Deck 17 Flashcards
A patient presents with a six-week history of occipital headaches with associated intermittent numbness in the occipital region, and significant limitations with AROM in all planes of motion in the cervical spine. Over the last week, the patient has started to notice some reported clumsiness with gait. Which of the following diagnoses is most likely for this patient?
A. Atlas fracture
B. Cervical myelopathy
C. Vertebral basilar artery insufficiency
D. Upper cervical ligamentous instability
D. Upper cervical ligamentous instability
Likely to see occipital numbness along with occipital HA, significant ROM limitations, and s/s of cervical myelopathy with this pathology
upper cervical ligamentous instability
Which of the following surgical procedures is associated with a higher risk for carpal tunnel syndrome?
A. Cervical fusion
B. Hysterectomy
C. Kidney Transplant
D. Removal of thyroid
B. Hysterectomy
Which of the following special tests is included as a variable in the clinical prediction rule for the diagnosis of carpal tunnel syndrome?
A. Carpal compression test
B. Phalen test
C. Tinel test for median n.
D. None of the above
D. None of the above
A physical therapist knows the criteria for the clinical prediction rule for the diagnosis of carpal tunnel syndrome. However, he wants to know which of the criteria has the best sensitivity. Of the following, which has the best sensitivity?
A. Age
B. Median nerve sensation of the thumb
C. Symptom Severity Scale score greater than 1.9
D. Wrist ratio index greater than 0.67
D. Wrist ratio index greater than 0.67
Wrist ratio index greater than 0.67
Sensitivity
93%
A physician has diagnosed a patient with cervical myelopathy and referred her to physical therapy. The physical therapist is asking some follow-up questions and gathering his own objective findings. Which of the following findings would be most helpful for diagnosis?
A. Blood pressure greater than 160/95
B. Dizziness or light-headedness related to neck movement
C. Unexplained weight loss
D. Urinary retention
D. Urinary retention
BP > 160/95 would point to these, NOT cervical myelopathy
inflammatory condition
systemic disease
Corticosteroid injections have been given to a patient with severe bilateral carpal tunnel syndrome. The patient received one injection in each wrist/hand. Which is true regarding the use of corticosteroid injections for carpal tunnel syndrome?
A. Corticosteroid injections are effective for approximately one month, but symptom relief after that point is unknown
B. Oral corticosteroids are much more effective than corticosteroid injections, so the patient should have been given oral corticosteroids instead of the injections
C. The patient should receive another corticosteroid injection in each wrist/hand in six weeks because two injections have greater clinical benefit than one
D. Surgery is the only proven method of significant pain relief, so the patient should have undergone surgery instead
A. Corticosteroid injections are effective for approximately one month, but symptom relief after that point is unknown
A patient who originally was thought to have carpal tunnel syndrome was correctly diagnosed as having anterior interosseous nerve entrapment. Which of the following muscles will be weak with anterior interosseous nerve entrapment, but not weak with carpal tunnel syndrome?
A. Flexor digitorum profundus
B. Flexor digitorum superficialis
C. Flexor pollicis longus
D. Pronator quadratus
D. Pronator quadratus
A patient has persistent pain/numbness in the thumb, index finger, and middle finger. She reports that the pain/numbness increases with keyboarding or needlepoint, but no other activities seem to trigger her symptoms. Which of the following is most likely the issue?
A. Compression of the C6 nerve root
B. Compression of the nerve in Guyon’s canal
C. Compression of the nerve in the carpal tunnel
D. Compression of the nerve in the cubital tunnel
C. Compression of the nerve in the carpal tunnel
A physical therapist is working on strengthening with a patient who tore his posterior cruciate ligament two weeks ago. It was a full-thickness tear, but he has not had a surgery for the injury. Which of the following muscles should be strengthened to assist with stability of the knee and reducing the potential for excessive posterior translation?
A. Biceps femoris
B. Popliteus
C. Quadriceps femoris
D. Semimembranosus
B. Popliteus
Popliteus helps resist which forces on the tibia?
posterior forces
Which of the following does not reside in the carpal tunnel?
A. FCR tendon
B. FDP tendon
C. FDS tendons
D. FPL tendon
A. FCR tendon
A physical therapist is working to rule in a lateral meniscal tear. Which of the following special tests is the best at ruling in tears?
A. JL tenderness
B. McMurray test
C. Thessaly test at 5˚ flexion
D. Thessaly test at 20˚ flexion
A. JL tenderness
Palpating the lateral jt line has a specificity of for ruling in meniscal tears
97%
Which of the following statements is NOT true regarding the menisci of the knee?
A. The lateral meniscus attaches to the anterior cruciate ligament, the lateral collateral ligament, and the posterior cruciate ligament
B. The lateral meniscus attaches to the anterior and posterior cruciate ligaments and the popliteus, but not to the lateral collateral ligament
C. The medial meniscus attaches to the anterior cruciate ligament, the medial collateral ligament, and the posterior cruciate ligament
D. The medial meniscus has a strong capsular attachment
A. The lateral meniscus attaches to the anterior cruciate ligament, the lateral collateral ligament, and the posterior cruciate ligament`=
A physical therapist assesses for a medial collateral ligament tear via the valgus stress test at 0 degrees. The patient had approximately 6–10 millimeters of separation between the femur and tibia during the test. What does this signify?
A. Abnormal
B. Nearly normal
C. Normal
D. Severely abnormal
A. Abnormal
If an isolated posterolateral corner injury occurs, which of the following positions will most successfully assess the injury?
A. 0˚ knee flex
B. 30˚ knee flex
C. 60˚ knee flex
D. 90˚ knee flex
B. 30˚ knee flex
For a PLC injury, maximal varus and ER will be best assessed where?
30˚ flex
A physical therapist is treating a patient with a posterolateral corner injury and is measuring the difference in tibial external rotation between a patient’s injured left knee and healthy right knee. The patient has a difference of 4 degrees between the knees. What grade of injury has this patient sustained on the left knee?
A. Grade I
B. Grade II
C. Grade III
D. Grade IV
A. Grade I
A grade I PLC injury means the difference in tibial ER is
< 5˚
Grade II PLC injury has difference in tibial ER of
5-10 deg
Grade III PLC injury has difference in tibial ER of
> 10˚
Grade IV PLC injury has difference in tibial ER of
trick question: there is no grade IV PLC injury
A physical therapist is working on improving knee flexion and overall lower extremity strength in a patient who has undergone an anterior cruciate ligament reconstruction. Which intervention approach will exhibit the best outcomes with improved knee flexion and overall lower extremity strength?
A. Balance and proprioceptive exercises
B. Balance and proprioceptive exercises plus lower extremity strengthening
C. Lower extremity strengthening only
D. Range-of-motion exercises only
B. Balance and proprioceptive exercises plus lower extremity strengthening
In trying to rule in subacromial impingement, which of the following special tests is most helpful?
A. Painful arc
B. Empty can test
C. HK test
D. Neer impingement test
B. Empty can test
higher specificity
Patients under anesthesia who have adhesive capsulitis will exhibit range of motion that is equal to the range of motion that is present when the patient is awake in what stages of adhesive capsulitis?
A. Stages 1 and 2
B. Stages 2 and 3
C. Stages 3 and 4
D. There are no two stages where patients will show similar results under anesthesia or awake in regard to range of motion.
B. Stages 2 and 3
When integrating the use of manual therapy into an intervention plan for a patient with adhesive capsulitis, a physical therapist uses joint mobilization. The patient is moderately irritable, so the physical therapist is deciding what type of techniques to use. Which of the following is appropriate regarding manual therapy use with patients who exhibit moderate irritability?
A. End-range techniques into tissue resistance can be integrated, but only low amplitude should be employed
B. Only low-intensity techniques should be used, and there should be no movement into tissue resistance
C. Techniques that progress into tissue resistance can be incorporated as long as there is not pain after the intervention
D. Until the patient is in the low irritability classification, very little joint mobilization should be incorporated; instead, passive range of motion is appropriate
C. Techniques that progress into tissue resistance can be incorporated as long as there is not pain after the intervention
What is currently known in regard to stretching for patients with adhesive capsulitis?
A. Stretching at least two times per day will result in the most positive gains in range of motion
B. Stretching beyond limits of a patient’s pain can result in poor overall outcomes
C. Stretching for sixty seconds with at least two repetitions per stretch will decrease pain and improve range of motion
D. Stretching should only be implemented in those who exhibit low irritability
B. Stretching beyond limits of a patient’s pain can result in poor overall outcomes
