All Quiz Questions

1. What is the only true bone-to-bone connection between the upper extremity and the trunk?

A. Sternoclavicular joint

B. Acromioclavicular joint

C. Scapulothoracic joint

D. Glenohumeral joint

2. Which bone connects the sternum to the scapula?

A. Radius

B. Clavicle

C. Humerus

D. Ulna

3. The humerus articulates with which part of the scapula at the shoulder?

A. Coracoid process

B. Glenoid fossa

C. Acromion

D. Spine of the scapula

4. What type of joint is the glenohumeral joint?

A. Hinge joint

B. Ball-and-socket joint

C. Pivot joint

D. Saddle joint

5. What motion does the glenohumeral joint allow?

A. Flexion and extension

B. Flexion, extension, abduction, adduction, external rotation

C. Abduction, adduction, flexion, extension

D. Flexion, extension, abduction, adduction, rotation, and circumduction

6. What is the primary role of the sternoclavicular joint?

A. To stabilize the acromion

B. To allow slight movement of the clavicle for smooth shoulder motion

C. To stabilize the scapula

D. To connect the scapula to the humerus

7. What is the general rule of movement for the scapulothoracic joint during shoulder flexion and abduction?

A. For every 1 degree of glenohumeral joint movement, there is 2 degrees of scapulothoracic movement

B. For every 2 degrees of glenohumeral joint movement, there is 1 degree of scapulothoracic movement

C. Scapulothoracic joint does not move during glenohumeral motion

D. Scapulothoracic joint moves equally with the glenohumeral joint

8. What is the term for the coordinated movement between the scapula and humerus during shoulder flexion or abduction?

A. Scapulohumeral rhythm

B. Scapular kinesis

C. Acromioclavicular coordination

D. Scapular dyskinesis

9. Which bone is located on the thumb (lateral) side of the forearm?

A. Radius

B. Humerus

C. Ulna

D. Scaphoid

10. What bone rotates during forearm pronation and supination?

A. Radius

B. Ulna

C. Humerus

D. Pisiform

11. What type of fracture is very common in the forearm?

A. Olecranon fracture

B. Distal ulna fracture

C. Distal radius fracture

D. Proximal humerus fracture

12. Where is the ulna located in the forearm?

A. Lateral/thumb side

B. Medial/pinky side

C. Center of the forearm

D. Posterior side of the forearm

13. Which forearm bone provides the main articulation with the humerus?

A. Radius

B. Scaphoid

C. Ulna

D. Trapezium

14. During pronation and supination, what happens to the ulna?

A. It rotates around the radius

B. It stays stationary

C. It flexes and extends

D. It separates from the radius

15. What joint connects the radial head with the ulna near the elbow?

A. Distal radioulnar joint

B. Humeroradial joint

C. Proximal radioulnar joint

D. Interosseous joint

16. What structure stabilizes the shafts of the radius and ulna and provides muscle attachment?

A. Annular ligament

B. TFCC

C. Interosseous membrane

D. Brachial plexus

17. Which bone is located on the thumb (lateral) side of the forearm?

A. Radius

B. Humerus

C. Ulna

D. Scaphoid

18. What bone rotates during forearm pronation and supination?

A. Radius

B. Ulna

C. Humerus

D. Pisiform

19. What type of fracture is very common in the forearm?

A. Olecranon fracture

B. Distal ulna fracture

C. Distal radius fracture

D. Proximal humerus fracture

20. Where is the ulna located in the forearm?

A. Lateral/thumb side

B. Medial/pinky side

C. Center of the forearm

D. Posterior side of the forearm

21. Which forearm bone provides the main articulation with the humerus?

A. Radius

B. Scaphoid

C. Ulna

D. Trapezium

22. During pronation and supination, what happens to the ulna?

A. It rotates around the radius

B. It stays stationary

C. It flexes and extends

D. It separates from the radius

23. What joint connects the radial head with the ulna near the elbow?

A. Distal radioulnar joint

B. Humeroradial joint

C. Proximal radioulnar joint

D. Interosseous joint

24. What structure stabilizes the shafts of the radius and ulna and provides muscle attachment?

A. Annular ligament

B. TFCC

C. Interosseous membrane

D. Brachial plexus

25. Which muscle is the primary abductor of the shoulder joint?

a. Deltoid

b. Infraspinatus

c. Supraspinatus

d. Teres minor

26. Which muscle originates from the supraspinous fossa?

a. Subscapularis

b. Infraspinatus

c. Teres major

d. Supraspinatus

27. The deltoid muscle inserts on which bony landmark?

a. Greater tubercle of the humerus

b. Deltoid tuberosity

c. Bicipital groove

d. Deltoid groove

28. What is the main action of the subscapularis muscle?

a. Lateral rotation of the humerus

b. Abduction of the arm

c. Medial rotation of the humerus

d. Extension of the elbow

29. Which of the following muscles is NOT part of the rotator cuff group?

a. Teres minor

b. Infraspinatus

c. Supraspinatus

d. Teres major

30. What is the primary action of the triceps brachii?

a. Elbow flexion

b. Elbow extension

c. Shoulder flexion

d. Supination of the forearm

31. Which head of the triceps brachii crosses both the shoulder and elbow joints?

a. Medial head

b. Long head

c. Lateral head

d. Deep head

32. What is the action of the coracobrachialis muscle?

a. Flexion and weak abduction of the shoulder

b. Lateral rotation of the shoulder

c. Flexion and weak adduction of the shoulder

d. Extension of the shoulder

33. What is a shared action of both the biceps brachii and the brachialis?

a. Shoulder extension

b. Elbow flexion

c. Elbow flexion and shoulder flexion

d. Shoulder lateral rotation

34. Which nerve innervates the biceps brachii, brachialis, and coracobrachialis?

a. Axillary nerve

b. Radial nerve

c. Musculocutaneous nerve

d. Median nerve

35. Which of the following muscles is a primary wrist flexor and also causes radial deviation?

a. Flexor carpi ulnaris

b. Flexor carpi radialis

c. Palmaris longus

d. Extensor carpi radialis brevis

36. Which forearm muscle inserts into the palmar aponeurosis and is sometimes absent in people?

a. Flexor pollicis longus

b. Flexor carpi ulnaris

c. Palmaris longus

d. Pronator teres

37. Which nerve innervates most of the flexor muscles in the forearm?

a. Ulnar nerve

b. Radial nerve

c. Musculocutaneous nerve

d. Median nerve

38. Which muscle pronates the forearm and lies deep near the wrist?

a. Pronator teres

b. Supinator

c. Brachioradialis

d. Pronator quadratus

39. The common flexor tendon originates from which bony landmark?

a. Lateral epicondyle of the humerus

b. Radial tuberosity

c. Olecranon process

d. Medial epicondyle of the humerus

40. Which muscle flexes the DIP joints of the fingers?

a. Flexor digitorum superficialis

b. Extensor digitorum

c. Flexor digitorum profundus

d. Lumbricals

41. The flexor digitorum superficialis splits into tendons that insert on which phalanges?

a. Distal phalanges

b. Proximal phalanges

c. Middle phalanges

d. Metacarpals

42. Which muscle has tendons that pass through the split tendons of the FDS?

a. Extensor indicis

b. Flexor digitorum profundus

c. Flexor pollicis longus

d. Brachioradialis

43. What is a key difference between FDS and FDP in terms of insertion?

a. FDS inserts on distal phalanges, FDP on middle phalanges

b. FDS inserts on metacarpals, FDP on carpal bones

c. FDS inserts on middle phalanges, FDP on distal phalanges

d. FDS inserts on proximal phalanges, FDP on middle phalanges

44. Where do most flexor muscles of the forearm originate?

A. Lateral epicondyle of the humerus

B. Medial epicondyle of the humerus

C. Radial head

D. Ulnar notch

45. Which of the following muscles is part of the posterior compartment of the forearm?

A. Flexor carpi radialis

B. Extensor carpi ulnaris

C. Flexor digitorum superficialis

D. Palmaris longus

46. Which compartment of the forearm contains the muscles responsible for wrist flexion?

A. Anterior compartment

B. Posterior compartment

C. Lateral compartment

D. Medial compartment

47. What are intrinsic muscles?

A. Muscles that originate in the forearm and insert in the hand

B. Muscles that are solely in the hand

C. Muscles that only function in the wrist

D. Muscles that connect the elbow to the hand

48. What is the primary action of the dorsal interossei?

A. Flexes the MCP joint

B. Adducts the fingers

C. Abducts the fingers

D. Extends the PIP and DIP joints

49. What is the primary action of the palmar interossei?

A. Abducts the fingers

B. Adducts the fingers

C. Flexes the PIP joints

D. Extends the MCP joints

50.What is the primary function of the thenar muscles?

A. To control movements of the pinky

B. To control movements of the thumb

C. To extend the wrist

D. To stabilize the hand during gripping

51. What action do the lumbricals of the hand perform?

A. Flex the MCP joints and extend the PIP/DIP joints

B. Abduct the fingers

C. Adduct the thumb

D. Extend the wrist

52. Which muscles are responsible for flexion of the fingers?

A. Intrinsic muscles of the hand

B. Extrinsic flexors from the forearm

C. Abductor pollicis brevis

D. Extensor digitorum

53. Where do the interossei muscles lie in the hand?

A. Between the metacarpals

B. Between the phalanges

C. On the palm side only

D. On the back of the hand

54. Which nerve innervates the thenar muscles?

A. Median nerve

B. Ulnar nerve

C. Radial nerve

D. Musculocutaneous nerve

55. Which nerve innervates the hypothenar muscles?

A. Median nerve

B. Ulnar nerve

C. Radial nerve

D. Musculocutaneous nerve

56. Which nerve innervates the extensor muscles of the hand?

A. Median nerve

B. Ulnar nerve

C. Radial nerve

D. Musculocutaneous nerve

57. What are the main functions of the lymphatic system?

a. Supply oxygen to tissues and remove carbon dioxide

b. Provide nutrients to the blood and store fat

c. Remove waste, fight infection, and return excess fluid to the bloodstream

d. Maintain bone health and blood sugar levels

58. Where does lymph fluid originate from?

a. Cerebrospinal fluid

b. Digestive enzymes

c. Synovial fluid

d. Blood plasma

59. Which lymph nodes are the main filtering site for the upper extremity?

a. Ulnar lymph nodes

b. Brachial lymph nodes

c. Radial lymph nodes

d. Axillary lymph nodes

60. At what anatomical landmark does the subclavian artery become the axillary artery?

a. Elbow

b. Clavicle

c. First rib

d. Teres major muscle

61. Where does the brachial artery split into the radial and ulnar arteries?

a. At the shoulder

b. At the cubital fossa

c. At the wrist

d. In the palm

62. What is an arterial anastomosis?

a. A blockage in an artery

b. A connection between arteries to maintain blood flow

c. A branch of a vein into an artery

d. A muscle supplied by multiple veins

63. What are the main superficial veins of the upper extremity?

a. Subclavian and brachial veins

b. Cephalic, basilic, and median cubital veins

c. Radial and ulnar veins

d. Axillary and jugular veins

64. Which of the following best describes adhesive capsulitis?
A. Sudden shoulder dislocation and muscle atrophy
B. Progressive stiffening of the shoulder causing pain and limited motion
C. A genetic condition leading to shoulder instability
D. Cartilage degeneration and bone spurs

65. Adhesive capsulitis affects which types of shoulder motion?
A. Only active range of motion
B. Only passive range of motion
C. Both active and passive range of motion
D. Neither; strength is the only issue

66. What is the main cause of restricted motion in adhesive capsulitis?
A. Torn rotator cuff
B. Bone spur formation
C. Bursitis in the shoulder
D. Thickening and scarring of the joint capsule 

67. Which of the following is a likely external cause of secondary adhesive capsulitis?
A. Autoimmune response
B. Trauma or surgery
C. Diabetes
D. Female gender

68. Which type of adhesive capsulitis is associated with systemic conditions like diabetes or thyroid disorders?
A. Secondary
B. Mechanical
C. Primary
D. Inflammatory only

69. Which joint positions characterize a Boutonniere deformity?

A. Flexion at the DIP, hyperextension at the PIP

B. Flexion at both the PIP and DIP

C. Flexion at the PIP, hyperextension at the DIP

D. Extension at both the PIP and DIP

70. Which structure is primarily injured in a Boutonniere deformity?

A. Central slip of the extensor tendon

B. Volar plate

C. Flexor digitorum profundus

D. Lateral collateral ligament

71. What happens to the lateral bands in a Boutonniere deformity?

A. They rupture completely

B. They move dorsally and stabilize the DIP

C. They stay in place and maintain DIP flexion

D. They slip volarly, contributing to DIP hyperextension

72. Which of the following is a common cause of Boutonniere deformity?

A. Repetitive typing

B. Finger jam or trauma to a flexed PIP joint

C. Forceful extension of the PIP joint

D. Distal phalanx fracture

73. What is the primary goal of orthotic intervention for Boutonniere deformity?

A. Prevent DIP hyperextension

B. Immobilize the DIP joint for healing

C. Hold the PIP joint in neutral to allow the tendon to heal

D. Strengthen the flexor tendon

74. What is carpal tunnel syndrome?

A. Compression of the median nerve at the wrist

B. Compression of the ulnar nerve at the elbow

C. A rupture of tendons in the wrist

D. Dislocation of the carpal bones

75. Which structure forms the roof of the carpal tunnel?
A. Flexor digitorum profundus
B. Pisiform bone
C. Transverse carpal ligament (flexor retinaculum)
D. Palmar aponeurosis

76. Which of the following does NOT pass through the carpal tunnel?
A. Flexor pollicis longus
B. Median nerve
C. Extensor carpi radialis
D. Flexor digitorum superficialis

77. Which fingers are typically affected by carpal tunnel syndrome?
A. Thumb, index, middle, and half of the ring finger
B. Ring and pinky fingers only
C. All five fingers
D. Thumb and pinky finger only

78. Which symptom indicates late-stage carpal tunnel syndrome?
A. Pain that radiates down the leg
B. Atrophy of the thenar eminence
C. Increased range of motion in the wrist
D. Tingling that only occurs with gripping

79. What is the typical outcome if carpal tunnel syndrome is left untreated?
A. It resolves spontaneously
B. It stabilizes with no long-term damage
C. It can progress to permanent nerve damage
D. It causes permanent wrist fusion

80. What is a hallmark symptom of early-stage carpal tunnel syndrome?
A. Thenar atrophy
B. Constant numbness during the day
C. Muscle twitching in the wrist
D. Nighttime symptoms with relief after shaking the hand

81. What can occur when the median nerve is repeatedly compressed?
A. Tendon hypertrophy and rupture
B. Ulnar nerve displacement
C. Demyelination and edema in the nerve
D. Atrophy of forearm flexors

82. What nerve is affected in cubital tunnel syndrome?

A. Ulnar nerve

B. Radial nerve

C. median nerve

D. Axillary nerve

83. Which muscle surrounds the cubital tunnel and can contribute to nerve compression?
A. Flexor digitorum superficialis
B. Flexor carpi radialis
C. Flexor carpi ulnaris
D. Pronator teres

84. Which movement commonly increases pressure in the cubital tunnel?
A. Wrist extension
B. Elbow flexion
C. Shoulder flexion
D. Finger abduction

85. Which of the following is an early symptom of cubital tunnel syndrome?
A. Thumb pain
B. Numbness in the index finger
C. Numbness in the ring and pinky fingers
D. Muscle wasting in the thenar eminence

86. Which activity is most likely to worsen cubital tunnel symptoms?
A. Typing with straight wrists
B. Sleeping with the elbow extended
C. Holding a phone with a bent elbow
D. Lifting with a straight arm

87. Which of the following is a sign of advanced cubital tunnel syndrome?

A. Increased grip strength

B. Tingling that resolves quickly

C. Elbow dislocation

D. Claw deformity of the 4th and 5th digits

88. Where is pain typically located in De Quervain’s tenosynovitis?

A. On the ulnar side of the wrist

B. On the thumb side of the wrist

C. In the center of the palm

D. At the elbow

89. What movement most commonly aggravates symptoms of De Quervain’s?

A. Thumb movement and radial/ulnar deviation

B. Finger extension

C. Elbow flexion

D. Supination of the forearm

90. Which compartment is involved in De Quervain’s tenosynovitis?

A. Second dorsal compartment

B. First dorsal compartment

C. Thenar compartment

D. Palmar compartment

91. What two tendons are involved in De Quervain’s?

A. Extensor carpi radialis and extensor digitorum

B. Flexor pollicis longus and abductor pollicis brevis

C. Abductor pollicis longus and extensor pollicis brevis

D. Flexor digitorum profundus and extensor indicis

92. What structure do the tendons in the first dorsal compartment rub against, contributing to inflammation?

A. Carpal tunnel

B. Extensor retinaculum

C. Annular pulley

D. Palmar aponeurosis

93. What orthosis is typically used to treat De Quervain’s?

A. Elbow immobilizer

B. Resting hand splint

C. Thumb spica orthosis

D. Dynamic MCP extension splint

94. Which population is especially at risk for developing De Quervain’s?

A. Teenagers who text frequently

B. Older adults with arthritis

C. Pregnant women and new mothers

D. People with carpal tunnel syndrome

95. What is the most common type of distal radius fracture?

A. Smith’s fracture

B. Greenstick fracture

C. Colles’ fracture

D. Torus fracture

96. Which population is most likely to experience a buckle or greenstick fracture?

A. Elderly individuals

B. Adolescents

C. Middle-aged adults

D. Pediatric population

97. Which of the following describes a comminuted fracture?

A. Bone breaks into multiple pieces

B. Bone cracks but does not break completely

C. Involves the joint surface

D. Bone stays aligned

98. An intra-articular fracture involves which of the following?

A. Only the bone shaft

B. The bone and the surrounding muscle

C. The joint surface

D. The tendon sheath

99. What age groups are most commonly affected by distal radius fractures?

A. Middle-aged adults and older adults

B. Neonates and infants

C. Children/adolescents and older adults

D. Children/adolescents and middle-aged adults

100. How long might it take for full recovery of strength and range of motion after a distal radius fracture?

A. 2-4 weeks

B. 3 months

C. 6 months

D. Up to 1 year

101. During a Smith’s fracture, the distal radius fragment typically shifts in which direction?

A. Volar

B. Dorsal

C. Distal

D. Proximal

102. What wrist position at the time of injury is most likely to cause a Colles’ fracture?

A. Wrist in extension

B. Wrist in ulnar deviation

C. Wrist in neutral

D. Wrist in flexion

103.  What is Dupuytren’s contracture?

A. Inflammation of finger tendons

B. Thickening and shortening of fascia in the palm and fingers

C. Dislocation of the MCP joint

D. Rupture of the extensor tendon

104. Which fingers are most commonly affected in Dupuytren’s contracture?

A. Index and middle fingers

B. Thumb and index finger

C. Ring and pinky fingers

D. Middle and ring fingers

105. What tissue forms rope-like cords that pull the fingers into flexion?

A. Flexor tendons

B. Palmar fascia

C. Joint capsule

D. Extensor mechanism

106. What joints are typically affected by Dupuytren’s contracture? 

A. DIP only

B. MCP and PIP

C. CMC and IP

D. Radiocarpal and MCP

107. What causes the connective tissue in Dupuytren’s to thicken and stiffen?

A. Loss of synovial fluid

B. Inactive fibroblasts

C. Overproduction of collagen by overactive fibroblasts

D. Ligament tears

108. How do cords in Dupuytren’s differ from tendons?

A. Cords are vascular, tendons are not

B. Cords are in the dorsal hand

C. Cords are thickened fascia and can be mistaken for tendons

D. Cords run vertically while tendons run horizontally

109. Over time, Dupuytren’s contracture results in:

A. Triggering and locking of the thumb

B. Flexion contractures and loss of extension

C. Joint dislocation

D. Wrist instability

110. What is the most common cause of lateral epicondylitis?

A. Overuse of the common extensor tendon at the lateral epicondyle

B. Compression of the radial nerve at the lateral elbow

C. Tearing of the triceps tendon

D. Overuse of the common flexor tendon at the lateral epicondyle

111. Which tendon is primarily affected in lateral epicondylitis?

A. Flexor carpi radialis

B. Extensor carpi radialis brevis

C. Extensor carpi ulnaris

D. Supinator

112. Lateral epicondylitis involves which of the following processes?

A. Acute inflammation of the tendon

B. Tendon avulsion

C. Tendinosis with degeneration of the tendon

D. Bone spur formation

113. Where is pain typically located in lateral epicondylitis?

A. Medial elbow and wrist

B. Lateral elbow, 1–2 cm distal to the lateral epicondyle

C. Posterior forearm

D. Lateral elbow, 2-5 cm proximal to the lateral epicondyle

114. What tissue changes are commonly present in lateral epicondylitis?

A. Microscopic tendon tears and disorganized collagen

B. Ligament rupture and synovial swelling

C. Cartilage erosion and nerve compression

D. Joint dislocation and muscle wasting

115. What are common contributing activities to the development of lateral epicondylitis?

A. Writing and typing

B. Rock climbing and cycling

C. Racquet sports and tool use involving wrist extension

D. Push-ups and tool use involving wrist flexion

116. What is mallet finger?

A. A fracture at the distal phalanx

B. An injury to the terminal extensor tendon at the fingertip

C. A torn flexor tendon at the fingertip

D. A dislocated DIP joint

117. Which joint is affected in mallet finger?

A. MCP joint

B. PIP joint

C. DIP joint

D. Nonsense, there is no joint involvement in mallet finger

118. The terminal extensor tendon inserts on which bone?

A. Distal phalanx

B. Proximal phalanx

C. Middle phalax

D. Trapezium

119. What symptom is most characteristic of mallet finger?

A. Tingling in the fingertip

B. Inability to active flex the DIP joint

C. Inability to actively extend the DIP joint

D. Triggering with finger flexion

120. What kind of injury sometimes occurs in addition to the tendon injury?

A. Radial head fracture

B. Avulsion fracture of the distal phalanx

C. MCP joint dislocation

D. Torn lateral band

121. What is a possible lingering issue after recovery from mallet finger?

A. Chronic edema in the finger

B. Numbness in the finger

C. Extensor lag

D. Joint instability at the PIP joint

122. Which of the following statements is true about orthosis use in mallet finger treatment?

A. It must be worn full-time for 6–8 weeks with no DIP flexion

B. It should be worn only during exercise and activity for at least 4 weeks

C. It should immobilize the entire hand for at least 8 weeks to prevent activation of wrist and finger flexors

D. It is optional unless pain increases

123. What is medial epicondylitis commonly caused by?

A. Ligament tear at the medial elbowf

B. Overuse of the common extensor tendon

C. Compression of the radial nerve

D . Overuse of the common flexor tendon

124. Which tendon group is primarily affected in medial epicondylitis?

A. Extensor tendons of the wrist

B. Common flexor tendons of the forearm

C. Biceps tendon

D. Rotator cuff tendons

125. What two muscles are most commonly involved?

A. Extensor carpi radialis and supinator

B. Flexor carpi radialis and pronator teres

C. Brachialis and triceps

D. Flexor digitorum profundus and anconeus

126. Which activity is most likely to contribute to developing medial epicondylitis?

A. Reaching overhead

B. Wrist extension during typing

C. Repetitive wrist flexion or gripping

D. Finger abduction against resistance

127. What is the underlying pathology of medial epicondylitis?

A. Acute inflammation of muscle tissue

B. Tendinosis with microscopic tendon degeneration

C. Nerve compression causing motor loss

D. Ligament sprain and synovitis

128. Pain is most commonly reproduced with:

A. Resisted wrist flexion and forearm pronation elbow extension

B. Resisted elbow extension

C. Passive shoulder internal rotation

D. Passive wrist extension

129. What is typically the first joint structure affected by osteoarthritis?

A. Synovial membrane

B. Articular cartilage

C. Subchondral bone

D. Joint capsule

130. What type of osteoarthritis is associated with no prior injury or disease?

A. Secondary osteoarthritis

B. Idiopathic arthritis

C. Primary osteoarthritis

D. Inflammatory osteoarthritis

131. What is the most common type of osteoarthritis?

A. Inflammatory osteoarthritis

B. Secondary osteoarthritis

C. Post-traumatic arthritis

D. Primary osteoarthritis

132. Which risk factor is MOST strongly associated with developing primary osteoarthritis?

A. Recent infection

B. Previous tendon repair

C. Increasing age

D. Low calcium levels

133. What is the goal of an arthroplasty surgery for osteoarthritis?

A. Fuse bones together

B. Remove bone spurs

C. Replace damaged joint components

D. Realign tendons

134. What type of osteoarthritis results from a preexisting joint injury or abnormality?

A. Idiopathic

B. Primary

C. Degenerative

D. Secondary

135. What type of disease is rheumatoid arthritis (RA)?

A. Genetic-only disorder

B. Localized infection

C. Systemic autoimmune disease

D. Degenerative bone disease

136. What is the strongest known environmental risk factor for developing RA?

A. Cigarette smoking

B. Alcohol use

C. Cannabis smoking

D. Cold climates

137. Which joints are typically affected first in RA?

A. Larger joints such as knees and hips

B. Small joints in the hands and feet

C. Shoulders and elbows

D. Joints of the spine

138. In RA, what structure is primarily attacked by the immune system?

A. The tendons

B. The muscles

C. The synovium

D. The bone marrow

139. What are the two main contributors to the development of RA?

A. Only bacterial infections

B. Repetitive overuse and aging

C. Vitamin deficiencies

D. Genetic predisposition and environmental factors

140. What is a flare-up in RA?

A.  A period of joint healing

B.  A sudden allergic reaction to medication

C.  A period when symptoms worsen

D. A period when symptoms improve

141. What is the primary cause of the locking or catching sensation in trigger finger?

A. Overuse of the extensor muscles
B. A dislocated MCP joint
C. Inflammation of the tendon sheath causing restricted tendon gliding
D. Loss of synovial fluid in the DIP joint

142. Which pulley is most commonly affected in trigger finger?

A. A2 pulley
B. A3 pulley
C. C1 pulley
D. A1 pulley

143. Where is the most commonly affected pulley located?

A. Near the DIP joint on the dorsal surface
B. At the mid-shaft of the proximal phalanx
C. Near the base of the finger at the MCP joint on the palmar surface
D. Near the PIP joint on the dorsal surface

144. What is the primary function of the annular pulley system?

A. To hold the flexor tendons close to the bone and prevent bowstringing
B. To allow the tendon to contract independently
C. To allow synovial fluid to enter the tendon sheath
D. To support MCP joint extension

145. Which tendons are involved in trigger finger?

A. Extensor carpi radialis longus and brevis
B. Palmaris longus and flexor carpi ulnaris
C. Flexor digitorum superficialis and flexor digitorum profundus
D. Abductor pollicis longus and extensor pollicis brevis

146. Which symptom is most characteristic of trigger finger?

A. Burning sensation along the lateral forearm
B. Clicking or locking during finger movement
C. Numbness in the entire hand
D. Sharp pain at the wrist

147. Why is digit locking more likely to occur after extension?

A. Extension is more forceful than flexion
B. The extensor muscles are weaker and cannot pull the tendon through the narrowed sheath
C. The A2 pulley is damaged during extension
D. The synovial sheath dries out after extension

148. What is the typical width of the subacromial space in a healthy shoulder?

A. 2–3 cm
B. 1–1.5 cm
C. 0.3–0.8 cm
D. 3–4 cm

149. What is a common anatomical cause of primary subacromial impingement?

A. Irregular shape of the acromion
B. Weak rotator cuff muscles
C. Labral degeneration
D. Posterior capsule tightness

150. Which classification of subacromial pain syndrome is associated with rotator cuff weakness and excessive humeral head motion?

A. Primary impingement
B. Secondary impingement
C. External impingement
D. Static impingement

151. What type of impingement occurs when rotator cuff tendons are pinched between the humeral head and glenoid rim?

A. External impingement
B. Secondary impingement
C. Internal impingement
D. Supraspinatus impingement

152. What typically happens to the subacromial space during shoulder movement?

A. It remains unchanged in size
B. It becomes larger to allow more tendon movement
C. It becomes tighter, increasing the risk of tendon compression
D. It shifts posteriorly toward the scapula

153. What joint positions characterize a swan neck deformity?

A. Hyperextension at the PIP and flexion at the DIP

B. Flexion at the PIP and DIP joints

C. Hyperextension at the DIP and flexion at the PIP

D. Hyperextension at all finger joints

154. Which of the following is a common cause of swan neck deformity?

A. Rheumatoid arthritis

B. Carpal tunnel syndrome

C. De Quervain’s tenosynovitis

D. Lateral epicondylitis

155. What does dysfunction of the distal extensor mechanism cause?

A. Extension of the DIP joint 

B. Flexion of the DIP joint due to loss of extension force

C. Hyperextension of the DIP joint

D. Dislocation of the DIP joint

156. In a swan neck deformity, the force from the FDP tendon contributes to:

A. PIP joint flexion

B. MCP joint hyperextension

C. DIP joint flexion

D. Extension of all finger joints

157. What is the purpose of an extension block orthosis in swan neck deformity treatment?

A. To restrict all joint motion

B. To flex the DIP joint

C. To immobilize the MCP joint

D. To prevent PIP hyperextension while allowing PIP flexion To restrict all joint motion

158. What makes fluidotherapy beneficial for desensitization?

A. Its low-frequency electrical stimulation

B. The tactile stimulation from blowing cellulose particles

C. The vibration caused by sound waves

D. Compression from the enclosed chamber

159. What is a unique feature of fluidotherapy compared to other thermal modalities?

A. It can be applied to the entire body

B. It combines heat with ultrasound

C. It allows active movement during treatment

D. It uses moist heat

160. Which of the following is an indication for using fluidotherapy?

A. Open wound

B. Joint stiffness

C. Active infection

D. Peripheral vascular disease

161. What physiological effect does heat from fluidotherapy have on blood vessels?

A. Vasoconstriction

B. Vasodilation

C. Coagulation

D. Vessel rupture

162. Why is fluidotherapy contraindicated in individuals with impaired sensation?

A. They may not detect harmful levels of heat It restricts movement in the extremity

B. It restricts movement in the extremity

C. It causes extreme cold in the tissues

D. It increases blood pressure

163. In addition to heating tissues, fluidotherapy helps with:

A. Muscle atrophy

B. Bone healing

C. Scar remodeling

D. Limb regeneration

164. What scientific processes are promoted by the heat generated in fluidotherapy?

A. Coagulation and protein breakdown

B. Muscle hypertrophy and fluid loss

C. Vasodilation, increased cellular metabolism, and phagocytosis

D. Nerve regeneration and ossification

165. What type of heat transfer is used when applying a hot pack?

A. Conduction

B. Convection

C. Radiation

D. Evaporation

166. What is the primary physiological response of blood vessels to heat from a hot pack?

A. Vasoconstriction

B. Vasodilation

C. Hypertension

D. Vasovalgus syncope

167. How does a hot pack promote tissue healing?

A. By cooling the muscles to reduce inflammation

B. By stimulating muscle hypertrophy

C. By increasing blood flow and metabolism in the treated area

D. By compressing the soft tissue structures

168. How deep do hot packs typically penetrate tissue?

A. 2–3 cm

B. 5–6 cm

C. Less than 1 cm

D. 4–5 inches

169. When should a therapist consider using a modality like ultrasound instead of a hot pack?

A. When the patient prefers a hot pack

B. When the treatment area is a large surface

C. When their subjective pain level is 7/10 or higher

D. When deeper tissue heating is required

170. Which of the following is an appropriate indication for hot pack use?

A. Joint hypermobility

B. Malignancy in the treatment area

C. Joint stiffness

D. Acute inflammation

171. What is the primary mechanism by which cryotherapy reduces swelling and inflammation?

A. Vasodilation and increased circulation

B. Vasoconstriction and reduced tissue metabolism

C. Muscle hypertrophy

D. Increased synovial fluid production

172. Which of the following best describes how an ice massage is applied?

A. Pushing ice up and down against the skin

B. Rubbing ice rapidly back and forth across the skin

C. Applying ice directly to skin in slow, circular motions

D. Using a vibrating ice tool on the skin

173. In what order do patients usually feel sensations during an ice massage?

A. Numbness, tingling, cold, burning

B. Cold, burning, aching/tingling, numbness

C. Cold, tingling, heat, numbness

D. Cold, numbness, aching, burning

174. Which method of cryotherapy is generally preferred for larger treatment areas?

A. Ice bath

B. Cold pack

C. Ice massage

D. Contrast bath

175. Which of the following is a contraindication for cryotherapy?

A. Acute pain

B. Bruising

C. Raynaud’s phenomenon

D. Muscle tightness

176. What is a known benefit of ice massage compared to cold packs?

A. It increases muscle strength

B. It causes greater vasodilation

C. It offers deeper penetration and is better for small areas

D. It can be left on for longer durations

177. How many electrodes are typically used during an IFC treatment?

A. 4

B. 2

C. 3

D. 6

178. What is the purpose of crossing two medium-frequency currents in IFC?

A. To decrease skin resistance

B. To deliver heat to the muscles

C. To create a therapeutic low-frequency current deeper in the tissues

D. To strengthen the affected muscles

179. Why is IFC preferred over applying a low-frequency current directly?

A. Low-frequency currents can cause muscle spasms

B. Medium-frequency currents pass through the skin more easily and are less painful

C. High-frequency is better for bone remodeling

D. Low-frequency causes vasodilation

180. What does a beat frequency of 2–10 Hz in IFC promote?

A. Muscle hypertrophy

B. Bone healing

C. Endorphin release for pain reduction

D. Scar remodeling

181. Which machine setting in IFC helps prevent nerve accommodation by varying the beat frequency over time?

A. Intensity

B. Volume

C. Sweep

D. Pulse width

182. Which of the following is a contraindication for using IFC?

A. Chronic pain

B. Muscle spasms

C. Joint stiffness

D. Presence of a pacemaker

183. What type of neurons are primarily stimulated by the low-frequency current in IFC therapy?

A. Motor efferent neurons

B. Sensory afferent neurons

C. Sympathetic neurons

D. Interneurons

184. What pain management theory is supported by IFC’s ability to block pain signals?

A. Gate Control Theory of Pain

B. Muscle Re-education Theory 

C. Pythagorean Theorem

D. Reflex Arc Theory

185. What is a key advantage of using IFC over other forms of electrical stimulation?

A. It’s faster to apply

B. It penetrates deeper with less discomfort

C. It works without electrodes

D. It more effectively targets bone tissue

186. What type of nerve does NMES primarily stimulate to cause a muscle contraction?

A. Sensory afferent nerve

B. Motor nerve

C. Autonomic nerve

D. Interneuron

187. What is the primary goal of NMES therapy?

A. Stimulate sensory nerves for pain relief

B. Cause repeated muscle contractions to increase strength or endurance

C. Relax the muscle with constant vibration

D. Deliver medication through the skin

188. What is the recommended duty cycle for a significantly weak or atrophied muscle?

A. 1:1 (10 sec on, 10 sec off)

B. 1:4 (10 sec on, 40 sec off)

C. 2:5 (10 sec on, 25 sec off)

D. 1:9 (10 sec on, 90 sec off) 

189. Why is the ramp setting used during NMES treatment?

A. To deliver slight heat during contraction

B. To maximize electrical penetration to the targeted muscles

C. To gradually build and reduce contraction for comfort and natural movement

D. To improve skin conductivity for comfort

190. What is the typical pulse frequency range for NMES to balance contraction strength and fatigue?

A. 1–5 Hz

B. 60–100 Hz

C. 10–50 Hz

D. 200–300 Hz

191. Which of the following is an appropriate indication for NMES use?

A. Joint stiffness due to a bony block

B. Presence of a trigger point in a muscle

C. Muscle weakness after stroke

D. Malignancy in the treatment area

192. Which of the following patients would most likely benefit from a 1:1 duty cycle during NMES?

A. A patient near the end of rehab with good strength

B. A patient with peripheral neuropathy

C. A patient in early rehab with severe weakness

D. A patient who had a stroke less than 24 hours ago

193. What role does NMES play in managing spasticity?

A. It relaxes the affected muscle by stimulating the surrounding connective tissue

B. It fatigues the spastic muscle or stimulates its antagonist

C. It activates sensory nerves to dull the spasm

D. It blocks neural input from the spinal cord to the spastic muscle

194. Why should a patient’s hand be dry before using a paraffin bath?

A. Wax won’t adhere otherwise

B. Water droplets can cause a fire or splatter hazard

C. Moisture interferes with heat transfer

D. It causes burns more easily

195. Why might paraffin therapy be chosen over a standard hot pack for treating the hand?

A. It's faster

B. It's less expensive

C. It conforms better to finger contours

D. It produces deeper tissue heating

196. Which of the following is a contraindication for paraffin use?

A. Muscle spasms

B. Joint stiffness

C. Open wounds

D. Scar remodeling

197. How does wrapping the hand in Coban before paraffin application help?

A. Makes the wax stick better

B. Provides a stretch as tissues relax from the heat

C. Prevents burns

D. Keeps the wax from dripping

198. How many times should a patient typically dip their hand into the wax during paraffin application?

A. 2–3 times

B. 5 times

C. 7–10 times

D. 1 time

199. How does TENS differ from IFC in terms of current delivery?

A. TENS uses high-frequency intersecting currents

B. TENS uses two medium-frequency currents that cross in the tissue

C. TENS uses a single low-frequency current

D. TENS uses ultrasound waves to stimulate tissues

200. Why might TENS feel more uncomfortable than IFC for some patients?

A. It uses suction electrodes

B. Low-frequency currents are more difficult to travel through the skin

C. It uses higher voltage settings

D. It penetrates the bone directly

201. Which of the following frequencies would best stimulate the opioid mechanism of pain relief?

A. 80–130 Hz

B. 50–70 Hz

C. 2–10 Hz

D. 140–180 Hz

202. Which TENS mode is designed to provide longer carry-over pain relief once the unit is removed?

A. Traditional

B. Acupuncture

C. Brief intense

D. Burst

203. What is the recommended pulse duration for most TENS settings?

A. 100 microseconds

B. 500 microseconds

C. 200 microseconds

D. 50 microseconds

204. Which TENS mode delivers both gate control and opioid mechanisms by interrupting flow in bursts?

A. Acupuncture

B. Burst

C. Brief intense

D. Traditional

205. What is the primary mechanism by which therapeutic ultrasound heats tissue?

A. Conduction from the machine

B. Electrical stimulation

C. Vibration of tissue molecules from sound waves

D. Radiation from the probe

206. What depth of tissue is targeted using a frequency of 3 MHz?

A. Greater than 5 cm

B. 3–4 cm deep

C. 0.5–2 cm deep

D. Any depth depending on time

207. What is the appropriate frequency setting to use for targeting deeper tissues (e.g., >2 cm)?

A. 1 MHz

B. 2 MHz

C. 3 MHz

D. 0.5 MHz

208. Which of the following duty cycles would be best for treating an acute injury?

A. 50% or 1:1

B. 25% or 1:3

C. Continuous

D. 75% or 3:1

209. If the ultrasound head fits 3 times over the treatment area and a 1:4 duty cycle is used, what should the treatment time be?

A. 5 minutes

B. 12 minutes

C. 15 minutes

D. 10 minutes

210. What kind of duty cycle is generally best for treating a chronic condition with therapeutic ultrasound?

A. 20% or 1:4

B. 25% or 1:3

C. 33% or 1:2

D. 50% or continuous (1:1)

211. What is the primary goal of the wound healing process?

A. To prevent infection through antibiotics

B. To restore the skin’s integrity and function

C. To increase immune system response

D. To dissolve scar tissue

212. What happens during the haemostasis stage of wound healing?

A. Collagen production and scar formation

B. Inflammatory cells infiltrate the area

C. Blood vessels constrict and clotting occurs

D. Granulation tissue appears

213. Which stage is characterized by an increase in white blood cells and swelling?

A. Inflammatory stage

B. Haemostasis stage

C. Remodeling stage

D. Proliferation stage

214. Why is orthotic positioning important during the inflammatory stage?

A. It improves scar mobility

B. It prevents contractures caused by protective flexion postures

C. It accelerates collagen cross-linking

D. It enhances immune cell activity

215. What is granulation tissue, and when does it appear?

A. Hardened scar tissue; appears after 6 weeks

B. Wound scab; appears immediately after injury

C. New connective tissue; appears during the fibroplasia/ proliferation stage

D. Vascular tissue; appears during remodeling

216. Why can scar tissue on or near a joint limit range of motion?

A. It pulls on surrounding ligaments, causing instability

B. It absorbs too much synovial fluid, stiffening the joint

C. It is less elastic and stretches less than normal skin

D. The associated inflammation overactivates the joint capsule, leading to muscle spasms

217. What is the approximate strength of scar tissue compared to uninjured skin?

A. 100%

B. 80%

C. 60%

D. 50%

218. What is the primary structural component of scar tissue?

A. Elastin

B. Collagen

C. Keratin

D. Fibronectin

219. What is a key feature of mature scars compared to immature scars?

A. Elevated temperature and redness

B. Ridge formation due to edema

C. Loose collagen arranged randomly

D. Densely packed collagen aligned along tension lines

220. Why can scar tissue near joints restrict range of motion?

A. It pulls on surrounding ligaments

B. It increases joint fluid pressure

C. It is less flexible and stretches only ~15% of its original length

D. It weakens muscle contraction strength

221. Which of the following describes a hypertrophic scar?

A. Sunken below the surrounding skin

B. Raised and confined within the original wound borders

C. Flat and blends with surrounding skin

D. Thick scar that spreads far beyond the injury site

222. What is a key difference between hypertrophic and keloid scars?

A. Hypertrophic scars are darker in color than keloids

B. Keloid scars extend beyond the original wound borders

C. Keloid scars form sooner than hypertrophic scars

D. Hypertrophic scars cannot improve over time

223. Which type of scar adherence is most likely to cause functional impairment?

A. Mild adherence

B. Moderate adherence

C. Severe adherence

D. Elastic adherence

224. When does collagen accumulation peak after an injury?

A. 1 week post-injury

B. Around 3 weeks post-injury

C. 2 months post-injury

D. During the remodeling stage

225. Which description best fits an immature scar?

A. Pink, raised, with erythema and a ridge

B. Flat, white, and well-aligned fibers

C. Sunken with loss of tissue

D. Thick and extends beyond wound border

226. Which symptom is most suggestive of a developing infection around the nail fold (paronychia)?

A. Joint instability

B. Redness, swelling, and tenderness near the nail

C. Cracking of the fingernail

D. Excessive nail growth

227. What is the most appropriate response if pus is observed during hand therapy after surgery?

A. Apply cold pack and continue session if pain is not present

B. Perform modified edema massage to remove pus

C. Refer patient to a physician

D. Refer patient to a chiropractor

228. Which infection is characterized by fusiform swelling and pain with finger extension?

A. Cellulitis

B. MRSA

C. Chronic paronychia

D. Tendon sheath infection

229. What is the biggest concern if a tendon sheath infection is not treated urgently?

A. Tendon rupture and scar adhesions

B. Muscle atrophy 

C. Nerve degeneration

D. Loss of pigmentation of surrounding skin

230. Why are cat bites particularly high risk for infection?

A. Cats carry viruses in their saliva

B. The bites are generally more forceful

C. The small punctures are harder to clean thoroughly

D. They affect bones more than soft tissue

231. Which of the following is TRUE about MRSA?

A. It is a fungal infection

B. It is resistant to many antibiotics and highly contagious

C. It usually clears without intervention

D. It cannot spread to others through skin contact

233. Which of the following correctly lists the order of brachial plexus components from spinal cord to terminal nerves?

a. Roots, cords, trunks, divisions, branches

b. Trunks, roots, cords, branches, divisions

c. Roots, trunks, divisions, cords, branches

d. Branches, divisions, cords, trunks, roots

234. Which nerve supplies sensory input to the little finger and adjacent half of the ring finger?

a. Radial nerve

b. Axillary nerve

c. Median nerve

d. Ulnar nerve

235. Which nerve's innervation is least visible when viewing the palm of the hand?

a. Ulnar nerve

b. Median nerve

c. Radial nerve

d. Musculocutaneous nerve

236. Which spinal nerve roots contribute to the formation of the brachial plexus?

a. C5–T1

b. C1–C5

c. T2–T6

d. L1–L5

237. If a patient reports numbness in the palm and palmar side of the index and middle finger, which nerve is most likely involved?

a. Ulnar nerve

b. Median nerve

c. Radial nerve

d. Axillary nerve