Exam A Flashcards
An elderly pt with hypothyroidism is recovering from a fall and is referred to PT to increase exercise tolerance and safety. The pt complains to the therapist of significant muscle pain in both LE. What additional musculoskeletal effects should the therapist examine for?
Proximal ms weakness.
During an examination of a pt referred to a women’s health clinic, the therapist discovers the pt’s uterus has prolapsed into the vaginal opening. What additional sx associated with a cystocele should the therapist examine for?
Back and perineal pain aggravated by prolonged standing.
A child experienced a superficial partial-thickness burn from a scalding pot of water affecting 26% of the thorax and neck. On what should the therapist’s INITIAL plan of care focus?
Chest wall mobility and prevention of scar contracture.
A pt with coronary artery disease has been doing regular aerobic exercise on a treadmill. If the pt fails to comply in taking prescribed beta-blocker medication and continues to exercise, what potential rebound effect could result?
Increase in BP and HR during exercise.
A pt has persistent midfoot pain with WB. The injury occurred during a soccer match when a opposing player stepped on the pt’s (R) foot when is was planted and cutting to the left. Pt locates the pain where laces are tied up. Upon examination there is splaying of the first metatarsal and increased pain when passively stressing the foot with PF and rotation. What injury should the therapist suspect?
Lisfranc injury
A pt is referred to PT with a 10-yr hx of RA. What are possible extra-articular complications?
Vasculitis
A PT is instructing an elderly pt how to perform bed mobility following a total hip replacement. The therapist should carefully consider the effects of aging that related to skin. What is one such effect?
Impaired sensory integrity
What would a therapist who is examining the breathing pattern of a pt with a complete (ASIA A) C5 SCI expect to observe?
Rising of the abdomen due to no abdominal muscle tone on the abdominal viscera.
Men are at risk for development of metabolic syndrome if they exhibit:
A waist size greater than 40 in.
During an examination, the limitations of US imaging include:
Difficulty penetrating bone and therefore visualizing internal structure of bones.
A pt with a body mass index of 37 is referred to PT for exercise conditioning. What are additional clinical manifestations associated with the BMI that this pt might exhibit?
Hypertension and hyperinsulinism
When visually examining active abduction of the arm to 150 degress, what is the normal composition of the motion a therapist would expect?
100 GH, 50 scapulothoracic motion
To prepare a pt with a cauda equina lesion for ambulation with crutches, what upper quadrant ms would be the most important to strengthen?
Lower trap, Lat dorsi, pec major
What will a pt with significant (R) thoracic stuctuctural scoliosis demonstrate on examination?
Increase lateral costal expansion on the (R)
A therapist has been treating a pt over a period of 4 mo for decreased shoulder elevation and a loss of ER. Recovery has bee good; however, the pt still complains of being unable to reach the upper shelves of kitchen cabinets and closets. To help the pt achieve this goal, what should be the focus of manual therapy?
Anterior glide
Which activity would help break up obligatory LE synergy patterns with hemiplegia?
- High kneeling position, ball throwing
- Standing, alt marching in place with hip and knee flexion and hip abd
- sitting, alt toe tapping
- Sitting, foot slides under the seat
High kneeling position (Out of synergy position)
A pt recovering from stroke reports lack of feeling in the more-affected hand. Light touch testing reveals lack of ability to tell when the stimulus is being applied (1/10). What additional sensory test can the therapist perform?
- Test of pain and temp
- Test for 2-pt discrimination
- Test for sterognosis
- Test for barognosis
Test for pain and temp (ALS)
Light touch, 2pt, stero and baro are all dorsal column-lemniscal pathway.
In managing the residual limb of an elderly pt with a transfemoral amputation, what is the MOST IMPORTANT factor the therapist should consider?
- Contracture of hip musculature
- Residual limb shape
- Ms atrophy
- Residual limb healing
Residual limb healing
Three months ago a pt experienced a traumatic injury to the hand that resulted in surgical tendon repair and fracture stabilization. The therapist is planning a treatment program to address tightness of the lumbricals. What exercise would be BEST in order to increase range of motion?
- Both MCP and IP moved into flexion
- Both MCP and IP moved into extension
- The MCP joints are extended and IP are flexed
- The MCP are flexion and the IP joints are extended.
The MCP joints are extended and IP are flexed
A pt with a long hx of cigarette smoking has been admitted to the hospital and presents with tachycardia, signs of lung infection, abnormal breath sounds in both lower lobes, and dullness to percussion. What should the therapist’s initial intervention focus on with this pt.
- Getting the pt to quit smoking
- Breathing reeducation to increase efficiency of ventilation.
- Airway clearance and secretion removal.
- Graded inspiratory ms training
Breathing reeducation to increase efficiency of ventilation.
The pt has signs and sxs consistent with pneumonia. It is most important to assist with secretions clearance to assist with recovery from the infection and to improve gas exchange.
A pt has AC of the GH joint. What is the expected greatest limitation of motion when performing shoulder ROM?
- Flexion
- Abduction
- IR
- ER
ER
ER then flex then IR
During a home visit an adult pt ask the PT assistant to see the PT progress notes in the medical record. What should the PT assistant do?
- Refuse to let the pt see the record.
- Allow the pt to see the record
- Let the pt see the notes only with the permission of the PT.
- Contact the pt’s physician and explain the situation.
Allow the pt to see the notes.
A chest tube gets dislodged during PT treatment. If the therapist fails to cover the defect, what could the pt develop?
- Pulmonary embolism
- Pulmonary edema
- Pneumothorax
- Aspiration pneumonia
Pneumothorax
With removal of the chest tube, there is an increase positive pressure on the lung tissue. The lung is not able to inflate, and it succumbs to the pressure and therefore collapses.
Following a MVA, a pt with chest trauma developed atelectasis. What is the LEAST appropriate intervention to help with the immediate management of atelectasis?
- Pain reduction techniques
- Segmental breathing
- Incentive spirometry
- Paced breathing
Paced breathing
In order to reverse atelectasis, the pt needs a technique to facilitate deep breathing. Paced breathing controls the rate of breath, not the depth of breathing and will therefore be ineffective.