Question 1

Which of the following is a true statement about a muscle's response to immobilization?

Accepted Answer

A)  When a muscle is immobilized for a period of time, atrophy occurs more rapidly and extensively in fast-twitch fibers than in slow-twitch fibers.
B)  As the immobilized muscle atrophies, an increase in fibrous and fatty tissue in the muscle occurs.
C)  Atrophy of an immobilized muscle will begin after the first 30 days of inactivity, resulting in contractile weakness.
D)  A muscle immobilized in a shortened position will have an increased ability to produce maximum tension at its resting length because of sarcomere absorption. B

Question 2

What is the safest and most effective way of stretching the multijoint flexor digitorum profundus?

Accepted Answer

A)  Stabilize the wrist, metacarpophalangeal, and proximal interphalangeal (PIP)  joints in full extension; then passively extend the distal interphalangeal (DIP)  joint.
B)  With the wrist in neutral, stabilize the metacarpophalangeal and DIP joints in full extension; then passively extend the PIP joint.
C)  First flex the wrist; then fully extend the DIP joint to the point of tissue resistance; then extend the PIP joint and then the metacarpophalangeal joint.
D)  With the wrist stabilized in a neutral position, first extend the DIP joint, then the PIP joint, and then the metacarpophalangeal joint of each finger. D

Question 3

The most effective means of stretching the latissimus dorsi in order to increase flexion of the shoulder is to:

Accepted Answer

A)  Place the patient in a prone position; stabilize the scapula and hyperextend the shoulder.
B)  Place the patient in a supine position; stabilize the lateral border of the scapula as you flex the shoulder.
C)  Place the patient in the supine position with hips and knees flexed; stabilize the pelvis at the iliac crest and flex the shoulder.
D)  Place the patient in a supine position; hyperextend the shoulder and move the arm over the side of the table as you stabilize the anterior aspect of the shoulder. C

Question 4

Of the following choices, which is the most appropriate application of the hold-relax (contract-relax) method of muscle inhibition and elongation of the gastrocnemius muscle? Extend the patient's knee, stabilize the lower leg, and:

Accepted Answer

A)  Place the patient's ankle in as much dorsiflexion as is comfortable; have the patient isometrically contract the plantar flexors against resistance for 6 to 10 seconds.Then have the patient relax as you passively dorsiflex the ankle.
B)  Place the patient's ankle in a fully plantar flexed position.Have the patient concentrically contract the dorsiflexors against your manual resistance through as much ROM as possible.
C)  Place the patient's ankle in as much dorsiflexion as possible; have the patient isometrically contract the dorsiflexors against resistance for 6 to 10 seconds.Then have the patient relax as you passively dorsiflex the ankle.
D)  Place the patient's ankle in a comfortably dorsiflexed position; have the patient concentrically contract the plantar flexors against your resistance through the available ROM.Then have the patient dorsiflex the ankle as far as possible.

Question 5

To achieve maximum elongation of the long head of the biceps brachii during passive stretching:

Accepted Answer

A)  Extend the elbow with the forearm in pronation and then extend the shoulder.
B)  Flex the shoulder overhead after extending the elbow with the forearm in supination.
C)  Extend the elbow with the forearm in supination and then extend the shoulder.
D)  Flex the shoulder overhead after extending the elbow with the forearm in pronation.

Question 6

During a stretching maneuver, you apply a 30-second stretch of a shortened muscle group just up to the point of tissue resistance.After this maneuver, rather than relaxing with the patient and returning the body segment to a neutral position, you move the body segment into the newly gained range to apply another stretch of the same muscle group and hold the stretch for an additional 30 seconds.What term best describes this type of stretching?

Accepted Answer

A)  Static
B)  Cyclic
C)  Ballistic
D)  Static-progressive

Question 7

Stress within the elastic range of tissue deformation may cause all of the following except:

Accepted Answer

A)  Straining of bonds (cross-links)  between collagen fibers.
B)  Microfailure between collagen bonds.
C)  Squeezing water out of the ground substance.
D)  Grade II ligament injuries.

Question 8

Which of the following terms best describes impaired extensibility of a muscle-tendon unit as the result of spasticity or rigidity from a lesion of the central nervous system?

Accepted Answer

A)  Myostatic contracture
B)  Fibrotic contracture
C)  Pseudomyostatic contracture
D)  Hypotonic contracture

Question 9

In a patient's medical record you see "knee flexion contracture." What does it mean?

Accepted Answer

A)  The patient is unable to actively extend the knee through the full range of motion (ROM)  despite full passive knee extension.
B)  The quadriceps muscle group is tight and limits full, passive knee flexion.
C)  Full, passive knee extension is not possible.
D)  The patient cannot actively contract the hamstrings to flex the knee.

Question 10

Based on the neurophysiological properties of the contractile components of muscle, a high-intensity, quick stretch of a muscle-tendon unit is believed to create phasic elevation of tension in the stretched muscle by:

Accepted Answer

A)  Facilitating the muscle spindle via the Ib fibers.
B)  Facilitating the GTO.
C)  Facilitating the primary (Ia)  afferents, which in turn stimulate the extrafusal fibers of the muscle.
D)  Inhibiting the secondary (II)  afferents, which in turn stimulate the extrafusal fibers of the muscle.

Question 11

Which of the following is a true statement about a muscle's response to stretch?

Accepted Answer

A)  The muscle spindle is the motor receptor that protects the sarcomeres when a stretch is applied.
B)  "Sarcomere give" is best described as a plastic change in muscle that occurs as the result of stretch force that is applied quickly.
C)  A quick stretch of a muscle is believed to facilitate contraction of muscle fibers by means of the Golgi tendon organ (GTO) .
D)  The primary source of a muscle's resistance to passive stretch is the connective tissue in and around muscle.

Question 12

The glycosaminoglycans and water in the ground substance of connective tissue are important for connective tissue health because:

Accepted Answer

A)  They bind the collagen fibers together, giving them their crystalline qualities.
B)  They stimulate the elastic qualities in elastin.
C)  They reduce friction and transport nutrients and metabolites.
D)  They provide bulk to add strength to ligaments and tendons.

Question 13

Which of the following is categorized as an extrinsic factor contributing to limited ROM?

Accepted Answer

A)  Bony block
B)  Inflammation of soft tissue
C)  Paralysis
D)  Cast immobilization after a fracture

Question 14

When applying a stretch, you first feel some resistance; as you maintain the stretch, you feel as though you can move into a greater range using the same amount of force.This describes what mechanical property of connective tissue?

Accepted Answer

A)  Stress relaxation
B)  Tissue failure
C)  Elastic limit
D)  Creep

Question 15

You are teaching a client total-body relaxation techniques as part of a pain management program.Each of the following is an indicator of relaxation except:

Accepted Answer

A)  Flat facial expression.
B)  Lowered heart and respiratory rates.
C)  Decreased skin temperature in the extremities.
D)  Decreased muscle tension evidenced by relaxed jaw and hands.

Question 16

Which of the following statements about stretching is true?

Accepted Answer

A)  To effectively stretch the tensor fascia latae, you first flex the hip to 30° and then adduct the hip.
B)  To maximally lengthen the wrist extensors, you fully flex the wrist and flex the elbow.
C)  To stretch the posterior tibialis, you dorsiflex and evert the foot and ankle.
D)  To stretch the long head of the triceps brachii, you fully flex the elbow and then extend the shoulder past neutral.

Question 17

To increase terminal knee extension, you position the patient prone so the lower leg is not supported on the treatment table.The patient relaxes while the lower leg and foot "hang" off the end of the table.The therapist adds a cuff weight around the ankle.What type of stretching procedure is being applied?

Accepted Answer

A)  Ballistic
B)  Mechanical
C)  Dynamic
D)  Cyclic

Question 18

Each of the following is a true statement about self-stretching procedures except:

Accepted Answer

A)  A portion of body weight is often the source of the stretch force when the distal segment is fixed.
B)  Self-stretching is effective only when the distal segment is stabilized and the proximal segment moves.
C)  Proper stabilization of one segment sometimes can be achieved intrinsically (i.e., by an isometric or active muscle contraction) .
D)  A stationary object or surface can be used to stabilize one body segment as the other segment is moved.

Question 19

Which is the safest (for protection of the long arch of the foot) and most effective way to apply a long-duration self-stretch of the gastrocnemius-soleus muscle group?

Accepted Answer

A)  Stand facing a wall; lean into the wall while keeping both heels on the floor.Sustain that position for as long as possible.
B)  Assume a long-sitting position on the floor; loop a towel or strap under one foot (strap should be at the heads of the metatarsals)  and pull on the towel or strap.
C)  Stand on a solid wedge (5°, 10°, or 15° angle)  for an extended period of time.
D)  Stand on a step with your heels hanging over the edge and let your heels drop slightly below step level and maintain that position as long as tolerated.

Question 20

Multiple potential benefits and outcomes are speculated to result from stretching programs.Which of the following is strongly supported by evidence and research?

Accepted Answer

A)  Reduction in the risk of soft tissue injury by participating in a stretching warm-up routine
B)  Improved flexibility and increased ROM by restoring extensibility of the muscle-tendon unit with specific stretching techniques
C)  Reduction in muscle soreness after rigorous exercise by participating in a warm-up and cool-down stretching routine
D)  Enhanced physical performance (strength and endurance)  in athletics when participating in pre-event (acute)  stretching

Exam 4: Stretching for Improved Mobility