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NPTE Memorization > Mega Review > Flashcards

Mega Review Flashcards

1
Q

What main muscles do the musculocutaneous nerve innervate?

A

Biceps brachii
Brachialis
Coracobrachialis

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2
Q

What nerve supplies sensory innervation to the lateral forearm?

A

Musculocutaneous

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3
Q

What nerve innervates the latissimus dorsi?

A

Thoracodorsal

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4
Q

What nerve innervates the serratus anterior?

A

Long thoracic

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5
Q

What muscles do the Median nerve innervate?

A

MeaT LOAF
Median nerve
Pronator teres
Lumbricals (1,2)
Opponens pollicis
Flexors (wrist + fingers) EXCEPT flexor carpi ulnaris and ulnar side of flexor digitorum profundus

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6
Q

What muscles do the Ulnar nerve innervate?

A

MAFIA
Medial lumbricals (4+5)
Adductor pollicis
FCU/FCP ulnar side
Interossei (dorsal)
Abductor digiti minimi

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7
Q

What muscles do the Radial nerve innervate?

A

Rudolph is a BEAST
Brachioradialis
Extensors
Anconeus/APL
Supinator
Triceps

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8
Q

What key muscles does the Axillary nerve innervate?

A

Teres minor
Deltoid

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9
Q

What muscles does the Femoral nerve (L2-L4) innervate?

A

F-QuIPS
Iliopsoas
Sartorius
Pectineus
Quadriceps femoris

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10
Q

What muscles does the Obturator nerve (L2-L4) innervate?

A

Adductor longus/brevis
Gracilis
Adductor magnus
Obturator externus

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11
Q

The Gluteus Maximus is innervated by what nerve?

A

Inferior gluteal nerve (L5-S2)

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12
Q

What muscles does the Superior gluteal nerve (L4-S1) innervate?

A

Gluteus medius
Gluteus minimus
TFL

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13
Q

The Tibial nerve (L4-S3) innervates which muscles?

A

Gastrocnemius
Soleus
Popliteus
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus

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14
Q

The common peroneal nerve branches into what two nerves?

A

Superficial peroneal
Deep peroneal

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15
Q

What two muscles does the Superficial peroneal nerve innervate?

A

Fibularis longus
Fibularis brevis

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16
Q

What muscles do the deep peroneal nerve innervate?

A

Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus

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17
Q

Tarsal Tunnel Syndrome affects what nerve?

A

Posterior tibial nerve

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18
Q

Where would a patient with Tarsal Tunnel Syndrome have pain? Weakness?

A

Pain: medial heel, medial arch, worse with standing/walking
Weakness: foot intrinsics

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19
Q

For a patient with adhesive capsulitis, what joint mobilization would be most effective?

A

Posterior (second best is inferior)

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20
Q

Purpose of Long Sitting (Supine to Sit) Test

A

Identifies SI joint dysfunction that may be cause of leg length discrepancy

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21
Q

What joint mobilization increases Glenohumeral ER?

A

Anterior

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22
Q

What joint mobilization increases Glenohumeral IR?

A

Posterior

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23
Q

What hip mobilization will increase IR?

A

Posterior

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24
Q

What hip mobilization will increase ER?

A

Anterior

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25
Q

What patellar glide will encourage knee extension?

A

Superior

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26
Q

What talocrural mobilization increases DF?

A

Posterior

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27
Q

What talocrural mobilization increases PF?

A

Anterior

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28
Q

With UMN disorders, you expect to see:
hypotonia/hypertonia
hyporeflexia/hyperreflexia

A

HYPER

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29
Q

What is anosognosia?

A

A lack of awareness, or denial, of a paretic extremity as belonging to the person. Could also be lack of awareness/denial of paralysis and disability.

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30
Q

Neglect is most commonly a symptom of a CVA in what lobe (and what side)?

A

Right parietal lobe

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31
Q

What is prosopagnosia?

A

Inability to recognize familiar faces

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32
Q

What is ideomotor apraxia?

A

There is a disconnection between the idea of a movement and its motor execution.
SO, a patient may be able to carry out habitual tasks automatically and describe how they are done, but is unable to imitate gestures or perform on command.

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33
Q

What is ideational apraxia?

A

The inability to perform a purposeful motor act, either intentionally or on command.

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34
Q

What are risk factors of diabetic neuropathy?

A

Duration and severity of DM
Elevated triglycerides
High BMI
History of smoking or HTN

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35
Q

When the anterior cerebral artery is affected, there is contralateral hemiparesis which mostly affects (LEs/UEs)

A

LEs, since the ACA supplies mostly the medial part of the brain (homunculus)

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36
Q

Aphasia is a result of a CVA involving which cerebral artery?

A

Middle Cerebral Artery
Broca’s, Wernicke’s, and global aphasia

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37
Q

Signs and symptoms of CVA involving ACA

A

Contralateral hemiparesis and hemisensory loss (LE)

ACA = ABCD = kids/babies
Urinary incontinence
Problems with imitation, bimanual tasks, apraxia
Slowness, delay, motor inaction
Contralateral grasp reflex, sucking reflex

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38
Q

What is Apraxia?

A

Difficulty with previously known tasks

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39
Q

What is the main difference in Left and Right MCA infarcts?

A

Left = language
Right = perceptual disorders/neglect

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40
Q

(UEs/LEs) are more involved in MCA infarcts?

A

Upper extremities

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41
Q

Homonymous hemianopsia is seen with which artery?

A

MCA

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42
Q

What are the symptoms of a Middle Cerebral Artery infarct?

A

Contralateral hemiparesis and hemisensory loss (UE + face)

MCA mnemonic = MPH
Mouth = aphasia
Perceptual disorders = neglect
Homonymous hemianopsia

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43
Q

What is global aphasia?

A

When both Broca’s and Wernicke’s areas are damaged.
Patient cannot understand or communicate.

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44
Q

Wernicke’s area is in the (parietal/temporal) lobe.

Patient’s with Wernicke’s aphasia would benefit most from what form of communication?

A

Temporal

Gestures

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45
Q

Broca’s area is in the (frontal/temporal) lobe.

Patients with this type of aphasia would benefit from what form of communication?

A

Frontal

Yes/no questions

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46
Q

Unilateral neglect is most common in (R/L) (MCA/PCA)

A

Right MCA stroke

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47
Q

Is vision affected in unilateral neglect?

A

No, perception is affected

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48
Q

Someone with a R MCA would neglect their (R/L) side.

A

Left

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49
Q

For a patient with left unilateral neglect, what side should you initially start interventions on?

Left/Right

A

Right: you have to start on their right side (the side they can perceive) or else they’ll just ignore you.

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50
Q

What is Homonymous Hemianopsia?

A

When the same half of your visual field is affected in both eyes. Common with MCA and PCA CVA.

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51
Q

Left Homonymous Hemianopsia means the (left/right) visual field is affected?

A

Left: it’s named for the side that’s affected

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52
Q

A Right MCA would lead to (left/right) homonymous hemianopsia.

A

Left

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53
Q

After a patient had a PCA infarct, they complain that they can feel the clothes on their skin and that it hurts. What is this a case of?

A

Thalamic Pain Syndrome, which happens in Central Territory

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54
Q

Your patient has to be driven to therapy due to him being unable to understand the directions on the roads.
What is this called and what cerebral artery damage would cause this?

A

Topographical disorientation, which is caused by the peripheral territory of PCA being damaged.

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55
Q

Your patient’s caregiver reports the patient keeps trying to use the TV remote as a phone after their stroke.
What is this called and what artery was affected?

A

Visual agnosia: patient can see, but they cannot understand what they’re seeing.
Common in peripheral territory of PCA.

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56
Q

The TV in the clinic is showing a movie with Tom Cruise and Tom Hanks in it. Your post-stroke patient has no clue who those people are.
What is this and what artery was affected to cause this?

A

Prosopagnosia: difficulty naming familiar faces.
Common in peripheral territory of PCA.

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57
Q

T/F: homonymous hemianopsia occurs only in the left hemisphere

A

F: HH can occur in both the left and right hemispheres

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58
Q

A patient with neglect would have the most difficulty with (visual/verbal) cues

A

Visual

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59
Q

Describe the behavior, intellect, and emotion of a left hemisphere CVA.

A

Left = oLd
Behavior: slow, cautious
Intellect: highly distractible
Emotion: difficulty with positive emotions

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60
Q

Describe the behavior, intellect, and emotion of a right hemisphere CVA.

A

Right = child/baby
Behavior: quick, impulsive, safety risk
Intellect: rigidity of thought
Emotion: difficulty with negative emotions

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61
Q

Spasticity is assessed with (PROM/AROM)

A

Passive: you can’t spell Spastic without “pas”

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62
Q

Muscle synergies are assessed with (PROM/AROM)

A

Active: synergies are patterned movements so you need to have the patient move to see them

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63
Q

Brunnstrom Stages of Stroke Recovery

A

Remember that it’s like a bell curve in terms of spasticity.

Stage 1: flaccidity
Stage 2: beginning of minimal voluntary movement
Stage 3: voluntary control of movement synergy (spasticity peak)
Stage 4: movement outside of synergy
Stage 5: greater independence from limb synergies
Stage 6: individual and coordinated movements
Stage 7: normal

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64
Q

What is the UE spasticity pattern?

A

Chicken Dance
Scapula: retracted and downwardly rotated
Shoulder: ADD, IR, depression
Elbow: flexion
Forearm: pronation
Wrist: flexion, ADD
Hand: finger flexion, clenched fist with thumb ADD in palm

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65
Q

What is the LE spasticity pattern?

A

Ballerina
Pelvis: hip hike
Hip: ADD, IR, extension
Knee: extension
Foot/Ankle: PF, INV, equinovarus, toes claw/curl

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66
Q

When positioning a patient with an UE spasticity pattern, you want their shoulder (protracted/retracted) and arm (abducted/adducted).

A

Always opposite of synergy:
Protracted
Abducted

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67
Q

The LE spasticity pattern is the same as which synergy pattern?

A

LE Extension synergy: ballerina

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68
Q

Describe the LE flexion synergy pattern.

A

“Hot guy crossing his legs putting on a sock.”
Hip flexion, ABD, ER
Knee flexion
Ankle DF, INV
Toe DF

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69
Q

The UE (flexion/extension) synergy pattern looks like you are trying to show off your biceps

A

Flexion

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70
Q

The UE (flexion/extension) synergy pattern looks like you are being handcuffed behind your back.

A

Extension

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71
Q

T/F: you can have both a flexion and extension synergy pattern.

A

True

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72
Q

Which stroke is more serious: ischemic or hemorrhagic?

A

Hemorrhagic

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73
Q

What are the 2 purposes of the lymphatic system?

A

1- immune system
2- drain lymph

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74
Q

What is the flow of lymph in the body?

A

“CV NoTeD”
Capillaries
Vessels
Nodes
Trunks
Ducts

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75
Q

The face and RUE drains to which duct?

A

RULE
Face + RUE = lymphatic duct

Everywhere else drains to the thoracic duct.

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76
Q

Name some of the causes of secondary lymphedema

A

Venous insufficiency
Lymph node removal
> Lymphatic load
> Transport capacity

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77
Q

What are the 3 causes of primary lymphedema?

A

Milroy disease
Lymphedema Praecox (Meige disease)
Lymphedema Tarda

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78
Q

At what age are people diagnosed with Milroy’s disease?

A

0-2 yrs, it’s congenital

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79
Q

At what age are people diagnosed with Meige disease (Lymphedema praecox)?

A

10-20yrs

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80
Q

At what age are people diagnosed with Lymphedema Tarda?

A

> 35 years, tarda = late

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81
Q

What condition is the Stemmer Sign testing for?

A

Lymphedema (stage II or III)

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82
Q

What are the stages of lymphedema?

A

2 mnemonics: Lymph 0-3 dema and SPIT
Subclinical: 0 latency
Pitting edema: 1 reversible stage
Irreversible: 2 spontaneously irreversible
Trunk-like: 3 lymphostatic elephantiasis

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83
Q

At what stage of lymphedema does elevation reverse the symptoms?

A

Stage 1: reversible stage

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84
Q

At what stage of lymphedema do you get a positive Stemmer sign?

A

Stage 2: spontaneously irreversible

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85
Q

At what stage of lymphedema do you see pitting edema?

A

Stage 1: reversible stage

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86
Q

At what stage of lymphedema is hyperkeratosis and papillomas common?

A

Stage 3: lymphostatic elephantiasis

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87
Q

Your patient presents with 1/4 inch pitting edema that returns to normal in 10s. What stage is this?

A

2+

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88
Q

Pitting Edema Grades

A

1+: <1/4 inch
2+: 1/4-1/2inch, <15s
3+: 1/2-1inch, 15-30s
4+: >1in, >30s

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89
Q

Lipedema is (BL/UL)

A

“You have 2 lips”
Bilateral

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90
Q

In (lymphedema/lipedema), patients will bruise easily and their skin will be more sensitive to pressure + touch.

A

Lipedema

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91
Q

Lipedema (does/does not) occur in the feet.

A

Does NOT

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92
Q

T/F: in lymphedema, distal edema in the foot is present

A

True

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93
Q

(Volumetric/girth) measurements are more appropriate for distal limbs.

A

Volumetric

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94
Q

(Volumetric/girth) measurements are more appropriate for proximal limbs.

A

Girth

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95
Q

When are bioimpedance measurements taken?

A

On a lymphedema patient pre and post surgery.

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96
Q

What does a Lymphoscintigraphy identify?

A

Lymphatic insufficiency

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97
Q

What do lymph nodes usually feel like on palpation?

A

Soft, non-tender, non-palpable
Pea sized (<1cm)

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98
Q

You are palpating your patient’s lymph nodes and notice they are hard. The patient reports slight pain with palpation. Your patient has not been sick for a while now. What should you do?

A

Refer to PCP

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99
Q

What tool is used to assess lymphedema pre/post surgery?

A

bioelectric impedence

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100
Q

During manual lymphatic drainage, you should clear (proximal/distal) areas first.

A

Traffic jam!
Proximal

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101
Q

During manual lymphatic drainage, stroking should be done towards more (distal/proximal) proximal

A

Proximal, AKA stroke distal to proximal

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102
Q

During phase I of compression therapy, the patient wears (low/high) stretch bandages (at night/at all times).

A

Low stretch
At all times

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103
Q

During phase II of compression therapy, patients wear (low stretch bandages/compression garments) during the day.

A

Compression garments during the day.
They still wear low stretch bandages during the night.

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104
Q

Low stretch bandages have a (high/low) working pressure and (high/low) resting pressure.

A

High working pressure: applies resistance so when you move, your muscles need to work against the resistance
Low resting pressure: no increased resistance at rest

105
Q

When does a patient begin the maintenance phase of lymphedema therapy?

A

When their symptoms plateau.

106
Q

What are the two things patients do when they go into the maintenance phase of lymphedema therapy?

A

1.) patient performs self-manual lymphatic drainage
2.) graduates to compression garments during the day, while they still bandage at night

107
Q

What exercise should lymphedema patients NOT do?

A

High intensity exercises

108
Q

T/F: Lymphedema patient’s should not wear their bandages during workouts to reduce risk of skin breakdown.

A

FALSE: you want to wear bandages during workouts to increase lymphatic drainage

109
Q

You are giving your lymphedema patient an HEP. You order the exercises so that you are working the (distal/proximal) muscles first.

A

Proximal, so start with cervical/chest exercises and then move distal.

110
Q

T/F: swimming is not recommended for patients with lymphedema

A

False: the increased pressure aids in lymphatic drainage

111
Q

T/F: Compression garments are wrapped with more pressure proximally.

A

False: more pressure distally and less pressure proximally

112
Q

What is Rate Product Pressure?

A

HR x SBP: tells us about the myocardial oxygen demand on the heart

113
Q

What 3 vital signs are supposed to increase linearly during exercise?

A

HR, CO, and MAP

114
Q

(Systolic/Diastolic) BP increases during exercise.

A

Systolic

115
Q

Stage 1 HTN values

A

Systolic between 130-139
OR
Diastolic between 80-89

116
Q

What are the names of the blood pressure categories?

A

Normal
Elevated
Stage 1
Stage 2
Hypertensive crisis

117
Q

Hypertensive crisis values

A

Systolic >180
AND/OR
Diastolic >120

118
Q

What is normal blood pressure?

A

Less than 120/80 mmHg

119
Q

What values fall under “elevated” blood pressure?

A

Systolic 120-129
AND
Diastolic <80

120
Q

Stage 2 HTN values

A

Systolic at least 140
OR
Diastolic at least 90

121
Q

When VO2 reaches a steady state, what does that tell you?

A

The ATP demand is being met aerobically.

122
Q

What are the INITIAL changes you see in vital signs in a higher altitude environment?

A

HR increases
BP increases
CO increases
SV no change

123
Q

What are the changes you see in vital signs in a higher altitude environment once you acclimatize?

A

HR increases
BP normal
CO normal
SV decreases

124
Q

What are the cardiovascular effects of aquatic therapy?

A

“Going into the water is relaxing.”
HR decreases
BP decreases
Vo2 decreases
CO increases
SV increases

125
Q

When you are standing in water that is up to your ASIS, what percentage weight bearing are you?

A

50%

126
Q

When you are standing in water that is up to your Xiphoid process, what percentage weight bearing are you?

A

33%

127
Q

When you are standing in water that is up to C7, what percentage weight bearing are you?

A

10%

128
Q

How do you calculate cardiac output?

A

HR x SV = CO

129
Q

What is a great measure to assess change in fitness from pre and post fitness training?

A

The time it takes for the heart rate to return to baseline.

130
Q

What 4 valves do we auscultate?

A

Aortic, Pulmonic, Tricuspid, and Mitral (Bicuspid)

131
Q

S4, also known as atrial gallop, is associated with what?

A

Ventricular filling and atrial contraction
HTN

132
Q

S3, also known as ventricular gallop, is associated with what?

A

Ventricular filling
Heart failure but also seen in some athletes.

133
Q

S1 is (lub/dub) and marks the onset of (systole/diastole)

A

Lub
Systole

134
Q

S2 is (lub/dub) and marks the onset of (systole/diastole)

A

Dub
Diastole

135
Q

Closure of the mitral and tricuspid valves are associated with what heart sound?

A

S1

136
Q

Closure of the aortic and pulmonic valves are associated with what heart sound?

A

S2

137
Q

Where does the S2 sound the loudest?

A

Base of heart

138
Q

Where does S1 sound the loudest?

A

Apex of heart (bottom)

139
Q

When your patient presents with abnormal smooth pursuit and saccades, what should you do?

A

Refer out, this is pointing to a central vestibular pathology which we can’t treat.

140
Q

Peripheral vestibular pathology presents with (pendular/jerk) nystagmus.

A

Jerk, where there are slow and fast phases

141
Q

In peripheral vestibular pathology, does a visual fixation help improve nystagmus?

A

Yes

142
Q

(Central/peripheral) vestibular pathology can present with hearing loss.

A

Peripheral

143
Q

When you are asking a patient to follow your moving finger with their eyes, what are you testing?

A

Smooth pursuit

144
Q

When you are asking a patient to look from your finger to your nose, what are you testing?

A

Saccades

145
Q

When performing a Head Impulse/Thrust Test to the left, your patient’s eyes jump back to yours. What does this tell you?

A

Left sided peripheral vestibular pathology
Left sided VOR issues

146
Q

What is Charcot’s Triad? What condition would it point to?

A

SIN
Scanning speech
Intention tremor
Nystagmus

Points to MS

147
Q

T/F: Nystagmus with Canalithiasis will last <1min

A

True

148
Q

When performing the Dix-Hallpike Test, your patient exhibits upbeating nystagmus. What canal is affected?

A

Posterior Canal “PUP”

149
Q

When performing the Dix-Hallpike test, your patient’s head is turned to the Left and exhibits downbeating nystagmus. What does this tell you?

A

Left Anterior Canal is affected.

150
Q

Which canal presents with upbeating nystagmus?

A

Posterior Canal

151
Q

Which canal presents with downbeating nystagmus?

A

Anterior Canal

152
Q

Your patient has posterior canal BPPV Canalithiasis. What maneuver should you perform?

A

Epley

153
Q

The Semont or Liberatory Maneuver is for what type of BPPV?

A

Cupulolithiasis

154
Q

Your patient gets extremely nauseated every time you attempt an Epley maneuver. What intervention can you do instead?

A

Brandt Daroff Exercise

155
Q

What tests the horizontal canals for BPPV?

A

Roll Test/Horizontal Canal Test

156
Q

You do the roll test and find that the patient had ageotrophic nystagmus on both sides, but the patient reported increased symptoms on the Left side. What’s the Dx?

A

HC R cupulolithiasis
Ageo = cupulo
>Sx on L = R side affected

157
Q

When a patient has horizontal canal cupulolithiasis, the side on the roll test with the (more/less) intense symptoms is affected.

A

Less intense

158
Q

When a patient has horizontal canal canalithiasis, the side on the roll test with the (more/less) intense symptoms is affected.

A

More intense

159
Q

Horizontal Canalithiasis presents with (a/geotropic) nystagmus.

A

Canals are in the ground
Geotrophic

160
Q

Horizontal Cupulolithiasis presents with (a/geotrophic) nystagmus.

A

Ageotrophic

161
Q

What is the treatment for Horizontal Canal Canalithiasis?

A

BBQ Roll/Maneuver

162
Q

List the steps of the BBQ Maneuver.

A

Patient starts supine with head on pillow for ~20 degrees of cervical flexion.
1- Turn head towards affected side
2- Turn back to midline
3- Turn away from affected side
4- Go prone

163
Q

During the Roll Test, your patient has geotrophic nystagmus, which is more intense on the right side. What is the diagnosis and intervention?

A

Dx: Horizontal Canal R sided Canalithiasis
Treatment: BBQ Maneuver going to the R side initially

164
Q

What is one unique symptom of Labrynthitis?

A

Labrynthitis = Loss of hearing
L and L

165
Q

What is one symptom a patient will describe if they have Meniere’s Disease?

A

Aural fullness, AKA feeling like they have water stuck in their ears.

166
Q

What type of cerebral palsy has movements that are described as “worm-like?”

A

Athetoid cerebral palsy due to mixed muscle tone.

167
Q

What does the “too many toes” sign correlate with?

A

Tib posterior tendon dysfunction

168
Q

Pain from urinary caculi most often occurs because of blockage of which structure?

A

Ureter

169
Q

Which muscles actively compress the urethra, vagina, and rectum, thus maintaining continence?

A

Levator ani muscles: pubococcygeus, iliococcygeus, and puborectalis

170
Q

Which respiratory pattern is seen in coma and near death?

A

Cheyne-Stokes respiratory pattern: period of apnea followed by gradually increasing depth and frequency of respirations.

171
Q

In gaze stability, when both the patient’s head and the target are moving, this is (VORx1/VORx2)

A

VORx2

172
Q

In gaze stability, when your patient is looking at a static target while moving their head, this is (VORx1/VORx2)

A

VORx1

173
Q

For unilateral vestibular hypofunction, you (should/shouldn’t) do actions that bring a patient’s symptoms on.

A

SHOULD: habituation training

174
Q

What are the risk factors for Metabolic Syndrome?

A

WEIGHHT
Waist Expanded: waist circumference
Impaired Glucose: fasting plasma glucose
HDL
HTN
Triglycerides

175
Q

How many positive criteria do you need in order to diagnose Metabolic Syndrome?

A

3 or more

176
Q

What is the criteria for Metabolic Syndrome?

A

Waist circumference: >40in M, >35in F
Triglycerides: 150mg/dL or higher
HDL: <40 M, <50 F
Blood Pressure: 130 or higher SBP and/or 85 or higher DBP
Fasting Plasma Glucose: >100 mg/dL

177
Q

What are some symptoms of Addison’s Disease?

A

“Mrs. Addison: a petite brown old lady who walks with a stick.”
Adrenal insufficiency: decreased cortisol and aldosterone
Decreased BP, dehydration.
Hyperkalemia
Decreased glucose
Bronze pigmented skin
Weight loss, anorexia, GI disturbances
Intolerance to cold and stress
Generalized weakness

178
Q

What is a disease of adrenal insufficiency?

A

Addison’s Disease

179
Q

What’s the difference between Cushing’s Disease vs Syndrome?

A

Disease: increased ACTH released by pituitary
Syndrome: increased cortisol released by adrenal

180
Q

What are the symptoms of Cushing’s Disease?

A

“Mr. Cushings: white chubby boy who loves chugging beer.”
Elevated cortisol + aldosterone
Increased BP, water retention
Hypokalemia
Increased glucose
Ruddy/red appearance
Weight gain, centripetal obesity, moon face
Proximal muscle weakness and atrophy

181
Q

Frozen shoulder is very common with which endocrine disorders?

A

Thyroid disorders (both hyper and hypo)

182
Q

Graves’ disease is what type of endocrine disorder?

A

Hyperthyroidism

183
Q

How does hyperthyroidism affect a person’s MSK system?

A

Decreased bone mineral density
Increased risk of osteoporosis
Hyperreflexia

184
Q

Hashimoto’s disease is what type of endocrine disorder?

A

Hypothyroidism

185
Q

(Hypo/hyper)thyroidism increases the risk of DM2

A

Hypothyroidism

186
Q

What are the symptoms of hypothyroidism?

A

“A lazy person laying on the couch watching TV, cozy under a comforter.”
Decreased HR
Low BMR
Cold intolerance
Decreased glucose absorption (increased blood glucose)
Sleepiness, tiredness, proximal muscle weakness
Constipation
Weight gain and decreased appetite
Prolonged deep tendon reflexes

187
Q

What are the symptoms of Hyperthyroidism?

A

“David! Super hyper, doesn’t gain weight with all the mango lassis he drinks, and has silky hair.”
Increased HR (decreased BP)
High BMR
Heat intolerance
Increased glucose absorption (decreased blood glucose)
Restlessness, insomnia
Diarrhea
Weight loss and increased appetite
Increased perspiration
Hyperreflexia

188
Q

What is the job of the parathyroid gland?

A

Controlling calcium and phosphate.

189
Q

Parathyroid Hormone (PTH) is (directly/inversely) related to calcium levels.

A

PTH is directly related to calcium, inversely to phosphate.

190
Q

Hyperparathyroidism is (+/-) calcium and (+/-) phosphate

A

Increased calcium
Decreased phosphate

Remember that parathyroid hormone is directly related to calcium levels, and inversely related to phosphate levels.

191
Q

What are the symptoms of Hyperparathyroidism?

A

Bones: osteopenia
Stones: kidney stones
Groans: peptic ulcers
Moans: fatigue, depression, confusion, drowsiness
Sensory: glove/stocking sensory loss

192
Q

Hypercalcemia, as seen in Hyperparathyroidism, leads to increased (bone/blood) calcium levels.

A

Blood calcium: this is why osteopenia is a side effect of hyperparathyroidism

193
Q

Symptoms of Hypoparathyroidism

A

CATS are Numb
Convulsions
Arrhythmias
Twitching/tetany
Spasms
Numb: paresthesia of fingers and mouth, fatigue

194
Q

The pancreas does not produce enough insulin in (Type 1/Type 2) DM.

A

Type 1: also called hypoinsulinemia

195
Q

What are the symptoms of T1DM?

A

3Ps:
Polyphagia (increased hunger)
Polyuria (increased urination)
Polydipsia (increased thirst)

196
Q

Ketoacidosis is much more common in which type of Diabetes?

A

T1DM

197
Q

Symptoms of Hypoglycemia

A

TIRED
Tachycardia
Irritable
Restless
Excessive hunger
Dizzy
“If they’re cold and clammy, give them a candy.”

198
Q

Symptoms of Hyperglycemia

A

HOT + DRY = SUGAR HIGH
Dry mouth, polyuria, excessive thirst, etc.

199
Q

At what blood glucose levels should you NEVER exercise?

A

<70
>300

200
Q

Exercise (increases/decreases) insulin sensitivity, which in turn decreases blood glucose.

A

Increases insulin sensitivity

201
Q

Rules for Diabetic Foot Care

A
  • Look for diabetic neuropathy
  • Screen feet regularly
  • Wash (do not soak) feet in warm water daily
  • Keep toenails trimmed
  • Clean white socks should be worn
  • Alternate shoes, snug fit
  • Shop for shoes in the afternoon
202
Q

What type of incontinence is the involuntary leakage of urine during coughing, sneezing, or exercising?

A

Stress Incontinence: pelvic floor weakness
- can be seen postpartum

203
Q

What type of incontinence is the involuntary contraction of the detrusor muscle with a strong desire to void?

A

Urge Incontinence: overactive bladder
- can be seen with infections, PD, UMN lesions

204
Q

What type of incontinence is caused by the acontractile or underactive detrusor muscle? Bladder is overdistended, cannot empty completely, and urine dribbles or leaks out.

A

Overflow Incontinence: underactive bladder
- can be seen with DM

205
Q

What type of incontinence is due to mobility, dexterity, or cognitive deficits?

A

Functional Incontinence
- can be seen with dementia, LE weakness

206
Q

What is the treatment for Overflow Incontinence?

A

Behavioral modification like double voiding, medication, and catheterization.

207
Q

What is the treatment for Urge Incontinence?

A

Treat infections, voiding schedule, and relaxation.

208
Q

What is the treatment for Stress incontinence?

A

Strengthen pelvic floor muscles

209
Q

What is the treatment for Functional Incontinence?

A

Clear clutter, improve accessibility, and prompted voiding

210
Q

How would you describe what your patient should expect with cryotherapy?

A

CBAN
Cold
Burning
Aching
Numb

211
Q

For heat:
What is the ideal temperature of storage?
Treatment time?
Layers of toweling?

A

Temp: 158-167 deg F
Time: 20-39min
Layers: 6-8

212
Q

For cold:
What is the ideal temperature of storage?
Treatment time?
How often can you apply?

A

Temp: 25 deg F
Time: 10-20min
Can be applied every 1-2 hours.

213
Q

NMES Parameters

A

Pulse Fq: 35-88 pps
Pulse Duration: 150-200 for small muscles, 200-350 for large muscles
Amplitude: >10% MVIC in injured, >50% MVIC in uninjured
On:Off Time: 1:5
Ramp Time: 2sec or more

214
Q

High-Voltage Pulsed Current is used for what?

A

Promoting wound healing

215
Q

For inflamed or infected wounds, you’d want to use (positive/negative) electrodes.

A

Negative

216
Q

For wounds without inflammation and/or in the proliferation phase, you would use (positive/negative) electrode.

A

Positive

217
Q

For High-Voltage Pulsed Current, the pulse frequency is always at ___.

A

100-105 pps

218
Q

What are the negative ions used in Iontophoresis?

A

I SAD
Iodine
Salicylate
Acetate
Dexamethasone

219
Q

For acute wounds, you would use a (pulsed/continuous) duty cycle for US.

A

Pulsed

220
Q

For chronic wounds, you would use a (pulsed/continuous) duty cycle for US.

A

Continuous

221
Q

For Ultrasound, a frequency of 1MHz is (deep/superficial).

A

Deep

222
Q

For Ultrasound, a frequency of 3MHz is (deep/superficial), but also hotter than the 1MHz.

A

Superficial

223
Q

When performing EMG Biofeedback on a patient with spasticity, you want the sensitivity to be (low/high) and electrodes to be (close/far).

A

“She Loves and Fancies Him”
Spasticity = Low = Close

224
Q

When performing EMG Biofeedback on a patient with flaccidity, you want the sensitivity to be (low/high) and the electrodes to be (close/far).

A

“She Loves and Fancies Him”
Flaccidity = High = Far

225
Q

How would you position a patient with a posterior disc herniation for lumbar traction?

A

Prone

226
Q

When aiming to get a full joint distraction, how much weight should be applied during traction?

A

50lbs or 50% of body weight

227
Q

When treating a disc protrusion with traction, how much weight would you use?

A

25% of body weight

228
Q

What are the contraindications to mechanical traction?

A

Immobilization
Acute injury or inflammation
Joint hypermobility or instability
Peripheralization of Sx with traction
Uncontrolled HTN

229
Q

What is a positive Babinski sign?

A

Toes point UP when you stroke the side of the foot.
UMN = UP

230
Q

What is Dysdiadochokinesia?

A

Inability to perform rapid alternating movements

231
Q

When the Basal Ganglia is affected, how does a patient’s tone change?

A

Increased: Rigidity (not velocity dependent)

232
Q

Ataxia, intention tremor, dysdiadochokinesia, dysmetria, and nystagmus are all symptoms of what type of lesion?

A

Cerebellar lesion

233
Q

When the Basal Ganglia is affected, how do voluntary movements change?

A

They are decreased and slowed.
Bradykinesia, akinesia

234
Q

How do voluntary movements change with UMN dysfunction?

A

They move in synergic patterns.

235
Q

What are the cardinal signs of PD?

A

TRAP
Tremor
Rigidity
Akinesia
Postural instability

236
Q

Micrographia, mask-like face, hypophonia, and loss of smell are all symptoms of what disease?

A

Parkinson’s

237
Q

What does Parkinson’s gait look like?

A

Freezing: sudden inability to initiate movement
Festinating: short stride, shuffling, increased speed

238
Q

Festinating gait happens due to patient’s posture, so what can be added to shoes to help?

A

Toe wedge or declined heel: because PD patients are very kyphotic, their COM is moved anterior. You can add these things to bring it back more.

239
Q

Hoehn and Yahr Classification of Disability

A

I: unilateral
II: bilateral
III: balance
IV: rolling walker
V: wheelchair

240
Q

Your patient is taking Sinemet for PD. When should you tell them to take their medication in relation to your PT appointment?

A

PT should be scheduled 1 hour after dose

241
Q

What type of diet should patients taking Sinemet avoid?

A

High protein

242
Q

What are the signs and symptoms of Multiple Sclerosis?

A

All common UMN symptoms
Optic Neuritis
Trigeminal Neuralgia
Pseudobulbar affect (inappropriate laughing or crying)

243
Q

What is Lhermitte’s Sign?

A

In MS, when patients feel a shock-like sensation down their spine with neck flexion.

244
Q

What is Uhthoff’s Phenomenon?

A

Uhthoff sounds like Utah
Heat gives a pseudoexacerbation or temporary worsening of symptoms.

245
Q

What temperature should the pool be for Multiple Sclerosis patients?

A

<85 deg F

246
Q

What are the 4 MS Types

A

Relapse-Remitting
Primary Progressive
Secondary Progressive
Clinically Isolated Syndrome

247
Q

What is Clinically Isolated Syndrome (CIS)?

A

The first episode of inflammatory demyelination of the CNS (first episode of MS symptoms).

248
Q

When should you schedule your PT session with your patient with MS?

A

In the morning to avoid fatigue.

249
Q

Amyotrophic Lateral Sclerosis presents as UMN or LMN?

A

Both

250
Q

T/F: ALS presents with motor and sensory loss

A

False: ALS is death of motor neurons, sensory is intact

251
Q

What is a key muscle group that is commonly weak in people with ALS?

A

Cervical extensors

252
Q

Guillain-Barre Syndrome presents as a (LMN/UMN) disorder.

A

LMN

253
Q

Demyelination of the nerves in the brain occur in (MS/GBS)

A

MS

254
Q

Demyelination of nerve roots, peripheral nerves, and cranial nerves happens in (MS/GBS)

A

GBS

255
Q

Guillain-Barre Syndrome symptoms

A

GBS
Glove and stocking paresthesia as well as motor loss.
Bilateral
Symmetrical

256
Q

What condition is a painful rash with clusters of fluid filled vesicles that present in a dermatomal pattern?

A

Herpes Zoster

257
Q

Which cranial nerve is most often affected in Herpes Zoster?

A

Trigeminal (V)

258
Q
A

NPTE Memorization (8 decks)

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