Fortinberry - Chapter 2 (PT Apps) Flashcards
Examinaton
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
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
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
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
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
Whiplash injury from a rear-end collision would tear which of the following ligaments?
PLL
ALL
Ligamentum nuchae
Ligamentum flavum
ALL
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
Where is the most common site of fracture in osteoporosis?
Metacarpals
Skull
Proximal radius
Vertebral bodies
Vertebral bodies
Which one of the following conditions is characterized by reduced osteoclastic bone resorption?
Paget’s disease of the bone
Osteoporosis
Osteopetrosis
Osteomalacia
Osteopetrosis
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
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
A defining symptoms of fibromyalgia is
Fatigue
Diffuse pain
Regional pain
Unexplained weight loss
Diffuse pain
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
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
What shoulder view best demonstrates the greater tubercle?
ER
IR
Baby arm
Transthoracic
ER
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
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
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
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
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
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
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
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
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
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 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 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 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
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