2 Part V

Question 1

swelling and limited range of motion combined with the patient’s ongoing treatment with radiation are suggestive of

Answer 1

lymphedema - take accurate circumferential measurements. Measure and record limb circumference at that landmark and at 3.94 inch (10 cm) intervals to the axilla (or along the extent of the edema)

Question 2

One of the key components of the immediate postoperative phase following anterior cruciate ligament reconstruction is

Answer 2

protection of the graft by minimizing strain on the anterior cruciate ligament. Open-chain knee extension is avoided during this time period because it causes significant stress on the ligament and joint.

Question 3

The PRIMARY purpose of pursed-lip breathing is to:

Answer 3

help prevent the collapse of pulmonary airways during exhalation. Pt with COPD has premature collapse of the airways upon exhalation, which leads to air trapping and ultimately poor gas exchange. Breathing out through pursed lips slows the airflow and creates a back pressure

Question 4

During a posture examination, the physical therapist notes that both of the patient’s patellae point inward when viewed from the front of the patient. The MOST likely cause of this problem is excessive:

Answer 4

femoral anteversion - inwardly pointing or “squinting patellae” is excessive femoral anteversion. Although there is normally 8° to 15° of femoral anteversion, an excessive amount leads to squinting patellae & toeing in.

Question 5

What might cause the patellae to point outward?

Answer 5

Genu varum, weakness of the vastus medialis, and medial tibial torsion

Question 6

Radial nerve ULTT?

Answer 6

shoulder girdle depression, elbow extension, shoulder medial (internal) rotation, and wrist flexion.

Question 7

A physical therapist is measuring the shoulder passive joint range of motion of a patient who has acute bursitis. What type of joint end-feel is MOST likely to occur?

Answer 7

Empty - pain with PROM bc of bursitis

Question 8

In a research study, the independent t-test was used as the statistical tool. How would statistically significant results be presented if alpha was set at .05?

Answer 8

p <.05 - A p value is the probability value. With the prestudy alpha set at .05, p values less than .05 are considered statistically significant. The p value must be less than .05 to be considered statistically significant.

Question 9

ABI Indexes

Answer 9

> 1.0 = noncompressible, calcified large LE arteries
1.0 = normal arterial blood flow
0.8 = mild arterial occlusive disease
0.5 to 0.8 = moderate arterial occlusive disease
Compression therapy is contraindicated when the ankle-brachial index is < 0.8

Question 10

The spinothalamic tracts are responsible for

Answer 10

pain and temperature

Question 11

The dorsal column-medial lemniscus tract is responsible for

Answer 11

proprioception, vibration, deep touch, and discriminative touch.

Question 12

The spinocerebellar tracts are responsible for

Answer 12

unconscious proprioception from the trunk and lower extremities

Question 13

Keloid scarring is a condition in which

Answer 13

excessive scar tissue grows outside of the original margins of the wound

Question 14

Lichenification is a term used to describe

Answer 14

skin that becomes hard and leathery. Its texture is similar in appearance to lichens

Question 15

Hypertrophic scarring would describe

Answer 15

a healed wound with thick fibrous tissue that remains within the original wound border

Question 16

Epibole is used to describe a condition in which

Answer 16

the wound edges are rolled under and the wound bed remains open.

Question 17

The mode of exercise is a double-leg press unit. After 1 week, the patient shows a 10-lb (4.5-kg) increase in the amount of weight the patient is able to lift. What is the MOST likely cause of the patient’s increase in strength?

Answer 17

Neurological adaptation - most likely to due to neurological factors such as more efficient motor unit recruitment, autogenic inhibition, and more efficient coactivation of muscle groups.

Question 18

A patient with chronic venous insufficiency of the lower extremities is MOST likely to exhibit:

Answer 18

dilation of superficial veins, edema, and stasis ulceration.

Question 19

39-year-old male patient with a 20-year history of smoking reports cramping pain of the buttock, thigh, and calf that is worse when walking. Which of the following findings is MOST likely present?

Answer 19

Blood pressure that is greater in the arm than in the leg.Peripheral arterial disease correlates most strongly with cigarette smoking. Male gender is also a risk factor. The patient is experiencing intermittent claudication pain, aching, or cramping of muscles, causing limping. Ischemia should be strongly suspected when systolic blood pressure is lower at the ankle than at the arm.

Question 20

The ideal amount of time for therapeutic heating effects with minimal risk of burns is

Answer 20

20-30 minutes

Question 21

For an individual with a T12 spinal cord injury to be able to walk, achievement of which of the following ranges of motion is MOST important?

Answer 21

Full hip extension is required for a person with a T12 level injury to be able to walk.

Question 22

Which of the following findings is present in a patient who has Guillain–Barré syndrome, but is not present in a patient who has multiple sclerosis?

Answer 22

Hypoactive deep tendon reflexes. Guillain–Barré syndrome is a demyelinating disease that affects the lower motor neurons; while multiple sclerosis is a demyelinating disease that affects the upper motor neurons. Hypoactive, or absent, deep tendon reflexes are indicative of lower motor neuron damage

Question 23

A patient is lying supine with hips and knees extended and hands behind the head. The patient is able to raise the head, shoulders, and thorax from the treatment table but is unable to come to a complete long-sitting position. What muscle should the physical therapist target for a strengthening program?

Answer 23

Iliopsoas - In order to come to a long-sitting position, however, the hips must be flexed, and the abdominals cannot perform this action because they do not cross the hip joint. Therefore, the hip flexors (iliopsoas among others) would have to complete this motion. The inability to achieve a long-sitting position would suggest weakness in the iliopsoas muscle

Question 24

The median nerve innervates the following muscles in the forearm:

Answer 24

1) pronator teres and quadratus, (2) flexor digitorum superficialis, (3) flexor digitorum profundus (index and middle fingers [2nd and 3rd digits]), (4) thenar muscles (abductor pollicis brevis, opponens pollicis, flexor pollicis brevis). Therefore, a lesion of the median nerve would affect those muscles and their accompanying actions: forearm pronation, finger flexion, and thumb (1st digit) opposition.

Question 25

A long-distance runner comes to physical therapy with insidious onset of lower leg pain. The pt’s examination results reveal weakness of toe flexion and ankle inversion. The PT suspects vascular compromise associated with this presentation. Palpation at which location is MOST likely to reveal diminished arterial pulses in the patient?

Answer 25

Posterior to the medial malleolus. The posterior tibial artery is most likely to be involved in chronic posterior compartment syndrome, which is described in the question. This artery should be palpated posterior to the medial malleolus.

Question 26

Complete blockage of the left middle cerebral artery would most likely cause a problem with

Answer 26

expressive speech (Broca aphasia), especially in a right-handed individual.

Question 27

blockage of the right middle cerebral artery causes

Answer 27

Left hemiparesis and Left homonymous hemianopsia

Question 28

Hemineglect syndrome is much more common

Answer 28

in right cerebral hemisphere lesions

Question 29

Which of the following modalities is MOST appropriate for decreasing pain and increasing tissue extensibility prior to active hand exercises in a patient with rheumatoid arthritis?

Answer 29

Paraffin wax baths are used to decrease pain and increase tissue extensibility in patients with rheumatoid arthritis. The increase in collagen extensibility associated with heating may decrease pain perception and increase tolerance for participation in active exercise. Ice deceases tissue extensibility.

Question 30

patient in the 8th month of pregnancy has numbness and tingling of the left hand, except for the little finger (5th digit). She demonstrates edema of the hand and fingers, a positive Tinel sign at the wrist, and a Good (4/5) muscle test grade of the wrist and finger flexors. The MOST appropriate intervention is:

Answer 30

frequent rest and elevation of the left upper extremity. - Compression on the median nerve (carpal tunnel syndrome) is occurring, most likely as a result of swelling associated with the individual being in the 8th month of pregnancy.

Question 31

During evaluation of a patient’s gait, a physical therapist observes that the patient leans forward shortly after heel strike (initial contact). The patient’s forward bending is MOST likely a compensation for weakness in the:

Answer 31

Quads - are active shortly after heel strike (initial contact) to prevent excessive knee bending during the loading phase of initial stance. Weakness of the quadriceps causes the patient to compensate by leaning forward at heel strike (initial contact) and to use the body weight to help keep the knee extended.

Question 32

patient comes to physical therapy with a diagnosis of a medial meniscus tear of the right knee. Which of the following signs and symptoms is MOST indicative of this diagnosis?

Answer 32

A history of mechanical locking is a common symptom of knee medial meniscus tear.

Question 33

During Phase I (inpatient) cardiac rehabilitation, vital sign parameters with activity that warrant termination are:

Answer 33

diastolic blood pressure of 110 mm Hg or greater, systolic blood pressure above 210 mm Hg or an increase greater than 20 mm Hg from resting,
& heart rate increases beyond 20 bpm above resting.