Fortinberry - Chapter 3 (PT Apps) Flashcards
Foundations for Evaluation, Differential Diagnosis, and Prognosis
The most serious complication of lower extremity thrombophlebitis is
Cerebral infarction
Pulmonary infarction
Myocardial infarction
Kidney infection
Pulmonary infarction
A 50-year-old man has a persistent cough, purulent sputum, abnormal dilation of bronchi, more frequent involvement of the lower lobe than the right, hemoptysis, and reduced forced vital capacity. What is the most likely pulmonary dysfunction?
Chronic bronchitis
Emphysema
Asthma
Bronchiectasis
Bronchiectasis
A patient presents to a clinic with decreased tidal volume (TV). What is the most likely cause of this change in normal pulmonary function?
COPD
Restrictive lung dysfunction
Emphysema
Asthma
Restrictive lung dysfunction
A patient presents with tachypnea, cor pulmonale, hypoxemia, rales on inspiration, and decreased diffusing capacity. What is the probable cause?
Restrictive lung dysfunction
COPD
Asthma
Emphysema
Restrictive lung dysfunction
Which of the following are tests for peripheral arterial involvement in a patient with complaints of calf musculature?
Claudication time
Homan’s sign
Percussion test
Hoffa’s sign
Claudication time
A physician instructs the therapist to educate a patient about the risk factors of atherosclerosis. Which of the following is the most inappropriate list?
a.Diabetes, male gender, and excessive alcohol
b. Genetic predisposition, smoking, and sedentary lifestyle
c. Stress and inadequate exercise
d. Obesity, smoking, and hypotension
d. Obesity, smoking, and hypotension
A therapist is ordered by a physician to treat a patient with congestive heart failure in an outpatient cardiac rehabilitation facility. Which of the following signs and symptoms should the therapist not expect?
Stenosis of the mitral valve
Orthopnea
Decreased preload of the right heart
Pulmonary edema
Decreased preload of the right heart
At a team meeting, the respiratory therapist informs the rest of the team that the patient, just admitted to the subacute floor, experiences breathing difficulty in the acute care department. The respiratory therapist describes the breathing problem as a pause before exhaling after a full inspiration. Which of the following is the therapist describing?
Apnea
Orthopnea
Eupnea
Apneusis
Apneusis
A therapist is performing chest physiotherapy on a patient who is coughing up a significant amount of sputum. The therapist later describes the quality of the sputum in his notes as mucoid. This description tells other personnel which of the following?
The sputum is thick
The sputum has a foul odor
The sputum is clear or white in color
The patient has possible bronchopulmonary infection
The sputum is clear or white in color
A therapist is sent to provide passive range of motion to a patient in the intensive care unit. The chart reveals that the patient is suffering from pulmonary edema. The charge nurse informs the therapist that the patient is coughing a thin, white sputum, with a pink tint. Which of the following terms best describe this sputum?
Purulent
Frothy
Mucopurulent
Rusty
Frothy
Strengthening exercises for persons with hemophilia should
a. Begin as soon as joint bleed is recognized
b. Never include isokinetic exercises
c. Be increased using high repetition, low load PREs
d. Only occur in joints that demonstrate muscle weakness
Be increased using high repetition, low load PREs
A patient with cryoglobulinemia presents to outpatient physical therapy with complaints of lumbar pain. Which of the following should the physical therapist avoid during intervention for this diagnosis?
Most heat packs
Weight-bearing exercises
Muscle energy techniques
Cold pack application
Cold pack application
A physical therapist is assessing the endurance of a 12-year-old female with cystic fibrosis. Which objective screening tool would be most appropriate to quantify the patient’s endurance?
Six-minute walk test
Tinetti Performance-Oriented Mobility Assessment
VOMax Test
Romberg test
Six-minute walk test
A physical therapist is performing an examination for an infant that has recently been diagnosed with a congenital her defect. Which of the following clinical signs would not likely be present?
Bradycardia
Poor weight gain
Decreased respiratory rate
Lower extremity swelling
Bradycardia
Besides the anterolateral abdominal muscles, which muscles assists in forced expiration, coughing, sneezing, vomiting, urinating, defecating, and fixation of the trunk during strong movements of the upper limb?
Piriformis
Pelvic diaphragm
Trapezius
Gluteus maximus
Pelvic diaphragm
Which muscle does not flex the knee and extend the hip?
Semitendinosus
Hamstring portion of the adductor magnus
Long head of the biceps femoris
Semimembranosus
Hamstring portion of the adductor magnus
History taking revealed that a patient experiences pain after horseback riding or skating. The pain is located over the anteromedial thigh and is aggravated by resisted abduction. What is the most likely preliminary diagnosis?
Piriformis syndrome
Trochanteric bursitis
Adductor longus strain/tendonitis/tendinosis
Avascular necrosis
Adductor longus strain/tendonitis/tendinosis
A patient has dull posterior hip pain radiating down the leg. He say that he has a limp and that his pain is aggravated by turning his leg outside or with deep pressure near the middle of the right buttock. What is the most likely preliminary diagnosis?
Piriformis syndrome
Trochanteric bursitis
Adductor longus strain/tendonitis/tendinosis
Avascular necrosis
Piriformis syndrome
What is the best imaging modality for detecting the changes in the articular cartilage seen with chondromalacia patella?
Plain film radiography
Bone scan
Magnetic resonance imaging
Computed tomography
Magnetic resonance imaging
Which of the following imaging modalities does not give a radiation dose to the patient?
MRI
CT
Mammography
Bone scan
MRI
A therapist is examining a 3-year-old child who is positioned as follows: supine, hips flexed to 90 degrees, hips fully adducted, and knees flexed. The therapist passively abducts and raises the thigh, applying an anterior shear force to the hip joint. A click at 30 degrees of abduction is noted by the therapist. What orthopedic test is the therapist performing, and what is its significance?
a. Ortolani’s test, hip dislocation
b. Apley’s compression/distraction test, cartilage damage
c. McMurray test, cartilage damage
d. Piston test, hip dislocation
a. Ortolani’s test, hip dislocation
A patient presents to physical therapy with complaints of pain in the right hip due to osteoarthritis. Which of the following is not true about this type or arthritis?
a. Osteoarthritis causes pain that is usually symmetric because it is a systemic condition
b. Osteoarthritis is not usually more painful in the morning
c. Osteoarthritis commonly involves the distal interphalangeal joint
d. Osteoarthritis mainly involves weight-bearing joints
a. Osteoarthritis causes pain that is usually symmetric because it is a systemic condition
A teenager comes to an outpatient facility with complaints of pain at the tibial tubercle when playing basketball. The therapist notches that the tubercles are abnormally pronounced on bilateral knees. What condition does the patient most likely have?
Jumper’s knees
ACL sprain
Osgood-Schlatter disease
Sever’s disease
Osgood-Schlatter disease
Which of the following is used to treat a patient referred to physical therapy with a diagnosis of Dupuytren’s contracture?
Knee continuous passive motion
Work simulator set for squatting activities
Hand splint
A 2-pound dumbbell
Hand splint
A 17-year-old football player is referred to the outpatient physical therapy clinic with a diagnosis of a recent third-degree medial collateral sprain of the knee. The patient wishes to return to playing football as soon as possible. Which protocol is the best?
a. Fit the patient with a brace that prevents him from actively moving the knee into the last available 20 degrees of extension. Prescribe general lower extremity strengthening with the exception of side-lying hip adduction
b. Do not fit the patient with a brace that prevents him from actively moving the knee into the last available 20 degrees of extension. Avoid all open-chain strengthening for the lower extremity
c. Fit the patient with a brace that prevents him from actively moving the knee into the last available 20 degrees of extension. Avoid all open-chain strengthening for the LE
d. Do not fit the patient with a brace. Prescribe general lower extremity strengthening with the exception of side-lying hip adduction
a. Fit the patient with a brace that prevents him from actively moving the knee into the last available 20 degrees of extension. Prescribe general lower extremity strengthening with the exception of side-lying hip adduction
During an examination, the therapist taps on the flexor retinaculum of the patient’s wrist, which causes tingling in the thumb. What test is this? For what condition does it screen?
Phalen’s test, carpal tunnel
Finkelstein test, De Quervain’s disease
Tinel’s sign, De Quervain’s disease
Tinel’s sign, carpal tunnel
Tinel’s sign, carpal tunnel
A physical therapist is treating a patient with balance deficits. During treatment, the physical therapist notes that large-amplitude changes in the center of mass cause the patient to lose balance. The patient, however, can accurately compensate for small changes nearly every time a change is introduced. What muscles most likely need to be strengthened to help alleviate this dysfunction?
Tibialis anterior, gastrocnemius
Peroneus longus/brevis, tibialis posterior
Rectus abdominis, erector spinae
Iliopsoas, gluteus maximus
Iliopsoas, gluteus maximus
The physical therapist is reading the physician’s interpretation of an x-ray that was taken of the left humerus of a 7-year-old patient. The physician notes in the report the presence of an incomplete fracture on the convex side of the humerus. Which type of fracture is the physician describing?
Comminuted
Avulsion
Greenstick
Segmental
Greenstick
A physical therapist is beginning an examination of a 5-year-old boy. The mother indicates that she pulled the child from a seated position by grasping the wrists. The child then experienced immediate pain at the right elbow. The physician’s orders are for right elbow range of motion and strengthening. Which of the following is the most likely diagnosis?
Radial head fracture
Nursemaid’s elbow
Erb’s palsy
Ulnar coronoid process fracture
Nursemaid’s elbow
A child presents to physical therapy with a diagnosis of right Sever’s disease. What joint should be the focus of the therapist’s examination?
Right knee joint
Right hip joint
Right wrist joint
Right ankle joint
Right ankle joint
A 31-year-old boy presents to outpatient physical therapy with complaints of diffused pain in the right hip, thigh, and knee joint. The patient was involved in a motor vehicle accident 3 weeks ago. He is also obese and has significant atrophy in the right quadricep. The right lower extremity is held by the patient in the position of flexion, abduction, and lateral rotation. Which of the following is most likely the source of the patient’s signs and symptoms?
Greater trochanteric bursitis
Avascular necrosis
Slipped femoral capital epiphysis
Septic arthritis
Slipped femoral capital epiphysis
Which tendon is most commonly involved with lateral epicondylitis?
Extensor carpi radialis longus
Extensor carpi radialis brevis
Brachioradialis
Extensor digitorum
Extensor carpi radialis brevis
A high-school athlete is considering whether to have an ACL reconstruction. The therapist explains the importance of this ligament, especially in a person that is young and athletic. Which of the statements is correct in describing part of the function of the ACL?
The ACL prevents excessive (anterior/posterior) roll of the femoral condyles during (flexion/extension) of the femur at the knee joint
The ACL prevents excessive POSTERIOR roll of the femoral condyles during FLEXION of the femur at the knee joint
A patient who has suffered a zone 2 rupture of the extensor tendon of the third digit presents to physical therapy. This patient had a surgical fixation of the avulsed tendon. During the period of immobilization, which of the following deformities is most likely to develop?
Boutonniere deformity
Claw hand
Swan neck deformity
Dupuytrne’s contracture
Swan neck deformity
Which of the following muscle tendons most commonly sublux in patients who suffer from rheumatoid arthritis?
Flexor digitorum profundus
Extensor carpi radialis
Extensor carpi radialis longus
Flexor pollicis longus
Extensor carpi radialis
A therapist is scheduled to examine a patient with a chronic condition of hammer toes. Where should the therapist not expect to find callus formation?
a. The distal tips of the toes
b. The superior surface of the interphalangeal joints
c. The metatarsal heads
d. The inferior surface of the interphalangeal joints
The inferior surface of the interphalangeal joints
Each of these factors influences the probability of scoliosis curve progression in the skeletally immature patient except
Magnitude
Gender
Race
Age
Race
The child with clubfoot will have
A larger than normal calcaneus
Forefoot valgus
Significant tibial shortening
Fixed equinus
Fixed equinus
Differential diagnosis in the infant born with severe calcaneovalgus includes
Congenital vertical talus
Metatarsus adductus
Accessory navicular
Tarsal coalition
Congenital vertical talus
What clinical examination technique will establish whether an infant’s hip is dislocated but reducible?
Barlow’s test
Ortolani’s maneuver
Hoffman test
Galeazzi test
Ortolani’s maneuver
All of the following may be part of the clinical picture of a child in the first 48 hours after onset of osteomyelitis except
Radiographs are positive for signs of infection and avascular necrosis
Needle aspiration may or may not be produce pus
The child does not appear sick and has no fever
High fever and refusal to walk
Radiographs are positive for signs of infection and avascular necrosis
In a child, the most common site of transient synovitis, slipped epiphysis and septic arthritis is the
Shoulder
Hip
Knee
Ankle
Hip
All of the following are common in children who have slipped capital femoral epiphysis except
Knee pain
Obesity
No history of trauma
Negative findings on a frog lateral radiograph
Negative findings on a frog lateral radiograph
Which of the following conditions are not implicated in overuse injuries in youth?
Training errors
Musculotendinous imbalances
Anatomic malalignment of the lower extremity
Constant practice of turf (grass)
Constant practice of turf (grass)
The signs and symptoms of juvenile rheumatoid arthritis include all of the following except
Swollen joints
Neurologic impairments
Stiffness
Muscle weakness
Neurologic impairments
Fourteen weeks after surgical repair of the rotator cuff, a patient presents with significant deltoid weakness. ROM is within normal limits and equal bilaterally. Internal and external rotation strength is equal bilaterally; flexion and abduction strength is significantly reduced. What is the most likely cause of this dysfunction?
a. Poor compliance with a home exercise program
b. Tightness of the inferior shoulder capsule
c. Surgical damage to the musculocutaneous nerve
d. Surgical damage to the axillary nerve
d. Surgical damage to the axillary nerve
Which of the following is an absolute contraindication to initiation of an outpatient cardiac rehabilitation program?
Obesity
Patient currently on dialysis 3 days a week because of renal failure
Asthma
Third -degree heart block
Third -degree heart block
A patient has recently undergone an acromioplasty. What is the most important goal in early rehabilitation?
Regaining muscle strength
Return to activities of daily living (ADLs)
Endurance and functional progression
Return of normal ROM
Return of normal ROM
A 39-year-old patient presents with complaints of pain and point tenderness slightly anterior to the TMJ. the tissue that likely is causing the pain is the
Temporalis tendon
Masseter
Maxillary sinus
Parotid gland
Masseter
A 72-year-old female comes into the clinic complaining of a new onset of sudden severe right temporal headache and pain with chewing. The likely cause of her headache is
Migraine
Subarachnoid hemorrhage
Temporal arteritis
Cervicogenic headache
Temporal arteritis
A patient cannot open the jaw greater than 15 mm interincisal with active and passive opening. Lateral jaw movements are 8 mm bilaterally and protrusion is 6 mm. What type of disorder do these symptoms indicate?
Anterior disc displacement with reduction
Anterior disc displacement without reduction
Trismus
Capsulitis
Capsulitis
A 15-year-old patient complains of acute jaw pain. The patient opens to 23 mm active and passive deflection to the right. Right lateral deviation is 8 mm, left lateral deviation is 3 mm. Palpation is negative for crepitus. What type of disorder do these symptoms indicate?
a. Right temporomandibular anterior disc displacement with reduction
b. Right temporomandibular anterior disc displacement without reduction
c. Trismus
d. Left temporomandibular anterior disc displacement with reduction
b. Right temporomandibular anterior disc displacement without reduction
What is the temporomandibular reciprocal click?
a. Clicking that occurs during the end of opening
b. Clicking that occurs during the beginning of opening
c. Clicking that occurs during the middle of opening
d. Clicking that occurs during opening and closing
d. Clicking that occurs during opening and closing
A 28-year-old male complains of pain in his right jaw and his bite not touching on the right side after biting into beef jerky 5 days ago. What is the probable disorder?
a. Right acute anterior disc displacement without reduction
b. Right acute anterior disc displacement with reduction
c. Right acute osteoarthritis
d. Right acute capsulitis
d. Right acute capsulitis
What are signs and symptoms of an acute TMJ anterior displaced disc without reduction?
a. Clicking and pain in the TMJ
b. Absence of clicking and opening limited to 26-30 mm, lateral movements limited to contralateral side, deflection to the same wide with protrusion
c. Crepitation and limitation to 26 mm
d. Absence of clicking and opening is limited to 26-30 mm, lateral movements limited to I/L side, deflection to same side with protrusion
b. Absence of clicking and opening limited to 26-30 mm, lateral movements limited to contralateral side, deflection to the same wide with protrusion
A physical therapist is completing a manual muscle testing (MMT) examination of a patient with right lateral hip pain. The standing alignment reveals anterior pelvic tilt and associated hip flexion. During the MMT of the right posterior gluteus medius, which substitution is likely to occur?
a. Increase in hip flexion angle to substitute with the TFL
b. Increase in lateral rotation to substitute with the TFL
c. Forward rotation of the pelvis to substitute with the gluteus minimus
d. Knee flexion to substitute with the lateral hamstrings
a. Increase in hip flexion angle to substitute with the TFL
Osgood-Schaltter’s disease is primarily
An inflammatory process
An injury to epiphyseal cartilage
An injury in adolescent females
Caused by tight calf muscles
An injury to epiphyseal cartilage
A swollen knee immediately following trauma indicates
Blood in the joint
Blood or synovial fluid accumulation
Possible gout
Underlying arthritic degeneration
Blood in the joint
The most likely cause for a baseball pitcher to injure the throwing arm is
Throwing side-arm
High pitch counts
Throwing curve balls
“Dead arm” syndrome
Throwing curve balls
The ulnar collateral ligament of the elbow is injured during which phase of the baseball pitch?
Early cocking phase
Late cocking phase
Acceleration phase
Deceleration phase
Acceleration phase
Ankle pain anteriorly
Is usually a bone bruise
Is usually osteochondritis dissecans
Is usually ligament pain following sprain
Is usually soft tissue impingement
Is usually soft tissue impingement
Swimmer’s shoulder
Occurs in all swimmers
Is a rotator cuff tear
Is worse with backstrokers
Is an impingement syndrome
Is an impingement syndrome
Anterior “black line” tibia stress fracture
Is a failure in compression
Heals predictability with rest and splinting
Requires bone stimulation to heal
May require intramedullary rodding to heal
May require intramedullary rodding to heal
During MMT of knee flexion strength, the physical therapist wishes to differentiate between medial and lateral hamstrings. To test medial hamstrings, the therapist positions the patient in hip
a. External rotation to test semimembranosus and biceps femoris
b. Internal rotation to test semimembranosus and semitendinosus
c. External rotation to test semimembranosus and semitendinosus
d. Internal rotation to test biceps femoris
c. External rotation to test semimembranosus and semitendinosus
A patient is involved in a near-end motor vehicle accident and now complains of neck pain, muscle spasm, and decreased cervical ROM. after performing your subjective examination, the next thing you would most appropriately do is
Ligamentous testing
Muscle testing
Active ROM testing
Passive motion testing
Active ROM testing
The piano key sign is a test used to assess the
Glenoid labrum
Long head of the biceps
AC joint
Anterior shoulder stability
AC joint
Your patient is a 16-year-old male who injured his left knee playing football. There was an onset of immediate swelling, a locking sensation, and restricted ROM. You hypothesize the most likely structure involved is
A collateral ligament
A tear of the retinaculum
A meniscus injury
The cruciate ligament
A meniscus injury
You suspect that your patient has a torn rotator cuff. Which three tests would best confirm this diagnosis?
a. The lift off test, the anterior apprehension test, and Speed’s test
b. The drop arm test, crank test, load and shift test
c. The belly press test, drop arm test, and lift off test
d. Internal rotation lag sign, drop arm test, crank test
c. The belly press test, drop arm test, and lift off test
A cause of a noncapsular pattern might be which of the following?
Arthrosis in the knee
Hemarthrosis of the shoulder
Septic arthritis in the knee
Loose body in the shoulder
Loose body in the shoulder
In the single leg stance, when the C/L hip drops because of weakness, it is considered
A compensated hip varus
An uncompensated Trendelenburg
A compensated Trendelenburg
An uncompensated hip varus
An uncompensated Trendelenburg
Your patient has sustained a fracture of the coronoid process. Which of the following is most true about these fractures?
a. It is most commonly an isolated fracture
b. It is more often accompanied by avulsion of the biceps
c. Fractures of the coronoid process account for better than of elbow fractures
d. Fractures of the coronoid process are usually accompanied by a radial head fracture
d. Fractures of the coronoid process are usually accompanied by a radial head fracture
A 45-year-old male electrician presents with a gradual onset of left shoulder pain. He notes it is most prominent with overhead activities and throwing. The position that hurts his shoulder the most is 90 degrees of flexion with internal rotation. This most likely indicates
A SLAP lesion
Anterior instability of the shoulder
Impingement syndrome
Posterior instability of the shoulder
Impingement syndrome
You find that a patient has a leg length discrepancy. Upon review of the radiographs, you notice that the angle of the neck of the femur to the femoral shaft is less than 120 degrees. You have determined that the apparent leg length difference is due to
A pelvic obliquity
A coxa varum
A coxa valga
An acetabular tropism
A coxa varum