FORTINBERRY CH1 Flashcards
The sinoatrial node is located in what chamber of the heart?
A. Leftatrium
B. Right atrium
C. Leftventricle
D. Right ventricle
Right atrium
The sinoatrial node is located in the right atrium of the heart. It serves as the pacemaker for the heart. Impulses generated there are passed on from right to left and inferiorly to the atrioventricular node in the lower end of the interatrial septum.
Where in the tissues does nutrient exchange take place?
A. Capillaries
B. Interstitial spaces
C. Arterioles
D. Venules
Interstitial spaces
The vessels of the various sizes provides transmission conduits for body fluids, but the exchange described takes place between cell surfaces and the interstitial fluid.
During which phase of the cardiac cycle is ventricular volume the lowest?
A. Atrial systole
B. Isovolumetric ventricular contraction
C. At the onset of rapid ventricular ejection
D. Isovolumetric ventricular relaxation
Isovolumetric ventricular relaxation
During the isovolumetric ventricular relaxation phase, all of the ventricular volume has been ejected. The semilunar and AV valves are closed, and no volume is changing in the ventricles. This phase has the lowest volume.
The heart contains a variety of different types of muscle fibers, each with a different frequency of spontaneous contraction. Which of the following has the shortest period (highest frequency) of spontaneous contraction?
A. Purkinje fibers
B. SA node
C. AV node
D. Myocardium
SA node
The SA node has a frequency of 70 to 80 depolarization per minute: the AV node frequency is 40 to 60; and the purkinje cell frequency is 15 to 40; the myocardium is even slower. This question refers to how often these fibers will have action potentials, not haw fast they travel.
Stimulation of CN X will cause which of the following effects?
A. Atrial fibrillation
B. Sinus bradycardia
C. Cardiac rigor
D. Ventricular fibrillation
Sinus bradycardia
Cranial nerve X stimulation causes
bradycardia by inhibiting automaticity of the SA node. Tachycardia effects are caused by inhibiting, not stimulating, the vagus. Cardiac rigor is a consequence of hypercalcemia and causes the heartto stop in systolic
The volume of air moved going from full forced expiration to full forced inspiration is known as
A. Inspiratory capacity
B. Vital capacity
C. Total lung capacity
D. Inspiratory reserve volume
Vital capacity
Inspiratory capacity is the volume of air moved going from normal expiration to full forced inspiration. Total lung capacity is the volume of air in the lung on full forced inspiration and cannot be measured on spirometiv. Inspiratorv reserve volume is the volume or air moved going from normal inspiration to full forced inspiration
During periods of intense physical activity, many physiologic adaptations occur, especially in the circulatory system. Which of the following occurs during increased physical exertion?
A. Increased ventricular refilling, secondary to increased venomotor tone
B. Decreased cardiac output
C. Decreased stroke volume
D. Increased cardiac cycle time
Increased ventricular refilling, secondary to increased venomotor tone
Cardiac output and stroke volume both increase during exertion. Increase cardiac cycle time is just another way of saying the heart beating is slower, which is the opposite of what occurs with exertion.
Which of the following is indicative of left heart failure?
A. Pitting pedal edema
B. Neck vein distention
C. Orthopnea
D. Ascites
Orthopnea
Orthopnea, which is dyspnea in the recumbent position, is a typical symptom of chronic left heart failure. All of the other symptoms and signs are due to right heart failure.
A patient asks the therapist to explain the function of his medication verapamil (a calcium antagonist. Which of the following points should be conveyed in the therapist’s explanation?
A. Verapamil causes decreased contractility of the heart and vasodilation of the coronary arteries.
B. Verapamil causes decreased contractility of the heart and vasoconstriction of the coronary arteries.
C. Verapamil causes increased contractility of the heart and vasodilation of the coronary arteries.
D. Verapamil causes increased contractility of the heart and vasoconstriction of the coronary arteries.
Verapamil causes decreased contractility of the heart and vasodilation of the coronary arteries.
Verapamil reduces contractility of the heart and increases coronary artery dilation, resulting in decreased cardiac workload and increased blood flow to the heart muscle.
The protocol for a cardiac patient states that the patient should not exceed 5 metabolic equivalents (METs) with any activity at this stage of recovery. Which of the following activities would be inappropriate for the patient?
A. Cycling 11 mph
B. Walking 4 mph
C. Driving a car
D. Weeding a garden
Cycling 11 mph
Cycling 11 mph is approximately 6 to 7
METs. Walking 4 mph is approximately 4.6
METs. Driving a car is approximately 2 METs.
Weeding a garden is approximately 3 to 5 METs.
During the opening of a patient’s mouth, a palpable and audible click is discovered in the left temporomandibular joint. The physician informs the therapist that the patient has an anteriorly dislocated disk. This click most likely signifies that
A. The condyle is sliding anteriorly to obtain normal relationship with the disk
B. The condyle is sliding posteriorly to obtain normal relationship with the disk
C. The condyle is sliding anteriorly and losing normal relationship with the disk
D. The condyle is sliding posteriorly and losing normal relationship with the disk
The condyle is sliding anteriorly to obtain normal relationship with the disk
In the case of a reciprocal click, the initial click is created by the condyle slipping back into the correct position under the disk with opening of the mouth. In this disorder, the condyle is resting posterior to the disk before jaw opening. With closing, the click is caused by the condyle slipping away from the disk.
In what position should the therapist place the upper extremity to palpate the supraspinatus tendon?
A. Full abduction, full flexion, and full external rotation
B. Full abduction, full flexion, and full internal rotation
C. Full adduction, full external rotation, and full extension
D. Full adduction, full internal rotation, and full extension
Full adduction, full internal rotation, and full extension
The supraspinatus tendon is best
palpated by placing the patient’s involved upper extremity behind the back in full internal rotation.
A 13-year-old girl has fractured the left patella during a volleyball game. The physician determines that the superior pole is the location of the fracture. Which of the following should be avoided in earl rehabilitation?
A. Full knee extension
B. 45 degrees of knee flexion
C. 90 degrees of knee flexion
D. 15 degrees of knee flexion
90 degrees of knee flexion
The superior pole is in most contact at approximately 90 degrees of knee flexion.
During conference with the physical therapist, a respiratory therapist indicates that the patient has a low expiratory reserve volume. What does this mean?
A. The volume of air remaining in the lungs after a full expiration is low.
B. The volume of air in a breath during normal breathing is low.
C. The volume of air forcefully expired after a forceful inspiration is low.
D. The amount of air expired after a resting expiration is low.
The amount of air expired after a resting expiration is low.
Choice D describes an expiratory
reserve volume. Choice A is residual volume, choice B is tidal volume, and choice C is vital capacity.
During an evaluation a 74-year-old woman informs you that she is “taking a heart pill.” The patient does not have her medication with her but states that the medication “slows down my heart rate.” Which of the following is the most probable medication?
A. Epinephrine
B. Digitalis
C. Quinidine
D. Norepinephrine
Quinidine
Epinephrine, digitalis, and
norepinephrine increase heart rate. Quinidine is an antiarrhythmic drug.
A patient is referred to physical therapy with a secondary diagnosis of hypertension. The physician has ordered relaxation training. The therapist first chooses to instruct the patient in the technique of diaphragmatic breathing.
Which of the choices is the correct set of instructions?
A. Slow the breathing rate to 8 to 12 breaths perminute, increase movement of the upper chest, and decrease movement in the abdominal region.
B. Slow the breathing rate to 12 to 16 breaths perminute, increase movement of the abdominal region, and decrease movement in the upper chest.
C. Slow the breathing rate to 8 to 12 breaths per minute, increase movement of the abdominal region, and decrease movement in the upper chest.
D. Slow the breathing rate to 12 to 16 breaths per minute, increase movement of the upper chest, and decrease movement in the abdominal region.
Slow the breathing rate to 8 to 12 breaths per minute, increase movement of the abdominal region, and decrease movement in the upper chest.
Choice C provides correct instructions.
The patient is often instructed to begin this technique in the supine position and progress to the sitting position. This technique should be practiced for approximately 5 minutes several times per day.
Which of the following statements about cardiovascular response to exercise in trained and/or sedentary patients is false?
A. If exercise intensities are equal, the sedentary patient’s heart rate will increase faster than the trained patient’s heart rate.
B. Cardiovascular response to increased workload will increase at the same rate for sedentary patients as it will for trained patients.
C. Trained patients will have a larger stroke volume during exercise.
D. The sedentary patient will reach anaerobic threshold faster than the trained patient if workloads are equal.
Cardiovascular response to increased workload will increase at the same rate for sedentary patients as it will for trained patients.
The sedentary patient’s cardiovascular response increases faster than the trained patient’s if the workloads are equal.
A therapist is asked to examine a patient in the intensive care unit. The patient is comatose but breathing independently. During the assessment of range of motion in the right upper extremity, the therapist notices that the patient is breathing unusually. The pattern is an increase in breathing rate and depth followed by brief pauses in breathing. The therapist should notify the appropriate personnel that the patient is exhibiting which of the following patterns?
A. Biot’s respiration
B. Cheyne-Stokes respiration
C. Kussmaul’s respiration
D. Paroxysmal nocturnal dyspnea
Cheyne-Stokes respiration
The pattern described in the question: a
gradual increase in the rate and depth of respirations followed by periods of absent breathings known as Cheyne-Stokes breathing,
Small breaths followed by inconsistent periods of absent breathing are known as a Biot’s breathing pattern. Deep gasping breaths are known as a Kussmaul’s breathing pattern.
Awakening during the night because of periods of absent breathing is known as paroxysmal nocturnal dyspnea.
Which of the following statements is not a common physiologic change of aging?
A. Blood pressure taken at rest and during exercise increases.
B. Maximal oxygen uptake decreases.
C. Residual volume decreases.
D. Bone mass decreases.
Residual volume decreases.
Residual volume, the amount of air left in the lungs after a forceful expiration, increases with age.
A patient with cardiac arrhythmia is referred to physical therapy services for cardiac rehabilitation. The therapist is aware that the heart receives nerve impulses that begin in the sinoatrial node of the heart and then proceed to the
A. Atrioventricular node, then to the Purkinie fibers, and then to the bundle branches
B. Purkinie fibers, then to the bundle branches, and then to the atrioventricular node
C. Atrioventricularnode, then to the bundle branches, and then to the Purkinie fibers
D. Bundle branches, then to the atrioventricular node, and then to the Purkinie fibers
Atrioventricularnode, then to the bundle branches, and then to the Purkinie fiber
The heart receives nerve impulses that travel through the sinoatrial node to the ventricles by way of the atrioventricular node, bundle branches, and Purkinie fibers.
A 65-year-old man is scheduled to begin a wellness program. He has no cardiovascular disease, major svstemic illness, or musculoskeletal abnormality. However, he is deconditioned because of an extremely sedentary lifestyle. Resting heart rate is 90 beats minute, and resting blood pressure is 145/92 mm Hg. Which of the choices describes the most correct intensity, frequency, and duration at which the patient should begin exercise?
A. 75Vo2max: 30 min/day: 3 days/wk
B. 40Vo2 max; 30 min/ day; 5 days/wk
C. 40 Vo2 max: 10 minutes twice dailv: 5 davs /wk
D. 75 Vo 2max; 10 minutes twice daily: 3 days/wk
40 Vo2 max: 10 minutes twice dailv: 5 davs /wk
Deconditioned people benefit initially from low-intensity exercise with multiple sessions per day and perweek.
A 17-year-old athlete has just received a posterior cruciate ligament reconstruction. The therapist is attempting to explain some of the characteristics of the posterior cruciate ligament. Which of the following is incorrect information?
A. The posterior cruciate ligament prevents posterior translation of the tibia on the femur.
B. Posterior bands of the posterior cruciate ligament are their tightest in full knee extension.
C. The posterior cruciate ligamentis attached to the lateral meniscus and not to the medial meniscus.
D. The posterior cruciate ligament helps with medial rotation of the tibia during full knee extension with open-chain activities.
The posterior cruciate ligament helps with medial rotation of the tibia during full knee extension with open-chain activities.
The posterior cruciate ligament becomes tight in full knee extension. This assists the tibia in external rotation, which is needed for the screw home mechanism with open-chain activities.
A patient starting to use antihypertensive medications must be observed when getting up or leaving a warm therapeutic pool in order to avoid an episode of
A. Bradycardia
B. Orthostatic hypotension
C. Dysrhythmias
D. Skeletal muscle weakness
Orthostatic hypotension
Antihypertensive medication may cause a sharp drop in blood pressure when getting up quickly or leaving a warm pool, which causes vasodilation. This is most evident at the beginning of therapy. Patients must be supervised and warned to get up slowly, to hold on to something firm, and to sit down when leaving the pool.
A patient whose exercise-induced heart rate is less than the heart rate was before exercise is most likely starting therapy with
A. Anticholinergic drugs
B. Alphablockers
C. Betablockers
D. Antianginals
Betablockers
Beta blockers block the beta receptors on the heart; they also block sympathetic nerve impulses and reduce heart rate and contractility.
The other drugs have no effects, or they might increase heart rate.
A patient inhales a beta agonist to relieve his asthma. After its use, you may notice
A. An increase in heart rate
B. A few moments of incoordination
C. Flushing with red face
D. A decrease in blood pressure
An increase in heart rate
A beta agonist stimulates cardiac beta receptors, leading to an increase in heart rate and blood pressure.
A patient is using a statin drug. Which of the following drug-induced signs or symptoms should be reported to the treating physician?
A. Muscle pain
B. Irregular heart beat
C. Persistent diarrhea
D. Intermittent confusion
Muscle pain
In a small percentage of patients, statin drugs can cause liver damage (liver function tests are required) and muscle pain, which can leadto rhabdomyolisis (dark urine due to muscle breakdown), a potentially life-threatening condition. The other
signs/symptoms are usually not drug related.
Statin drugs lower cholesterol by
A. Preventing cholesterol absorption
B. Binding to cholesterol in the intestines
C. Inhibiting HMG-CoA reductase
D. Inhibiting lipoprotein lipase
Inhibiting HMG-CoA reductase
Statin drugs inhibit HMG-CoA reductase and lower cholesterol levels most effectively (about 30% or more), while the other drugs interfere with absorption and lipase activity.
A patient is being treated with an antiarrhythmic drug. The drug might cause all of the following adverse reactions except
A. Dizziness and fainting
B. Stevens Johnson svndrome
C. Irregular heartbeats
D. Joint and muscle pain
Joint and muscle pain
All of the listed reactions can be observed, with joint and muscle pain being the exception.
An asthmatic patient is to be exercised in a rather cool environment. It is recommended that the patient use the inhaler
A. About 1 hr before exercise
B. About 20 minutes before exercise
C. Just at the beginning of exercise
D. At the first onset of breathing problems during exercise
About 20 minutes before exercise
While the use of an inhaler is user specific, it is generally recommended to have the patient inhale about 20 minutes before exercise, particularly in a cool environment, which seems to aggravate existing asthma.
A patient using a beta blocker is exercised and might experience all of the following except
A. Some breathing difficulties
B. Muscle cramps and pain
C. A smaller than expected increase in heart rate
D. Some drowsiness
Muscle cramps and pain
The reactions described in choices A
and C can be expected because of blockade of beta receptors in the lungs and heart, and drowsiness is perhaps caused by a central action. No muscle cramps and pain should be expected.
A beta blocker reduces blood pressure by all of the following actions except
A. A reduction in cardiac output
B. A reduction in central sympathetic outflow
C. Inhibition of renin release
D. A reduction in peripheral resistance
A reduction in peripheral resistance
Beta receptor blockade, both
peripherally and perhaps centrally, causes the blood pressure reducing effects, but peripheral resistance is not reduced but rather might be slightly increased (patient might complain about cold extremities).
A patient on calcium channel blocker therapy might complain during therapy sessions about all of the following except
A. Lightheadedness and dizziness
B. Muscle pain and joint stiffness
C. Tremors
D. Edema
Tremors
Calcium channel blockers will cause all of the listed reactions, except tremors, by interfering with calcium fluxes in blood vessels and cardiac muscle.
A patient under the influence of local anesthetic therapy might experience all of the following
except
A. Some sensory impairment
B. Increased blood pressure
C. Tremors
D. Motor deficits
Increased blood pressure
A local anesthetic that might leak into the general blood circulation can affect the cardiac (bradvcardia, hvpotension) and central nervous systems (restlessness, tremors, seizures) and can interfere with the functions of sensory nerves and motor neurons.
A patient with angina pectoris experiences some pain during exercise therapy and uses three tablets of sublingual nitroglycerin, but the pain does not subside. You should
A. Ask the patient to stretch out quietly and breathe deeply
B. Tell patient to continue the medication until the pain stops
C. Call 911 since this could signal a true heart attack
D. Administer two tablets of a non-narcotic analgesic to help reduce the pain
Call 911 since this could signal a true heart attack
Nitroglycerin dilates coronary blood vessels and provides more blood and oxygen to the heart and also reduces peripheral resistance, making it easier for the heart to pump. Both actions eliminate the pain. If no relief is obtained, then this could be a true heart attack.
Your patient is a 48-year-old male who reports to phvsical therapy with complaints of left shoulder and neck pain. Symptoms began insidiously 3 weeks ago and have been increasing in frequency and duration since that time. He notices the symptoms with lifting heavy objects and shoveling dirt for a garden that he is building. Walking fast elicits symptoms. Symptoms abate after several minutes of rest. He is in relatively good health with the exception of high blood pressure and shortness of breath. What system is most likely affected?
A. Cardiovascular
B. Pulmonary
C. Musculoskeletal
D. Hepatic
Cardiovascular
All of the symptoms could potentially
be related to musculoskeletal problems within the shoulder, but several factors make the cardiovascular svstem the best answer. The symptoms began insidiously, and many musculoskeletal shoulder issues can be traced back to a single incident or repetitive motions that aggravate and result in damage to musculoskeletal tissue. The patient cannot remember any incident that triggered the symptoms. Most of the symptoms that the patient is reporting can be attributed to the cardiovascular system. Lifting heavy objects, shoveling dirt, walking fast, high blood pressure, and shortness of breath are all symptoms indicative of cardiovascular system involvement.
Your patient is a 38-year-old male who is a patient that you have been treating for left shoulder pain. He was in a motor vehicle accident since you last treated him 2 days ago.
He was the driver and was rear-ended. He hit his left side on the door handle and has been having sharp pain in his ribs. X-rays the day of the accident revealed fractured ribs (ribs 6 and 7 on the left. He has been having difficulty breathing and has been very short of breath.
Sharp pain is noted on the left with breathing and coughing. He has also noticed some blood in his sputum. What svstem is mostly likely the source of the patient’s symptoms?
A. Musculoskeletal
B. Pulmonary
C. Cardiovascular
D. Hepatic
Pulmonary
Although some of the svmptoms could be the result of musculoskeletal svstem involvement (i.e., rib fracture) or the cardiovascular system (left-sided pain), the best answeris the pulmonary system. The blood in the sputum is an indicator that the ribs may have punctured the lungs. This evidence, coupled with the breathing problems, should move the pulmonary system up as your top hypothesis.
Aspirin and clopidogrel (Plavix) fall into which class of antithrombics?
A. Thrombolvtics
B. Platelet aggregator inhibitors
C. Anticoagulants
D. Fibrinolytics
Platelet aggregator inhibitors
Aspirin and clopidogrel act as
anticlotting/anticoagulant medications by preventing platelets from clumping together, thereby making it harder to form a clot.
Which of the following drugs should angina patients always carry with/on them in case of an angina attack?
A. Nitroglycerin patch
B. An ACE inhibitor
C. Digoxin
D. Sublingual nitroglycerin
Sublingual nitroglycerin
Sublingual nitroglycerin acts very
quickly to relieve anginal pain by relaxing blood vessels to allow more blood to flow to the heart.
Nitroglycerin patches are used to prevent an angina attack but sublingual nitroglycerin is most effective once an attack occurs.
The part of the respiratory system that is most effected by asthma is/are the
A. Bronchioles
B. Trachea
C. Nasal cavity
D. Bronchi
Bronchioles
The bronchioles are the smallest
branches of the airways and are surrounded by smooth muscle. During an asthma attack. inflammation and muscle contraction occur, narrowing these airways and causing asthma symptoms.
Some of the classes of drugs used to treat angina include
A. Nitrates
B. HMG-CoA reductase inhibitors
C. Alpha-blockers
D. Diuretics
Nitrates
Angina is caused by decreased blood flow to the heart resulting in pain. Nitrates relax blood vessels, allowing more blood to flow to the heart and thereby decreasing pain.
Beta-blockers that are useful in the treatment of hypertension
A. Work by competitively inhibiting beta-receptors, thereby decreasing heart rate
B.Are alwavs selective for betal-receptors
C. Do not cause bronchoconstriction in patients with asthma
D. Should not be combined with any other type of antihypertensive
Work by competitively inhibiting beta-receptors, thereby decreasing heart rate
Beta-blockers block beta1-and beta2-receptors, resulting in decreased heart rate and dilation of blood vessels, which helps decrease hypertension. Unfortunately, they could also trigger an asthma attack in susceptible persons by blocking the beta2-receptors in the lungs.
Which of the following medications should be used to treat an acute asthma attack?
A. An oral steroid such as prednisone
B. Along-acting beta-agonist such as salmeterol
C. An inhaled steroid such as fluticasone
D. A short-acting beta-agonist such as albuterol
A short-acting beta-agonist such as albuterol
Short-acting beta-agonists, also known as “rescue” meds, act very quickly by binding to the beta2-receptors in the bronchioles, causing relaxation of the airways. They are indicated for asthma attacks and are not useful for long-term control of asthma symptoms.
In children with osteogenesisimperfecta, fractures heal
A. Within the normal healing time
B. More quickly than normal
C. More slowly than normal
D. Only with assistance of medication
Within the normal healing time
Healing time is unchanged with this patient population.
Components of lower extremity alignment that contribute to toe-in include (1.44)
A. Femoral retroversion
B. Femoral anteversion
C. Calcaneovalgus feet
D. External tibial torsion
Femoral anteversion
Femoral anteversion is the only one that would account for the internal rotation seen in toe in.
Osteochondritis dissecans occurs most commonly in the (1.45)
A. Capitellum
B. Humeral condyle
C. Medial femoral condyle
D. Lateral femoral condyle
Medial femoral condyle
The medial femoral condvle is the most
common area for osteochondritisdissecans, although it can occur in the femoral capital epiphysis.
The joint most frequently involved in pauciarticular juvenile rheumatoid arthritis is the (1.46)
A. Cervical spine
B. Lumbarspine
C. Knee
D. Wrist
Knee
The knee is most common with this diagnosis followed by the ankles and elbows.
The most common onset type of juvenile rheumatoid arthritis is (1.47)
A. Svstemic
B. Juvenile ankylosing spondylitis
C. Polyarticular
D. Pauciarticular
Pauciarticular
Pauciarticular iuvenile rheumatoid arthritis (RA) occurs in 50to 60 of the cases, followed by polyarticular RA and then svstemic RA.
Considering an injury to the medial collateral ligament (MCL) of the knee, when does the inflammatory phase of healing begin? (1.48)
A. First days after injury
B. 2 to 3 weeks after injury
C. 4 to 6 weeks after injurv
D. 6 to 8 weeks after injury
First days after injury
The healing phase of ligaments is divided into the following categories:
inflammatory phase (first few days after injury, proliferative phase (1 to 6 weeks after injury), and remodeling phase (begins at 7 weeks postinjury).
Which of the following types of exercise is most likely to intensify delayed onset muscle soreness (DOMS)? (1.49)
A. Concentric exercise is most likely to intensify DOMS.
B. Eccentric exercise is most likely to intensify DOMS.
C. Isometric exercise is most likely to intensify DOMS.
D. DOMS will remain constant no matter the type of exercise.
Eccentric exercise is most likely to intensify DOMS.
Since eccentric exercise makes the muscle work the hardest, this type of exercise will exacerbate DOMS. DOMS symptoms are alleviated in 2 to 3 days with stretching and ice application.
What is the correct order of the stages of bone healing after a fracture? (1.50)
A. Inflammatory phase, hard callous phase, soft callous phase, remodeling phase
B. Inflammatory phase, soft callous phase, hard callous phase, remodeling phase
C. Remodeling phase, soft callous phase, hard callous phase, inflammatory phase
D. Remodeling phase, hard callous phase, soft callous phase, inflammatory phase
Inflammatory phase, soft callous phase, hard callous phase, remodeling phase
Healing phases of bone after fracture are divided into the following categories:
Inflammatory phase (immediately after injury), soft callous phase (1 to 6 weeks postinjury), hard callous phase (4 to 6 weeks after injury), and remodeling phase (6 weeks to several months postinjury).
Which type of connective tissue includes the superficial sheath of body tissue under the skin, muscle, and nerve sheaths, and the framework of internal organs?
A. Dense regular connective tissue
B. Dense irregular connective tissue
C. Loose irregular connective tissue
D. Loose regular connective tissue
Loose irregular connective tissue
Dense regular connective tissue includesligaments and tendons, and dense irregular connective tissue includes joint capsules, periosteum, and aponeurosis. Choice D does not exist.
Which patient population is most likely to have osteophyte formation that leads to rotator cuff damage?
A. 16-year-old baseball player
B. 34-year-old factory worker
C. 45-year-oldtennis plaver
D. 75-year-old sedentary individual
75-year-old sedentary individual
The aged are more likely to have osteophyte formation. All other populations can have rotator cuff damage, but it will most likely come from another source.
You are seeing a patient who has just received a steroid injection into a joint. You should
A. Treat this joint vigorously
B. Treat this joint gently
C. Not touch this joint at all
D. Postpone the session for at least 1 week
Treat this joint gently
A steroid injection can weaken tendons andligaments; thus, the joint must be moved carefully.
A patient with osteoporosis might be treated with all of the following drugs except
A. Bisphosphonates
B. Calcitonin
C. Calcium with vitamin D
D. Thyroid hormones
Thyroid hormones
Thyroid hormone is not used but the parathyroid hormone is used in cases of certain calcium imbalances. All of the listed agents are used with bisphosphonates to be taken on an empty stomach and sitting or standing for at least 30 min.
A patient has been told to use Advil for rheumatoid arthritis. You notice that the patient uses acetaminophen because a friend uses it, and it is cheaper. You can tell the patient that acetaminophen
A. Can be used since it is the same as Advil
B. Is different from Advil but has the same therapeutic action
C. Is actually more effective than Advil
D. Does not work in rheumatoid arthritis
Does not work in rheumatoid arthritis
Acetaminophen has analgesic and antipyretic but no antiinflammatory properties.
It is not indicated in rheumatoid arthritis, which is an inflammatory condition; however, it can be used in osteoarthritis, which is not an inflammatory problem.
Skeletal muscle relaxants
A. May interfere with walking in patients who use their spasticity to control balance
B. Selectively paralyze certain muscle groups
C. Should be stopped quickly after long-term use when problems have been resolved
D. Have never been proven effective
May interfere with walking in patients who use their spasticity to control balance
Some patients use certain aspects of spasticity to maintain balance; weakening of this spasticity could interfere with their balance.
Skeletal muscle relaxants (except botulinus toxin) weaken but do not paralyze muscles, and some may cause physical dependence, which prohibits abrupt cessation of their long-term use. Numerous studies have confirmed the effectiveness of skeletal muscle relaxants.
While doing a worksite assessment in the hospital business office, a physical therapist found several employees complaining of neck and shoulder pain. It was determined that making a simple change in the set-up of the computer stations could reduce symptoms. The change to the computer monitor that would MOST affect neck and shoulder discomfort is
A. Lowering the monitor to the desk surface
B. Moving the computer monitor closer to the employee’s face
C. Tilting the monitor forward
D. Putting a nonglare screen on the monitor
Moving the computer monitor closer to the employee’s face
The line of vision dictates head and neck posture. If the screen is too low or too far away from the face, the user must flex the neck and trunk. If the head is held forward, cervical muscles become fatigued.
The cuboid bone is located just posterior to the
A. Base of the first metatarsal
B. Head of the first metatarsal
C. Medial cuneiform bone
D. Tuberosity of the fifth metatarsal
Tuberosity of the fifth metatarsal
The tuberosity of the fifth metatarsal is at the base of the metatarsal. The base of the metatarsal is proximal and the head is distal.
The medial cuneiform is on the high medial side of the transverse arch of the foot. The cuboid bone is on the lower lateral side of the foot.
- The metacarpophalangeal joints are classified as what type of joint?
A. Plane
B. Hinge
C. Condyloid
D. Saddle
Condyloid
Metacarpophalangealjoints are condyloid joints. These are biaxial joints that allow flexion /extension around one axis and abduction /adduction around another axis.
Which muscle would move the abducted (90 degree) arm anteriorly?
A. Sternocostal head of the pectoralis major
B. Clavicular head of the pectoralis major
C. Inferior fibers of the serratus anterior
D. Pectoralis minor
Clavicular head of the pectoralis major
These actions can be easily demonstrated and palpated. Resisting anterior movement of the arm abducted to 60 degrees tests the sternocostal head of the pectoralis major; the clavicular head is tested after the arm is abducted to 90 degrees.
Which one of the following structures does NOT pass through the foramen magnum of the occipital bone?
A. Spinal cord
B. Meninges
C. Cranial nerve XII
D. Vertebral artery
Cranial nerve XII
The structures that pass through the foramen magnum include the spinal cord, the meninges, the spinal components of cranial nerve Xl, and the vertebral arteries. Cranial nerve XII exits the skull through the hypoglossal canals.
Contraction of which muscle produces extension of the head?
A. Spinaliscervicis
B. Longuscapitis
C. Longuscolli
D. Sternocleidomastoid
Spinaliscervicis
The longuscapitis, longuscolli, and sternocleidomastoid muscles are all associated with the anterior aspect of the cervical vertebrae and thus produce flexion of the head.
The nucleus pulposus is thickest in which region of the spine?
A. Lumbar spine
B. Inferior half of the thoracic spine
C. Superior half of the thoracic spine
D. Cervical spine
Lumbar spine
The nucleus pulposus is thickest in the lumbar spine, followed by the cervical region; it is thinnest in the thoracic spine.
The speed of muscle contraction is a function of which of the following factors?
A. Resting length of the muscle fiber
B. Cross-sectional diameter of the muscle
C. Creatine phosphate of the muscle
D. Glycolytic capacity of the muscle
Resting length of the muscle fiber
The speed of contraction is directly related to the resting length of the muscle fiber, whereas the force of contraction depends upon the cross-sectional diameter. Creatine phosphate content ensures availability of ATP for the contraction-relaxation cvcles, and glycolytic capacity is important for endurance.
Which of the following describes the proper normal anatomy of the proximal carpal row, from lateral to medial?
A. Capitate, lunate, triquetrum, pisiform
B. Lunate, trapezium, capitate, hamate
C. Scaphoid, lunate, triquetrum, pisiform
D. Scaphoid, hamate, lunate, capitate
Scaphoid, lunate, triquetrum, pisiform
This is the normal anatomy, lateral to medial of the proximal row of the carpus. The distal row, lateral to medial, is the trapezium, trapezoid, capitate, and hamate.
A therapist is testing key muscles on a patient who recently suffered a spinal cord injury. The current test assesses the strength of the long toe extensors. Which nerve segment primarily innervates this key muscle group?
A. L2
B. L3
C. L4
D. L5
L5
The long toe extensors represent the spinal cord segment L5. The iliopsoas represents L2. The quadriceps are innervated by L3 and the tibialis anterior is innervated by L4.
A physician notes a vertebral fracture in the
x-ray of a patient involved in a car accident. The fractured vertebra has a bifid spinous process.
Which of the following vertebrae is the most likely to be involved?
A. Fourth lumbar vertebra
B. Fifth cervical vertebra
C. Twelfth thoracic vertebra
D. First sacral vertebra
Fifth cervical vertebra
Bifid spinous processes (spinous
processes that are split) are found only in the cervical spine.
If the line of gravity is posterior to the hip joint in standing, on what does the body first rely to keep the trunk from moving into excessive lumbar extension?
A. Iliopsoas muscle activity
B. Abdominal muscle activity
C. Anterior pelvic ligaments and the hip joint capsule
D. Posterior pelvic ligaments and the hip joint capsule
Anterior pelvic ligaments and the hip joint capsule
In static standing, the line of gravity is posterior to the hip joint. The body relies on the anterior pelvic ligaments and the hip joint capsule. The iliopsoas may be recruited at times, but anterior ligaments are used first to keep the trunk from extending in static stance.
What is the closed-packed position of the shoulder?
A. Internal rotation and abduction
B. External rotation and abduction
C. Internal rotation and adduction
D. External rotation and adduction
External rotation and abduction
The area of contact between the humerus and the glenoid fossa is maximal in this position.
A patient with a diagnosis of a rotator cuff tear has just begun active range of motion. The
therapistis strengthening the rotator cuff muscles to increase joint stability and oppose the superior shear of the deltoid. Which of the rotator cuff muscles participate least in opposing the superior sheer force of the deltoid?
A. Infraspinatus
B. Subscapularis
C. Teres minor
D. Supraspinatus
Supraspinatus
The subscapularis, teres minor, and infraspinatus muscles oppose the superior pull of the deltoid muscle. The supraspinatus does not oppose the pull of the deltoid but is important because (along with the other cuff muscles) it provides a compression force to the glenohumeral joint.
What portion of the adult knee meniscus is vascularized?
A. The outer edges are vascularized.
B. The inner edges are vascularized.
C. The entire meniscus is vascular.
D. The entire meniscus is avascular.
The outer edges are vascularized.
Only the edges of the adult meniscus are vascularized by the capillaries from the synovial membrane and joint capsule.
At what age does a human have the greatest amount of fluid in the intervertebral disc?
A. 1 year
B. 4 years
C. 7 years
D. 10 years
1 year
The intervertebral disc has the greatest amount of fluid at the time of birth. The fluid content decreases as a person ages.
Which of the following is not an example of a synarthrodial joint in the body?
A. Coronal suture
B. The fibrous joint between the shaft of the tibia and fibula
C. Symphysis pubis
D. Metacarpophalangeal
Metacarpophalangeal
The metacarpophalange al joint is enclosed in a joint capsule and therefore is considered a diarthrodial joint.
A football player presents to an outpatient clinic with complaints of pain in the right knee after an injury suffered the night before. The phvsician determines that the anterior cruciate ligament (ACL) is torn. Which of the following is most commonly associated with an injury causing damage to the ACL only?
A. Varus blow to the knee with the foot planted and an audible pop
B. Foot planted, medial tibial rotation, and an audible pop
C. Valgus blow to the knee with the foot planted and no audible pop
D. Foot planted, lateral tibial rotation, and no audible pop
Foot planted, medial tibial rotation, and an audible pop
Choice B best describes the position that causes injury only to the ACL. In most cases an audible pop indicates a tear of the ACL. Varus or valgus blows to the knee injure the collateral ligaments and possibly the ACL.
A 27-year-old woman is referred to a physical therapy clinic with a diagnosis of torticollis. The right sternocleidomastoid is involved. What is the most likely position of the patient’s cervical spine?
A. Right lateral cervical flexion and left cervical rotation
B. Right cervical rotation and right lateral cervical flexion
C. Left cervical rotation and left lateral cervical flexion
D. Leftlateral cervical flexion and right cervical rotation
Right lateral cervical flexion and left cervical rotation
Torticollis involving the right sternocleidomastoid would cause right lateral cervical flexion and left cervical rotation.
Observing a patient in a standing position, the therapist notes that an angulation deformity of the right knee causes it to be located medially in relation to the left hip and left foot. This condition is commonly referred to as
A. Genu varum
B. Genu valgum
C. Pescavus
D. None of the above
Genu valgum
Genu valgum is a term used to describe a deformity of the knee causing an inward bowing of the legs. Genu varus is an outward bowing of the legs. Coxavalgum is a deformity at the hip in which the angle between the axis of the neck of the femur and the shaft of the femur is greater than 135 degrees. In coxavarus this angle is less than 135 degrees. Pescavus is an increase in the arch of the foot. Pesplanus is flat foot.
Which of the following is the most vulnerable position for dislocation of the hip?
A. 30 degrees hip extension, 30 degrees
hip adduction, and minimal internal rotation
B. 30 degrees hip flexion, 30 degrees hip adduction, and minimal external rotation
C. 30 degrees hip flexion, 30 degrees hip abduction, and minimal external rotation
D. 30 degrees hip extension, 30 degrees
hip abduction, and minimal external rotation
30 degrees hip flexion, 30 degrees hip abduction, and minimal external rotation
This is the loose-packed position of the
hip. code: FABER 3030slight
Which of the following articulate with the second cuneiform?
A. Navicular
B. Talus
C. First metatarsal
D. Cuboid
Navicular
The second cuneiform of the foot
articulates with the first cuneiform, second metatarsal, third cuneiform, and navicular.
The terms below refer to properties of water that make hydrotherapy valuable to a variety of patient populations. Match the following terms with the statement that best relates to each term.
1. Viscosity
2. Buoyancy
3. Relative density
4. Hydrostatic pressure
I.This property can assist in the prevention of blood pooling in the lower extremities of a patient in the pool above waist level
II. This property makes it harder to walk
faster through water
III. A person with a higher amount of body fat can float more easilvthan a lean person because of this property
IV. This property makes it easier to move a body part to the surface of the water and harder to move a part away from the surface.
A. 1-II, 2-III, 3-IV, 4-I
B. 1-II, 2-IV, 3-III, 4-I
C. 1-111, 2-II, 3-1, 4-IV
D. 1-1. 2-II, 3-I, 4-IV
1-II, 2-IV, 3-III, 4-I
Viscosity is the friction of fluids.
Buoyancy is the property that pushes up on the part immersed with a pressure that is equal to the weight of the amount of water displaced by that part. Relative density states that if the specific gravity of an object is less than one, it will float, and if it is greater than one, it will sink.
Hydrostatic pressure is the property of water that places pressure equally on the immersed part.
A physician ordered a splint for a patient who should keep the thumb of the involved hand in abduction. A new graduate is treating the patient and is confused about the difference between thumb flexion, extension, abduction, and adduction. Which of the following lists is correct?
A. Extension is performed in a plane parallel to the palm of the hand, and abduction is performed in a plane perpendicular to the palm of the hand.
B. Flexion is performed in a plane perpendicular to the palm of the hand, and adduction is performed in a plane parallel to the palm of the hand.
C. Extension is performed in a plane perpendicular to the palm of the hand, and adduction is performed in a plane parallel to the palm of the hand.
D. In referring to positions of the thumb, flexion and adduction are used synonymously, and extension and abduction are used synonymously.
Extension is performed in a plane parallel to the palm of the hand, and abduction is performed in a plane perpendicular to the palm of the hand
Flexion and extension of the thumb are performed in a plane parallel to the palm of the hand. Abduction and adduction are performed in a plane perpendicular to the palm of the hand.
A physical therapist receives an order from the physician to treat a patient using iontophoresis.
The order indicates that the purpose of the treatments to attempt to dissolve a calcium deposit in the area of the Achilles’ tendon.
When preparing the patient for treatment, the therapist connects the medicated electrode to the negative pole. Which of the following medications is the therapist most likelv preparing to administer?
A. Dexamethasone
B. Magnesium sulfate
C. Hydrocortisone
D. Acetic acid
Acetic acid
Acetic acid is sometimes used in
attempts to dissolve a calcium deposit and is driven by the negative pole. Dexamethasone is an anti-inflammatory driven by the negative pole. Magnesium sulfate is used to decrease muscle spasms andis driven by the positive pole. Hydrocortisone is also used to treat inflammation and is driven by the positive pole.
A therapist is assisting a patient in gaining lateral stability of the knee joint. The therapist is using strengthening exercises to strengthen muscle groups that will increase active restraint on the lateral side of the joint. Which of the following offers the least amount of active lateral restraint?
A. Gastrocnemius
B. Popliteus
C. Bicepsfemoris
D. Iliotibial band
Gastrocnemius
The popliteus, biceps femoris, and iliotibial band offer active restraint for the lateral side of the knee joint. The gastrocnemius assists in active restraint of the posterior side of the knee joint.
A patient is in an outpatient facility because of an injury sustained to the right knee joint. Only the structures within the synovial cavity were compromised during the injury. Knowing this information only, the therapist is not concerned with injury to which of the following structures?
A. Patellofemoral ioint
B. Anterior cruciate ligament
C. Medial meniscus
D. Femoral condyles
Anterior cruciate ligament
The anterior cruciate ligament is located within the articular cavity but outside the synovial lining. The anterior and posterior cruciate ligaments have their own synovial lining.
Code: ICES
A patient is being examined by a physical therapist because of bilateral knee pain. The therapist is attempting to rule out ankle or foot dysfunction as the source of the pain. Which of the following observations is not true in examining a patient without foot or ankle problems in the standing position?
A. The talus is situated somewhat medially to the midline of the foot.
B. In quiet standing, the muscles surrounding the ankle joint remain silent.
C. The first and second metatarsal heads bear more weight than the fourth and fifth metatarsal heads.
D. The talus transmits weight to the rest of the bones of the foot.
In quiet standing, the muscles surrounding the ankle joint remain silent.
Plantar flexors have to contract in quiet standing. Other muscles are recruited with movement of the center of gravity.
A physical therapist is examining a female distance runner who complains of intermittent medial ankle pain. In static standing, the therapist palpates excessive lateral deviation of the head of the talus. From this information, in what position is the subtalar joint during palpation?
A. supination
B. Pronation
C. Neutral
D. Unable to determine from the information given
supination
The talus is palpated just anterior and lateral to the medial malleolus. Supination is excessive lateral deviation of the talus, and pronation is excessive medial deviation.
Which of the following is not part of the triangular fibrocartilage complex of the wrist?
A. Dorsal radioulnar ligament
B. Ulnar collateral ligament
C. Radial collateral ligament
D. Ulnar articular cartilage
Radial collateral ligament
The triangular fibrocartilage complex is made up of the dorsal radioulnar ligament, ulnar collateral ligament, ulnar articular cartilage, volar radioulnar ligament, ulnocarpal meniscus, and sheath of the extensor carpi ulnaris.
A physical therapist is attempting to explain the importance of slow stretching to an athlete training to compete in a marathon. The therapist explains that quick stretching often causes the muscle to________ , which is a response initiated by the _______ which are located in the muscle fibers.
A. Relax, Golgi tendon organs
B. Contract, Golgi tendon organs
C. Relax muscle spindles
D. Contract, muscle spindles
Contract, muscle spindles
The muscle spindles are responsible for
the stretch reflex. When a muscle is stretched too quickly, the muscle spindles cause the muscle to contract and shorten (which is called the stretch reflex). The Golgi tendon organs are responsible for the inverse stretch reflex. They are located in the junction between the muscle andtendon and detect changes in tension.
When a tendon is stretched too quickly, the Golgi tendon organs cause the muscle to relax.
What is the normal low-end range for interincisal opening with a TMD patient?
A. 50 mm
B. 30 mm
C. 40 mm
D. 60 mm
40 mm
Forty millimeters is the normal end range of opening.
What is dental trismus?
A. Capsulitis of the TMJ
B. Osteoarthritis of the TMJ
C. Muscle spasm of the TMJ
D. The triggerpoint of the TMJ
Muscle spasm of the TMJ
Dental trismus mav be due to spasm or to abnormally short law muscles. There is an inability to open the jaw fully.
Temporomandibular anterior disc displacement without reduction occurs between the
A. Disc and the lower joint compartment
B. Disc and the ementia articularis
C. Disc and the lateral pterygoid muscle
D. Disc and the upper joint compartment
Disc and the upper joint compartment
The condyle glides anterior translatory down the eminence (26 mm to 50 mm of opening) with the disc in the upper joint compartment. Occasionally the disc is displaced anteriorly, and adhesions may occur that produce an anterior displaced disc without reduction (locked joint).
What are the signs and symptoms of a temporomandibular anterior displaced disc with reduction?
A. Crepitation with loss of opening
B. Clicking with opening
C. No clicking with loss of opening
D. Temporomandibular joint tenderness and loss of opening
Clicking with opening
Reduction indicates that the condvle is able to slide under the disc (reduce), causing a clicking noise.
What is the normal TMJ arthrokinematics for lateral movements?
A. Bilateral translation
B. Bilateral rotation
C. Contralateral rotation and ipsilateral translation
D. Ipsilateral rotation and contralateral translation
Ipsilateral rotation and contralateral translation
Ipsilateral rotation and contralateral translation describe lateral jaw movement.
What is the normal TMJ arthrokinematics for protrusion?
A. Bilateral anterior translation
B. Bilateral posterior translation
C. Ipsilateral rotation with contralateral translation
D. Bilateral rotation
Bilateral anterior translation
Bilateral anterior translation describes
jaw protrusion.
What is the normal TMJ arthrokinematics for wide opening?
A. Bilateral translation
B. Combination of rotation occurs first 26 mm then anterior translation
C. Combination of anterior translation occurs first 26 mm then anterior rotation
D. Bilateral rotation
Combination of rotation occurs first 26 mm then anterior translation
A combination of rotation occurs during the first 26 mm. then anterior translation describes wide jaw opening.
Positioning of a patient in right side-lying can create pressure on the
A. Right ischial tuberosity
B. Left greater trochanter
C. Right lateral malleolus
D. Occiput
Right lateral malleolus
Pressure in right side-lying would create pressure on the right greater trochanter and right lateral mallelous. No pressure is put on the occiput or ischial tuberosity in side-lying.
Ideal postural alignment is influenced by appropriate muscle balance. What
combinations of muscle imbalance would likely contribute to increased anterior pelvic tilt?
A. Short hamstrings and elongated hip flexors
B. Strong anterior abdominals and strong hip flexors
C. Short hip flexors and lengthened anterior abdominals
D. Strong anterior abdominals and strong hip extensors
Short hip flexors and lengthened anterior abdominals
Shortened hip flexors and lengthened anterior abdominals will contribute to an anterior tilt. Choices A and D would create a posterior pelvic tilt, and choice B will likely present with a more neutral position of the pelvis.
A patient presents with anterior knee pain, which of the following cannot be the source of that pain?
A. SYnovium
B. Capsule
C. Patella cartilage
D. Patella bone
Patella cartilage
Patella cartilage cannot be the source of the pain. Every structure in the knee has pain nerve fibers except the articular cartilage.
Anterior cruciate ligament tears do not heal as well as medial collateral ligament tears because
A. The ACL is under greater tension
B. Synovial fluid inhibits ACL healing
C. The MCL is broad and flat allowing better healing
D. There is more motion in the ACL
Synovial fluid inhibits ACL healing
Synovial fluid has been shown to inhibit healing of ligament tissues.
Patellofemoral joint reactive forces are highest with
A. Running
B. Straight leg raises
C. Prolonged sitting
D. Plyometrics
Plyometrics
Jumping (plyometrics) can generate up to 7 times body weight at the patella. Running is next most stressful at 3.5 times body weight.
Rotator cuff tear
A. Is rare under the age of 40
B. Is usually painful
C. Progresses from the bursal side toward the articular side
D. Requires surgical repair
Is rare under the age of 40
Rotator cuff tear is rare under
the age of 40. It can occur from either side and is very common. Cadaver studies confirm that cuff tear is not usually svmptomatic.
Foot drop following total hip arthroplasty most likely indicates
A. Stroke
B. Disc herniation
C. Sciatic laceration
D. Traction neurapraxia
Traction neurapraxia
Traction from operative positioning, retractor placement, or lengthening of the leg leads to most cases of sciatic traction neurapraxia and foot drop.
Sever’s apophysitis
A. Frequently occurs with Achilles tendinitis
B. Is a result of leg length inequality
C. Is not an inflammatory condition
D. Responds to ultrasound treatment
Frequently occurs with Achilles tendinitis
Sever’s apophysitis is a physeal stress injury. Tight Achilles tendons are uniformly seen and frequently there is tendinitis.
Pesplanus
A. Is a painful condition
B. Is common in patients with hyperlaxity
C. Requires orthotics treatment
D. Results in anterior knee pain if not corrected
Is common in patients with hyperlaxity
Pesplanus is common and
usually painless. Hyperlaxity is a powerful risk factor for development of pesplanus. In most cases, no treatment is necessary.
A patient was referred for physical therapy after removal of a long arm cast extending to the forearm. She lacks full passive elbow extension. What may be causing this problem?
A. Active insufficiency of the biceps
B. Tightness in posterior humeroulnar joint capsule
C. Passive insufficiency of the pronator teres
D. Passive insufficiency of the triceps
Passive insufficiency of the pronator teres
Passive insufficiency of the
pronator teres. The question asks specifically about passive limitations to elbow extension.
The pronator teres is a polyarticular muscle crossing anterior to the elbow joint.
A 10 degrees hip flexion contracture produces torque at the hip that increases muscle demand on the
A. Extension, quadriceps
B. Flexion, biceps femoris
C. Abduction, adductor magnus
D. Flexion, iliopsoas
Flexion, biceps femoris
Choice B, flexion, biceps femoris,
is the correct answer. A hip flexion contracture increases flexor torque across the anterior hip.
This increases muscle demand on the hip extensors. The biceps femoris is an extensor of the hip.
The physical therapist is analyzing a patient’s gait with descending stairs. During left single limb stance, the patient demonstrates a right pelvic drop with left trunk lean. The physical therapy hypothesis is
A. Weak right gluteus medius with left trunklean to move center of mass towards stronger side
B. Weak left gluteus medius with left trunk lean to move center of mass towards weaker side
C. Weakleft quadratuslumborum producing left trunk lean
D. Weak right gluteus medius with left trunklean to move center of mass towards stronger side
Weak left gluteus medius with left trunk lean to move center of mass towards weaker side
Weak left gluteus medius with
left trunk lean to move center of mass towards weaker side is the correct hypothesis. A pelvic drop in single limb midstance is a classic positive Trendelenberg sign of gluteus medius weakness. The compensatory trunk laterallean is to bringthe center of mass closer to the weaker side to decrease the external moment arm on the weak muscle.
Left lateral trunk flexion is limited
primarily by
A. The thoracic spine because of sagittal facet alignment
B. The rib cage because of multiple attachments
C. The lumbar spine because of horizontal plane facet orientation
D. The left quadratuslumborum
The rib cage because of multiple attachments
Left lateral trunk flexion is
limited primarily by the rib cage because of multiple attachments. The thoracic spine has frontal plane facet alignment. The lumbar spine facets are oriented in the sagittal plane. The left quadratuslumborum is on slack during left lateral flexion.
Which is true about the hip joint?
A. The hip joint’s closed pack position is extension with full external rotation.
B. The hip joint’s loose pack position is 30 degrees of abduction, 70 degrees of flexion with lateral rotation.
C. With its capsular pattern of restriction, medial rotation is most restricted in the hip joint.
D. With its capsular pattern of restriction, flexion is most restricted in the hip joint.
With its capsular pattern of restriction, flexion is most restricted in the hip joint.
According to Cyriax’s classical description, flexion in the hip is limited to the greatest in its capsular pattern.
A physical therapist is conducting a screen for visual field deficits by having the client look straight ahead and presenting a stimulus at the outer margins of the person’s visual fields. The examination technique checks cranial nerves)
function.
A. II
B. III, IV, VI
C. V
D. VIII
II
Of the choices listed, cranial
nerve Il or the optic nerve functions to constrict the pupil and vision. Ischemia, resulting from stroke or head injury, or pressure from tumors can adversely affect the function of the nerve.
Visual field loss depends on the location of the lesion. A lesion occurring before the optic chiasm results in loss of vision in the fields on the same side. After the optic chiasm, a lesion will cause loss of vision in both fields. The visual field affected will be opposite to the side of the lesion and is also known as homonymous hemianopsia.
The next patient on your schedule is a
69-year-old Asian woman with a diagnosis of
“T8 fracture.” What condition are you most concerned with for this patient?
A. Neckpain
B. Myopathy
C. Dizziness
D. Osteoporosis
Osteoporosis
Risk factors for osteoporosis
include advanced age, being thin, positive family history, exposure to certain medications, and ancestry (Caucasian or Asian).
Which of the following are not appropriate interventions for a patient with osteoporosis and a T8 compressions fracture?
A. Balance exercises
B. Postural exercises
C. Proprioceptive training
D. Ultrasound
Ultrasound
Physical therapy intervention
for individuals with osteoporosis has several goals: optimization of bone formation, fall prevention, fracture prevention, postfracture rehabilitation, and treatment of musculoskeletal conditions that place the individual at risk for falls in the future. Ultrasound is contraindicated over a fracture site.
A patient is suffering from chronic back pain as a result of a recent automobile accident.
He is currently taking an opioid medication for reliefof this pain. Which of the following medications is an opioid?
A. Ibuprofen
B. Aspirin
C. Codeine
D. Acetaminophen
Codeine
Opioids belong to a class of
drugs that provide pain relief by binding to opioid receptors. Ibuprofen and aspirin are nonsteroidal anti-inflammatory (NSAID) medications, while acetaminophen is in a class of its own; however, none of these three medications bind to opioid receptors.
An athlete has been complaining of muscle spasms. Her physician decided to treat herwith a medication called cyclobenzaprine, which is a muscle relaxant. She is unfamiliar with this medication and asks if you can tellher anything about it. Which of the following is a correct statement?
A. There are no such medications as muscle relaxants.
B. Muscle relaxants are the same thing as anti-inflammatory medications.
C. Drowsiness, blurred vision, and dry mouth are some of the side effects of muscle relaxants.
D. You cannot overdose on muscle relaxants.
Drowsiness, blurred vision, and dry mouth are some of the side effects of muscle relaxants.
Drowsiness, blurred vision, and
dry mouth are side effects of the anticholinergic properties that muscle relaxants possess. These side effects are also the ones patients complain about most often.
All NSAIDs inhibit manner or another.
A. Bradykinin
B. Cyclooxygenase (COX)
C. Prostaglandins
D. Lipoxygenase
Cyclooxygenase (COX)
All NSAIDs inhibit the enzyme
cyclooxygenase (COX), thereby decreasing the inflammatory reaction.
Which NSAID has been used because of
its lower incidence of GI complications?
A. Naproxen
B. Aspirin
C. Ketoprofen
D. Celecoxib
Celecoxib
Celecoxib is unique from the
other NSAIDs in that it specifically inhibits COX-
2. One of the most worrisome side effects of NSAIDs is the potential for ulcers since nonselective COX inhibitor NSAIDs block the production of prostaglandins that provide a protective effect against acids in the stomach.
COX-2 specific NSAIDs do not inhibit the production of these protective prostaglandins.
