exam 2

Question 1

what amount of hip internal rotation would suggest hip OA

Answer 1

Reason: Less than 15 degrees is the amount of active internal rotation range of motion that Altman et al. discussed in their hip osteoarthritis diagnostic cluster. However, there is a more recent clinical prediction rule by Sutlive et al. and the patient in this case meets all of the other criteria for that, only needing less than 25 degrees of internal rotation to meet five of five predictors. Also, this patient has unilateral hip pain, no report of bilateral hip pain, and the Sutilve et al. clinical prediction rule was determined by using patients with unilateral hip pain.

Question 2

what are some symptoms of lower GI pathology with back pain patients

Answer 2

fecal incontinence, bloody stool, central low back pain

Question 3

Upper thigh and low back pain is suggestive of what arran system pathology

Answer 3

reproductive or UTI pathology

Question 4

What neurodynamic test is used in the lumbar traction CPR

Answer 4

positive cross straight leg raise

Question 5

what is the recommended treatment dose for lumbar mechanical traction

Answer 5

40-60% of body weight for max of 12 minutes

Question 6

what is the gold standard for diagnosis of cervical headaches

Answer 6

C2 nerve block, The diagnostic gold standard for cervicogenic headaches is a nerve block of the C2 nerve root. This is because the C2 nerve root travels through the obliquus capitis, splenius capitis, and trapezius muscle before then traveling through the occipital notch and innervating the unilateral scalp. Note that sometimes this diagnostic standard also is accompanied with long-term resolution of symptoms for patients with cervicogenic headaches! (Anthony 2000)

Question 7

what assessing for upper cervical instability what test should you perform first

Answer 7

Mintken et al. described the reasoning behind performing the Sharp Purser test first in JOSPT. The Sharp Purser test is an alleviation test, and should be utilized first to determine if there is excessive mobility. Provocative tests, such as the alar ligament stress test, anterior shear test and aspinall test, should only be performed after the Sharp Purser test if no symptoms were generated and no excessive mobility is sensed via the Sharp Purser test. (Mintken 2008)

Question 8

Does splinting or surgery work best for CTS

Answer 8

Although it is unclear if this statement is true for those with mild symptoms, the studies included in a recent Cochrane Review revealed that surgical treatment is more effective than splinting. (Verdugo 2008)

Question 9

what role does C5-6 play in CTS

Answer 9

Although evidence is mixed for whether or not proximal cervical radiculopathy can cause carpal tunnel syndrome, it has been studied as a possible cause for carpal tunnel syndrome due to a double crush injury. (Uchiyama 2010)

Question 10

what conclusion did the Edson 2011 study find regarding loading patterns following a posterior horn tear

Answer 10

avoid valgus loading, not varus

Question 11

After a posterior cruciate ligament injury, what is recommended regarding weight bearing status?

Answer 11

PWB 2-4 weeks

Question 12

Which activity is most likely to be limited in the long term after a posterior cruciate ligament injury?

Answer 12

In those who had posterior cruciate ligament tears, high speed running was the activity most affected in the long term as reported by Logerstedt et al in the APTA’s clinical practice guidelines on knee ligament sprains. (Logerstedt 2 2010)

Question 13

what tests are most appropriate for fulling in SLAP lesion

Answer 13

Power et al found that a compensation of the active compression test and the Jobe relation test or a second combination of the Jobe relatication test and the anterior apprehension maneuver was most helpful in ruling in a SLAP lesion (Powell 2010)

Question 14

What variable appears to have the greatest predictor see debridement outcome failure?

Answer 14

Spahn et al studied the factors that led to poor outcomes after arthroscopy for medial compartment osteoarthritis of the knee, and if an individual had a history of knee osteoarthritis for greater than 24 months, they were more likely to have poorer outcomes. (Spahn 2006)

Question 15

who has the most knee OA

Answer 15

black women followed by white women

Question 16

what interventions were used in the CPR for manual therapy for the hip in improving knee OA pain

Answer 16

non-thrust, Reason: Currier et al described five variables that comprised a clinical prediction rule for the use of hip mobilizations in those with knee osteoarthritis. The hip anterior posterior mobilization, along with a caudal glide, posterior anterior glide and a posterior anterior glide with flexion, abduction and external rotation, were the four glides used in the study. (Currier 2007)

Question 17

The Neck Disability Index (NDI) has often been used for those with neck pain. What outcome measure is it often closely associated with as far as what is measured in each outcome measure?

Answer 17

Riddle and Stratford discovered there was a significant association between these two scales. (Riddle and Stratford 1998 and Childs 2008)

Question 18

does supervised exercise have greater short term or long term benefits of knee OA relative to HEP

Answer 18

better one month versus one year

Question 19

A physical therapist is using the craniocervical flexion test to assess for the strength of the deep neck flexors. The physical therapist wants to make sure the patient does not substitute with other muscles during the test, so he tells the patient to put the tongue on the roof of the mouth. By doing this, what muscle is deactivated?

Answer 19

Activation of the platysma and the hyoid muscles will be decreased if the patient places their tongue on the roof of their mouth. (Childs 2008 and Netter 2014)

Question 20

a patient has neck pain and radiating symptoms to the anterior mid forearm, which intervention is most beneficial for the patient

Answer 20

Based on the neck pain clinical practice guidelines, upper quarter and nerve mobilization procedures have moderate evidence, and of all of the interventions listed in this question, this is the highest level of evidence. So in this case, they should be used. (Childs 2008)

Question 21

what muscle does spinal accessory innervate and what finding you you not except, but is possivel

Answer 21

trap and SCM, cervical impairments

Question 22

Superficial radial innervates what muscles

Answer 22

none

Question 23

cleland 2009 used what direction of mobilization for PF patients

Answer 23

eversion and lateral glides

Question 24

what is the scoring criteria for the patient health questionnaire for depression and anxiety

Answer 24

1-4 min, 5-9 mild, 10-14 mod, 15-19 severe, A score of 9-12 on the Patient Health Questionnaire for Depression and Anxiety indicates that an individual has severe anxiety and depression. (Harrison 2014, TMJ study}

Question 25

bite separator test is good for determining what what TMJ patient

Answer 25

Joint arthralgia (general joint paint) not necessarly OA specific diagnosis

Question 26

what muscle is used activity before 6-8 weeks after ope RTC can lead to failure of the surgery

Answer 26

deltoid, During an open rotator cuff repair, there is splitting and detachment of the deltoid and reattachment of this muscle to the acromion is a significant part of the surgical procedure. Because of the extent of involvement of the deltoid, it is imperative to not use this muscle actively for a relatively long period of time after surgery, and if used, could lead to a failure of the procedure. (Ghodadra 2009)

Question 27

symptoms of ectopic pregnancy

Answer 27

insidious shoulder pain
abdominal pain,
crampon that “comes in waves”
history of infertility

Question 28

attachments of the inferior and superior extensor retinaculum

Answer 28

1 inferior - calcareous and fibular

2. superior - fibula and tibia