Mordor / NPTE Flashcards
1
Q
Weakness of elbow flexion, wrist extension, and diminished brachioradialis reflex?
A
C6 Myotome
2
Q
Medial/superior winging of scapula, absent upward rotation of scapula?
A
Spinal Accessory Nerve
3
Q
Sensory loss over webspace of thumb and weak supination?
A
Radial Nerve
4
Q
Weakness with shoulder abduction and ER?
A
Axillary Nerve
5
Q
Weakness with shoulder abduction and sensory loss of anterior forearm, diminished biceps reflex?
A
C5 Nerve Root
6
Q
No tip to tip pinch of 1st and 2nd fingers?
A
AIN Syndrome
7
Q
Weakness with elbow extension and diminished triceps reflex?
A
C7 or Radial Nerve
8
Q
Deep shoulder pain, weakness with ER?
A
Suprascapular Nerve
9
Q
Ape Hand
A
Median Nerve
10
Q
What is a Lisfranc injury and what are they typically caused by?
A
mets separating from tarsus, caused by crush injury.
11
Q
What is the diaphragm innervated by?
A
phrenic nerve through C3-C5.
12
Q
What sensations does the DCML give rise to?
A
monofilament (fine touch), vibration, proprioception (MVP)
13
Q
What sensations does the ALS give rise to?
A
pain and temp (what “ails” you)
14
Q
For adhesive capsulitis, what motion will be most limited?
A
lateral/ER
15
Q
What is a common comorbidity of adhesive capsulitis?
A
DMII
16
Q
What is atelectasis and what are appropriate treatments for it? Is it obstructive or restrictive?
A
A partial or collapsed lung or fluid captured in a lung. It’s obstructive.
- Segmental Breathing - prolongs inspiration
- Incentive Spirometry
17
Q
What nerve is the saphenous nerve a branch of and where is it located?
A
femoral, medial lower limb
18
Q
What nerve is implicated if your patient has weak dorsiflexion, sensory loss over the 1st webspace of the foot?
A
Deep peroneal nerve
19
Q
What nerve is implicated is you have weak plantar flexors, paresthesia over your heel/posterior leg?
A
S1 nerve root
20
Q
What nerve is implicated with a +1 patellar tendon reflex, weak hip flexion, and a loss of sensation on the medial malleolus?
A
Femoral nerve
21
Q
What nerve is implicated if you have weak eversion?
A
Superficial peroneal
22
Q
What nerve is implicated if you have weak toe flexion and lateral foot paresthesia?
A
Tibial nerve
23
Q
A patient has sustained an injury that has severed the musculocutaneous nerve. What muscles are MOST likely to be used to assist with elbow flexion?
A
Pronator Teres (median nerve) and Brachioradialis (radial nerve).
24
Q
If your patient presents with an inability to externally rotate or adduct their hip, what nerve may be implicated?
A
Obturator
25
What nerve supplies the gluteus medius, minimus?
Superior gluteal nerve
26
What nerve supplies the glute max?
Inferior gluteal nerve
27
What are some signs and symptoms of tarsal tunnel syndrome?
medial arch pain / pain with passive eversion, weak foot intrinsics / weak toe flexors, pronated foot, calcaneal valgus from impingement of posterior tibial nerve
28
Which ions used in iontophoresis are negative and therefore will they require a cathode or anode for delivery?
ISAD - iodine, salicylate, acetate, dexamethasone
Cathode will be needed because it's negative and like charges repel each other.
29
If a patient is able to open their jaw to the RIGHT much more than LEFT what is this called and what is the appropriate intervention?
LEFT TMJ hypermobility and RIGHT TMJ hypomobility, inferior glide manipulation
30
What metabolic abnormalities are associated with adrenal insufficiency?
Hyponatremia, hyPERkalemic (think weakness), hypoglycemic, and may have acidosis.
31
What are the 3 stages of lyme disease characterized by?
Stage 1 - weeks, inflammation
Stage 2 - palsy/meningitis/heart palpitations
Stage 3 - mths-yrs, neuralgia, myalgia, cognitive effects
32
What is a positive Stemmer's sign?
Implicated in cases of lymphedema by inability to pull up skin on the base of the second toe or finger.
33
What are the two different common obstetric brachial plexopathies? What other syndrome can also be present with one of these?
Erb DUchenne's, C5-C6 (upper), caused by traumatic birth, waiter's tip presentation
Klumpke's, C8-T1 (lower), climbing a tree / birth, presents with claw hand
- can also involve Horner's - eye dilation, eyelid droop / ptosis
34
What is tenderness at McBurney's point and what is this indicative of?
RIGHT lower quadrant tenderness, indicative of appendicitis
35
What is Murphy's sign?
pain and tenderness over the RIGHT costovertebral angle indicative of acute cholecystitis.
36
What level indicates a severe limitation for Gross Motor Classification for CP? What kind of PT goals can we expect at other levels?
Level 5 = severe
Level 1 = jumping/climbing
Level 3 = stair training
Level 3 or 4 = MWC use
37
What is decerebrate posture? Decorticate?
extension x 4, 2/2 or Joe
38
What is the range of the Glasgow Coma Scale and what does the lowest level indicate?
3-15, a 3 is comatose
39
What intervention may be used in a patient with emphysema and why? Is this pathology obstructive or restrictive?
Pursed Lip Breathing because this increases the resistance to airways on exhalation which increases pressure which prevent airway collapse.
Emphysema is obstructive, air sacs are weak which essentially creates collapse / makes is hard to get air out.
40
What is loose packed position for the humeral/ulnar joint?
70 deg of elbow flexion
41
What is the definition of these wound descriptors: purulent, serosanguinous, maceration?
foul smelling / yellow-green
some blood
softening of tissues / white
42
What is the obturator sign and what is it used for?
FADIR, indicative of an inflamed appendix
43
What is ROVSING's sign?
referred pain to RLQ with palpation of LLQ indicative of appendicitis
44
What is the Psoas Sign?
LEFT side lying w/ R hip extension indicative of appendicitis
45
What number is indicative of good reliability? What number is indicative of poor?
Above 0.75 = good
| Below 0.5 = poor
46
What type of stroke may present as contralateral hemiplegia w/ the LE affected more than the upper?
ACA
47
What type of stroke may present w/ visual impairment, pain, involuntary movements (with the possibility of hemiplegia)?
PCA
48
What type of stroke is likely present with hemiplegia greater in the UE than LE?
MCA
49
What kind of stroke may present w/ herniation/coma/death due to massive infarct in MCA/ACA?
Internal Carotid
50
Will a patient w/ Guillain-Barre present more like someone with obstructive or restrictive lung disease?
Restrictive
51
If I have an increased inspiratory to expiratory ratio AND increased subcostal angle what kind of lung disease do I have?
Obstructive
52
What are normal-ish ranges for maximal inspiratory pressures and maximal expiratory pressures?
85-125 and 150-230 respectively
53
FEV1/FVC <70% is indicative of which type of lung disease?
Obstructive
54
FEV1/FVC >80% is indicative of which type of lung disease?
Restrictive
55
What is normal platelet count and what is it called?
150k-450k
```
<150 = thrombocytopenia
>450 = thrombocytosis
```
56
What is the capsular pattern of the hip?
IR, hip flex, AB (in order of most limited to least)
57
Myopathy is characterized by what principal feature and what medication is associated with risk of this?
Proximal muscle weakness, Statins
58
What are some central features of myasthenia gravis?
1. 20-30yr. old females or 50-60yr. old male
2. AI which diminishes nerve signals (LMN!)
3. associated w/ hyperthyroidism
4. bilateral UE and LE proximal weakness
5. mild ptosis
- no fever, no stiffness
59
What are some defining features of ALS?
1. distal to proximal weakness
2. asymmetric
3. will have LMN and UMN involvement w/o sensory loss
60
What are some defining features of Guillain-Barre?
1. Usually follows a respiratory infection of some kind
2. distal to proximal weakness
3. glove/stocking
4. can have fever
61
Where is an individual most likely to experience gout and what will be elevated in their labs?
1st MTP, knee, wrist
| uric acid
62
How many PVCs in a row must be thrown in order to qualify for ventricular tachy?
>3
63
What is the central pathology of a Boutonniere deformity?
extensor digitorum rupture through trauma or disease which yields volar slippage of lateral bands
64
What are a positive head jolt test and Kernig's sign indicative of?
meningeal irritation
- positive head jolt - cervical rot 2-3x/sec
- kernig's - supine/hip flexed and then knee straightened
65
What is agnosia?
inability to recognize something
66
What is ideational apraxia?
can't perform a familiar motor task automatically or on command
67
What is anosognia?
Denial of one's paralysis
68
What will you hear with a pneumothorax?
Absent breath sounds
69
Where two vessels does lymph travel towards? And how much?
75% thoracic duct, 25% right lymphatic duct from RIGHT upper body
70
When performing manual lymphatic massage where should the PT begin first?
Proximal to distal bc the lymph load in proximal areas must be relieved first.
71
What are the 4 stages of lymphedema?
Stage 1: abnormal flow, but no sx
Stage 2: sx, but resolve w/ elevation
Stage 3: sx, but no change w/ elevation
Stage 4: elephants
72
What is a common side effect of statins?
Muscle pain (rhabdo), liver
73
Describe ASIA levels.
A: complete - no motor/sensory in sacral segments.
B: incomplete - sensory, but not motor in sacral segments.
C: incomplete - motor preserved but at <3/5
D: incomplete - motor preserved but at > or equal to 3/5
E: normal
74
What are the four wound stages?
1. can't be blanched
2. partial thickness/blister
3. full thickness, crater, CAN'T SEE BONE/MUSCLE/TENDON
4. full thickness plus now you can see it
75
What is the difference between a prospective cohort and case control study?
prospective looks forward in time, a case control is retrospective
76
What are US parameters for deep tissue?
1MHz for anything greater than 2cm deep
77
What muscles are used in mouth opening?
Lateral pterygoid, ant head of digastric, suprahyoid
78
What is a max score on the FABQ and what does it mean?
96, highest fear
79
What does a 100% on the Oswestry indicate?
Bed bound disability
80
How do you distinguish between lymphedema, CVI, CHF, and lipedema?
lymphedema is not necessary bilateral while the other 3 are
CVI is characterized by varicose veins w/ pain and achiness along those veins
CHF = cardio sx and hypoxic skin changes
lipedema - no swelling in feet/hands
81
What is the scale of the Rancho Los Amigos?
I - not responsive to X which is modI
82
For FIM levels, what might a 1 indicate? a 7?
```
1 = total assistance
7 = complete independence
```
83
What glides should use to increase wrist extension? Wrist flexion?
PA - to increase extension
| AP - to increase flexion
84
If someone has spasticity, what might forceful PROM put them at risk for?
HO
85
What is an early sign of RIGHT ventricular failure?
Dependent edema due to backlog of blood
86
To increase calcaneal eversion, what direction should you mobilize in?
medial
87
What are the current recommendations for pressure relief for patients w/ SCI?
10-15 sec, every 15-20 min
88
What is Reiter's syndrome characterized by?
"Can't see, pee, climb a tree."
89
What is Paget's Disease characterized by?
increased temp over the long bones, usually of the pelvis
90
What is hypothyroidism characterized by?
muscle ache / myalgia, cold intolerance, bradycardia, obesity, constipation
91
What is hyperthyroidism characterized by?
heat intolerance, tachy, eye bulging, hyperreflexia, diarrhea
92
What is hypoglycemia characterized by?
"like you're drunk"
| tachy, sweating, pallor, hunger, blurred vision
93
What is hyperglycemia characterized by?
increased thirst "high and dry", dim pulse, acetone breath
94
What is Addison's disease?
Low adrenal activity, postural hypertension (fall risk), dehydration, hypoglycemia
95
What is Cushing's syndrome?
High adrenal activity "crush": HTN, Na+ and water retention, osteoporosis, moon face, kyphosis, hypokalemia, hypergylcemia
96
What is hyperparathyroidism characterized by?
Increased secretion of PTH leads to hypercalcemia, LMN reflexes, OP fx risk (due to osteoclast activity)
97
What are some contraindications to aquatic therapy?
Vital Capacity <1L
Severe Peripheral Disease
Severe Kidney Disease
98
What glide should you perform to increase wrist flexion?
dorsal
99
What glide should you perform to increase pronation of the proximal radio-ulnar joint?
PPL (if supination SAM) - for distal, flipped
100
What glide should you perform to increase ulnar deviation?
radial glide
101
What's the differential diagnosis between osteosarcoma and Ewing's sarcoma?
osteosarcoma - 10-25y.o. w/ pain around the lump
Ewing's - 5-16 y.o., fever, usually in long bones/pelvis
102
What is the amount of standard deviations of decrease in bone mass a patient has to have to qualify for osteoporosis diagnosis?
>2.5
103
What is order of radiolucence to radiopacity on a radiograph?
air, fat, soft tissue/water, bone, metal
104
What's the difference between Trigeminal Neuralgia and Bell's Palsy?
Trigeminal Neuralgia involves CN V vs. Bell's Palsy which involves CN VII - neuralgia is painful, bell's palsy involves paralysis "whistle, wink, wrinkle".
105
What presentation will we see with a patient w/ Brown Sequard Syndrome?
loss of pain/temp on the contralateral side
loss of fine touch, proprio + motor on the ipsilateral side
106
What presentation will we see for a patient w/ Central Cord Syndrome?
cervical/thoracic impact (these are more central), UE probs > LE, distal problems will be worse than proximal
107
What presentation will we see for a patient w/ Anterior Cord Syndrome?
they will lose motor, pain, and temp but retain DCML (fine touch/proprio)
108
What type of syndrome might occur with a bilateral loss of proprioception?
Posterior Cord Syndrome
109
When should you not complete PT for a PaO2 level?
<60mmhg
110
When is a SaO2 level ok for patients with COPD?
88-92mmhg
111
What platelet level should you NOT ambulate a patient with?
<10k
112
What are the norms for potassium levels and what can happen if your patient is abnormal?
3.5-5.0, arrythmias
113
At what level or INR should you exercise caution with a patient?
>4 (>5 is a serious bleed risk)
