ORTHOTIC WRITTEN SIMULATION EXAM 200 EXAM QUESTIONS & ANSWERS COMPREHENSIVE PREPARATION FOR 2026/2027 EXAMINATION

ORTHOTIC WRITTEN SIMULATION EXAM 200 EXAM QUESTIONS & ANSWERS COMPREHENSIVE PREPARATION FOR 2026/2027 EXAMINATION Question 1 A 45-year-old male with a complete T10 spinal cord injury wishes to ambulate for household distances. Assuming full upper extremity strength, which orthotic configuration is the standard clinical recommendation? A) Bilateral solid-ankle AFOs with a walker B) Bilateral KAFOs with locked knee joints and posterior offsets C) A unilateral HKAFO with a cane D) A rigid LSO with bilateral dynamic braces E) Bilateral KAFOs with free knee joints Correct Answer: B) Bilateral KAFOs with locked knee joints and posterior offsets Rationale: Patients with paraplegia at T10 lack motor control of the hips, knees, and ankles but retain full upper body control. Bilateral KAFOs with locked knee joints provide the structural stability needed for upright ambulation using a swing-to or swing-through gait pattern. The posterior offset helps with knee stability during stance . ________________________________________ Question 2 During gait analysis, you observe a patient's knee buckling in mid-stance. Which orthotic modification would most effectively address this issue? A) Adding a dorsiflexion stop to the AFO B) Implementing a plantarflexion stop with the ankle set in 2-3 degrees of dorsiflexion C) Increasing the heel height of the shoe D) Adding a medial flare to the footplate E) Reducing the trimline height posteriorly Correct Answer: B) Implementing a plantarflexion stop with the ankle set in 2-3 degrees of dorsiflexion Rationale: Knee hyperextension or buckling during stance can be controlled by creating a knee flexion moment. Setting the ankle in slight dorsiflexion with a rigid plantarflexion stop shifts the ground reaction force anterior to the knee axis, promoting knee stability . ________________________________________ Question 3 A patient presents with weakness in elbow extension. Which myotome is most likely affected? A) C5 B) C6 C) C7 D) C8 E) T1 Correct Answer: C) C7 Rationale: Elbow extension is the hallmark motor function for the C7 myotome, primarily testing the triceps brachii muscle. Loss of this function is common in mid-cervical spinal cord injuries . ________________________________________ Question 4 Which nerve innervates the quadriceps femoris muscle group? A) Sciatic nerve B) Femoral nerve C) Obturator nerve D) Superior gluteal nerve E) Tibial nerve Correct Answer: B) Femoral nerve Rationale: The femoral nerve (L2, L3, L4) innervates the quadriceps femoris, which is responsible for knee extension. This is a critical muscle group for ambulation and orthotic decision-making . ________________________________________ Question 5 A patient with an L5 spinal cord injury would most likely demonstrate limited function in which muscle group? A) Hip flexors B) Knee extensors C) Dorsiflexors and toe extensors D) Plantarflexors E) Hip adductors Correct Answer: C) Dorsiflexors and toe extensors Rationale: The L5 nerve root is critical for the tibialis anterior (dorsiflexion) and extensor hallucis longus (toe extension). While hip flexion and knee extension (L2-L4) remain intact, distal stabilizers and hip abductors are compromised . ________________________________________ Question 6 A patient with an S1 spinal cord injury would have which functional limitation? A) Loss of knee extension B) Limited knee flexion and plantarflexion C) Inability to adduct the hip D) Complete loss of upper extremity sensation E) Respiratory failure requiring ventilation Correct Answer: B) Limited knee flexion, hip extension, plantarflexion, and toe flexion Rationale: S1 innervates the gastrocnemius/soleus complex (plantarflexion) and hamstrings (knee flexion/hip extension). The patient retains most proximal L2-L5 functions but lacks distal power for push-off during gait .