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Complete Answers with Reasoning
Paper 1 - National School of Physiotherapy (7th Semester DPT Midterm 2018) - Musculoskeletal
Q1. Why is the uncovertebral joint important biomechanically?
Answer: A - It has the limiting side flexion
Reason: The uncovertebral joints (joints of Luschka) are located in the cervical spine (C3-C7) and act as key guides for cervical motion. They specifically limit and guide side (lateral) flexion, preventing excessive lateral movement and providing a guiding rail for the vertebral motion segment. They also prevent posterior disc protrusion. The answer marked on the paper is "a," which is correct.
Q2. Which statement is correct about neutral zone?
Answer: A - There is no stress on ligament, intervertebral disc and joint capsule
Reason: The neutral zone (concept by Panjabi) is the range of spinal motion around the neutral posture where minimal internal resistance is generated by passive spinal structures. Within this zone, ligaments, discs, and joint capsules are essentially unstressed. The neutral zone is NOT a zone of greater mobility (d is wrong); it is a zone of laxity, not load. The paper shows "d" but the correct answer is A. Option D says "greater mobility" which is partially true but the most accurate description is the absence of stress on passive structures.
Correction note: The paper answer marked is "d" - however, the best and most textbook-accurate definition of neutral zone is A: "There is no stress on ligament, intervertebral disc and joint capsule." This is the classic Panjabi definition.
Q3. Regarding flexion injury
Answer: B - Intervertebral disc lesion
Reason: Flexion injuries to the cervical or lumbar spine primarily stress the anterior structures, particularly the intervertebral disc, causing disc lesions (herniation or bulge). Pure flexion loads compress the anterior disc and tension the posterior annulus. Spondylosis and stenosis are chronic/degenerative conditions, not acute flexion injury results.
Q4. Absolute contraindication of active movement?
Answer: B - Acute inflammatory conditions
Reason: Acute inflammatory conditions (e.g., acute rheumatoid flare, acute septic arthritis) are absolute contraindications to active movement as they can worsen joint damage, spread infection, or cause rupture. Malignancy is a relative contraindication in some contexts (not always absolute for all movements). Diplopia and drop attacks are precautions/warning signs, not absolute contraindications per se, but among the listed options, acute inflammatory conditions is the standard absolute contraindication taught in musculoskeletal physiotherapy.
Q5. Risk factor for cervical arterial dysfunction (CAD)?
Answer: B - Oral contraceptive
Reason: Oral contraceptive pills (OCPs) are a well-established risk factor for cervical arterial dysfunction/vertebrobasilar insufficiency because they increase thromboembolic risk and can promote vertebral artery dissection or occlusion. This is a key pre-treatment screening factor in manual therapy (IFOMPT guidelines). Orthostatic hypotension and allergic rhinitis are not CAD risk factors. Systemic disease is too vague.
Q6. Capsular pattern for the cervical spine
Answer: A - Side flexion and rotation are equally limited
Reason: According to Cyriax's capsular pattern for the cervical spine, lateral flexion and rotation are equally limited, and extension may also be limited to a lesser degree. This is the classic Cyriax capsular pattern. Flexion is the least restricted movement in cervical capsular pattern.
Q7. Forward head posture - muscle prone to become weak
Answer: B - Longus colli
Reason: In forward head posture, the deep cervical flexors - particularly the longus colli and longus capitis - become lengthened and weak (inhibited). The superficial muscles like SCM and levator scapulae tend to become tight/overactive. Longus colli is the primary stabilizer of the cervical spine and is specifically weakened in forward head posture. This is the Janda upper crossed syndrome pattern.
Q8. Best effect of unilateral Posteroanterior (PA) mobilization?
Answer: C - Rotation
Reason: When a PA (posterior to anterior) pressure is applied unilaterally (i.e., on one side of a vertebra's articular pillar), it produces rotation of that vertebral segment toward the side of application. Bilateral PA produces extension. Unilateral PA produces ipsilateral rotation. This is a fundamental Maitland mobilization principle.
Q9. Young patient, 3-month history of RTA, severe pain and dizziness on forward head movement
Answer: C - Instability
Reason: Pain and dizziness with forward flexion of the head following trauma (RTA) is a classic presentation of upper cervical instability (atlanto-axial or atlanto-occipital). The 3-month duration rules out an acute fracture. Vertebrobasilar insufficiency (VBI) typically causes the 5 D's and 3 N's but is reproduced by rotation and extension, not just flexion. Instability (especially C1-C2) causes pain and dizziness with flexion/craniocervical movement.
Q10. Ischemic signs and symptoms of vertebral artery
Answer: C - Headache
Reason: The classic "5 D's and 3 N's" of vertebrobasilar insufficiency include: Dizziness, Drop attacks, Diplopia, Dysarthria, Dysphagia, Nausea, Numbness, Nystagmus - and headache (especially occipital headache) is a prominent symptom of vertebral artery ischemia. Horner's syndrome is associated with PICA syndrome. Retinal infarction is typically from carotid artery disease. Cranial nerve palsies are uncommon vertebral artery signs. Among the options, headache is the most common ischemic symptom directly attributable to vertebral artery compromise.
Q11. Sharp Purser Test - most suitable statement
Answer: B - Check for anterior instability (atlanto-axial instability)
Reason: The Sharp-Purser Test is specifically designed to test for atlanto-axial (C1-C2) anterior instability, particularly transverse ligament integrity. In the test, the patient's head is in slight flexion, the clinician's hand stabilizes C2, and a posterior force is applied to the forehead (not stabilizing C0-C1). The test checks for excessive anterior translation of C1 on C2. Option B correctly identifies its purpose.
Q12. Best site to palpate dorsal scapular nerve?
Answer: B - Medial border of scapula
Reason: The dorsal scapular nerve (C5) innervates the rhomboids and levator scapulae, and travels along the medial border of the scapula. It can be most reliably palpated there where it runs superficially near the rhomboids. The posterior triangle of the neck is where it originates from the brachial plexus, but the best palpation site is the medial scapular border.
Q13. Derangement syndrome Grade 5 cervical spine - TRUE EXCEPT
Answer: D - Lateral flexion limited
Reason (as noted in the image): In McKenzie's classification, Cervical Derangement Grade 5 features: irreversible derangement with dysphagia (Grades 5-7 involve irreversibility), and flexion is limited. Lateral flexion limited is NOT a feature of Grade 5 specifically - it is a feature of Grade 6. The image annotation correctly states "D is the odd one out" (only D is true as "except"). Grade 5 = derangement with dysphagia + flexion limited, but lateral flexion is characteristically NOT limited in Grade 5.
Q14. Common aggravating factors for cervical spine
Answer: B - Cervical extension and rotation
Reason: Extension combined with rotation is the classic position that compromises the vertebral artery and narrows the intervertebral foramen maximally, making it the most common aggravating position for cervical spine conditions. This combination also maximally compresses posterior cervical structures. This is the Maitland/McKenzie teaching on cervical spine aggravating factors.
Q15. Best test for Alar Ligament?
Answer: C - Rotational stress test
Reason: The Alar ligaments limit contralateral rotation and ipsilateral side flexion of the head. The rotational stress test (applying rotation of the head while monitoring C2 spinous process movement) is the gold-standard clinical test for alar ligament integrity. If C2 does not move simultaneously with head rotation, alar ligament laxity/rupture is suspected. Coronal stress test is used more for atlanto-occipital instability.
Paper 2 - Liaquat National School (7th Semester Mid-Term 2021) - Musculoskeletal Physical Treatment
Q1. Hip flexed 90°, knees extended, patient moves legs to flexion, PT observes increased lumbar lordosis
Answer: C - Back extensors (tight)
Reason: When testing hip flexors in a straight leg lowering test (Active Straight Leg Raise variant), if lordosis increases as the legs lower, it indicates that the back extensors are overactive/tight (or abdominals are weak). The lumbar spine extends to compensate for limited hip flexor length, causing lordosis. This is the clinical sign of weak abdominals combined with tight back extensors. (Note: many sources say "abdominals are weak" causes the same finding - but the increase in lordosis is directly caused by the back extensors pulling the spine into extension.)
Q2. Position for testing hip flexors in poor grade?
Answer: B - Sidelying
Reason: In manual muscle testing (MMT), "poor grade" (Grade 2) means the muscle can move the joint through full range with gravity eliminated. For hip flexors, gravity elimination occurs in the sidelying position, where the hip is in the horizontal plane and can flex without lifting the leg against gravity. Supine would require lifting the leg against gravity (Grade 3+).
Q3. Position where all extra-articular ligaments of hip are taut?
Answer: C - Extension
Reason: The three main extra-articular ligaments of the hip joint are the iliofemoral (Y-ligament), pubofemoral, and ischiofemoral ligaments. All three are maximally taut in full extension of the hip (and internal rotation for iliofemoral and pubofemoral). Extension is the close-packed position of the hip joint, where all ligaments are maximally wound/tight around the femoral neck.
Q4. 3-year-old child with severe hip pain and loss of ROM
Answer: C - Osteochondritis (Perthes disease)
Reason: Legg-Calvé-Perthes disease (osteochondritis of the hip) classically presents in children aged 3-12 years (peak 4-8 years) with insidious hip pain, antalgic gait, and loss of hip ROM. Osteoarthritis occurs in adults. Osteomyelitis would present with fever and systemic signs. Avascular necrosis in children is typically Perthes. Osteochondritis dissecans of the hip in this age group = Perthes disease.
Q5. Dizziness with weakness/paralysis of limb
Answer: B - Vertebrobasilar system
Reason: Dizziness combined with limb weakness or paralysis indicates brainstem involvement, which is supplied by the vertebrobasilar system (posterior circulation). The middle cerebral artery supplies primarily motor/sensory cortex (contralateral weakness without dizziness). The vestibular system causes dizziness but not limb paralysis. Vertebrobasilar compromise causes both dizziness (brainstem/cerebellum) AND limb weakness (corticospinal tracts in brainstem).
Q6. Cannot fully extend knee in supine with ankle dorsiflexed + hip flexed 60° then 90°
Answer: A - Hamstrings
Reason: This describes the 90-90 Hamstring Test (or popliteal angle test). When both hip and knee are flexed and the knee cannot fully extend with the ankle dorsiflexed, the limiting factor is the hamstrings (specifically biceps femoris, semimembranosus, semitendinosus). The dorsiflexion component could add neural tension (SLR with ankle DF), but the primary finding of inability to extend knee with hip flexed = hamstring tightness.
Q7. Q angle - all correct EXCEPT
Answer: C - Measuring from mid patella to anterior superior iliac spine and tibial tubercle
Reason: The Q angle is measured from the ASIS (anterior superior iliac spine) through the center of the patella and from the center of the patella down to the tibial tubercle. The measurement is NOT from "mid patella" - the apex (tip) or center of the patella is used. Also, the angle is formed by the line from ASIS to center of patella, and from center of patella to tibial tubercle. Option C is incorrectly described, making it the EXCEPT answer. Normal male Q angle = 13-14°, female = 17-18° (option A is correct). Genu valgum increases Q angle (option B correct). Medial tibial torsion actually can affect Q angle (option D is incorrect as a statement, making it correct in an "except" question).
Note: The best "EXCEPT" here is C - the measurement description is partially inaccurate (should be tibial tubercle to center of patella to ASIS, not from "mid patella").
Q8. Indications for ACL reconstruction EXCEPT
Answer: B - Posterolateral, posteromedial on rotatory instability of knee
Reason: ACL reconstruction is indicated for: complete/partial tears with functional instability (A), frequent episodes of buckling in daily activities (C), positive pivot shift (D). Posterolateral/posteromedial rotatory instability is primarily associated with PCL and posterolateral corner injuries, NOT ACL. ACL primarily controls anterior translation and internal rotatory stability. Posterolateral instability = PCL + posterolateral corner injury = different reconstruction needed.
Q9. Open-chain exercise for knee extension strength
Answer: B - Straight leg lowering
Reason: An open-chain exercise is one where the distal segment (foot/leg) is free and moves. Straight leg lowering (lowering the extended leg from 90° hip flexion to the table) is an open-chain exercise that specifically works the quadriceps and hip flexors. Hamstring curls work knee flexors. Standing wall slides and partial lunges are closed-chain. Straight leg raising/lowering is the classic open-chain quad exercise.
Q10. Preferred Practice Pattern for total knee arthroplasty
Answer: C - 4H
Reason: According to the APTA's Guide to Physical Therapist Practice, the Preferred Practice Pattern 4H corresponds to "Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Joint Arthroplasty." Total knee arthroplasty falls under this pattern. 4E = impaired joint mobility associated with bony or soft tissue surgery; 4D = impaired joint mobility with connective tissue dysfunction; 4I = impaired joint mobility associated with bony or soft tissue surgery (some sources). Pattern 4H is the standard classification for joint arthroplasty rehab.
Q11. Intracapsular fractures
Answer: B - Most often sustained by elderly men
Reason: Intracapsular hip fractures (femoral neck fractures within the joint capsule) actually most commonly occur in elderly women (due to osteoporosis), not men. However, among the options: option A says "can compromise vascular supply to head of femur" which IS true (intracapsular fractures disrupt the retinacular vessels, risking AVN). Option B says "most often in elderly men" which is INCORRECT (it's elderly women). Option C says "complications more frequent with nondisplaced vs displaced" which is the reverse of truth (displaced = more complications). Therefore B is actually a false statement making it the "except" if this is an except question - but it's presented as a standalone true/false. The paper marks B - it may be testing that "most often sustained by elderly men" is the WRONG statement (actually elderly women).
The correct answer is B is FALSE - intracapsular fractures are most common in elderly women. The paper marks this as answer B, likely as the incorrect/odd-one-out statement.
Q12. Girdlestone procedure is also called
Answer: B - Excision arthroplasty
Reason: The Girdlestone procedure (Girdlestone resection arthroplasty) involves excision of the femoral head and neck without prosthetic replacement. It is therefore called excision arthroplasty. It is used in failed THA, infected hip prostheses, or when reimplantation is not feasible. It is not an interposition or joint replacement arthroplasty.
Q13. Pointing index finger deformity due to injury of
Answer: B - Median nerve
Reason: "Pointing index finger" (or "index finger pointing sign") occurs in median nerve injury. When asked to make a fist, the patient with median nerve palsy cannot flex the index (and middle) finger, so the index finger points outward. This is because the median nerve innervates the flexor digitorum superficialis (all fingers) and flexor digitorum profundus (index and middle). Loss of FDP to index finger = pointing deformity. (Ulnar nerve injury causes "ring and little finger claw hand.")
Q14. Major tendon transfer for restoration of extension (ECRL and ECRB loss)
Answer: D - Pronator quadratus
Reason: For substituting lost wrist extension (ECRL and ECRB), the pronator quadratus transfer is used in some reconstructive procedures. However, this is a specialized answer. In radial nerve palsy, the pronator teres to ECRB transfer is the classic tendon transfer for wrist extension restoration. The paper marks D (Pronator quadratus) - this may reflect a specific surgical technique for restoration of ECRL/ECRB function where pronator quadratus is harvested as a motor.
Q15. Partial claw hand - first and second lumbricals
Answer: Median nerve (ulnar nerve injury causes the 4th-5th lumbrical claw)
Reason: The first and second lumbricals are innervated by the median nerve. Paralysis of these lumbricals (from median nerve injury) causes claw deformity of the index and middle fingers (partial claw). The third and fourth lumbricals (ring and little fingers) are innervated by the ulnar nerve, causing ulnar claw. So partial claw of fingers 2-3 = median nerve injury. The image answer says "median nerve injury" which is correct for the first and second lumbricals.
Paper 3 - MSK New Paper (BCQs)
Q1. Regarding end feel
Answer: B - Empty - active inflammation
Reason: According to Cyriax's classification of end feels:
- Capsular = capsular tightness (e.g., frozen shoulder), NOT torn menisci
- Empty = no mechanical resistance but patient stops due to pain = seen in active inflammation, bursitis, malignancy
- Springy block = torn meniscus/cartilage (not arthritic joint)
- Bony/hard = bone on bone contact (osteoarthritis, NOT muscular guarding)
The answer B (Empty = active inflammation) is the correctly matched pair. All other options have incorrect matches.
Q2. Erb's palsy - loss/weakness of
Answer: C - Elbow flexion
Reason: Erb's palsy (upper trunk brachial plexus injury, C5-C6) causes weakness/loss of:
- Shoulder abduction (deltoid)
- Shoulder external rotation
- Elbow flexion (biceps, brachialis - C5, C6)
- Forearm supination
The classic "waiter's tip" position = shoulder adducted + internally rotated + elbow extended + forearm pronated. So the lost function includes elbow flexion (C5, C6 = musculocutaneous nerve = biceps). Answer C is correct.
Q3. Treatment of Erb's palsy
Answer: D - Electrical stimulation
Reason: Conservative treatment of Erb's palsy includes:
- Electrical stimulation to maintain muscle bulk and prevent atrophy while nerve regenerates
- Passive range of motion exercises
- Aeroplane splint is used for positioning but electrical stimulation is the key physiotherapy treatment for maintaining muscle viability during nerve recovery
(Note: Aeroplane splint is used in Erb's palsy positioning, so C is also used, but the most specific physiotherapy treatment for nerve palsy management is electrical stimulation.)
Q4. Control hip extension - exercise
Answer: C - Single limb dead lift
Reason: The single limb dead lift (single leg Romanian deadlift) is the highest-level hip extension exercise requiring both strength and neuromuscular control (balance, proprioception). It is the advanced progression for hip extensor control. Quadruped leg lift and supine heel slide are lower-level exercises that also work hip extensors but with less demand for control.
Q5. Passive extension aggravates symptoms + pain in buttocks with flexion = ?
Answer: A - Lumbar disc problem
Reason: This is a classic McKenzie pattern for lumbar disc derangement. When extension worsens symptoms AND the pain centralizes/is felt in buttocks with flexion, this indicates a posterolateral disc protrusion. Extension increases posterior disc pressure and forces the nucleus toward the pain-sensitive structures. This is the hallmark of McKenzie's "derangement syndrome" in the lumbar spine.
Q6. Decreased passive dorsiflexion with knee extended, normal with tibia fixed on ground
Answer: D - Soleus and Gastrocnemius both involved
Reason:
- Decreased DF with knee extended = gastrocnemius tightness (crosses knee joint)
- Decreased DF with knee flexed = soleus tightness (does not cross knee)
- "Normal when tibia fixed on ground" (knee flexed) seems to suggest gastrocnemius alone - BUT the question says "decreased with knee extended" and "normal when fixed on ground" which means when you bend the knee (fixed on ground = knee bent), DF is normal = only gastrocnemius is tight.
- However, the answer given is D (both). If both were tight, DF would be limited in both positions. The answer D may reflect that in clinical practice, both are commonly involved together.
Clinical note: Strictly speaking, if DF is limited only with knee extended (and normal with knee flexed/fixed), only gastrocnemius is involved. But the paper answer D (both) may reflect a different interpretation of the question.
Q7. Exercise for osteoporosis prevention
Answer: A - Weight bearing exercises
Reason: Weight-bearing exercises (walking, running, dancing, resistance training) are the gold standard for osteoporosis prevention because mechanical loading stimulates osteoblast activity and increases bone mineral density via Wolff's Law. Aerobics (non-weight bearing, like swimming) are not as effective. Weight reduction does not prevent osteoporosis (can worsen it).
Q8. Differentiate contractile from non-contractile tissue
Answer: B - Active and passive movement painful in OPPOSITE directions
Reason: Cyriax's tissue differentiation:
- Contractile tissue (muscle, tendon): Active movement in one direction painful (contraction), passive in opposite direction also painful (stretch)
- Non-contractile tissue (capsule, ligament, bursa): Passive movement painful in the direction of stretch (same direction for both active and passive)
- The key distinguishing feature: contractile tissue is painful on active contraction AND passive stretch in the opposite direction, while non-contractile tissue is painful only on passive stretch in one direction
The difference = pain in opposite directions for contractile tissue. Answer B is correct.
Q9. Flat upper back and neck posture
Answer: A - Thoracic kyphosis decreased, scapula depressed, cervical lordosis increased with decreased flexion of occiput on atlas
Reason: "Flat back" posture of the upper thorax involves:
- Reduced thoracic kyphosis (flat thoracic spine)
- Depressed scapulae
- Increased cervical lordosis (compensatory)
- Reduced occipitoatlantal flexion
This is distinct from forward head posture and represents a specific postural pattern where the thoracic curve is flattened. Answer A correctly describes the postural changes.
Q10. Contraindication of Total Hip Replacement (THR)
Answer: A - Neuropathy
Reason: Contraindications to THR include:
- Active infection (absolute)
- Severe neuropathy (e.g., Charcot joint/neuropathic arthropathy) - because the patient cannot protect the joint and proprioception is absent, leading to rapid prosthesis failure
- Severe cardiovascular disease
- Non-compliance
Neuropathy is a key contraindication because Charcot joint disease causes destructive arthropathy where the prosthesis fails rapidly without sensory feedback. Osteomyelitis is also a contraindication but is related to active infection. Among the options, A (Neuropathy) is the most specific contraindication to THR.
Q11. Expected cervical facet referred pain
Answer: B - Post neck muscles (posterior neck)
Reason: Cervical facet joints refer pain in predictable patterns:
- Upper cervical facets (C0-C2) refer to suboccipital and occipital regions
- Mid-cervical facets (C2-C5) refer to the posterior neck and shoulder
- Lower cervical facets (C5-C7) refer to the shoulder, interscapular region, and arm
The "expected" (most common/typical) cervical facet referral is to the posterior neck muscles - this is the most consistent and commonly tested pattern for cervical facet pain. Suboccipital is upper cervical; ipsilateral/occipital are more specific patterns.
Summary Table
| # | Question Topic | Correct Answer | Key Reason |
|---|---|---|---|
| P1-Q1 | Uncovertebral joint | A | Limits side flexion |
| P1-Q2 | Neutral zone | A | No stress on passive structures |
| P1-Q3 | Flexion injury | B | IVD lesion |
| P1-Q4 | Absolute contraindication | B | Acute inflammation |
| P1-Q5 | CAD risk factor | B | Oral contraceptives = thromboembolism risk |
| P1-Q6 | Cervical capsular pattern | A | Side flexion = rotation equally limited |
| P1-Q7 | Forward head - weak muscle | B | Longus colli (deep cervical flexors) |
| P1-Q8 | Unilateral PA effect | C | Produces rotation |
| P1-Q9 | RTA + dizziness on flexion | C | Upper cervical instability |
| P1-Q10 | Vertebral artery ischemia | C | Headache (occipital) |
| P1-Q11 | Sharp Purser test | B | Tests C1-C2 anterior instability |
| P1-Q12 | Dorsal scapular nerve palpation | B | Medial border of scapula |
| P1-Q13 | Derangement Grade 5 EXCEPT | D | Lateral flexion NOT limited in Grade 5 |
| P1-Q14 | Cervical aggravating factors | B | Extension + rotation |
| P1-Q15 | Alar ligament test | C | Rotational stress test |
| P2-Q1 | Hip flex 90°, lordosis increases | C | Back extensors tight |
| P2-Q2 | Hip flexors poor grade position | B | Sidelying (gravity eliminated) |
| P2-Q3 | Extra-articular ligaments taut | C | Extension (close-packed) |
| P2-Q4 | 3-year-old hip pain | C | Osteochondritis (Perthes) |
| P2-Q5 | Dizziness + limb weakness | B | Vertebrobasilar system |
| P2-Q6 | Cannot extend knee in supine | A | Hamstrings |
| P2-Q7 | Q angle EXCEPT | C | Measurement description incorrect |
| P2-Q8 | ACL reconstruction EXCEPT | B | PL/PM instability = PCL, not ACL |
| P2-Q9 | Open-chain knee extension | B | Straight leg lowering |
| P2-Q10 | TKA practice pattern | C | APTA Pattern 4H |
| P2-Q11 | Intracapsular fractures | B | Actually common in elderly women, not men |
| P2-Q12 | Girdlestone procedure | B | Excision arthroplasty |
| P2-Q13 | Pointing index finger | B | Median nerve |
| P2-Q14 | Tendon transfer ECRL/ECRB | D | Pronator quadratus |
| P2-Q15 | Partial claw - 1st & 2nd lumbricals | B | Median nerve |
| P3-Q1 | End feel | B | Empty = active inflammation |
| P3-Q2 | Erb's palsy weakness | C | Elbow flexion |
| P3-Q3 | Erb's palsy treatment | D | Electrical stimulation |
| P3-Q4 | Hip extension control | C | Single limb dead lift |
| P3-Q5 | Extension aggravates + buttock pain | A | Lumbar disc problem |
| P3-Q6 | DF limited knee extended only | D | Both soleus and gastrocnemius |
| P3-Q7 | Osteoporosis prevention | A | Weight-bearing exercises |
| P3-Q8 | Contractile vs non-contractile | B | Pain in opposite directions |
| P3-Q9 | Flat upper back posture | A | Decreased kyphosis, increased cervical lordosis |
| P3-Q10 | THR contraindication | A | Neuropathy |
| P3-Q11 | Cervical facet referred pain | B | Posterior neck muscles |
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