Basic and Clinical Sciences
What this domain tests
This domain tests whether you can use anatomy, physiology, biomechanics, pathology, and neuroscience to explain a patient's presentation. Licensing items typically ask for the structure at risk, the healing phase, or the mechanical consequence of a joint position, not isolated recall.
Core rules
- Tissue healing: hemostasis/inflammation (days), proliferation (weeks), remodeling (months). Match load and stretch to irritability; avoid aggressive stretching of acutely inflamed tissue.
- Muscle: type I fibers are fatigue-resistant; type II fibers produce fast, forceful contractions. Length-tension is greatest near mid-range; eccentric contractions generate more force than concentric at the same velocity.
- Arthrokinematics: a convex surface moving on a concave surface rolls and glides in opposite directions; a concave surface on a convex surface glides in the same direction as the roll.
- Stress-strain: elastic deformation is reversible; plastic deformation is permanent; failure occurs beyond the plastic region.
- Neurological screening: upper motor neuron signs include hyperreflexia, spasticity, and a Babinski sign; lower motor neuron signs include flaccidity, atrophy, and fasciculations.
Worked example
During shoulder abduction, the humeral head is convex and the glenoid is concave. The head rolls superiorly, so the accessory glide must be inferior to maintain congruence. A candidate who chooses a superior glide because the head moves up confuses roll with glide and misses the item. The rule predicts the slide that allows roll without impingement.
Traps
Mixing osteokinematic motion (voluntary joint motion) with arthrokinematic motion (roll, glide, spin). Treating all swelling as acute inflammation. Assuming eccentric exercise is always contraindicated in tendinopathy; controlled eccentric loading is often used during remodeling.