4.1 - PT Final Exam 1 Review (Section 1)

Question 1

Describe the function of CN IV

Answer 1

Innervates the superior oblique muscle of the eye

Down & inward (adduction) eye movement; intorsion
of eye

Question 2

Describe the “common triad” for clinical presentation of mitral valve prolapse

Answer 2

a) Profound fatigue
b) Palpitations
c) Dyspnea

Question 3

63 yo F complains of chest muscle spasms, intermittent sternal pain that lasts several seconds & is sharp in naute. Symptoms occur frequently for a few weeks then disappear. PT can hear a “murmur” upon auscultation of the heart.

What is the likely cause of this patient’s symptoms?

Answer 3

Mitral valve prolapse

Question 4

Grading Pulses

Answer 4

0: No palpable pulse
1+: Diminished
2+: Normal
3+: Bounding

Question 5

Why would a posterior walker be used for a child w/ spastic diplegia CP?

Answer 5

These patients often walk in a high-guard position

Posterior walker facilitates a more upright posture & natural gait pattern
Often have a seat attachment, making sit to stand transfers easier

Question 6

Describe each of the following types of validity

Concurrent validity
Construct validity
Content validity
Face validity

Answer 6

Concurrent validity - compares two tools against each other; most often with one being the gold standard

Construct validity - the degree to which the tool measures an abstract concept

Content validity - indicates that the items on the tool appropriately measure the subject matter

Face validity - does it seem like it measures what it’s supposed to at face value

Question 7

Describe the clinical presentation of hyperthyroidism (Grave’s disease)

Answer 7

“Speeding things up”

Warm flushed skin
Muscle weakness
Increased DTRs
Tachycardia
Palpitations
Polyuria
Amenorrhea
Ophthalmopathy (bulging eyes)

Question 8

Describe each of the following types of incontinence

Functional
Overflow
Stress
Urge

Answer 8

Functional - there is normal urine control, but a physical impairment or decrease in mobility prevents the patient from reaching a toilet in time

Overflow - continual leakage of urine from a full bladder that is unable to empty

Stress - occurs with increases in intraabdominal pressure (coughing, laughing, lifting)

Urge - uncontrolled loss of urine following a sudden urge to urinate

Question 9

Describe the LE peripheral nerve sensory innervation

Question 10

What causes meralgia paresthetica?
Describe the clinical presentation

Answer 10

Entrapment of the lateral femoral cutaneous nerve under the inguinal ligament

Sensory changes along the lateral aspect of the thigh
NO motor involvement

Can be seen during pregnancy when the weight of the developing fetus in the abdominal cavity compresses the nerve

Question 11

What is osteitis pubis?

Answer 11

Inflammation of the pubic symphysis

Question 12

Which of the following reflexes is LEAST likely to be included during physical examination of DTRs?

Brachioradialis
Finger flexors
Jaw
Plantar

Answer 12

Plantar Reflex

This is a superficial cutaneous reflex –> flexion of the big toe
“Babinski reflex”

Question 13

When are pressure garments indicated following a burn?
How often should they be worn?

Answer 13

For burns that take longer than 14 days to heal.
To address excessive scarring

23 hours a day (for several months to years)

Question 14

What exercises should be avoided in patients with osteoporosis? Why?

Answer 14

Spinal flexion

Can cause vertebral compression fracture

Question 15

Describe the values for the ABI and what they indicate

Answer 15

1.0-1.4 = normal
>1.4 = vessel calcification / hardening
<1.0 = arterial disease

.8-.9 = some arterial disease (treat risk factors)
..5 - .8 = moderate arterial disease (refer to vascular specialist)
<.5 = severe (refer to vascular specialist)

Question 16

Describe the function of each of the GH ligaments

Anterior fibers of the inferior GH ligament
Inferior GH ligament
Inferior GH ligament
Middle GH ligament
Superior GH Ligament

Answer 16

Anterior fibers - primary stabilizers against anterior movement

Inferior - primary stabilizer against anterior translation while in 90 deg of abd & ER

Middle - primarily stabilizes against anterior translation w/ the arm in ER & <90 deg abd

Superior - important inferior stabilizer

Question 17

Which Rancho level is “confused & agitated”?

Answer 17

Rancho Level 4

Question 18

Describe the Ottawa ankle rules

Answer 18

Inability to WB immediately & in emergency department
OR
Bone tenderness at the posterior edge of the tip of the lateral & medial malleolus; navicular; base of 5th met

Question 19

Describe the proper fitting for axillary crutches

Answer 19

2-3 inch (5-7 cm) gap between the top of the axillary pads & the patient’s axilla

15-30 deg of elbow flexion

Question 20

Describe disseminated herpes zoster

Recommended isolation precautions

Answer 20

Lesions occur outside of the primary or adjacent dermatomes. Has blisters that contain fluid with the virus
- Can be transmitted thru air or contact

Airborne plus contact precaution
- Private room; negative airflow; mask, gown, and gloves

Question 21

Which side is involved with L torticollis? What would the baby’s head position be?

Answer 21

L torticollis = L SCM is involved

L side bend & R rotation

Question 22

What is Murphy’s sign?
What does it indicate?

Answer 22

Acute cholecystitis
(gallbladder information)

Ask the patient to take a deep breath while palpating the R subcostal area
(+) = pain w/ inspiration when the gallbladder comes into contact w/ the examiner’s hand

Question 23

Describe the Wagner Stages of Neuropathic Ulcer

Answer 23

0 = foot at risk
1 = superficial ulcer
2 = Deep ulcer (full thickness with exposed tendon, muscle, and/or bone without osteomyelitis)
3 = abscessed deep ulcer
4 = limited gangrene
5 = extensive gangrene

Question 24

Morphology of the acromion is best observed using which radiograph view?

Answer 24

Scapula Y

Question 25

Which of the following conditions would NOT be an absolute contraindication to exercise testing?

Acute pericarditis
High-degree AV block
Uncontrolled symptomatic heart failure
Unstable angina

Answer 25

High-degree AV block

Question 26

Describe pectus excavatum vs pectus carinatum

Answer 26

Pectus excavatum - Posteriorly displaced sternum; decreased anterior to posterior dimension of the chest
- Can impair respiration

Pectus carinatum - anteriorly displaced sternum & increased anterior to posterior dimensions of the chest

Question 27

Describe pudendal neuralgia

Clinical presentation
What dermatome does this nerve follow?

Answer 27

Entrapment of the pudendal nerve

• Low back, thigh, and groin pain
• Pelvic tension or laxity

Follows the S2-3 dermatome

Question 28

Describe the levels of phase 1 inpatient cardiac rehab

Answer 28

Main focus of phase 1: low-level exercise, education, and monitoring vital signs during activity

Level 1 - patient on bed rest

Level 2 - 1.5-2.0 METs
- Sitting EOB
- Walking to / from bathroom w/ supervision

Level 3
- Independent ambulator

Level 4 - IDK couldn’t find it