓✓head rotated and SB to the left and slightly flexed = max opening of the right lateral foramen Pt presents with pain btw their shoulder blades and n/t of L hand in stocking glove pattern, what is the most likely dx? - ✓✓✓T4 Syndrome will have sx in thoracic region with paresthesias of the hands in a stocking glove pattern. the pattern of paresthesias can mimic sx of DM or radic. Which muscles are innervated by the AIN? - ✓✓✓Radial half of FDP FPL Pronator Quadratus NOT Pronator Teres (median nerve) When r/o a sinister pathology, a PT should use a test that is highly sensitivity to decrease the ... - ✓✓✓likelihood of a false negative. very Sn tests identify most pts with a condition whereas very sp tests help to r/o those without a condition. Those with myelopathy present how? - ✓✓✓multiple dermatomes affected vs radic d/t stenosis may have dermatomal loss with specific nerve root(s) >45 y/o weakness in legs gait disturbances Pt has thoracic spine pain, she has long term hx of corticosteroid use. What else would increase suspicion of compression fx? - ✓✓✓age >50 this and corticosteroid use significant increase your suspicion of compression fx What are high RF for Canadian Cspine rules? - ✓✓✓age > 65 hx of paresthesias in extremities fall from height of 6 ft What are pathologies associated with predisposed cervical instability or ligamentous instability? - ✓✓✓Marfan Morquio - bone dysplasia associated with C1-2 subluxation OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 6 | 65 RA Down's EDS? What's another name for the Waiting Room Sign? - ✓✓✓Bakody Sign = cerivcal radic Describe the difference in suprascapular notch and spinoglenoid notch with nerve entrapment? - ✓✓✓when the suprascapular nerve is entrapped at the suprascapular notch you would expect atrophy of both the supraspinatus and infraspinatus only atrophy of the infraspinatus, the suprascapular nerve is entraped at the spinoglenoid notch What should you be thinking with fatty infiltration of teres minor, sx with shoulder ABD and ER (weakness) and posterior shoulder pain. - ✓✓✓Quadrilateral Space Syndrome -fatty infiltration teres minor and compression of axillary nerve -can mimic radic and cause pain in the quadrilateral space on the posterior shoulder. Which nerve root would cause sx to the dorsal and lateral neck down to the anterior portion of the clavicle, the trapezius and the AC joint? - ✓✓✓C3-4 C4 nerve root is between C3-4, in c-spine the roots exit above until C8-T1 roots then they exit below What is the best tx option for CHG? - ✓✓✓grade 3-4 mobs and DNF strengthening Which is the best tx option for decreasing the frequency of CHG based on current evidence? - ✓✓✓manipulation How would you describe Arnold Chiari malformation? - ✓✓✓Displacement of the cerebellar and brain stem tissue into the foramen magnum; we typically see Type 1 What are the nerves/artery in the Quadrilateral Space? - ✓✓✓Axillary N Posterior Circumflex Humeral Artery Boarders of the Quadrilateral Space? - ✓✓✓Superiorly: Teres Minor Inferior: Teres Major Medial: long head of triceps Lateral: humeral shaft Which cervical nerve roots innervates the teres minor and deltoid? - ✓✓✓C5 & 6 OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 7 | 65 Parsonage-Turner syndrome - ✓✓✓common occurs in 5th decade of life. it's also known as acute brachial neuritis. Cervical radiculopathy usually has insidious onset. associated with recent illness or vaccinations. for this pathology, nerve conduction velocities will be normal. trademark sx are severe pain at onset which resolves, but muscle weakness as it progresses Neurogenic muscle edema corresponding to a particular nerve. Suprascapular nerve: Supraspinatus, Infraspinatus. Axillary nerve: Teres minor, Deltoid. Acute pain followed by weakness. Associations: Vaccinations, Viral illness, General anesthesia. Wartenberg sign is associated with what nerve? - ✓✓✓Ulnar sx include weakness of palmar interosseous muscle leading to ABD of 5th digit FOOSH - fx of middle third of humerus, what nerve is most likely to be compromised? - ✓✓✓RADIAL fx of 1/3 of the humerus commonly results in radial nerve injury. the radial nerve runs posterior to the humerus and is most commonly injured in fx to this part of humerus TMJ - when are posterior disc displacements common? - ✓✓✓after dental procedures where the pt has to keep their mouth open for extended amt of time. with posterior disc displacement the pt may not be able to close their mouth What nerve is entrapped at the arade of Frohse? - ✓✓✓PIN, branch of Radial Nerve - this will NOT reproduce n/t or paresthesia What is the best tx for a 4 mos old pt with congenital torticollis when the R orbit of the pt appears to be lower in the position than the L. - ✓✓✓stretching of the Right SCM during your eval of a pt with hand weakness, you note a positive Froment's sign. What is true of Froment's sign? - ✓✓✓weakness of the adductor pollicis, flexor pollicis brevis and first dorsal interosseous suggestive of the ulnar neuropathy or entrapment 37 y/o male presents to PT with flu like symptoms, malaise, decreased active lumbar SB and limited chest expansion. What is the likely dx? - ✓✓✓Ankylosing Spondylitis What level doesn't have a SP? - ✓✓✓C1 OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 10 | 65 What are 3 things associated with Ankylosing Spond? - ✓✓✓elevated C-reactive protein HLA B27 gene expression Crohn's What is the peak incidence of thoracic disc herniations? - ✓✓✓30-50 y/o for thoracic equal both genders Manual Therapy immediate changes - what structure is really in effect (brain) - ✓✓✓periaqueductal gray - produces analgesia through the descending pathway If a pt experienced a change in skin temperature and skin conductance after a spinal manip, which system causes this response? - ✓✓✓Sympathetic NS - division of the autonomic NS. a change in skin conductance and temp after mobilization is d/t stimulation of the dorsal peri-aqueductal matter of the mid brain Scheurmann's Disease? - ✓✓✓kyphosis in adolescents; occurs primarily in the upper back AKA: calve disease or juvenile osteochondrosis of spine Perform the Cervical rotation-lateral flexion test to detect elevated 1st rib - what is considered (+)? (R) Sided N/T - ✓✓✓when a pt has an elevated 1st rib, you would expect a decrease in ROM when the pt is passively rotated to the left and laterally flexed to the right dec in contralateral rotation dec in ipsilateral SB Klippel-Feil Syndrome - ✓✓✓Sprengel deformity (hypoplastic, elevated scapula). Omovertebral bone. Fused cervical vertebrae. Hemivertebrae. Kyphoscoliosis. Rib anomalies. will present with appearance of having no neck 2/2 congenital fusion of 2 or more cervical vertebrae. they may have lower hairline T/F: Scheurmann's disease is characterized by a thoracic kyphosis >than 40deg and anterior wedging of at least 3 sequential vertebrae by at least 5 degrees of XR. - ✓✓✓TRUE Thoracic Manip for Neck pain - what grade of evidence? - ✓✓✓C cervical mobs/manip = A OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 11 | 65 Stretching = C coordination, strength, endurance = A centralization = C upper quarter and nerve mobs = B traction = B pt education = A Lhermitte's Sign - ✓✓✓Patient is long sitting on table. Passively flex patient's head and one hip while keeping knee in extension. Repeat this step with other hip (+) TEST: pain down the spine and into the UE or LE "barber sign" can be indicative of cervical myelopathy and other neuro pathologies Kernig's Sign - ✓✓✓suggestive of meningitis, sig limitation when straightening the knee when the hip is flexed to 90deg What does the dorsal scapular nerve innervate? - ✓✓✓Rhomboids & Levator Scapulae From medial to lateral, starting at the Thoracic Vert, what is the order of muscles? - ✓✓✓spinalis, longissimus, iliocostalis What nerve innervates both the teres major & Subscapularis? - ✓✓✓Lower Subscapularis does BOTH the upper nerve innervates only the subscapularis There are 12 thoracic vertebrae _____ true ribs and _____ false ribs - ✓✓✓7 true, 5 false Ribs 1-7 are true ribs and attach directly to sternum Ribs 8-12 are considered false b/c they do not directly connect to sternum Pregnant pt developed sx of hypotension after laying supine for 2 mins. What structure is being compressed? - ✓✓✓Inferior Vena Cava You suspect a pneumothorax of the right lung b/c of trachial deviation - which direction is the trachea shift? - ✓✓✓away from the right lung pneumothorax = trachea AWAY acute shoulder pain at the tip of the left shoulder, pt is 30 y/o M and denies any MOI yet shoulder pain is excruciating. What's the dx? - ✓✓✓ruptured spleen - Kehr's Sign The inferior vena cave enters the diaphragm at the ____ thoracic vert. The esophagus enters the diaphragm at the ___ thoracic vert. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 12 | 65 The aorta enters the diaphragm at the ____ thoracic vert. - ✓✓✓8th 10th 12th When elevating arm >120deg what muscles primarily facilitate upward rotation - ✓✓✓Lower Trap & Serratus Anterior Trunk stabilizer endurance hold times are commonly used for establishing benchmarks. Which has the best sn, sp and predictive value of LBP? - ✓✓✓Prone double SLR test T/F: Is afib common in long distance runners? - ✓✓✓TRUE - very common What nerve innervates the diaphragm? - ✓✓✓Phrenic nerve (C3, C4, C5) while assessing the static position of the scapula you measure the distance between T4 and the medial boarder of the scapula. You notice that the distance from T4 to the right medial border of the scapula is greater than the left side. What would be the reason? - ✓✓✓Right Long Thoracic Nerve Injury; right scapula winging, you would expect the distance from T4 to the right medial border to be greater than the contralateral side in the presence of unilateral winging. What dermatomes are associated with the nipples and umbilicus? - ✓✓✓T4 and T10 What TOS test should be utilized to confirm compression of the brachial plexus by scalenes? - ✓✓✓Adson's Test; while assessing radial pulse the PT has pt turn head towards the affected arm, then extends and ER arm, inhale and hold breath 10". any reduction in pulse is (+) the costoclavicular test is almost the same but with the head straight ahead (+) test indicates TOS 2/2 compression at the costoclavicular region Wright Test: TOS but does not confirm compression of brachial plexus by scalenes What orientation are the facet joints of the 6th thoracic vertebrae? - ✓✓✓Frontal Plane the facets of the mid thoracic spine are oriented in the frontal plane the upper and lower thoracic facet joints may be oriented in conjunction with the cervical and lumbar facet joints OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 15 | 65 immediate referral to neurosurgeon for laminectomy & discectomy What are the most common levels for disc herniation? - ✓✓✓L4-5 and L5-S1; 95% at these two levels Which nerve innervates the adductor longus and gracilis, and provides sensation to the medial thigh? - ✓✓✓anterior branch of obturator nerve the posterior branch innervates the externus and ADD magnus and has no sensory innervation What are s/s are Meralgia Paresthetica? - ✓✓✓entrapment of the lateral femoral cutaneous nerve, (only sensory) anteriolateral thigh numbness 55 y/o M has a sudden sharp onset of LBP that comes and goes. it radiates to his right testicle, he doesn't have a fever. Whats the most likely dx/ - ✓✓✓Kidney stones What's a Later Sign? - ✓✓✓gross limitations in SB - can be associated with ankylosing spond. 6 y/o M is referred to PT for hip pain and strengthening. he has been limping for 2 weeks. Based on this, what is likely dx? - ✓✓✓LCPD 4-10 yrs loss of circulation of the femoral head leading to necrosis of proximal femoral epiphysis. Transient synovitis is a common cause of acute hip pain but resolves within a week. septic arthritis - ✓✓✓7 y/o M - can present like transient synovitis but can have more significant consequences if not caught early. pt's s/s don't resolve within a week, elevated WBC >12000, ESR >39 it could be septic arthritis Gilmore Groin? - ✓✓✓tear in the External Oblique aponeurosis and conjoint tendon - type of athletic pubalgia if a pt has characteristics that make you suspect femoral neck fx (amenorrhea, young female athlete, insidous) what test should you think about using? - ✓✓✓Patella-Pubic- Percussion Test -better sn than fulcrum test What does the Inferior gluteal nerve supply? - ✓✓✓gluteus maximus OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 16 | 65 SCFE has what kind of ROM? - ✓✓✓increased hip ER limited hip IR, ABD and Flexion What nerve innervates the facet joint? - ✓✓✓Medial branch of dorsal rami What is the most specific diagnostic test for ruling in cauda equina syndrome? - ✓✓✓Urinary Retention + LR 18 Sp 0.95 Sn 0.9 Research done on lumbar manipulation consisted of what age groups? - ✓✓✓18-60 In a pt with absolute lumbar stenosis, due to degenerative changes, what would you expect the anterior posterior diameter of the SC on myelography to be? - ✓✓✓8 mm <10 mm = absolute stenosis A-P McKenzie: Postural Syndrome - ✓✓✓pt is young with concordant pain reproduced with sustained postures that is not changed with repeated movements. T/F: if the pt doesn't centralize or peripheralize with repeated motion testing of the lumbar spine, the diagnostic utility of the SIJ dysfunction cluster improves? - ✓✓✓TRUE ____% chance of RTW if LBP hasn't resolved in 6 months? - ✓✓✓40% if out a full year = decrease to 20% if she's out 2 yrs = 0% What is the capsular pattern for the hip? - ✓✓✓Hip IR < Hip ABD < Hip Flexion Sign of the Buttock - ✓✓✓pt has painful and limited passive SLR and when hip flexion and knee flexion occur, they continue to present with painful and limited ROM. indicated of serious pathology - osteomyelitis - neoplasm - sacral fx What is the best test to r/o facet arthropathy? - ✓✓✓extension rotation test is highly sn What test can accurately identify who has radiographic lumbar instability? - ✓✓✓Passive Lumbar Extension Test OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 17 | 65 Which nerves are most likely to be affected in a pt who has been dx'd with cauda equina? - ✓✓✓S1-4 it more commonly affects the sacral plexus, this explains why most subjects develop deficits in peri-anal area What is the most Sn SIJ test? - ✓✓✓Thigh Thrust increased tension in the lats and/or glute max can cause slackening of what ligament? - ✓✓✓Long Posterior Sacroiliac Ligament _____: sacrum rotates posterior as ilium rotates anterior ____: sacrum rotates anterior as ilium rotates posterior - ✓✓✓Counternutation Nutation What type of collagen is the lumbar disc made of? - ✓✓✓Type 2 which functions to resist compressive forces Type 1 is very common and found usually in scar tissue Type 3 is not as common as 1 but usually found in conjunction with 1 in muscles and other visceral matrixes Type 4 is not found in the nuclear matrix What are the primary stabilizers of the spine that do not cause global movement? - ✓✓✓TA and Multifidus What muscles dynamically resist excessive anterior translation of the GHJ? - ✓✓✓infraspinatus & teres minor You note that the patient also demonstrates winging of the medial border of the right scapula. This is most apparent when bearing weight through the right upper extremity but is also noticeable with shoulder forward flexion and flexion in the scapular plane. Which of the following exercises would best address this form of scapular dyskinesia? - ✓✓✓Push-up position with end range scapular protraction, elevated as necessary to perform the exercise pain-free. Correct: This exercise (often called 'push-ups with a plus') strongly fires the serratus anterior, which is the primary muscle that prevents winging. The closed chain exercise also encourages co-contraction of the rotator cuff musculature. Injury to what nerve is most closely associated with medial scapular winging? - ✓✓✓Long Thoracic nerve OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 20 | 65 Correct: The glenohumeral joint does not comply with strict concave-convex rules due to capsular constraint. The humeral head needs to have enough capsular mobility available to posteriorly translate on the glenoid during external rotation. This concept was supported in a recent RCT, which found greater improvements in ER with posterior gleno-humeral glides. Following anterior stabilization procedure for the shoulder, ___________ are typically delayed for to allow biologic healing of the repaired soft tissue. - ✓✓✓Combined abduction and external rotation PROM Correct! These combined motions mimic those which often precede anterior dislocation of the shoulder. Which of the following surgical procedures involves overlapping and shortening of the subscapularis muscle? - ✓✓✓Putti-Platt Correct: This procedure divides the subscapularis tendon, overlaps it, and repositions it to achieve anterior capsular stability. This is not performed in throwers due to the risk for range of motion loss. Accessory motion at the sterno-clavicular joint during arm elevation includes _________. - ✓✓✓Inferior glide of the clavicle Correct: During arm elevation, the clavicle slides inferiorly and rolls posteriorly on the sternum. The primary restraint to inferior translation of the humerus at 90 degrees of gleno- humeral abduction is the ______________. - ✓✓✓Inferior glenohumeral ligament Correct: The Inferior glenohumeral ligament is the primary restraint when abducted. When the arm is at zero degrees of elevation, the superior glenohumeral, and coracohumeral ligaments are the primary restraints to inferior humeral translation. The capsular pattern for the glenohumeral joint is _____________. - ✓✓✓External rotation, abduction, internal rotation Correct: This is the capsular pattern of the shoulder as described by Cyriax. A patient presents in a physical therapy clinic with shoulder pain following a motor vehicle collision. The physical therapist observes a painful arc during arm elevation from 120 to 160 degrees of flexion, indicating _________________. - ✓✓✓Acromio-clavicular joint dysfunction OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 21 | 65 Correct: The key finding in this information is the presence of a painful arc from 120-160 degrees of shoulder flexion, which is indicative of an AC joint problem. The best position to strengthen the supraspinatus for a patient with sub-acromial impingement syndrome is _____________. - ✓✓✓The "full-can" position Correct: According an EMG analysis by Reinold et al., the standing "full-can" exercise produced successful activation of the supraspinatus while minimizing the contribution from the deltoid, thus, this is the best exercise to target the supraspinatus. See PMCID: PMC2140071 for the paper. A physical therapist is testing to rule out inferior shoulder laxity. The therapist performed a load and shift test and obtained a negative result. Given the negative likelihood ratio of 0.92 reported for the load and shift test in this patient population, the therapist should ________. - ✓✓✓Perform a hyper-abduction test Correct: This test has a -LR of 0.16, which will be more helpful in allowing the examiner to rule out this condition. A 63-year-old patient is being evaluated by a physical therapist in a direct access setting for right shoulder pain. The patient complains of pain in the shoulder while dressing and washing her hair. No specific mechanism of injury was apparent. The patient reports to the therapist that she feels as if the shoulder has been continually losing motion, and that the pain is often sharp. Additionally, the patient describes pain radiating into the right arm and hand, often occurring at night. Comorbidities include obesity, HTN, and Type II Diabetes Mellitus and is a breast cancer survivor x 10 years. Question: The physical therapist has developed a pre-test probability for this patient's likely diagnosis which would NOT include_______________. - ✓✓✓AMBRI would include: Systemic pathology Shoulder impingement Adhesive Cap A 63-year-old patient is being evaluated by a physical therapist in a direct access setting for right shoulder pain. The patient complains of pain in the shoulder while dressing and washing her hair. No specific mechanism of injury was apparent. The patient reports to the therapist that she feels as if the shoulder has been continually losing motion, and that the pain is often sharp. Additionally, the patient describes pain OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 22 | 65 radiating into the right arm and hand, often occurring at night. Comorbidities include obesity, HTN, and Type II Diabetes Mellitus and is a breast cancer survivor x 10 years. Question: Which of the following factors are potential red flags? - ✓✓✓Night pain Correct: Night pain is a potential red flag for neck and shoulder dysfunction. Also consider other red flags: constant and severe pain, especially at night unexplained weight loss, loss of appetite, unusual fatigue (malaise), fever, chills or night sweats, unexplained nausea or vomiting, shortness of breath frequent or severe headaches, dizziness, arm pain lasting >2-3 months, bowel or bladder dysfunction Secondary Shoulder Impingement - ✓✓✓Secondary shoulder impingement describes a relative impingement occurring in the presence of rotator cuff weakness or instability of the capsule. This patient is a good fit for this condition. caused by dynamic instability, translation of humerus decreases subacromial space, injury occurs in late cocking/early acceleration phases of throwing; s/s: weak rotator cuff and scapular stabilizers What does the lateral scapular slide test indicate? - ✓✓✓"The Lateral Scapular Slide Test (LSST) is used to determine scapular position with the arm abducted 0, 45, and 90 degrees in the coronal plane. Assessment of scapular position is based on the derived difference measurement of bilateral scapular distances." Patients with suspected scapular weakness have increased measurement values on the involved side. In a case that is likely looking like secondary shoulder impingement, why might they test (+) for Speed's test? - ✓✓✓Upward migration of the humerus due to instability during arm flexion Correct: This is a mechanism for causing irritation to the biceps tendon in type two shoulder impingement A 16 year old who is the starting pitcher for his high school baseball team is referred for medial elbow pain that began during the beginning of the season during practices and is now limiting the number of throws he can make at each baseball game. He reports occasional paresthesia to the fourth and fifth digits of his throwing hand while throwing. He reports that he has been pitching for 7 years, and that he played year round baseball until starting high school. The elbow is not painful at rest (begins hurting after approximately 10 full speed throws). He has not had imaging performed. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 25 | 65 but experienced lingering weakness and paresthesia in the forearm and hand. The patient is right-handed and is employed as an electrician. The physical therapist suspects a peripheral nerve injury. Question: The anomalous structure that can be responsible for entrapment of the median nerve proximal to the elbow in some individuals is : - ✓✓✓The Ligament of Struthers Correct. This ligament, which occurs in less than 3% of the population, can be a site of Median nerve entrapment above the elbow. A patient was injured in a automobile collision and suffered a circumferential laceration of the right forearm just below the elbow. The patient was treated with primary intention, but experienced lingering weakness and paresthesia in the forearm and hand. The patient is right-handed and is employed as an electrician. The physical therapist suspects a peripheral nerve injury. Question: According to the International Classification of Health, Disability, and Function's definition of participation restriction, the physical therapist should perform which of the following interventions to address this limitation? - ✓✓✓A peg board activity to simulate a work task Correct: This address the fact that this patient's employment participation (an electrician) may be limited in a functional manner. A high-school aged athlete fell on an outstretched arm and immediately complained of elbow pain. The physical therapist is reviewing the Emergency Department notes and notes the presence of a fat-pad sign. The patient was managed with immobilization to protect the injured tissues. The patient now presents in a physical therapy clinic with reduced elbow range of motion, mild pain, and weakness. Question: A fat pad sign at the elbow describes __________. - ✓✓✓A radiographic finding indicative of intra-articular fracture Correct. A 7th grade aged athlete fell on an outstretched arm and immediately complained of elbow pain. The physical therapist is reviewing the Emergency Department notes and notes the presence of a fat-pad sign. The patient was managed with immobilization to protect the injured tissues. The patient now presents in a physical therapy clinic with reduced elbow range of motion, mild pain, and weakness. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 26 | 65 Question: The tissue most-likely to have needed protection through immobilization was_________. - ✓✓✓Trochlea Correct: This is an intra-articular structure that would result in a positive fat-pad sign, and require immobilization. Supracondylar fractures are the most common fracture in children. FYI in adults the most common fracture is a radial head fracture. During examination, the patient reports tenderness on the most lateral structure in the cubital fossa. Which describes the correct order of structures in the cubital fossa from lateral to medial? - ✓✓✓Biceps tendon, brachial artery, median nerve A 5-year-old child fell off his bike and complains of pain in the elbow, which is held in a guarded position. Plain film radiographs demonstrate posterior displacement of the distal aspect of the humerus. The most likey diagnosis is? - ✓✓✓Extension-type supracondylar humeral fracture Correct: This is the most common form of pediatric elbow fracture, accounting for 95% of all supracondylar fractures, and typically occur following a fall on an outstretched hand. What structures pass through the carpal tunnel? - ✓✓✓Tendons of... 1)Flexor Digitorum Profundus 2)Flexor Digitorum Superficialis 3)Flexor Pollicis Longus *) Also the Median Nerve the FCR does NOT Which of the following accurately describes the Bunnell-Littler test? - ✓✓✓Intrinsic muscle tightness of the hand is indicated if PIP passive flexion range of motion is greater with the MCP flexed than with the MCP extended. Correct: Note that in this question you could also answer it by picking the answer that is not false - without knowing what the Bunnell-Littler test is. This test assesses intrinsic muscle length. In general, what is the best (or 'safe') position for splinting of the hand after injury for prevention of ligamentous and muscular shortening? - ✓✓✓Wrist extended, MCP partially flexed, IP joint extended, thumb palmarly abducted. Correct: this position should help prevent ligamentous shortening and intrinsic tightness. The MCP joints are placed in some degree of flexion because the collateral ligaments OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 27 | 65 are not shortened in this position. The combination of wrist extension and IP joint extension is important to prevent the extrinsic flexors from becoming tight. The sensitivity for the prediction rule was 0.79. The prevalence of fractures in this sample was 50% (24/48). If a follow-up study was performed in which the prevalence of fracture was 75%, the sensitivity would most likely: - ✓✓✓Remain about the same Correct: Sensitivity is a measure of the proportion of a population with a condition that tests positive for it. It is a property of a test, and is not affected by condition prevalence. A 22 y/o male is referred to you for wrist pain. He reports that he fell on his outstretched hand 2 days ago and now has pain with any wrist movement or bearing weight through the involved upper extremity. He reports that he went to the emergency room after his injury, radiographs were taken and he was told they were negative for fracture. Upon examination all wrist motions are painful but he has full active range of motion. Resisted motions are painful but strong. The radial side of the wrist is very tender to palpation, particularly at the hook of the hamate and the anatomical snuff box. Finkelstein's test is particularly painful as is ulnar deviation of the wrist. Question: Which of the following conditions should be of immediate concern? - ✓✓✓Scaphoid Fracture Correct: Scaphoid fractures are characterized by a mechanism of injury of a fall on outstretched hand and tenderness to the anatomical snuff box. Initial radiographs are often negative. This injury is of particular concern because undiagnosed fracture of the scaphoid can lead to avascular necrosis. Bone scan, CT or MRI can be used to confirm diagnosis. You are concerned about the potential for a scaphoid fracture. What would be the most appropriate action to take? - ✓✓✓Immobilize the wrist in a thumb spica splint. Discuss your concerns with the referring physician, recommend further imaging and/or consultation with an orthopedic physician. Correct. Suspected scaphoid fractures should be treated as if a fracture is present until ruled out. A thumb spica cast is most appropriate but most physical therapists will not have access to these. Further imaging would be appropriate as well as consultation with an orthopedic physician. Which of the following fractures have a high incidence of nonunion because of a threatened or tenuous blood supply? - ✓✓✓Scaphoid Talus Odontoid OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 30 | 65 An unexpected complication for patients receiving surgery for degenerative cervical conditions include - ✓✓✓Blurred Vision - this is unexpected and requires immediate work up. dysphagia hoarseness infection are all expected potential complications Compared to other areas of the spine, the cervical spine tends to have MORE problems with which of the following pathologies: - ✓✓✓Degeneration of disc and joints Cervical discs degenerate as part of a normal aging process and relative to the other regions of the spine, the cervical region experiences more degenerative changes. A patient presents with a POSITIVE Adson's test. The physical therapist should conclude which of the following: - ✓✓✓Potential neural entrapment by the scalene muscles Correct! Adson's test is a special test for Thoracic Outlet Syndrome, and a possible cause of this is tight scalenes. When differentiating between C6 nerve root compression and Median nerve entrapment, which of the following will indicate a C6 nerve root compression? - ✓✓✓Decreased biceps tendon reflex Correct: This deep tendon reflex does not receive any contribution from the Median nerve and so is able to differentiate between these two conditions. Your patient is a 60 year old female who has significant osteoporosis with an ACUTE compression fracture of a thoracic vertebral body. Which treatment approach would be the MOST effective for pain control and future problems: - ✓✓✓Education regarding posture, general exercise and extension exercises Correct: This group of interventions is the best answer, with the extension exercises helping to reduce stress on the most common site of compression fracture, the anterior vertebral body. Cervical Myelopathy can be differentiated from Cervical Radiculopathy by the presence of - ✓✓✓(+) Babinski OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 31 | 65 The correct position to provide a stretch to the levator scapulae muscle is: - ✓✓✓Ipsilateral arm abducted, head side-bent away from arm Correct the LS is a downward rotator of the scapula while also sideflexing the cervical spine ipsilaterally When being rear-ended in MVC, what is the likely MOI? - ✓✓✓combined cervical extension and rotation - Most injuries occur with head in a rotated position out of anatomic alignment. In fact, head position is the only accident factor correlated with symptom duration. 48 hrs acute MVC - what is appropriate tx? - ✓✓✓ice, estim bed-rest (conflicting but may be recommended initially) Cervical Collar NSAID are not appropriate While anti-inflammatory medications are indicated for this patient, physical therapist prescription of pharmaceutical medication is beyond the Description of Advanced Specialty Practice, though some physical therapists in federal government settings do have this privilege. What ribs are typical? - ✓✓✓3rd the 1st, 2nd and 10th are atypical Which is true concerning a cervical rib? - ✓✓✓The cervical rib may be asymptomatic in many instances. Correct: The presence of a cervical rib does not correlate to any symptoms in most individuals. Non-acute medical causes of thoracic pain include ________. - ✓✓✓Peptic ulcer disease Correct: Peptic ulcer disease is not an acute presentation. A condition characterized by a defect of the apophysis of a thoracic vertebral body with anterior wedging of the affected vertebrae, and presents clinically with thoracic kyphosis is ____________ - ✓✓✓Scheuermann's Disease Correct: Scheuermann's Disease is often observed with Schmorl's nodes and thoracic pain with extension and presents in adolescents more often. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 32 | 65 Systematic Review - ✓✓✓A systematic review is a literature review focused on a single question that tries to identify, appraise, select and synthesize all high quality research evidence relevant to that question. Typically, systematic reviews are comprised of randomized clinical trials. Along with meta-analysis, it is the highest level of evidence. The type of validity which deals with the degree to which the results of a trial can be generalized to different subjects and settings is _________________. - ✓✓✓External validity Correct. External validity refers to the ability of a measure to predict or relate to outcomes beyond the population of a given trial. A patient's normal group of friends all interact as members of a running club. Not being able to run due to heel pain prevents him from being as socially active as he expects to be. According to the Guide to Physical Therapy Practice and the Nagi model of disability, This is best described as_______________________. - ✓✓✓Disability Correct! "Disability is the inability or restricted ability to perform actions, tasks and activities related to required self-care, home management, work (job/school/play), community and leisure roles in the individuals sociocultural context and physical environment" In plain English - if the patient's functional limitations impact their ability to participate in society this can create disability. Disability is highly individualized - it is based on the interaction of the patient's functional limitations with the patient's (and society's) expectations and needs. If not being able to run caused the patient to be unable to participate in his normal social behavior (exa. his normal group of friends all interact as members of a running club) it could cause 'disability'. If this patient adapted to not being able to run (ie adapts by interacting with his friends in a different setting) not being able to run may not cause this patient disability (ref: Guide) Guide to PT and Nagi Model: Impairment: - ✓✓✓An impairment is defined as "alterations in anatomical, physiological, or psychological structures or functions that both 1)result from underlying changes in the normal state and 2) contribute to illness. Impairments occur at the tissue, organ and system level and are indicated by signs and symptoms." The Guide uses the definition "abnormality of structure or function" also. (ref: Guide to Physical Therapy Practice, Guccione AA. PT, 1991) An example of an impairment in this scenario would be "tight gastroc/soleus complex" or "decreased ability to perform unilateral heel raises due to pain"- this is an impairment rather than a functional limitation because unilateral heel raises are not a functional task. Guide to PT and Nagi Model: Functional Limitation: - ✓✓✓"Functional limitations occur when impairments result in a restriction of the ability to perform a physical action, task, or activity in an efficient, typically expected or competent manner." Because the patient was able to (and would be able to) run if he was not restricted by Achilles tendinopathy (pathology), which is the underlying cause of pain with the required strong contraction of OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 35 | 65 A 65 y/o male is being seen in an acute care setting post-op day #1 after a Total Hip Arthroplasty (THA) surgery. The operative report indicates that a cemented hip with a posterior approach was utilized by the surgeon. When you examine this patient they complain of calf pain on the involved extremity. Upon examination, the calf is swollen and tender. What action should you take? - ✓✓✓Hold physical therapy intervention. Contact the physician as soon as possible. Correct. Calf swelling, erythema, tenderness and pain with ankle dorsiflexion are potential signs of a deep vein thrombosis (DVT). 10-20% of patients post THA develop DVTs. These findings warrant urgent physician attention. The most common type of acetabular labral tear is a . - ✓✓✓Anterior Correct! Anterior and anterior superior tears are the most common type of labral tear due to the higher overall forces experienced by this part of the labrum. The femoral head has the least amount of bony restraint anteriorly. A patient presents with complaints of persistent hip pain and is being examined by a physical therapist. The therapist performs a straight leg raise test to assess for hamstring length and obtains a value of 55 degrees of hip flexion. The therapist then flexes the patient's knee to 90 degrees and continues with hip flexion and obtains a value of 55 degrees of hip flexion again. Both tests reproduce the patient's pain. What is the appropriate next step? - ✓✓✓Refer the patient to a physician for full work-up Correct! This patient exhibits a red-flag (sign-of-the-buttock) and needs to be referred for additional work-up. This red flag may indicate an abscess, or other systemic process. A patient is being examined by a physical therapist for persistent hip pain of gradual onsent. The patient reports the pain is primarily located in the buttock and posterior thigh. No mechanism of injury is reported, and the patient notes difficulty with prolonged sitting. Question: Which diagnosis can be best excluded from the differential diagnosis for this patient based on this information? - ✓✓✓Hip Osteoarthritis Correct: Pain with hip OA is most often experienced in the anterior thigh and groin medially. piriformis syndrome sciatica and HS strain maybe in this scenario A patient is being examined by a physical therapist for persistent hip pain of gradual onset. The patient reports the pain is primarily located in the buttock and posterior thigh. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 36 | 65 No mechanism of injury is reported, and the patient notes difficulty with prolonged sitting. Question: The patient also demonstrates to the therapist pain when crossing the legs while donning running shoes. The therapist then checked hip external rotation strength which was found to be normal. Finally, the therapist moved the leg into full internal rotation and adduction, which increased the pain. This information would make which of the following diagnosis most likely? - ✓✓✓Trochanteris Bursitis Correct! This patient had pain at end range of ER and with hip adduction/IR. All these motions can potentially stress the bursa. A 5-year-old male presents with an antalgic gait. The patient's mother reports that, "He just woke up limping!" Upon observation, the child is reluctant to move the limb and has pain in both the hip and knee. The most likely explanation for these symptoms is . - ✓✓✓Transient Synovitis Correct! This is the most common cause of hip pain in young children, aged 5-8. All of the following are possible contributing sites to coxa saltans except_____ . - ✓✓✓Iliotibial band over the posterior inferior iliac spine Correct! This is not a true anatomical relationship. The point of this question is to highlight the causes of coxa saltans or snapping hip. Potential sites include the Iliopsoas over the femoral head, proximal lesser trochanter, and iliopectineal eminence. A positive ____________ test suggests excessive femoral anteversion. - ✓✓✓Craig's Correct! This test is performed in prone with the greater trochanter positioned horizontal to the floor. The amount of hip internal rotation is measured in this position. Amounts greater than 15 degrees indicate femoral anteversion. A 16 year-old female reports a popping sensation when getting up from a chair. The physical therapist notes tenderness to the femoral triangle and grades iliopsoas strength at a 4/5. The ______ is MOST likely related to her complaints of pain. - ✓✓✓Lesser trochanter Correct! This question challenges your knowledge of the femoral triangle. Since weak hip flexion and the illiopsoas are involved, and a likely place for the illiopsoas to be involved with snapping hip is the lesser trochanter, this is the best answer. The femoral triangle is bounded by: (superiorly) the inguinal ligament, (medially) the medial border of adductor longus,(laterally) the medial border of sartorius. Its floor is formed (med to lat) by adductor longus, pectineus, and illiopsoas. Femoral Triangle - ✓✓✓Superiorly: inguinal ligament Medially: medial border of adductor longus Laterally: medial border of sartorius OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 37 | 65 floor: (med to lat) Add longus, pectineus, iliopsoas A 33 y/o male is referred to your clinic for knee pain that started 2 weeks ago after an initial injury that occurred during a soccer game. He reports a 'step and twist' mechanism of injury. He was able to walk off the field and his knee became swollen over the next couple of hours. With ice and rest he is improving but still having pain when he walks prolonged distances and has been unable to return to sports. He has a mild effusion. His range of motion: full extension but has increased pain with flexion at end range. Resisted motions are mildly painful but strong, knee flexion is more painful than knee extension. Functionally squatting is painful. His knee is tender to palpation, particularly along the joint line and he also has pain with patella compression. Given the above scenario, what is the most likely diagnosis? - ✓✓✓Medial meniscal tear Correct. Key discriminators: 1)Mechanism of injury: step and twist; 2)Effusion that occurs over several hours (as opposed to immediate); 3)Joint line tenderness A 33 y/o male is referred to your clinic for knee pain that started 2 weeks ago after an initial injury that occurred during a soccer game. He reports a 'step and twist' mechanism of injury. He was able to walk off the field and his knee became swollen over the next couple of hours. With ice and rest he is improving but still having pain when he walks prolonged distances and has been unable to return to sports. He has a mild effusion. His range of motion: full extension but has increased pain with flexion at end range. Resisted motions are mildly painful but strong, knee flexion is more painful than knee extension. Functionally squatting is painful. His knee is tender to palpation, particularly along the joint line and he also has pain with patella compression. As part of your examination you want to rule out an ACL tear. Which of the following tests is most appropriate? - ✓✓✓Lachman's Test Correct. Lachman's test is very sensitive for ACL tears and is a good test for ruling out an ACL lesion. What would be the most appropriate imaging modality to visualize the integrity of the ligaments and menisci of the knee? - ✓✓✓Magnetic Resonance Imaging (MRI) Correct. MRI is the most appropriate modality for imaging soft tissue such as ligaments and menisci. Your are requested to provide crutch training for a 15 y/o female who reported to the ER last night with a tibia fracture after a bicycling accident. The fracture was treated with closed reduction and a short leg cast and the patient was prescribed Percocet for pain management. When your arrive at the patient's room she appears distressed and reports 9/10 pain that has been increasing from a baseline of 7/10 when she got to the ER. Her knee range of motion is normal, her ankle is immobilized and she can move her OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 40 | 65 In the presence of knee pain, Altman's criteria also requires one of three other clinical findings to be present to have high confidence (sensitivity 91%, specificity 86%) that knee osteoarthritis is present. Which of the following is not one of these criteria? - ✓✓✓Pain with prolonged sitting > 30 minutes Correct: The purpose of this fairly easy question is to demonstrate that knowledge of a research study or 'named' criteria is rarely required to answer this type of question, but is often used as a distractor. age >50 AM stiffness <30 min Crepitus Which of the following physical therapy interventions has the highest level of evidence supporting its use for knee osteoarthritis? - ✓✓✓Manual therapy and exercise directed to improve impairments for the entire lower extremity and lumbar spine. Correct. Oxford Evidence Grade A (level = 1a studies). See Deyle, et al. Ann Intern Med, 2000. Which of the following best characterizes plyometric exercise? - ✓✓✓Plyometric exercise involves stretch of the muscle-tendon unit immediately followed by shortening. The stretch-shortening cycle enhances the ability of the muscle to produce maximal force in the shortest amount of time. Training in this manner is appropriate to enhance return to sports after injury. Correct. Plyometric exercise is utilized to develop or improve power - the ability to develop force over time. A physical therapist must consider a patient's prior functional level when designing a post-operative program following total joint arthroplasty primarily because ______ - ✓✓✓Patients with low pre-surgical function may have persistently low function post-op. Correct! This question challenges your awareness of current evidence supporting rehabilitation programs following total joint arthroplasty. This body of literature is diverse and often contradictory, but one thread among various sources is the question of timing of the replacement. It seems waiting too long can be a bad thing, as patients with very low pre-operative function do have persistently low function post-operatively. A skier reports experiencing a knee injury when the downhill ski "caught a ridge" and forced the foot to externally rotate and move away from the skier's body while the knee was relatively extended. It is one day following the injury and the knee presents with a grade II effusion, loss of both flexion and extension range of motion, and pain is reported during single limb support in gait. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 41 | 65 Which special test mimics the mechanism of injury and is more likely to produce a positive result? - ✓✓✓Slocum's Test Correct! This test can detect anterior and rotary instabilities, which is reflective of the rotational mechanism of ACL injury incurred by many skiers.In order to perform the test, the patient is supine with knee flexed 90 deg. and hip flexed 45 deg. Therapist rotates foot 30 deg. medially to test anterolateral instability or 15 deg. laterally to test anteromedial instability. Therapist stabilizes leg by sitting on foot. Therapist grasps the prox. tibia with hands and places thumb on tibial plateau and administers an anterior directed force to tibia on femur. Positive test is indicated by movement of tibia occurring primarily on lateral side, may be indicative of anterolateral instability A skier reports experiencing a knee injury when the downhill ski "caught a ridge" and forced the foot to externally rotate and move away from the skier's body while the knee was relatively extended. It is one day following the injury and the knee presents with a grade II effusion, loss of both flexion and extension range of motion, and pain is reported during single limb support in gait.The structure most likely injured is the ____________. - ✓✓✓ACL Correct! This mechanism describes a valgus rotational injury, which is a common mechanism of ACL injury reported in skiers. A skier reports experiencing a knee injury when the downhill ski "caught a ridge" and forced the foot to externally rotate and move away from the skier's body while the knee was relatively extended. It is one day following the injury and the knee presents with a grade II effusion, loss of both flexion and extension range of motion, and pain is reported during single limb support in gait. The portion of the anterior cruciate ligament most often injured when the knee is in extension is the _________. - ✓✓✓Posterior bundle Correct! The posteriolateral bundle of the ACL are most tight in knee extension, the anteriomedial bundle most engaged with knee flexion. A skier reports experiencing a knee injury when the downhill ski "caught a ridge" and forced the foot to externally rotate and move away from the skier's body while the knee was relatively extended. It is one day following the injury and the knee presents with a grade II effusion, loss of both flexion and extension range of motion, and pain is reported during single limb support in gait. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 42 | 65 The special test most likely to detect an injury of the anterior bundle of the anterior cruciate ligament for this individual is the ______________. - ✓✓✓Anterior drawer test Correct! Performing this test at 90 degrees of knee flexion will stress the anteriomedial bundle, which is most taut in this range. The primary component of articular cartilage is: - ✓✓✓Type II collagen You are seeing a patient who is 5 weeks s/p ACL reconstruction with a bone-patellar tendon-bone autograft. Which of the following interventions is inappropriate? - ✓✓✓Open chain leg extensions between 60 and 30 degrees Correct: OKC knee extension has been shown safe between the ranges of 90-70 degrees. Anything greater than 70 degrees will put increased stress through the patella, and can lead to increased anterior shear of the tibia. See Flemming et al. (2005) for a review of OKC vs. CKC exercises after ACL-R. An 26 year old male recently suffered his second non-contact ACL tear on this right LE. His first was reconstructed with an BPTB autograft 4 years ago. The MRI currently reveals a 2x2 cm, grade IV, focal articular cartilage lesion of the medial femoral condyle, a partially torn medial meniscus, as well as a ruptured ACL. The decision was made to perform an arthroscopic meniscus debridement, ACL reconstruction using an allograft, as well as an articular cartilage procedure. Based on this individual's presentation, which articular procedure appears the most appropriate? - ✓✓✓Microfracture Correct: Microfracture has been shown to have excellent long term results. Additionally, The microfracture technique is a reasonable first-line approach to the treatment of full thickness chondral defects. This technique does not burn any bridges with regard to future procedures such as a mosaicplasty or an autologous chondrocyte transplant as a second procedure should the microfracture fail. See Lewis et al. (2006) for articular cartilage basic science and treatment options An 26 year old male recently suffered his second non-contact ACL tear on this right LE. His first was reconstructed with an BPTB autograft 4 years ago. The MRI currently reveals a 2x2 cm, grade IV, focal articular cartilage lesion of the medial femoral condyle, a partially torn medial meniscus, as well as a ruptured ACL. The decision was made to perform an arthroscopic meniscus debridement, ACL reconstruction using an allograft, as well as an articular cartilage procedure. You inform this patient that the new cartilage will not be the same as the native cartilage. Which of the following accurately depicts the relationship between the native OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 45 | 65 tries to walk without crutches. With testing, she has near full passive range of motion with pain at end ranges and a positive anterior drawer and inversion stress test. She is tender over the anterior lateral malleolus and along the ATFL insertion and the base of the fifth metatarsal. She is not tender at the medial malleolus or the navicular. She is neurovascularly intact. Question: Utilizing the Ottawa ankle rules, which of the following is correct? - ✓✓✓This patient needs radiographs. In addition to an AP/lateral and mortise view of the ankle, an AP/lateral and oblique view of the foot should be taken. Correct: Bony tenderness at the base of the fifth metatarsal is sufficient reason to order radiographs. This set of views of the foot are the most appropriate to image a possible Jones fracture (fracture of the base of the fifth metatarsal). Your are the physical therapist for a collegiate women's rugby team. A team member sprained her ankle during practice yesterday. She reports a plantar flexed and inversion mechanism of injury, with immediate effusion. She was able to walk off of the field and is able to bear weight with pain although she has a fairly dramatic antalgic gait if she tries to walk without crutches. With testing, she has near full passive range of motion with pain at end ranges and a positive anterior drawer and inversion stress test. She is tender over the anterior lateral malleolus and along the ATFL insertion and the base of the fifth metatarsal. She is not tender at the medial malleolus or the navicular. She is neurovascularly intact. Question: After radiographs and an evaluation with the team orthopedic physician, the patient was found to have a fracture in Zone 2 of the proximal fifth metatarsal. Which of the following statements is correct regarding the orthopedic management of this injury? - ✓✓✓Acute fractures in zone 2 are at risk of mal or non-union. Most cases will be able to be treated non-surgically with cast immobilization for 6-8 weeks, but early internal fixation may be considered for some patients, such as the athlete in this scenario. Correct. Mismanagement of a fifth metatarsal fracture may result in metatarsalgia with a plantar callus or chronic lateral foot pain. Six months later, this patient is returning to practice for the next season. Rehab was short but effective, with the patient returning home for the summer with a normal, non- painful gait and no feelings of instability. You had given her instructions for a plyometric and running progression to do on her own during the break, which she reports she was only partial compliant with. She reports that she has experienced a persistant anterolateral pain with running, and no pain at rest. When analyzing her running gait OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 46 | 65 you notice that she has a shortened stance phase on the involved side with early heel off. Pain is reported at the end of the stance phase after running for several minutes. She denies any buckling or feelings of instability. Question: Given the minimal information in the above scenario, which of the following mobilization techniques would be the most appropriate? - ✓✓✓Posterior Glide of the Talus Grade IV (Maitland) Correct. A posterior glide of the talus would be appropriate to improve closed chain dorsiflexion (the likely impairment given the patient has pain at end stance). The patient does not have pain at rest so a Grade IV mobilization would most likely be tolerated. Six months later, this patient is returning to practice for the next season. Rehab was short but effective, with the patient returning home for the summer with a normal, non- painful gait and no feelings of instability. You had given her instructions for a plyometric and running progression to do on her own during the break, which she reports she was only partial compliant with. She reports that she has experienced a persistant anterolateral pain with running, and no pain at rest. When analyzing her running gait you notice that she has a shortened stance phase on the involved side with early heel off. Pain is reported at the end of the stance phase after running for several minutes. She denies any buckling or feelings of instability. Question: Given the information above, which of the following is the most likely diagnosis? - ✓✓✓Anterolateral Impingement Syndrome Correct: Anterolateral impingement syndrome is caused by scar tissue impingement in the lateral gutter. This syndrome is common in athletes after an inversion ankle sprain. It is usually absent at rest and increases with activities. These patients do not usually report signs of instability. If physical therapy is not effective steroid injection or arthroscopic debridement may be required. What is the appropriate treatment for a fracture of the 4th phalange with 5 degrees of angulation and that does not involve the joint? - ✓✓✓Tape the 4th phalange to the 3rd phalange, with a gauze pad placed between the toes Correct: Buddy taping the injured toe to the adjacent toe is appropriate, and the more medial toe is the better choice to limit motion. A gauze pad helps prevent maceration of the skin from sweating. Which of the following orthotic features would be the primary corrective component in an orthotic designed to prevent overpronation in a patient with a flexible rearfoot? - ✓✓✓A medial (or varus) rearfoot post OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 47 | 65 Correct. A medial (or varus) post (or wedge) reduces the amount of motion available in the frontal plane and therefore in all planes of motion available at the subtalar joint. The arch plays an important role in capturing the inclination angle of the calcaneous to optimize the effects of the corrective post, but is not the primary corrective component. A 60 y/o male with a long history of diabetes mellitus II is referred to you for a foot care education program. A Semmes-Weinstein microfilament test reveals that on the left foot he can feel the nylon filament with a 12 gram bending force but not the filaments that bend at 11 grams or less. On the right foot he can feel the nylon filament with an 8 gram bending force, but not 7 grams or less. He does not have any signs of ulceration. Question: Which statement best characterizes the results of the Semmes-Weinstein microfilament test? - ✓✓✓This patient has lost protective sensation on his left foot, but still retains protective sensation on his right foot. He is likely to benefit from protective footwear and a foot care education program. Correct. Patients unable to feel a nylon filament with a 10 gram bending force have lost protective sensation and would benefit from protective footwear and a foot care education program. A 60 y/o male with a long history of diabetes mellitus II is referred to you for a foot care education program. A Semmes-Weinstein microfilament test reveals that on the left foot he can feel the nylon filament with a 12 gram bending force but not the filaments that bend at 11 grams or less. On the right foot he can feel the nylon filament with an 8 gram bending force, but not 7 grams or less. He does not have any signs of ulceration. Question: Which orthotic treatment would be most appropriate for this patient if neuropathic ulceration was a concern? - ✓✓✓Full-contact cushioned orthosis in extra-depth shoes Correct. Custom shoes are also available and a rocker bottom sole can be used as needed to unload the forefoot depending upon the area of concern. A 55 y/o female presents with left medial sided foot and ankle pain that has been bothersome for several years and has recently worsened. She reports insidious onset and no recent trauma, although she had multiple ankle sprains when she was younger. She reports a recent diagnosis of diabetes mellitus II and hypertension. She complains that she feels like the ankle 'rolls in' whenever she walks. Upon examination, you note that the patient is morbidly obese and has a mildly antalgic gait with decreased toe off on the left. In stance the left arch appears lower than the right and the left forefoot appears abducted when viewed from behind. When asked to stand on her toes the patient is able to but the left foot does not rotate inward as far as the right does and this maneuver is painful. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 50 | 65 so with a high index of suspicion for a hip fracture urgency is called for and sending the patient to the ER to rule out a hip fracture would be the most appropriate action to take. A right posteriorly rotated illium will cause which of the following? - ✓✓✓The right leg to appear longer in long sitting. Correct: A posterior innominate rotation moves the position of the acetablum more anterior in long sitting, which will cause the leg will appear to lengthen in the long sitting position. This test was described by Cibulka et al. in 2002: "With the patient in the supine position, the lengths of the inferior aspects of both medial malleoli are compared. In the supine position, the finding of a shorter leg when compared with the opposite side is suggestive, but not confirmatory, of a posteriorly rotated innominate. While the clinician holds the medial border of the medial malleoli with the thumbs, the patient is asked to come to a long sitting position. Any apparent lengthening of the short leg implied to us the presence of sacroiliac joint dysfunction and a posteriorly rotated innominate. In the supine and long sitting positions test, the apparent short lower extremity in the supine position suggests the ilium is rotated posteriorly on the sacrum; the apparent lengthening of the same lower extremity during long sitting also suggests the ilium is rotated posteriorly on the sacrum. An observable difference of at least 2.54 cm between the supine and long sitting positions was used to establish a positive result." - ✓✓✓learn this bullshit A physical therapist examining a patient with lower back pain performs a special test and decides to initiate a series of exercises designed to stabilize the lumbo-pelvic spine. A positive result in which test likely precipitated this decision? - ✓✓✓Posterior Pelvis Pain Provocation Test Correct: This test has been described as useful in detecting patients with spinal instability. (Fritz et al, 2007) A crossed straight leg raise test has a specificity of greater than 0.8 for a lumbar disc pathology. Given this information, a positive finding on the crossed straight-leg raise test________. - ✓✓✓Helps to rule in a disc pathology Correct: The high specificity of the crossed straight-leg raise test helps to rule in this condition when positive. A 46-year-old electrician is being examined by a physical therapist for lateral hip and low back pain of 4 weeks duration. The patient reports tingling sensation in the anterior thigh. The physical therapist asks the patient if he wears a tool belt to rule out ______________ as a diagnosis. - ✓✓✓Meralgia paresthetica Correct: Meralgia paresthetica is entrapment of the lateral femoral cutaneous nerve, which has a sensory distribution to the lateral hip and proximal anterior thigh. It is cause OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 51 | 65 most often by compression, with the use of tool belts, or tight pants/belt lines in obese patients. The muscle responsible for trunk flexion with rotation to the left on a fixed pelvis is the ________. - ✓✓✓Left Internal Oblique Correct: The origin of this internal oblique, the middle layer of the abdominal wall, is varied and so the muscle has many different motions available. It is most active during gait at initial contact, but is also present during active sitting and standing postures. When acting bilaterally, it is a trunk flexor, when acting unilaterally, the internal oblique creates ipsilateral rotation over a fixed pelvis. According to Panjabi, the mechanism by which the spine is stabilized does not include the ________. - ✓✓✓Motor subsystem Correct: This is not part of Panjabi's theory of spinal stabilization. He proposed the passive subsystem, made up of bones and ligaments, and the dynamic system, made up of the active muscle stabilization and neural subsystem all combine to stabilize the spine. A factor in favor of using high-velocity thrust manipulation for an individual with low back pain is ________. - ✓✓✓Centralized low back pain Correct: Centralized low back pain is a factor in favor of lumbar manipulation (Flynn et al. 2002; Childs et al., 2004) A physical therapist is examining a patient and decides that a lumbar stabilization program is warranted for an acute onset of low back pain based on_____ - ✓✓✓Gower's Sign Correct: A Gower's sign, or using the hands on the thighs to achieve an upright position from a forward flexed one, is indicative of altered muscular control of the spine and is an indication for a spinal stabilization treatment protocol. Which of the following are risk factors for Diastasis Rectus Abdominus? - ✓✓✓Multiple births Correct: Risk factors for diastasis rectus abdominis include obesity, a narrow pelvis, multipara, 3rd trimester, multiple births, excess uterine fluid, large babies, and weak abdominal muscles prior to pregnancy. Prevention, or gentle abdominal exercises are preferred interventions. Scenario: OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 52 | 65 A 28-year-old male patient presents to physical therapy for evaluation due to insidious onset low back pain. The patient is employed as a web developer for a major software firm. He reports that in addition to low back pain, occasional pain in the thoracic and cervical spine bothers him while at work. The pain is described as intermittent, and he can go up to 10 days without pain at different points in time. The patient reports that his weekly volleyball match reduces his pain temporarily. Examination: The physical therapist noted reduced lumbar lordosis Lumbar ROM is WNL and does not increase pain with repeated motions Special tests are negative Muscle strength in lumbar myotomes are negative. Question: Based on the McKenzie classification system for back pain, which syndrome does this patient's presentation fit? - ✓✓✓Postural Syndrome Correct: Young patients with intermittent symptoms of insidious onset who often have sedentary jobs fall into the postural syndrome category. The McKenzie system classifies derangement syndrome as _________. - ✓✓✓constant pain presentation A 28-year-old male patient presents to physical therapy for evaluation due to insidious onset low back pain. The patient is employed as a web developer for a major software firm. He reports that in addition to low back pain, occasional pain in the thoracic and cervical spine bothers him while at work. The pain is described as intermittent, and he can go up to 10 days without pain at different points in time. The patient reports that his weekly volleyball match reduces his pain temporarily. Examination: The physical therapist noted reduced lumbar lordosis Lumbar ROM is WNL and does not increase pain with repeated motions Special tests are negative Muscle strength in lumbar myotomes are negative. Question: OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 55 | 65 What best describes the + Prone Instability Test? - ✓✓✓The patient lies prone with the body on the examination table and legs over the edge with feet resting on the floor. The test is positive if pain provoked with posterior to anterior pressure to the lumbar spine in the resting position subsides when the pressure is repeated while the patient is lifting the legs off of the floor. Correct: Note also that the test cannot be performed if the provocative posterior to anterior pressure is not painful at 1 or more segments. The PIT is part of a clinical prediction rule developed by Hicks et al. (Phys Med Rehabil 2005). Alone it has a sensitivity of .72 (-LR .48) and specificity of .58 (+LR of 1.7). What does the lateral scapular slide test indicate? - ✓✓✓weakness of the scapular stabilizers A high-school aged athlete fell on an outstretched arm and immediately complained of elbow pain and was subsequently taken to the emergency department. The physical therapist was reviewing the Emergency Department notes and notes the documentation of a positive fat-pad sign. The patient was managed with immobilization for 6 weeks to protect the injured tissues. The patient now presents in a physical therapy clinic with reduced elbow range of motion, mild pain, and weakness. Question: The tissue most-likely to have needed protection through immobilization was_________. - ✓✓✓Trochlea Correct: This is an intra-articular structure that would result in a positive fat-pad sign, and require immobilization. The portion of the anterior cruciate ligament most often injured when the knee is in extension is the _________. - ✓✓✓Posterior bundle Correct: The posteriolateral bundle of the ACL are most tight in knee extension, the anteriomedial bundle most tight in knee flexion. The special test most likely to detect an injury of the anterior bundle of the anterior cruciate ligament is the ______________. - ✓✓✓Anterior Drawer Test Correct: Performing this test at 90 degrees of knee flexion will stress the anteriomedial bundle, which is most taut in this range. The Lachman test is performed in approximately 30 degrees of knee flexion, where both the anteriomedial and posteriolateral bundles are equally stressed. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 56 | 65 The radiologist reported that a Reverse Segond fracture was noted on plain films. This fracture is ________. - ✓✓✓An avulsion fracture of the medial tibial plateau Correct: Segond fractures are associated with excessive varus force and internal rotation applied to the lower leg. 75% with ACL and on the lateral portion of the tibial plateau. Reverse Segond fracture, as its name suggests, is caused by abnormal valgus forces. Which of the following is true concerning fibromyalgia? - ✓✓✓Evidence supports aerobic exercise as beneficial Correct: Systematic reviews support the role of aerobic exercise, and to a lesser extent, strength training as effective interventions for patients with fibromyalgia. The patient is a 14 y/o male who injured his back when he dove into a base one week prior. The pt states his pain is about a 7/10. He denies any radiating symptoms and is point tender over the L4 spinous process. The patient c/o pain when you have him stand on one leg and and the examiner notes that one PSIS moves more than the other during this motion. The patient has not had any imaging taken. The test described is the___________. - ✓✓✓Stork Standing Test Correct. This is the accurate description of the Stork Test, which involves assessment of PSIS symmetry while moving into single limb stance. A physical therapist is interested in determining how many people who test positive for a special test designed to detect SI joint pain actually have the disorder based on the overall population prevalence of SI joint pain. This therapist is interested in ______________. - ✓✓✓Positive Predictive Value Correct. PPV is the proportion of patients with positive test results who are correctly diagnosed. when is it appropriate to use lumbar traction? - ✓✓✓This patient exhibits signs and symptoms of nerve root pathology or disc pathology. The presence of a positive straight-leg raise test, neurological signs and inability to centralize symptom with repeated motions suggest traction may be beneficial to this patient. What's an appropriate intervention for someone w Achilles Tendonosis? - ✓✓✓A therapeutic exercise program focusing on stretching the gastroc/soleus complex and heavy-load eccentric exercise. Correct: Both stretching the gastroc/soleus complex and eccentric exercise are appropriate. Eccentric exercise has a growing body of evidence supporting its efficacy OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 57 | 65 over concentric exercise in Achilles tendinopathy. One theory that may explain why eccentric exercise is more effective is that it is thought to counteract the failed healing response that apparently underlies tendinopathy and facilitates tendon remodeling. At a follow-up appointment the patient was found to have a calcium deposit in the mid- substance of their Achilles tendon, and the patient's physician requested iontophoresis to this area. Which ionic solution would be indicated? - ✓✓✓Acetic Acid Correct: Acetic acid is indicated for calcium deposits (2-5% solution). Acetic acid has a negative polarity. Which of the following mechanisms of injury reported during a football injury is most likely to cause a syndesmotic ankle injury? - ✓✓✓A direct blow to the lateral knee, with the foot remaining planted on the ground in relative external rotation. Correct: This situation would force a widening of the ankle mortise and potentially rupture the ligamentous structures responsible for stabilizing the distal syndesmotic articulation. Which of the following radiographic views would best assess syndesmotic instability in this patient if he tolerates weight bearing through the involved lower extremity? - ✓✓✓Mortise view in unilateral stance Correct: A mortise view taken with the patient positioned in unilateral stance is the most accurate way to assess syndesmotic instability radiographically. It may not be possible in many cases due to pain (ref Lin C, JOSPT 2006) Stress radiography with a lateral view while external rotation force is applied to the foot has been shown to correlate more with actual measurements and, if tolerated, a weight bearing view is the best view. A 17-year-old male football player is referred to a physical therapist for a syndesmotic ankle injury. Question: For the first 2 weeks, which of the following non-surgical treatment approaches would be most appropriate? - ✓✓✓PRICE, immediate non-weight bearing with crutches, a posterior splint with the ankle positioned in ten degrees plantar-flexion. Correct: The early phase of rehab is designed to hasten tissue healing and prevent further injury to the distal tibiofibular syndesmosis and the surrounding tissues. A 45-year-old male complains of a deep burning pain at the plantar aspect of his foot, which increases with walking and started about 2 weeks ago after an extended hiking trip. The pain started after the hike and has worsened until it is now painful with walking. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 60 | 65 The surgeon is concerned about the angulation of this fracture and risk for poor repair given the patients reduced bone mineral density. What motion is likely the most impacted by this fracture? - ✓✓✓Forearm supination and pronation Correct. This motion is primarily determined by the available motion and alignment of the radius and is the best choice for this question. A 74-year-old female fell when she tripped on the curb of her sidewalk. She landed on her outstretched right hand as she reached out to brake her fall. X-rays at the emergency room revealed a distal radial fracture. The fracture was displaced and will require surgical intervention. Question: The physical therapist should place the highest priority on which of the following areas of tightness following a distal radius surgical repair? - ✓✓✓Extrinsic extensor tightness The most common portion of the thoracic vertebrae to experience a compression fracture is _______ - ✓✓✓Vertebral Body Correct: The most common portion of the thoracic vertebral body to be involved in a compression fracture is the anterior 1/3. Thus, radiographic presentation of compression fractures often demonstrates anterior wedging. Based on the current understanding of patellar taping, which of the following is a valid assumption? - ✓✓✓An assessment of the patellar tracking is not critical prior to taping. Correct: Assessing patellar position has low reliability and recent studies do not support taping's ability to alter or maintain positional changes throughout an exercise session, reducing the need for exact patellar positional assessment. In adults males with initial episodes of anterior glenohumeral dislocation, what is the best initial course of action to maximize outcomes? - ✓✓✓At least 1 week of immobilization Correct: Immobilization of the shoulder is recommended to allow healing of the joint capsule prior to restoring strength or mobility. How long and whether in neutral or external rotation is a point of argument although there is some evidence that longer periods (4-6 weeks) are no more likely to result in recurrent dislocation than shorter periods. The acronym to help remember is TUBS. Traumatic, Unidirectional, 'Bankhart lesion, 'Surgical' A 16 y.o. competitive gymnast presents with a complaint of acute central low back pain. Her pain is worsened with the combined movements of extension, ipsilateral rotation, and side bending of her lumbar spine. She denies any LE pain or motor weakness. Her symptoms began following an increase in the intensity of her training 3 weeks ago. Pt reports pain is becoming so intense she is unable to perform a back bend. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 61 | 65 Question: What is the most likely diagnosis? - ✓✓✓Spondylolysis Correct. Acute injury to the pars interarticularis is possible with extreme lumbar extension as often performed in gymnastics. This should be ruled out before other diagnosis such as neuromuscular instability are considered. A 35-year-old woman presents to your physical therapy clinic after surgery for an ORIF of a radial head fracture after falling on an outstretched arm in her yard. She is very uncomfortable with attempts to move her elbow due to the pain and moderate swelling. Shoulder and wrist are clear in terms of ROM and pain. Question: The patient returns for Physical Therapy 5 days post-op. Which positions should be avoided during the initial (protection) phase of rehabilitation? - ✓✓✓Flexion with Pronation A 74-year-old female fell when she tripped on the curb of her sidewalk. She landed on her outstretched right hand as she reached out to brake her fall. X-rays at the emergency room revealed a distal radial fracture. The fracture was displaced and will require surgical intervention. 6 weeks after surgery, the physical therapist wants to utilize manual therapy to improve residual hypomobility of the radiocarpal joint limiting wrist extension. Question: Which of the following would be the most appropriate joint mobilization? - ✓✓✓A Grade IV mobilization of the proximal carpal row in a volar direction, while holding the radius and ulna immobile. Correct: A Grade IV mobilization is appropriate for improving joint mobility, and in order for the wrist to fully extend the proximal carpal row must be able to glide in a volar direction. During a load and shift test, you note that the patient's humeral head is felt to move over the glenoid rim, but returns back to the patient's "normal" upon release. What grade of glenohumeral translation is given to this patient? - ✓✓✓Grade 2 Correct: A grade 2 refers to the ability to shift the humeral head off of the glenoid, but it spontaneously relocates once the pressure is removed. The patient also brings a copy of her plain films with her. The report, as interpreted by the radiologist, notes the presence of a Hill-Sachs lesion. Where on the humeral head would you expect to see this? - ✓✓✓Posterolateral Correct: This is the location of a Hill-Sachs lesion, which is an injury to the bone commonly associated with a anterior glenohumeral dislocation. OCS Exam Questions with 100% Verified Correct Answers Latest Updated 2024 Top Ranked for GradeA+. P a g e 62 | 65 A patient is referred to the clinic complaining of painful clicking when he first begins to open his mouth. He notes these symptoms just began and he is having trouble chewing gum and eating tough foods. What is most likely this patient's diagnosis? - ✓✓✓early stage anterior disc displacement Which choice accurately describes normal lumbar-pelvic rhythm? - ✓✓✓Initial flexion of the lumbar spine following by anterior rotation of the pelvis Correct. This motion exists normally at a 1:1 ration throughout the entire range. A 42 yo female was referred to an outpatient PT clinic by her dentist with complaints of right TMJ pain. Pt complains of a history of "popping" and difficulty chewing steak and bread. Upon examination, mandibular opening is 22 mm. Mandibular deflection towards the right occurs with opening and protrusion. There is also a decrease in lateral excursion toward the left. Pain is decreased by having the client bite down with a cotton roll b/w their right molars. The rest of the examination is unremarkable except the presents with a moderate forward head and rounded shoulder posture. Question: What is the most likely cause of this patient's TMJ Disorder? - ✓✓✓Anterior dislocation of the disc without relocation Correct: Significantly limited mandibular depression <25mm and altered mandibular mechanics are indicative of disc dislocation without relocation. To differentiate b/w a muscle imbalance vs. disc pathology, the patient was asked to bite down on a cotton roll at their molars. This decreased the patient's pain because of the reduced pressure on the disc due to gapping the TMJ. If this test had increased the patient's pain it would point to a muscular or ligamentous cause. Anterior dislocations with relocation are associated with a click with opening and closing of the jaw. The TMJ is innervated by branches of which cranial nerve? - ✓✓✓Trigeminal nerve Correct: The trigeminal nerve's (CN V) mandibular division gives off three nerves that innervate the TMJ: auriculotemporal, deep temporal, and masseteric nerves. A 68 year old female presents to physical therapy 3 weeks s/p radial head fracture and dislocation with ORIF after falling on an outstretched arm. Post-operatively the patient was placed in a soft cast from mid-shaft humerus to hand with elbow in 90 degrees of flexion and neutral supination/pronation. Question: What type of fracture did this patient present to the ER with based on the Mason classification system? - ✓✓✓type IV Type III fractures involve the entire radial head and are comminuted. This is a good guess and this is really a test taking strategy question... you can often figure a question