ORTHOTICS WRITTEN EXAM 2025/2026 QUESTIONS WITH
ANSWERS GRADED A+
✔✔The "unhappy triad" includes injury to the following structures: - ✔✔ACL, MCL, and
medial meniscus
From forces that cause genu valgum, flexion, and external rotation applied to the knee
when the foot is planted
✔✔A patient has bilateral pars fractures at L5 and is currently in a custom polymer
overlapping style LSO with decreased lumbar lordosis. Physician wants to further
immobilize the fracture site; what do you use? - ✔✔Add a hip spica to the LSO- allows
how much hip flexion and extension is allowed, which can further immobilize the patient
✔✔A Knight Taylor LSO is classified as ______ whereas a Taylor LSO is classified as
________. - ✔✔A/P and M/L control
A/P control
✔✔A patient with an upper motor neuron disorder has a posterior loss of balance with
immediate sit to standing due either to tight muscles or weakness. What would be the
most likely cause? - ✔✔Spasticity of the gastrocnemius-soleus - Posteriorly located
ankle stabilizing muscle; anterior tibialis is anterior
✔✔A scoliosis patient has a thoracic curve apex at T6. Which orthosis would be most
appropriate? - ✔✔A Milwaukee CTLSO - utilized for scoliosis curves T7 and higher. In
some instances additions can be built into a Boston system to simulate the
effectiveness of a Milwaukee system, which can increase patient comfort and
compliance
✔✔Posterior trim lines of an LSO
Anterior trim lines of an LSO - ✔✔Posterior: Inferior angle of scapula to sacrococyggeal
joint
Anterior: Xiphoid process to symphysis pubis
✔✔A patient with a year long history of amyotropic lateral sclerosis is ambulating with
bilateral canes, shows limited endurance, and foot drop. Based on the diagnosis, what
device do you recommend for trial? - ✔✔ALS is a progressive degenerative disease
where an AFO would be appropriate for her fatigue and foot drop
✔✔Describe Guillain-Barre syndrome - ✔✔Acquired inflammatory disease causing
demyelination of the peripheral nerves w/ sparing of axons. Acute onset w/ ascending
motor paralysis. Usually preceded by bacterial or viral infection
,✔✔Patient presents with unstable odontoid fracture. What orthosis is indicated? - ✔✔A
HALO CTLSO is indicated for unstable C1 and C2 fractures. The orthosis spans a long
distance to maximize end-point control
✔✔Patient presents with DX of lower lumbar stenosis, RX LSO aligned appropriately.
What do you recommend? - ✔✔LSO aligned in flexion will allow the spinal canal to
relatively decrease occlusion and whereby increase space for the spinal cord
✔✔A patient has fixed forefoot varus. What are three compensatory strategies? -
✔✔Subtalor pronation
Plantarflexed first ray
Tibial internal rotation
✔✔A patient has a fxed forefoot varus, what isn't a compensatory strategy? -
✔✔Subtalor supination
✔✔Where is the proper anterior pin placement in a HALO CTLSO application? -
✔✔Lateral 1/3 of eyebrows, slightly superior to eyebrow - this placement gives you a
relatively safe starting position to avoid puncturing sinues, nervous system structures,
as well as ecrease migration of HALO ring
✔✔Where is the proper posterior pin placement in a HALO CTLSO application? -
✔✔Slightly superior to ear, opposing the anterior pins directly, inferior to the equator of
the cranium - optimize placement to avoid nervous system structures as well as
superior migration of the HALO
✔✔A patient with median nerve lesion is expected not to lose the function in: -
✔✔Flexor carpi ulnaris - one of the few muscles in the anterior compartment of the
forearm that the median n doesn't innervate. Lesion to the median n. can produce
carpal tunnel, ape hand deformity, and benedictine deformity
✔✔What are the "visible to the eye" clinical signs of scoliosis? - ✔✔Rib hump
Arm gapping, shoulder asymmetry
Pelvic obliquity
Prominent scapula
✔✔When fabricating a Williams Flexion LSO or spondylolithesis, what should the
anterior corset panel be fabricated out of? - ✔✔Elastic material so as to not limit sagittal
plane flexion
✔✔You are consulted for treatment of a 6 year-old girl spina bifida with a 30 deg
scoliotic thoracic curvature and club foot. What would be part of her treatment? -
✔✔Prevent contractures due to neurogenic deformities
With hydrocephalus, decompress and place shunt in place
, Prevent pressure sores
Fit patient with AFO and TLSO
Spina bifida is caused by incomplete closure of one or more neural arches that can
cause a wide range of impairments. Joint contractures and pressure ulcers are always a
risk for the patient with neurological defects.
✔✔What are the signs of congenital scoliosis? - ✔✔Wedge, bar, hemi-vertebrae are
common radiographic findings for congenital scoliosis
✔✔What are the signs of neuromuscular scoliosis? - ✔✔Right lumbar and left thoracic
curves are often signs of neuromuscular scoliosis
✔✔Gowers sign is seen when a person gets up from the floor, walking his hands up his
legs to get upright. The diagnosis most commonly seen with this is: - ✔✔Duchenne
muscular dystrophy - characterized by rapid loss of muscle, eventually leading to loss of
ability to ambulate and death. By age 10, most are using orthoses to aide in walking. By
age 12, patients are wheelchair-bound. Proximal weakness in the hips leads to the child
exhibiting the gowers sign
✔✔When applying the HALO for pediatric patient, protocol from adult patients will differ
in these ways: - ✔✔Less torque to avoid any potential dural punctures
MOre pins to distribute pressure more evenly across the cranium
✔✔When examining a scoliosis radiograph, the vertebral body is seen to rotate toward
the _________ in relation to the curve and the spinous process is seen to rotate toward
the ______ in relation to the curve. - ✔✔Convexity, concavity
✔✔A brachial plexus injury occurs resulting in decreased wrist and hand function. What
brachial injury would this most likely cause? - ✔✔Klumpke's palsy - results in decreased
wrist and hand functon due to involvement of C8-T1
✔✔A brachial plexus injury occurs resulting in decreased humeroscapular movement.
What brachial injury would this most likely cause? - ✔✔Erb's palsy - decreased shoulder
girdle function (waiter's tip) due to involvement of C5-C6
✔✔When evaluating to see if a scoliotic curve is nonstructural, what wll you notice with
forced lateral side bending? - ✔✔Rotational components of the curve will correct
themselves
✔✔What type of scoliotic curves would you expect to progress more when given only
the location of the curve? - ✔✔Simgle lumbar
Thoracolumber
ANSWERS GRADED A+
✔✔The "unhappy triad" includes injury to the following structures: - ✔✔ACL, MCL, and
medial meniscus
From forces that cause genu valgum, flexion, and external rotation applied to the knee
when the foot is planted
✔✔A patient has bilateral pars fractures at L5 and is currently in a custom polymer
overlapping style LSO with decreased lumbar lordosis. Physician wants to further
immobilize the fracture site; what do you use? - ✔✔Add a hip spica to the LSO- allows
how much hip flexion and extension is allowed, which can further immobilize the patient
✔✔A Knight Taylor LSO is classified as ______ whereas a Taylor LSO is classified as
________. - ✔✔A/P and M/L control
A/P control
✔✔A patient with an upper motor neuron disorder has a posterior loss of balance with
immediate sit to standing due either to tight muscles or weakness. What would be the
most likely cause? - ✔✔Spasticity of the gastrocnemius-soleus - Posteriorly located
ankle stabilizing muscle; anterior tibialis is anterior
✔✔A scoliosis patient has a thoracic curve apex at T6. Which orthosis would be most
appropriate? - ✔✔A Milwaukee CTLSO - utilized for scoliosis curves T7 and higher. In
some instances additions can be built into a Boston system to simulate the
effectiveness of a Milwaukee system, which can increase patient comfort and
compliance
✔✔Posterior trim lines of an LSO
Anterior trim lines of an LSO - ✔✔Posterior: Inferior angle of scapula to sacrococyggeal
joint
Anterior: Xiphoid process to symphysis pubis
✔✔A patient with a year long history of amyotropic lateral sclerosis is ambulating with
bilateral canes, shows limited endurance, and foot drop. Based on the diagnosis, what
device do you recommend for trial? - ✔✔ALS is a progressive degenerative disease
where an AFO would be appropriate for her fatigue and foot drop
✔✔Describe Guillain-Barre syndrome - ✔✔Acquired inflammatory disease causing
demyelination of the peripheral nerves w/ sparing of axons. Acute onset w/ ascending
motor paralysis. Usually preceded by bacterial or viral infection
,✔✔Patient presents with unstable odontoid fracture. What orthosis is indicated? - ✔✔A
HALO CTLSO is indicated for unstable C1 and C2 fractures. The orthosis spans a long
distance to maximize end-point control
✔✔Patient presents with DX of lower lumbar stenosis, RX LSO aligned appropriately.
What do you recommend? - ✔✔LSO aligned in flexion will allow the spinal canal to
relatively decrease occlusion and whereby increase space for the spinal cord
✔✔A patient has fixed forefoot varus. What are three compensatory strategies? -
✔✔Subtalor pronation
Plantarflexed first ray
Tibial internal rotation
✔✔A patient has a fxed forefoot varus, what isn't a compensatory strategy? -
✔✔Subtalor supination
✔✔Where is the proper anterior pin placement in a HALO CTLSO application? -
✔✔Lateral 1/3 of eyebrows, slightly superior to eyebrow - this placement gives you a
relatively safe starting position to avoid puncturing sinues, nervous system structures,
as well as ecrease migration of HALO ring
✔✔Where is the proper posterior pin placement in a HALO CTLSO application? -
✔✔Slightly superior to ear, opposing the anterior pins directly, inferior to the equator of
the cranium - optimize placement to avoid nervous system structures as well as
superior migration of the HALO
✔✔A patient with median nerve lesion is expected not to lose the function in: -
✔✔Flexor carpi ulnaris - one of the few muscles in the anterior compartment of the
forearm that the median n doesn't innervate. Lesion to the median n. can produce
carpal tunnel, ape hand deformity, and benedictine deformity
✔✔What are the "visible to the eye" clinical signs of scoliosis? - ✔✔Rib hump
Arm gapping, shoulder asymmetry
Pelvic obliquity
Prominent scapula
✔✔When fabricating a Williams Flexion LSO or spondylolithesis, what should the
anterior corset panel be fabricated out of? - ✔✔Elastic material so as to not limit sagittal
plane flexion
✔✔You are consulted for treatment of a 6 year-old girl spina bifida with a 30 deg
scoliotic thoracic curvature and club foot. What would be part of her treatment? -
✔✔Prevent contractures due to neurogenic deformities
With hydrocephalus, decompress and place shunt in place
, Prevent pressure sores
Fit patient with AFO and TLSO
Spina bifida is caused by incomplete closure of one or more neural arches that can
cause a wide range of impairments. Joint contractures and pressure ulcers are always a
risk for the patient with neurological defects.
✔✔What are the signs of congenital scoliosis? - ✔✔Wedge, bar, hemi-vertebrae are
common radiographic findings for congenital scoliosis
✔✔What are the signs of neuromuscular scoliosis? - ✔✔Right lumbar and left thoracic
curves are often signs of neuromuscular scoliosis
✔✔Gowers sign is seen when a person gets up from the floor, walking his hands up his
legs to get upright. The diagnosis most commonly seen with this is: - ✔✔Duchenne
muscular dystrophy - characterized by rapid loss of muscle, eventually leading to loss of
ability to ambulate and death. By age 10, most are using orthoses to aide in walking. By
age 12, patients are wheelchair-bound. Proximal weakness in the hips leads to the child
exhibiting the gowers sign
✔✔When applying the HALO for pediatric patient, protocol from adult patients will differ
in these ways: - ✔✔Less torque to avoid any potential dural punctures
MOre pins to distribute pressure more evenly across the cranium
✔✔When examining a scoliosis radiograph, the vertebral body is seen to rotate toward
the _________ in relation to the curve and the spinous process is seen to rotate toward
the ______ in relation to the curve. - ✔✔Convexity, concavity
✔✔A brachial plexus injury occurs resulting in decreased wrist and hand function. What
brachial injury would this most likely cause? - ✔✔Klumpke's palsy - results in decreased
wrist and hand functon due to involvement of C8-T1
✔✔A brachial plexus injury occurs resulting in decreased humeroscapular movement.
What brachial injury would this most likely cause? - ✔✔Erb's palsy - decreased shoulder
girdle function (waiter's tip) due to involvement of C5-C6
✔✔When evaluating to see if a scoliotic curve is nonstructural, what wll you notice with
forced lateral side bending? - ✔✔Rotational components of the curve will correct
themselves
✔✔What type of scoliotic curves would you expect to progress more when given only
the location of the curve? - ✔✔Simgle lumbar
Thoracolumber
