Physical Therapy Examination

Question 1

Accessory mobility testing is rated by the accessory mobility scale when the joint capsule is the loose packed position. List the scale used to grade joint play accessory mobility (pg. 131 course manual).

Answer 1

0 - ankylosed joint
1 - considerable limitation
2 - slight limitation
3 - normal mobility
4 - slight hypermobility
5 - considerable hypermobility
6 - pathological unstable

Question 2

What are the 4 possible findings with resisted muscle testing?

Answer 2

Strong and painless - no pathology in contractile tissue
Strong and painful - minor structural lesion of muscle-tendon unit.
Weak and painless - complete rupture of muscle-tendon unit or neurological deficit present. (further testing needed)
Weak and painful - partial disruption in muscle-tendon unit. Pain response due to serious pathology or concurrent neurological deficit.

Question 3

What is the name, number, and description of each muscle grade (pg. 131-32).

Answer 3

Normal = 5/5 - can resist max pressure
Good = 4/5 - can resist moderate pressure
Fair+ = 3+/5 - can only resist minimal pressure
Fair = 3/5 - can hold testing position against gravity
Fair- = 3-/5 - same as fair but gradual release against gravity
Poor+ = 2+/5 - can move against gravity in small ROM
Poor = 2/5 - full ROM in gravity eliminated
Poor- = 2-/5 - can only initiate ROM in gravity eliminated position
Trace = 1/5 - fasciculation or palpable muscle contraction but unable to move
Zero = 0/5 - no visible or palpable muscle contraction

Question 4

What special test are performed during upper quarter screen, how are they performed, and why?

Answer 4

Vertebral artery test - (supine or sitting) fully extend neck and rotate and holds for 10 sec. If (+) avoid mobs and cervical spine movements into extension and rotation at ranges that produce symptoms. *notify the physician.
Quadrant test (AKA Spurling's test) - determines if cervical spine is contributing to UE symptoms. Pt is positioned in cervical extension, rotation, and ipsilateral side-bending with overpressure. If (+) further exam required for radiculopathy, disc prolapse, and neck pain.
Distraction test - supine, hold pt under chin and occiput, flex neck while applying distraction force of about 14 pounds.

Question 5

What is the capsular pattern for the Glenohumeral joint?

Answer 5

ER > abduction > flexion > IR

Question 6

What is the capsular pattern for the elbow joint?

Answer 6

flexion > extension

Question 7

What is the capsular pattern of the radioulnar joint?

Answer 7

pronation = supination

Question 8

What is the capsular pattern of the wrist joint?

Answer 8

flexion = extension

Question 9

What is the capsular pattern of the interphalangeal joints?

Answer 9

flexion > extension

Question 10

What is an irregular pulse and what could be the cause?

Answer 10

• variations in force and frequency

- may be due to arrhythmias, myocarditis

Question 11

What is a weak pulse and what could cause this?

Answer 11

• a thready pulse

- may be due to low stroke volume, cardiogenic shock

Question 12

What is a bounding pulse and what can cause this?

Answer 12

• a full pulse

- may be due to shortened ventricular systole and decreased peripheral pressure, aortic insufficiency