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Advanced Spine > M2 Multiple Choice Quizzes > Flashcards

M2 Multiple Choice Quizzes Flashcards

1
Q

During repeated flexion in standing, the pt says her leg pain is decreasing but her back pain is increasing. Almost as soon as she stops doing the motion, her leg pain goes back to baseline and her back pain remains increased. This response to RFIS would best be described as centralized,

A. Better
B. No better
C. Worse
D. No worse

A

B. No better

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2
Q

Muscle activation in people with episodic LBP generally presents as ____ of superficial muscles

A. Temporary underactivation
B. Temporary overactivation
C. Lasting underactivation
D. Lasting overactivation

A

D. Lasting overactivation

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3
Q

Which of the following sets of findings most suggest the need for referral?

A. Babinski: great toe ext and flexion of toes, 3+ Achilles reflex
B. Babinski: great toe ext and abduction of toes, 3+ Achilles reflex
C. Babinski: great toe flexion and flexion of toes, 2+ Achilles reflex
D. Babinski: great toe flexion and abduction of toes, 2+ Achilles reflex

A

B. Babinski: great toe ext and abduction of toes, 3+ Achilles reflex

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4
Q

PPIVM in the spine is most analogous to end ROM passive ____in the shoulder

A. GH posterior glide
B. Shoulder girdle flexion
C. GH flexion

A

C. GH flexion

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5
Q

accessory movement =

A

applied by an outside force

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6
Q

physiologic movement =

A

motion the pt can do

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7
Q

Idiopathic scoliosis is an example of a ____ spinal curve

A. Protective, structural
B. Protective, non-structural
C. Non-protective, non-structural
D. Non-protective, structural

A

D. Non-protective, structural

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8
Q

Which of the following is most likely to result from slump testing in a pt with non-neurodynamic source of posterior R thigh pain?

A. His pain begins with slumping and does not change with neck flexion
B. His pain begins with knee extension and decreases with neck extension
C. His pain does increase when DF is added to knee extension
D. His pain is increased with DF and decreases with neck extension

A

A. His pain begins with slumping and does not change with neck flexion

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9
Q

A patient with posterior L thigh pain says that her thigh pain is reproduced with passive R SLR What is the best assessment of the source of her pain?

A. Neurodynamic
B. Discal
C. Non-MSK
D. MSK

A

B. Discal

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10
Q

PerformIng prone knee bend in sidelying instead of prone is especially good for

A. Ruling out a discal component to the symptoms
B. Stabilizing the pelvis more effectively to prevent anterior tilting
C. Distinguishing neurodynamic from non-neurodynamic pain
D. Differentiating upper lumbar from lower lumbar source out a discal component to the symptoms

A

C. Distinguishing neurodynamic from non-neurodynamic pain

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11
Q

The two-stage treadmill test is particularly useful for differentiating

A. Spinal stenosis pain from neurodynamic pain
B. Arterial claudication from venous claudication
C. Spondylolisthesis from spinal stenosis
D. Spinal stenosis (neurogenic claudication) from vascular claudication

A

D. Spinal stenosis (neurogenic claudication) from vascular claudication

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12
Q

Abdominal bracing for spinal stabilization is

A. Likely to provide more spinal stability than isolated TrA contraction
B. Likely to be more effective in reducing pain than isolated TrA contraction
C. Is the lay term for TrA contraction so pt’s can understand better
D. Likely to provide less compressive load to the spine than the isolated TrA contraction

A

A. Likely to provide more spinal stability than isolated TrA contraction

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13
Q

Which of the following LEAST indicates the need for a limited exam?

A. Pt who reports their symptoms have been increasing
B. Pt referred for acute post-op rehab
C. Pt with symptoms that are easily provoked and eased
D. Pt who is on anticoagulant medication

A

C. Pt with symptoms that are easily provoked and eased

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14
Q

A provisional Dx is made

A. After the objective exam and before beginning treatment
B. After the subjective exam and before the objective exam
C. After the first visit so the effects of treatment can be assessed
D. At the end of visit 3 when all of the regional screening has been completed

A

B. After the subjective exam and before the objective exam

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15
Q

What’s the difference between swayback posture and kyphotic/lordotic posture?

A. The lumbar spine in swayback is flat, not lordotic
B. The thoracic spine in swayback is in normal kyphosis
C. The hips are more likely to be extended in swayback posture

A

C. The hips are more likely to be extended in swayback posture

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16
Q

Lumbopelvic sitting results in ___ thoracic ES activity when compared to telling a pt to “sit up straight”

A. More
B. Less
C. Normal
D. Unchanged

A

B. Less

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17
Q

A pt with high fear avoidance behaviors is likely to have ____ step length and ____ gait speed (compared to normal)

A. Longer, increased
B. Shorter, decreased
C. Longer, decreased
D. Shorter, increased

A

B. Shorter, decreased

18
Q

You are screening for balance problems in a 69 y/o pt with LBP. She is able to maintain her balance for 40 secs to double leg standing with eyes open and 25 secs with eyes closed

A. She should be asked to perform tandem stance
B. The screen should stop and she does not need balance training
C. The screen should stop and this suggests she needs balance training
D. Not enough info has been provided to make a balance assessment

A

D. Not enough info has been provided to make a balance assessment

19
Q

A pt is performing RFIS and reports pain in mid range but not end range, and it resolves when standing is resumed. REIS does not provoke his sx. This is most likely to be

A. Derangement
B. Dysfunction
C. Neither

A

C. Neither

20
Q

PAIVM is intended to detect ____ problems

A. Segmental mobility
B. Motor control
C. Muscle strength
D. Fear avoidance

A

A. Segmental mobility

21
Q

All LE DTR’s are 1+/5 bilaterally and BAbinski is negative bilaterally in a pt with LBP and R hip and thigh pain. What is the best assessment of these findings?

A. A referral should be considered
B. Musculoskeletal imaging should be requested
C. This is probably normal

A

C. This is probably normal

22
Q

Which of the following is NOT a contraindication for neurodynamic testing?

A. New neuro signs
B. Diabetic neuropathy
C. Inexperience of the examiner
D. Breast cancer

A

B. Diabetic neuropathy

23
Q

The diagnostic process ends with

A. Pt discharge
B. The objective examination
C. The end of the first treatment
D. Reassessment at the first revisit

A

A. Pt discharge

24
Q

A pt has genu recurvatum on the R side standing. The PT assesses this pt’s pelvic landmarks and are all level in standing. The actual measured length of her R leg (measured in supine) is likely to be

A. Longer than left
B. Shorter than left
C. Same length as left

A

A. Longer than left

25
Q

Excessive pronation will often cause extremity to appear

A. Lengthened
B. Shortened
C. NA- no effect

A

B. Shortened

26
Q

The appearance of a short R leg in standing can be caused by all of the following except

A. A bony asymmetry
B. Knee malalignment
C. Unilateral hip DJD
D. Unilateral quadratus tightness

A

D. Unilateral quadratus tightness

27
Q

The capsular pattern of the spine causes limited

A. Contralateral lateral flexion and rotation
B. Contralateral lateral flexion and ipsilateral rotation
C. Ipsilateral lateral flexion and ipsilateral rotation
D. Ipsilateral lateral flexion and contralateral rotation

A

B. Contralateral lateral flexion and ipsilateral rotation

28
Q

A patient with very flexible hamstrings is likely to have

A. Limited hip contribution to lumbar flexion
B. Excessive hip contribution to lumbar flexion

A

B. Excessive hip contribution to lumbar flexion

29
Q

An inclinometer that is placed on the sacrum during flexion will give a good assessment of

A. Hip mobility and/or hamstring flexibility
B. Lumbar joint mobility and muscle flexibility
C. Overall lumbar and hip/hamstring flexibility (lumbopelvic rhythm)

A

A. Hip mobility and/or hamstring flexibility

30
Q

A pt with a disc herniation at L5-S1 with nerve root impingement is most likely to have weakness in the

A. Ankle dorsiflexors
B. Great toe extensors
C. Plantarflexors

A

C. Plantarflexors

31
Q

Your pt with lower lumbar spine pain has 3+ R achilles DTR. All other DTR’s in both extremities are 2+. This hyperreflexia suggests

A. A lower lumbar vertebral canal problem
B. A CNS problem
C. Nerve root irritation
D. Nerve root compression

A

B. A CNS problem

32
Q

Your 69 y/o pt has excessive thoracic kyphosis and FHP and reports bilateral symmetrical LBP of several weeks duration. He says he started working as a Walmart greeter a few months ago, which involves standing on his feet several hours per shift. His pain is worst in standing, best with reclining in his armchair. Sitting in an upright chair is also uncomfortable but not as bad as standing. He thinks his posture has deteriorated since starting his job. How can you decide whether his postural problems are relevant to his LBP?

A. Assess baseline symptoms, have him actively improve his standing posture with instruction, then reassess his sx
B. Assess baseline symptoms, have him actively improve his sitting posture with instruction, then reassess sx
C. Do the two stage treadmill test to look for reproduction of sx which would suggest spinal stenosis
D. Instruct him to put a pillow or lumbar roll in his lumbar spine in the recliner and then assess the effect of the next visit

A

A. Assess baseline symptoms, have him actively improve his standing posture with instruction, then reassess his sx

33
Q

Joe has low back and R leg pain and stands with his shoulders level but to the left of his pelvis. Which of the following describes this observation?

A. Left lateral shift, which is typical
B. Left lateral shift, which is atypical
C. Right lateral shift, which is typical
D. Right lateral shift, which is atypical

A

A. Left lateral shift, which is typical

34
Q

Joe says that he started “standing crooked” a few days ago when his back and R calf pain began but that he can’t correct it when you cue him to do so. What should you do to decide if this is a relevant lateral shift?

A. I don’t need to do anything because the pain and shift started at the same time which automatically makes it relevant
B. Manually correct the shift and if that improves his back pain then it is relevant
C. Manually correct the shift and if his calf pain diminishes by the next visit then it is relevant
D. Manually correct the shift and if his distal calf pain diminishes but the proximal calf pain remains the same then it is relevant

A

D. Manually correct the shift and if his distal calf pain diminishes but the proximal calf pain remains the same then it is relevant

35
Q

Before Joe leaves treatment your CI reminds you to instruct Joe in home shift correction since you got such good results with manual shift correction today. The instructions for joe should be to stand with his ___ arm against the wall with the elbow 90 degrees and slide his hips to the _____

A. Right, right
B. Right, left
C. Left, left
D. Left, right

A

C. Left, left

36
Q

If Joe’s leg pain increased with shift correction but his back pain improved, the best course of action would be to

A. Stop the standing shift correction and try an unloaded shift
B. Teach him self-shift correction for his HEP
C. Continue the shift until overcorrection has been achieved and reassess
D. Start the prone progression by placing him over 2-3 pillows

A

A. Stop the standing shift correction and try an unloaded shift

37
Q

The lumbar quadrant is best used in a pt with LBP

A. And hip pain to help you decide if you should further evaluate the lumbar spine
B. To help you rule out SIJ as possible contributing source
C. That increased with extension and increased with ipsilateral flexion to rule in spondylosis
D. Rule out spinal stenosis when contralateral flexion and flexion increase pain

A

A. And hip pain to help you decide if you should further evaluate the lumbar spine

38
Q

During slump testing, you tell the pt to slump and she drops her face toward her lap at the same time she rounds her spine. She says this increases her buttock pain. This is

A. OK since dropping her head forward is the next step anyway and the therapist should proceed with extending the knee to continue the test
B. Not OK since flexing the head forward puts the nervous system on slack and will limit her knee extension range
C. Not OK since neurodynamic tests must be done in careful, stepwise progression in order to make the appropriate assessment
D. OK since neck flexion tells me that the pain has a neurodynamic source, I can skip the rest of the slump test and call this (+)

A

C. Not OK since neurodynamic tests must be done in careful, stepwise progression in order to make the appropriate assessment

39
Q

Your pt reports R buttock and thigh pain when doing downward dog since she started trying to use a yoga DVD at home to rehab from a mild R hamstring strain after resting it for a couple of months by doing no exercise or recreational activity. Her L SLR is 105 degrees (including DF) and (-)this tells us that her hamstring length is more than enough. Her R SLR is 90 degrees and DF increases her familiar pain. What is your assessment of these results?

A. Her R SLR is (+) for a neurodynamic contribution to her pain
B. Her R SLR is also (-) since her SLR ROM is WNL
C. It is unclear until a sensitizing maneuver has been done to clarify HS from neurodynamics
D. SLR is not an appropriate test; slump is better for this type of suspected neurodynamic problem

A

A. Her R SLR is (+) for a neurodynamic contribution to her pain

40
Q

Why is it important to eval hip in a pt w/ LBP- name 2 reasons

A
  • Hip can refer to low back
  • Thoracolumbar fascia and mm attachments cross both joints
  • Lumbopelvic rhythm can be altered
  • Differentiate hip/lumbar problem
  • Lower cross syndrome
41
Q

Which of the following is NOT a common S/S of hip OA

A. A report of lateral hip pain
B. Significant limitation of hip IR
C. Painful arc during active SLR
D. (+) scour test, esp. Loaded

A

C. Painful arc during active SLR

Advanced Spine (50 decks)

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