Final Exam Review Flashcards by Mary Cate Wysong

What are body mechanics?
A. Positioning in anatomical neutral alignment.
B. Efficient use of one’s body to produce safe motion.
C. Positioning to produce adequate force.
D. Use of mechanical mobility assistive devices to reduce muscle usage.

B. Efficient use of one’s body to produce safe motion

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In general, where is a person’s COG located?
A. Vertical midpoint in their vertebral column.
B. Approximately at the level of the umbilicus
C. Horizontal midpoint between posterior SI (sacroiliac) joints.
D. Anterior to the upper portion of sacrum.

D. Anterior to the upper portion of sacrum.

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Think about a 1-year-old, just learning to walk. Does COG differ, compared to their parents?
A. COG is lower as the child is very short.
B. Depends on if the child is proficient in balanced gait.
C. COG is higher.
D. There is no significant difference.

C. COG is higher.

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Which of the below will probably present with the smallest BOS, all reference the same adult patient?
A. Normalized gait, with normal step length and UE(arm) swing.
B. Stance in someone who has genu valgum (knock-knee).
C. Tibial fracture, utilizing a knee trolley to support LE (leg).
D. Guarding on right heel secondary to acute plantar fasciitis.

D. Guarding on right heel secondary to acute plantar fasciitis

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Reference body mechanics, which are descriptors:

anatomical/neutral efficient/safe power/force

efficient/safe

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When moving patient, which of these is least efficient and why? push, slide, lift, pull, roll

lift

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Define the patient status of Modified Independent.

does not need assistance, but needs AD

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Min, Mod, Max assist: % pt work levels?

75%, 50%, 25%

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Given Min-Mod-Max-Total Assist, what do you need to use for safety?

gait belt

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How much weight is patient supposed to bear in TTWB?

~10% or 10 lbs

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Patient <=50% WB =________________ (WB)?

partial

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Populations at Risk when positioning

Amputee
Hemiplegic
Burn victims
Bed/WC bound
Plegia

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Ifpatientisnotmovingregularly(i.e.bedbound),whatbecomesa concern?

ulcers, pressure injuries, contractures

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Whatneedstobedonetopreventformationofdecubiti?

move @ MINIMUM every 1-2 hours

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Timeframesfor:Possibletissuedamage?

15 min

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Decubitus=tissuebreakdownover______________________?

bony prominences

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Whataresomeofthepositivesofsupinepositioning?

good communication, verbal/non-verbal
easily modifiable
pt comfortable

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Describechallengesinpronepositioning.

communication difficult, verbal/nonverbal
harder position to get into
might not be as comfortable

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Whatpositionpromotesgoodcommunicationwithpatient?

supine or sitting

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Howdoyoudecidetodrapeornot?

cultural/religious preferences

appropriate area exposed

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Whatisnotneededforweightacceptance?
A.Forwardprogression.
B.Limbstability.
C.Footclearance.
D.Shockabsorption.

C.Footclearance.

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WhichoftheseshouldNOTbedone,when
assistingapatienttoambulate?
A.Useagaitbelt.
B.Astherapist,haveawideBOS.
C.Challengepatientwithgaitpatternintheirability.
D.Guardpatientfromthefronttoprovidestability.

D.Guardpatientfromthefronttoprovidestability.

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Patientwithmultiplesclerosis(MS),occasionalbalance
issues,stillambulatoryandgood,equalstrengthinUE,LE,andcore.
Whatassistivedevicedoyousuggest?
A.Singlecane.
B.Standardwalker.
C.WheelchairasMSisprogressive.
D.Lofstrandcrutches.

A.Singlecane.

Pediatricpatient,7YO,withcerebralpalsy(CP),veryactive,
pronouncedscissoringgait,minorbalanceissuesfatiguesinlong
hallwaysatschool.WhatADdoyousuggest?
A. Customwheelchairduetofatigue.
B. Rollingwalker.
C.Quadcane.
D.Axillarycrutches.

B. Rollingwalker.

When doing observational gait analysis (OGA), you observe your patient from right heel strike to left heel strike. This is a _________.

step

How do you change a step to equal a stride? What term is synonymous?

heel strike to ipsilateral heel strike; gait cycle

Number of steps/minute = cadence or speed? | Walk ½ mile in 8 minutes = cadence or speed?

cadence | speed

What are the two main periods in the gait cycle and relative time spent in each?

stance (60%); swing (40%)

A patient describes pain in walking when weight is transferred to the forefoot region. Which phase of gait is this?

terminal stance

In getting ready to do gait training with a patient using crutches for the first time, what would is the most appropriate action to perform first? And how?

ensure appropriate measurement first; 2 fingers b/t armrest and axilla; hand grip @ level of radial styloid; measure from 2" horizontally from toes/6" out in front of toes

Describe patient WB status for 4point, 3point, and 2point gait patterns. Which are slower/faster? More stable?

FWB,NWB, FWB; 4-point slowest, 2-point/3-point faster; 4-point/2-point most stable

Assistive devices (AD) are used to compensate for impaired balance, decreased strength, decreased WB status, or pain during weight bearing. Which of these can be addressed by use of a cane?

impaired balance

Your patient is safest with a 3‐1 gait pattern. What does that mean and which assistive device will be most appropriate?

PWB in affected limb; bilateral AD/walker

Describe how to properly fit a rolling walker to your elderly patient.

handle at level of radial styloid

What modification can allow for the motion that is | needed for sports?

camber

ADA refers to ________________ and prohibits discrimination against people with disabilities in what situations?

Americans with Disabilities Act; protects in all capacities esp. federal; buildings, activities, etc.

In the initial phase of differential diagnosis, what is the first thing that PT needs to answer about their patient?

do they even belong in my clinic; red/yellow flags

In general, what are red flags? Provide some examples.

any reason to refer pt out; unexplained weight loss, psychological issues, pain awaking pt at night/keeps them from going to sleep, fever/vomiting, etc.

Formulation of a hypothesis is? continuous/dynamic; static/fixed

continuous/dynamic

After you have done any chart review, established patient rapport, and gathered general information, what is the next step in the Subjective Examination?

analysis; hypothesis generation

When looking at past and present history, MOI is often an enlightening factor. What does that stand for?

mechanism of injury

Disability and functional status should be screened during the subjective examination. One of the more common used is the Oswestry Disability Index. This index measures_____________ .

measures a patient's permanent functional disability; low back functionality

What scale can be used to measure functional status throughout all regions of the body?

PSFS (pt-specific functional scale)

When doing a subjective examination, your patient tells you that they notice their pain significantly increases if they stand for more than 10 minutes, probably to a 6/10. They usually have to sit down, which decreases the pain. From this discussion, extended standing is an example of:_______.

agg

What does the term “easing factors” mean?

anything that relieves pain

PSHx stands for ____________________.

Past Surgical History

SINSS? describe

``` severity irritability nature stage stability ```

Why would it be important to establish the irritability of a patient’s condition during the subjective examination, with continual reassessment throughout the evaluation? A. Decide if patient’s goals are appropriate. B. Determine how constantly the symptoms present. C. Assess what the appropriate vigor of the objective exam should be. D. Predict patient’s ability to do advanced skills.

C. Assess what the appropriate vigor of the objective exam should be.

Your patient estimates that their knee pain is about a 2/10. It does bother them but they have been able to continue their job as a cashier. What is the severity in this case? A. Moderately severe B. Non‐severe C. Chronic D. Moderately irritable

B. Non‐severe

Truck driver presenting with cervical pain, stating that the pain can get as high as a 7/10 when turning head to clear blind spot. She notes that pain subsides when gaze returns forward and she has never had to stop driving. What do you rate the irritability level? A. Non‐irritable B. Moderately irritable C. Severe irritability D. Chronic, aggravated

A. Non‐irritable

High school tennis player injured their knee during a tournament over the weekend. You are about to see them for your 9am appointment on Monday morning. In reviewing their medical history form, you see that they have injured that same LE previously. The appropriate stage for their injury is: A. Chronic B. Exacerbation C. Sub‐acute D. Acute

D. Acute

Shoulder abduction occurs within the frontal plane. A. True B. False

A. True

``` You are performing elbow flexion AROM assessment. This is an example of: A. Accessory Mobility B. Physiologic Mobility C. Passive Mobility D. None of the above ```

B. Physiologic Mobility

A goniometer is not used to measure which of the following: A. AROM of knee flexion B. PROM in cervical rotation C. Gliding accessory motion in shoulder rotation D. Available motion in small finger joints

C. Gliding accessory motion in shoulder rotation

``` Which of the following is an abnormal end‐feel? A. Tissue stretch B. Soft tissue approximation C. Capsular—can be hard or soft D. Bone‐to‐bone ```

C. Capsular—can be hard or soft

You are working with a patient who has shoulder muscle weakness. The patient is able to hold the UE up against gravity against moderate resistance. What is the most appropriate MMT grade? A. 2 B. 3 C. 4 D. 5‐

C. 4

You observe a patient ambulate to the examination room for initial evaluation and notice that a struggle to dorsiflex his R ankle during the swing phases of gait. There looks to be some motion but not through the full expected range. What is the most appropriate choice for patient positioning when assessing tibialis anterior? A. For safety, the patient should be placed in the sitting position. B. The patient should be made to stand, to assess endurance. C. The patient should be placed in supine position. D. You should not test the tibialis anterior.

C. The patient should be placed in supine position.