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WorksheetsPTA 1800 Chap 5
Total questions: 59
Worksheet time: 30mins
Which term best describes increased resistance to passive movement that is velocity-independent and affects agonist and antagonist muscles equally?
Action potential with depolarization
Spasticity with clasp-knife pattern
Rigidity with lead-pipe quality
Flaccidity with absent reflexes
A patient shows velocity-dependent increase in muscle tone, most prominent in antigravity muscles. Which term fits this presentation?
Synapse involving chemical junction
Flaccidity involving muscle hyperlength
Spasticity involving stretch reflex
Rigidity involving both muscle groups
Which term denotes markedly reduced muscle tone with decreased resistance to passive movement and diminished reflexes?
Spasticity with velocity dependence
Rigidity with cogwheel pattern
Flaccidity with hypotonia signs
Motor unit with recruitment
What is the rapid electrical signal that propagates along a neuron to trigger neurotransmitter release?
Rigidity sustained tonic contraction
Action potential along axolemma
Motor unit end-plate field
Synapse structural cleft membrane
Which option best defines a motor unit?
A synaptic cleft between neurons
A motor neuron and its fibers
A neurotransmitter storage pool
A peripheral reflex receptor
Which statement correctly describes a synapse?
Passive stretch resistance
Bundle of motor units
Junction where cells communicate
Electrical signal itself
Neurotransmitters are best described as which of the following?
Structures that store synapses
Ions that form action potentials
Chemicals that transmit signals
Muscle units that contract fibers
Which statement best defines muscle tone in a resting muscle?
Electrical activity recorded by EMG only
Endurance capacity during repeated use
Active force generated during contraction
Passive resistance to stretch at rest
Which challenge most directly affects accurate assessment of muscle tone during examination?
Patient must provide no active resistance
Examiner must measure joint angles only
Patient must maximally contract the muscle
Testing must occur after vigorous exercise
Hypotonicity is best described as
Decreased resistance to stretch compared to normal
Increased resistance to stretch compared to normal
Velocity-dependent resistance at high speeds only
Sustained involuntary co-contraction of agonists
Flaccidity is most accurately characterized as
Total absence of resistance to passive stretch
Mildly increased resistance to quick stretch
Intermittent beats following a sudden stretch
Sustained tremor with small amplitude
Which feature distinguishes spasticity from general hypertonia?
Resistance increases with higher stretch velocities
Muscle is weak only during voluntary effort
Resistance is constant across all stretch speeds
Tone decreases during quick passive stretch
Clonus is best defined as
Multiple rhythmic oscillations after quick stretch
Sustained rigidity throughout the entire range
Low-amplitude high-frequency tremor at rest
Random dance-like jerky movements of limbs
Which description matches dystonia?
Involuntary sustained contractions causing abnormal postures
Brief ballistic movements throwing the limb outward
Totally absent resistance with flaccid positioning
Velocity-dependent catch during rapid stretch
A patient shows large throwing-type limb movements. This pattern is most consistent with
Ballismus, a subtype of dyskinesia
Chorea, a subtype of rigidity
Tremor, a form of hypotonia
Clonus, a type of dystonia
Which statement about dyskinesia is accurate?
It is a descriptive term for involuntary abnormal movement
It is synonymous with paralysis of voluntary muscles
It is defined as constant muscle stiffness at rest
It is another name for muscle strength assessment
Which pair correctly links abnormal movement subtype with its description?
Ballismus – sustained postures from co-contraction
Chorea – dance-like sharp jerky motions
Tremor – large ballistic throwing movements
Athetoid – high-frequency small oscillations
Which statement about rigidity in hypertonicity is most appropriate?
It represents a total absence of passive resistance
Muscles are stiff or immovable and resistant to stretch
Resistance appears only at very high velocities of stretch
Tone fluctuates dramatically from moment to moment
When tone fluctuates, the clinician should primarily
Describe the type of involuntary movement observed
Rely only on strength testing and ignore tone
Classify the patient as flaccid without further tests
Measure tone solely with a handheld dynamometer
Which statement best defines how fluctuating muscle tone is documented during examination?
Average several tone readings across sessions
Record the observed dyskinesia rather than the tone
Report tone only during voluntary contractions
Label it as variable spasticity across muscle groups
Describe it as alternating hypertonia and hypotonia
Which measure is considered quantitative for assessing muscle tone in clinical practice?
Ashworth scale rating resistance during movement
Electromyography measuring electrical muscle activity
Clinical tone scale scoring from zero to four
Muscle stretch reflex hammer testing to grade reflexes
Observation of passive limb movement quality
In the pendulum test for spasticity, which observation most indicates increased tone?
Limb stops quickly due to stretch resistance
Limb accelerates to greater terminal velocity
Limb shows delayed drop but prolonged swing
Limb swings freely through full range repeatedly
Limb oscillates symmetrically without damping
Which device directly quantifies force or torque when measuring tone?
Palpation of muscle bulk
Dynamometer or myometer instruments
Reflex hammer and ruler
Manual muscle testing only
Goniometer for joint angles
Which best matches the Modified Ashworth Scale grade 0 description?
Slight catch and minimal end-range resistance
Marked increase through most of the range
Rigid affected part in flexion or extension
Considerable increase making passive movement hard
No increase in muscle tone detected
On the Modified Ashworth Scale, which description corresponds to grade 1+?
More marked tone increase through most of ROM
Catch followed by minimal resistance through less than half ROM
Catch and release at end range only
Rigid limb held in flexion or extension throughout
Considerable tone increase with difficult passive movement
Which clinical approach is primarily qualitative rather than quantitative?
Isokinetic dynamometry torque curves
Surface EMG amplitude analysis
Pendulum kinematic angle traces
Load-cell based myometry
Clinical tone scale scoring 0–4
Which Modified Ashworth grade best fits: passive movement difficult due to high resistance?
Grade 3
Grade 1
Grade 2
Grade 1+
Grade 4
During midrange measurement of tone, the clinician emphasizes which movement region?
Terminal range to provoke stretch reflex
Full range repeated to average tone
Middle of range to reduce length-dependent effects
Beginning range near resting position
End range where tissue slack is minimal
Which scenario best differentiates spasticity using a quick stretch during assessment?
Eccentric load showing delayed onset fatigue
Sustained stretch producing gradual yielding over minutes
Rapid stretch causing a catch and release response
Slow passive movement with no change in resistance
Active contraction increasing resistance uniformly
Which structure is the final common pathway that directly stimulates skeletal muscle contraction?
Golgi tendon organ in the tendon
Sensory neuron from peripheral skin
Muscle spindle within the muscle belly
Alpha motor neuron in the spinal cord
Muscle tone is most accurately assessed at which muscle length position during clinical examination?
Fully shortened length of the muscle
Midrange length of the tested muscle
Maximally stretched muscle length
Random length determined by comfort
Which cellular event immediately enables actin–myosin cross-bridge formation during activation?
Neural stimulation triggers calcium release
Temperature decreases within the tissue
Myelin thickening around the axon
ATP is stored without hydrolysis occurring
What is the principal role of myelin on peripheral motor axons regarding action potentials?
Generate muscle force directly
Increase conduction speed of signals
Store calcium for release
Initiate synaptic neurotransmitter production
Which sensor primarily detects changes in muscle length to help regulate tone via stretch reflexes?
Cutaneous pressure receptors
Muscle spindle intrafusal fibers
Golgi tendon organ receptors
Joint capsular Ruffini endings
During which condition would action potential transmission along a motor nerve most likely slow down?
Increased ATP availability
Exposure to cold temperature
Greater actin–myosin overlap
Mild tissue warming
The length–tension relationship predicts maximal cross-bridge formation at which approximate sarcomere state?
Midrange overlap of actin and myosin
No overlap between thin and thick
Complete compression without space
Random alignment of filaments
Which statement best differentiates muscle spindles from Golgi tendon organs?
Spindles produce myelin; GTOs release calcium
Spindles sense stretch; GTOs sense tension
Spindles sense tension; GTOs sense heat
Spindles generate force; GTOs store ATP
What ionic mechanism initiates the wave of depolarization in a motor neuron during an action potential?
Osmotic movement of water across myelin
Na+/K+ pump–driven changes in membrane potential
Passive diffusion of chloride through dendrites
Calcium buffering inside the sarcoplasmic reticulum
When standardizing manual muscle tone assessment, which practice improves reliability across sessions?
Consistent limb and body positions relative to gravity
Varying touch and pressure between trials
Testing only at end-range flexion or extension
Ignoring underlying muscle strength differences
Which receptor detects muscle stretch and sends signals into the spinal cord?
Golgi tendon organ
Basal ganglia loop
Muscle spindle
Nociceptor unit
Golgi tendon organs primarily monitor which variable during movement?
Blood glucose
Muscle contraction
Joint vibration
Skin temperature
Cutaneous receptors can change muscle tone because they transmit which types of stimuli?
Equilibrium, rotation, acceleration, tilt
pH, osmolarity, hormones, gases
Light, sound, smell, taste
Temperature, pressure, texture, stretch
Low muscle tone is also known by which term?
Hypotonicity
Dyssynergia
Hypertonicity
Anisotropy
A common functional consequence of low muscle tone is most accurately described as
Increased tendon reflexes with clonus
Difficulty generating force to maintain posture
Inability to relax after maximal effort
Rapid alternating movements becoming faster
Which clinical example is linked to low muscle tone in post-stroke patients?
Carpal tunnel syndrome
Patellar dislocation
Shoulder subluxation
Achilles tendinopathy
Damage to which neuron type most directly causes low muscle tone from denervation?
Somatosensory neuron
Alpha motor neuron
Gamma interneuron
Upper motor neuron
Which rehabilitation modality is listed for alpha motor neuron damage?
Electrical stimulation
Ballistic plyometrics
Whole-body vibration
High-load eccentric lifting
High muscle tone results from abnormally high excitatory input to an intact alpha motor neuron, often due to lesions in which system?
Pulmonary vascular system
Central nervous system
Peripheral endocrine system
Autonomic enteric system
Which associated effect is specifically linked with high muscle tone?
Contractures
Joint laxity
Osteopenia
Hyposensitivity
Spinal cord injury often evolves from initial flaccidity to which condition?
Areflexia
Ataxia
Bradykinesia
Spasticity
Which strategy is appropriate for managing high tone from cerebral lesions?
Prolonged stretch with positioning or orthotics
Maximal resistance with ballistic speed training
Heat avoidance and immobilization without ROM
Hyperventilation to reduce intracranial pressure
Which statement best defines muscle tone in clinical practice?
Passive resistance of a muscle to stretch
Active force produced during maximal contraction
Neural drive required to initiate movement
Elastic recoil of tendons after loading
Normal muscle tone and activation depend primarily on the integrated function of which systems?
Skeletal muscles, PNS, and CNS
Endocrine glands, liver, and kidneys
Respiratory system and heart
Skin, fascia, and lymphatics
Abnormal inhibitory or excitatory input to which neuron most directly contributes to hypo- and hypertonicity?
Sensory ganglion cell
Gamma interneuron
Alpha motor neuron
Purkinje neuron
Which intervention is most appropriate to decrease excessively high muscle tone?
Ballistic stretching before activity
High-frequency e-stim for activation
Quick icing with tapping facilitation
Prolonged stretch with relaxation techniques
Which set of modalities is commonly used to facilitate low muscle tone for easier activation?
Neutral warmth, prolonged cold, desensitization
Compression garments, casting, sustained positioning
Hydrotherapy, quick icing, e-stim, tapping, ROM
Prolonged heat, prolonged stretch, relaxation
A client exhibits fluctuating muscle tone that varies across sessions. What is the primary rehabilitation aim?
Maintain current tone to avoid fatigue
Eliminate reflexes without task practice
Normalize tone while maximizing function
Focus only on strengthening weak muscles
Which approach is listed as helpful for managing high tone by reducing spasticity triggers?
Eliminate pain and apply neutral warmth
Perform plyometrics with resistance
Apply quick ice and vigorous tapping
Use cold spray with fast stretching
In a therapy plan, physical agents such as electrical stimulation, hydrotherapy, and quick ice are best described as what?
Adjuncts to exercise, orthotics, and functional training
Replacements for therapeutic exercise altogether
Primary treatments independent of any exercise
Methods used only in acute surgical recovery
