Srg Feb2017 Compre Week 2 (Back, Le, Hfn Anakines)

The therapist observes an abnormal increase in passive hip extension when evaluating the patient. This indicates that the iliofemoral ligament, also known as the Y ligament of Bigelow, is damaged. The iliofemoral ligament is one of the strongest ligaments in the hip joint and helps to stabilize and limit excessive extension of the hip. Damage to this ligament can result in increased passive hip extension, leading to the patient's complaints of right hip pain.

The lordotic posture is characterized by an exaggerated inward curve of the lower back. Anterior tilting of the pelvis is commonly associated with a lordotic posture. This occurs when the front of the pelvis tilts forward, causing the lower back to arch excessively. This is often seen in individuals with Down Syndrome due to muscle imbalances and hypotonia, which can affect the alignment of the pelvis and spine. Lumbar flexion refers to a forward bending of the lower back, which is not typically associated with a lordotic posture. Nutated SIJ refers to a specific position of the sacroiliac joint and is not directly related to the lordotic posture.

The lateral pterygoid muscle is not responsible for weak/poor mouth closure. The masseter, medial pterygoid, and temporalis muscles are all involved in closing the mouth tightly. The lateral pterygoid muscle is responsible for opening the mouth and moving the jaw from side to side. Therefore, it would not be responsible for the patient's inability to maintain mouth closure.

Cicatricial torticollis is a type of torticollis that is caused by traumatic injury, specifically burn injury. It occurs when scar tissue forms in the neck muscles, causing them to contract and resulting in a twisted or tilted neck position. This differs from other types of torticollis, such as psychogenic torticollis which is caused by psychological factors, congenital torticollis which is present at birth, and traumatic torticollis which is caused by physical trauma other than burns.

The correct answer is medial rotation. In this case, the adolescent female has pes planus (flat feet), lateral tibial torsion (the tibia bone is twisted outward), and genu valgum (knock knees). These conditions can cause the femur bone to rotate medially, meaning it moves inward toward the midline of the body. This excessive medial rotation of the femur can contribute to anterior knee pain.

The correct answer is (L) SCM. The sternocleidomastoid (SCM) muscle is responsible for rotating the head towards the opposite side and laterally flexing it towards the same side. In this case, the patient's neck is rotated towards the right and laterally flexed towards the left, indicating that the left SCM muscle is tight.

The statement "It is the only muscle that opens the eyes" is incorrect because there are other muscles involved in opening the eyes, such as the superior tarsal muscle and the orbicularis oculi muscle. The levator palpebrae superioris muscle primarily lifts the upper eyelid, but it is not the only muscle responsible for opening the eyes.

The patient's inability to come to a complete long-sitting position suggests a weakness in the hip flexors. The iliopsoas muscle is the primary hip flexor, responsible for lifting the thigh towards the abdomen. Strengthening the iliopsoas through targeted exercises would help the patient improve their ability to sit up fully. The other muscles listed do not have as direct of a role in hip flexion and would not be the primary target for this specific issue.

During birth delivery, the coccyx, which is the small bone at the base of the spine, moves posteriorly or backwards. This movement is important to create more space in the pelvic outlet, allowing the baby to pass through the birth canal more easily. The coccyx is flexible and can be pushed back to accommodate the baby's head during delivery. This movement is a natural part of the birthing process and helps facilitate a smoother and safer delivery.

If a patient has Coxa Vara, it means that their hip joint has a decreased angle, causing the leg to be shorter. In order to compensate for this leg-length discrepancy, the patient may exhibit subtalar inversion during assessment. Subtalar inversion refers to the inward rolling of the foot, which helps to raise the arch and effectively lengthen the leg. This compensation helps to equalize the leg lengths and maintain balance during walking or standing.

To determine which side of the scapula is at the right position, you would palpate for the spine of the scapula at T3. The spine of the scapula is a bony ridge that can be felt along the upper back. By palpating for the spine of the scapula at T3, you can compare the position of the scapula on each side and identify any elevation or asymmetry. This will help you determine which side is at the correct position and which side may be elevated relative to the other.

The middle meningeal arteries pass beneath this part of the skull. These arteries are branches of the maxillary artery and are responsible for supplying blood to the meninges, which are the protective layers surrounding the brain and spinal cord. They are located between the dura mater and the skull, and any damage to these arteries can lead to a condition called epidural hematoma.

The thoracic vertebrae have costal facets on the transverse processes for attachment of the ribs, so the statement that costal facets are present on all segments for attachments of the ribs is true.

When asking the patient to look down and right, the cranial nerves being tested are the right cranial nerve 3 (oculomotor nerve) and the left cranial nerve 4 (trochlear nerve). The oculomotor nerve controls the movements of the eye, including downward gaze, while the trochlear nerve controls the movement of the superior oblique muscle, which helps to move the eye downward and inward. Therefore, testing these cranial nerves helps to assess the patient's eye movements and coordination.

The individual in question has damage to their left medial rectus muscle. This muscle is responsible for inward movement of the eye towards the nose (adduction). Damage to the medial rectus muscle can result in a condition known as medial rectus palsy, which causes the affected eye to be unable to move inward properly. This can lead to double vision and difficulty with tasks that require both eyes to work together.

The patient has less movement towards the right side compared to the left side during oblique curl ups. This indicates that the right internal oblique and left external oblique muscles need to be strengthened. The internal oblique muscles are responsible for trunk rotation and lateral flexion, while the external oblique muscles assist in trunk flexion and rotation. Strengthening these specific muscles will help improve the patient's movement towards the right side during oblique curl ups.

The special test that tested positive suggests that the Sacroiliac Joint is involved in the case of low back pain. The Sacroiliac Joint is located at the junction of the sacrum and the ilium bones in the pelvis. When this joint is affected, it can cause pain in the lower back. By ruling out other joints through assessment procedures, the positive result of the special test points to the involvement of the Sacroiliac Joint as the source of the patient's pain.

Cranial Nerve II, also known as the optic nerve, exits at the optic canal. The ophthalmic branch of Cranial nerve 5, also known as the trigeminal nerve, exits at the superior orbital fissure. The abducens nerve, which is Cranial Nerve VI, also exits at the superior orbital fissure. Therefore, the correct statements are I, III, and V.

The facets of the lumbar region are oriented towards the sagittal plane, which means they allow for anterior-posterior (AP) movement. This AP glide facilitates flexion and extension in the lumbosacral joint.

During trunk lateral flexion to the right, the lumbar segments will rotate to the left. This is because during lateral flexion, the spine undergoes a combination of lateral bending and rotation. When the trunk bends to the right, the lumbar segments will bend to the right side, but due to the natural curvature of the spine, they will also rotate towards the left. This rotation helps to maintain the alignment and stability of the spine during lateral flexion.

In this case, the correct answer is that the Gluteus Maximus is contracted due to excessive activation versus the flexors. This means that the Gluteus Maximus is overactive and tight, causing the muscle imbalance in the hip. The intervention required would be to strengthen the Gluteus Maximus to restore balance and reduce the excessive activation of the muscle. Stretching the Gluteus Maximus would not be appropriate in this case as it is already in a contracted state.

The ligamentum flavum is the correct answer because it is the ligament that connects the laminae of adjacent vertebrae. This ligament is located in the spinal column and helps to support and stabilize the vertebral column. It is composed of elastic fibers and is known for its yellow color, hence the name "ligamentum flavum" which means "yellow ligament" in Latin.

Counternutation refers to the movement of the sacrum in the pelvis. During counternutation, the sacrum moves upward and posteriorly. This movement is opposite to nutation, where the sacrum moves downward and anteriorly. Counternutation is a normal motion that occurs during certain activities such as sitting or bending forward. It helps to maintain stability and balance in the pelvis and spine.

The correct answer is active resistive strengthening exercise to the piriformis with the patient prone and the knee flexed. This exercise would involve contracting the piriformis muscle against resistance, which could potentially exacerbate the compression and increase pain in the sciatic nerve. Therefore, it would not be included in the intervention for a patient with right sciatic pain caused by piriformis compression.

The olfactory nerve is responsible for the sense of smell and is located in the nasal cavity. In certain situations, such as head trauma or a strong impact to the face, this nerve can become compressed or injured, resulting in a nerve contusion.

The gluteus maximus is the correct answer because it is a major hip muscle responsible for hip extension and external rotation. Strengthening the gluteus maximus can help improve hip stability, power, and overall lower body strength.

The deep muscles of the back include the interspinales, iliocostalis, and intertransversarii. These muscles play a role in various movements and stabilizing the spine. However, the serratus posterior inferior is not considered part of the deep muscles of the back. Instead, it is a muscle located in the lower back and is involved in the movement of the ribcage during breathing.

Weak hip flexors can lead to a lengthening or stretching of the rectus femoris muscle. The rectus femoris is one of the muscles that helps to flex the hip, so if it is weak, it may become stretched or lengthened. This is because the opposing muscles, such as the hamstrings, may be stronger and pull the hip into extension, causing the rectus femoris to be stretched.

Mueller's muscle is responsible for elevating the eyelid. In Horner's syndrome, there is partial ptosis, which means only a partial drooping of the eyelid. This is because Mueller's muscle is still functioning partially, allowing some elevation of the eyelid.

The correct answer suggests that the neck should be stretched towards right rotation and lateral flexion. This is because the patient has tight (L) scalenes, which are muscles located on the left side of the neck. Stretching the neck towards right rotation and lateral flexion will help to stretch and lengthen the tight scalene muscles, providing relief and improving flexibility.

The rotatores muscle is part of the oblique running intermediate muscle in the deep muscles of the back. It is responsible for rotating and stabilizing the spine. The other options listed, such as Longissimus, Interspinales, and Intertransversarii, are also muscles in the back, but they do not specifically belong to the oblique running intermediate muscle group. Therefore, the correct answer is Rotatores.

The correct answer is I and II.

I. Digastric is a suprahyoid muscle: This statement is true. The digastric muscle is located above the hyoid bone, making it a suprahyoid muscle.

II. Omohyoid is an infrahyoid muscle: This statement is true. The omohyoid muscle is located below the hyoid bone, making it an infrahyoid muscle.

III. Ansa cervicalis supplies all of the hyoid muscles: This statement is false. The ansa cervicalis is a nerve loop that supplies some of the infrahyoid muscles, but not all of the hyoid muscles.

IV. Hyoid bone is found at the level of C6: This statement is false. The hyoid bone is located at the level of C3-C4, not C6.

V. Sternohyoid is found above the hyoid bone: This statement is false. The sternohyoid muscle is located below the hyoid bone, making it an infrahyoid muscle.

The mentalis muscle is involved in this motion. The mentalis muscle is located in the chin area and is responsible for controlling the movement of the lower lip. It helps in raising and wrinkling the skin of the chin and pushing the lower lip upwards. This muscle is important for facial expressions such as pouting or expressing doubt.

The illustration shows the patient's inability to reach her toes in a long sitting position, indicating limited flexibility in the hamstrings muscle. Passive insufficiency refers to the inability of a muscle to lengthen fully due to its antagonist muscle being shortened. In this case, the hamstrings muscle is being passively insufficient, meaning it is unable to lengthen fully due to the shortened quadriceps muscle. Therefore, the correct answer is that the hamstrings muscle is responsible for the result due to its passive insufficiency.

The neck region is not only composed of the cervical vertebrae and the hyoid bone, but also includes other bones such as the clavicle. It serves as the base of the skull and contains several muscular layers that protect structures passing through it.

The patient having strong quadriceps femoris muscles suggests that the tightness in the knee extensors is not due to weakness in these muscles. Strong quadriceps femoris muscles would typically provide adequate strength for knee extension, so the tightness experienced by the patient is likely due to other factors such as tight iliopsoas muscles.

LCPD stands for Legg-Calve-Perthes disease, which is a condition that affects the hip joint in children. It occurs when the blood supply to the femoral head (top of the thigh bone) is disrupted, leading to bone death and subsequent deformity. The x-ray film is likely showing characteristic changes in the hip joint associated with LCPD, such as flattening and fragmentation of the femoral head. SCFE (Slipped Capital Femoral Epiphysis) is another condition that affects the hip joint in children, but it is characterized by the slippage of the femoral head from the femoral neck. Hip dislocation and malalignment syndrome are unrelated conditions and would not present with the same x-ray findings as LCPD.

Based on the information provided, the patient's habitual posture is noted to have stretched hip flexors and strong hip extensors. This suggests that the hip flexors are being constantly stretched and lengthened, while the hip extensors are being strengthened and contracted. This imbalance in muscle length and strength indicates that the patient may have a tendency to tilt their pelvis forward, leading to increased stress and tension on the hip flexors and extensors. This can result in low back pain, as the muscles in the hip region are not functioning optimally to support the spine and maintain proper posture.

In the presence of paralysis of active hip extension, the technique that allows for functional standing balance is to place the center of gravity of the Head, Arms and Trunk posterior to the hip joint and lean against the Iliofemoral ligament. This positioning helps to create a counterbalance and stability by shifting the weight behind the hip joint. Leaning against the Iliofemoral ligament provides additional support and helps to maintain balance.

Lumbar lordosis is the inward curvature of the lower spine. It develops when a person starts standing. When standing, the weight of the body is supported by the legs and spine, causing the lumbar spine to curve inward. In supine and prone positions, the spine is typically in a more neutral position, and the curvature is not as pronounced. Supported sitting may also contribute to some degree of lumbar lordosis, but it is not as significant as when standing. Therefore, standing is the milestone at which lumbar lordosis develops.

The correct answer is right posterior S1 mobilization. The patient's leg length discrepancy suggests a possible sacroiliac joint dysfunction. Right posterior S1 mobilization would be a suitable treatment plan as it can help address any dysfunction or misalignment in the sacroiliac joint, specifically on the right side. This mobilization technique can help restore proper joint mechanics and alleviate the patient's right sacroiliac joint pain.

The test being done to the patient is SI Gapping.

To prevent hip dislocation, one should guard against the motion of flexion and adduction. Flexion refers to bending the hip joint, while adduction refers to bringing the leg towards the midline of the body. These motions can put excessive stress on the hip joint, leading to dislocation. By avoiding flexion and adduction, one can help maintain the stability of the hip joint and reduce the risk of dislocation.

The patient's medial malleoli being aligned in the supine position suggests that the innominates are in a neutral position. However, when the patient assumes the long-sitting position and the right malleolus shifts inferiorly, it indicates anterior rotation of the right innominate. This means that the right side of the pelvis is rotating forward, causing a positional change in the malleoli. Therefore, the most likely cause of this patient's test results is anterior rotation of the innominate on the right.

The lateral femoral cutaneous nerve of the thigh may be the cause of the pain in this case. The pain is elicited while performing hip motions with resistance and is specifically palpated on the area of the ASIS (anterior superior iliac spine). The lateral femoral cutaneous nerve supplies sensation to the skin over the lateral part of the thigh, and compression or irritation of this nerve can result in pain in this area.

The capsular pattern of the lumbar spine refers to the characteristic pattern of joint restriction or limitation of movement that is commonly seen in certain conditions or pathologies affecting the lumbar spine. In this case, the correct answer suggests that the capsular pattern of the lumbar spine involves a limitation in lateral flexion and rotation, followed by a limitation in extension, and then a limitation in flexion. This means that in conditions affecting the lumbar spine, lateral flexion and rotation will be more restricted compared to extension and flexion.

The muscular triangle is the only unpaired triangle of the neck. The other three triangles mentioned (submandibular, submental, and carotid) are all paired, meaning there is one on each side of the neck. The muscular triangle is located in the front of the neck, between the anterior belly of the digastric muscle, the superior belly of the omohyoid muscle, and the midline of the neck. It contains several muscles, including the infrahyoid muscles and the thyroid gland.

The correct answer is Grade 5 Lower trapezius. The patient's ability to retract the scapula against maximal resistance indicates that the lower trapezius muscle is functioning at full strength. The other options, upper trapezius, middle trapezius, and rhomboid major, are not appropriate assessments because the patient's ability to perform the movement indicates that these muscles are not the primary source of strength in this action.

The given answer "None of the above" is correct because all of the statements provided in the question accurately describe the atlanto-occipital joint. It allows slight lateral flexion, it is a hinge type joint, and it is attached by the anterior atlanto occipital ligament to the anterior margin of the foramen magnum. Additionally, it allows extension beyond midline. Therefore, there is no statement that is incorrect or does not describe the atlanto-occipital joint.

The supraspinous ligament is the correct answer because it is located on the posterior aspect of the vertebral column and connects the tips of the spinous processes. When the neck region moves, the supraspinous ligament is the first ligament to receive tension due to its position and function in stabilizing the vertebrae.