NPTE: MSK Extra Practice Questions
and Answers
1. Heel raises check what myotome?
2. What is the nerve that supplies the gastroc?
3. What is the test that checks for the integrity of the achilles tendon? - correct answer-✅1. S1
2. Tibial Nerve
3. Thompson test
1. What are the nerve roots for heel walking and what nerve supplies the anterior tib? - correct answer-
✅L4, L5, Deep fibular nerve
Name the myotomes in O'sullivan from L2-S1. (Page 14) - correct answer-✅L2- (Hip flexion) Iliopsoas
and sartorius
L3- (Knee extension) Quadriceps femoris
L4- (DF) Tibalis anterior (Reflex - Iliopsoas)
L5-(Hip AB, Flexion, IR) Glut med, (Great toe ext) Extensor hallucis longus (Reflex - Semitendionsus)
S1- (Foot eversion) Peroneals (Foot inversion) Posterior Tibalis
Reflexes of the LE in O'sullivan from L2-S1 (Page 14) - correct answer-✅L4- Iliopsoas
L5- Semitendinosus
S1- Posterior Tib & Gastroc/soleus complex
Myotomes:
C4-C7 - correct answer-✅C4- Shoulder shrug, upper trapezius
C5- Shoulder abduction, Deltoid
C6- Elbow flexion
C7- Wrist Ulnar flexion*
Myotomes:
C8, T1 - correct answer-✅C8- Thumb MCP abduction
T1- Finger abduction, Interossei
Strong and painful - correct answer-✅minor structural lesion the muscle-tendon junction
Weak and painless muscle causes? - correct answer-✅Complete rupture, or nerve deficit.
Weak and painful - correct answer-✅Partial disruption of the junction, or pain response due to serious
pathology, or concurrent neuro deficit.
What is active insufficiency - correct answer-✅A 2 joint muscle can not contract maximally across both
joints at the same time.
(Ex. Make a fist (finger flexors) you can make a strong fist when your wrist is in a neutral of slightly
extended position. But when you flex your wrist with a clenched fist you loose some of the grip. This is
because the finger flexors are unable to shorten any more than they have and so begin to extend and
lose grip strength)
Poor+ muscle grade - correct answer-✅Can move against gravity in a small range of motion
If someone can move their limb against gravity but then has gradual release of the position against
gravity, what muscle grade do they get? - correct answer-✅Fair -
Passive insufficiency definition - correct answer-✅Occurs with 2 joint muscles and refers to the fact that
these muscles cannot stretch maximally across both joints at the same time!
, SLR testing: How do you bias the tibial nerve - correct answer-✅SLR with DF and eversion
SLR testing: How do you bias the peroneal nerve? - correct answer-✅SLR with PF and inversion
SLR testing with DF and inversion will bias what nerve? - correct answer-✅Sural
What portion of the LE does the sural nerve supply? - correct answer-✅Lateral aspect of the leg
What cutaneous nerve supplies the medial aspect of the leg ? - correct answer-✅saphenous nerve
When checking for clonus do you want the knee to be in flexion or extension? - correct answer-✅Slight
flexion
What test should be performed prior to manual therapy treatment of the cervical spine - correct answer-
✅Vertebral artery test
How to maximally close the foramen versus maximal approximation of the facet. - correct answer-
✅Foramen- Extend, Ipsilateral SB and rotation
Facet joint- Extend, Ipsilateral SB, Contralateral rotation
How many pounds of force should be applied during cervical traction to rule out neck involvement? -
correct answer-✅14 lbs
What is the standing flexion test for the lumbar spine - correct answer-✅Palpate both PSIS in standing.
Patient bends forward.
The PSIS that moves cranially first or that moves the farthest is the Positive or "blocked side".
(False positives could be caused by an ipsilateral tight QL or a contralateral tight hamstring)
Gillets test, what is the positive? - correct answer-✅Gillets assesses posterior movement of the ileum
relative to the sacrum.
When the knee is brought to the chest, the PSIS should move inferiorly.
Positive test is no movement of the PSIS.
Long-sitted test positives - correct answer-✅ALPS
Anterior -> long to short
Posterior -> short to long
what is lumbopelvic rhythm? - correct answer-✅When moving into lumbar flexion:
Spine flexes first 60-70 degrees,
Pelvis rotates anteriorly,
Flexion of the hips
What is the lumbopelvic rhythm when moving from lumbar flexion to standing? - correct answer-✅Hips
extend,
pelvis rotates posteriorly,
spine extends.
What test can you do to assess if there is an upper lumbar spine nerve root lesion - correct answer-
✅Prone knee bend test. This test also assesses the femoral nerve
The centralization phenomenon in which specific repetitive movements move symptoms from distal
regions to more central locations is highly reliable and specific in identifying - correct answer-✅Painful
lumbar discs.
Repetitive movements are highly specific for finding lumbar discs, what does high specificity mean? -
correct answer-✅Good at finding negatives. If its positive you can rule it in.
*Spin
Of the test cluster for SI dysfunction how many need to be positive to indicate a high likelihood of SI
dysfunction. - correct answer-✅3/5
What are the 5 tests that make up the SI cluster? - correct answer-✅Distraction,
and Answers
1. Heel raises check what myotome?
2. What is the nerve that supplies the gastroc?
3. What is the test that checks for the integrity of the achilles tendon? - correct answer-✅1. S1
2. Tibial Nerve
3. Thompson test
1. What are the nerve roots for heel walking and what nerve supplies the anterior tib? - correct answer-
✅L4, L5, Deep fibular nerve
Name the myotomes in O'sullivan from L2-S1. (Page 14) - correct answer-✅L2- (Hip flexion) Iliopsoas
and sartorius
L3- (Knee extension) Quadriceps femoris
L4- (DF) Tibalis anterior (Reflex - Iliopsoas)
L5-(Hip AB, Flexion, IR) Glut med, (Great toe ext) Extensor hallucis longus (Reflex - Semitendionsus)
S1- (Foot eversion) Peroneals (Foot inversion) Posterior Tibalis
Reflexes of the LE in O'sullivan from L2-S1 (Page 14) - correct answer-✅L4- Iliopsoas
L5- Semitendinosus
S1- Posterior Tib & Gastroc/soleus complex
Myotomes:
C4-C7 - correct answer-✅C4- Shoulder shrug, upper trapezius
C5- Shoulder abduction, Deltoid
C6- Elbow flexion
C7- Wrist Ulnar flexion*
Myotomes:
C8, T1 - correct answer-✅C8- Thumb MCP abduction
T1- Finger abduction, Interossei
Strong and painful - correct answer-✅minor structural lesion the muscle-tendon junction
Weak and painless muscle causes? - correct answer-✅Complete rupture, or nerve deficit.
Weak and painful - correct answer-✅Partial disruption of the junction, or pain response due to serious
pathology, or concurrent neuro deficit.
What is active insufficiency - correct answer-✅A 2 joint muscle can not contract maximally across both
joints at the same time.
(Ex. Make a fist (finger flexors) you can make a strong fist when your wrist is in a neutral of slightly
extended position. But when you flex your wrist with a clenched fist you loose some of the grip. This is
because the finger flexors are unable to shorten any more than they have and so begin to extend and
lose grip strength)
Poor+ muscle grade - correct answer-✅Can move against gravity in a small range of motion
If someone can move their limb against gravity but then has gradual release of the position against
gravity, what muscle grade do they get? - correct answer-✅Fair -
Passive insufficiency definition - correct answer-✅Occurs with 2 joint muscles and refers to the fact that
these muscles cannot stretch maximally across both joints at the same time!
, SLR testing: How do you bias the tibial nerve - correct answer-✅SLR with DF and eversion
SLR testing: How do you bias the peroneal nerve? - correct answer-✅SLR with PF and inversion
SLR testing with DF and inversion will bias what nerve? - correct answer-✅Sural
What portion of the LE does the sural nerve supply? - correct answer-✅Lateral aspect of the leg
What cutaneous nerve supplies the medial aspect of the leg ? - correct answer-✅saphenous nerve
When checking for clonus do you want the knee to be in flexion or extension? - correct answer-✅Slight
flexion
What test should be performed prior to manual therapy treatment of the cervical spine - correct answer-
✅Vertebral artery test
How to maximally close the foramen versus maximal approximation of the facet. - correct answer-
✅Foramen- Extend, Ipsilateral SB and rotation
Facet joint- Extend, Ipsilateral SB, Contralateral rotation
How many pounds of force should be applied during cervical traction to rule out neck involvement? -
correct answer-✅14 lbs
What is the standing flexion test for the lumbar spine - correct answer-✅Palpate both PSIS in standing.
Patient bends forward.
The PSIS that moves cranially first or that moves the farthest is the Positive or "blocked side".
(False positives could be caused by an ipsilateral tight QL or a contralateral tight hamstring)
Gillets test, what is the positive? - correct answer-✅Gillets assesses posterior movement of the ileum
relative to the sacrum.
When the knee is brought to the chest, the PSIS should move inferiorly.
Positive test is no movement of the PSIS.
Long-sitted test positives - correct answer-✅ALPS
Anterior -> long to short
Posterior -> short to long
what is lumbopelvic rhythm? - correct answer-✅When moving into lumbar flexion:
Spine flexes first 60-70 degrees,
Pelvis rotates anteriorly,
Flexion of the hips
What is the lumbopelvic rhythm when moving from lumbar flexion to standing? - correct answer-✅Hips
extend,
pelvis rotates posteriorly,
spine extends.
What test can you do to assess if there is an upper lumbar spine nerve root lesion - correct answer-
✅Prone knee bend test. This test also assesses the femoral nerve
The centralization phenomenon in which specific repetitive movements move symptoms from distal
regions to more central locations is highly reliable and specific in identifying - correct answer-✅Painful
lumbar discs.
Repetitive movements are highly specific for finding lumbar discs, what does high specificity mean? -
correct answer-✅Good at finding negatives. If its positive you can rule it in.
*Spin
Of the test cluster for SI dysfunction how many need to be positive to indicate a high likelihood of SI
dysfunction. - correct answer-✅3/5
What are the 5 tests that make up the SI cluster? - correct answer-✅Distraction,
