Decode Physiotherapy Through M.C.Q's

51. The greatest amount of weight a muscle can move through the full available range of motion with control at specific number of times before fatiguing is defined as _ _. a. A repetition maximum b. An overload principle c. The volume of exercise d. The frequency resistance

A repetition maximum is the greatest amount of weight (load) a muscle can move through the full available range of motion with control at a specific number of times before fatiguing.

Reference: Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 172.

82. The feedback received during the task, post task related to the quality of performance is ___ _. a. Knowledge of performance b. Knowledge of results c. Augmented feedback d. Extrinsic feedback

Explanation

Knowledge of performance: When intrinsic feedback is sensed during a task or immediate, post-task, augmented feedback (usually verbal) is related to the nature or quality of the performance of a motor task.

Knowledge of results: Immediate, post-task, augmented feedback related to the outcome of a motor task.

Intrinsic Feedback: Sensory cues inherent in the execution of a motor task while performing or attempting to perform the task through proprioceptive, kinesthetic, tactile, visual, or auditory cues.

Augmented (Extrinsic) Feedback: Sensory cues from an external source that are supplemental to intrinsic feedback and that are not inherent in the execution of the task but may arise from a mechanical source or from another person.

Reference: Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 33.

83. In _ _ type of contracture, the musculotendinous structure is shortened but there is no specific pathology in the muscle. a. Myostatic b. Pseudomyostatic c. Arthrogenic and periarticular d. Fibrotic and irreversible

An

.1099. nse are Mechanical goal for initial contact is position of foot, that for loading response are weight acceptance and pelvic stability; and for midstance is knee stability.

Reference: J. Magee. Orthopaedic Physical Assessment, 4th edition. Elsevier; 2005. p. 1105.

41. Which of the following is the most commonly weakened muscle in forward head posture? a. Upper trapezius b. Middle trapezius c. Lower trapezius d. Rhomboid major

Explanation

Upper trapezius is shortened in forward head posture and lower trapezius is weakened.

Image summary: This is an anatomical diagram. The figure illustrates a profile view of a human head and neck, highlighting specific muscle groups and their associated states of tension or weakness. It identifies the deep neck flexors as weak and inhibited, while the pectoralis and sternocleidomastoid muscles are described as tight and facilitated. Conversely, the upper trapezius and levator scapulae are noted as tight and facilitated, whereas the rhomboids, lower trapezius, and serratus anterior are characterized as weak and inhibited. The diagram concludes that there is a muscle imbalance where certain anterior and superior muscles are overactive while the deep neck and posterior shoulder stabilizers are underactive.

Reference: J. Magee. Orthopaedic Physical Assessment, 4th edition. Elsevier; 2005. p. 1139.

42. Which of the following is not a plane?

a. Sagittal b. Vertical c. Transverse d. Frontal

Explanation

Sagittal, frontal, transverse all these are planes except vertical is an axis. Rotation of a body segment around the Y-axis means the vertical axis occurs in the transverse plane. It is also termed the longitudinal axis.

Image summary: This is an anatomical diagram. The figure illustrates the primary planes and axes used to describe human body movement and orientation, featuring a human figure with intersecting planes and dotted lines representing the axes. The diagram demonstrates that the longitudinal, frontal, and sagittal axes are perpendicular to each other, and similarly, the sagittal, frontal, and transverse planes divide the body into distinct sections, providing a comprehensive framework for anatomical referencing.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 8.

Ans.

41. c 42. b 43. Range of hip flexion with knee extension is approximately _ _ a. 0°-60° b. 0°-90° c. 0°-130° d. 0°-180° Hip flexion with knee extension range is less than hip flexion with knee flexion. The normal range of hip flexion with knee extension, that is S.L.R, is from 0° to 85°–90°. Hamstring muscles restrict movement, as hamstrings are two joint muscles causing knee flexion and hip extension.

Explanation

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 368.

Image summary: This figure is a medical illustration. It depicts a human leg positioned to demonstrate a specific joint angle, with a geometric indicator highlighting the degree of flexion between the upper and lower portions of the limb. The illustration shows that the leg is bent at a right angle, indicating a perpendicular relationship between the thigh and the lower leg.

44. _ _ is used to change the angle of pull. a. Vertical suspension b. Pulley c. Axial suspension d. Goniometry Pulley is used to change the direction without changing the magnitude of the applied force, that means, it helps to redirect a force to make a task easier. ide of the ier.

Image summary: This figure is a technical diagram. It illustrates a simple pulley system consisting of a wheel, a rope, a load, and a person applying effort. The diagram shows a person pulling downward on one end of the rope, which passes over a wheel to lift a load upward. This setup demonstrates a basic mechanical advantage where the direction of the applied force is reversed to move an object vertically.

45. Atlanta-occipital joint is an example of _ _ lever. a. First order b. Second order c. Third order d. Fourth order

Atlanto-occipital joint is first order lever. In nodding movement of the head, the skull represents the lever, the atlanto-occipital joint is the fulcrum and the weight is situated anteriorly to the face, and the effort is through the contraction of the posterior neck muscles.

Image summary: This is an anatomical diagram illustrating a mechanical lever system. The figure shows a human skull with labels indicating the positions of resistance, the fulcrum, and the applied force, accompanied by a simplified schematic representation of the lever above the skull. The arrangement demonstrates that the fulcrum is positioned between the resistance and the applied force, indicating that the jaw acts as a second-class lever where the effort is applied to overcome a load.

Reference: Dena Gardiner. The Principles of Exercise Therapy, 4th Revised Coloured Enlarged Edition. C.B.S Publishers & Distributors Pvt. Ltd.; 2023. p. 12.

46. The phenomenon of gradual continuous elongation of the connective tissue after an initial elastic response to a constant tensile load and gradually returning to the original length once load is removed is called _ _. a. Hysteresis b. Creep c. Stress relaxation d. Strain rate sensitivity

If a fixed force is applied to a tissue and maintained, and the deformation produced by this force is measured, the deformation will increase over time. Force remains constant while length changes. For a tendon or ligament, the tissue will gradually elongate under the constant tensile load (creep) and gradually return to its original length when the load is removed (recovery). For cartilage and bone, compressive loading is used, and so the depth of indentation represents creep and recovery.

Ans.

45. a 46. b Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 87, 88.

Image summary: This is a line graph. The figure illustrates the relationship between stress and strain, depicting the stages of material deformation including primary creep, secondary creep, and tertiary creep. It marks critical points such as the elastic limit, necking, and final failure. The graph shows that as strain increases, stress rises through the primary and secondary creep phases until it reaches a peak. Following this peak, the material undergoes necking, leading to a decrease in stress until complete failure occurs.

47. Rotary movement of the bones in space during physiological joint motion is called _ _. a. Osteokinematics b. Arthrokinematics c. Arthrokinetics d. Osteokinetics

Explanation

Osteokinematics refers to the movement of the bones in space during physiologic joint motion. These are the movements in the sagittal, frontal, and transverse planes that occur at joints. The movements are typically described by the plane in which they occur, the axis about which they occur, and the direction of movement. Reference:

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 96.

48. The physiologic posterior convexity at the spine throughout life is known as ___ _. a. Kyphosis b. Lordosis c. Scoliosis d. Hunchback

The thoracic and sacral spinal curves that retain the original posterior convexity throughout life are called primary curves, also known as kyphotis ogical joint physiologic transverse the plane is known posterior kyphotic curves, whereas cervical and lumbar curves that show anterior convexity are called secondary curves also known as lordotic curves. The secondary or lordotic curves develop as a result of the accommodation of the skeleton to the upright posture.

Image summary: This figure is a schematic diagram. It depicts a horizontal line intersecting a vertical dashed line, with an arrow pointing to the intersection labeled as failure. The diagram illustrates a threshold or boundary condition where a process transitions into a state of failure. It can be inferred that once the horizontal progression reaches the vertical limit, the system reaches a critical point of failure.

Reference: Pamela K Levangie, Cynthia Norkin. Joint Structure and Function, A Comprehensive Analysis, 5th edition. p. 143.

Image summary: This figure is an anatomical diagram. It illustrates the normal physiological curves of the human vertebral column from a lateral view, labeling the distinct regions of the spine. The diagram shows that the spine consists of multiple curves, specifically identifying the cervical spine as having lordosis, the thoracic spine as having kyphosis, and the lumbar spine as having lordosis, ending with the sacrum and coccyx. It can be inferred that a healthy human spine is not a straight line but rather a series of alternating curves that provide structural support and flexibility.

49. The arrangement, number, size, and type of muscle fibers may vary from muscle to muscle but each fiber is a single muscle cell that is enclosed in a cell membrane called the _ _. a. Sarcolemma b. Sarcoplasm c. Myofibril d. Myofilament

Explanation

A skeletal muscle is composed of many thousands of muscle fibers. A single muscle contains many fascicles, which are made up of groups of muscle fibers (cells) surrounded by connective tissues. The arrangement, number, size, and type of these fibers may vary from muscle to muscle, but each fiber is a single muscle cell that is enclosed in a cell membrane called the sarcolemma.

Like other cells in the body, the muscle fiber is composed of cytoplasm, which in a muscle is called sarcoplasm. The sarcoplasm contains myofibrils.

Image summary: This figure is an anatomical diagram. It illustrates the internal structure of a muscle fiber, showing a cross-sectional and longitudinal view of various cellular components. Key labeled parts include the sarcolemma, nucleus, mitochondria, and myofibrils, with a detailed inset focusing on the T tubule, terminal cisterna, triad, and sarcoplasmic reticulum. The diagram demonstrates that muscle fibers are composed of numerous bundled myofibrils surrounded by a specialized membrane and supporting organelles. It highlights the complex organization of the sarcoplasmic reticulum and T tubules, which are essential for coordinating muscle contraction.

Image summary: This figure is a textual snippet. It contains a section header for answers followed by a specific question number and its corresponding letter choice. The content indicates that for the identified question, the correct option is the first alphabetical choice.

Ans.

49. a Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 109.

50. In the posterior pelvic tilt, the hip joint goes into which brings the symphysis pubis up and the sacrum of the pelvis closer to the femur, rather than moving the femur posteriorly on the pelvis. a. Flexion b. Extension c. Abduction d. Adduction

Explanation

Anterior and posterior pelvic tilts are motions of the entire pelvic ring in the sagittal plane around a coronal axis. In the normally aligned pelvis, the anterior superior iliac spines A.S.I.S's of the pelvis lie on a horizontal line with the posterior superior iliac spines and on a vertical line with the symphysis pubis.

Anterior and posterior tilting of the pelvis on the fixed femur produce hip flexion and extension, respectively.

Posterior tilting of the pelvis brings the symphysis pubis up and the sacrum of the pelvis closer to the femur, rather than moving the femur posteriorly on the pelvis, moving the hip into extension.

Image summary: This figure consists of two anatomical diagrams. The diagrams illustrate the relationship between pelvic tilt and the curvature of the lumbar spine, showing an anterior pelvic tilt on the left and a posterior pelvic tilt on the right. The left diagram shows that when the pelvis tilts forward, it is associated with hip flexion and forces the lumbar spine into hyper-lordosis. Conversely, the right diagram demonstrates that when the pelvis tilts backward, it is associated with hip extension and pulls the lumbar spine flat. The comparison indicates that the orientation of the pelvis directly influences the curvature of the lower back.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 370.

51. Physiologic valgus at the knee is _ _. a. 0 degrees to 10 degrees b. 10 degrees to 15 degrees c. 15 degrees to 20 degrees d. 20 degrees to 25 degrees

The medial femoral condyle lies slightly distal to the lateral femoral condyle, which results in a physiologic valgus angle in the extended knee also known as pelvis closer ne pelvis. ring in the the anterior the posterior produce hip the sacrum orly on the Q angle. With knee flexion around the obliquely oriented axis, the tibia moves from a position oriented slightly lateral to the femur to a position slightly medial to the femur in full flexion; that is, the foot approaches the midline of the body with knee flexion. Flexion is, therefore, considered to be coupled to a varus motion, while extension is coupled with valgus motion. Also, women have a slightly greater Q-angle compared to men because of the presence of a wider pelvis, increased femoral anteversion, and a relative knee valgus angle.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 431.

Image summary: This is an anatomical diagram. The figure illustrates the measurement of the Q angle in the human lower limb, showing the relationship between the anterior superior iliac spine, the center of the patella, and the tibial tuberosity. The diagram demonstrates that the Q angle is formed by the intersection of lines connecting these anatomical landmarks, while also indicating the presence of a valgus angle at the knee joint. It can be inferred that the Q angle serves as a clinical measure of the alignment of the quadriceps muscle relative to the patellar tendon, and the indicated range suggests a typical anatomical orientation for the limb.

52. _ _ is most commonly called the deltoid ligament. a. L.D.L b. M.C.L c. A.C.L d. P.C.L

Explanation

The M.C.L, also called the deltoid ligament, is fan-shaped. It has superficial and deep fibers that arise from the borders of the tibial malleolus and insert in a continuous line on the navicular bone anteriorly and on the talus and calcaneus distally and posteriorly. The deltoid ligament as a whole is extremely strong. Valgus forces that would open the medial side of the ankle may actually fracture and displace (avulse) the tibial malleolus before the deltoid ligament tears. This ligament helps control medial distraction stresses on the ankle joint and also helps check motion at the extremes of joint range, particularly with calcaneal eversion.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 444.

53. During plantar flexion/dorsiflexion, _ _ occurs within the mortise in the transverse plane around a vertical axis. a. Talar inversion b. Talar eversion c. Talar rotation d. Talar plantar flexion

Ans.

52. b 53. c Talar rotation within the mortise, in both the transverse plane around a vertical axis (talar rotation or talar abduction/adduction) and in the frontal plane around an A-P axis (talar tilt or talar inversion/eversion), must occur to maintain tibiotalar congruence.

Image summary: This figure consists of a series of anatomical diagrams. The diagrams illustrate a bone from multiple perspectives, labeling anatomical directions such as superior, inferior, anterior, posterior, medial, and lateral, while also depicting various ranges of motion including internal and external rotation, eversion, inversion, dorsiflexion, and plantarflexion. The figure demonstrates the complex three-dimensional orientation of the bone and the specific directions of movement associated with the joint it forms.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 447.

54. During plantar flexion/dorsiflexion, _ _ movement occurs within the mortise in the frontal plane around an anterior posterior axis. a. Talar adduction b. Talar abduction c. Talar plantar flexion d. Talar tilt

Talar rotation within the mortise, in both the transverse plane around a vertical axis (talar rotation or talar abduction/adduction) and in the frontal plane around an A-P axis (talar tilt or talar inversion/eversion), must occur to maintain tibiotalar congruence.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 447. and a vertical plane around to maintain Anterior — Medial movement anterior- d a vertical ane around maintain 55. The plantar calcaneonavicular ligament is most commonly referred to as the ___ _ ligament. a. Bifurcate b. Deltoid c. Cervical d. Spring In the ankle joint the inferior aspect of the joint capsule is formed by the plantar calcaneonavicular ligament (spring ligament) that spans the gap between the calcaneus and navicular immediately below the talar head. The capsule is reinforced medially by the deltoid and laterally by the bifurcate ligaments.

Image summary: This is an anatomical diagram. The figure illustrates the medial view of the human foot, specifically highlighting various supporting ligaments and connective tissues including the plantar calcaneonavicular ligament, the short plantar ligament, the long plantar ligament, and the plantar aponeurosis. The diagram demonstrates that these ligaments and the aponeurosis are positioned along the bottom and inner side of the foot, spanning from the heel toward the midfoot and forefoot. It can be inferred that these structures work together to provide structural stability and support for the longitudinal arch of the foot.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 455.

56. In left thoracic rotation _ _ muscles are recruited. a. Left internal intercostal + Right external intercostal b. Right internal intercostal + Left external intercostal c. Left internal intercostal + Left external intercostal d. Right internal intercostal + Right external intercostal

Explanation

The major role of the lateral intercostal muscles is in axial rotation of the thorax, with ipsilateral internal intercostal and contralateral external intercostal muscles working synergistically to produce trunk rotation (e.g., left internal and right external intercostal muscles are active during trunk rotation to the left).

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 203.

57. _ _ muscle supports both longitudinal and transverse arches. a. Tibialis anterior b. F.H.L c. F.D.L d. Peroneus longus

Ans.

The tendon of the peroneus longus muscle passes around the lateral malleolus, under the cuboid bone, and across the transverse arch and inserts into the medial cuneiform bone and base of the first metatarsal.

Because of its path across the arches, the peroneus longus tendon is credited with support of the transverse and lateral longitudinal arches as it causes pronation after heel contact, and stabilizes the forefoot after heel rise.

Image summary: This figure consists of anatomical diagrams. The content illustrates the structural arches of the human foot from a plantar view and provides detailed lateral views of the foot's bony architecture and supporting ligaments. The diagrams identify the medial longitudinal arch, lateral longitudinal arch, and anterior transverse arch, while also highlighting specific bones such as the calcaneum, cuboid, and metatarsals, along with associated tendons and plantar ligaments. It can be inferred that the foot possesses a complex system of arches and connective tissues that work together to provide structural support and stability. The arrangement of the ligaments and tendons suggests a mechanism for maintaining the integrity of these arches during weight-bearing activities.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 474.

58. During inspiration, _ _ in thoracic size and _ _ in intrathoracic pressure occurs. a. increase, decrease b. decrease, increase c. increase, increase d. decrease, decrease The thoracoabdominal movement during quiet inspiration is a result of the pressures that are generated by the contraction of the diaphragm. When the diaphragm contracts and the central tendon descends, there is an increase in thoracic size and a resultant decreased intrapulmonary pressure that is responsible for inspiration. There is also an increase in abdominal pressure, which causes the abdominal contents to be displaced anteriorly and laterally.

When active muscle contraction of the diaphragm ceases, the dome returns to its resting position within the thorax. The thoracic volume decreases, intrapulmonary pressure increases, and exhalation occurs.

Image summary: This figure is a biological diagram. It illustrates the anatomical processes of inspiration and expiration within the human respiratory system, highlighting the movement of the ribs, sternum, and diaphragm. During inspiration, the external intercostal muscles and the diaphragm contract, causing the chest wall and lungs to expand while the ribs and sternum move upward and outward. Conversely, during expiration, the diaphragm and external intercostals relax, leading to the contraction of the chest cavity and lungs, which results in the depression of the ribs and sternum.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 200.

59. An axis through the humeral head and neck in relation to a longitudinal axis through the shaft of the humerus forms an angle of _ _ in the frontal plane. a. b.

Math summary: This computation calculates the difference between two angle measurements. It subtracts a larger degree value from a smaller degree value to determine the numerical interval.

c. 130 degrees minus 150 degrees d. 140 degrees minus 155 degrees As a general rule, the head faces medially, superiorly, and posteriorly with regard to the shaft of the humerus

Image summary: This figure is an anatomical diagram. It illustrates the proximal end of a long bone, specifically highlighting the relationship between the anatomical axis of the shaft and the orientation of the femoral head. The diagram labels the angle of inclination, which is the angle formed between the longitudinal axis of the bone and the axis of the neck. The image demonstrates that the neck of the bone is positioned at an oblique angle relative to the shaft, indicating that the head is offset to allow for a specific range of joint motion and weight distribution.

Ans.

59. C and the humeral condyles. An axis through the humeral head and neck in relation to a longitudinal axis through the shaft of the humerus forms an angle of 130°-150° in the frontal plane. This is commonly known as the angle of inclination of the humerus.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 245.

60. In the transverse plane, the axis through the humeral head and neck in relation to the axis through the humeral condyles forms an angle known as ___ _. a. Angle of inclination b. Angle of rotation c. Angle of torsion d. Both a and c

Explanation

In the transverse plane, the axis through the humeral head and neck in relation to the axis through the humeral condyles forms an angle that varies far more than other parameters but is usually described as approximately 30° posteriorly. This angle is known as the angle of torsion. The normal posterior position of the humeral head with regard to the humeral condyles may be termed posterior torsion, retrotorsion, or retroversion of the humerus. lead and neck in imprehensive ead and neck in an angle known Check in relation varies far more 30° posteriorly, prior position of med posterior

Image summary: This figure is a medical anatomical diagram. It illustrates the concept of femoral torsion by showing the relationship between the axis of the femoral head and neck and the axis of the femoral condyles. The diagram provides a three-dimensional view of the proximal femur and several profile views demonstrating different degrees of torsion. Based on the visual evidence, femoral torsion is categorized into three states: normal, increased, and decreased. An increased angle of torsion is identified as anteversion, while a reduced angle of torsion is identified as retroversion.

61. When acting unilaterally, the _ _ can laterally flex the spine and the attachments of the muscle to the lumbar transverse processes, allow it to control rotational motion as well. a. Quadratus lumborum b. Multifidus c. Erector spinae d. Intertransversarii lumborum

Explanation

The quadratus lumborum serves an important role in stabilization in the horizontal plane as well as frontal plane when acting bilaterally. When acting unilaterally, the quadratus lumborum can laterally flex the spine and the attachments of the muscle to lumbar transverse processes allow it to control rotational motion as well.

Image summary: This is an anatomical diagram. The figure illustrates the musculature of the lower back positioned over the spinal column and the pelvic girdle, with arrows indicating the direction of muscle contraction. The diagram suggests that the muscles exert force both upward and downward along the spine, indicating their role in stabilizing the lower back and facilitating movements of the torso and pelvis.

Image summary: This is an anatomical diagram. The figure illustrates the relationship between the psoas muscle, the lumbar spine, and the pelvis, using arrows to indicate the direction of force and movement. The diagram demonstrates that contraction of the muscle pulls the lumbar spine forward and tilts the pelvis upward, suggesting that muscle tension can lead to spinal misalignment and pelvic instability.

Image summary: This is an anatomical diagram. The figure illustrates the human lower back and pelvic region, specifically highlighting a muscle group located between the spine and the flank, with an arrow indicating a direction of movement or pressure. The diagram suggests a relationship between the highlighted muscular area and the alignment of the lumbar spine and pelvis, implying that tension or force in this region can influence spinal positioning.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 183.

62. Elbow is a _ _ type of joint. a. Pivot b. Saddle c. Modified hinge d. Pure hinge

Elbow joint is formed by the distal end of the humerus articulating with the proximal end of ulna and radius, (humeroulnar and humeroradial). It is a modified hinge variety of joint.

Ans.

61. a 62. c Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 272.

Image summary: This is an anatomical diagram. The figure illustrates the skeletal structure of the human arm, specifically focusing on the elbow joint, with a detailed close-up view identifying various bones and landmarks including the humerus, radius, and ulna. The diagram demonstrates how the distal end of the humerus articulates with the proximal ends of the radius and ulna to form the humeroradial and humeroulnar joints, as well as the proximal radioulnar joint, enabling the movement of the forearm relative to the upper arm.

63. In the wrist joint, that is, radiocarpal joint, ulnar deviation is more than radial deviation. a. True b. False

Explanation

As a whole, the compound proximal radiocarpal joint surface is oblique, angled slightly volarly and ulnarily. The average inclination of the distal radius is 23°. This inclination occurs because the radial length (height) is 12 millimeters greater on the radial side than on the ulnar side. The distal radius is also tilted 11° volarly, with the posterior radius slightly longer than the volar radius.

Joint incongruence and the angulation of the proximal joint surface result in a greater range of flexion than extension and in greater ulnar deviation than radial deviation for the radiocarpal joint. The total range of flexion/extension is greater than the total range of radial/ulnar deviation.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 307.

64. At the elbow, acute angle that forms medially to the long axis, due to lateral deviation of the ulna in relation to the humerus, is called _ _. a. Cubitus varus b. Cubitus valgus c. Genu varum d. Genu valgus

Image summary: This is an anatomical diagram. The figure illustrates the structural relationship between the bones of the forearm and the lower arm, specifically labeling the humerus, radius, and ulna, along with specific landmarks such as the lateral epicondyle, the humeroradial joint, the radial head, and the radial notch. The diagram demonstrates the articulation points where these bones meet, indicating how the radius and ulna align and connect to the humerus to facilitate joint movement.

on is more than oblique, angled al radius is 23°. n greater on the 1° volarly, with surface result in a ion than radial sion is greater ng axis, due us, is called When the upper extremity is in the anatomic position, the long axis of the humerus and the long axis of the forearm form an acute angle medially when they meet at the elbow. The angulation in the frontal plane is caused by the configuration of the articulating surfaces at the humeroulnar joint. The medial aspect of the trochlea extends more distally than does the lateral aspect, which shifts the medial aspect of the ulnar trochlear notch more distally and results in a lateral deviation (or valgus angulation) of the ulna in relation to the humerus.

This normal valgus angulation is called the carrying angle. The average angle in full elbow extension is about 15°. An increase in the carrying angle beyond the average is considered to be abnormal, especially if it occurs unilaterally and it is known as cubitus valgus. A varus angulation at the elbow is referred to as cubitus varus when the carrying angle decreases and is usually abnormal.

Image summary: This figure consists of two anatomical diagrams. The diagrams illustrate the alignment of the human arm, comparing a standard anatomical position to a pathological condition. The first diagram shows a typical arm with a normal carrying angle, while the second diagram depicts a condition labeled as cubitus valgus where the angle between the humerus and the forearm is significantly wider. It can be inferred that cubitus valgus is characterized by an abnormal increase in the lateral deviation of the forearm relative to the upper arm compared to the normal physiological carrying angle.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 283.

65. A force is most effective when it is applied at _ _ angle to lever. a. Parallel b. Right c. Acute d. Obtuse

Explanation

A force applied to a lever produces its greatest torque when the force is applied at 90° to the lever. The mechanical advantage is maximum when the force is applied perpendicularly to the segment and smallest when the forces lie closest to being parallel to the segment.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 47, 48.

Ans.

65. b

Ans.

66. b 67. c 68. c

66. Inability of the muscle to produce isometric tension or contraction at two joints simultaneously is called _ _. a. Passive insufficiency b. Active insufficiency c. Contractile insufficiency d. Stress insufficiency

A decrease in the torque produced by the muscle may be encountered when the full R.O.M is attempted simultaneously at all joints crossed by a multi joint muscle. This decrease in torque is often referred to as "active insufficiency".

Image summary: This figure consists of two anatomical diagrams. The illustrations depict a human hand and wrist in two different positions to demonstrate muscle insufficiency. The first diagram shows the wrist flexed, highlighting active insufficiency of the flexors and passive insufficiency of the extensors. The second diagram shows the wrist extended, highlighting active insufficiency of the extensors and passive insufficiency of the flexors. It can be inferred that the ability of a muscle to generate force or be stretched is dependent on the position of the joint, where a muscle is actively insufficient when it is too short to contract effectively and passively insufficient when it is stretched to its limit, restricting further joint movement.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 121.

67. Resistance to muscle is increased by the following methods; Except: a. Increase poundage b. Increase leverage c. Decrease duration of exercise d. Speed alteration

Explanation

Increase in weight, increase in leverage, and alteration in speed and increase in duration of exercise will increase resistance to muscle action.

Reference: Dena Gardiner. The Principles of Exercise Therapy, 4th Revised Coloured Enlarged Edition. C.B.S Publishers & Distributors Pvt. Ltd.; 2023. p. 75.

68. _ _ muscles help in both inspiration and expiration. a. Pectoralis minor b. Subclavius c. Abdominal d. Quadratus

The major function of the abdominal muscles with regard to ventilation is to caudally, into a motion of exhalation. By increasing intra-abdominal pressure, the abdominal muscles can push the diaphragm upward into the thoracic cage, increasing both the volume and speed of exhalation. Although considered accessory muscles of exhalation, the abdominal muscles play two significant roles during inspiration.

First, the increased intra-abdominal pressure created by the active abdominal muscles during forced exhalation pushes the diaphragm cranially and exerts a passive stretch on the costal fibers of the diaphragm. These changes prepare the respiratory system for the next inspiration by optimizing the length tension relationship of the muscle fibers of the diaphragm.

Second, the increased abdominal pressure created by lowering of the diaphragm in inspiration must be countered by tension in the abdominal musculature. Without sufficient compliance in the abdominal muscles, the central tendon of the diaphragm cannot be effectively stabilized so that lateral chest wall expansion can occur.

During periods of increased ventilation needs, the increased muscular activity of the abdominal muscles assists in both exhalation and inhalation.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 206.

69. Muscles can produce maximum torque in___ _.

a.Inner range

c. Outer range

Explanation

Since the greatest moment arm is in the middle range, maximum torque production is seen in the middle range of contraction.

The majority of torque on a segment will be produced by forces or force components (Fy) that are applied at 90° to the segment and at some distance from the joint axis.

The torque generated by the muscle changes as the

b. Middle range

d. Neutral range

Image summary: This figure consists of two anatomical diagrams. The diagrams illustrate the movement of the human arm, specifically focusing on the muscle action during the flexion and extension of the elbow joint. In the first panel, the muscle is contracted, pulling the forearm upward toward the upper arm. In the second panel, the muscle is relaxed, allowing the arm to straighten. It can be inferred that the contraction of the biceps muscle leads to the flexion of the elbow, while the relaxation of this muscle is associated with the extension of the arm.

moment arm of the muscle changes during joint motion. In position a, the torque is greater than in position b, because the moment arm of the biceps muscle force is greater (assuming that the force is the same in each position).

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 58, 124.

a. Pisiform b. Patella c. Ulna d. Clavicle

acts as an anatomic pulley.

The classic example of an anatomic pulley is that formed by the patella. The quadriceps muscle belly lies parallel to the femur. The tendon of the muscle passes over the knee joint and attaches to the leg (tibia) via the patellar tendon at the tibial tuberosity.

Image summary: This figure is an anatomical diagram. It illustrates the musculoskeletal structure of the human knee joint, specifically labeling the quadriceps muscles, quadriceps tendon, patella, and patellar ligament, while incorporating a pulley system to represent mechanical force. The diagram demonstrates how the contraction of the quadriceps muscles creates tension that pulls on the patella and patellar ligament, resulting in the extension of the lower leg.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 41.

71. _ _ is the primary component of the muscle that accounts for its stiffness. a. Titin b. Actin c. Myosin d. Z disc

Explanation

The passive stiffness of a muscle attached to bone and crossing a joint is the slope of the torque-angle relationship. Titin is the primary component of the muscle that accounts for its stiffness, the connective tissues in and around the muscle (perimysium and endomysium) are responsible for the extent to which the muscle can be elongated. This is the extensibility of the muscle. the that accounts int is the slope of the muscle combines Western theories of biomechanics, core stability, and motor control. a. Yoga b. Pilates c. Manipulation d. Mobilization Pilates is an approach to exercise that combines Western theories of biomechanics, core stability, and motor control with Eastern theories of the interaction of body, mind, and spirit.

Image summary: This figure is a biological diagram. It illustrates the structural organization of a muscle sarcomere, depicting the arrangement of myosin thick filaments and actin thin filaments. The diagram labels key components including the M line, titin, and Z discs. The arrangement shows that thick filaments are centrally located and overlap with thin filaments that are anchored to the Z discs at the boundaries. It can be inferred that the interlocking nature of these filaments allows for muscle contraction through the sliding filament mechanism, where the Z discs are pulled closer together.

Image summary: This is an anatomical diagram. The figure illustrates the mechanical arrangement of the knee joint, specifically labeling the muscles, quadriceps tendon, patella, and patellar ligament, while highlighting the patella as a pulley. The diagram indicates that the patella functions to change the direction of the force exerted by the quadriceps muscle, thereby increasing the mechanical advantage for knee extension.

Image summary: This is a schematic diagram. The figure illustrates the structural arrangement of a Z disc within a muscle sarcomere, showing the connection between various protein filaments and the central boundary. The diagram indicates that the Z disc serves as an anchoring point for multiple filaments, maintaining the organization and stability of the contractile unit.

Components of a Pilates exercise session typically include deep breathing and core stabilization exercises, focus on activation and relaxation of specific muscle groups, posture control and awareness training, strength training (primarily using body weight as resistance), balance exercises, and flexibility exercises.

Reference: Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 101.

73. In _ _ movement, there is rotation of a segment about a stationary mechanical axis, and the same point on the moving surface creates an arc of a circle as the bone spins.

a. Rolling b. Gliding

c. Spinning d. None of these

Explanation

In bone spinning, there is rotation of a segment about a stationary mechanical axis, the same point on the moving surface creates an arc of a circle as the bone spins.

Spinning rarely occurs alone in joints but in combination with rolling and sliding. Examples of spin occurring in joints of the body are the shoulder with flexion/extension, the hip with flexion/extension, and the radiohumeral joint with pronation/supination.

Image summary: This is a series of anatomical diagrams. The figure illustrates the different types of joint movements occurring during convex-on-concave arthrokinematics, specifically showing a convex bone surface moving against a concave bone surface. The diagrams demonstrate three distinct types of motion: rolling, sliding, and spinning. Based on the illustrations, it can be inferred that rolling involves a point of contact that changes across the surfaces, sliding involves a translation of the convex surface across a fixed point on the concave surface, and spinning occurs as a rotation around a longitudinal axis. Collectively, these movements describe the complex mechanical interactions required for joint mobility.

72. b 73. c 74. a 75. a 76. c Reference: Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 123.

74. Gentle joint-play techniques provide and maintain _ _ of the joint by mechanical effect. a. Nutrition b. Strength c. Length d. Size

Explanation

Small-amplitude distraction or gliding movements of the joint are used to cause synovial fluid motion, which is the vehicle for bringing nutrients to the avascular portions of the articular cartilage (and intra-articular fibrocartilage when present).

Gentle joint-play techniques help maintain nutrient exchange and, thus, prevent the painful and degenerating effects of stasis when a joint is swollen or painful and cannot move through the R.O.M.

Reference: Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 124.

75.___ _ are displacements that involve direct changes in the relationship of the body's center of mass to the base of support.

a. Mechanical perturbations

b. Sensory perturbations

c. Fixed support synergies

d. Fixed support strategies

Explanation

Mechanical perturbations are the displacements that involve direct changes in the relationship of the body's center of mass to the base of support. These displacements may be caused by movements of either the segments of the body or the entire body.

Image summary: This is a black and white photograph. The image depicts two individuals in an indoor setting where one person is standing and holding a device toward another person who is seated in a crouched position. The scene includes a chair and a projection screen in the background. The interaction suggests a professional or educational demonstration, likely involving the testing or application of a handheld tool on a human subject.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 486.

76. Altering the visual input by covering a person's eye unexpectedly is an example of ___ _. a. Muscle synergies b. Fixed support synergies c. Sensory perturbations d. Mechanical perturbations

re used to cause to the avascular cartilage when ange and, thus, it is swollen or changes in the ort.

Image summary: This is a black and white photograph. The image depicts a person seated and leaning forward, appearing to be engaged in a task or interacting with an object in front of them within an indoor setting. The composition suggests a candid moment of focused activity, indicating that the individual is concentrated on a specific action.

A sensory perturbation might be caused by altering visual input. The postural responses to perturbations caused by either platform movement or by pushes and pulls are reactive or compensatory responses and are involuntary reactions. In the literature, these postural responses are referred to as either strategies or synergies.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 486.

77. Which of the following statement is true regarding postural control and response?

a. Proactive responses occur in anticipation of internally generated destabilizing forces (e.g., raising arms to catch a ball or bending forward to pick up an object).

b. Reactive responses occur in anticipation of internally generated destabilizing forces (e.g., raising arms to catch a ball or bending forward to pick up an object).

c. Compensatory responses occur in anticipation of internally generated destabilizing forces (e.g., raising arms to catch a ball or bending forward to pick up an object).

d. Proactive responses occur in anticipation of externally generated destabilizing forces (e.g., raising arms to catch a ball or bending forward to pick up an object).

Proactive (anticipatory) responses occur in anticipation of internally generated destabilizing forces (e.g., raising arms to catch a ball or bending forward to pick up an object).

Reactive (compensatory) responses occur as reactions to external forces that displace the body's C.O.M.

Image summary: This figure is a series of sequential illustrations. The content depicts two individuals performing physical movements: a man transitioning from a crouched position to a standing posture, and a woman lifting a large ball from the ground to chest height. The sequence demonstrates the shift in body mechanics and center of mass during lifting and standing actions, concluding that these movements require a coordinated shift in posture to maintain balance while moving an object or the body upward.

Ans.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 485.

78. The design of orthoses is based on _ _ point pressure system. a. two b. four c. three d. zero

Explanation

All orthoses apply forces to the body segment that can be used either to resist motion or to protect a part of the body. Orthoses are based on a three-point pressure system with one force acting in one direction and the other two forces directed in the opposite direction to correct the deformity, and encourage proper joint alignment.

Image summary: This figure is a medical diagram. It illustrates the application of orthotic principles on a human torso, specifically showing a lumbar brace and a corresponding force vector diagram. The diagram highlights three points of pressure: one at the lumbar region and two opposing points at the sternal and pubic areas. The accompanying schematic demonstrates how three opposing forces act to stabilize a skeletal segment. It can be inferred that the brace utilizes a three-point force system to reduce unwanted angular rotation and provide stability to the lumbar spine by applying a central force opposed by two peripheral forces.

• 3-point force systems - Reduction in unwanted angular rotation - Stabilization about a joint, bone or skeletal segment

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 493.

79. _ _ is the linear distance between two successive points of contact of opposite extremities. a. Stride length b. Step length c. Double support time d. Step width Step length is the linear distance between two successive points of contact of opposite extremities.

Image summary: This figure is a schematic diagram. It illustrates various spatial parameters of human gait using footprints and directional arrows to define measurement boundaries. The diagram defines stride width as the total lateral distance, which is composed of the left and right step widths. It also distinguishes between step length, the distance between successive footprints of opposite feet, and stride length, the distance between successive footprints of the same foot. From the content, it can be inferred that stride length is greater than step length, and that stride width is the sum of the individual step widths relative to a central axis.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 528.

80. _ _ is the number of steps taken by a person per unit of time. a. Stance time b. Walking velocity c. Step duration d. Cadence

Explanation

Cadence is the number of steps taken by a person per unit of time.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 528.

81. Newton's Law of Inertia is also called _ _. a. Law of motion b. Law of acceleration c. Law of action reaction d. Law of equilibrium

Explanation

Newton's Law of Inertia is also called law of equilibrium. When an object that is acted upon by balanced forces or torques and remains stationary/motionless, it is in static equilibrium.

When the velocity of an object is constant but not zero, the object is in dynamic equilibrium, which can be linear (as for translatory motion), angular (as for rotary motion), or a combination of both (as for general motion).

Ans.

80. d 81. d The equilibrium of an object is determined only by forces or torques applied to (with points of application on) that object as long as there is more than one force or torque.

Image summary: This is a representative illustration. The figure depicts a soccer ball resting on a flat, rectangular surface. The placement of the ball suggests a state of equilibrium or a starting position on a defined plane.

References:

Image summary: This is an illustration. The image depicts a person's foot and lower leg in motion, positioned to kick a soccer ball resting on a flat surface. The movement of the foot is indicated by motion lines trailing behind it. The figure demonstrates the action of striking a ball, suggesting an athletic movement intended to propel the ball forward.

Image summary: This figure is a conceptual illustration. It depicts a soccer ball moving through the air with a trailing wake, positioned above a slanted parallelogram shape. The arrangement suggests a relationship between the trajectory of a moving object and a specific geometric area, implying a representation of displacement or the physical space covered during motion.

Image summary: This figure is an illustration. It depicts a soccer ball positioned against a goal net. The image suggests a successful goal has been scored as the ball is nestled within the netting.

1. Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 18.

2. Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 19.

82. A ___ _ will always produce pure rotary motion of an object. a. Moment of force b. Force couple c. Torque d. Force

Explanation

Two forces equal in magnitude, but opposite in direction, parallel, and applied to the same object at different points equidistant from the axis of rotation on either side are known as a force couple.

A force couple will always produce pure rotary motion of an object unless and until no other forces act on the object. The strength of rotation produced by a force couple is known as torque (τ), or moment of force.

Image summary: This figure is a physics diagram illustrating a mechanical system. It depicts a rigid bar with endpoints A and B and a central pivot point O. Two equal and opposite forces, labeled F, are applied perpendicularly at the ends of the bar, while a distance d indicates the span between the application points of these forces. The curved arrows indicate that these forces create a rotational effect, known as a couple, acting in the same clockwise direction. From this arrangement, it can be inferred that the system is subjected to a pure torque, which would cause the bar to rotate around its center without any net translational movement.

Image summary: This figure is a physics diagram. It depicts a horizontal beam with two forces applied at different points along its length, labeled as F1 and F2. The force F1 is directed downwards at the left end, while the force F2 is directed upwards toward the right end. The opposing directions and separate positions of these forces indicate that the system is subject to a net torque, which would cause the beam to rotate.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 33. ques appliedre than one ed upon ced force ed and on plied to ess and ed by a 83. All of the following are the external forces that are manipulated to maximize torque production; Except:

a. Increasing the magnitude of the applied force.

b. Applying the force perpendicularly.

c. Decreasing the distance of the point of application of the force from the joint axis.

d. Increasing the distance of the point of application of the force from the joint axis.

Explanation

External forces are manipulated to maximize torque production. The torque of an external force can be increased by increasing the magnitude of the applied force, by applying the force perpendicularly to (or closer to) the lever, also by increasing the distance of the point of application of the force from the joint axis.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 56.

84. Circumduction of the thumb is also termed ___ _.

a. Flexion b. Abduction

c. Rotation d. Opposition

Explanation

The circumduction motion of the thumb is commonly termed opposition. Opposition permits the tip of the thumb to oppose the tips of the fingers. It is the unique range and direction of motion at the first carpometacarpal joint that produces opposition of the thumb. Opposition is sequential abduction, flexion, and adduction of the first metacarpal, with simultaneous rotation.

The functional significance of the carpometacarpal joint of the thumb and of the movement of opposition, can be appreciated when one realizes that use of the thumb against a finger occurs in almost all forms of prehension (grasp and dexterity activities).

Image summary: This is a photographic illustration. The image shows a human hand with an arrow indicating a specific direction of movement for one of the fingers. The arrow suggests a curling or bending motion of the finger toward the palm. This indicates a demonstration of a particular joint movement or a manual gesture.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 339.

85. ___ _ and ___ _ ligaments are the key stabilizers of the carpometacarpal joint.

a. Dorsoradial, anterior oblique b. Intersesamoid, anterior oblique

c. Dorsoradial, intersesamoid d. Dorsoradial, posterior oblique

Ans.

83. c 84. d 85. a The dorsoradial and anterior oblique ligaments are reported to be key stabilizers of the carpometacarpal joint. The capsule of the carpometacarpal joint is relatively lax but is reinforced by radial, ulnar, volar, and dorsal ligaments. There is also an intermetacarpal ligament that helps tether the bases of the first and second metacarpals, preventing extremes of radial and dorsal displacement of the base of the first metacarpal joint.

Image summary: This figure is an anatomical diagram. It illustrates the ligamentous structures of the human hand, specifically focusing on the connections between the metacarpal bones from both anterior and posterior perspectives. The diagram identifies key ligaments including the anterior intermetacarpal ligament, the anterior volar beak ligament, the posterior intermetacarpal ligament, the posterior oblique ligament, and the dorsoradial ligament. Based on the illustration, it can be inferred that the stability of the metacarpal joints is maintained by a complex network of ligaments located on both the front and back of the hand, with different specific ligaments providing support for various directions of movement.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 339, 340.

86. During the flexion of the knee joint, the amount of tension generated by the pull of the quadriceps muscle is ___ _ than the patellar tendon. a. Equal b. More c. Less d. Zero

Explanation

The quadriceps muscle passing over the patella and/or femoral condyles forms a rigid "pulley" due to the femoral condyles deflecting the pull of the quadriceps muscle when the knee is flexed, independent of the patella.

During knee flexion, the maximum tension is generated by the pull of the quadriceps muscle, however, the tension on the patellar tendon is reduced. As the angle of pull increases, there is a greater difference in the pull of the muscle on the tendon and the tension in the tendon at its bony attachment.

As the coefficient of friction is reduced because of an interposed bursa or tendon sheath, the difference in tension proximal and distal to the pulley is reduced. One study found 8:5 ratio between quadriceps tendon tension above the patella and patellar tendon tension below the patella. to be key metacarpal ligaments of the first splacement ated by patellar rsa or is Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 57.

Image summary: This figure is an anatomical illustration. It depicts a long bone, specifically a metacarpal or phalanx, showing its shaft and the articulating surfaces at both ends. The illustration demonstrates the structural morphology of the bone, highlighting the joint surfaces that allow for movement and connection with adjacent bones.

87. Which of the following muscles helps in both inspiration and expiration?

Sternocleidomastoid c. Pectoralis major d. Trapezius

Explanation

The pectoralis muscle helps in both inspiration as well as in expiration.

The sternocostal portion of the pectoralis major muscle helps in inspiration by elevating the upper rib cage when the shoulders and the humerus are stabilized.

The clavicular head of the pectoralis major can be either inspiratory or expiratory in action, depending on the position of the upper extremity. When the position of the arm is below the level of the clavicle, the clavicular portion of the muscle acts as an expiratory muscle by pulling the manubrium and upper ribs downward, when the arms are raised overhead, the muscle becomes an inspiratory muscle, pulling the manubrium and upper ribs up and out.

The pectoralis minor can help in elevating the third, fourth, and fifth ribs during active inspiration.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 204.

88. During lateral flexion of spine, from erect standing, the force of gravity will continue the motion, then, the contralateral muscle helps to control the movement by contracting eccentrically. a. Quadratus lumborum b. Erector spinae c. Multifidus d. Gluteus maximus The quadratus lumborum is deeper than the erector spinae and multifidus muscles. The quadratus lumborum, when acting bilaterally, serves as an important frontal plane stabilizer as well as horizontal plane stabilizer.

Explanation

When acting unilaterally, the quadratus lumborum can laterally flex the spine. If from an erect standing position, spinal lateral flexion occurs and the motion continues with the force of gravity, then the contralateral quadratus lumborum will control the movement by contracting eccentrically.

It can also control rotational motion, and also "hike the hip", or laterally tilt the pelvis in the frontal plane, when pelvis is free.

Ans.

Image summary: This figure consists of two anatomical diagrams. The left side shows the skeletal structure of the lower back and pelvis, while the right side illustrates the muscular overlay on the same skeletal region, specifically labeling the quadratus lumborum and gluteus medius muscles. The figure demonstrates the spatial relationship and anatomical positioning of these specific muscles relative to the lumbar spine and the pelvic girdle.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 183.

89. If the first metatarsal is equivalent in length to the second metatarsal, then it is _ _ foot. a. Index plus b. Index minus c. Index plus minus d. Index zero

Explanation

The lengths of the five metatarsals may vary amongst individuals and are classified into (1) Index plus—in this the first metatarsal being longer than the second with the other remaining three progressively decreasing in length. (2) Index plus minus—in this, the first and second metatarsals being the same length, with the other remaining three progressively decreasing in length. (3) Index minus or Morton's foot is classified by the second metatarsal being longest followed progressively by the first, third, fourth, and fifth metatarsals.

Image summary: This figure is an anatomical diagram. It depicts the skeletal structure of a human foot, highlighting a specific metatarsal bone and indicating a transverse line crossing the mid-foot region. The diagram illustrates a focal area of interest on the first metatarsal, suggesting a localized condition or a specific point of surgical or clinical significance across the forefoot.

Image summary: This figure is an anatomical illustration. It depicts the skeletal structure of a human foot, highlighting a specific bone in the midfoot area and showing a line crossing through the metatarsal region. The illustration indicates a localized area of interest within the first metatarsal, suggesting a focal point for medical or anatomical study, and the intersecting line implies a potential plane of fracture or a surgical incision site.

Image summary: This is an anatomical diagram. The figure illustrates the skeletal structure of a human foot, specifically highlighting one of the metatarsal bones and indicating a transverse line across the midfoot area. The highlighted region suggests a focal point of interest or a specific site of injury, while the line indicates a potential fracture or surgical plane across multiple metatarsals. It can be inferred that the image is intended to demonstrate a specific medical condition or a clinical procedure involving the bones of the forefoot.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 463. nd metatarsal d are classified the second with 1) Index plus length, with Index minus gest followed

90. An increase in the normal valgus angulation of the first M.T.P is referred to as ___ _. a. Hallux varus b. Hallux valgus c. Hallux cavus d. Hallux planus

The first toe normally is adducted on the first metatarsal about 15° to 19° An increase in this normal valgus angulation of the first metatarsophalangeal joint is referred to as hallux valgus and may be associated with a varus angulation of the first metatarsal at the tarsometatarsal joint, known as metatarsus varus.

Hallux valgus can cause a reduction in first metatarsophalangeal joint R.O.M, gradual lateral subluxation of the toe flexor tendons crossing the first metatarsophalangeal joint, reduced weight-bearing on the great toe, and increased weight-bearing on the first metatarsal head. These structural changes can lead to pain and difficulty during walking.

Image summary: This figure is an anatomical illustration. It presents a side-by-side comparison of the skeletal structure of the foot, specifically focusing on the first metatarsophalangeal joint in a normal state versus a condition known as hallux valgus. The illustration labels the phalanges, the metatarsophalangeal joint, and the first metatarsal. The comparison shows that while a normal foot has a slight natural angulation, hallux valgus is characterized by a significant outward deviation of the big toe and a corresponding inward shift of the first metatarsal, resulting in a more pronounced angle at the joint.

Normal valgus angulation at first metatarsophalangeal joint Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 465, 466.

91. In supination twist of the forefoot, the _ _ everts, and the _ _ plantarflexes and adducts. a. Calcaneus, talus b. Talus, calcaneus c. Calcaneus, navicular d. Talus, navicular

In supination twist of the forefoot, the calcaneus everts, and the talus plantarflexes and adducts. With sufficient pronation, the navicular bone is pushed downward with the motion of the head of the talus, limiting the ability of the transverse tarsal joint to supinate adequately.

Ans.

90. b 91. a The first and second rays will dorsiflex and invert, whereas the fourth and fifth rays will plantarflex and invert, which results in a supination (inversion) twist of the T.M.T joints to attempt to adequately adjust the forefoot.

Since the five T.M.T joints have some independence, the configuration of the forefoot in a supination twist can vary according to the weight-bearing needs of the foot and the terrain.

Image summary: This figure is an anatomical diagram. It illustrates the structural alignment and rotational movement of the bones in a finger, specifically highlighting the supination twist. The diagram indicates that the bones undergo a series of opposing rotational shifts along the length of the digit, suggesting that the finger does not move in a simple linear fashion but rather through a complex twisting mechanism during certain movements.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 459.

92.___ _ muscle is a dorsiflexor at talocrural joint and key supinator at subtalar joint simultaneously. a. Tibialis posterior b. Tibialis anterior c. Peroneus longus d. Extensor hallucis longus

Explanation

The tibialis anterior muscle passes anteriorly to the talocrural axis and medially to the subtalar joint axis, and so, it produces a dorsiflexion at the ankle and a supination at the subtalar joint. Besides being a strong dorsiflexor muscle at the ankle joint, it is a key supinator of the subtalar and transverse tarsal joints.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 474.

93. With tibialis anterior, _ _ muscle helps in dorsiflexion against the plantar flexion for preventing dragging of the first metatarsophalangeal joint during the foot off phase of the gait cycle. a. Tibialis posterior b. Peroneus longus c. Extensor hallucis longus d. Peroneus brevis

Tibialis anterior and extensor hallucis longus, both muscles are active in dorsiflexing the ankle when foot leaves the ground with moving the foot up against the plantar flexion torque of gravity during the foot off phase of the gait cycle.

The extensor hallucis longus muscle also averts the toes from dragging by extension of the metatarsophalangeal joints of the hallucis eas the fourth and nation (inversion) configuration of the-bearing needs of joint and key and medially ankle and a muscle at the joints. orsiflexion the first cycle. active in the foot up of the gait gging by Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 6th edition. Philadelphia: F.A. Davis Company; 2019. p. 474.

94. The point beyond which the tissue does not return to its original shape and size is the _ _. a. Elastic limit b. Elastic range c. Toe region d. Plastic range

Explanation

Elastic limit is the point beyond which the tissue does not return to its original shape and size. Elastic range is the region where tissue can be taken to end range of motion, but once the load is released, it returns to its original shape. Toe region is the area of considerable deformation that takes place without much force. Plastic range is the region where permanent deformation of the tissue takes place.

Image summary: This is a line graph illustrating a stress-strain curve. The figure plots stress against strain, marking several critical points including the proportional limit, elastic limit or yield point, lower-yield point, breaking stress, and the fracture point. The graph is divided into two primary sections: the elastic region, where Hooke's law applies, and the plastic region. Based on the curve, it can be inferred that as strain increases, stress initially increases linearly up to the proportional limit. Beyond the elastic limit, the material enters the plastic region where it undergoes permanent deformation. The material reaches its maximum strength at the breaking stress before finally failing at the fracture point.

Reference: Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 83.

95. Golgi tendon organ is located near

a. Muscle spindle

b. Musculotendinous junction of extrafusal muscle fibers

c. Musculotendinous junction of intrafusal muscle fibers

d. Neural bag (sensory portion)

Golgi tendon organ is a sensory organ located near the musculotendinous junctions of extrafusal muscle fibers. Its function is to monitor changes in tension of muscle-tendon units.

Ans.

94. a 95. b Reference: Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 81.

Image summary: This figure is an anatomical diagram. It illustrates the connection between muscles and bone, specifically highlighting the tendon and the Golgi tendon organ. The diagram labels the muscle fibers, the collagen within the tendon, the bone, and the Type Ib afferent nerve fiber. It also indicates a tear occurring at the junction where the tendon attaches to the bone. The figure demonstrates that the Golgi tendon organ is situated at the musculotendinous junction to monitor tension, and it shows how a structural failure or tear in the tendon disrupts the physical link between the muscular system and the skeletal system.

96. Related to the scapular movements, the word "Scaption" motion means ___ _.

a. Movement of arm in frontal plane

b. Elevation of arm in scapular plane

c. Movement in sagittal plane

d. None of the above

Explanation

Frontal plane motions: Abduction/adduction movements.

Scaption: Movement in the plane of the scapula mid-way between the frontal or sagittal planes.

Sagittal plane: Flexion and extension movements.

Image summary: This figure is an anatomical diagram. It illustrates the orientation of the human arm relative to the sagittal and frontal planes, specifically highlighting the scapular plane. The diagram shows the arm extended outward at an angle between the two primary anatomical planes. It can be inferred that the scapular plane represents an intermediate position that is neither fully forward in the sagittal plane nor fully to the side in the frontal plane.

Reference: Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 210.

97. First order, second order, third order levers are respectively levers of _ _. a. Stability, power, velocity b. Equilibrium, stability, velocity c. Velocity, displacement, torque d. Mechanical advantage, stability, power

Explanation

Lever is any rigid segment that rotates around a fulcrum. A lever system exists whenever two forces are applied to a lever in a way that produces opposing torques. First order, second order and third order levers are respectively levers of stability, power, and velocity.

Image summary: This figure is a collection of anatomical and mechanical diagrams. It illustrates different types of lever systems by comparing human body movements with common tools, identifying the positions of the effort, fulcrum, and load in each instance. The diagrams show that the human body utilizes various lever classes to achieve movement, such as the neck acting as a first class lever, the ankle as a second class lever, and the arm as a third class lever. These biological examples correspond directly to the mechanical functions of scissors, wheelbarrows, and tweezers, demonstrating that the mechanical advantage of a system depends on the relative placement of the pivot point and the applied force.

References:

1. Dena Gardiner. The Principles of Exercise Therapy, 4th Revised Coloured Enlarged Edition. C.B.S Publishers & Distributors Pvt. Ltd.; 2023. p. 12.

2. Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis. 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 48, 49.

98. The phenomenon of gradual continuous elongation of the connective tissue after an initial elastic response to a constant tensile load and gradually returning to the original length once load is removed is called _ _. a. Hysteresis b. Creep c. Stress Relaxation d. Strain rate sensitivity

Ans.

97. a 98. b If a force is applied to a tissue and maintained at the same level while the deformation produced by this force is measured, the deformation will gradually increase. Force remains constant while length changes. Connective tissues also will gradually elongate (creep) after an initial elastic response to a constant tensile load and then gradually return to their original length (recovery) after the load is removed.

Image summary: This is a line graph. The figure illustrates the relationship between deformation and time following the application of a constant load, specifically depicting the phenomenon of creep. The graph shows an immediate initial deformation upon the application of the load, followed by a gradual increase in deformation over time. It can be inferred that the material undergoes continuous deformation under a steady load, with the rate of deformation slowing down as time progresses.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 84.

99. Rotary movement of the bones in space during physiological joint motion is called _ _. a. Osteokinematics b. Arthrokinematics c. Arthrokinetics d. Osteokinetics

Explanation

Osteokinematics describes clear movements of bones which are visible from the outside. They are the gross movement that happens between two bones. They arise from rotation around the joint axis.

For example, flexion, extension, abduction, adduction, medial and lateral rotation.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 96.

100. Rate of muscle fatigue is fast in muscles with these muscle fibers. a. Type 1 or slow oxidative b. Type I.I.A or fog fast oxidative glycolytic c. Type I.I.B or fast glycolytic d. Type 3 or oxidative glycolytic

Expla Beca

level while the on will gradually active tissues also a constant tensile (y) after the load logical joint ple from the ones. They and lateral ple fibers Because of anaerobic glycolysis, these muscle fibers undergo fast muscle fatigue.

- Type 1 Slow twitch muscle fibers Long distance—endurance Less fatigue

- Type 2.A Fast twitch—oxidative Moderate distance and intensities Moderate fatigue

- Type 2.B Fast twitch—glycolytic Short distances High intensity High fatigue

Type of fibers

Image summary: This figure is a series of instructional photographs. The images depict a person performing a physical exercise sequence, starting from a standing position, moving into a forward motion, and ending in a deep lunging posture. The sequence demonstrates a progression of movement that increases the flexion of the knee and hip joints, suggesting a routine designed to improve lower body flexibility and strength.

Image summary: This figure is a photograph. It depicts a person in athletic attire captured while running forward. The image suggests a state of motion and physical activity, indicating that the individual is engaged in a sporting event or exercise.

Image summary: This figure is an illustration. It depicts a human figure in a running posture with several circular overlays positioned across the body and extending behind it. The arrangement suggests a sequence of movement or a focus on specific anatomical points during a stride. It can be inferred that the figure is intended to analyze the biomechanics of running or the trajectory of motion over time.

Image summary: This figure is a photograph. It depicts a person in athletic attire captured in a dynamic running pose. The subject is shown in mid-stride, suggesting rapid forward motion and physical activity.

Table summary: The table compares slow twitch and fast twitch muscle fibers, highlighting that slow twitch fibers are characterized by slower contraction and fatigue rates, aerobic energy usage, lower lactic acid production, and suitability for endurance, whereas fast twitch fibers exhibit faster contraction and fatigue, anaerobic energy usage, higher lactic acid production, and suitability for power and strength.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 119.

101. Type 1 muscle fibers and type 2 muscle fibers are respectively called ___ _.

a. Mobility/nonpostural and stability/postural

b. Stability/postural and mobility/nonpostural

c. Mobility/postural and stability/nonpostural

d. Stability/mobility and postural/nonpostural

Explanation

As Type 1 muscle fibers have capability to contract for a longer time without getting fatigued easily (slow muscle fatigue) they play an important role in stability and type 2 fibers work more for mobility purpose but as they get fatigued at very fast rate, they cannot contribute for maintaining joint stability.

102. A functional unit formed by a metatarsal and its associated cuneiform bone is called: a. Ray b. Axis c. Arch of foot d. All of these

Ans.

101. b 102. a It is structural anatomic part of foot formed by metatarsal and its respective cuneiform bone.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 4th edition. Philadelphia: F.A. Davis Company; 2005. p. 458.

103. When the arm is in a dependent position at the side, the glenohumeral joint capsule is _ _.

a. Taut superiorly and slack anteriorly and inferiorly

b. Taut anteriorly and slack superiorly and inferiorly

c. Taut anteriorly and slack posteriorly and inferiorly

d. Taut superiorly and slack anteriorly and posteriorly

Explanation

The glenohumeral joint is surrounded by a large, loose capsule which is taut superiorly and slack anteriorly and inferiorly with the arm dependent at the side.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 247.

104. The normal angle of torsion of the humerus is approximately _ _. a. 15° b. 20° c. 30° d. 35°

Explanation

Head of the humerus is normally angled posteriorly approximately 30°, with regard to an axis through the humeral condyles, called an angle of torsion.

Image summary: This figure is an anatomical diagram. It illustrates the angle of inclination of the proximal humerus, showing the relationship between the axis of the humeral shaft and the axis of the humeral head. The diagram indicates that the angle formed between these two axes typically falls within a specific range, suggesting that the humeral head is positioned at an oblique angle relative to the shaft to allow for a greater range of motion in the shoulder joint.

Image summary: This figure is a photograph. It depicts a spherical object being rotated along an axis, with an indicated angle of torsion. The image demonstrates the degree of twist applied to the object relative to a horizontal baseline, showing a moderate angular displacement.

Reference: Levangie, Norkin, Lewek. Joint Structure & Function: A Comprehensive Analysis, 5th edition. Philadelphia: F.A. Davis Company; 2011. p. 246. glenohumeral which is taut at the side. roximately 30°, with ion.

105. A force applied parallel to the cross-sectional area of the tissue is called force. a. Tension c. Shear b. Compression d. Strain Shear force is a force acting in a direction that is parallel to (over the top of) a surface or cross section of a body, like the pressure of air flow over an airplane wing. A force acting in a direction parallel to a surface or to a planar cross section of a body, as for example the pressure of air along the front of an airplane wing. Shear forces often result in shear strain. Resistance to such forces in a fluid is linked to its viscosity, also called shearing force.

Reference: Kisner, Colby, Borstad. Therapeutic Exercise: Foundations and Techniques, 6th edition. Philadelphia: F.A. Davis Company; 2012. p. 83.

106. Upward rotation of the scapula and rotation of the clavicle, which occur with shoulder flexion is called ___ _.

a. Physiological movement b. Voluntary movement

c. Joint play d. Component movement

Explanation

Component movement: Involuntary obligatory joint motion occurring outside the joint accompanies active motion that is, scapulohumeral rhythm. The scapulohumeral rhythm is defined as the ratio of the glenohumeral movement to the scapulothoracic movement during the arm elevation.

Image summary: This is an anatomical diagram. The figure illustrates the various directions of movement for the scapula, including elevation, depression, protraction, retraction, and posterior rotation. The diagram demonstrates that the scapula can move upward and downward, forward and backward, and rotate along its axis.

105. c 106. d

You have reached the end of the document.