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826: Geriatrics > Chapters 14-16 Review Questions > Flashcards

Chapters 14-16 Review Questions Flashcards

1
Q

Which of the following is true regarding age-related changes in muscle fibers?

A. Apoptosis does not play a key role in skeletal muscle cell loss
B. Type I (slow twitch) atrophy more than type II (fast twitch)
C. Increase number of fiber type grouping
D. Satellite cells are decreased equally in type I and type II muscle fibers

A

C

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2
Q

A 50% decline in available _____________ and a diminished number and availability of satellite cells lead to a decline in muscle size and strength.

A. Motor neurons
B. Mitochondria
C. Protein Synthesis
D. Cross-bridge cycling

A

A

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3
Q

Which of the following is true regarding growth hormone as it relates to sarcopenia?

a. There is definite, long term, positive effects in improving muscle mass with growth hormone administration.
b. Growth hormones have no side effects.
c. Growth hormones should be avoided with the older population.
d. Growth hormones should be used frequently to combat sarcopenia.

A

C

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4
Q

Question: Which of the following is not a genetic trait that affects muscle performance and strength?

a. Body Size
b. Muscle fiber number
c. Body weight
d. body segment lengths

A

C

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5
Q

Which of the following is the strongest predictor of self-reported functional status and falls in older adults?

A. Upper extremity strength
B. VO2 Max
C. Leg muscle power
D. General flexibility

A

C

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6
Q

All of the following are true regarding resistance training in older adults EXCEPT:

a. Resistance training decreases fatty infiltration
b. Resistance training increases muscle mass, muscle strength, and power
c. Resistance training is more predictable in older populations
d. Resistance training should occur prior to age 80

A

C

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7
Q

What is the most important nutrient to combat sarcopenia?

a. Fat
b. Protein
c. Carbs
d. All of the above

A

B

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8
Q

Which diseases or conditions can affect fractionated movements?

a) TBI
b) Stroke
c) Multiple sclerosis
d) Cerebral palsy
e) Spinal cord injury
f) None of the above
g) All of the above

A

G

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9
Q

All of the following may define ataxia except:

A) Difficulties with balance and gait
B) Reduced ability to isolate or fractionate movements
C) Damage to the cerebellar structures
D) Difficulty controlling movement-generated forces

A

B

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10
Q

Patients with Somatosensory loss rely heavily on what system? (Select all that apply)

A. Auditory
B. Tactile
C. Vision
D. Taste

A

C

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11
Q

What does the Motricity Index assesses?

A) Paresis
B) Spasticity
C) Ataxia
D) Somatosensation

A

A

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12
Q

Which conditions can the modified ashworth scale be used for?

a) Adults and children with lesions
b) CP
c) MS
d) Pediatric hypertonia
e) SCI
f) Stroke
g) TBI
h) All of the above

A

H

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13
Q

Where does light touch sensation occur when testing for motor control impairments?

A. Calf/ Foot
B. Fingertips/ foot-ankle
C. Shoulder/ hand
D. Neck/ palm

A

B

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14
Q

You observe a patient during a sit to stand analysis of movement that demonstrated pushing toward the weaker side. You deem this to be which impairment:

A. paresis
B. hypokinesia
C. no impairment
D. perceptual deficit

A

D

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15
Q

The Reintegration to Normal Living Index assessment evaluates patients on how many different categories?

a. 10
b. 11
c. 9
d. 25

A

B

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16
Q

The purpose of asking whether or not a specific intervention is going to change a patient’s expected outcome in patients with impaired motor control is to:

A. Thoroughly examine the value of possible interventions
B. Help determine whether or not goals should be approached based on remediation or compensation
C. Argue against the value of physical therapy services
D. A and B
E. All of the above

A

D

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17
Q

The first critical decision when considering POC to address motor control impairments in adults is to determine if the remediation or compensation approach should be used.

a. True
b. False

A

A

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18
Q

With the compensatory approach, the therapist would be most concerned about?

a. The patient’s toe-off with gait
b. The amount of lateral sway
c. The type of bracing used by the patient after having a stroke
d. None of the above

A

C

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19
Q

Evidence has shown that ___ training is better at improving walking function in people with stroke than usual care?

A. Locomotor Training
B. Specific Impairment training
C. Broad impairment training
D. Task-Specific Training

A

D

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20
Q

While performing an evaluation on a 75 y/o patient, you have the patient ambulate across the room and notice they have lumbar rotation present while pushing off with their right lower extremity. What type of posture were you evaluating?

a. Static
b. Gait Posture
c. Dynamic Posture
d. Optimal Posture

A

C

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21
Q

Optimal posture involves all the following except.

a. Relaxed position of all the joints
b. Unnecessary tension eliminated in joints
c. Relaxed muscular positions
d. Protracted shoulders

A

D

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22
Q

Forward head posture is characterized by a shortening of the _______________ muscles concurrent with lengthening of the ________________ muscles.

A. Suboccipital, Prevertebral
B. Paraspinals, Upper Trapezius
C. Semispinalis, Lower Trapezius
D. Levator Scapulae, Semispinalis

A

A

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23
Q

List and discuss frequent clinical signs of a flattened lordotic curve. –
Which of the following IS NOT a clinical sign of a flattened lordodic curve?

a. Leaning forward with gait
b. Leaning backward when standing.
c. Recruiting buttock muscles.
d. Recruiting posterior thigh muscles.

A

B

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24
Q

Which two planes are most commonly assessed when addressing spinal curve alignment?

a. sagittal and frontal planes
b. frontal and transverse planes
c. sagittal and transverse
d. oblique and sagittal

A

A

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25
Q

Where are the inclinometer arms placed when measuring thoracic kyphosis?

A.  T1 downward and T12 upward
B.  T1 upward and T 12 downward
C.  C7 upward and S1 downward
D.  C7 downward and S1 upward
E.  None of the above
A

A

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26
Q

Match the following head alignments with the appropriate descriptions.

  1. Abnormal head alignment
  2. Normal head alignment

a. Tip of chin in line with manubrium
b. Forward head
c. Plumb line behind coronal suture, through external auditory meatus
d. Wall to occiput distance 1 cm

A

1) B and D

2) A and C

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27
Q

It’s important to assess all except for which of the following in postural dysfunction

a. Total body alignment
b. Spine ROM
c. Spinal curve alignment
d. Head alignment

A

B

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28
Q

What preferred practice pattern does “Impaired Posture” fall under?

a) 4A
b) 4B
c) 5A
d) 5B

A

B

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29
Q

All of the following is one of Sahrmann’s Movement Impairment Syndromes except:

A) Extension
B) Rotation
C) Lateral Flexion
D) Flexion

A

C

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30
Q

Improving thoracic extension to promote a neutral spine assists with all the following except:

A) Improving shoulder ROM
B) Decrease neck pain
C) Correct cervical and lumbar posture
D) Increase thoracic kyphosis

A

D

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31
Q

Which of the following is not one of the key rules for prescribing stretching exercises?

a. Do not put any structure at postural risk
b. Assure the movement isolates and stretches only the targeted tissue
c. Perform the stretch in a bouncing type pattern
d. Utilize a stretching time duration that is equal to or greater than 30 seconds

A

C

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32
Q

If the appropriate lumbar support is chosen for a patient, the best adjunct to eliminate low back pain with the use of a lumbar support would be:

A. Have the patient wear the brace all day long
B. Use in conjunction with strengthening exercises for the core and back
C. Apply a “X” taping technique to the patient’s upper back
D. Have the patient practice good posture techniques while wearing the brace only

A

B

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33
Q

When using muscle energy techniques it is best to apply manual resistance forces against those muscles that are ______ at rest.

a. Shortened
b. Lengthened
c. Tight
d. Inhibited

A

B

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34
Q

Which of the following is not true regarding lumbar external supports

A. Lumbar supports not usually recommended for treatment of postural dysfunction
B. If there is use of external lumbar supports, but no strengthening exercises, they are ineffective in preventing LBP.
C. There is evidence that lumbar supports reduce trunk motion for flexion/extension and lateral bending, but not rotation
D. Evidence for effective treatment of osteoporosis kyphosis with external supports

A

A

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35
Q

With every inch the head moves forward in posture, it increases the weight of the head on the neck by how many pounds?

A. 5 lbs
b. 10 lbs
C. 15 lbs
D. 20 lbs

A

B

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36
Q

____________ from the upper trapezius to the lower rib is useful for patient education during postural interventions

A. “J” taping
B. “M” taping,
C. “Z” taping
D. “X” taping

A

D

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37
Q

All of the following are muscle fiber changes associated with aging except:

a. fiber necrosis
b. fiber type grouping
c. Type I (slow twitch) atrophy more than type II (fast twitch)
d. Reduction in type II muscle fiber satellite cell content

A

C

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38
Q

All of the following are age associated changes in endocrine function linked to sarcopenia except:

A. Increased insulin resistance
B. Decreased growth hormone
C. Vitamin D Deficiency
D. Overproduction of estrogen and testosterone

A

D

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39
Q

Insulin-like growth hormone plays a critical role in _____________ in aging skeletal muscle, and without this can lead to increased risk of sarcopenia.

a. Hypotrophic response
b. Hypertrophic response
c. Isotrophic response
d. None of the above

A

B

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40
Q

A patient with which impairment will NOT demonstrate dysdiadochokinesis?

a. Parkinson’s Disease
b. Multiple Sclerosis
c. Cerebellar lesion
d. TIA

A

D

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41
Q

Observation of in-hand manipulation (manipulate a writing utensil that is placed in the palm of the pt’s hand) is used to assess:

A. Perceptual deficits
B. Ataxia
C. Paresis and fractionated movement deficits
D. Hypokinesia

A

C

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42
Q

If you notice your patient demonstrates lateral trunk bending, hip/trunk flexion, knee hyperextension, leg circumduction, and minimal dorsiflexion during gait analysis which impairment might you assume:

a. Paresis
b. Fractionated Movement Deficits
c. Ataxia
d. Hypokinesia

A

A

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43
Q

Which of the following ‘less than optimal’ postures is most likely to cause pain in the head and neck:

A. Forward head posture with hyperkyphosis
B. Flattened lordotic curve
C. None of the above
D. A and B

A

A

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44
Q

Which of the following is NOT a muscle and soft tissue change seen in the aging population that can impact posture?

a. Increased water and elastin content
b. Decreased cross-links
c. Abnormal muscle elongation
d. Decreased sarcomeres

A

A

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45
Q

Which thoracic postural impairments are often treated with taping techniques?

a. Rounded shoulders
b. Thoracic hyperkyphosis
c. Lumbar hyperlordosis
d. A & B

A

D

46
Q

Which of the following is true about the use of orthotics to correct postural impairments:

A. Orthotics can reestablish normal biomechanics in the foot and ankle during gait.
B. Lumbar supports reduce trunk motion for flexion-extension movements.
C. External supports can be an effective treatment of osteoporotic kyphosis.
D. All of the above are true statements

A

D

47
Q

Studies suggest that all of the following are true about testosterone therapy except?

A. Promote moderate increases in muscle mass
B. Hypothesis promote lean muscle and function In older adults
C. Testosterone therapy has been shown to increase muscle strength in older adults

A

C

48
Q

Significant strength improvements can occur in patients up to what age?

a. 70
b. 80
c. 50
d. 60

A

B

49
Q

What are the variables that may affect the strength response in individuals who are participating in resistance training?

A) Age and race
B) Age and gender
C) Age and duration of training
D) Age, gender, and duration of training

A

D

50
Q

What is the primary pathway for controlling voluntary movement?

a. Corticospinal tract
b. Spinoreticular tract
c. Spinothalamic tract
d. Rubrospinal tract

A

A

51
Q

What of the following structures allows for gating and initiation of movements?

a. Cerebellum
b. Thalamus
c. Basal ganglia
d. Precentral gyrus

A

C

52
Q

Which of the following is the most important question for physical therapists in regards to rehabilitation prognosis and treatment decisions?

a. What is the likelihood for motor control changes
b. What is the likelihood of functional changes
c. What is the likelihood that a specific intervention is going to change the expected outcome

A

C

53
Q

Which of the following is true about functional changes in patients with impaired motor control?

A) In most cases, motor control impairments and functions will improve.
B) In most cases, motor control impairments and functions will decline.
C) In most cases, motor control impairments will not change and functions will improve.
D) In most cases, motor control impairments will not change and functions will decline.

A

C

54
Q

Which of the following is the most common chronic condition associated with postural alignments?

A) Osteoporosis
B) Spinal osteoarthritis
C) Spinal stenosis
D) All of the above

A

D

55
Q

What kind of patient is appropriate for assessment with a flexible curve ruler?

A: patient who presents with moderate cervical kyphosis
B: patient who has abnormal kypholordosis during examination
C: patient with no history of low back pain
D: patient who has normal kypholordosis during examination

A

B

56
Q

What does the back pain function scale assess?

A) Low back pain
B) Low back pain and the impact on functional activities
C) Cervical pain
D) Thoracic pain

A

B

57
Q

You are the physical therapist examining a 12 year old patient with thoracic scoliosis and kyphosis. Which thoracic support device will best assist the patient?

a. Charleston brace
b. Boston brace
c. Milwaukee brace
d. Spinomed brace

A

D

58
Q

Sarcopenia leads to a decrease in

A. Protein reserves
B. Muscle strength
C. Functional quality
D. All of the above

A

D

59
Q

Vitamin D helps to preserve type ____ muscle fibers which are prone to atrophy in the elderly

A. Type I
B. Type II

A

B

60
Q

Considering the main purpose of the parathyroid hormone is to regulate blood calcium levels what education would you provide your patient when discussing high levels of parathyroid hormone and it’s effects on muscle degeneration (sarcopenia)?

a. Exercise 2-3x/wk to combat age-related muscle wasting
b. Increase sun exposure and vitamin D consumption to indirectly regulate PTH
c. Eliminate dairy from their diet to indirectly decrease serum calcium levels
d. None of the above

A

B

61
Q

Match the following Terms with their proper definitions:

  1. Hypotonicity
  2. Hypertonicity
  3. Flaccidity
  4. Spasticity

a. Increase in muscle tone
b. No presence of muscle tone
c. Velocity-dependent increase in tone
d. Decreased in muscle tone

A

1) D
2) A
3) B
4) C

62
Q

Match Kapandji Thumb Opposition scores with appropriate location

  • Tip of index finger
  • Crease of DIP on 5th finger
  • Tip of 4th finger
  • Distal volar crease of hand
A

3

7

5

10

63
Q

Which of the following scores represents a normal performance on the Action Research Arm Test?

A. 2
B. 3
C. 1
D. 0

A

B

64
Q

The Canadian Occupational Performance Measure is an outcome measure used to assess change in a client’s self-perception of occupational performance over time in what 3 areas?

A.  Self Care
B.  ADLs
C.  Productivity
D.  Leisure
E.	Athletics
A

A, C, and D

65
Q

The Berg Balance Scale is used to assess what type/types of balance (select all that apply):

a. Walking balance
b. Static balance
c. Dynamic balance
d. Circular balance

A

B and C

66
Q

Which of the following exercises would be the BEST way to improve an individual’s ability to sit down and sit up from a chair?

a) LAQ’s
b) Seated Leg Press
c) Sit-to-stand from an equal height chair.
d) Loaded Squats

A

C

67
Q

All of the following are true regarding Evidence-Based Review of Stroke Rehabilitation except

A. Contains 23 different sections that deals with a specific area of stroke rehab
B. Summarizes all relevant studies
C. Published bi-yearly
D. Provides up-to-date review of stroke rehab evidence in a clinician friendly manner

A

C

68
Q

What population is most prone to osteoporosis? (Choose 2)

A. Postmenopausal men
B. Postmenopausal women
C. men > 60 years of age
D. Patients taking steroids or steroidal drugs

A

B and D

69
Q

All of the following are associated with osteopenia except?

a. Increased risk of fracture
b. A precursor for osteoporosis
c. More common in females
d. Increased complaints of pain with bone thinning

A

D

70
Q

Posture can affect which of the following when it comes to balance and coordination?

a) The ability to stand in a shopping line
b) The ability to reach for an item on the top of the grocery store shelf.
c) The ability to get into and out of a vehicle
d) All of the above.

A

D

71
Q

Cervical taping for postural impairments is designed to

A. Support upper back and spine
B. Reduce stress on the cervical spine
C. Improve postural alignment
D. All of the above

A

D

72
Q

Sarcopenia progresses at rate of _____% per year after age _____.

a. 3-5; 50
b. 3-5; 60
c. 1-3; 50
d. 1-3; 60

A

C

73
Q

After _____ years old, RMR starts to decline at a rate of _______ per decade.

A. 30; 1-2%
B. 20; 3-4%
C. 30; 3-4%
D. 20 ; 1-2%

A

D

74
Q

In regards to sarcopenia, why is insulin important?

A. It provides an anabolic effect, increasing muscle growth
B. It aids in deactivation of satellite cells in the muscle fiber
C. It assists with blood pressure control
D. None of the above

A

A

75
Q

Eccentric training would benefit older adults presenting with:

a. HTN
b. No comorbidities
c. Diabetes
d. All of the Above

A

D

76
Q

All of the following are true about motor control, except:

A. The neural control of movement involves cooperation from the primary motor cortex, the nonprimary cortical motor areas, and the supplementary motor areas.
B. It is the ability to regulate and direct movement in the body
C. It is the relative sense of a body part in space
D. Decline in motor control is not a part of normal aging, rather a result of disease or health condition

A

C

77
Q

What type of motor impairment does the finger-to-nose test help identify?

a. Ataxia
b. Paresis
c. Perceptual deficits
d. Hypokinesia

A

A

78
Q

When detecting motor impairments, one method of assessment that can be used is observation of AROM as an observational analyses of movement. Which of the below definitions describes this method the best?

A. Goniometric measurement of voluntary movement against gravity
B. Note the presence or absence of other segments in the same limb or segments in other limbs that are moving when the target joint moves
C. All of the above
D. None of the above

A

B

79
Q

Watching a patient sitting/standing unsupported with eyes open allows for observation of deficits in what area?

A. Hearing
B. Balance perception
C. Tactile ability
D. Respiration

A

B

80
Q

Patients presenting with which of the following would not benefit from the remediation approach:

a. Stroke
b. Parkinson’s Disease
c. Incomplete Spinal Cord Injury
d. Traumatic Brain Injury
e. None of the Above

A

B

81
Q

What is the treatment of choice for adults with motor control impairments?

a. Electromyographic feedback
b. Neurodevelopmental techniques
c. Sensorimotor training
d. Task specific training

A

D

82
Q

Which of the following is true in regards to hyperkyphosis:

a. more common in males
b. thoracic kyphosis angle of >30 degrees may serve as possible cutoff for hyperkyphosis
c. increased kyphosis is often linked with lower self-reported health and life satisfaction
d. is not a commonly observed postural dysfunction in older adults

A

C

83
Q

An older adult with a hyperkyphotic and forward head posture may demonstrate difficulties with which movements?

A. Bending
B. Lifting
C. Rising from a chair
D. All of the above

A

D

84
Q

Which of the following is not assessed in the frontal plane?

a. Genu Varum
b. Pes planus
c. Genu recurvatum
d. Iliac crest height

A

C

85
Q

Examining two-joint muscle flexibility is particularly important when examining patients, as many postural changes are associated with:

A. Bony structural changes
B. Altered muscle length
C. The normal aging process
D. Previous injury or illness

A

B

86
Q 
Which of the following is a commonly advocated clinical approach to decrease discomfort and improve posture in patients with an osteoporotic vertebral fracture?
A.  2-wheeled walker
B.  4-point cane
C.  4-wheeled braking walker
D.  Standard wheelchair
A

C

87
Q

In the aging adult muscle mass is lost due to typical age related changes and disuse. Which of the following statements is true about decreased muscle mass in the geriatric patient?

A. During his training regimen Bob has more endurance than power because his type I fibers naturally have a better chance of recovery than type II fibers.
B. As muscle mass is lost with age it is replaced by fat mass.
C. The upper extremities lose more strength because they are non weight bearing.
D.Strength declines with age because type II fast twitch fibers become type I slow twitch fibers.

A

?

88
Q

Power can be measured as the amount of work performed per a unit of time. Which of the following contribute to a decrease in power in the older adult? Select all that apply.

A. Decreased compliance of a muscle’s tendinous attachment.
B.Reduced rate of cross-bridge cycling.
C. Alteration on excitation and contraction coupling.
D. Increased compliance of a muscle’s tendinous attachment.

A

B, C, ad D

89
Q

All of the following are motor system impairments EXCEPT?

A) Abnormal Tone
B) Ataxia
C) Perceptual deficits
D) Paresis

A

C

90
Q

Hypokinesia is associated with what disease/condition(s):

A. Parkinson’s disease
B. Parkinsonian-like conditions
C. Dementia
D. All of the above

A

D

91
Q

What is an example of a perceptual deficit?

a) Night blindness
b) Pusher’s syndrome
c) Anoxia

A

B

92
Q

Which of the following are correct in regards to AROM as an objective test of motor control impairments?

A. AROM is used to assess paresis
B. AROM is a goniometric measurement of voluntary movement against gravity
C. AROM is an indirect measure of ability to volitionally activate the spinal motoneuron pools
D. All of the above
E. A and C
F. None of the above

A

D

93
Q

What is the acquisition, modification, or reacquisition of movement?

a) Strength
b) Power
c) Motor learning
d) Motor control

A

C

94
Q

True or false:

Motor control interventions are best performed by using functional training,

A

True

95
Q

In frail older adults flexion is contraindicated for which condition(s)?

a) Spinal stenosis
b) Osteoporosis
c) Spondylolisthesis
d) All of the Above

A

B

96
Q

Which of the following does NOT increase valgus load on the knee:

A. Strong hip musculature
B. Coxa Vara
C. Excessive foot pronation

A

A

97
Q

What grade(s) of mobilizations are acceptable for older adults for pain control?

a) Only grade 1
b) Grades 1 and 2
c) Only grade 2
d) All grades are fine, mobilize away

A

B

98
Q

Which of the following techniques and accompanying statements is true.

a) Soft tissue mobilization is performed to mobilize myofascia into a more structurally supportive position.
b) Soft tissue mobilization is performed to muscles only in order lengthen them for ROM improvements
c) Contract relax and PNF techniques in combination overstretch tissues to a length that is more harmful than good.
d) Contract relax and PNF techniques in combination have been shown to improve ROM and functional movements among patients with shoulder disorders

A

D

99
Q

Which is false about aging?

A. Cytokine activity increases leading to a decrease in muscle mass formation
B. Cytokine activity leads to a decrease in fat mass
C. An increase in cytokine activity correlates with an increase in sarcopenia
D. None of the above

A

B

100
Q

Which category of persons demonstrates a high risk of falling despite a relatively fast time on the TUG?

A. LE amputees
B. Parkinson’s Disease
C. Older stroke patients
D. Community dwelling adults

A

B

101
Q

Which statement is false regarding spinal osteoarthritis?

A. Increases the risk of stenosis
B. Can lead to neurological issues over the course of the progression of the diseases
C. Osteophytes are formed as a response a decrease in spinal stability in order to increase stability
D. Synovial fluid thickens leading to an increase in inflammation

A

D

102
Q

What is the key mechanism to muscle loss associated with human aging?

A. Frailty
B. Loss of myocytes via apoptosis
C. Diminished muscle strength due to disuse
D. Changes in hormone levels

A

B

103
Q

Walking speed tests which of the following activity:

A. Balance
B. Functional mobility
C. Walking ability
D. Risk of falls

A

C

104
Q

Objective measures of pain comprise 2 broad categories; pick the 2 answers that apply.

A. Guides the physical therapy plan of care
B. Self-perception of the amount, intensity, and location of pain
C. Warrants discontinuation of exercise
D. Impact on daily activity

A

B and D

105
Q

What condition is associated with skeletal muscle loss most commonly in an obese population

A. COPD
B. Diabetes
C. Stroke
D. Parkinsons

A

B

106
Q

The stroke outcome scale measures all of the following except?

a. Hand function
b. Communication
c. ADL’s
d. Ability to run

A

D

107
Q

The plum line in proper posture runs where?

a. Through knee
b. Through ankle
c. Through shoulder
d. Through mastoid process

A

D

108
Q

Individuals benefit from resistance training can improve what functional outcomes.

A. strength
B. power
C. mobility
D. All of the Above

A

D

109
Q

Individuals with paresis see increased movement slowness due to…

A) Motor unit activation deficits.
B) Compensatory technique
C) Slower visual feedback
D) None of the above

A

A

110
Q

How many questions are in the Oswestry Disability?

A. 12
B. 14
C. 13
D. 16

A

A

826: Geriatrics (12 decks)

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