Musculoskeletal System Review

Musculoskeletal Quiz: Week 1 Review

• Irritability in the S.I.N.S.S framework reflects how easily symptoms are provoked and relieved.
• The Patient-Specific Functional Scale (PSFS) is used to rate patient-identified activity difficulty.
• Sign of the Buttock test reproduces symptoms with hip flexion both with and without knee bend, suggesting serious pathology.
• The prone knee bend test targets the femoral nerve.
• Reduced symptoms with PA pressure while lifting legs indicate lumbar instability.
• Active Straight Leg Raise (ASLR) test identifies SI joint instability due to poor load transfer.
• The Oswestry Disability Index is scored out of 100.
• Urinary retention and saddle anesthesia are strongly associated findings of Cauda Equina Syndrome.
• The OMPSQ outcome measure screens work disability and psychosocial risk.
• A Cobb angle ≥50° in scoliosis generally indicates surgical fusion.
• Grade I joint mobilization is small amplitude and targets pain.
• Relief of symptoms in seated or flexed positions may indicate spinal stenosis.
• The FABER test primarily assesses SIJ and hip joint dysfunction.
• Great toe extension strength tests nerve root L5.
• A score >37 on the Tampa Scale of Kinesiophobia indicates high fear of movement.
• Flexion typically aggravates lumbar disc herniation symptoms.
• The Thomas Test assesses hip flexor tightness.
• The Quadrant Test involves combined extension, rotation, and lateral flexion of the spine.
• A patient with stiffness, but no clear neuro symptoms, may benefit most from manual therapy and mobility exercises.
• Transverse processes are located 2-3 cm lateral to the spinous processes and are the palpation target.
• The transversus abdominis is commonly evaluated with a pressure biofeedback test for core control.

Low Back Pain - Week 2 Quiz

• 80% of adults experience low back pain at some point in their lives.
• The ICF classification for patients with hypomobile segments and no symptoms past the knee is Low Back Pain with Mobility Deficits.
• Patients with hypomobility and symptoms <16 days benefit most from manipulation, according to the Treatment-Based Classification.
• Osteoporosis is a contraindication to lumbar manipulation.
• The SINSS model stands for Severity, Irritability, Nature, Stage, Stability.
• Centralization in directional preference evaluation is characterized by symptoms shifting from leg to spine.
• Robin McKenzie developed the classification and treatment principles around directional preference.
• Pain worsening with lumbar flexion is common with an extension directional preference.
• Forward bending is initially discouraged in patients with an extension directional preference.
• Derangement Syndrome is the most common McKenzie classification syndrome.
• Extension-based exercises are not typically first-line for lumbar spinal stenosis.
• The "shopping cart sign" indicates lumbar spinal stenosis.
• Patients with radiating pain and positive nerve tension tests are most likely to benefit from lumbar traction.
• Sliding neural mobilization technique provides more nerve excursion.
• Symptoms worsen or peripheralize is a red light during a directional preference assessment.
• Immediate symptom reproduction is a sign of high irritability in neural tension testing.
• Mid-range positioning is the first force progression in an extension-based exercise protocol.
• Hip IR > 35° in at least one hip is part of the Clinical Prediction Rule for lumbar manipulation.
• Early pregnancy is a precaution (not a contraindication) for manipulation.
• Neural mobilization does not directly aim to improve nerve conduction velocity.
• 10-15 reps every 2 waking hours is the recommended frequency for repeated prone extensions in a HEP.

MSK LQ - Week 3 Quiz: Movement Control, Functional Optimization, SIJ & Post-Surgical Rehab

• Symptoms during initial to mid-range spinal movement are most associated with movement coordination impairments in acute low back pain.
• Trunk muscle strengthening and endurance is a Grade A intervention for movement coordination impairments.
• Abdominal bracing in quadruped is appropriate for early-phase movement control training.
• The "functional phase" of movement control training typically includes multi-planar loaded tasks.
• High reps (15–20) with low load is the appropriate rep scheme for early motor control exercises.
• Front squat provides the most anterior knee loading and quad activation.
• Romanian deadlift emphasizes hip hinge mechanics and hamstring engagement.
• Farmer's carry best mimics everyday carrying and functional lifting.
• Most LBP exercise interventions are often underdosed according to the 2024 systematic review.
• Describing pain as a protective mechanism best supports recovery in chronic LBP.
• Pain Neuroscience Education (PNE) explains that pain ≠ tissue damage.
• Fear avoidance is the cognitive factor measured by the FABQ.
• LBP with cognitive/affective tendencies applies to a patient with generalized low back pain and no clear diagnosis.
• Laslett Cluster is the most reliable test for identifying sacroiliac joint pain, not specific dysfunction.
• A positive supine-to-sit test suggests anterior innominate rotation.
• The purpose of the MET for anteriorly rotated innominate is to promote posterior rotation via muscle contraction.
• SI belt and gluteal strengthening is the treatment of choice for a hypermobile SI joint.
• Early walking and body mechanics training is a rehab priority following a lumbar microdiscectomy.
• Artificial disc replacement is the lumbar surgery that maintains motion and avoids fusion.
• Exercise resumes 24-48 hours after a lumbar spine injection.
• Wound infection is the most common complication after lumbar spine surgery.

MSK LQ Week 4 Quiz – Pelvic Health

• During pregnancy the pubic bone widens.
• Ischiocavernosus belongs to the superficial pelvic floor layer.
• Sphincteric control is a pelvic floor function associated with maintaining continence.
• Aids blood and lymph flow is the function of the pelvic floor described as the "sump pump".
• The coccygeus is not part of the levator ani group.
• Stress urinary incontinence is typically triggered by sneezing or lifting.
• Urge urinary incontinence is caused by involuntary detrusor contractions.
• "Just in case" urination contributes to overactive bladder.
• Waking up at least once per night to urinate defines nocturia.
• Smearing on toilet paper is a common symptom of fecal incontinence.
• Constipation is associated with less than 3 bowel movements per week.
• Forceps-assisted childbirth is a risk factor for pelvic organ prolapse.
• Reports of "feeling like a tampon is falling out" likely indicate pelvic organ prolapse.
• A hallmark symptom of vaginismus is involuntary vaginal muscle contraction.
• Bladder pain relieved by urination is associated with Interstitial cystitis.
• PCOS causes irregular periods, ovarian cysts, and acne.
• Obturator internus is a common trigger point location in pelvic pain.
• Trigger point therapy showed >80% improvement in urinary symptoms per Weiss (2001).
• Cobra yoga pose was studied for reducing dysmenorrhea.
• The Cozean Protocol identifies musculoskeletal contributors to pelvic pain and dysfunction.
• In the Knack technique, the patient is instructed to pre-contract pelvic floor before pressure increases.

MSK LQ - Week 5 Quiz: Hip Pathologies and Outcome Measures

• The Minimal Detectable Change (MDC) represents the smallest difference that exceeds measurement error.
• I-HOT12 is the best self-report tool for active patients with hip dysfunction.
• A 6-point improvement on the HAGOS pain subscale has not met the MCID has not been met.
• MRI is the most appropriate imaging modality for visualizing labral tears.
• An 8-year-old child with a limp and groin pain likely has Legg-Calvé-Perthes Disease.
• Septic hip arthritis presents with acute joint pain, redness, warmth, and unwillingness to weight bear.
• Femoral neck fracture requires immediate referral for potential surgical management.
• SCFE results from posterior slippage of the femoral epiphysis.
• Gluteal pain radiating down the leg and pain with FAIR test indicates Piriformis syndrome.
• Ober Test is most commonly positive in GTPS.
• Limited hip internal rotation (< 24°) is a hallmark sign of hip OA.
• A labral tear is most associated with the C-sign pain pattern.
• Pain aggravated by resisted hip adduction and passive hip abduction suggests adductor strain.
• Semimembranosus is the muscle most commonly injured in hamstring strains.
• Isometric mid-range loading is the best initial intervention for acute hamstring strain.
• Iliopsoas strain is characterized by anterior hip pain, pain with resisted hip flexion, and tenderness.
• Apophysitis involves overuse at tendon insertions in growing children.
• Groin pain when squatting, positive FADIR test, and pain with hip IR indicates FAI.
• HOOS is best for evaluating hip osteoarthritis.
• Load management, movement retraining, progressive strengthening is the recommended treatment approach for greater trochanteric pain syndrome (GTPS).

MSK LQ - Week 6 Quiz: Hip Assessment and Functional Evaluation

• In adolescents the toe-out posture suggests Slipped Capital Femoral Epiphysis (SCFE).
• Coxa vara is associated with a decreased femoral neck angle.
• Gluteus medius weakness leads to Trendelenburg gait.
• An antalgic gait is indicated by a shortened stance time on one side during gait analysis.
• Dynamic balance is best assessed with a lateral step down.
• Limited dorsiflexion is indicated by limited weight through the heels during a squat.
• Gluteus medius weakness can lead to pelvic drop during single-leg stance.
• Gluteus maximus is the most superficial posteriorly and contributes to hip extension.
• Hamstrings are suggested by pain at the ischial tuberosity.
• Greater trochanter is associated with greater trochanteric pain syndrome (GTPS).
• Hip internal and external rotation ROM are best measured using the center of patella as an axis reference.
• Capsular restriction is likely suggested by an excessively firm end-feel during hip ROM testing .
• Muscle weakness is suggested by PROM > AROM.
• Posterior-to-anterior hip mobility testing serves to evaluate hip extension mobility.
• Supine is the best gravity-eliminated position to test hip abduction.
• Hip abductors are tested in sidelying with resistance applied above the ankle.
• Hip Scour has a high sensitivity for hip OA and involves axial loading.
• Trendelenburg is most specific for gluteus medius weakness.
• FADIR is for hip pain and clicking during deep hip flexion and IR.
• Evaluating static/dynamic balance the Berg Balance Scale has a score range of 0–56.
• A patient takes >30 seconds to complete the Timed Up-and-Go (TUG) test, which suggests a high risk for falls.

MSK LQ - Week 7 Quiz: Hip Manual Therapy & Exercise

• Pain relief is the primary purpose of hip longitudinal distraction.
• Open-packed position is used during an inferior glide mobilization.
• A Posterior-to-Anterior (PA) glide improves anterior capsule mobility.
• A mobilization belt is often used by the therapist performing a flexion mobilization.
• Improve hip internal rotation ROM can be done with Inferior-lateral glide with active IR.
• Hold-relax is a PNF stretching technique.
• Familiar pain reproduced with palpation defines an active trigger point.
• The correct pressure range for trigger point compression is 2-4 lbs.
• The Iliopsoas is best treated using pincer palpation.
• The Parallel stroke direction is recommended for hamstring soft tissue mobilization.
• For TFL soft tissue mobilization, foam rolling is often used as an adjunct technique.
• GTPS is treated by reducing compression forces and progressing load.
• The Bilateral bridges with theraband is most appropriate in early rehab for piriformis syndrome,.
• Side-stepping with bands is part of Phase 2 (Weight-bearing) in piriformis rehab?
• Romanian deadlift belongs to Phase 3 (Functional) hamstring rehab.
• Cutting and bounding drills is associated with Phase 4 (Energy storage) hamstring rehab.
• A Posterior approach to THA requires precautions avoiding hip flexion past 90°, adduction, and IR.
• 75% ROM and proper muscle activation is a key milestone to progress from Phase 1 to Phase 2 post-hip arthroscopy?
• A Lateral step down with heel hover improves motor control for FAl rehab?
• Phase 3 – Functional Training of THA rehab includes balance & proprioception training?
• Hold-relax involves a 5-second isometric contraction followed by passive stretching?

MSK LQ - Week 9 Quiz: Knee Pathology, Screening, and Outcome Measures

• The MCID for the Lower Extremity Functional Scale (LEFS) is 9 points.
• VISA-P is specifically designed for patellar tendinopathy.
• ACL-RSI evaluates psychological readiness to return to sport after ACL injury.
• Meniscus would lock and catch in the knee after a pivoting injury?
• A (+) Thessaly Test suggests a Meniscus tear.
• Lachman is the most reliable test for ACL integrity?
• The Ottawa Knee Rule warrants an X-ray for, If the patient has isolated patella tenderness?
• Pain 2–4 cm below the medial joint line is key for pes anserine bursitis?
• IT band syndrome most often presents with pain at If the knee is flexed to 30°?
• Weak Gluteus maximus and medius what muscle groups are typically weak in patients with ITB syndrome?
• Knee osteoarthritis presents If Pain improves after ~15 minutes of movement?
• Which condition is most likely to require immediate referral, Septic arthritis?
• With decelerating and pivoting it indicates ACL?
• The risk factor that's common to both DVT/PE are Prolong Immobility?
• Advancing erythema with fever and chills may indicate Cellulitis (red flag condition)?
• A Pt. having Eccentric exercise loading will help Patella Tendinopathy?
• A patient can fit Osgood Schlatter w/ Basketball player,tibial 12 Years old, tubercle tenderness?

MSK LQ - Hip manual therapy & Exercise

• A technique that restores Flexion with Tibiofemoral mobilization?
• Posterior glide will use the belt and overpressure during active knee flexion?
• The patella superior Glide will restore knee extension by using patellar?
• The TFL and cue to stretch that is to reduce tension TFL inhibition-relation? The position that best isolates Gastrocnemius Stretch is standing straight leg extended backward?
• The worst for patient that uses foam rolling is to Exceed what they can tolerance?
• A stretch using rectus femoris is doing the test by having a belt that is Pronated and above their?
• An adequate amount stretch per session there should 60- second hold?
• The correct dosage is 1RM with the weight for hypertrophy is 75-85?
• What is the appropriate dosage for exercises is 10 reps x 6 second Isometrics?
• What kind of exercise retrains movement that is to ensure motor and coordination?
• ACL the definition of Coper that’s for non-surgical patient ACL, Testing needs to be +80% also the GRS needs +60?
• An ACL testing is that using for prevention will use an Isolated quad only, and external using? What population is most that is risk for ACL will be Females that are athletes and under 45 years old?
• When re-establishing a return and test what is a goal after surgeryACL patient that there needs to symmetry with the contract?
• An early rehab a goal is to use Meniscal repair is to act to activate the pain and quadriceps to minimum

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MSK LQ - Week 12 Quiz: Foot, Ankle, and Lower Extremity

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MSK LQ - Week 13 Quiz: Foot, Ankle, Lower Leg Evaluation & Testing

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MSK LQ - Week 14 Quiz: Manual Therapy, Exercise, Post-Op & RTS

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