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Physiology & Rehabilitation MCQs

Practice Set 1 of 26

This practice set contains high-yield board review questions covering key concepts in Physiology & Rehabilitation. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 1

Topic: Physiology & Rehabilitation

A 45-year-old bodybuilder feels a sudden snap in the back of his elbow while performing heavy bench presses. He has a palpable gap proximal to the olecranon and marked weakness in active elbow extension against resistance. What is the most common mechanism of this specific tendon rupture?

. Concentric contraction of the triceps against a heavy load
. Eccentric contraction of the triceps with a sudden deceleration force
. Direct blow to the olecranon tip
. Avulsion from a previous occult olecranon fracture
. Spontaneous rupture secondary to fluoroquinolone use

Correct Answer & Explanation

. Eccentric contraction of the triceps with a sudden deceleration force

Explanation

Triceps tendon ruptures typically occur due to an eccentric load on a contracting triceps muscle, such as decelerating a heavy weight or falling onto an outstretched hand. Immediate surgical repair is indicated for complete ruptures to restore extension strength.

Question 2

Topic: Physiology & Rehabilitation

The Alfredson protocol is considered a first-line treatment for non-insertional Achilles tendinopathy. Which of the following biomechanical principles is the primary focus of this rehabilitation protocol?

. Concentric strengthening of the gastrosoleus complex
. Eccentric lengthening of the gastrosoleus under load
. Isometric holds in maximal dorsiflexion
. Isokinetic strengthening at high angular velocities
. Passive static stretching of the plantar fascia

Correct Answer & Explanation

. Eccentric lengthening of the gastrosoleus under load

Explanation

The Alfredson protocol consists of a 12-week regimen of heavy-load eccentric exercises (lengthening contractions under load), which stimulates collagen synthesis and organization to reverse tendinosis.

Question 3

Topic: Physiology & Rehabilitation

Which of the following regimens is recommended for maintenance of cadiorespiratory fitness:

. 30 to 60 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate
. 30 to 60 minutes of exercise 7 days per week at 20% to 50% of maximum heart rate
. 90 to 120 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate
. 30 to 60 minutes of exercise 1 day per week at 60% to 90% of maximum heart rate
. 15 to 20 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate

Correct Answer & Explanation

. 30 to 60 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate

Explanation

Current recommendations for maintenance of cardiorespiratory fitness include 30 to 60 minutes of exercise 3 to 5 days per week at 60% to 90% of maximum heart rate.

Question 4

Topic: Physiology & Rehabilitation

Muscles at increased risk for injury include:

. Muscles that cross a single joint and act concentrically.
. Muscles that cross a single joint and act eccentrically.
. Muscles that cross two joints and act concentrically.
. Muscles that cross two joints and act eccentrically.
. Muscle injury is independent of the number of joints crossed and type of contraction.

Correct Answer & Explanation

. Muscles that cross two joints and act eccentrically.

Explanation

Muscles that cross two joints and that are acting in an eccentric fashion are at increased risk for injury. Frequently injured muscles also have a high percentage of type II (fast twitch) fibers.

Question 5

Topic: Physiology & Rehabilitation

During which phase of the gait cycle or knee flexion angle does the iliotibial band experience the maximum friction against the lateral femoral epicondyle?

. Full extension
. 30 degrees of knee flexion
. 60 degrees of knee flexion
. 90 degrees of knee flexion
. 120 degrees of knee flexion

Correct Answer & Explanation

. 30 degrees of knee flexion

Explanation

The IT band rubs against the lateral femoral epicondyle most prominently at approximately 30 degrees of knee flexion. This typically occurs just after foot strike in runners, leading to ITB friction syndrome.

Question 6

Topic: Physiology & Rehabilitation

Which type of muscle contraction generates the greatest peak force and is most commonly implicated in acute muscle strain injuries?

. Concentric
. Eccentric
. Isometric
. Isokinetic
. Plyometric

Correct Answer & Explanation

. Eccentric

Explanation

Eccentric contractions occur when the muscle forcefully lengthens while under tension, generating the greatest peak forces. They are the primary mechanism behind most acute muscle strain injuries, such as hamstring tears during sprinting.

Question 7

Topic: Physiology & Rehabilitation

During a maximum-effort 100-meter sprint lasting approximately 10 seconds, which energy system provides the primary source of ATP?

. Oxidative phosphorylation
. Anaerobic glycolysis
. ATP-CP (Creatine Phosphate) system
. Aerobic lipolysis
. Gluconeogenesis

Correct Answer & Explanation

. ATP-CP (Creatine Phosphate) system

Explanation

The ATP-CP (phosphagen) system is the primary energy source for short, high-intensity bursts of exercise lasting up to 10-15 seconds. Anaerobic glycolysis becomes the dominant source for maximal efforts lasting from 15 seconds up to about 2 minutes.

Question 8

Topic: Physiology & Rehabilitation

During rehabilitation following an anterior cruciate ligament (ACL) reconstruction, which of the following exercises places the highest amount of strain on the healing ACL graft?

. Closed kinetic chain exercises from 0 to 30 degrees of flexion
. Closed kinetic chain exercises from 60 to 90 degrees of flexion
. Open kinetic chain knee extension from 90 to 60 degrees of flexion
. Open kinetic chain knee extension from 30 to 0 degrees of flexion
. Isometric quadriceps contractions at 90 degrees of flexion

Correct Answer & Explanation

. Open kinetic chain knee extension from 30 to 0 degrees of flexion

Explanation

Open kinetic chain (OKC) knee extension exercises near terminal extension (30 to 0 degrees) produce maximum anterior tibial translation forces, placing the highest strain on an ACL graft. Closed kinetic chain exercises generally provide compressive joint forces that protect the graft.

Question 9

Topic: Physiology & Rehabilitation

Delayed onset muscle soreness (DOMS) typically peaks 24 to 72 hours after unaccustomed exercise. Which of the following types of muscle contraction is most strongly associated with the development of DOMS?

. Isometric
. Isotonic concentric
. Isokinetic concentric
. Eccentric
. Plyometric concentric

Correct Answer & Explanation

. Eccentric

Explanation

DOMS is most closely associated with eccentric muscle contractions, where the muscle lengthens while under tension. This specific type of contraction causes significant microtrauma to muscle fibers and connective tissue, leading to subsequent inflammation and soreness.

Question 10

Topic: Physiology & Rehabilitation

Skeletal muscle fibers can be classified based on their metabolic and contractile properties. Which of the following characteristics is true regarding Type I muscle fibers?

. Fast twitch, high fatigue resistance, anaerobic
. Slow twitch, low fatigue resistance, anaerobic
. Fast twitch, low fatigue resistance, high glycolytic capacity
. Slow twitch, high fatigue resistance, high oxidative capacity
. Fast twitch, intermediate fatigue resistance, high oxidative capacity

Correct Answer & Explanation

. Slow twitch, high fatigue resistance, high oxidative capacity

Explanation

Type I muscle fibers are slow-twitch fibers that rely heavily on oxidative metabolism. They are highly fatigue-resistant and primarily recruited during prolonged endurance activities, such as long-distance running.

Question 11

Topic: Physiology & Rehabilitation

A 30-year-old weightlifter feels a sudden pop in his anterior chest wall while performing a heavy bench press. He has bruising over his anterior axillary fold and weakness in internal rotation. If surgical repair is indicated, where does the ruptured tendon anatomically insert?

. Medial lip of the bicipital groove
. Lateral lip of the bicipital groove
. Coracoid process
. Lesser tuberosity of the humerus
. Sublime tubercle

Correct Answer & Explanation

. Lateral lip of the bicipital groove

Explanation

The pectoralis major inserts on the lateral lip of the bicipital groove of the humerus. Ruptures typically occur at the musculotendinous junction or the tendinous insertion during forced eccentric contraction, such as the eccentric phase of a bench press.

Question 12

Topic: Physiology & Rehabilitation

A 55-year-old female presents with refractory lateral hip pain. She walks with a distinct Trendelenburg gait. An MRI reveals a full-thickness tear of the gluteus medius tendon at its insertion on the greater trochanter with fatty atrophy. What physical exam finding is most likely present?

. Positive FADIR test
. Positive FABER test
. Weakness with resisted hip abduction
. Weakness with resisted hip adduction
. Positive straight leg raise

Correct Answer & Explanation

. Weakness with resisted hip abduction

Explanation

Gluteus medius tears present as recalcitrant greater trochanteric pain syndrome accompanied by a positive Trendelenburg sign. Patients exhibit profound weakness with resisted hip abduction in the lateral decubitus position.

Question 13

Topic: Physiology & Rehabilitation

A hockey player sustains an acute grade II strain of the adductor longus muscle. He is prescribed a phased physical therapy program. During the remodeling phase, which type of exercise is most effective for promoting tissue healing and preventing recurrence?

. Maximal isometric contractions
. Aggressive passive stretching
. Eccentric strengthening exercises
. Plyometric jumping
. Continuous passive motion

Correct Answer & Explanation

. Eccentric strengthening exercises

Explanation

Eccentric strengthening exercises are critical in the rehabilitation of muscle strains, including the adductors and hamstrings. They promote proper collagen alignment, increase muscle fascicle length, and significantly reduce recurrence rates.

Question 14

Topic: Physiology & Rehabilitation

Weight training that employs constant resistance throughout the arc of motion is referred to as:

. Isometric
. Isotonic
. Isokinetic
. Plyometric
. Functional

Correct Answer & Explanation

. Isotonic

Explanation

Isotonic training employs a constant resistance throughout the arc of joint motion

Question 15

Topic: Physiology & Rehabilitation

Weight training that employs a constant velocity and variable resistance is referred to as:

. Isometric
. Isotonic
. Isokinetic
. Plyometric
. Functional

Correct Answer & Explanation

. Isokinetic

Explanation

Isokinetic training employs constant velocity and variable resistance. Special equipment, such as a C ybex device (C ybex, Medway, Mass), is required for isokinetic training.

Question 16

Topic: Physiology & Rehabilitation

During open kinetic chain knee extension, the "screw-home" mechanism ensures maximal joint congruency in terminal extension. This mechanism is primarily characterized by which of the following coupled kinematic motions?

. External rotation of the tibia on the femur
. Internal rotation of the tibia on the femur
. Valgus angulation of the tibia
. Varus angulation of the tibia
. Posterior translation of the tibia

Correct Answer & Explanation

. External rotation of the tibia on the femur

Explanation

The screw-home mechanism is an obligatory 10 degrees of external rotation of the tibia on the femur during the final 30 degrees of open-chain terminal knee extension. It occurs due to the asymmetry of the femoral condyles and the tension of the cruciate ligaments.

Question 17

Topic: Physiology & Rehabilitation

A physical therapist is designing a rehabilitation protocol for a patient with severe patellofemoral osteoarthritis. To minimize patellofemoral joint reaction forces during open kinetic chain (OKC) knee extension exercises, the patient should avoid which arc of motion?

. 120 to 90 degrees of flexion
. 90 to 60 degrees of flexion
. 30 to 0 degrees of flexion
. Isometric holds at 90 degrees of flexion
. Open kinetic chain forces are minimal throughout the entire arc

Correct Answer & Explanation

. 30 to 0 degrees of flexion

Explanation

In open kinetic chain (OKC) knee extension, patellofemoral joint reaction forces are highest in terminal extension (30 to 0 degrees of flexion). Conversely, in closed kinetic chain exercises (e.g., squats), these forces are highest in deep flexion.

Question 18

Topic: Physiology & Rehabilitation

Peak patellofemoral joint reaction forces during normal gait occur at which phase?

. Initial contact
. Mid-stance
. Terminal stance
. Pre-swing
. Initial swing

Correct Answer & Explanation

. Mid-stance

Explanation

Peak patellofemoral joint reaction forces occur during the early mid-stance phase of gait. This correlates with the point of maximum knee flexion (around 15-20 degrees) during the weight-bearing phase.

Question 19

Topic: Physiology & Rehabilitation

During a closed kinetic chain lower extremity exercise, such as a deep squat, patellofemoral joint reaction forces reach their peak at approximately which range of knee flexion?

. 0 to 30 degrees
. 30 to 60 degrees
. 60 to 90 degrees
. 90 to 120 degrees
. Forces remain constant throughout the arc of flexion

Correct Answer & Explanation

. 90 to 120 degrees

Explanation

Patellofemoral joint reaction forces increase substantially with deeper flexion during closed kinetic chain activities. These forces typically peak around 90 to 120 degrees of knee flexion due to the increased quadriceps force required and the smaller contact area.

Question 20

Topic: Physiology & Rehabilitation

A patient suffers a penetrating knife wound to the thoracic spine resulting in a spinal cord hemisection (Brown-Sequard Syndrome). Which of the following deficit patterns is expected below the level of injury?

. Ipsilateral loss of motor function and contralateral loss of pain/temperature sensation
. Contralateral loss of motor function and ipsilateral loss of pain/temperature sensation
. Bilateral loss of pain and temperature with preserved proprioception
. Bilateral motor loss with preserved proprioception
. Ipsilateral loss of pain sensation and contralateral loss of proprioception

Correct Answer & Explanation

. Ipsilateral loss of motor function and contralateral loss of pain/temperature sensation

Explanation

Brown-Sequard syndrome results from a hemisection of the spinal cord. The patient will exhibit ipsilateral loss of motor function and proprioception (corticospinal tract and dorsal columns) and contralateral loss of pain and temperature (spinothalamic tract).

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