NPTE-PT Test Test Musculoskeletal System Examination 1 — Questions and Answers
Question 1: A physical therapist is assessing a patient with suspected lateral epicondylitis. Which special test is MOST appropriate to confirm this diagnosis?
- Cozen's test (Correct answer)
- Tinel's sign at the elbow
- Valgus stress test
- Lateral pivot shift test
Correct answer: Cozen's test
Cozen's test (resisted wrist extension with the elbow extended) reproduces pain at the lateral epicondyle by stressing the extensor carpi radialis brevis, the muscle most commonly involved in lateral epicondylitis.
Question 2: A patient presents with pain and clicking in the temporomandibular joint. During examination, the physical therapist notes that the mandible deviates to the right on opening. Which structure is MOST likely dysfunctional?
- Left lateral pterygoid muscle
- Right lateral pterygoid muscle (Correct answer)
- Left masseter muscle
- Right temporalis muscle
Correct answer: Right lateral pterygoid muscle
The mandible deviates toward the side of dysfunction on mouth opening. A dysfunctional right lateral pterygoid (or right disc displacement) causes the mandible to pull or deviate to the right during opening.
Question 3: When performing a posterior drawer test of the knee, the physical therapist places the patient supine with the hip at 45 degrees and knee at 90 degrees, then pushes the tibia posteriorly. Excessive posterior translation indicates injury to which structure?
- Anterior cruciate ligament
- Posterior cruciate ligament (Correct answer)
- Medial collateral ligament
- Posterolateral corner complex
Correct answer: Posterior cruciate ligament
The posterior drawer test specifically stresses the posterior cruciate ligament (PCL). Posterior force on the proximal tibia at 90 degrees of knee flexion causes excessive posterior tibial translation when the PCL is torn.
Question 4: A 45-year-old patient reports cervical spine pain radiating into the thumb, index finger, and middle finger with associated weakness of elbow flexion. Which cervical nerve root is MOST likely compressed?
- C4
- C5
- C6 (Correct answer)
- C7
Correct answer: C6
C6 nerve root compression produces sensory changes in the thumb, index, and middle fingers (lateral forearm and hand) and weakness of elbow flexors (biceps) and wrist extensors. The biceps reflex may also be diminished.
Question 5: A physical therapist performs the Thomas test on a patient and observes that the contralateral thigh rises off the table. This MOST likely indicates tightness of which structure?
- Hamstring muscle group
- Iliotibial band
- Hip flexor musculature (iliopsoas) (Correct answer)
- Piriformis muscle
Correct answer: Hip flexor musculature (iliopsoas)
The Thomas test detects hip flexor tightness. When the non-tested leg is pulled to the chest to flatten the lumbar spine, a tight iliopsoas on the tested side prevents the thigh from resting flat on the table, causing it to rise.
Question 6: During manual muscle testing, a patient can move the shoulder through full range of motion against gravity but cannot tolerate any additional resistance. What grade would a physical therapist assign to this muscle?
- Grade 2 (Poor)
- Grade 3 (Fair) (Correct answer)
- Grade 4 (Good)
- Grade 5 (Normal)
Correct answer: Grade 3 (Fair)
Grade 3 (Fair) is assigned when the patient can complete full range of motion against gravity but cannot tolerate any additional manual resistance. Grade 4 requires movement against some resistance, and Grade 5 requires movement against full resistance.
NPTE-PT Test Test Musculoskeletal System Examination 1
A physical therapist is assessing a patient with suspected lateral epicondylitis.
Which special test is MOST appropriate to confirm this diagnosis?