Deck 18

Question 1

A 27-year-old masters swimmer comes into your clinic with R shoulder pain. She complains of chronic shoulder pain through college that has worsened over the last year. She states her pain is often a dull ache but she can get intermittent sharp pains in the anterior right shoulder by the end of practice, which usually consists of ~4,000 yards. The patient has seen her PCP and was referred to your clinic with a diagnosis of shoulder impingement. Given this information, at what stage of impingement would you classify her based on Neer’s classification?

A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4

Answer 1

B. Stage 2

Question 2

A 45-year-old male attorney has recently been diagnosed with knee osteoarthritis, and his physician told him that he was fairly young to develop premature osteoarthritis. He has a normal BMI and no signs of osteopenia or osteoporosis. The patient has played basketball twice a week in a recreational league since he was 25 years old. Prior to that, he started playing basketball in junior high and continued through college, averaging an hour and a half of basketball five days a week from the time he was 13 years old. What factor played the largest role in the patient’s development of knee osteoarthritis?

A. Age
B. Gender
C. Hx of playing sports
D. Occupation

Answer 2

C. Hx of playing sports

Question 3

Which of the following knee pathologies puts an individual at the highest risk for developing knee osteoarthritis?

A. Anterior cruciate ligament tear
B. Meniscal tear
C. PFPS
D. PCL tear

Answer 3

B. Meniscal tear

Question 4

Which of the following diagnoses is not a cause of secondary knee osteoarthritis?

A. Acromegaly
B. Hyperparathyroidism
C. Hypothyroidism
D. Rickets

Answer 4

C. Hypothyroidism

Question 5

What are endocrine disorders that may be a cause of secondary knee OA?

Answer 5

acromegaly

hyperparathyroidism

Question 6

Rickets is a _____ disorder linked as a cause of secondary knee OA

Answer 6

metabolic

Question 7

A patient has recently been diagnosed with knee osteoarthritis via the Kellgren-Lawrence classification system. The patient reports knee pain after walking or standing for six to eight hours, as well as a significant increase in the amount of knee stiffness present over the last few months. Based on the radiograph, bone osteophytes are present, but the articular cartilage is still very healthy. Which of the following grades of osteoarthritis does this patient have?

A. Grade 1
B. Grade 2
C. Grade 3
D. Grade IV

Answer 7

B. Grade 2

Question 8

With grade 1 knee OA, what are the symptoms?

Answer 8

fewer symptoms present

no pain or discomfort present

Question 9

The patellofemoral joint is also at risk for the development of osteoarthritis. Which part of the patella is typically involved in knee osteoarthritis?

A. Knee
B. Lateral
C. Anterior
D. Posterior

Answer 9

B. Lateral

Question 10

In almost ___% of individuals who have PF OA, the lateral patellofemoral involvement is common bc of abnormal kinematics such as lateral patellar tilt

Answer 10

80%

Question 11

Which is not a specific feature of osteoarthritis?

A. Crepitation
B. Decreased sensitivity to cold and/or temp
C. Impairment in everyday activities
D. Nocturnal pain

Answer 11

B. Decreased sensitivity to cold and/or temp

Question 12

If a physical therapist wanted to use a Kaltenborn traction technique to stretch a patient’s joint capsule and soft tissues, what grade of traction would the physical therapist use?

A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4

Answer 12

C. Grade 3

Question 13

This grade traction technique from Kaltenborn is used to neutralize joint pressure without any separation of joint surfaces.

Answer 13

Grade 1

Question 14

This grade Kaltenborn traction technique separates articulating surfaces, taking up slack or eliminating play within the joint capsule

Answer 14

Grade 2

Question 15

How many grades of traction per Kaltenborn?

Answer 15

3

Question 16

A physical therapist believes an autonomic response has occurred in relation to the manual therapy technique she just applied to a patient with knee osteoarthritis. What autonomic response may occur due to manual therapy?

A. Change in skin temperature
B. Hypoalgesia
C. Increase in muscle strength
D. Increase in range of motion

Answer 16

A. Change in skin temperature

Question 17

These are the autonomic response that may occur with use of manual therapy

Answer 17

changes in

• skin temp
• skin conductance
• cortisol levels
• heart rate

Question 18

An axillary nerve lesion has caused significant impairments for a patient who was in a motor vehicle accident. Of the following, which is a distal attachment site of a muscle that is innervated by the axillary nerve?

A. Inferior facet of the greater tuberosity of the humerus
B. Lateral third of clavicle, acromion, and spine of scapula
C. Medial part of the bicipital groove
D. Middle third lateral border of the scapula

Answer 18

A. Inferior facet of the greater tuberosity of the humerus

Question 19

A patient has weakness in both the anconeus and the serratus anterior. The physical therapist is working with a resident physical therapist and asks the resident which deep tendon reflex would be diminished based on the weakness in both of these muscles. Which reflex would be impacted here?

A. Biceps
B. Brachioradialis
C. Triceps
D. No reflex would be impacted

Answer 19

C. Triceps

Question 20

The anconeus is innervated by which nerve?

Answer 20

radial

Question 21

Anconeus is innervated by which nerve roots?

Answer 21

C7-T1

Question 22

Long thoracic nerve is innervated by which roots?

Answer 22

C5-7

Question 23

Of the following objective findings, which is related to the development of chronic neck pain?

A. Hyporeflexia of any upper extremity deep tendon reflex(es)
B. Positive upper limb tension test for median nerve
C. Significant loss of active range of motion
D. Weakness in the hands

Answer 23

D. Weakness in the hands

Question 24

Pts who have weakness where are predisposed to chronic neck pain?

Answer 24

hands

Question 25

A physical therapist is implementing a stretching program for a patient with neck pain. Which of the following muscles should be included in the flexibility program?

A. Anterior scalene and middle trapezius
B. Medial scalene and upper trapezius
C. Levator scapulae and lower trapezius
D. Pectoralis major and middle trapezius

Answer 25

B. Medial scalene and upper trapezius

Question 26

Which muscles should be included in a stretching program for pts with neck pain?

Answer 26

• anterior/middle/posterior scalenes
• UT
• levator scapulae
• pectoralis muscles

Question 27

If a physical therapist used the deep neck flexor endurance test with a patient with weak deep neck flexors, for what amount of time would a patient with neck pain be expected to hold an isometric contraction of the deep neck flexors?

A. 24 sec
B. 35 sec
C. 40 sec
D. 50 sec

Answer 27

A. 24 sec

Question 28

A patient with whiplash-associated disorder is referred to physical therapy and is wearing a soft collar. Which of the following is true regarding the use of soft collars in patients with neck pain after a motor vehicle accident?

A. A soft collar can improve function in patients after a motor vehicle accident, but only if worn for less than four hours per day
B. If patients wear a soft collar but also participate in strengthening exercises for the upper quarter, the outcomes are the same if they wear no collar but perform strengthening exercises
C. Individuals who wear a soft collar after a motor vehicle accident are more likely to take prolonged time off work
D. Patients who wear a soft collar for two weeks after a motor vehicle accident have decreased pain and improved disability levels when assessed at six months

Answer 28

C. Individuals who wear a soft collar after a motor vehicle accident are more likely to take prolonged time off work

Question 29

A 35-year-old male patient is referred to physical therapy for an acute insidious onset of symptoms three weeks prior to referral. The patient only has symptoms in his neck, with no radiating symptoms. Objective findings reveal limited cervical range of motion in all planes, both actively and passively. Which diagnosis from the International Classification of Functioning, Disability and Health (ICF) does this patient have based on the findings provided?

A. Cervicalgia
B. Neck pain with headaches
C. Neck pain with mobility deficits
D. Spondylosis without radiculopathy

Answer 29

C. Neck pain with mobility deficits

Question 30

A physical therapist is treating a patient with neck pain and a left-sided headache. The headache is reproduced with upper cervical joint mobility testing, and the patient has decreased joint play with mobility testing in the same area. What else would be expected to accurately diagnose a patient with the ICF diagnosis of neck pain with headache?

A. The headache alternates from the left to the right side depending on the day
B. The headache is continuous on the left side for up to six hours at a time
C. The headache is not the only pain present, and bilateral neck pain occurs along with the headache
D. The headache increases if the patient moves the neck into flexion and extension

Answer 30

D. The headache increases if the patient moves the neck into flexion and extension

Question 31

If the ulnar nerve is damaged at the tunnel of Guyon, what would you expect to see in the presentation of the hand?

A. Flexor digitorum profundus is weak due to the ulnar nerve damage, and therefore the hand will be in a hyperextended position of the fourth and fifth digits at the MCP
B. Loss of the interossei and lumbricals through ulnar nerve damage causes the hand to rest in an intrinsic plus position
C. The hand will be resting in wrist flexion, MCP extension, and PIP/DIP flexion
D. The wrist and fourth and fifth MCP, PIP, and DIP joints will be in an extended position due to weakness of the FDP, lumbricals, and interossei. The extensors will now be unopposed.

Answer 31

C. The hand will be resting in wrist flexion, MCP extension, and PIP/DIP flexion

Question 32

A physical therapist believes a nerve entrapment is the cause for a patient’s weakness in her anterior forearm. Manual muscle testing reveals weakness in the flexor pollicis longus, the lateral half of the flexor digitorum profundus, and the pronator quadratus. Which diagnosis would cause this pattern of weakness?

A. Anterior interosseous nerve entrapment
B. CTS
C. Posterior interosseous nerve entrapment
D. Pronator teres syndrome

Answer 32

A. Anterior interosseous nerve entrapment

Question 33

A sprain or strain of the cervical spine is what ICF diagnosis?

A. Neck pain with headache
B. Neck pain with mobility deficit
C. Neck pain with movement coordination impairments
D. Neck pain with radiating pain

Answer 33

C. Neck pain with movement coordination impairments