MSK1: 1st Shifting Flashcards
In which part of the SOAP note will you document the
information such as results of ancillary procedure?
History of present illness
TRUE OR FALSE: The PT document may be used against the therapist so one should be truthful in writing the document at all times
True
TRUE OR FALSE: The patient is the one and only source of information. The
PT should not interview anyone besides the patient.
False
TRUE OR FALSE: The PT document may be used to reimburse expenses for
services rendered
True
TRUE OR FALSE: Palpation should always be done first in order to assess
the extent of pain
False
TRUE OR FALSE: The quickest way to test for the range of motion of the
shoulder is by doing Apleys Scratch Test
True
TRUE OR FALSE: In writing initial evaluation notes, plan of treatment should
be written at exact same sequence of performance
True
TRUE OR FALSE: Ocular Inspection includes visible defects, functional
deficits and body alignment
True
TRUE OR FALSE: When writing a subjective evaluation, use of medical
jargons is acceptable since patients have no access to
such records and only medical professional can read it
False
TRUE OR FALSE: Documentation can be used for legal, research and quality
assurance and improvement purpose
True
TRUE OR FALSE: Use of correction tapes and fluids are highly advisable in
documentation to ensure cleanliness of the task
False
TRUE OR FALSE: Shoulder depression test should only be done if the patient, at the time of the examination, is symptomatic.
False
TRUE OR FALSE: Examination is only used to refute suspected diagnosis
False
TRUE OR FALSE: One must follow the head-to-foot format when document
findings under postural analysis
True
TRUE OR FALSE: Use of correction tapes and fluids are allowed when making corrections to ensure cleanliness of the document
False
TRUE OR FALSE: When writing a subjective evaluation, use of medical jargons is acceptable since patients have no access to
medical their medical records
False
TRUE OR FALSE: In documenting your findings, you must write all the (+)
findings first before the (-) findings
True
Pt cannot maintain standing without holding the parallel bars. Document this finding
a. O: FA> P static standing balance
b. O: FA> F static standing balance
c. O: FA> P dynamic standing balance
d. O: FA> F dynamic standing balance
a. O: FA> P static standing balance
Upon evaluation, you have found out that patient works as a call center agent in Ortigas City for 8 hours a day with a
lot of desk job activities. He also says that his computer monitor is not eye leveled and his eyes are approximately 6 inches away from the computer monitor. So, as PT where will you document the finding about the distance of his eyes to the monitor?
Physical environment
Choosing an outcome measure should follow the “outcome measure tools should measure what it is supposed to measure” principle. What is being defined in the statement?
Validity
You are assisting a patient with bed to wheelchair transfers. You provide the patient with 50% assist in order to complete the task. What degree of assist did you offer
the patient?
Moderate
Based on the ICF model, how will you classify weakness
Impairment
Where do you document swelling?
Ocular inspection
You noted a blue violet discoloration on the patient’s ® front thigh. Which of the following entries is correct?
a. O: OI> (+) swelling on anterior aspect of ® thigh
b. O: OI> (+) cyanosis on anterior aspect of ® femur
c. O: OI> (+) hematoma on ® thigh
d. None of the above
c. O: OI> (+) hematoma on ® thigh
Which of the following entries under postural analysis is incorrect?
a. O: PA> (+) lateral view> (+) forward head posture
b. O: PA> posterior view> (+) too many toes sign on ®
c. O: PA> Anterior view> (+) protruded abdomen
d. O: PA> posterior view> ® shoulder higher than (L)
e. None of the above
c. O: PA> Anterior view> (+) protruded abdomen
These are factual findings from the examination or
assessment gathered by the PT
Signs
The resisted isometric examinations should be done with the joint in resting or ____ position
Neutral
You are interviewing your patient who was diagnosed with adhesive capsulitis on the (R) shoulder 4 months ago. You were able to deduce that at present, the patient presents
with severe pain and that there is progressive LOM developing on the joint. Given the information above, the most probable stage of adhesive capsulitis the patient is in, is at
a. freezing
b. frozen
c. thawing
a. freezing
With the patient seated on a chair, the arm at the side of the trunk, the elbow bent to 90º and the forearm positioned in midpronation and rested on a table, the PT’s one hand supports the forearm while patient attempts to move the arm towards the body. The PT’s other hand is placed on the superior-anterior aspect of the axilla. You then felt a “little push” at the right axilla. Document this finding.
a. (+) muscle spasm on the (R) chest (R) chest
b. (+) muscle guarding on the (+) tightness of the (R)
c. pectoralis major muscle
d. (R) Pectoralis Major 1/5
d. (R) Pectoralis Major 1/5
Modification of the sulcus sign
Feagin test
You have a 25 yo baseball pitcher who complains of pain on R shoulder during elevation of arm. Upon assessment, you noted clicking and catching during motion especially when raising arm. Condition started when patient fell on the fall with an outstretched limb. What anatomic structure
is being tested by your confirmatory test?
a. Rotator cuff
b. AC joint
c. Labrum
d. Glenohumeral ligaments
c. Labrum
You have a patient diagnosed with R subacromial bursitis. Which of the following is a consistent finding
a. “O: ROM> AROM> (R) shoulder abduction 0-40 degrees, endfeel= empty “
b. “O: ROM> AROM> (R) shoulder abduction 0-180 degrees, endfeel= firm c pain @ endrange”
c. “O: ROM> AROM> ® shoulder abduction 0-100 degrees, endfeel= empty”
d. None of the above
c. “O: ROM> AROM> ® shoulder abduction 0-100 degrees, endfeel= empty”
Sitting, arm supported on table in 90º of abduction, elbow partially flexed. Pt slides the arm across the table in horizontal abduction and completes range.
What muscle grade is given?
Grade 2
Prone, pt’s head turned to one side and the trunk at the edge of the plinth. The entire limb hands down loosely with the shoulder in neutral rotation, palm facing the table. Pt
performed 0-50 of shoulder lateral rotation
What muscle grade is given?
Grade 2-
A pt in prone with shoulder internally rotated, elbow flexed and hand resting on the back is the testing position for a F
muscle strength of
Rhomboids
A pt was referred to you following MD dx of R adhesive capsulitis. Pt reported that the condition started 2 weeks ago and worsened as the days passed. While probing, you were informed that pt was diagnosed with the same condition a year ago but on the opposite UE. Document this finding
a. S: Pt c/o pain on the (R) shoulder and was diagnosed with (R) adhesive capsulitis
b. S: HPI: Condition started 1 year ago when pt was diagnosed with (L) adhesive capsulitis. Condition improved until 2 weeks ago when pt was diagnosed with (R) adhesive capsulitis.
c. S: PMHx: Pt reports being diagnosed with (L) adhesive capsulitis 1 year ago.
c. S: PMHx: Pt reports being diagnosed with (L) adhesive capsulitis 1 year ago.
A positive Heuters sign suggests a pathology on the biceps brachii muscle. The Heuters sign is the term used to describe the forearm supination movement when elbow flexion is resisted.
A. Only the 1st statement is true
B. Only the 2nd statement is true
C. Both statements are true
D. Both statements are false
B. Only the 2nd statement is true
While touching the pt’s R shoulder, you noted the pt complained of pain, cringed, held his right shoulder and asked you to stop the examination. Document this finding
a. O: palpation> Gr. 1 tenderness on the (R) shoulder
b. O: Palpation> Gr. 2 tenderness on the (R) shoulder
c. O: Palpation> (+) Gr. 3 tenderness on the (R) shoulder
d. O:Palpation> Gr. 4 tenderness on the (R) shoulder
e. O: Palpation> (+) Gr. 5 tenderness on the (R) shoulder
d. O:Palpation> Gr. 4 tenderness on the (R) shoulder
Using a reflex hammer, you tapped on the antecubital area and noted a slight contraction on the R upper arm. Document this finding
a. O: DTR> Hyporeflexia of the (R) brachioradialis
b. O: DTR> Hyporeflexia of the (R) biceps brachii
c. O: DTR> Normoreflexia on the (R) brachioradialis
d. O:DTR> Normoreflexia of the (R) biceps brachii
b. O: DTR> Hyporeflexia of the (R) biceps brachii
In performing Yergason test, what is/are the motion/s that the therapist should resist?
Supination & ER of shoulder
You opted to use a questionnaire that assesses both pain and disability scores. This questionnaire has two domains. The first domain consists of 5 questions. The second
domain has 8 questions. Three of the five questions of the first domain were given a score of 8 while the rest were marked 9 points. Fifty percent of the questions of the
second domain were given a score of 5 while the rest were marked 6 points. How will you document this finding?
a. O: FA> SPADI> Score: 66.15%
b. O: FA> SPADI> Total SPADI score: 66.15%
c. O: FA> DASH> Total DASH Score: 66.15%
d. O: FA> DASH> Total DASH disability score: 66.15%
e. None of the above
b. O: FA> SPADI> Total SPADI score: 66.15%
You are observing the skin on the upper extremities of your geriatric patient who was admitted 2 weeks ago. Knowing that the patient has decreased sympathetic
activity, you are expecting that the skin may most likely be:
a. Reddish
b. Cyanotic
c. Dry and scaly
d. Smooth, shiny, glossy
c. Dry and scaly
Which of the following statement/s in subjective evaluation is/are least appropriate to ask the patient?
a. When does the condition start?
b. How many stair-steps do you have in your house?
c. Do you have any past conditions that i need to know
d. Are you a smoker or alcoholic beverage drinker
e. None of the above
e. None of the above
When screening the patient, you thought of slowing down to think that patient needs to be referred back to the physician in order to rule out any serious conditions. This
falls under which type of signs and symptoms?
a. Red
b. Yellow
c. White
d. Orange
a. Red
You measured the range of your patient’s external rotation. While passively moving the patient’s UE towards the end of the desired movement, you noted a restriction at the
end of the completed range. How will you document the end feel and what could possibly cause this?
a. Firm, bc of the tension of the ant. joint capsule, the GH and coracohumeral ligaments
b. Firm, bc of the tension in the subscapularis, teres major, and the clavicular fibers of the pectoralis major
c. Firm, bc of the tension in the latissimus dorsi, sternocostal fibers of the pectoralis major and minor, and the serratus anterior
d. All are correct.
e. None of the above
c. Firm, bc of the tension in the latissimus dorsi, sternocostal fibers of the pectoralis major and minor, and the serratus anterior
You asked the patient to stand still. While looking at the side, you noticed that both knees seem hyperextended. How will you document this finding?
a. O: PA> (+) genu valgum
b. O: PA> (+) genu varum
c. O: PA> (+) genu recurvatum
d. O: OI> (+) postural deviations (see PA)
e. None of the above
e. None of the above
In PA, view is lacking and it should be the deviation of specific structure, not name
of deformity (OI)
You asked the patient to stand still. While looking at the side, you noticed that there seems to be an exaggeration of lumbar spine extension. How will you document this
finding?
a. O: PA> (+) hyperextended lumbar spine
b. O: PA > (+) kyphosis of the lumbar spine
c. O: PA> (+) lumbar lordosis
d. O: PA> (+) protruded abdomen
e. None of the above
e. None of the above
View is lacking
You asked your patient to clip his (R) arm on his thorax and flex his elbow to 90 degrees. After this you instructed the patient to externally and internally rotate his forearm while you palpate the anterior aspect of his proximal upper arm. There was an underlying structure that moves and exerts
pressure on your palpating fingers as the patient does external and internal rotation. This is best documented as:
a. O> Special Test> (+) Hawkins-Kennedy test
b. O> Special Test> (-) Hawkins-Kennedy test
c. O> Special Test> (+) Yergason test
d. O> Special Test> (-) Yergason test
d. O> Special Test> (-) Yergason test
Patient complains of pain on resisted shoulder IR and passive shoulder external rotation. Which area should be palpated to rule out tendinitis?
a. Superior border of the greater tubercle of the humerus
b. Inferior border of the greater tubercle of the humerus
c. Lesser tubercle of the humerus
d. Anterior capsule of the shoulder
c. Lesser tubercle of the humerus
Internal rotator is attached on the lesser tubercle
C.E. a 45 y/o (L)-handed, (+) DM, (-) Htn c/o difficulty in combing her hair and reaching on overhead cabinets d/t restriction felt when doing these activities using her (L)
UE. Pt claims that about 4 months ago, she felt progressive, deep, aching pain graded 10/10 on (L) shoulder until it subsides with the pain presently graded 4/10. PE revealed severe LOM on (L) shoulder, (+) muscle
guarding on (L) shoulder, hypomobility of the (L) GH joint, (+) forward head posture. The patient presents with LOM during shoulder movements especially during elevation
activities. As PT, you know that during elevation of the shoulder the humeral head translates inferiorly. Which of the following structures provides this inferior translation?
a. Negative joint pressure within the joint
b. Glenohumeral ligaments
c. Glenoid labrum
d. Suprahumeral ligament
d. Suprahumeral ligament
C.E. a 45 y/o (L)-handed, (+) DM, (-) Htn c/o difficulty in combing her hair and reaching on overhead cabinets d/t restriction felt when doing these activities using her (L)
UE. Pt claims that about 4 months ago, she felt progressive, deep, aching pain graded 10/10 on (L) shoulder until it subsides with the pain presently graded 4/10. PE revealed severe LOM on (L) shoulder, (+) muscle
guarding on (L) shoulder, hypomobility of the (L) GH joint, (+) forward head posture. Upon radiographic assessment, which of the following is commonly seen that will confirm
the diagnosis of the patient?
a. Microtears on shoulder musculature
b. Osteophyte formation in the joint
c. Synovities of the GD
d. Fibroblastic proliferation with increased collagen formation
d. Fibroblastic proliferation with increased collagen formation
With the patient in short sitting, with the arm flexed to 90 degrees, you asked the patient to try to hold your arm in this position. With one hand in front of the inferior angle of the axillary border of the right scapula, you noted a palpable muscle hardening. How do you document this finding?
a. O: Palpation> (+) muscle guarding of the ®
subscapularis muscle
b. O: Palpation> (+) muscle guarding of the ® serratus anterior muscle
c. O: MMT> Gr. 1/5 of the (R) subscapularis muscle
d. O: MMT> Gr. 1/5 of the (R) serratus anterior muscle
e. None of the above
d. O: MMT> Gr. 1/5 of the (R) serratus anterior muscle
