ORTHOTIC WRITTEN SIMULATION EXAM-ACTUAL EXAM-LATEST UPDATE 2025| COMPLETE
QUESTIONS WITH CORRECT DETAILED AND VERIFIED ANSWERS-MOSTLY TESTED QUESTIONS |
RATED 100% CORRECT!!GUARANTEED PASS!!ALREADY GRADED A+
A patient presents with separated connective tissue at the pubis symphysis. What orthosis do you recommend and what
hormone is responsible for the increased elasticity of the pubis symphysis during pregnancy. - (answers)Relaxin
hormone - is released in pregnant women which increases the elasticity of connective tissue to assist and ease birth.
SI belt - used when pubis symphysis becomes too elastic causing pain and instability
Describe the flexion synergy pattern in the upper extremity and lower extremity. - (answers)UE: shoulder abduction,
external rotation, elbow flexion, forearm supination, wrist flexion
LE: hip flexion, abduction, external rotation, knee flexion, ankle dorsiflexion, inversion
Describe the extensor synergy pattern in the upper extremity and lower extremity. - (answers)UE: Shoulder adduction,
internal rotation, elbow extension, forearm pronation, wrist flexion
LE: hip extension, adduction, internal rotation, knee extension, ankle plantarflexion, inversion
During normal heel strike, the forward hip is how flexed? - (answers)25 deg flexed
Gait cycle is described by the activity between - (answers)Heel strike on one side and the follow heel strike on the same
side
Describe Legg-Calve-Perthes disease (osteochondrosis). - (answers)Males>females, average age onset 6 years old,
psoatic limp due to psoas major weakness, lower extremity moves into external rotation, flexion and adduction, MRI will
show collapse of subchondral bone at femoral neck
Describe slipped capital femoral epiphysis. - (answers)Males>females, age onset 13 years, AROM restricted in
abduction, flexion, and internal rotation, vague pain at hip, knee, and thigh
Describe avascular necrosis - (answers)Etiologies resulting in lack of blood supply to the femoral head, AROM is
decreased in hip flexion, internal rotation, and abduction, pain at groin, thigh, and tenderness at hip
Describe adhesive capsulitis - (answers)Characterized by restriction in shoulder motion in external rotation, abduction,
and flexion, inflammation and fibrosis at shoulder
,How would you align a patient with lumbar DJD in the sagittal plane? - (answers)Decrease lumbar lordosis which moves
pressure off the affected posterior portion of the vertebrae onto the vertebral body and away from the arthritic joints.
How would you align a patient with L5, S1 spondylolisthesis in the sagittal plane? - (answers)Decrease lumbar lordosis
which is the most appropriate position to prevent progression and allow for healing of the pathology
It is early in the recovery phase of a patient with a L3 complete spinal cord injury. The expect outcome would most
likely be? - (answers)Some recovery of function since damage is to the peripheral nerve roots. Spinal cord ends at L1 at
the conus medularis; a spastic bladder is expected with an upper motor neuron injury
With regard to spondylolithesis, what are the radiographic signs that contraindicate orthotic intervention and indicate a
surgical candidate? - (answers)Superior vertebrae angulation of 50 degrees relative to inferior vertebrae
Anterior translation of the superior vertebrae over the inferior vertebrae
Patient presents with an L1 burst fracture from a snowmobiling accident; which orthosis is most appropriate? -
(answers)Custom polymer TLSO - to have coverage spaning several levels above and below the pathological site. Burst
fractures are most unstable in the transverse plane. Custom TLSO is most efective at rotational control and has proper
coverage
With a traction injury to the anterior division of the brachial plexus you would expect: weakness of the elbow flexors,
wrist flexors, and forearm pronators. What other muscle weakness would you expect? - (answers)Thumb abductors -
Anterior nerve root gives rise to C6 nerve root, median nerve, which abducts the thumb
Patient presents with a T11 anterior compression fracture. Patient is neurologically intact and the fracture is stable.
Which orthoses would be appropriate? - (answers)CASH TLSO and Jewett TLSO - both effective for anterior
compression FX near the thoracolumbar junction. By placing the thoracic spine in extension, pressure is removed from
anterior portion of the vertebral body allowing natural bone remodeling to occur
When taking an impression for a patient with a L5/S1 spondylolihesis, how would you position the patient if they were
allowed to stand for the procedure? - (answers)Ask the patient to flex their hips and knees slightly to reduce lumbar
lordosis for optimal alignment for spondylolisthesis
You have a patient for an evaluation post stroke. You notice a forward flexed posture. What positive muscle length test
do you expect with this? - (answers)Thomas test - test for iliopsoas (hip flexion) tightness
,What are some of the biomechanical principles behind a LSO corset? - (answers)Kinesthetic reminder - to use proper
posture and to discourage certain motions
Increase intradominal pressure - solidifies soft tissie hydrostatically whereby providing support to the lumbar spine
Multiple three-point pressure systems - work to hold proper alignment and resist/stop certain motions
You are working with a physical therapist for gait training with a patient wh has complete L1 spinal cord injury along
with a patient with L4 spinal cord injury. What orthosising do you expect and with what ambulation tolerance
respectively? - (answers)L1: independent ambulation with KAFO (most likely needed due to iliopsoas weakness as
innervated by L2 nerve root) at household distance (due to high energy costs)
L4: independent ambulation with AFO (LMN lesion resulting in ankle DF and anterior tibialis weakness -> foot drop) in
community
Posterior trim lines for TLSO?
Anterior trim lines for TLSO? - (answers)Posterior: Inferior to spine of scapula to sacrococyggeal
Anterior: Inferior to sternal notch symphysis pubis
What pathology would indicate use of Williams flexion LSO? - (answers)Spondylolisthesis - Williams Flexion LSO
allows free lumbar flexion but stops lumbar extension making it a possible orthosis for spondylolithesis management
The "unhappy triad" includes injury to the following structures: - (answers)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? - (answers)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 ________. - (answers)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? - (answers)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? - (answers)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 - (answers)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? - (answers)ALS is a
progressive degenerative disease where an AFO would be appropriate for her fatigue and foot drop
Describe Guillain-Barre syndrome - (answers)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? - (answers)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? -
(answers)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? - (answers)Subtalor pronation
Plantarflexed first ray
Tibial internal rotation
A patient has a fxed forefoot varus, what isn't a compensatory strategy? - (answers)Subtalor supination
Where is the proper anterior pin placement in a HALO CTLSO application? - (answers)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
QUESTIONS WITH CORRECT DETAILED AND VERIFIED ANSWERS-MOSTLY TESTED QUESTIONS |
RATED 100% CORRECT!!GUARANTEED PASS!!ALREADY GRADED A+
A patient presents with separated connective tissue at the pubis symphysis. What orthosis do you recommend and what
hormone is responsible for the increased elasticity of the pubis symphysis during pregnancy. - (answers)Relaxin
hormone - is released in pregnant women which increases the elasticity of connective tissue to assist and ease birth.
SI belt - used when pubis symphysis becomes too elastic causing pain and instability
Describe the flexion synergy pattern in the upper extremity and lower extremity. - (answers)UE: shoulder abduction,
external rotation, elbow flexion, forearm supination, wrist flexion
LE: hip flexion, abduction, external rotation, knee flexion, ankle dorsiflexion, inversion
Describe the extensor synergy pattern in the upper extremity and lower extremity. - (answers)UE: Shoulder adduction,
internal rotation, elbow extension, forearm pronation, wrist flexion
LE: hip extension, adduction, internal rotation, knee extension, ankle plantarflexion, inversion
During normal heel strike, the forward hip is how flexed? - (answers)25 deg flexed
Gait cycle is described by the activity between - (answers)Heel strike on one side and the follow heel strike on the same
side
Describe Legg-Calve-Perthes disease (osteochondrosis). - (answers)Males>females, average age onset 6 years old,
psoatic limp due to psoas major weakness, lower extremity moves into external rotation, flexion and adduction, MRI will
show collapse of subchondral bone at femoral neck
Describe slipped capital femoral epiphysis. - (answers)Males>females, age onset 13 years, AROM restricted in
abduction, flexion, and internal rotation, vague pain at hip, knee, and thigh
Describe avascular necrosis - (answers)Etiologies resulting in lack of blood supply to the femoral head, AROM is
decreased in hip flexion, internal rotation, and abduction, pain at groin, thigh, and tenderness at hip
Describe adhesive capsulitis - (answers)Characterized by restriction in shoulder motion in external rotation, abduction,
and flexion, inflammation and fibrosis at shoulder
,How would you align a patient with lumbar DJD in the sagittal plane? - (answers)Decrease lumbar lordosis which moves
pressure off the affected posterior portion of the vertebrae onto the vertebral body and away from the arthritic joints.
How would you align a patient with L5, S1 spondylolisthesis in the sagittal plane? - (answers)Decrease lumbar lordosis
which is the most appropriate position to prevent progression and allow for healing of the pathology
It is early in the recovery phase of a patient with a L3 complete spinal cord injury. The expect outcome would most
likely be? - (answers)Some recovery of function since damage is to the peripheral nerve roots. Spinal cord ends at L1 at
the conus medularis; a spastic bladder is expected with an upper motor neuron injury
With regard to spondylolithesis, what are the radiographic signs that contraindicate orthotic intervention and indicate a
surgical candidate? - (answers)Superior vertebrae angulation of 50 degrees relative to inferior vertebrae
Anterior translation of the superior vertebrae over the inferior vertebrae
Patient presents with an L1 burst fracture from a snowmobiling accident; which orthosis is most appropriate? -
(answers)Custom polymer TLSO - to have coverage spaning several levels above and below the pathological site. Burst
fractures are most unstable in the transverse plane. Custom TLSO is most efective at rotational control and has proper
coverage
With a traction injury to the anterior division of the brachial plexus you would expect: weakness of the elbow flexors,
wrist flexors, and forearm pronators. What other muscle weakness would you expect? - (answers)Thumb abductors -
Anterior nerve root gives rise to C6 nerve root, median nerve, which abducts the thumb
Patient presents with a T11 anterior compression fracture. Patient is neurologically intact and the fracture is stable.
Which orthoses would be appropriate? - (answers)CASH TLSO and Jewett TLSO - both effective for anterior
compression FX near the thoracolumbar junction. By placing the thoracic spine in extension, pressure is removed from
anterior portion of the vertebral body allowing natural bone remodeling to occur
When taking an impression for a patient with a L5/S1 spondylolihesis, how would you position the patient if they were
allowed to stand for the procedure? - (answers)Ask the patient to flex their hips and knees slightly to reduce lumbar
lordosis for optimal alignment for spondylolisthesis
You have a patient for an evaluation post stroke. You notice a forward flexed posture. What positive muscle length test
do you expect with this? - (answers)Thomas test - test for iliopsoas (hip flexion) tightness
,What are some of the biomechanical principles behind a LSO corset? - (answers)Kinesthetic reminder - to use proper
posture and to discourage certain motions
Increase intradominal pressure - solidifies soft tissie hydrostatically whereby providing support to the lumbar spine
Multiple three-point pressure systems - work to hold proper alignment and resist/stop certain motions
You are working with a physical therapist for gait training with a patient wh has complete L1 spinal cord injury along
with a patient with L4 spinal cord injury. What orthosising do you expect and with what ambulation tolerance
respectively? - (answers)L1: independent ambulation with KAFO (most likely needed due to iliopsoas weakness as
innervated by L2 nerve root) at household distance (due to high energy costs)
L4: independent ambulation with AFO (LMN lesion resulting in ankle DF and anterior tibialis weakness -> foot drop) in
community
Posterior trim lines for TLSO?
Anterior trim lines for TLSO? - (answers)Posterior: Inferior to spine of scapula to sacrococyggeal
Anterior: Inferior to sternal notch symphysis pubis
What pathology would indicate use of Williams flexion LSO? - (answers)Spondylolisthesis - Williams Flexion LSO
allows free lumbar flexion but stops lumbar extension making it a possible orthosis for spondylolithesis management
The "unhappy triad" includes injury to the following structures: - (answers)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? - (answers)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 ________. - (answers)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? - (answers)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? - (answers)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 - (answers)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? - (answers)ALS is a
progressive degenerative disease where an AFO would be appropriate for her fatigue and foot drop
Describe Guillain-Barre syndrome - (answers)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? - (answers)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? -
(answers)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? - (answers)Subtalor pronation
Plantarflexed first ray
Tibial internal rotation
A patient has a fxed forefoot varus, what isn't a compensatory strategy? - (answers)Subtalor supination
Where is the proper anterior pin placement in a HALO CTLSO application? - (answers)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
