Exam 1 Review

Question 1

A patient presents w/ R shoulder pain w/ (+) sulcus sign.

The finding would MOST likely be present in which of the following medical conditions?
a) Early-onset Alzheimers
b) Rupture of the biceps tendon
c) CVA
d) Duchenne muscular dystrophy

Answer 1

c) CVA

CVA - weakness / paralysis -> flaccid shoulder & positive sulcus sign

Question 2

Hip flx 3+
Hip ext 3
Knee flx 3+
knee ext 3+
Ankle DF 2
Ankle inv & ev 1

sensation is intact & no abnormal tone noted

Which orthoses is most appropriate?

Answer 2

Plastic articulating AFO

Adequate hip & knee strength to allow for AFO
Plastic is appropriate since sensation is intact
Articulating joint allows for improved biomechanics during gait

Question 3

What is a metal upright AFO typically prescribed for?

Answer 3

Fluctuating tone
Sensory deficits

Question 4

Review appropriate shoe modifications for hallux valgus

Answer 4

High & wide toe box
Medial support
Decreased heel height
Contoured posterior counter

Question 5

What common symptom can help distinguish between the acute vs chronic phase of adhesive capsulitis?

Answer 5

Night pain - common during acute phase, but NOT during chronic phase

Question 6

Shoulder Abduction Test

What does this assess?
Describe how to perform
What is a positive test?

Question 7

If suspecting a post-surgical infection, what steps should be taken?

Answer 7

immediate consultation with the referring physician

Does NOT warrant an ER visit

Question 8

What is contract-relax stretching most appropriate for?

Answer 8

Muscle hypertonicity or spasms

Question 9

What is meant by “unremarkable” post-op progression?

Answer 9

Everything has been going fine & they’re doing great

Question 10

Describe each of the following primitive reflexes:

Moro
Galant
Landau
Asymmetrical Tonic Neck Reflex
Symmetrical Tonic Neck Reflex
Tonic Labyrinthe
Sucking
Rooting
Palmar Grasp
Plantar Grasp
Stepping / walking

Question 11

Following a CVA, which direction does an individual displaying “pusher syndrome” typically “push” / lean?

Answer 11

Active pushing toward the hemiplegic side (opposite side of the lesion)

“Weak on L, push to L”

Question 12

Describe the Stages of Motor Control

Answer 12

1) Mobility
a. The ability to initiate movement through a functional ROM
2) Stability
a. The ability to maintain a position or posture through cocontraction & tonic holding around a joint
3) Controlled mobility
a. The ability to move within a WB position or rotate around a long axis
4) Skill
a. The ability to consistently perform functional tasks and manipulate the envt

Question 13

Describe the Stages of Motor Learning

Answer 13

1) Cognitive
2) Associative
3) Autonomous

Question 14

In a patient w/ C5 SCI, what muscles would most likely be able to utilize while performing transfers?
a) Brachioradialis
b) Pronator teres
c) ECRB
d) Lats

Answer 14

a) Brachioradialis (nerves roots C5-6)

Question 15

Describe the scaling for rating sitting balance

Answer 15

Normal
- Sit unsupported, move in and out of the BOS, and accept maximal challenge w/o LOB

Good
- Sit unsupported, move in and out of the BOS
- Accept some challenge w/o LOB

Fair
- Maintain balance in sitting unsupported
- Cannot accept any challenge or go outside of their BOS w/o LOB

Poor
- Unable to maintain their balance in sitting w/o external support

Question 16

Following a CVA, if you want to facilitate elbow extension in a patient w/ hemiplegia, what motion would you want to perform? Why?

Answer 16

Head turn towards the affected side

To elicit ATNR

Question 17

What congenital defects are common in infants w/ Down syndrome? How can these impact motor development?

Answer 17

Congenital heart defects
Can delay gross motor development beyond the 6-12 months delay already associated w/ Down Syndrome

may require additional hospitalizations & surgeries

Question 18

Describe potential causes of each of the following lung sounds

Pleural friction rub
Decreased breath sounds
Crackles or rales

Answer 18

Pleural friction rub - pleural effusion
Decreased breath sounds - pulmonary fibrosis
Crackles or rales - impaired secretion clearance

Question 19

patient in an acute care setting w/ a hematologic disorder. What test shoulder be monitored on a daily basis to ensure patient safety w/ PT?

Answer 19

Complete blood count

Question 20

What all does a complete blood count include?

Answer 20

RBC count
WBC count
Platelets
Hemoglobin
Hematocrit

Question 21

How quickly should the pressure be released when obtaining a BP measurement?

Answer 21

2-3 mmhg per sec

Question 22

How high should you inflate the BP cuff when measuring BP?

Answer 22

20 mmHg above the estimated SBP

Question 23

1 MET = ?

What is the typical aerobic capacity for men & women in METs?
Highly trained men & women?

Answer 23

1 MET = amount of oxygen consumed at rest

maximal aerobic capacity = 8-12 METs
Highly trained = 15-20 METs

Question 24

What should be done if clear drainage is leaking from a pin site following a fracture w/ external fixation?

Answer 24

Use a gauze pad to absorb the drainage & continue w/ exercise session

Clear drainage from a pin site w/ external fixation is normal

Question 25

Describe the appropriate positioning for postural drainage of the R middle lob

Answer 25

1/4 turn from supine to L side
Foot of bed elevated 12 in
Percussion performed over the R chest between the axilla & R nipple

Question 26

An acute burn produces _______metabolism. What can this lead to?

Answer 26

Hypermetabolism

Increased O2 consumption
Increased minute ventilation
Increased core body temp

Question 27

Describe atrial flutter vs atrial fibrillation

Answer 27

Atrial flutter
- Rapid atrial tachycardia
- Rapid rate -> decreased filling time of the ventricles -> decreased stroke volume

A-fib
- Erratic electrical conductivity within the atria

A-flutter - heart beats fast, but in a regular rhythm
A-fib - heart beats fast, but the rhythm is irregular