Menu

Question 141

Topic: Physiology & Rehabilitation

The primary type of nerve fiber responsible for transmitting the acute, sharp pain signals associated with an acute fracture or injury to the periosteum is:

. Unmyelinated C fibers
. Large myelinated A-alpha fibers
. Medium myelinated A-beta fibers
. Small myelinated A-delta fibers
. Autonomic efferent fibers

Correct Answer & Explanation

. Small myelinated A-delta fibers


Explanation

Nociceptive (pain-sensing) nerve fibers are broadly classified into A-delta fibers and C fibers. A-delta fibers are small, thinly myelinated fibers that conduct impulses faster than C fibers. They are responsible for transmitting the "first pain" sensation – sharp, well-localized, and acute pain, such as that experienced immediately after a fracture or periosteal injury. C fibers are unmyelinated, conduct impulses more slowly, and are responsible for the "second pain" – dull, aching, burning, and poorly localized pain. A-alpha and A-beta fibers are large, heavily myelinated fibers associated with proprioception, motor control, and touch/pressure, respectively, not primary pain transmission.

Question 142

Topic: Physiology & Rehabilitation

During sustained, high-intensity muscle activity (e.g., a sprint), skeletal muscle primarily generates ATP through which metabolic pathway?

. Oxidative phosphorylation
. Beta-oxidation of fatty acids
. Anaerobic glycolysis
. Krebs cycle
. Cori cycle

Correct Answer & Explanation

. Anaerobic glycolysis


Explanation

Skeletal muscle can generate ATP through several pathways depending on the intensity and duration of activity. During sustained, high-intensity exercise (e.g., sprinting), the demand for ATP outpaces the oxygen supply for aerobic metabolism. In this scenario, anaerobic glycolysis becomes the primary pathway. Glucose is broken down into pyruvate, which is then converted to lactate in the absence of oxygen, rapidly producing a small amount of ATP. While less efficient than oxidative phosphorylation, it provides a quick burst of energy for maximal effort activities. Oxidative phosphorylation is the main pathway for prolonged, lower-intensity exercise.

Question 143

Topic: Physiology & Rehabilitation

During the single-leg stance phase of gait, the hip joint experiences forces significantly greater than body weight. This is primarily due to the contribution of which of the following?

. Ground reaction force only
. Lever arm of body weight
. Abductor muscle contraction
. Gravitational pull
. Adductor muscle contraction

Correct Answer & Explanation

. Abductor muscle contraction


Explanation

During single-leg stance, the hip joint is subjected to forces substantially greater than body weight. This is primarily because the hip abductor muscles (gluteus medius and minimus) must contract powerfully to counteract the adduction moment created by the body's center of gravity acting on a long lever arm relative to the hip joint center. The force generated by these muscles, combined with the body weight acting through its lever arm, results in a significantly elevated hip joint reaction force, often estimated at 2.5 to 3 times body weight in normal gait. The ground reaction force is a component, but the muscle force is the major additive factor.

Question 144

Topic: Physiology & Rehabilitation

The main function of the sarcoplasmic reticulum in skeletal muscle cells is to:

. Synthesize ATP
. Generate action potentials
. Store and release calcium ions
. Synthesize contractile proteins
. Produce lactic acid

Correct Answer & Explanation

. Store and release calcium ions


Explanation

The sarcoplasmic reticulum (SR) is a specialized endoplasmic reticulum found in muscle cells. Its primary and critical function is to store and rapidly release calcium ions (Ca2+) in response to an action potential. The release of Ca2+ into the sarcoplasm initiates muscle contraction by binding to troponin, while its re-uptake by SR calcium pumps leads to muscle relaxation. This precise control of intracellular calcium levels is central to excitation-contraction coupling.

Question 145

Topic: Physiology & Rehabilitation

During normal human gait, the peak force across the hip joint occurs during which phase of the gait cycle, and is primarily generated by the contraction of which muscle group?

. Heel strike; hip flexors
. Mid-stance; hip abductors
. Toe-off; hip extensors
. Mid-swing; hip adductors
. Terminal swing; hip flexors

Correct Answer & Explanation

. Mid-stance; hip abductors


Explanation

The peak joint reaction force across the hip occurs during the single-leg stance phase (mid-stance). It is driven predominantly by the strong contraction of the hip abductors (gluteus medius and minimus) acting to level the pelvis against the body weight's moment arm.

Question 146

Topic: Physiology & Rehabilitation

During rehabilitation of a quadriceps tendon rupture, the physiotherapist emphasizes specific muscle contractions. According to muscle physiology, which type of muscle contraction generates the highest maximal tension within the muscle fibers?

. Isometric contraction
. Concentric isotonic contraction
. Eccentric isotonic contraction
. Isokinetic concentric contraction
. Tetanic contraction

Correct Answer & Explanation

. Eccentric isotonic contraction


Explanation

Eccentric contractions (muscle lengthening under tension) generate the highest maximal force compared to isometric or concentric contractions. This mechanism is crucial in deceleration activities and is frequently implicated in tendon ruptures.

Question 147

Topic: Physiology & Rehabilitation

During the normal human gait cycle, at what specific phase does the gluteus maximus exhibit its peak electromyographic (EMG) activity?

. Mid-swing
. Terminal swing and initial contact (heel strike)
. Mid-stance
. Terminal stance (heel off)
. Pre-swing (toe off)

Correct Answer & Explanation

. Terminal swing and initial contact (heel strike)


Explanation

The gluteus maximus works eccentrically at terminal swing to decelerate the forward momentum of the swinging leg, and then achieves peak concentric activity immediately after initial contact (heel strike) to extend the hip and stabilize the trunk from pitching forward.

Question 148

Topic: Physiology & Rehabilitation

Which of the following physiological characteristics best distinguishes Type I (slow-twitch) skeletal muscle fibers from Type II (fast-twitch) skeletal muscle fibers?

. Higher reliance on glycolytic metabolism
. Lower capillary density
. Higher mitochondrial density and oxidative capacity
. Faster rate of myosin ATPase activity
. Greater peak force generation

Correct Answer & Explanation

. Higher mitochondrial density and oxidative capacity


Explanation

Type I muscle fibers are 'slow-twitch' and fatigue-resistant. They rely primarily on oxidative phosphorylation for energy production. Consequently, they possess a higher mitochondrial density, higher myoglobin content (giving them a red appearance), and greater capillary density. In contrast, Type II fibers have faster myosin ATPase activity, rely more on glycolysis, and generate greater peak force but fatigue much more rapidly.

Question 149

Topic: Physiology & Rehabilitation

According to Saunders et al., the determinants of normal human gait function to minimize the vertical and lateral displacement of the body's center of gravity. Which of the following movements is a primary determinant that specifically acts to reduce the peak of the vertical center of gravity trajectory?

. Pelvic tilt (Trendelenburg drop in swing phase)
. Foot pronation during initial contact
. Knee flexion in the stance phase
. Hip extension in the swing phase
. Ankle dorsiflexion in mid-stance

Correct Answer & Explanation

. Knee flexion in the stance phase


Explanation

Saunders et al. described six determinants of gait. Knee flexion in the stance phase (typically around 15 degrees) serves to lower the peak of the vertical displacement of the center of gravity, thereby reducing the metabolic energy required for walking.

Question 150

Topic: Physiology & Rehabilitation

During the descent phase of a squat exercise, the quadriceps muscle actively lengthens while remaining under tension to control knee flexion. What type of muscle contraction does this describe?

. Concentric
. Isometric
. Eccentric
. Isokinetic
. Plyometric

Correct Answer & Explanation

. Eccentric


Explanation

An eccentric contraction occurs when the muscle lengthens while actively producing force (e.g., the quadriceps during the descent phase of a squat acting as a brake). Concentric contractions occur when the muscle shortens, and isometric contractions occur when there is no change in muscle length.

Question 151

Topic: Physiology & Rehabilitation

A 72-year-old man with cervical spondylosis falls forward, striking his forehead. He presents with profound bilateral upper extremity weakness but retains moderate strength in his lower extremities. Which of the following is true regarding his condition?

. It is characterized by loss of pain and temperature with preserved proprioception.
. Early surgical decompression within 24 hours definitively shows superior functional outcomes.
. The pathognomonic lesion is isolated damage to the anterior spinal artery.
. It typically carries a better prognosis for ambulatory recovery than complete cervical cord injuries.
. Recovery usually occurs in a proximal-to-distal pattern in the upper extremities.

Correct Answer & Explanation

. It typically carries a better prognosis for ambulatory recovery than complete cervical cord injuries.


Explanation

This presentation is classic for Central Cord Syndrome, which disproportionately affects upper extremities. It carries a favorable prognosis for functional ambulation compared to complete injuries, with hand recovery typically being the last to return.

Question 152

Topic: Physiology & Rehabilitation

During skeletal muscle contraction, maximum isometric tension is generated at optimal resting length. This length corresponds physiologically to which of the following states?

. Maximum overlap of thick and thin filaments without interference
. Complete depletion of intracellular ATP
. Maximum release of calcium from the sarcoplasmic reticulum
. Complete overlap of actin filaments crossing the M-line
. Minimum overlap between myosin heads and actin binding sites

Correct Answer & Explanation

. Maximum overlap of thick and thin filaments without interference


Explanation

Maximum isometric tension occurs at optimal resting length due to the maximum number of cross-bridges formed between overlapping actin and myosin filaments without spatial interference.

Question 153

Topic: Physiology & Rehabilitation

In myelinated peripheral nerves, saltatory conduction occurs rapidly due to the high concentration of which specific ion channels at the Nodes of Ranvier?

. Voltage-gated calcium channels
. Ligand-gated sodium channels
. Voltage-gated sodium channels
. ATP-dependent potassium channels
. Mechanosensitive chloride channels

Correct Answer & Explanation

. Voltage-gated sodium channels


Explanation

Nodes of Ranvier contain highly concentrated voltage-gated sodium channels, which allow rapid depolarization and propagation of action potentials from node to node, known as saltatory conduction.

Question 154

Topic: Physiology & Rehabilitation

During a normal human gait cycle, maximum muscle activity of the tibialis anterior occurs at which specific phase to prevent foot drop?

. Mid-stance
. Terminal stance
. Heel strike (Initial contact)
. Toe-off (Pre-swing)
. Mid-swing

Correct Answer & Explanation

. Heel strike (Initial contact)


Explanation

The tibialis anterior peaks in activity just after heel strike (initial contact). It fires eccentrically to control plantarflexion of the foot, preventing it from slapping against the ground.

Question 155

Topic: Physiology & Rehabilitation

Which type of muscle contraction generates the highest maximum force, and what is its associated physiological energy characteristic?

. Isometric contraction; lowest energy expenditure
. Concentric contraction; greatest muscle hypertrophy potential
. Eccentric contraction; lowest energy expenditure for a given force
. Isokinetic contraction; variable velocity throughout the arc of motion
. Concentric contraction; highest energy expenditure for a given force

Correct Answer & Explanation

. Eccentric contraction; lowest energy expenditure for a given force


Explanation

Eccentric contractions generate the highest maximum force while consuming less ATP compared to concentric contractions. However, they are more frequently associated with delayed-onset muscle soreness.

Question 156

Topic: Physiology & Rehabilitation

During the normal human gait cycle, which muscle group demonstrates peak activity during the initial contact (heel strike) to loading response phase to safely lower the foot?

. Plantar flexors (gastrocnemius-soleus) eccentrically
. Plantar flexors (gastrocnemius-soleus) concentrically
. Dorsiflexors (tibialis anterior) eccentrically
. Dorsiflexors (tibialis anterior) concentrically
. Quadriceps eccentrically

Correct Answer & Explanation

. Dorsiflexors (tibialis anterior) eccentrically


Explanation

At initial contact to loading response, the tibialis anterior contracts eccentrically to smoothly lower the foot to the ground. This prevents the rapid plantar flexion known as "foot slap".

Question 157

Topic: Physiology & Rehabilitation

Type I (slow-twitch) skeletal muscle fibers are primarily characterized by which type of metabolism and fatigue resistance?

. Oxidative metabolism; high resistance to fatigue
. Glycolytic metabolism; high resistance to fatigue
. Oxidative metabolism; low resistance to fatigue
. Glycolytic metabolism; low resistance to fatigue
. Anaerobic metabolism; moderate resistance to fatigue

Correct Answer & Explanation

. Oxidative metabolism; high resistance to fatigue


Explanation

Type I muscle fibers rely on oxidative metabolism and have a high density of mitochondria and myoglobin. This allows them to maintain sustained, low-intensity contractions with a very high resistance to fatigue.

Question 158

Topic: Physiology & Rehabilitation

A physical therapy protocol specifies a muscle contraction where tension remains constant while the muscle actively lengthens to control a decelerating load. Which of the following best describes this type of muscle contraction?

. Concentric
. Isometric
. Eccentric
. Isokinetic
. Plyometric

Correct Answer & Explanation

. Eccentric


Explanation

An eccentric contraction occurs when a muscle lengthens while simultaneously generating tension, typically acting to decelerate a joint or resist gravity. It generates the highest forces compared to other contraction types and is primarily responsible for delayed onset muscle soreness (DOMS).

Question 159

Topic: Physiology & Rehabilitation

During the normal gait cycle, maximum physiological dorsiflexion of the ankle occurs at which of the following phases?

. Initial contact
. Loading response
. Midstance
. Terminal stance
. Pre-swing

Correct Answer & Explanation

. Terminal stance


Explanation

Maximum ankle dorsiflexion (approximately 10 degrees) occurs at the end of the terminal stance phase, immediately prior to heel-off. This pre-loads the gastrocsoleus complex for the rapid plantarflexion required during pre-swing (toe-off).

Question 160

Topic: Physiology & Rehabilitation

Because of the avascular nature of articular cartilage, chondrocytes reside in a relatively hypoxic environment. Which of the following represents the primary metabolic pathway utilized by mature chondrocytes for ATP production?

. Oxidative phosphorylation
. Anaerobic glycolysis
. Beta-oxidation of fatty acids
. Gluconeogenesis
. Pentose phosphate pathway

Correct Answer & Explanation

. Anaerobic glycolysis


Explanation

Mature articular chondrocytes operate in a characteristically low-oxygen environment and therefore rely almost exclusively on anaerobic glycolysis for cellular ATP production. This process results in the constant generation of lactic acid, which diffuses out into the synovial fluid.