Ox Practice Test Flashcards
Patents recovering from Guillian-Barre syndrome experience motor function return in which pattern?
Proximal to distal
Inadequate strength of the gastrocnemius results in which of the following gait deficiencies?
Excessive dorsiflexion @ midstance
An AFO with trimlines posterior to the malleoli provides PRIME?
Passive dorsiflexion assist
A hospital calls a practitioner to say that a patient who was fit with a device is bringing legal act on against the
hospital. The suit does not involve the device or the fittng. However the hospital is requesting the practitoner’s records regarding the patient. The practioner should?
Advise the hospital that the patient records can be released only after receipt of properly signed release forms or a subpoena.
Standard tightening value of halo skull pins for an adult
8in-lb
A KOs for OA is designed to?
Distract the joint surface of the medial or lateral compartment
Atlantoaxial instability is common with which of the following?
Rheumatoid arthritis
The functions of the tibialis anterior muscle are:
Dorsiflexion and inversion
Excessive knee flexion when standing in a locked metal KAFO results when?
Calf band is too shallow
Poliomyelits results from an acute viral infection of the:
Anterior horn cells
When fitting a thermoplastic AFO, which of the following helps diminish a moment at heel strike?
Decreasing heel height of shoe
The primary reason for developing good documentation practices is to establish?
Professional responsibility and accountability
MSDS stands for?
Manual Safety Data Sheet
Which of the following adjustments to a metal AFO would best accommodate excessive tibial torsion?
Deflection of sidebars
A HALO ring should be placed
1cm superior to the lateral third of the eyebrow
Quadriplegic patient with a functioning C7 will lose which of the following?
Finger flexion
A 57 year old adult female with adult onset diabetes mellitus presently in the wound care clinic with a recently healed plantar ulcer over the 1st met head and an insensate foot. Her current footwear is a pair of canvas tennis shoes. At this time the most appropriate orthotic treatment should be:
Extra depth shoes w/an accommodative insert
An anterior hyperextension TLSO offers MAXIMUM control in which of the following planes?
Sagital
An example of a congenital spinal deformity is?
Hemivertebrae
A patient with dropfoot and painful knee hyperextension was fit with a KAFO 2 weeks ago. At follow up the patient states that knee pain had decreased and foot clearance had improved, but that she fell twice when descending a
ramp. The practioner modifies the KAFO by:
Decreasing plantar flexion resistance
A mechanical knee joint that is too distal to the anatomical knee:
Anterior distal pressure on the thigh to increase when the knee is flexed
The primary goal of lower extremity orthoTIc management in children w/hypertonia is to?
Decrease spasisity
Cauda equine comprises the?
Nerve roots below the level of the spinal cord
In treatment of kyphotic deformity with CTLSO (Milwaukee), where in relation to the apical vertebra should the kyphosis pads be placed?
Adjacent and one vertebral body inferior
Which of the following nerves supplies the peroneus brevis?
Superficial peroneal
The ACL attaches to the non articular aspect of the tibia and to the posterior aspect of the
Medial surface of the lateral femoral condyle
After 6 months of wearing a KAFO for control of knee flexion, a patient reports return in the knee but not is the foot.
Evaluation reveals muscle strength of good (4/5) extensors and trace (1/5) in dorsiflexors and plantar flexors. The appropriate action:
Consult the referring physician to discuss changing to an AFO
The anatomical landmark for locating the mechanical ankle joint axis is the
Distal border of the medial malleolus
A dorsiflexion stop performs the PRIMARY function of which of the following muscles at midstance
Gastrocnemius/soleus
What is the most common type of stress in thermoplastic lower extremity orthoses
Bending
The primary goal in using a CTLSO (Milwaukee) in cases of Scheuermanns disease (juvenile apophysitis) is to:
Reduce kyphosis
The most appropriate orthoses for a patient with a median and ulnar nerve laceration at the wrist is:
A WHO (long oppones with thumb adduction stop)
Any functional adjustments to a recently provided orthoses must:
Conform to the original prescription
A patient has strong extensor spasticity secondary to brain pathology. The BEST ankle joint configuration for the patient would be one with a/an:
Plantar flexion stop
A manual muscle test grate of fair (3/5) is assigned for a range
Against gravity
The primary action of the brachioradialis muscle
Flex the elbow
With regard to orthotic treatment and goals, which of the following is most important patient education
Purpose of the orthoses
Hand washing should be washed for at least:
10-15 seconds
In which of the following condition is there NO spasticity
Cauda equine injury
The gastrocnemius and soleus group are innervated by what nerve
Tibial nerve
Which of the following muscles BEST substitutes for a non-functional tibialis anterior?
Extensor hallucis longus
An appropriate orthoses for a radial nerve injury at mid-humerus is a:
WHFO (dynamic orthoses to assit thumb, finger, and wrist extension)
A demyelinating disorder of the white ma>er in the central nervous system
MS
The ideal timme to begin treatment for positional plagiocephaly
4-6 months
All of the following bones form the acetabulum EXCEPT
Sacrum
If a patient is a Medicare beneficiary with no secondary coverage, and has met the deductible for the year, the
practitoner may collect what percentage of Medicare allowable at time of service?
20%
Flexion of the distal IP joints is accomplished by which of the following muscles
Flexor digitorum profundus
Vastus medialis muscle acts as:
An extensor of the knee
To correct genu recurvatum during standing you should:
Reduce the depth of the distal thigh band
Which of the following muscles in NOT innervated by the obturator nerve?
Sartorius
During normal gait, the hip reaches Maximum extension at?
Terminal stance
Blounts disease presents as which of the following deformities?
Tibia varum
An 8yr old boy underwent surgical fusion of a congenital distal tibial pseudarthrosis. Six weeks postop, the plaster cast is removed and clinical stability is improved. Which orthosis would be BEST to protect the fusion until complete healing takes place?
Thermoplastic PTB with anterior shell
The rate of foot drop during the heel rocker is controlled by?
Pretibial muscles
In a 3 point pressure system, the corrective force is how much force compared to the distal and proximal
counterforces?
2
An adult male 5’11” and weight 220 lbs., which of the following would be the MOST appropriate material to use in an AFO.
3/16” polypro
Before a patient with quadriplegia can benefit from an orthosis to improve upper extremities, the patient must have:
Trunk stability
Which type of force will cause bending of the sidebars?
Lateral
Which of the following is the most common form of CP?
Spastic
Which muscle passes directly behind the lateral malleolus?
Peroneus brevis
A patient with a soleus contracture is likely to exhibit which of the following gait deviations?
Genu recurvatum in midstance
In the stance phase of gait, a solid ankle plastic AFO set at neutral with a rigid full length footplate would?
Increase the knee extension moment at terminal stance
Prior to developing a treatment plan for a patient with a dislocating hip, a practioner must determine the:
Direction of the instability
The muscles that pass posterior to the medial malleolus act to:
Invert and plantar flex the foot
A solid ankle floor reaction AFO will assist knee extension by:
Restricting anterior tibial advancement over the foot
A patient is unable to independently don and doff a prescribed orthosis and refuses to be fit, what actions should be taken?
Contact the referring physician and discuss other treatment options
Verified coverage information which must be obtained before treatment includes all except?
Premium amount
The term “crouch gait” describes a pattern of:
Flexed hips, flexed knees, and dorsiflexed ankles
An 18 month old child with no history of neuromuscular dysfunction in referred for corrective foot orthoses.
Evaluation reveals 5 degrees of calcaneal valgus bilaterally, upon weight bearing. The MOST appropriate action is to:
Provide outflare shoes with Thomas heels
What are the 2 attachments used w/ a static WHFO to help prevent claw hand deformity?
MCP extension stop and IP extension assist
A wrist driven flexor hinge orthosis converts wrist extension to:
MCP flexion
When fabricating an orthosis for treatment of radial nerve palsy, in which position would the wrist be maintained?
20-40 degrees of extension
Before a patient with quadriplegia can benefit from an orthosis to improve upper extremities, the patient must have:
Trunk stability
A patient wearing a KAFO with a locked knee will have improved knee stability during stance and:
Compromised shock absorp%on during loading response
A patient who presents with an AFO is unable to independently communicate and care for himself. The MOST appropriate procedure is to:
Fit the patient with the proper AFO according to the prescription
Chronic subtalar pronation frequently leads to?
Hip external rotation
For a patient with posterior tibial tendon dysfunction, one objective of fittng a UCBL is to the mechanics of this:
Invertor muscles
Poor hip extensors will result in what postural deviation?
Backward trunk lean
A 14 year old male with Scheuermann’s kyphosis has a riser sign of 2 and is being treated with a CTLSO (Milwaukee).
Assuming patient compliance, what is the expected outcome?
There can be some permanent correction of the deformity
A hospital patient with Medicare and supplemental insurance has been provided Orthotic services. Upon contacting the hospital purchasing office, the practitoner is told to collect from the patient. The practitoner should?
Explain to purchasing that it is illegal for the practitoners company to bill the inpatient.
Which of the following is the MOST common congenital abnormality of the spine?
Spina Bifida
During normal gait the hip reaches maximum flexion during?
Terminal swing
Which concept of blood-borne disease control is applied regardless of perceived patient or patient population?
Universal precautions
Which of the following is the MOST appropriate treatment for a patient with rigid forefoot deformity?
Medial forefoot post
A 50 yr old male presents with a flail ankle and a flexible varus deformity the referring physician requests evaluation for an orthosis that will provide mediolateral stability. The MOST appropriate orthotic recommendation would be a:
Thermoplastic AFO with free dorsiflexion and a 90 degree plantar flexion stop
To accommodate the elongation of a neuropathic foot during weight bearing, a shoe should be how much longer than the length of the foot in non-weight bearing?
½” to ¾” (13mm to 19mm)
Which of the following muscles contributes to extension of the knee joint?
Vastus lateralis
After and AFO is removed, redness of the skin should:
Disappear in 15-20 min
Muscular dystrophy is defined as a/an:
Progressive degeneration of the muscle fibers
Medicare defines the “Date of Service” as being the date the:
Patient receives the item or service
A patient with MS presents with a script for a KAFO to control knee recurvatum. Muscle strength of the knee is fair plus (3+/5) with no history of falling due to knee buckling. Which of the following is the appropriate knee joint to select?
Posterior offset
When a posterior rigid frame TLSO is being fit, the superior end of the paraspinal bars terminate 1” (25mm) inferior to the:
Inferior angle of the scapula
Erbs palsy refers to paralysis from injury to the:
Upper trunk of the brachial plexus
ADduction and ABduction of the fingers occurs at what joint?
Metacarpophalangeal
A patient who present with a left thoracic curve with the apex at T3 will have a/an:
Elevated left shoulder
What is the MAXIMUM punishment ABC can do?
Permanent revocation
Medicare required providers of orthotics and prosthetics document upon delivery of services?
Delivery receipt
The PRIMARY purpose of a medial extrinsic heel post is to?
Control rearfoot eversion in the frontal plane
During normal human locomotion, the ground reaction force—the hip and knee between initial contact and foot flat
Hip flexion, knee flexion
Hydrocephalus may accompany:
Myelomeningocele
During stance, the hip joint is MOST stable when weight line is?
Posterior to the hip
Which of the following is a function of the serratus anterior?
Upward rotation of the scapula
Articulation between the sternum and the clavicle occur at?
Manubrium
The strength of a muscle is generally proportional to its?
Cross sectional area
A KO for medial compartment syndrome should provide which of the following systems?
Medial thigh, lateral knee joint, medial calf
A musculocutaneous nerve lesion will cause loss of function of which of the following?
Biceps
Which of the following characteristically results in a lower motor neuron lesion?
MS
A unique characteristic of AFO’s that are designed to inhibit spasticity/tone:
A toe extension pad
The pretibial muscle group does NOT include the :
Peroneus longus
Single-axis, unlocked knee joints are indicated for patients with?
Genu varum
Which of the following is a result of an irregular birth?
Klumpke’s pasly
Patient with paraplegia, standing balance in bilateral KAFOs is achieved by:
Fixed ankle dorsiflexion, locked knee, hip hyperextended
Medicare define “accepting assignment” as accepting:
The Medicare Fee Schedule allowable amount as payment
Coding verification requests are submitted to the
PDAC
Sensation is transmitted through which of the following structures?
Dorsal branch of the nerve roots
A patient with idiopathic scoliosis has been wearing a low profile TLSO at a clinic appointment, as in brace x-ray shows that the riser sign is 4, you should expect the physician to ask that
The patient begin weaning from the TLSO
Within the L-code system, Medicare will reimburse separate
Repairs to orthoses
Side bending films are used to demonstrate which of the following curves?
Curve magnitude
A patient who was fit with a custom TLSO after sustaining a L1 burst fracture returns for an adjustment at 2 week follow up visit. The patient reports a recurrence of pain at the fracture site beginning—–2 days ago & complains of eating difficulties due to nausea caused by the pain meds. The practioners most appropriate action is to:
Evaluate the patient for weight loss and adjust the TLSO as necessary
During normal gait at initial contact, the ground reaction force tends to do what at the ankle and knee?
———-Ankle——–Knee————–
Plantarflexion Extension
Which addition to the shoe of an axial unloading (PTB) orthosis will facilitate stance phase in a patient with triple arthrodesis?
Cushioned heel and rocker sole
A patient diagnosed with post polio walks with her hand on the front of her thigh, floor reaction AFO is fit, and 4 weeks later the patient is in the practionioners office for adjustments and patient still walks with her hand on her thigh, due to continued knee buckling. The next step is to:
Modify the floor reaction AFO by trimming the foot plate
Which of the following muscle groups controls forward movement of the tibia?
Posterior calf
A patient was fit with a pair of custom semirigid FOs and is given a wearing schedule of 3 hrs a day, increasing 1 hr each day, orthosis was checked and appropriate. The patient now states she cannot wear them for more than 5 hrs without discomfort. The practitioner should:
Wear the orthosis for 5 hrs a day and then increase by ½ hr increments
The statement “The patient appears to have missing information” should be written in which section of the
notes?
Objective
It is important to create adequate relief proximal to the 1st metatarsal head due to contraction of which muscle
during the heel off phase of gait.
Flexor hallucis longus
