Part III Flashcards
Superiorly displaced patella may contribute to lateral maltracking and is more often seen in:
genu valgus as the Q-angle is increased
Genu varum can contribute to early degeneration of the knee and is often associated with:
advanced degenerative joint disease in the medial compartment of the knee
The MOST likely etiology for increased low back pain with coughing or sneezing is
disc herniation - Coughing or sneezing will increase intradiscal pressure causing pain
Pain from spinal stenosis is related to:
postural position and activity; coughing or sneezing would not increase this pain
The patient is demonstrating signs and symptoms of autonomic dysreflexia, which position is best?
Upright positioning is preferred to lower blood pressure
Which position will drain the superior segments of the lower lobes?
Prone lying on a bed with two pillows under the pelvis
Which position drains the posterior segments of the upper lobes?
Sitting on a chair, leaning forward over a folded pillow
Which position drains the anterior segments of the lower lobes?
Lying supine on a bed with pillows under the knees
Which position drains the apical segments of the upper lobes?
Sitting in a recliner, leaning slightly backward
A PT is evaluating the gait of a patient with sciatic nerve damage. Which of the following gait deviations is the patient MOST likely to exhibit?
Decreased ankle dorsiflexion - muscular branches distribute to the flexors of the knee in the thigh and all muscles of the lower leg and foot
Venous insufficiency ulcers frequently are:
proximal to the medial malleolus. They are edematous.
Arterial ulcers are generally located on:
dorsal foot, distal toes, or areas of trauma
A 2-year-old child has spastic quadriplegic cerebral palsy, with persistence of primitive reflexes, no selective control of movement, and frequent respiratory infections. Which of the following elements is MOST critical to include in the physical therapist’s examination?
Oral-motor control could be a factor in respiratory infections because poor feeding is associated with weak suck, poor coordination of swallowing mechanism, and hypoactive gag reflex
A patient with lateral epicondylitis has been instructed to wear a counterforce brace. Over which muscle group should the counterforce be placed?
Lateral epicondylitis is a term synonymously used for tennis elbow and extensor tendinopathy. counterforce brace for this condition is on the wrist extensor muscle bulk.
In examination, a PT finds that a patient with chronic obstructive pulmonary disease has a weak wet cough. Which technique is MOST appropriate to help this patient clear secretions?
Postural drainage - facilitates drainage of secretions to the level of the segmental bronchus only. In addition, a cough is needed to clear secretions
a burning sensation between the 2nd and 3rd metatarsals that spreads across the forefoot. Pain occurs primarily with WB or pressure on the area, and at night
a Morton neuroma
left brain injuries are associated with:
apraxia, alexia (inability to read), receptive aphasia (Wernicke aphasia), expressive aphasia (Broca aphasia),
right-sided cerebrovascular accident:
overestimating personal abilities, Impulsiveness, poor safety awareness, and difficulty with spatial relationships, poor judgment and distorted body image
most useful measurements in determining the progression of obstructive pulmonary disease:
Forced expiratory volume in 1 second and the ratio of forced expiratory volume in 1 second to forced vital capacity ratio
In leg length discrepancy which gait deviation is MOST likely seen?
Increased dorsiflexion on the long limb during stance and increased plantar flexion of the short limb during stance would functionally shorten the long limb and functionally lengthen the short limb during stance
nitroglycerin is MOST often used by patients with
acute and prophylactic management of stable angina
chronic skin ulcer displays decreased blood pressure and skin turgor, as well as a weak, rapid pulse. A PT suspects a decreased dietary intake of:
water - aids in hydration of the wound site, and dehydration will result in elevated heart rate and decreased blood pressure
A Stage I pressure ulcer has
intact skin, not have exudate, no necrosis (ulcer can’t be staged with necrosis).
Stage II ulcer has
blistered skin
Which effect of long-term use of corticosteroids is MOST likely to delay wound healing?
Inhibition of inflammatory proteins. Cortisol delays healing by inhibiting production of the expression of cytokines,fibroblasts and prostaglandins.
patient with damage to cranial nerve V shows S&S of:
Pain along the forehead, face, and chin, and decreased tone in the masseter muscle
Hypersensitivity to sound would be caused by damage to
vestibulocochlear nerve (CN VIII)
responsible for the lateral rectus muscle of the eye
The abducent nerve (CN VI)
sense of hearing
vestibulocochlear nerve (CN VIII)
Which patellar glide encourages knee flexion
Inferior (downward) - patella must glide downward with knee flexion
Which patellar glide encourages knee EXT
Superior - patella glides superiorly with terminal knee extension
A patient has decreased passive terminal knee extension. Which mobilization will be MOST beneficial?
Anterior glide of the tibia on the femur - normal arthrokinematic motion for extension
The BEST position to stretch the right iliopsoas is hip extension combined with
posterior pelvic tilt and left lateral flexion of the trunk - The R iliopsoas flexes the hip and laterally flexes the trunk to R. Lengthening it requires - hip ext and L trunk lateral FL. The iliacus attaches to the upper 2/3 of the iliac fossa -more stretched when pelvis is tilts posteriorly
diastasis recti -
important that the patient begin gentle exercise to reduce the diastasis -recommend posterior pelvic tilts with abdominal splinting
Pt with L thoracotomy - PT can help to MINIMIZE the patient’s incisional pain associated with coughing by
placing the patient’s hands firmly over the incision - describes manually splinting
A patient is unable to perform a standing heel raise with the knee extended. During this attempted movement, the physical therapist observes toe flexion, inversion, and limited movement of the calcaneus. The MOST likely cause of this deviation is
substitution by the flexor digitorum and flexor hallucis longus muscles - toe flexors may substitute for a weak gastrocnemius
intermittent claudication (chronic arterial occlusion)
paleness, decreased temperature, and absent pedal pulses are typical of arterial insufficiencies. This condition is associated with pain due to insufficient oxygen to tissues
a teenaged athlete sustained a hematoma from a blow to the anterior thigh 2 weeks ago. Pt exhibits moderate knee pain with knee FL greater than 90°. She has a palpable mass in the quadriceps muscle. The MOST likely diagnosis is:
Myositis ossificans is a common diagnosis resulting from this mechanism of injury and may take 2-4 weeks to develop.
A patient is taking propranolol (Inderal). When evaluating this patient’s response to exercise, a PTshould expect this drug to cause the patient’s heart rate to:
be low at rest and rise very little with exercise - Beta blockers decrease both resting and exercise heart rates
headaches associated with prolonged sitting
Head forward posture places the upper cervical spine in EXT, shortening the suboccipital muscles. Tightness of these muscles can compress the suboccipital nerves and is frequently associated with headaches
A scar with retarded healing at 6 weeks would still show signs of
not being approximated, and not fully granulated or epithelialized
Signs of inflammation would include
a red color, warmth, and induration (firm, inflexible tissue)
Keloids would be
firm or inflexible, highly raised, and outside the wound borders
A normally healing scar at 6 weeks will be
pink or pale in color, flexible, less than 2 mm in height, and within the borders of the wound
Proprioception and light touch, deep pressure are carried through
posterior column to the medial lemniscus
Temperature is carried by
the lateral spinothalamic tract
A dependent variable is measured on a continuous scale and has a markedly skewed distribution. Which of the following statistical tests is MOST appropriate to detect a difference between two groups?
Mann-Whitney U test - nonparametric test designed to test the null hypothesis with two independent samples from the same population
Analysis of variance
used when there are three or more groups to compare
Student’s t-test
parametric test is designed to compare two means
Kruskal-Wallis test
test is primarily used with three or more independent samples
The Dix-Hallpike maneuver is the standard test used to establish a diagnosis of
benign paroxysmal positional vertigo
When instructing an individual with mental retardation, which of the following teaching techniques is MOST appropriate
Practice, review, and facilitate overlearning of concepts and techniques - long-term retention of skills requires repetition and overlearning
Metabolic syndrome is characterized by
abdominal obesity (waist size > 40 in (101.6 cm), high triglycerides levels, high low-density lipids and low high-density lipids cholesterol values, and elevated blood pressure (> 130/85 mm Hg).
