Fortinberry - Chapter 2 (PT Apps) Flashcards by Ralph Liam Yulo

A patient who suffered a myocardial infarction is participating in an exercise test. The therapist notes ST-segment depression of 1.7 mm on the patient’s current rhythm strip. What is the most appropriate course of action?

a. Stop the exercise session immediately and send the patient to the emergency room
b. Continue with the exercise session
c. Contact the patient’s cardiologist about continuing the exercise
d. Stop the exercise session to take the patient’s heart rate and blood pressure

b. Continue with the exercise session

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The therapist is treating a patient who received an above-elbow amputation 2 years ago. The prosthesis has a split cable that controls the elbow and the terminal device. With this type of prosthesis, the patient must first lock the elbow to allow the cable to activate the terminal device. This is accomplished with what movements?

a. Extending the humerus and elevating the scapula
b. Extending the humerus and retracting the scapula
c. Extending the humerus and protracting the scapula
d. Extending the humerus and depressing the scapula

d. Extending the humerus and depressing the scapula

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A physical therapist is treating a patient who is participating in cardiac rehabilitation. Because the patient complains of chest pain, the therapist attempts to assess heart sounds with a stethoscope. Which of the following is true about the first sound during auscultation of the heart?

a. The first sound is of the closure of the aortic and pulmonic valves
b. The first sound is of the closure of the mitral and tricuspid valve
c. The first sound is of the beginning of ventricular diastole
d. The first sound is usually the loudest

b. The first sound is of the closure of the mitral and tricuspid valve

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A 53-year-old man with chronic obstructive pulmonary disease reports to an outpatient cardiopulmonary rehabilitation facility. Pulmonary testing reveals that forced expiratory volume in 1 second (FEV1) and vital capacity (VC) are within 60; of predicted values. What is the appropriate exercise prescription?

a. Exercise at 75-80 of the target heart rate 3 times/week
b. Begin exercise with levels of 1.5 METs and increase slowly 3 times/week
c. Exercise to 75 to 80 of the target heart rate 7 times/week
d. Begin exercise with levels of 1.5 METs and increase slowly 7 times/week

d. Begin exercise with levels of 1.5 METs and increase slowly 7 times/week

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A patient reports throbbing pain in the lower extremities accompanied by trophic changes and diminished pulses. What source of pain is most likely responsible for these complaints?

Peripheral neuropathy
Restless leg syndrome
Vascular pain
Neurogenic pain

Vascular pain

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Whiplash injury from a rear-end collision would tear which of the following ligaments?

PLL
ALL
Ligamentum nuchae
Ligamentum flavum

ALL

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A physical therapist is working with a patient who has COPD. If the patient’s level of oxygen being carried by arterial blood pressure is measured, a PaO2 finding of ________ is considered normal.

35-45 mmHg
60-80 mmHg
80-100 mmHg
100-120 mmHg

80-100 mmHg

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Where is the most common site of fracture in osteoporosis?

Metacarpals
Skull
Proximal radius
Vertebral bodies

Vertebral bodies

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Which one of the following conditions is characterized by reduced osteoclastic bone resorption?

Paget’s disease of the bone
Osteoporosis
Osteopetrosis
Osteomalacia

Osteopetrosis

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Which of the following conditions is descriptive of osteoarthritis?

a. It provokes giant cell pigmented villonodular synovitis
b. It is associated with decreased type II collagen, cytokines, and chondrolysis
c. Ankylosis and follicular inflammation are predominant
d. It is associated with increased cartilage matrix synthesis and deposition

b. It is associated with decreased type II collagen, cytokines, and chondrolysis

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An overweight 12-year-old presents with hip pain and weight-bearing difficulties. These symptoms presented rapidly following physical activity. On examination, limping is observed and PROMs are limited and painful. Which of the following is the most probable diagnosis?

Legg-Calve-Perthes disease
Transient hip synovitis
Congenital hip dysplasia
Slipped femoral capital epiphysis

Slipped femoral capital epiphysis

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A defining symptoms of fibromyalgia is

Fatigue
Diffuse pain
Regional pain
Unexplained weight loss

Diffuse pain

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Morton’s neuroma is usually located between which metatarsal heads?

First and second
Second and third
Third and fourth
Fourth and fifth

Third and fourth

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A 50-year-old, slightly obese man presents with a 1-month history of right hip pain without radiation, a protective limp, and activity-induced symptoms. He improves with rest and has some mild morning stiffness. Examination reveals restricted and painful internal rotation of the hip. What is the most likely diagnosis?

Inflammatory arthritis
Osteoarthritis
Osteoporotic hip fractures
Iliopsoas tendinosis

Osteoarthritis

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What is the most common myofascial pain syndrome of the low back?

Piriformis
Quadratus lumborum
Iliopsoas
Tensor fascia latae

Quadratus lumborum

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What shoulder view best demonstrates the greater tubercle?

ER
IR
Baby arm
Transthoracic

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The Waddell test are used to identify

Pain of a non-organic origin
Space-occupying lesions
Balance and coordination functions
History of alcohol or substance abuse

Pain of a non-organic origin

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While assessing the standing posture of a patient, the therapist notes that a spinous process in the thoracic region is shifted laterally. The therapist estimates that the T2 is involved vertebra because he/she notes that it is the approximate level of the

Inferior angle of the scapula
Superior angle of the scapula
Spine of the scapula
Xiphoid process of the sternum

Superior angle of the scapula

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While ambulating a stroke patient (the right side is the involved side), the therapist notes increased circumduction of the right lower extremity. Which of the following is an unlikely cause of this deviation?

Increased spasticity of the right gastrocnemius
Increased spasticity of the right quadriceps
Weak hip flexors
Weak knee extensors

Weak knee extensors

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The therapist is treating a 52-year-old woman after right total hip replacement. The patient complains of being self-conscious about a limp. She carries a heavy briefcase to and from work everyday. The therapist notes a Trendelenburg gait during ambulation on level surfaces. What advice can the therapist give to the patient to minimize gait deviation?

a. Carry the briefcase in the right hand
b. Carry the briefcase in the left hand
c. The patient should not carry a briefcase at all
d. It does not matter in which hand the briefcase is carried

a. Carry the briefcase in the right hand

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Which of the following actions places the greatest stress on the patellofemoral joint?

a. When the foot first contacts the ground during gait cycle
b. Exercising on a stair-stepper machine
c. Running down a smooth decline of 30 degrees
d. Squats to 120 degrees of knee flexion

d. Squats to 120 degrees of knee flexion

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While observing the ambulation of a 57-year-old man with an arthritic right hip, the therapist observes a right lateral trunk lean. Why does the patient present with this gait deviation?

a. To move weight toward the involved hip and increase joint compression force
b. To move weight toward the uninvolved hip and decrease joint compression force
c. To bring the line of gravity closer to the involved hip joint
d. To take the line of gravity away from the involved hip joint

c. To bring the line of gravity closer to the involved hip joint

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A therapist has been treating a patient who received a rotator cuff surgical repair with sessions consisting only of PROMs (for an extended period). The patient has just returned from a follow-up doctor’s visit with an additional order to continue with PROM only. Which of the following is the best course of action for the therapist?

a. Continue with PROM as instructed, and call the physician to consult with him or her about the initiation of AROM
b. Begin AROM within the pain-free range, and continue PROM
c. Continue PROM and do not question the physician’s decision
d. Perform PROM and any other exercise that is within the normal protocol for this diagnosis

a. Continue with PROM as instructed, and call the physician to consult with him or her about the initiation of AROM

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A patient’s lawyer calls the therapist requesting his/her client’s clinical record. The lawyer states that he/she needs the records to pay the patient’s bill. What is the best course of action?

a. Tell the lawyer either to have the patient request a copy of the record or to have the patient sign a medical release
b. Fax the needed chart to the lawyer
c. Mail a copy of the chart to the patient
d. Call the patient and tell him/her of the recent development

a. Tell the lawyer either to have the patient request a copy of the record or to have the patient sign a medical release

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A 35-year-old woman with a diagnosis of lumbar strain has a physician’s prescription with a frequency and duration of 3 sessions/week for 6 weeks. The physical therapy examination reveals radiculopathy into the L5 dermatome of the right lower extremity, increased radiculopathy with lumbar flexion, decreased radiculopathy with lumbar extension, poor posture, and hamstring tightness bilaterally at 60 degrees. What is the best course of treatment? a. Lumbar traction, hot packs, and ultrasound b. McKenzie style lumbar extensions, a posture program, hamstring stretching, and a home exercise program c. McKenzie style lumbar extensions, a posture program, hamstring stretching, home program, hot packs, and ultrasound d. Lumbar traction, hot packs, ultrasound, and hamstring stretching

b. McKenzie style lumbar extensions, a posture program, hamstring stretching, and a home exercise program

Which of the following does the therapist observe if a patient is correctly performing an anterior pelvic tilt in standing position? a. Hip extension and lumbar flexion b. Hip flexion and lumbar extension c. Hip flexion and lumbar flexion d. Hip extension and lumbar extension

b. Hip flexion and lumbar extension

At what point in the gait cycle is the center of gravity the lowest? Double support Terminal swing Deceleration Midstance

Double support

A 14-year-old girl with right thoracic scoliosis is referred to physical therapy. The therapist should expect which of the following findings? a. Left shoulder high, left scapula prominent, and right hip high b. Left shoulder low, right scapula prominent, and left hip high c. Right shoulder high right scapula prominent, and right hip high d. Right shoulder low, right scapula prominent, and left hip high

b. Left shoulder low, right scapula prominent, and left hip high

A posterolateral herniation of the lumbar disc between vertebrae L4 and L5 most likely results in damage to which nerve root? L4 L5 L4 and L5 L5 and S1

What is the most likely cause of anterior pelvic tilt during initial contact (heel strike)? Weak abdominals Tight hamstrings Weak abductors Back pain

Weak abdominals

During examination of a patient, the therapist observes significant posterior trunk lean at initial contact (heel strike). Which of the following is the most likely muscle that the therapist needs to focus on during the exercise session in order to minimize this gait deviation? Gluteus medius Gluteus maximus Quadriceps Hamstrings

Gluteus maximus

A patient presents to an outpatient physical therapy clinic with a 140 degrees kyphoscoliotic curve. What is the therapist’s greatest concern? The patient's complaint of low back pain Gait deviations Pulmonary status Poor upright standing posture

Pulmonary status

After performing an examination, a therapist notes the following information: * severe spasticity of PF in the involved lower extremity, * complete loss of active DF in the involved lower extremity, * minimal spasticity between 0-5 degrees of DF with increased spasticity when the ankle is taken into more than 5 degrees of DF. Which AFO is most likely contraindicated for the patient, an 87-year-old man who had a stroke 4 weeks ago? DF spring assist AFO Posterior leaf spring AFO Hinged AFO Spiral AFO

DF spring assist AFO

The therapist is performing an orthopedic test on a 25-year-old man with the chief complaint of low back pain. The patient has a positive Thomas test. With this information, what might the therapist need to include in the treatment? Stretching of the hip ABD Stretching of the hip ADD Stretching of the hip extensors Stretching of the hip flexors

Stretching of the hip flexors

A patient is positioned by the therapist with the cervical spine rotated to the right, The patient then extends the neck as the therapist externally rotates and extends the right upper extremity. The patient is then instructed to hold a deep breath. The radial pulse is palpated in the right upper extremity by the therapist. What type of special test is this and for what condition? Adson’s maneuver, cervical disc herniation Lhermitte's sign, cervical disc herniation Adson’s maneuver, TOS Lhermitte’s sign, TOS

Adson’s maneuver, TOS

The therapist observes a patient with the latter stages of Parkinson’s disease during ambulation. Which of the following characteristics is the therapist most likely observing? Shuffling gait Increase step width Wide base of support Increased cadence especially at the onset of gait

Shuffling gait

A therapist is assessing radial deviation ROM at the wrist. The correct position of the goniometer should be as follows: the proximal arm is aligned with the forearm and the distal arm is aligned with the third metacarpal. What should be used as the axis point? Lunate Scaphoid Capitate Triquetrum

Capitate

A therapist is examining the gait pattern of a patient and notes that the pelvis drops inferiorly on the right during the mid swing phase of the right lower extremity. The patient also leans laterally to the left with the upper trunk during this phase. Which of the following is the most likely cause of this deviation? Weak right gluteus medius Weak right adductor longus Weak left gluteus medius Weak left adductor longus

Weak left gluteus medius

The therapist is performing an orthopedic test that involves * (1) placing the patient in a side-lying position, * (2) placing the superior lower extremity in hip extension and hip abduction, * (3) placing the knee of the superior lower extremity in 90 degrees of flexion, and * (4) allowing the superior lower extremity to drop into adduction. Failure of the superior lower extremity to drop indicates a tight Iliopsoas Rectus femoris Iliotibial band Hamstring

Iliotibial band

The therapist is assessing a patient’s strength in the right shoulder. The patient has 0 degrees of active shoulder ABD in the standing position. In the supine position, the patient has 42 degrees of active shoulder ABD and 175 degrees of pain-free passive shoulder ABD. What is the correct manual muscle testing grade for the patient’s ABD? 3-/5 (fair -) 2+/5 (poor +) 2-/5 (poor -) 1/5 (trace)

2-/5 (poor -)

A therapist is examining a patient with poor motor coordination. The therapist observes that when the patient is standing erect and still, she does not respond appropriately when correcting a backward sway of the body. With the body in a fully erect position, a slight backward sway should be corrected by the body firing specific muscles in a specific order. Which list if the correct firing order a. Bilateral abdominals, bilateral quadriceps, bilateral tibialis anterior b. Bilateral abdominals, bilateral tibialis anterior, bilateral quadriceps c. Bilateral tibialis anterior, bilateral abdominals, bilateral quadriceps d. Bilateral tibialis anterior, bilateral quadriceps, bilateral abdominals

d. Bilateral tibialis anterior, bilateral quadriceps, bilateral abdominals

A physical therapist is performing a functional capacity evaluation on a patient with a L4-L5 herniated disc. Part of the evaluation consists of performing floor to waist lifts using 30 pounds as resistance. During the first trial, the physical therapist notices that the patient exhibits decreased anterior pelvic tilt. What should the physical therapist do during the second trial? a. The therapist should correct the deviation verbally before the lift b. The therapist should correct the deviation with manual contact during the lift c. The therapist should correct the deviation both verbal and manual during the lift d. The therapist should not attempt to correct the lift

d. The therapist should not attempt to correct the lift

A physical therapist is examining a patient with muscular dystrophy. The patient seems to “waddle” when she walks. She rolls the right hip forward when advancing the right lower extremity and the left hip forward when advancing the left lower extremity. Which of the following gait patterns is the patient demonstrating? Gluteus maximus gait Dystrophic gait Arthrogenic gait Antalgic

Dystrophic gait

A 48-year-old woman is being examined by a physical therapist. Her diagnosis is right rotator cuff tendinitis. She reports right shoulder weakness and pain for the past 2 months. The patient describes “pins and needles” over the lateral right shoulder and upper extremity, extending into the thumb. She also reports no causative trauma. Manual muscle testing in the RIGHT upper extremity reveals the following data: * flexion = ⅘, * extension = ⅗, * ABD = ⅗, * ADD = ⅘, * IR = ⅗, and * ER = ⅗ Manual muscle testing in the LEFT upper extremity reveals the following data: * flexion = ⅘, * extension = 5/5, * ABD = 5/5, * ADD = ⅘, * IR = ⅘, and * ER = ⅘ Active and passive shoulder range of motion is within normal limits and equal bilaterally. All thoracic outlet tests are negative. All shoulder special tests are negative. Which of the following steps would most likely assess the source of the patient’s problem? Elbow strength and ROM testing Grip strength testing Cervical spine testing Scapular muscle strength testing

Cervical spine testing

A patient is in a prone position with this head rotated to the left side. The left upper extremity is placed at this side and fully internally rotated. The left shoulder is then shrugged toward the chin. The therapist then grasps the midshaft of the patient’s left forearm. The patient is then instructed to “try to reach your feet using just your left arm”. This movement is resisted by the therapist. This test is assessing the strength of what muscle? Upper trapezius Posterior deltoid Latissimus dorsi Triceps brachii

Latissimus dorsi

A therapist is screening a patient complaining of pain at the anterior left shoulder region. The pain is increased when the examiner instructs the patient to position the left arm by his side with the elbow flexed at 90 degrees and to actively supinate the forearm against resistance (provided by the examiner). What test is being performed? Froment’s sign Yergason’s test Waldron test Wilson test

Yergason’s test

A therapist is examining a patient with traumatic injury to the left hand. The therapist asks the patient to place the left hand on the examination table with palm facing upward. The therapist then holds the second, third, and fifth digits in full extension. The patient is then asked to flex the fourth digit. What movement would be expected by a patient with an uninjured hand, and what muscle or muscles is the therapist restricting? a. The fourth finger would flex at the DIP joint only, and the muscle being restricted would be the flexor digitorum superficialis b. The fourth finger would flex at the PIP joint only, and the muscle being restricted would be the flexor digitorum profundus c. The fourth finger would flex at the DIP joint only, ant the muscles being restricted would be the lumbricals d. The fourth finger would flex at the PIP joint only, and the muscles being restricted would be the palmar interosseous

b. The fourth finger would flex at the PIP joint only, and the muscle being restricted would be the flexor digitorum profundus

Which of the following is the normal end-feel perceived by an examiner assessing wrist flexion? Bone to bone Soft tissue approximation Tissue stretch Empty

Tissue stretch

A patient with decreased function of the gluteus minimus is referred to physical therapy for gait training. During the examination, the therapist places the patient in a prone position and instructs the patient to extend the hip. Knowing that the gluteus minimus is extremely weak, which of the following is most likely to happen? a. The patient will abduct the hip more than usual when attempting to perform hip extension b. The patient will externally rotate the hip excessively when attempting to perform hip extension c. The patient will be excessively flex the knee when attempting to perform hip extension d. The patient will not have difficulty performing straight hip extension

b. The patient will externally rotate the hip excessively when attempting to perform hip extension

A physical therapist is beginning an examination of a patient with a diagnosis of “knee strain”. ROM limitation does not follow the normal capsular pattern of the knee. Which of the following are possible causes of the restriction in range of motion? Ligamentous adhesions Internal derangement Extra-articular lesions All of the above

All of the above

Which of the following statements best describes lower extremity positioning in standing during the first 2 years of a child with no dysfunction? a. Femoral anteversion, femoral external rotation, foot pronation b. Femoral anteversion, femoral internal rotation, foot supination c. Femoral retroversion, femoral external rotation, foot pronation d. Femoral retroversion, femoral internal rotation, foot supination

a. Femoral anteversion, femoral external rotation, foot pronation

A patient is placed in a supine position with the knee in 90 degrees of flexion. The foot is stabilized by the therapist’s body on the examination table. The therapist then wraps his fingers around the proximal tibia so that the thumbs are resting along the anteromedial and anterolateral margins. The therapist then applies a force to pull the tibia forward. What special test is being performed? Pivot shift Lachman’s test Anterior drawer Posterior drawer

Anterior drawer

A therapist is examining a patient who complains of frequent foto, ankle, and knee pain. The therapist asks the patient to assume a standing position with the knees slightly flexed. The therapist then demonstrates active bilateral foot pronation to the patient. When asked to perform this task, the patient has difficulty. Which of the following limitations is a possible cause of the patient's difficulty in performing this task? a. Restriction limiting plantar flexion and lateral rotation of the talus b. Restriction limiting dorsiflexion and medial rotation of the talus c. Restriction limiting eversion of the calcaneus and medial rotation of the talus d. Restriction limiting inversion of the calcaneus and lateral rotation of the talus

c. Restriction limiting eversion of the calcaneus and medial rotation of the talus

Of the following, which is the earliest period after surgery that an 18-year-old boy who received an uncomplicated partial meniscectomy of the right knee can perform functional testing, such as a one-leg hop test, for distance? 1 week p-surgery 2 weeks p-surgery 6 weeks p-surgery 12 weeks p-surgery

6 weeks p-surgery

A patient presents to therapy with an ankle injury. The therapist has determined that the injury is at the junction of the distal tibia and fibula. Which of the following functions the most in preventing excessive external rotation and posterior displacement of the fibula? Anterior inferior tibiofibular ligament Posterior inferior tibiofibular ligament Interosseous membrane Long plantar ligament

Anterior inferior tibiofibular ligament

A therapist is beginning an examination of a 34-year-old woman with a diagnosis of carpal tunnel syndrome. Part of the evaluation consists of grip strength testing. To accurately test the strength of the flexor digitorum profundus, where should the grip dynamometer’s adjustable handle be placed? a. 1 inch from the dynamometer’s non-adjustable handle b. 3 inches from the dynamometer’s non-adjustable handle c. 1.5 inches from the dynamometer’s non-adjustable handle d. 4 inches from the dynamometer’s non-adjustable handle

b. 3 inches from the dynamometer’s non-adjustable handle

A physical therapist is examining a patient who complains of posterior ankle pain. The patient is positioned prine with the feet extended over the edge of the mat. The therapist squeezes the involved gastrocnemius over the middle third of the muscle belly. What test is the therapist performing? What indicates a positive test? Thompson’s test, PF of the ankle Homan’s test, PF of the ankle Thompson’s test, no ankle movement Homan’s test, no ankle movement

Thompson’s test, no ankle movement

Which of the following is the correct method to test for interossei muscle tightness of the hand? a. Passively flex the PIP joints with the MP joints extension, then passively flex the PIP joints with the MP joints in flexion. Record the difference in PIP joint passive flexion b. Passively extend the PIP with the MP joints in flexion. Record the difference in PIP joint passive flexion c. Passively flex the PIP joints with the MP joints in extension, then passively extend the PIP joints with the MP joints in flexion. Record the difference in PIP joint passive flexion d. Passively extend the PIP joints with the MP joints in extension, then passively flex the PIP joints with the MP joints in flexion. Record the difference in PIP joint passive flexion

a. Passively flex the PIP joints with the MP joints extension, then passively flex the PIP joints with the MP joints in flexion. Record the difference in PIP joint passive flexion

When ambulating on uneven terrain, how should the subtalar joint be positioned to allow forefoot rotational compensation? a. The subtalar joint should be placed in pronation b. The subtalar joint should be placed in supination c. The subtalar joint should be placed in a neutral position d. The position of the subtalar joint does not influence forefoot compensation

a. The subtalar joint should be placed in pronation

A physical therapist is examining a 17-year-old distance runner with complaints of lateral knee pain. During the evaluation, the therapist performs the following test: the patient is placed in supine position with the hip flexed to 45 degrees and the knee to 90 degrees. The therapist then places firm pressure over the lateral femoral epicondyle and extends the patient’s knee. Pain is felt by the patient at the point of palpation when the knee is 30 degrees from full knee extension. The positive result of this suggests which of the following structures as the source of pain? Iliotibial band Biceps femoris Quadriceps Lateral collateral ligament

Iliotibial band

A physical therapist begins gait training for a patient with bilateral knee flexion contractures at 30 degrees at a long-term facility. The therapist knows that the patient will have a forward trunk lean during gait because the patient’s line of gravity Is anterior to the hip Is anterior to the knee Is posterior to the ankle Is posterior to the hip

Is posterior to the hip

What motion takes place at the lumbar spine with the right lower extremity single limb support during the gait cycle? Left lateral flexion Right lateral flexion Extension Flexion

Right lateral flexion

An outpatient physical therapist is gait-training a patient recently discharged from the hospital. The inpatient therapist's notes describe a decrease in the left stride length due to pain with weight bearing on the right lower extremity. The outpatient therapist knows that the patient’s gait deviation is an abnormally short a. Distance from the left heel strike and the successive right heel strike b. Amount of time between the left heel strike and the successive right heel stroke c. Amount of time in stance phase on the left lower extremity d. Distance between the left heel strike and the successive heel strike

d. Distance between the left heel strike and the successive heel strike

In the terminal swing phase of gait, what muscles of the foot and ankle are active? Extensor digitorum longus Gastrocnemius Tibisalis posterior Flexor hallucis longus

Extensor digitorum longus

A physical therapist is beginning a gait examination. During heel strike to foot flat on the right lower extremity, which of the following does not normally occur? a. The left side of the pelvis initiates movement in the direction of travel b. The right femur medially rotates c. The left side of the thorax initiates movement in the direction of travel d. The right tibia medially rotates

b. The right femur medially rotates

When the knee is at its maximal amount of flexion during the gait cycle, which of the following muscles are active concentrically? Hamstrings Gluteus maximus Gastrocnemius Flexor hallucis longus

Hamstrings

When comparing the gait cycle of young adults to the gait cycle of older adults, what would a therapist expect to find? a. The younger population has a shorter step length b. The younger population has a shorter stride length c. The younger population has a shorter period of double support d. The younger population has a decrease in speed of ambulation

c. The younger population has a shorter period of double support

A therapist is treating a patient with venous insufficiency ulcer over the medial malleolus. The wound is moist and not infected. The involved lower extremity is swollen, and the patient reports no pain around the wound. The physician has ordered wound care 3 times/week. Which of the following should be used in intervention of this wound? Warm whirlpool Sharp debridement Intermittent compression pump Hot packs to the wound

Warm whirlpool

A physical therapy examination of an infant with osteogenesis imperfecta should include all of the following except Pain Passive ROM Caregiver’s handling Active functional movement

Passive ROM

During therapy, a patient with Parkinson’s disease on levodopa/carbidopa therapy might experience all of the following except The “off” phase Dizziness Involuntary movements Marked bradycardia

Marked bradycardia

The alar ligament stress test is considered positive if Laxity is felt in neutral Laxity is felt in extension Laxity is felt in flexion Laxity is felt in both flexion and extension

Laxity is felt in both flexion and extension

A springy block end-feel in a joint is indicative of Normal end feel An inflamed capsule A meniscal tear An unstable joint

A meniscal tear

A physical therapist is examining a patient reporting knee pain. The patient is positioned in a prone position, and the physical therapist passively flexes the knee to end range. Based on the examination technique, which of the following structures would not be expected to limit movement? Joint capsule Vastus intermedius Sciatic nerve Rectus femoris

Sciatic nerve

A physical therapist is assessing the posture of a 12–year-old female with cystic fibrosis. All of the following are common postural abnormalities except Thoracic kyphosis Forward head posture Scapular retraction Cervical lordosis

Scapular retraction

A child loses balance and falls down whenever she tries to catch a ball thrown in her direction; otherwise, the child can sit, stand, and walk well. The physical therapist would determine that the child has a problem with Development of higher-level balance skills Protective reactions Anticipatory postural control Labyrinthine head righting

Anticipatory postural control

A grasp that is often used to control tools or other objects is the Hook grasp Power grasp Lateral pinch Tip pinch

Power grasp

Nerve conduction velocity/EMG studies of motor nerves are not able to differentiate a. Peripheral nerve disease from anterior horn cell disease b. The specific location cord, nerve, root, plexus, or peripheral nerve c. Neuromuscular junction disease from peripheral nerve disease d. The specific cause or nature of the neural lesion

d. The specific cause or nature of the neural lesion

Which impairment occurs in carpal tunnel syndrome? a. Atrophy of the hypothenar eminence b. Paresthesias over the dorsal aspect of the hand c. Decreased resisted thumb abduction d. Decreased resisted forearm pronation

c. Decreased resisted thumb abduction

What is the difference in testing motor function when examining for a nerve root deficit versus a peripheral nerve deficit? a. In peripheral nerve deficit, the motor weakness is evident more rapidly when applying resistance compared with nerve root deficit b. In nerve root deficit, the motor weakness is evident more rapidly when applying resistance compared with peripheral nerve deficit c. In peripheral nerve deficit, the motor weakness is only evident when applying resistance without gravity d. In nerve root deficit, the motor weakness is only evident when applying resistance without gravity

a. In peripheral nerve deficit, the motor weakness is evident more rapidly when applying resistance compared with nerve root deficit

The L4 deep tendon reflex is elicited at the Achilles tendon Femoral tendon Medial hamstring tendon Patella tendon

Patella tendon

A 25-year-old football player fell on his shoulder vertically and violently stretched his neck in the opposite direction. He was later diagnosed with a brachial plexus injury (Erb-Duchenne paralysis). His arm is hanging at his side in medial rotation in the “waiter’s tip” position. What results are expected from the neurologic examination? a. Paralysis of the deltoid, triceps, wrist extensors (long and short carpi radialis), and finger extensors b. Paralysis of all intrinsic muscles of the hand, flexor muscles (claw hand), loss of sensation over C8-T1 dermatomes, and Horner’s syndrome c. Hypesthesia over C5-C6 and weakness of the deltoid, supraspinatus, and infraspinatus, biceps and brachioradialis muscle d. Klumpke paralysis caused by forced hyperabduction of the arm

c. Hypesthesia over C5-C6 and weakness of the deltoid, supraspinatus, and infraspinatus, biceps and brachioradialis muscle

A patient presents to an outpatient physical therapy clinic with a severed ulnar nerve of the right upper extremity. What muscle is still active and largely responsible for the obvious hyperextension at the MCP joints of the involved hand? Dorsal interossei Volar interossei Extensor carpi radialis brevis Extensor digitorum

Extensor digitorum

A patient presents to an outpatient facility with complaints of pain in the groin area (along the medial left thigh). With manual muscle testing of the involved lower extremity, a therapist determines the following: hip flexion = 4/5, hip extension = 4/5, hip adduction = 2/5, hip internal rotation = 2/5, and hip external rotation = 2/5. Which nerve on the involved side is most likely injured? Lateral cutaneous nerve of the upper thigh Obturator nerve Femoral nerve Ilioinguinal nerve

Obturator nerve

A tennis player receives a surgical repair of the annular ligament. Where should the therapist expect to note the most edema? Radial ulnar joint Olecranon bursa Ulnohumeral joint Lateral triangle

Lateral triangle

In the geriatric population, __ usually occurs after __ is present. a. Spondylolisthesis, spondylosis b. Spondylolysis, spondylolisthesis c. Spondyloschisis, spondylolysis d. Spondylolisthesis, spondyloschisis

a. Spondylolisthesis, spondylosis

A mother comes to a therapist concerned that her 4-month-old infant cannot sit up alone yet. Which of the following responses is the most appropriate for the therapist? a. “Your infant probably needs further examination by a specialist because, although it varies, infants can usually sit unsupported at 2 months of age” b. “Your infant probably needs further examination by a specialist because, although it varies, infants can usually sit unsupported at 3 months of age”. c. “Your infant probably needs further examination by a specialist because, although it varies, infants can usually sit unsupported at 8 months of age”. d. “This is probably nothing to be concerned about because, although it varies, most infants can sit unsupported at 5 months of age”.

c. “Your infant probably needs further examination by a specialist because, although it varies, infants can usually sit unsupported at 8 months of age”.

A patient presents to an outpatient clinic with complaints of shoulder pain. The therapist observes a painful arc between 70 degrees and 120 degrees of active abduction in the involved shoulder. This finding is most indicative of what shoulder pathology? Rotator cuff tear Acromioclavicular joint separation Impingement Labrum tear

Impingement

A patient is referred to the therapist with a diagnosis of arthritis. What type of arthritis would the therapist expect if the patient presented with the following signs and symptoms? (1) Bilateral wrists and knees are involved, (2) pain at rest and with motion, (3) prolonged morning stiffness, and (4) crepitus. a. The patient has osteoarthritis. b. The patient has rheumatoid arthritis. c. The patient has degenerative joint disease. d. It is not possible to determine with the given information.

b. The patient has rheumatoid arthritis.

A physical therapist is assessing a 40-year-old man’s balance and coordination. The following instructions are given to the patient: “Stand normally, with your eyes open. After fifteen seconds, close your eyes and maintain a normal standing posture.” Several seconds after closing his eyes, the patient nearly falls. What type of test did the patient fail? Postural sway test Nonequilibrium test Romberg test One-legged stance test

Romberg test

A physical therapist is performing electromyographic testing. During a maximal output test of the patient’s quadricep muscle, 25 of the motor unit action potential is polyphasic. What is the significance of this finding? a. It is normal in the quadricep b. It is normal in the triceps brachii, not in the quadricep c. It is normal in the biceps brachii, not in the quadricep d. It is abnormal in any muscle

d. It is abnormal in any muscle

A physical therapist is ordered to examine a patient in the late stages of amyotrophic lateral sclerosis. In the patient’s chart is an electromyography report and nerve conduction velocity test. What should the physical therapist not expect to find in these test results? a. Decreased amplitude of motor unit and action potential b. Decreased duration of motor unit action potential c. Decreased sensory evoked potentials d. Decreased polyphasic action potentials

c. Decreased sensory evoked potentials

A physical therapist is asked by a coworker to finish examining a patient because an emergency requires the therapist to leave. The coworker agrees and resumes the examination. The first therapist left noted titled, “sensory assessment.” Two wooden blocks identical in appearance but 1 pound different in weight are on the table in front of the patient. What test was the prior therapist most likely performing? Barognosis test Stereognosis test Graphesthesia test Texture recognition

Barognosis test

A physical therapist is reviewing the chart of a 24-year-old woman with a diagnosis of L2 incomplete paraplegia. The physician noted that the left quadricep tendon reflex is 2+. What does this information relay to the therapist? a. No active quadricep tendon reflex b. Slight quadriceps contraction with reflex testing c. Normal quadricep tendon reflex d. Exaggerated quadricep tendon reflex

c. Normal quadricep tendon reflex

A patient is referred to physical therapy with a history of TMJ pain. The therapist notices that the patient is having difficulty closing his mouth against minimal resistance. With this information, which of the following muscles would not be a target for strengthening exercise to correct this deficit? Medial pterygoid muscle Temporalis Masseter Lateral pterygoid muscle

Lateral pterygoid muscle

A physical therapist performs the following test during an examination: With the patient lying in supine position, the therapist traces a diamond shape around the patient’s umbilicus with a sharp object. What reflex is being assessed, and what is the significance if the patient’s umbilicus does not move in response to the stimulus provided by the therapist? a. Cremaster reflex, suggest upper motor neuron involvement b. Superficial abdominal reflex, suggests upper motor neuron involvement c. Cremaster reflex, suggests lower motor neuron involvement d. Superficial abdominal reflex, suggests lower motor neuron involvement

b. Superficial abdominal reflex, suggests upper motor neuron involvement

A physical therapist is asked to examine a 37-year-old man with right-side sciatica. The therapist performs a passive straight leg raise test of the right lower extremity with the knee and ankle in neutral position. In performing this test on a patient with an L5 disc protrusion, what is the lowest degree at which the therapist would expect to reproduce the patient’s symptoms? At 0 degrees of hip flexion At 35 degrees of hip flexion At 70 degrees of hip flexion At 90 degrees of hip flexion

At 35 degrees of hip flexion

Using test of neurologic status and motor function, an experienced physical therapist or pediatrician should be able to accurately diagnose cerebral palsy in all but the mildest cases by 3 months of age 6 months of age 1 year of age 2 years of age

6 months of age

Indicators of complex regional pain syndrome include all of the following except Pain from superficial touch Profuse sweating Skin color changes Increased uptake on bone scan

Profuse sweating

Which of the following muscles would you not expect to be affected by a C6-C7 lesion? Biceps brachii Anterior deltoid Infraspinatus Triceps brachii

Triceps brachii

What is the BEST order of these tests during neurologic patient examination? a. Cognition, sensation, range of motion (ROM), reflexes, spasticity testing, manual muscle testing (MMT) b. Reflexes, MMT, cognition, sensation, ROM, spasticity testing c. Cognition, sensation, spasticity testing, ROM, MMT, reflexes d. ROM, reflexes, sensation, MMT, spasticity testing, cognition

a. Cognition, sensation, range of motion (ROM), reflexes, spasticity testing, manual muscle testing (MMT)

The patient has dysdiadochokinesia. What is the best measure of patient function? Drawing of figure eight Alternating pronation/supination Rebound test Static balance

Alternating pronation/supination

Upon observation, the patient has unilateral left facial weakness. He is unable to smile or show his teeth on the left side. He is unable to smile or show his teeth on the left side. However, he is able to raise his left eyebrow. The physical therapist suspect Peripheral CN5 lesion Central CN5 lesion Peripheral CN7 lesion Central CN 7 lesion

Central CN 7 lesion

During physical therapy examination, the patient has full ROM bilaterally. Muscle tone at rest appears normal bilaterally. Reflexes on the right side are 2+. On the left, they are 1+. What is the next thing you should test for? a. Repeat reflex testing with Jendrassik maneuver to enhance deep tendon reflex on the left b. Spasticity testing on the left due to increased reflexes c. Assess for associated reactions as patient has upper motor neuron syndrome findings on the left d. Cognition, as the patient may may have been confused with reflex testing so results could be unreliable

a. Repeat reflex testing with Jendrassik maneuver to enhance deep tendon reflex on the left

During your cranial nerve examination of extraocular muscle function, you note that your patient has vertical nystagmus during smooth pursuits. You suspect Lesion of optic nerve (CN2) Posterior canal BPPV Acoustic neuroma CNS lesion

CNS lesion

When performing an examination on a patient after traumatic spinal cord injury to determine the American Spinal Injury Association (ASIA) sensory level of injury, a clinician tests Proprioception Kinesthesia Pain Reflexes

Pain

Your patient presents with a nerve injury that causes the thenar eminence to be flattened because of muscle atrophy. The thumb is adducted and extended. You would want to test the muscles supplied by the Ulnar nerve Antebrachial nerve Median nerve Radial nerve

Median nerve

Your patient is a farmer on a construction project. He has been wearing a heavy carpenter’s belt for the last month. He now complains of painful hyperesthesia on the proximal anterior lateral thigh. He gets relief with sitting, and walking seems to aggravate his symptoms. The structure most likely producing these symptoms is the Lateral femoral cutaneous nerve Motor branch of the femoral nerve Medial femoral cutaneous nerve Inguinal nerve

Lateral femoral cutaneous nerve

Your patient complains of neck pain and peripheral symptoms. Radiographs revealed narrowing of the C4-C5 intervertebral foramen. The nerve root most likely involved would be the C5 nerve root C4 nerve root C6 nerve root Sensory branch of C4

C5 nerve root

A physical therapist is conducting a screening examination on a patient with a suspected upper motor neuron lesion. In the presence of an upper motor neuron lesion, deep tendon reflexes will be Hypoactive Absent Diminished Hyperactive

Hyperactive

You are performing an examination on a 2-month-old infant diagnosed with Klumpke’s palsy. The classic physical findings of a Klumpke’s palsy are a. Lack of forearm supination, elbow extension, and wrist flexion b. Lack of forearm supination, elbow flexion, and wrist extension c. Lack of shoulder ER, elbow flexion, and wrist extension d. Lack of elbow extension, forearm pronation, and wrist flexion

d. Lack of elbow extension, forearm pronation, and wrist flexion

A 5-year-old male had an undiagnosed arteriovenous malformation and was recently hospitalized because of an acute brain bleed. The patient does not acknowledge individuals who stand on the left side of his bed, he does not respond to sensory stimuli that is applied to the left side of his body, and he displays visual spatial deficits. What lobe of the brain has been affected by the stroke? Right parietal Left temporal Frontal Occipital

Right parietal

A 16-year-old male is diagnosed with a spinal tumor and has undergone surgery to resect the mass. After the procedure, the patient presents with variable motor paralysis and loss of pain and temperature sensation below the level of injury. The patient would be diagnosed with what spinal cord syndrome? Brown-Sequard Anterior Cord Posterior Cord Cauda Equina

Anterior Cord

An infant is able to transition from quadruped to sitting, demonstrate protective extension reactions in all directions except backwards, and pivots on the belly in a prone position. This infant is demonstrating gross motor skills at what chronologic age? 3 to 4 months 5 to 6 months 7 to 8 months 11 to 12 months

7 to 8 months

A two month-old infant is diagnosed with left congenital muscular torticollis, which has resulted in plagiocephaly. This would result in a. Flattening of the left frontal and left occipital regions b. Flattening of the right frontal and left occipital regions c. Flattening of the right frontal and right occipital regions d. Flattening of the left frontal and right occipital regions

d. Flattening of the left frontal and right occipital regions

A therapist is asked to estimate the percentage of a patient’s body that has been burned. The patient is a 32-year-old man of normal size. Burns are located along the entire anterior surface of the face. The patient also burned the entire anterior portion of the right upper extremity in an attempt to guard himself from flames. Using the rule of nines, what percentage of the patient’s body is burned? 9% 1% 4.5% 27%

The patient with the least chance of survival of the following injuries is an a. 18-month-old male, s/p 40; total body surface area (TBSA), third-degree scald b. 13-year-old male, s/p 60; TBSA, intermediate flame burns with inhalation injury c. 8-year-old female, s/p motor vehicle accident MVA with 20; deep burns to face, neck, chest, hands, and pelvic fractures d. 4-year-old male, s/p 80; TBSA, severe sunburn with blisters

b. 13-year-old male, s/p 60; TBSA, intermediate flame burns with inhalation injury

A 10-year-old female has been diagnosed with a stage IV pressure sore on the sacrum. She was transferred to the hospital from a subacute facility and is being followed by the wound care team. After 2 weeks of wound care treatment, the physical therapist is reassessing the wound and determines that the bone is no longer visible. How would the physical therapist document the stage of the wound at this time? Stage IV Stage III Stage II Stage I

Stage IV

Signs and symptoms of hypertrophic burn scar include all of the following except a. Increasing itching and redness in a healed burn b. Increasing difficulty in achieving a full stretch of the burn area c. Fever and malaise d. Raised edges around a newly healed graft

c. Fever and malaise

To decrease the risk of hypoglycemia in a patient with type 1 insulin-dependent diabetes, which of the following is inappropriate? a. Eat or drink a snack high in carbohydrates 30 minutes before exercise b. Exercise muscles that have not had an insulin injection recently c. A carbohydrate snack for each 30 to 45 minutes of exercise d. Exercise at the peak time of insulin effect

d. Exercise at the peak time of insulin effect

Which of the following is false regarding T2-weighted MRI images? a. Synovial fluid displays high signal intensity b. Cortical bone displays high signal intensity unless fat-suppression techniques are used c. Bone marrow edema-like lesions (when present) are commonly seen in the images d. Cerebral spinal fluid displays high signal intensity

b. Cortical bone displays high signal intensity unless fat-suppression techniques are used

Your patient presents with radiating pain down the right posterior leg, which is aggravated by running and seated hip internal rotation. What is the most likely cause? a. Right semimembranosus tendonitis causing posterior leg pain b. Right piriformis syndrome resulting in sciatica c. Lumbar central stenosis with L4 radiculopathy d. Right lumbar intervertebral foramen stenosis with radiculopathy

b. Right piriformis syndrome resulting in sciatica

When discussing magnetic resonance imaging (MRI) images, all observations of tissue appearance should be described in terms of Lucency Window Density Signal intensity

Signal intensity

Edema on a T2 weighted MRI image will appear as __ signal intensity (SI) Low signal intensity (SI) High signal intensity Radiopacity Radiolucent

High signal intensity

Musculoskeletal MRI “fluid sensitive” sequences include all of the following except STIR T1 weighted T2 weighted Proton density

T1 weighted

While evaluating a shoulder split tau inversion recovery (STIR) sequence MRI study, you note increased SI on the images within the region. This suggests Fibrosis Organized hematoma Edema or effusion Calcification of the tendon

Edema or effusion

What is correct regarding the atlanto-dens interval? a. The atlanto-dens interval is measured on AP projections b. The atlanto-dens interval is measured on lateral views c. An abnormality of the atlanto-dens interval may correlate with compromise of the ligamentum nuchae d. Normal measurement is the same for adults and children

b. The atlanto-dens interval is measured on lateral views

An MRI study of the shoulder typically includes three anatomic planes of study. Image slices taken in perpendicular to the long axis of the scapular spine are identified as what plane of study? Coronal oblique Axial Sagittal oblique Lateral

Sagittal oblique

A commonly encountered MRI sequence in PT practice is FS PD FSE. This sequence is most often used to display Abnormal fat tissues Brain trauma or hemorrhage Orthopedic pathology Details of cortical bone

Orthopedic pathology

The “FS” in FS PD FSE sequence refers to Fat pre-saturation technique Fast spin echo Use of contrast media Functional MRI sequence

Fat pre-saturation technique

Normal high SI tissues on T1 weighted images include Acute edema CSF Fat Synovial fluid

Fat

CT studies of the knee typically include three planes of study. Which choice is not one of the conventional planes? Condylar oblique Sagittal Coronal Axial

Condylar oblique

A high repetition time (TR) combined with low echo time (TE) setting noted on the scout film would indicate what common orthopedic sequence? T1 T2 Proton density STIR

Proton density

MRI studies of the knee typically include three planes of study. Which choices is not one of the conventional planes? Medial oblique Sagittal Coronal Axial

Medial oblique

A “window” in computerized tomography (CT) terminology refers to a. Lucent regions of the lung b. Lytic lesions of bone c. Hounsfield units d. CT machine setting for enhancement of contrast

d. CT machine setting for enhancement of contrast

The left posterior oblique (LPO) cervical spine projection specifically allows study of what anatomical structures? Intervertebral disk Left side intervertebral joints Right side intervertebral foramina Left side intervertebral foramina

Right side intervertebral foramina

What radiologic terms are incorrectly paired? Density/opacity Density/sclerosis Lucency/high density Lucency/low density

Lucency/high density

Increased bone density viewed on plain film x-rays would appear as __ bone on T1 weighted MRI images. Low SI High SI Radiopacity None of these

Low SI

A scaphoid fracture is suspected on plain film x-ray but not clearly demonstrated. The imaging technology most commonly employed for further evaluation and diagnosis is Positron emission tomography MRI Plain film x-ray with contrast media Computerized tomography

Computerized tomography

Standard nomenclature used to describe radiodensity employed when reading plain film x-rays include all of the following except Ligamentous density Air Bone density Fat density

Ligamentous density

On plain film x-ray a black or dark gray lesion within a normally white region such as cortical bone would be termed a region of Density Opacity Sclerosis Lucency

Lucency

Radiology reports using the terms “sequestra and in volucrumare” referring specifically to what diagnosis of concern to a treating physical therapist? Bone cancer Osteomyelitis Fracture Spondylolisthesis

Osteomyelitis

A lateral x-ray projection of a dorsal phalangeal avulsion fracture reveals sagittal plain dislocation. What standard view should be ordered to assess possible coronal plane dislocation? AP PA Oblique Opposite side lateral

Superimposition of soft tissue structures on plain film images creates the illusion of Increased density Decreased density Abnormal lucency Gas bubbles

Increased density

Which structure is most poorly studied or assessed on an AP lumbar spine projection? a. Intervertebral disk height of superior lumbar vertebra b. Superior end plates c. Pars interarticularis d. Inferior end plates

c. Pars interarticularis

Cortical bone as viewed on CT scans within a “bone window” will appear as Low density High density Low SI Hyperintense signal

High density

The celebrated “Scotty Dog” appears on what x-ray projection? Lumbar AP Lumbar oblique Coned lateral Lumbar lateral

Lumbar oblique

The front leg of the celebrated “Scotty Dog'' is what anatomical structure? Inferior articular process Superior articular process Pars interarticularis Transverse process

Inferior articular process

The spinolaminar line employed in evaluation of a lateral view of the cervical spine is drawn immediately anterior to the Posterior aspect of central canal Anterior aspect of vertebral bodies Posterior aspect of vertebral bodies Superior to C3 uncus if present

Posterior aspect of central canal

Normal articular cartilage appears as __ on plain film x-ray? Radiodense Water or mid-density Lucent or lung density Opaque or bone density

Water or mid-density

Degenerative arthritic changes viewed on x-ray images may typically include all of the following except Subchondral sclerosis Osteophyte formation Periarticular osteopenia Loss of joint space

Periarticular osteopenia

Your patient has low back pain that you diagnose clinically as degenerative disease of the left L4-L5 facet. Which lumbar spine projection would best support your clinical impression? Right posterior oblique Left posterior oblique Right lateral Left lateral

Left posterior oblique

Osteoarthritis may be differentiated from rheumatoid arthritis on x-ray by the observation of Loss joint space Periarticular osteopenia Asymmetric joint involvement Osteophyte formation

Osteophyte formation

You are examining a child with a fractured distal femur. The fracture begins at the medial aspect of the distal diaphyseal region, progresses distal-laterally through the metaphysis, epiphyseal plate, and epiphyseal region, exiting into the knee joint surface. This would be classified as a Salter-Harris type __ fracture. 1 2 3 4

Cortical bone appears as __ on virtually all MRI sequences because of low water content. Radiopaque Radiolucent Low signal intensity High signal intensity

Low signal intensity

Lumbar spondylolisthesis is best evaluated on what x-ray projection? Lateral AP PRA Anterior oblique

Lateral

Following a suspected stress fracture of the third metatarsal bone, bone callus would normally first become radiographically visible at about 3-4 days 1-14 days 2-4 months 6-18 months

1-14 days

When an adult lumbar spine degenerating disk breaks through either the superior or inferior end plate, it is referred to as a(n) Napoleon’s hat sign Schmorl’s nodule Salter-Harris 5 fracture Osteoblastoma

Schmorl’s nodule

Anteriorly located anatomic structures appear larger than posterior structures on anteroposterior (A) x-ray projections because of what form of x-ray distortion? Superimposition Enlargement Foreshortening Compression

Enlargement

A cardiopulmonary specialist observing a patient’s chest x-ray, you note radiolucency within the lung fields. This is most likely to be Heterotopic ossification Tuberculosis Collapse of lung Normal air density lung

Normal air density lung

Fortinberry - Chapter 2 (PT Apps) Flashcards

Examinaton