Quiz Questions Exam 1 Flashcards
Why might a physical therapist want to examine sensory function prior to motor function?
A) The sensory exam takes less time and therefore it is the most time-efficient way to perform the exam.
B) The sensory exam does not cause any discomfort and therefore the patient can stay alert for the motor exam.
C) The sensory system is more sensitive to fatigue and should be examined before the patient becomes fatigued.
D) The sensory system influences movement and therefore examination first may direct the examination of motor function
D) The sensory system influences movement and therefore examination first may direct the examination of motor function
During a sensory screening examination what should the therapist do?
A) Examine the patient’s visual acuity, hearing acuity, and light touch.
B) Examine very small areas of the body, especially on the extremities.
C) Use the most highly sensitive types of examinations for the trunk.
D) Select modalities from each of the general categories of sensation.
D) Select modalities from each of the general categories of sensation.
What should the therapist examine first during a sensory examination, superficial (exteroceptive), deep (proprioceptive), or combined (cortical) sensations?
A) Superficial sensations because these must be sufficiently intact in order to allow for testing of combined (cortical) sensations.
B) Deep sensations because these indicate most significantly a patient’s ability to participate in motor activities.
C) Combined (cortical) sensations to allow for the most efficient examination and determine immediately areas of deficiency.
D) There is no specific order for examination, so the therapist can choose based on time, equipment, and patient awareness.
A) Superficial sensations because these must be sufficiently intact in order to allow for testing of combined (cortical) sensations.
What progression should the therapist make when performing a sensory examination?
A) Complete the examination by allowing the patient to indicate verbally the location of the most sensory loss.
B) Examine each of the dermatomes completely for each modality before moving on to the next dermatome.
C) Begin the examination distally because patients typically present with the most significant deficits distally.
D) Perform the examination on the posterior aspect of the trunk first followed by the anterior portion and the extremities.
C) Begin the examination distally because patients typically present with the most significant deficits distally.
How would a therapist examine kinesthesia?
A) The therapist will place the patient’s joint in a position and ask the patient to duplicate the position with the opposite joint.
B) The therapist will randomly touch the patient’s skin with a tool and ask the patient o differentiate sharp and dull touch.
C) The therapist will lightly touch the patient with a piece of cotton or soft brush and ask the patient to indicate when something is felt.
D) The therapist will move the patient’s joint within a small range and ask the patient to describe the direction and range of movement.
D) The therapist will move the patient’s joint within a small range and ask the patient to describe the direction and range of movement.
How would a therapist examine proprioceptive awareness?
A) The therapist will place the patient’s joint in a position and ask the patient to duplicate the position with the opposite joint.
B) The therapist will randomly touch the patient’s skin with a tool and ask the patient to differentiate sharp and dull touch.
C) The therapist will lightly touch the patient with a piece of cotton or soft brush and ask the patient to indicate when something is felt.
D) The therapist will move the patient’s joint within a small range and ask the patient to describe the direction and range of movement.
A) The therapist will place the patient’s joint in a position and ask the patient to duplicate the position with the opposite joint.
Examination of stereognosis perception determines the patient’s ability to do what?
A) Localize a touch sensation on the skin.
B) Perceive two points of touch applied simultaneously.
C) Recognize familiar objects by touch.
D) Duplicate the position of a joint while in motion.
C) Recognize familiar objects by touch.
When might examination using graphesthesia be an appropriate procedure?
A) The patient has speech impairments.
B) The patient is unable to grasp an object.
C) The patient prefers a test using numbers.
D) The patient is visually impaired.
B) The patient is unable to grasp an object.
Which of the following would be considered a compensatory approach to interventions for a patient with sensory impairments?
A) Guided practice with augmented feedback to supplement sensation.
B) Having the patient walk at home without shoes to increase sensory input.
C) Regular skin checks of areas where there is impaired sensation.
D) Thermal stimulation of the impaired extremity in a whirlpool bath.
C) Regular skin checks of areas where there is impaired sensation.
You are conducting a sensory evaluation and ask the patient to duplicate the position of an extremity with the contralateral extremity. You are assessing which type of sensation? A) Vibration perception B) Proprioceptive awareness C) Pressure perception D) Stereognosis perception
B) Proprioceptive awareness
Exerting pressure on the skin with a monofilament
Tactile threshold
Gentle poking with a pin interspersed with light touches with the blunt end of the pin
Sharp, fast pain
Light touching of two points on the skin, using smaller distances between the points until the points cannot be distinguished as separate points
Two-point discrimination
Light touching of both sides of the body simultaneously
Bilateral simultaneous touch
Drawing a line (using a dull point) on the subject’s skin
Directional cutaneous kinesthesia
Patient to identify the letter ‘drawn’ in the palm of their hand
Graphesthesia
If only one sensory root is severed, does a complete loss of sensation result in that area?
A) Yes. Sensation does not depend on multiple dermatomes.
B) No. Overlapping dermatomes ensure not all sensation is lost.
C) No. Multiple sensory roots must be severed for complete sensory loss to occur.
D) Yes. Overlapping dermatomes will not prevent complete sensation loss.
B) No. Overlapping dermatomes ensure not all sensation is lost
What numerical value(s) is (are) involved in determining whether the results of a nerve conduction study are normal? A) Conduction velocity B) Distal latency C) Amplitude of the evoked potential D) All of the above
D) All of the above
If sitting with the legs crossed, sensory loss will eventually occur. (Part of the limb will “fall asleep.”) In what order will this loss occur? (Hint: compression of a nerve affects function in order according to axon diameter and myelination; largest diameter myelinated axons are affected first)
A) 1. Slow pain; 2. heat; 3. fast pain; 4. cold; 5. conscious proprioception and discriminative touch
B) 1. Conscious proprioception and discriminative touch; 2. heat; 3. fast pain; 4. cold; 5. slow pain
C) 1. Conscious proprioception and discriminative touch; 2. cold; 3. fast pain; 4. heat; 5. slow pain
D) 1. Slow pain; 2. cold; 3. fast pain; 4. heat; 5. conscious proprioception and discriminative touch
C) 1. Conscious proprioception and discriminative touch; 2. cold; 3. fast pain; 4. heat; 5. slow pain
Lesions in what location(s) will result in decreased or lost sensation from the contralateral body or face?
A) Ventral posterolateral (VPL) nucleus of the thalamus
B) Ventral posteromedial (VPM) nucleus of the thalamus
C) A and B
D) None of the above
C) A and B
Which of the following is(are) part of the pain matrix? A) Amygdala B) Thalamus C) Hypothalamus D) All of the above
D) All of the above
How should ambient vision be examined?
A) Instruct the patient while in a sitting position to visually track from right to left with increasing speed.
B) Instruct the patient to read a Snellen eye chart from a distance of 20 feet.
C) Instruct the patient to move across the busy gym area while observing ability to navigate safely, avoiding obstacles
D) Instruct the patient to look at the therapist’s nose while the therapist slowly brings a
pencil into the patient’s field of view from the right or left.
C) Instruct the patient to move across the busy gym area while observing ability to
navigate safely, avoiding obstacles.
What is included in examination of sensory organization of postural control and
balance?
A) Vision, lower extremity somatosensation, and vestibular function
B) Vision, lower extremity range of motion, and vestibular function
C) Hearing, lower extremity somatosensation, and vestibular function
D) Vision, lower extremity somatosensation, and reflex integration
A) Vision, lower extremity somatosensation, and vestibular function
A patient who presents with significant deficits in lower extremity somatosensation will have to depend on what systems to maintain balance? A) Auditory and proprioception B) Visual and auditory C) Auditory and vestibular D) Visual and vestibular
D) Visual and vestibular
Deep tendon reflexes in a patient with an upper motor neuron lesion are A) increased. B) decreased. C) not changed. D) dependent on location of the lesion.
A) increased
The patient is able to walk independently from his room to the physical therapy gym
while talking to the therapist. This is an example of
A) selective attention.
B) sustained attention.
C) alternating attention.
D) divided attention
D) divided attention
What type of sensation can be described as a painless abnormal sensation in the absence of nociceptor stimulation? A) Dysesthesia B) Allodynia C) Paresthesia D) Secondary hyperalgesia
C) Paresthesia
What type of sensation can be described as an unpleasant abnormal sensation, whether evoked or spontaneous? A) Dysesthesia B) Allodynia C) Paresthesia D) Secondary hyperalgesia
A) Dysesthesia
What type of sensation can be described as pain evoked by a stimulus that would not normally cause pain? A) Dysesthesia B) Allodynia C) Paresthesia D) Secondary hyperalgesia
B) Allodynia
What type of sensation can be described as excessive sensitivity to stimuli that is normally mildly painful in uninjured tissue? A) Dysesthesia B) Allodynia C) Paresthesia D) Secondary hyperalgesia
D) Secondary hyperalgesia
Which of the following is true about the Golgi tendon organ (GTO)?
A) Maximum GTO activation occurs before maximum voluntary contraction.
B) GTO inhibition of the agonist alpha motor neuron causes immediate muscle relaxation via the GTO reflex.
C) Effectiveness of the contract-relax technique for stretching is dependent on GTO input.
D) GTO conveys information via a type IIa afferent to the spinal cord.
E) All of the above are true statements.
B) GTO inhibition of the agonist alpha motor neuron causes immediate muscle relaxation via the GTO reflex.
What is the purpose of alpha-gamma coactivation?
A) Prevents simultaneous activation of fast twitch and slow twitch muscles.
B) Coordinates reciprocal reflex innervation.
C) Coordinates the actions of the basal ganglia and cerebellum.
D) Maintain muscle spindle sensitivity when extrafusal muscle fibers contract.
E) Prevents contraction of an antagonist muscle when the agonist is contracting.
D) Maintain muscle spindle sensitivity when extrafusal muscle fibers contract.
Reciprocal inhibition produces inhibition of the alpha motor neurons to which of the following?
A) Agonist muscle
B) Agonist muscle and its synergists
C) Antagonist muscle
D) Agonist muscle, its synergists, and its antagonists
E) Homologous muscles in the opposite limb
C) Antagonist muscle
Interneurons serve which one of the following functions? A) Modulation of sensory information B) Coordination of motor activity C) Autonomic regulation D) All of the above
D) All of the above
Which one of the following involuntary muscle contractions is always abnormal? A) Muscle spasms B) Cramps C) Fasciculations D) Fibrillations E) All of the above
D) Fibrillations
If the lower motor neurons to a muscle are destroyed, which of the following signs affects the denervated muscles? A) Loss of reflexes B) Atrophy C) Muscle hyperstiffness D) Both A and B E) A, B, and C
D) Both A and B
After lower neuron motor denervation caused by poliomyelitis, how does recovery of some muscle strength occur?
A) Cell division of surviving motor neurons produces new motor neurons.
B) Loss of interneuronal inhibition causes hyperreflexia.
C) Axonal sprouting of surviving neurons innervates muscle fibers.
D) Both A and B
E) A, B, and C
C) Axonal sprouting of surviving neurons innervates muscle fibers.
Abnormal cutaneous reflexes that occur after an upper motor neuron lesion include which of the following?
A) Emergence of Babinski’s sign
B) Muscle spasms in response to normally innocuous stimuli
C) Paresthesias
D) Both A and B
E) A, B, and C
D) Both A and B
Which one of the following major factors limits movement in individuals who have had a stroke?
A) Paresis caused by decreased agonist activation
B) Loss of ability to fractionate movement
C) Abnormal timing of muscle activation
D) Both A and B
E) A, B, and C
E) A, B, and C
Decorticate rigidity occurs with which of the following?
A) Lesions of the medulla
B) Vascular lesions of the anterior choroidal artery
C) Lesions superior to the midbrain
D) Lesions to the cerebellar lobes
E) All of the above
C) Lesions superior to the midbrain
Which of the following characteristics distinguish central nervous system dysfunction from peripheral nervous system dysfunction?
A) Hypertonia in upper motor neuron involvement
B) Paraspinal sensation
C) Slow muscle atrophy
D) Hypertonia in lower motor neuron involvement
A) Hypertonia in upper motor neuron involvement
Which one of the following is NOT a sign of an upper motor neuron lesion? A) Muscle paresis B) Hyperreflexia C) Muscle fasciculations D) Positive Babinski's sign E) Spasticity
C) Muscle fasciculations
