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O Sullivan Exam A > Exam A > Flashcards

Exam A Flashcards

1
Q

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?

A

Proximal ms weakness.

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2
Q

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?

A

Back and perineal pain aggravated by prolonged standing.

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3
Q

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?

A

Chest wall mobility and prevention of scar contracture.

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4
Q

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?

A

Increase in BP and HR during exercise.

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5
Q

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?

A

Lisfranc injury

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6
Q

A pt is referred to PT with a 10-yr hx of RA. What are possible extra-articular complications?

A

Vasculitis

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7
Q

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?

A

Impaired sensory integrity

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8
Q

What would a therapist who is examining the breathing pattern of a pt with a complete (ASIA A) C5 SCI expect to observe?

A

Rising of the abdomen due to no abdominal muscle tone on the abdominal viscera.

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9
Q

Men are at risk for development of metabolic syndrome if they exhibit:

A

A waist size greater than 40 in.

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10
Q

During an examination, the limitations of US imaging include:

A

Difficulty penetrating bone and therefore visualizing internal structure of bones.

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11
Q

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?

A

Hypertension and hyperinsulinism

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12
Q

When visually examining active abduction of the arm to 150 degress, what is the normal composition of the motion a therapist would expect?

A

100 GH, 50 scapulothoracic motion

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13
Q

To prepare a pt with a cauda equina lesion for ambulation with crutches, what upper quadrant ms would be the most important to strengthen?

A

Lower trap, Lat dorsi, pec major

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14
Q

What will a pt with significant (R) thoracic stuctuctural scoliosis demonstrate on examination?

A

Increase lateral costal expansion on the (R)

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15
Q

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?

A

Anterior glide

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16
Q

Which activity would help break up obligatory LE synergy patterns with hemiplegia?

  1. High kneeling position, ball throwing
  2. Standing, alt marching in place with hip and knee flexion and hip abd
  3. sitting, alt toe tapping
  4. Sitting, foot slides under the seat
A

High kneeling position (Out of synergy position)

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17
Q

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?

  1. Test of pain and temp
  2. Test for 2-pt discrimination
  3. Test for sterognosis
  4. Test for barognosis
A

Test for pain and temp (ALS)

Light touch, 2pt, stero and baro are all dorsal column-lemniscal pathway.

18
Q

In managing the residual limb of an elderly pt with a transfemoral amputation, what is the MOST IMPORTANT factor the therapist should consider?

  1. Contracture of hip musculature
  2. Residual limb shape
  3. Ms atrophy
  4. Residual limb healing
A

Residual limb healing

19
Q

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?

  1. Both MCP and IP moved into flexion
  2. Both MCP and IP moved into extension
  3. The MCP joints are extended and IP are flexed
  4. The MCP are flexion and the IP joints are extended.
A

The MCP joints are extended and IP are flexed

20
Q

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.

  1. Getting the pt to quit smoking
  2. Breathing reeducation to increase efficiency of ventilation.
  3. Airway clearance and secretion removal.
  4. Graded inspiratory ms training
A

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.

21
Q

A pt has AC of the GH joint. What is the expected greatest limitation of motion when performing shoulder ROM?

  1. Flexion
  2. Abduction
  3. IR
  4. ER
A

ER

ER then flex then IR

22
Q

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?

  1. Refuse to let the pt see the record.
  2. Allow the pt to see the record
  3. Let the pt see the notes only with the permission of the PT.
  4. Contact the pt’s physician and explain the situation.
A

Allow the pt to see the notes.

23
Q

A chest tube gets dislodged during PT treatment. If the therapist fails to cover the defect, what could the pt develop?

  1. Pulmonary embolism
  2. Pulmonary edema
  3. Pneumothorax
  4. Aspiration pneumonia
A

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.

24
Q

Following a MVA, a pt with chest trauma developed atelectasis. What is the LEAST appropriate intervention to help with the immediate management of atelectasis?

  1. Pain reduction techniques
  2. Segmental breathing
  3. Incentive spirometry
  4. Paced breathing
A

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.

25
Q

Following a reattachment of the flexor tendons of the fingers, the pt is in a splint. One PT goal is to minimize adhesion formation. What should the PT teach the pt to perform after 72 hrs post-sx?

  1. Passive ext and act flex of IP joints
  2. Active ext and flex of the IP joints
  3. Active ext and passive flex of the IP joints
  4. Gentle passive ext and flex of the IP joints.
A

Active ext and passive flexion of the IP joints.

Severe edema increase tendon drag and likelihood of rupture. Therefore, wait 48-72 hrs postop prior to initiating ROM therapy. This pt is a few days postop and can begin passive finger flexion with caution so as not to disrupt the repait. Begin by blocking the MCP in full flexion and actively extend the IP joints, followed by passive PIP flex and act ext.

26
Q

A pt with a transtibial amp of 2 mo duration complains of an intense burning pain that seems to emanate from the heel. This phantom pain mirrors the pt’s preoperative pain. What is the most likely previous source of this pain?

  1. Dorsal pedis artery obstruction
  2. Popliteal artery obstruction
  3. Damage to the superficial peroneal/ fibular nerve
  4. Damage to the tibial nerve
A

Damage to the tibial nerve

27
Q

A pt’s plan of care includes use of iontophoresis for the management of calcific bursitis of the shoulder. To administer this treatment using the acetate ion, that current characteristics and polarity should be used?

  1. Monophasic twin-peaked pulses using the positive pole
  2. Monophasic twin-peaked pulses using the negative pole
  3. direct current using the positive pole
  4. direct current using the negative pole
A

Direct current using the negative pole.

The acetate ion has a negative charge, and thus a negative pole will be needed to repel the drug into the tissue. Direct current will continuously drive the acetate into the tissue during the treatment time.

28
Q

A snowmobile left the trail and struck a tree. The drivers’s left knee was flexed approx 90 degrees and the tibia impacted with the inside front of the snowmobile. What would this mechanism of injury MOST LIKELY result in?

  1. Dislocated patella
  2. Sprained or ruptured PCL
  3. Sprained of ruptured ACL
  4. Rupture of the popliteal artery
A

PCL

“Dashboard injury” occurs when the knee is flexed and the force strikes the anterior tibia and displaces it posteriorly.

29
Q

The interview with an 18-yo female cross-country runner elicits a hx of stiffness and diffuse ache in her right knee that is aggravated by prolonged sitting. Going down stairs is also painful. Based on this information, what is the likely diagnosis that should serve as a focus for the physical examination?

  1. IT Band friction syndrome
  2. Osgood-schlatters disease
  3. Meniscal tear
  4. Patellofemoral syndrome
A

Patellofemoral syndrome

Occurs due to mistracking of the patella within the intercondylar groove.

30
Q

Following mastectomy with axillary lymph node dissection, a pt developed 4+ edema in the ipsilateral arm. A compression garment was ordered. What is the primary reason this garment decreases edema?

  1. Dec osmotic pressure of the capillaries
  2. Inc capillary permeability
  3. Exceeds the internal tissue hydrostatic pressure
  4. It equals the fluid outflow from the capillaries
A

Exceeds the internal tissue hydrostatic pressure

31
Q

A pt in the late stages of PD exhibits episodes of akinesia while walking. What should the therapist examine?

  1. Primary involvement of the head and trunk.
  2. Associated dyskinesias
  3. Primary involvement of the hips and knees.
  4. Triggers the precipitate the freezing episodes.
A

Triggers that precipitate the freezing episodes.

Freezing of gait (episodes of akinesia) is typically associated with the trigger (turning, changing direction or speed doorways). Identification of triggers is helpful in developing the plan of care.

32
Q

A pt is referred to PT for balance and gait training following two falls in the home in the past month. The therapist notes in the medical record that the pt has adrenal insufficiency. What are the metabolic abnormalities associated with adrenal insufficiency?

  1. Hypokalemia
  2. Hypoatremia
  3. Hyperglycemia
  4. Alkalosis
A

Hypoatremia - decreased Na concentration in the blood.

33
Q

A PT is treating a pt with active infectious hepatitis B. In addition to wearing a protective gown when in the pt’s room, what precautions should be taken to avoid transmission of the disease?

  1. Avoid direct contact with the pt’s blood or blood-contaminated equipment by wearing gloves.
  2. Avoid direct contact with any part of the pt
  3. Have the pt wear a mask to minimize droplet spread of the organisms from coughing
  4. Prove tissue and no touch receptacles for disposal of tissue
A

Avoid direct contact with the pt’s blood or blood-contaminated equipment by wearing gloves.

Hep B is transmitted in blood, body fluids or body tissues. Precautions should include avoiding direct contact with blood or blood-contaminated equipment.

34
Q

Idiopathic scoliosis is suspected in a 12 yo girl. During the physical examination, what is the standard screening test for this condition?

  1. Longsitting, forward bend test
  2. Standing, Adam’s forward bend test
  3. Sitting, rotation test to the right and left
  4. Standing back ward extension test
A

Standing, Adam’s forward bend test

35
Q

Use of continuous US at 1.5 Watts/cm2 can increase?

  1. Local metabolic rate
  2. Rate of ms hypertrophy.
  3. Stiffness of collagen tissue
  4. The resolution of acute inflammation
A

Local metabolic rate

Cont Us if for a thermal effects and higher the intensity, the greater the probability of causing a tissue temperature rise that would result in a increase metabolic rate in the area applied.

36
Q

The therapist is treating a pt with chronic Lyme disease of more than 1 yr’s duration. What joints are likely to demonstrate more arthritic changes and therefore should be the focus of PT interventions?

  1. Sm joints of the hands and feet
  2. Lg joints of the body, especially the knee
  3. Axial jt, especially the lumbrosacral spine
  4. Axial jt, especially the cervical and thoracic spine
A

Lg joints of the body, especially the knee

Stage 3 Lyme disease is characterized i characterized by intermittent arthritis with marked pain and swelling, especially in the large joints. Permanent jt damage can occur.

37
Q 
During auscultation of the heart, the therapist hears S1 and S2 heart sounds. During early diastole the therapist also hears a low frequency sound of turbulence. What suspected abnormal sound should the therapist record this as?
1. S4 sound
2. S3 sound
3. Heart murmur
4 Pericardial friction rub
A

S3 sound

S3 is an abnormal 3rd heart sound due to poor ventricular compliance and turbulence. It is heard as low frequency sound during early diastole.

S4 - heard in LATE diastole.

Heart murmur are swishing sound in systole and diastole.

38
Q

A pt with type 1 DM has generalized osteoporosis. What is the BEST exercise to include in this pt’s POC?

  1. (B) quad presses against resistance in sitting
  2. Aquatic ex
  3. Running on treadmill
  4. Partial squats in standing
A

Partial Squads in standing

39
Q

A pt suddenly falls and lands on a piece of equipment left on the floor. A severe laceration with spurting blood is noted in the area of the lateral distal right thigh. To help control bleeding, where should the PT apply pressure in addition to directly over the wound?

A

Femoral triangle

Pressure applied over the wound

40
Q

While gait training a pt following a stroke, the therapist observes the knee on the hemiparetic side going into recurvatum during stance phase. What is the MOST likely cause of this deviation?

  1. Severe spasticity of HS or weakness of the gastroc-soleus
  2. Weakness or severe spasticity of the quads
  3. Weaknes of the gastroc-soleus or spasticity of pretibs
  4. Weakness of both gastroc-sol and pretibs
A

Weakness of severe spasticity of quad.

O Sullivan Exam A (1 decks)

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