Readings (Day 41-50) & Lectures 12-15 Flashcards by Danielle Hood

Rigidity is ______ resistant whether fast or slow and is usually seen in _____ opposing mm groups

always
both

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Structures involved in UMN lesions

Cortex, brainstem, spinal cord

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If someone has:

increase tone/hypertonia
hyperreflexia/clonus/babinski
Decreased sensation

They may have a _____ lesion

UMN

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If someone has:

decreased tone/hypotonia
hyporeflexia/absent reflexes
decreased sensation
twitch
weak/absent voluntary movement

They may have a ____ lesion

LMN

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If someone has:

rigidity
decreased or normal reflexes
normal sensation
resting tremors
bradykinesia/akinesia/hypokinesia

They may have a lesion of ______

Basal ganglia

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If someone has:

decreased or normal tone
decreased or normal reflexes
normal sensation
no involuntary movements
ataxia, intention tremor, dysdiadochokinesia, dysmetria, nystagmus

They may have a lesion of ______

Cerebellum

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Stroke, MS, TBI, SCI, ALS are all examples of ______ lesions

UMN

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Peripheral n injury, bells palsy, GBS, and ALS are all examples of _____ lesions

LMN

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tremor that you have while in movement

intention tremor

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rapid alternating movements are difficult

dysdiadochokinesia

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over or undershooting movements

dysmetria

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A PT informs a SPT that the pt they will be treating today has LMN signs. Presence of which of the following should be expected by the SPT?

A. Positive babinski, presence of spasticity and foot drop

B. Neg babinski, dec in mm tone and sensations

C. Increase in mm tone and no change in sensation, presence of resting tremor

D. Presence of intentional tremors and nystagmus

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Progressive neurological disorder caused by depletion of dopamine in substantia nigra

males>female

Parkinson’s disease

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Cardinal signs of PD:

TRAP

Tremor (resting)
Rigidity
Akinesia
Postural instability

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T or F: With PD, proximal rigidity is greater than distal rigidity

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Type of rigidity that is smooth and consistent

lead-pipe rigidity

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Type of rigidity that is ratchet-like

cogwheel rigidity

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If moving into elbow extension and you feel spasticity, is the biceps or triceps the spastic muscle?

biceps, bc it is causing the resistance into extension

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Hoehn and Yahr Classification

Stage 1:
Stage 2:
Stage 3:
Stage 4:
Stage 5:

Stage 1: Minimal, UL
Stage 2: BL, balance ok
Stage 3: Impaired righting reflexes, impaired balance, live independently
Stage 4: standing & walking only possible w assistance
Stage 5: Confined to bed/wheelchair

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start writing big but gets smaller as go on

microphagia

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sudden inability to initiate movement while walking

freezing of gait

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Things to help with freezing gait

drop tissue, music, wide doorways/modify environment, metronomes

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Short stride, shuffling, increasing speed, anteropulsive gait

festinating gait

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Ways to help festinating gait

toe wedge or declined heel to move COM posteriorly

big movements

posture training

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Levodopa/Carbidopa/Sinemet

Gold standard for treating PD

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What does Levodopa/Carbidopa/Sinemet do?

delivers higher level dopamine to brain

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Involuntary, writhing movements caused during the “on phase” of levodopa

Dyskinesia

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involuntary muscle contractions causing repetitive or twisting movements during the “off phase” of levodopa

Dystonia

Already have “ON” so don’t need more

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A clinician is evaluating a pt who has been diagnosed with PD. While observing the pt’s gait, which of the following is MOST likely to be increased?

A. Forefoot loading
B. stride length
C. Arm swing and trunk rotation
D. Step width

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Autoimmune disease with progressive demyelination of the neurons in the CNS

Multiple sclerosis

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Lhermitte’s Sign “hair messy”

neck flexion causes electric like shock down spine to legs (MS)

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Uhthoff’s Phenomenon “U Turn Heat OFF”

heat causes false exacerbation of symptoms that last less than 24 hours (MS)

-want to work out early in AM (bc cold)
aquatic
hydrate
rest breaks

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Charcot’s Triad (SIN)

Scanning speech
Intention tremor
Nystagmus

(MS)

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Cranial Nerve II

“Marcus pulls out gunn”

Marcus pulls out gunn= big eyes
optic neuritis

(MS)

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Name the disease:

Motor: Spasticity
Sensory: N & T
Cerebellum: nystagmus, ataxia, coordination, balance, intention tremor
Gait: scissoring, ataxia, uneven steps, extensor spasticity in LE

Bladder: spastic, flaccid

Speech/swallow: Dysphagia, dysphonia

Emotion: Pseudobulbar affect (abnormal emotional responses)

Cognition: Diminished attention, concentration

Optic neuritis

Trigeminal neuralgia

FATIGUE

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Abnormal emotional responses to things

pseudobulbar affect

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A 32 y/o female pt presents with presence of abnormal reflexes. She also notes “weird” sensations throughout her body. During the assessment, she asks the PT to decrease the temperature in the treatment room, as she was heat-intolerant. Considering pt’s presentation so far, which signs and sx are LEAST likely expected to be seen in this case?

A. Ataxia
B. optic neuritis
C. Trigeminal neuritis
D. Electric shock-like sensation with neck extension

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Type of MS with a steady increase in disability with superimposed attacks

Progressive Relapsing (PRMS)

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Type of MS that is initially relapsing remitting, then symptoms increase without periods of remission

Secondary Progressive MS (SPMS)

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Type of MS with steady increase in disability without attacks/exacerbations

Primary Progressive MS (PPMS)

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Type of MS with short duration attacks with full or partial recovery, may or may not leave lasting symptoms/deficits

Relapsing-Remitting MS (RRMS)

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Most common form of MS

Relapsing Remitting

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Worst type of MS

Progressive Relapsing

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Exercise recommendations for MS:

Frequency=___-___ days/week

Intensity= Low, __-___ METS, ____-____% VO2max

Time= ____ minutes/session

Type=

Frequency=3-5 days/week

Intensity= Low, 3-5 METS, 50-70% VO2max

Time= 30 minutes/session

Type= cycle, swim, walk, circuit training

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Progressive neurological disorder that damages nerve cells, causes death of motor neurons, and causes disability

Amyotrophic Lateral Sclerosis (ALS)/ Lou Gehrig’s/ Motor Neuron Disease

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Name the disorder:

UMN & LMN presentation without sensory loss (muscle atrophy, fasciculations, spasticity, hyperreflexia, dysphagia, dysarthria)

Cognition: dementia, attention deficits

Emotion: pseudobulbar affect

Muscles: cervical spine extensor weakness

ALS

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A PT is treating a pt with a diagnosis of ALS. The pt has weakness of all extremities and gets fatigued very easily while doing ADLs. His main goal is to maintain mobility and function as much as possible. Which of the following will be LEAST appropriate for this patient?

A. Recommending soft foam collar for neck

B. Taking frequent breaks during activities

C. Recommend HKAFO and walker for ambulation

D. Slow, prolonged stretches and ROM exercises for UE and LE

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Autoimmune disorder that happens after an infection causing rapid asymmetrical loss of myelin in nerve roots, peripheral nerves and cranial nerves

Guillain Burre Syndrome (GBS)

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Name the disorder:
-Fatigue
-Motor loss/Paralysis distal to proximal
-Glove and stocking sensory loss
-Decreased reflexes/arreflexia
-Respiratory and cranial involvement

Guillain Burre Syndrome (GBS)

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What disorder benefits from the following interventions?

-Respiratory care
-Energy conservation techniques
-Avoiding overuse
-Recovery 6-12 months

Guillain Burre Syndrome (GBS)

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A pt presents to clinic with weird sensations in the body, difficulty with urination, slightly wide BOS with gait, 1+ tones of biceps, CN II,III,V,VII involved.

Which of the following diagnosis is the pt MOST likely expected to have?

A. ALS
B. GBS
C. MS
D. Cerebellar tumor

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A pt presents to clinic with weird sensations in the body, difficulty with urination, slightly wide BOS with gait, 1+ tones of biceps, CN II,III,V,VII involved.

The therapist decides to assess the pt’s pupillary reflexes. On shining light into the pt’s L eye, both pupils constrict; however, on shining light into the pt’s R eye, both pupils paradoxically dilate. Which of the following is MOST likely diagnosis and cause of this presentation?

A. Marcus Gunn Pupil; lesion to CN II

B. Cataract; lesion to CN III

C. Cataract; lesion to CN II

D. Marcus gunn pupil; lesions to CN III

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A pt presents to clinic with weird sensations in the body, difficulty with urination, slightly wide BOS with gait, 1+ tones of biceps, CN II,III,V,VII involved.

As the therapist determines the plan of care for the patient, which of the following is LEAST appropriate?

A. Exercise sessions should be scheduled at the same time every day in the evening for consistency

B. Rest breaks and activity pacing should be incorporated based on pt sx

C. During pool therapy, the temp of water should be <85 deg

D. Balance and proprio training must be incorporated in rehab

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What artery supplies the lateral brain?

Middle cerebral artery

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What artery supplies the middle brain?

Anterior Cerebral Artery

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What artery supplies the posterior brain/occipital lobe?

Posterior cerebral artery

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Type of stroke that occurs when a clot blocks or impairs blood flow, depriving the brain of essential oxygen and nutrients

Ischemic stroke

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The most common stroke type

Ischemic stroke

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Type of stroke that occurs when blood vessels rupture causing leakage of blood in or around the brain

Hemorrhagic stroke

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Which stroke has a worse prognosis? Ischemic or hemorrhagic?

hemorrhagic

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A pt diagnosed with R-sided stroke is participating in home health PT d/t poor mobility and respiratory function. Which symptom is this patient MOST LIKELY to present with?

A. hypotonia, positive babinski
B. Spasticity, positive clonus
C. Hyporeflexia, positive Babinski
D. Rigidity, present of rest tremors

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Stroke Syndrome
“LA”
CL hemiparesis of LE
CL hemisensory loss of LE
“ACA”–> “ABCD”
urinary incontinence, problems w imitation, bimanual tasks, apraxia, slow, delay, motor inaction, CL grasp reflex, sucking reflex

“LA” –> “LE for ACA”
Anterior Cerebral Artery Syndrome

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Stroke syndrome:

“MPH”
Mouth (speech), Perceptual disorders, homonymous hemianopsia

CL hemiparesis of UE & face
CL hemisensory loss of UE & face

w/ L infarct= Aphasias
w/R infarct= Unilateral neglect, perceptual disorders

CL homonymous hemianopsia

“MPH” –> “MCA”
Mouth (speech), Perceptual disorders, Homonymous hemianopsia

MCA syndrome

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What side homonymous hemianopsia is this?

R MCA infarct b/c L side is affected which is causing L HH (vision lost on both L sides of the eyes)

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What side homonymous hemianopsia is this?

L CVA causing R HH
b/c R side is affected which is R HH (vision lost on both R sides of the eyes)

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A pt presents with sudden onset of weakness on one side of the body. When asked about how his day was, the pt said, “The boat is color is pink.” Which of the following is the MOST likely cause of this presentation?

A. L MCA infarct
B. R ACA infarct
C. L ACA infarct
D. R MCA infarct

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MCA infarct causes what language aphasia?

Wernickes

b/c in Temporal lobe

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Temporal lobe
speech intact
word salad “wowsome”
can’t understand
Treatment: visuals, demonstration, gestures

Wernicke’s aphasia

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Frontal lobe
Broken speech - cannot express
Treatment= yes/no Qs

Broca’s aphasia

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Non fluent aphasia is AKA

Broca’s Aphasia

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Receptive Aphasia is AKA

Wernicke’s Aphasia

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Damage to MCA superior division causes ______ aphasia

Broca’s aphasia

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Damage to MCA inferior division causes ____ aphasia

Wernickes

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Damage to stem of MCA causes _____ aphasia

Global aphasia

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lack of awareness of the weak side

unilateral neglect

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most common side and artery that unilateral neglect is seen on

R MCA CVA causing L neglect

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A pt presents with sudden onset of weakness on one side of the body. When asked, he was unable to name his friend who accompanied him to the hospital. During assessment, he was able to write a sentence perfectly but was unable to read his sentence. A lesion in which of the following is the most likely cause of this symptom?

A. Sup division of MCA
B. Central territory PCA
C. Inf division MCA
D. Peripheral territory PCA

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Stroke Syndrome:
-Peripheral territory= CL HH, Visual agnosia, dyslexia w/o agraphia, color discrimination, memory deficits, topographical disorientation

-Central territory= thalamic pain syndrome

Posterior Cerebral Artery Syndrome

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Not understanding what you’re seeing

visual agnosia

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Inability to recognize faces (facial blindness)

Prosopagnosia

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difficulty writing

Agraphia

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not knowing directions

Topographical disorientation

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Syndrome when sensations are painful even when they shouldn’t be

Thalamic pain syndrome

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What hemisphere has the infarct?

L hemiparesis/hemisensory loss
UE
Neglect
Difficulty w visual cues
R visual agnosia
quick, impulsive behavior
Rigid in thought
Difficulty w negative emotions

Right hemisphere

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What hemisphere has the infarct?

R hemiparesis/hemisensory loss
LE
Aphasias
Difficulty w verbal cues
Slow, cautious behavior
highly distractible
difficulty with positive emotions

Left hemisphere

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A 55 y/o female with CVA presented to an OP clinic to continue with therapy services after meeting goals from a therapy program at a skilled nursing home facility. The pt is perceived to be quick, impulsive, and exhibiting poor awareness of impairments. Upon further evaluation, the PT recognized there are hemispheric differences commonly seen following stroke. Which of the following deficits would LEAST likely occur based on this pt presentation?

A. Difficulty processing visual cues
B. Difficulty processing verbal cues
C. Difficulty with expressing negative emotion
D. Safety risk increases

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Is spasticity based on PROM or AROM?

PROM

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Are synergies based on PROM or AROM?

AROM

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Brunnstrom Stages of Stroke Recovery:

Stage 1=
Stage 2=
Stage 3=
Stage 4=
Stage 5=
Stage 6=
Stage 7=

Stage 1= flaciddity
Stage 2= minimal voluntary control
Stage 3= voluntary control of mvmt synergy (spasticity at peak)
Stage 4= movement outside of synergy
Stage 5= inc. complex mvmt, more independence from limb synergies
Stage 6= individual joint mvmt, coordinated mvmt
Stage 7= normal function

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Brunnstrom stages

“6th finger stands independently”

Stage 6= individual joint mvmt, coordinated mvmt

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Stage 1 of Brunnstrom Stages

flaciddity

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Stage 2 of Brunnstrom Stages

minimal voluntary control

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Stage 3 of Brunnstrom Stages

voluntary control of mvmt synergy (spasticity at peak)

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Stage 4 of Brunnstrom Stages

movement outside of synergy

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Stage 5 of Brunnstrom Stages

inc. complex mvmt, more independence from limb synergies

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Stage 6 of Brunnstrom Stages

individual joint mvmt, coordinated mvmt

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Stage 7 of Brunnstrom Stages

normal function

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chicken dance

Spasticity pattern in UE

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Ballerina

spasticity pattern in LE

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Which spasticity pattern?

Retracted & downardly rotated scapula
Shoulder ADD, IR, depression
Elbow flexion
Forearm pronation
Wrist flexion, ADD
Finger flexion, clenched fist thumb ADD in palm

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Which spasticity pattern?

Pelvis retraction (hip hike)
Hip ADD, IR, Ext
Knee Ext
PF, INV, Equinovarus, toes claw and toes curl

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Rosie Riveter

UE Flexion synergy in stroke

Scapular retraction/elevation or hyperext
Shoulder ABD, ER
Elbow flexion
Wrist & finger flexion

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What synergy pattern?

Scapular retraction/elevation or hyperext
Shoulder ABD, ER
Elbow flexion
Wrist & finger flexion

UE flexion synergy

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What synergy pattern?

Scapular protraction
Shoulder ADD, IR
Elbow ext
pronation
wrist and finger flexion

UE extension synergy

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Waiter’s tip

UE extension synergy in stroke

Scapular protraction
Shoulder ADD, IR
Elbow ext
pronation
wrist and finger flexion

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What synergy pattern?

Hip flex, ABD, ER
knee flex
DF, Inv
Toe DF

LE flexion synergy

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“Hot guy putting on a sock”

LE flexion synergy in stroke

Hip flex, ABD, ER
knee flex
DF, Inv
Toe DF

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What synergy pattern?

Hip ext, ADD, IR
Knee extension
PF, INV
Toe PF

LE extension synergy

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85 y/o pt admitted for L MCA infarct, previous TIAx2, hemiparesis of R arm with compensatory motions for overhead shoulder motions, Partial ROM w elbow flexion and extension, but was uncoordinated and effortful, mild-non-fluent aphasia, decreased standing tolerance and standing balance.

With respect to the UE, which of the following MOST accurately describes the UE position at rest.

A. Forearm pronation w wrist and finger flexion and thumb abduction

B. Forearm supination with wrist extension finger flexion and thumb adduction

C. Shoulder in adduction and IR and thumb adduction

D. shoulder abducted, ER, elbow flexed, forearm supinated

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Considering the pt has extreme spasticity, PE demonstrates flexion synergy patterns of the UE while attempting to move her UE. Which of the following is MOST likely to be seen w respect to her presentation and the appropriate classification per the Brunnstrom Staging?

A. Shoulder ER, elbow & wrist flexed, forearm supinated; Stage 3

B. Shoulder IR, ADD, elbow & wrist flexed, forearm supinated; Stage 3

C. Shoulder ER, ABD, elbow & wrist extended, forearm pronated; Stage 4

D. Shoulder IR, ABD, elbow & wrist flexed, forearm pronated; Stage 5

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PT is educating pt on various positioning strategies. Which of the following is the MOST appropriate while lying on the L side?

A. head/neck neutral, L scap protracted, L arm slight ABD & ER, elbow extended, forearm supinated, wrist neutral, fingers ext, thumb ABD

B. Head/neck neutral, L scap retracted, L arm slight ABD and IR, elbow ext, forearm pronated, wrist neutral, fingers ext, thumb ADD

C. Head/neck neutral, R scap retracted, L arm slight ABD & IR, elbow ext, forearm pronated, wrist neutral, fingers ext, thumb ADD

D. Head/neck neutral, L scap protracted, L arm slight ADD & ER, elbow flex, forearm supinated, wrist ext, fingers flex, thumb ABD

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68 y/o male pt in Acute inpatient setting with increased sx of SOB, wheezing, fatigue with simple ADLS, COPD, smokes 1 pack/wk, wife with limited mobility, daughter helps in home and transports to appointments, uses 4WW and supplemental O2 at 1L prior to admission, pt is drowsy, oriented to person, place, and time, MinA STS, ModA sit to supine, Pt ambulates minA with FWWx15 feet to bathroom and x15 ft return to bedside, O2sat at 92% prior ot activity, 89% during, 88% after recovery to 92% within one minute.

The pt’s daughter who works in the same hospital on a different floor as a nurse visits him in the hospital. She asked to access her father’s medical record. What is the LEAST appropriate regarding healthcare record access??

A. She can visit her father but not access his records

B. She can access the chart because she is involved in the care for her father

C. She must have the permission of her father before she can access the chart

D. She may review the chart only if she is recorded as her father’s POA

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The treating PT enters the pt’s room and finds him in an agitates state following the billing department visiting him regarding his stay in the hospital. The patient refused PT. He is educated on the benefits and importance of mobility and PT but continues to deny PT. Which is MOST appropriate response of the PT?

A. Call the pt’s daughter and ask her to speak to him about cooperating with PT as with his condition PT is necessary

B. respect the pt’s decision not to utilize PT services today

C. Start the treatment as the pt will most likely cooperate once he is sat upright, and PT is necessary for him to be discharged home

D. Ask another PT to reattempt after you leave the room

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During treatment, the pt makes an inappropriate statement to the PT about their body. The PT ignores the comment but the pt persists, making the PT uncomfortable. What is the MOST appropriate response?

A. Refuse to treat the pt and refer to another therapist

B. Ignore the flirting and continue to treat the pt

C. Inform the pt you will notify his wife if the behavior continues

D. Report the behavior to the doctor and human resources and continue to treat the pt

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Who is directly responsible for the actions of PTA related to pt/client management? PT or PTA?

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PTA works under _______ supervision of the PT, meaning the PT must be available via _____________

general; telecommunication

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PT or PTA: Who can modify the POC to include a new modality?

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PT or PTA: Who can add hamstring exercises to the POC that states “LE strengthening”?

Both

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PT or PTA: Who can supervise a PTA student?

Both

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PT or PTA: Who can Treat a pt first day following surgical intervention that had been treated in clinic prior to surgery?

PT (re-eval, change in POC)

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PT or PTA: Who can Grade V mobs & sharp debridement?

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PT or PTA: Who can progress a pt from a front wheeled walker to a cane with a WBAT status?

Both

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PT or PTA: Who can sign notes?

Both, PT needs to sign off on PTAs notes

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A PTA asks an aide to perform exercises with a pt that has recently had a CVA while the PTA goes to the hospital cafeteria. The aide asks the pt to complete a bridging exercises that was not in the original POC. During the bridging exercises, the pt reports a back injury. Which individual is responsible for the injury?

A. PT
B. PTA
C. PT aide
D. pt

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A pt is being treated for pelvic pain and is accompanied by his wife to the PT session. While treating, the patient expressed dissatisfaction in his marital life and says he has planned to end his life. What would be the BEST PT action?

A. Ask the pt to seek an appt with a mental health practitioner

B. Disagree w the pt and encourage him to focus on the positive things in his life

C. Refer the pt immediately to mental health practitioner and stay there until help arrives

D. Inform the pt’s wife about his statements and inform her she should help her husband in seeking professional help

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Who accredits hospitals, SNF, home health agencies, PPO, HMO, Mental health institutions?

A. JACHO
B. CARF
C. CMS
D. OSHA

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Who accredits free standing rehabilitative programs/facilities?

A. JACHO
B. CARF
C. CMS
D. OSHA

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Who determines what and how much will be reimbursed by Medicare for pt care?

A. JACHO
B. CARF
C. CMS
D. OSHA

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Who determines the safety of the work environment?

A. JACHO
B. CARF
C. CMS
D. OSHA

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Occupational Safety and Health Administration (OSHA) is responsible for which of the following?

A. Determining the how much compensation a PT should receive annually

B. Assuring minimum standards are met at the hospital to maintain accreditation and prevent negligence in pt care

C. Assuring minimum standards are met by rehabilitation clinics to maintain accreditation and safety of patients

D. Ensuring adequate steps taken to prevent exposures to harmful radiation to employees at an X-ray center

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Who is responsible for Assuring minimum standards are met at the hospital to maintain accreditation and prevent negligence in pt care?

A. JACHO
B. CARF
C. CMS
D. OSHA

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Who is responsible for Assuring minimum standards are met by rehabilitation clinics to maintain accreditation and safety of patients?

A. JACHO
B. CARF
C. CMS
D. OSHA

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Which organization is always concerned about patient safety?

A. JACHO
B. CARF
C. CMS
D. OSHA

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Which organization is always worried about employee safety?

A. JACHO
B. CARF
C. CMS
D. OSHA

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A hot pack should be kept between the temperatures of ____-____ deg F with __-___ layers of toweling for ___-___ mins with peak heat at ___ mins

160-170
6-8
20-30
5

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A Paraffin bath should be kept at ___-___ deg F for __-___ mins

125-127
15-20

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Contrast bath is hot:cold and should immerse the involved limb in ___-___ deg F water for __ mins, then ___-___ deg F for ___ min(s)

100-111
4
55-65
1

A PT student has been having PIP and DIP joint pain for 2 weeks following handwriting notes for a weekend event and then for a 5 hr NPTEFF Boot camp 2 wks ago. The student’s main report is joint stiffness. Which of the following modalities is MOST appropriate?

A. Hot pack x 20 mins
B. cold pack x 10 mins
C. conventional TENS x 20 mins
D. Paraffin dip wrap method

Does heat or cold increased blood flow?

heat

Does heat or cold decrease nerve conduction velocity?

cold

Does heat or cold increase local metabolism?

heat

Does heat or cold decrease collagen extensibility?

cold

Does heat or cold improve joint mobility?

heat

Does heat or cold decrease pain?

both

Does heat or cold help with edema?

cold

For acute injuries, heat or cold?

cold

For hypermobility, heat or cold?

cold

For spasticity, heat or cold?

cold, long periods

A pt with BMI of 33 kg/m^2 presents to a clinic with pain and swelling on the R hip. The PT is planning to use ultrasound as a therapeutic modality. Which of the following is an ABSOLUTE contraindication for use of ultrasound?

A. Polyethylene hip implant
B. Chronic R hip fracture
C. Metal hip implant
D. Acute hip adductor tear

Which device requires insertion through cephalic or internal jugular vein for long term drug administration? (ex. chemo, antibiotics, TPN, blood samples)

A. Arterial line
B. Central venous pressure catheter
C. Swanz-ganz
D. Hickman catheter

Which device is a soft flexible catheter inserted through a vein (usually jugular or femoral) and reaching the pulmonary artery to monitor pulmonary artery pressure and heart function?

A. Arterial line
B. Central venous pressure catheter
C. Swanz-ganz
D. Hickman catheter

Which device is inserted into an artery and attached to a monitoring system to measure BP and obtain blood samples?

A. Arterial line
B. Central venous pressure catheter
C. Swanz-ganz
D. Hickman catheter

Which device is an indwelling venous catheter with a pressure monitor (manometer) to measure pressure in R Atrium or superior Vena Cava, R ventricle function, and circulating blood volume?

A. Arterial line
B. Central venous pressure catheter
C. Swanz-ganz
D. Hickman catheter

What is a manometer?

A pressure monitor

A PT is performing gait training with a pt with pleural effusion. Which of the following precautions is important management of a chest tube?

A. The collection tank should be kept below the level of the inserted tube

B. The collection tank should be kept at the level of the chest

C. The tube should be disconnected before ambulation

D. The PT should not ambulate with the pt until the tube is discharged

A male pt has been diagnosed w a complete C5 spinal cord injury. He used a power chair to commute from the parking lot to the PT clinic. While performing a transfer, which of the following is the MOST important safety consideration?

A. Encourage the pt to use his shoulder extensors to support his upper body

B. Ensure the PT aide is supporting the pt’s legs

C. Make sure the power chair is turned off

D. Utilize a sliding board for the transfer

For a single rescuer, if a child or infant with an unwitnessed collapse, should you:

A. give CPR x 2 min then activate emergency/get AED

B. Get AED first, then start CPR

For a second rescuer the ____ person gets/activates the AED, begins CPR ______, use ____ when available

2nd
immediately
AED

What is the compression:ventilation ratio for adults?

___:___
____-____bpm

30:2
100-120 bpm

What is the compression:ventilation ratio for children with one rescuer?

___:___
___-___ bpm

30:2
100-120 bpm

What is the compression:ventilation ratio for children with two rescuers?

___:___
___-___ bpm

15:2
100-120 bpm

What is the compression depth and hand placement when giving CPR to adults?

___ inches
2 hands on ______

2 in
lower sternum

What is the compression depth and hand placement when giving CPR to child/infants?

___ AP chest diameter
___ inches for child
___ inches for infant
___ hand (s) on small child
___ finger(s) on infant in center of chest

1/3 AP chest diameter
2 in
1.5 in
1
2

A therapist in a pediatric clinic is preparing for their next patient, a 9 month old baby with torticollis. In the waiting room the PT hears the mother shout for help as her baby has stopped breathing and is unresponsive. When performing life saving care for this infant, which of the following procedures is LEAST appropriate?

A. Give the front desk instructions to call 911 and get the clinics AED

B. Give compressions at a rate of 80-100 bpm

C. When giving compressions, compress at a depth of 1/3 the AP diameter of the chest

D. Use a compression-ventilation ratio of 30:2 if a single rescuer is delivering care

A PT visits a large banking facility to assess for proper workstation set up and ergonomics for the employees while working at their desks. Which of the following recommendations is LEAST appropriate for the PT to recommend?

A. The feet should rest on the floor with the knees at 110 deg

B. The elbows should rest on the armrest with 90 deg of flexion

C. The top of the computer monitor should be just below eye levels

D. The monitor should be 20 inches from the pt’s face

A 28 y/o pt is lifting her school bag as pictures. Which of the following is the MOST significant factor in increased compression forces on the spine in addition to the weight of the bag?

A. The height of the bag from the ground

B. Performing the lift with the lumbar spine in a neutral position

C. The distance of the school bag from the base of the spine

D. The muscle strength of the LE

Which isolation precautions involve:

-hand wash before entering and after leaving room

-gloves & gown only when in direct contact w pt or pt’s items in room (remove before leaving room)

-Treatment in private room or cohort pt w same infection

-Pt washed hands if they leave room

Which isolation precautions involve:

-Hand wash upon entering and leaving the room

-Mask when working within 3 ft of pt

-Private room without negative air flow

-Pt wears surgical mask when leaves room

A. Contact precautions
B. Droplet precautions
C. Airborne precautions

Which isolation precautions involve:

-hand wash upon entering and leaving room

-N-95 mask, gown & gloves if sever contamination, discard mask upon leaving room

-Private room w negative air flow, keep door closed

-Pt wears surgical mask when leaves room

A. Contact precautions
B. Droplet precautions
C. Airborne precautions

A PT is working w a pt who has tuberculosis. Which of the following options BEST describes the appropriate precautions and type of personal protective equipment that a PT should wear?

A. Contact precautions, N-95 respirator

B. Airborne precautions, N-95 respirator

C. Contact precautions, Gloves and gown

D. Airborne precautions, gloves and gown

A 3 y/o is being treated by a PTA for burns of bilateral feet and ankles. The mother is present for the initiation of the session but then leaves to pick up her other child from school. The PT notices the child also has bruising along both forearms. The child provides minimal subjective information and seems reluctant to conversation. What is the most appropriate action of the PTA?

A. alert the PT immediately

B. Wait until witnessing the interactions of the child and her mother to assess for reasonable suspicion

C. Contact the mother and ask about how the injuries occurred

D. Contact a child abuse hotline immediately

_______ data measures quantity

Parametric

______ data measures quality

Nonparametric data

Type of parametric data with equal intervals but no true zero

Interval data

Type of parametric data with equal intervals but has a true zero

Ratio data

Type of nonparametric data that has categories which are mutually exclusive, no zero, no order/rank, no intervals

Nominal data

Type of nonparametric data that has categories which are ordered/ranked but interval is not measurable or equal

Ordinal data

A group of PT students are assisting in collecting data for a research project. The students are measuring pain free shoulder abduction ROM in individuals w shoulder pain before and after applying ultrasound to the supraspinatus. A single student is taking ROM measures both before and after treatment. Which of the following best describes this study?

A. Ratio data collection ,intra-relator reliability

B. Ordinal data collection, intra-relator reliability

C. Ratio data collection, inter-relator reliability

D. Interval data collection, intra-relator reliability

Type of reliability:

accuracy of repeated measurements by the same tester

intra-relator reliability

Type of reliability:

accuracy of repeated measurements taken by different testers

inter-relator reliability

Type of reliability:

same test repeated on the same individual

test/retest reliability

A researcher is collecting data on effect of muscle stretching on passive hip ROM in 20 pts. The researcher will provide stretching every day for a week and measure ROM every day. Which of the following experimental designs is the MOST appropriate for this type of study?

A. Divide the patients into 2 groups w/ 10 subjects in experimental and 10 in control group, measure ROM on day 7

B. Divide the pts into 2 groups with 3 subjects in experimental and 17 in control group, measure ROM on day 1 and 7

C. Divide the pts into 2 groups with 10 subjects in experimental and 10 in control group, measure ROM on both days 1 and 7

D. Divide the pts into 2 groups with 10 subject in experimental and 10 in control group. For the experimental group, measure ROM on day 7 and for the control group, measure ROM only on day 1.

Wheelchair measurements:

Seat height should be measured from ______ to _____ +____ inches

heel; popliteal fold; 2

Wheelchair measurements:

Seat depth should be measures from _______ to ______ - ___ inches

posterior buttock; popliteal fold; 2

Wheelchair measurements:

Seat width should be measured at the ________ aspect of the buttocks/thighs + ____ inches

widest; 2

Wheelchair measurements:

Back height should be measured from ______ to _____ - __ inches

chair seat; axilla; 4

Wheelchair measurements:

Armrest height should be measured from _____ to _____ + ___ inch(es)

chair seat; olecranon; 1

Avg seat height for wheelchairs

20 in

Avg seat depth for wheelchairs

16 in

Avg seat width for wheelchairs

18 in

Avg back height for wheelchairs

16 in

Avg armrest height for wheelchairs

9 inches

A PT is measuring a pt for a wheelchair fitting. The pt’s axilla is measured to be 16 in from the seat of the wheelchair with her shoulder flexed to 90 deg. She will also be using a 2 in pressure relief cushion. Which of the following measurements is the correct height for the back of the wheelchair?

A. 12 in
B. 16 in
C. 14 in
D. 18 in

A PT is training a 65 y/o to walk with a quad cane. He had severe arthritis of the R hip and was operated on 2 months ago. What is the MOST appropriate way the PT should instruct the pt to use the assistive device?

A. Hold the can in your L hand and move L hand and R leg together

B. Hold cane in R hand and move R hand and L leg together

C. Hold cane in L hand and move L hand and L leg together

D. Hold can in R hand and move R hand and R leg together

What type of transfer is used to transfer a pt from a stretcher to a bed or treatment plinth?

3-person lift/carry

What type of transfer is used to transfer pts of different heights or surfaces or transferring to the floor?

Two-person lift

What type of transfer is used to transfer a pt who cannot stand independently but can bear some weight through the trunk and LE?

Dependent squat pivot transfer

What type of transfer is used for dependent transfers when the pt is obese, there is only one therapist available to assist with the transfer, or pt is totally dependent

Hydraulic lift

The PT is evaluating a pt with a SCI. Which of the following is the MOST reasonable expectation of a pt with a C7 level SCI with respect to transfers?

A. Completely unable to perform transfers on even surfaces

B. Independent with transfers on even surfaces

C. Independent with floor to wheelchair transfer

D. Completely unable to perform transfers on uneven surfaces

low walls are similar to ____ muscles

weak

high walls are similar to ___ muscles

tight

A 32 y/o with a R AKA presents to the clinic. On evaluating the patient, the PT notices that the pt has a R trunk lean during standing. What could be the MOST likely cause?

A. high lateral wall
B. High anterior wall
C. High medial wall
D. High posterior wall

What gait deviation may occur during stance phase for someone with AKA for a person with weak abductors, short amputation limb or short prosthesis, inadequate lateral wall?

lateral bend towards weak side

What gait deviation may occur for someone with AKA during stance phase when they have abduction contracture, knee instability or long prosthesis, abducted hip joint?

Abduction

What gait deviation may occur for someone with AKA during stance phase when they have hip flexion contracture, weak extensors, or anterior socket wall discomfort?

lumbar lordosis

What gait deviation may occur for someone with AKA during stance phase when they have weak quads, an unstable knee joint or a short walker?

Forward flexion

A 28 y/o female pt with AKA presents to a PT clinic. The pt must maintain the knee in extension while weight-bearing. Where should the ground reaction force line fall in order to maintain the knee in extension?

A. Posterior to the axis of the right knee jt

B. Lateral to the axis of the R knee jt

C. Anterior to the axis of the R knee jt

D. Medial to the axis of the R knee jt

What foot orthosis controls hindfoot valgus and reduces subtalar motion?

UCBL (univ of Cal berkley lab)

A 77 y/o pt post CVA presents with difficulty in DF the L foot during heel strike. Which orthotic device is least restrictive to assist with DF?

A. hinged ankle AFO with anterior stop

B. Molded solid ankle AFO

C. Posterior leaf spring

D. AFO with a resilient heel

Which core value:

PT shall adhere to the core values of the profession and act in best interest of the pt’s over PT’s interest

A. Autonomy
B. Professional Judgment
C. Altruism
D. Beneficence

Which core value:

PT shall provide all necessary information to allow patients to make informed decisions about care

A. Autonomy
B. Professional Judgment
C. Altruism
D. Beneficence

Which core value:

PT shall be accountable for making sound professional judgments

A. Autonomy
B. Professional Judgment
C. Altruism
D. Beneficence

Which core value:

Act of charity, mercy, and kindness with a strong connotation of doing good to others including moral obligation. All professionals have the foundational moral imperative of doing right

A. Autonomy
B. Professional Judgment
C. Altruism
D. Beneficence

A single 22-year old woman who is three months pregnant, arrives at a PT’s private practice with reports of shoulder and leg pain. She has a black eye and some bruising at the wrists. Which of the following actions should the PT take?

A. Administer massage for bruising, TENS, and ice modalities for pain, as indicated by the exam findings

B. Direct the patient to the nearest ambulatory care center for physician evaluation

C. Refuse to examine the pt and send her to the nearest emergency room

D. Examine the pt, and if abuse is suspected, report the findings to the appropriate authorities

A PT is observing a client at their workstation in an office. The client reports low back pain. The following are findings from the ergonomic assessment: Forward trunk lean to get closer to screen, sitting for long periods of time with no break, no lumbar support from chair, keyboard and mouse are on an ergonomic adjustable tray, and feet are flat on the floor. What changes would the PT make to alleviate client’s low back pain?

A. NO changes are necessary; client has adequate posture, The client must be faking their LBP

B. Place keyboard and mouse on desktop for easier access, have clients recline chair, and slouch shoulders to relax back extensors

C. Pt education to take multiple breaks throughout the day, keep the same chair, and move the monitor farther away from the client

D. Pt education to take multiple breaks throughout the day, obtain a chair with proper lumbar support, and move monitor closer to client

A PT is facilitating an in-service on BLS by educating on the Do’s and Don’ts of adult high quality CPR. Which of the following SHOULD the rescuer do during the training?

A. Include pauses in between compressions for greater than 10 seconds

B. Compress chest to depth of less than 2 cm

C. Minimize pauses in between compressions

D. Compress chest at a rate of 123/min

A PTA got a new job at an acute care center and is undergoing training about PPE. What is the correct sequence of removing (doffing) the PPE using standard precautions?

A. Gown, Mask, Goggles, Gloves

B. Mask, Goggles, Gloves, Gown

C. Goggles, Mask, Gown, Gloves

D. Gloves, Goggles, Gown, Mask

GLOOM

Doffing PPE order:

Gloves
Goggles
Gown
Mask

______ PPE is in alphabetical order

Gloves
Goggles
Gown
Mask

Doffing

Order for donning PPE:
1.
2.
3.
4.

Gown
Mask
Goggles
Gloves

A pt with pleural effusion is being ambulated by a PT. Which of the following precautions should the PT keep in mind?

A. Collection bottle should be kept below the level of inserted tube

B. Collection bottle should be kept below level of urinary catheter

C. Collection bottle should be removed before ambulating

D. Collection bottle should be held by the PT while pt ambulates

A 21 y/o male pt has a T5 SCI status post 2 months, he fell from a ladder 2 months prior while working at a construction site, stayed in the hospital for 4 wks, now lives in 1 story home w parents, requires CGA for Supine to sit and bed to chair transfers.

The PT treating this patient is given a task by their CI to provide the appropriate WC measurements. Which of the following options provide the correct measurement for seat depth?

A. Measure the length from posterior buttock to posterior aspect of popliteal fossa and add 2 in

B. Measure the total area of both the hips and add 2 in

C. Measure total area from posterior buttock to posterior of popliteal fossa and subtract 2 in

D. Measure trunk length and subtract from lower leg length and add 2 in

Pt uses a WC to commute from the parking lot to the PT clinic. While performing a WC transfer, which of the following is MOST important consideration?

A. Make sure he is using his shoulder extensors to support his upper body

B. Make sure his legs are supported by PT aide

C. Make sure WC is locked before transfer

D. Make sure to use the sliding board

A PT is teaching the pt to negotiates a 4 in curb with the WC. Which of the following is the MOST appropriate instruction to be given to the pt?

A. Hook the arms around push handle and descend backward

B. Ascend backward with large wheels first

C. Ascend in a wheelie position by lifting the front casters

D. Place the front casters down first during descent

Which phase of WC propulsion?

Begins w initial hand contact on push rim and ends with release of hand contact from push rim

Propulsive phase

Which phase of WC propulsion?

Begins with release of hand contact from push rim and ends with initial hand contact with push rim

Recovery phase

A posterior approach was used for a case of revised total hip arthroplasty. Which of the following is LEAST likely to be included while educating the patient to prevents posterior dislocation?

A. Transfer to the sound side from chair to bed

B. When descending stairs, lead with operated leg

C. Keep knees higher than hips when sitting

D. Avoid standing activities that involve rotating the body towards the operated extremity

How many inches of axilla space should you have with axillary crutches?

2 in

With axillary crutches, the crutch should be ____ in lateral and ___-___ in anterior to the patients toe of the shoe

2
4-6

With axillary crutches, elbow flexion should be about ___-___ deg when grasping handpiece

20-25

For forearm crutches, the top of the forearm cuff is just distal to ___, approximately __-___ in below olecranon process

elbow; 1-1.5

For forearm crutches, the crutch is about ___ in lateral and __-___ in anterior to the pt’s toes of the shoe

2
4-6

For forearm crutches, elbow flexion is about __-___ deg

20-25

For canes, it always goes on the _____ side

oppo

When ascending with a cane, the ______ goes up first, followed by the _______ and ______

good foot
bad foot
cane

When descending with a cane the ______ and _____ go first, followed by ____

bad foot and cane
good foot

When guarding pt who is ambulating on ground level, PT should….

Stand ________

Hand________

Step________

Stand Behind and slightly towards pt involved LE

Hand nearest to pt to grasp under back of gait belt w supinated forearm

Step with pt (PT’s forward foot moves w AD)

A 45 y/o female pt is recovering from a left fibula fracture and is restricted to partial (50%) WB on the L side. Which of the following is the BEST assistive device for partial weight bearing?

A. Cane on L side
B. 2 axillary crutches
C. Forearm crutch on L
D. Reciprocating gait orthosis

A PT examines a pt who reports foot pain while running. The exam shows that the pt has excessive pronation. Which of the following would be the MOST appropriate orthotic insert?

A. A lateral post under the 5th metatarsal head

B. A lateral post under the calcaneus placing it in an everted position

C. A middle post just proximal to the 3rd met head

D. A medial post just proximal to the 1st met head

What does a posterior leaf spring do?

Pushes pt into DF when they try to PF

What is a plastic hinged AFO used for?

To stop PF or add resistance when trying to PF

Which of the following combinations of orthotic and anatomical causes will MOST likely lead to the same gait deviation?

A. Excessive height of medial upright of KAFO and gluteus maximus weakness

B. Excessive height of lateral upright of KAFO and gluteus maximus contracture

C. Inadequate DF stop and pes equinus deformity

D. Inadequate DF assist and weak hip flexors

Inadequate = _______

weak

Excessive = ______

Tight

Two point gait

One crutch and opposite extremity move together followed by opposite crutch and extremity

(2 canes or 2 crutches)

Three point gait

Both crutches and involved leg are advanced together, then uninvolved leg is advanced forward

(2 canes/crutches or a walker)

Four point gait

one crutch is advanced forward and placed on the floor, the opposite leg is advanced, then the remaining crutch is advanced forward, followed by the opposite remaining leg

(two crutches or canes)

Which orthotic provides knee extension moment in stance without preventing knee flexion during swing?

Ground reaction AFO with anterior band

Type of team:

A number of professionals from different disciplines conduct assessments and interventions independent from one another

A. Interdisciplinary
B. Multidisciplinary
C. Intradisciplinary

Type of team:

All disciplines relevant to the case agree to collaborate for decision making. Eval and intervention is still performed independently

A. Interdisciplinary
B. Multidisciplinary
C. Intradisciplinary

Type of team:

One or more members of one discipline evaluate, plan and implement treatment of the individual

A. Interdisciplinary
B. Multidisciplinary
C. Intradisciplinary

Thermal Modalities effect on:

Cardiac Output ___
Stroke Volume ___
Muscle Activity ___
HR ____
Blood to internal organs ___
RR___
Metabolic Rate___
BP___
Blood flow to resting mm ___
Vasodilation ___

Cardiac Output = Inc
Stroke Volume = Dec
Muscle Activity = Dec
HR = Inc
Blood to internal organs = Dec
RR= Inc
Metabolic Rate= Inc
BP = Dec
Blood flow to resting mm =Dec
Vasodilation= Inc

Cryotherapy Effect on:

Joint stiffness =
Collagen Extensibility=
Capillary Permeability=
Local Metabolism=
Pain threshold=
Spasticity=
Nerve conduction velocity=
Blood flow=
Muscle activation=

Joint stiffness = Inc
Collagen Extensibility= Dec
Capillary Permeability= Dec
Local Metabolism= Dec
Pain threshold= Inc
Spasticity= Dec
Nerve conduction velocity= Dec
Blood flow= Dec
Muscle activation= Inc

A PT student is treating a pt w acute low back pain. The student elects to use an ice pack to decrease associated pain and inflammation. Which of the following is LEAST accurate regarding the use of ice?

A. Ice pack should be stored at 25 deg F

B. If pt dislikes ice, a warm towel can be wrapped around the ice pack initially

C. When checking the skin at 10 mins, the skin should have mild erythema and should not blanche

D. If the student wants to increase the conduction of cold, a cold towel can be wrapped around the ice pack initially

Hot pack:

Temp=
Tx time=
__-___ towel layers
Peak heat @ __ mins

160-170 deg F
20-30 mins
6-8
5 mins

Cold pack:

Temp=
Tx time=
Can be applied every __-___ hrs
Stages of cold=

25 deg F
10-20 mins
1-2 hrs
Stages= cold, burn, ache, numb

Which of the following questions is LEAST important to ask a pt when considering the use of thermotherapy on a pt w chronic medial elbow pain?

A. Do you have a blood clot in this area?

B. Can you feel me touching this area?

C. Have you experienced any unexplained weight loss or gain?

D. Are you, or could you be pregnant?

What is the pulse frequency in E-stim?

How many times per second it pulses

Is a higher or lower pulse frequency more comfortable with e-stim?

higher

For muscle strengthening, what should the pulse frequency be with E-stim?

35-80 pps

What should the pulse duration for E-stim be for small muscles?

150-200 ms

What should the pulse duration for E-stim be for large muscles?

200-350 ms

Is a longer or shorter pulse duration more comfortable for E-stim?

short

What should the on:off ratio be for E-stim?

1:5

as you progress you want on time to be greater than off time

Treatment time for E-stim

10-20 mins

A PT is treating a 32 y/o male pt four weeks post arthroscopic debridement of L knee. The PT uses FES to improve the strength of the quads. Which of the following parameters is the MOST APPROPRIATE?

A. Pulse duration= 250-300 ms; 10 sec on, 50 sec off

B. Pulse duration= 150-170 ms; 10 sec on, 20 sec off

C. Pulse duration= 250-300 ms; 10 sec on, 20 sec off

D. Pulse duration= 150-170 ms; 10 sec on, 50 sec off

What kind of electrode is used to promote healing of inflamed or infected wounds?

negative electrodes

What kind of electrode is used to promote healing of wounds without inflammation?

positive electrodes

Which of the following is more accurate regarding High Voltage Pulsed Galvanic Current (HVPGC) E-stim?

A. Pulse Frequency= 60-125 pps, Pulse duration= 40-100 ms, Tx time= 45-60 mins

B. Pulse Frequency= 100-150 pps, Pulse duration= 150-200 ms, Tx time= 10-20 mins

**Used for wound care

A PT is treating a wound that demonstrates a moderate odor, seropurulent drainage, and induration. The PT is implementing electrical stimulation in the pt’s POC to promote healing of the wound. Which of the following will be the MOST effective for this pt?

A. High voltage pulsed waveform on positive electrode in wound, 110 pps

B. High voltage pulsed waveform on negative electrode in wound, 20 pps

C. High voltage pulsed waveform on positive electrode in wound, 80 pps

D. High voltage pulsed waveform on negative electrode in wound, 110 pps

E-stim that delivers medications into the tissue

Iontophoresis

Iontophoresis Polarity of ions:

Water=_______
ISAD=________
Everything else=______

Water= neutral
ISAD= negative
Everything else= positive

Which medical ion (-) is used for sclerotic scars?

Iodine

Which medical ion (-) is used as an Analgesic?

Salicylate

Which medical ion (-) is used for calcium deposits?

Acetate

Which medical ion (-) is used for musculoskeletal inflammation?

Dexamethasone

Which medical ion (+) is used for dermal ulcers?

A. Water
B. Zinc
C. Calcium
D. Acetate

Which medical ion (+) is used as an analgesic?

A. Iodine
B. Salicylate
C. Lidocaine
D. Copper

Which medical ion (+) is used for fungal infections?

A. Water
B. Hyaluronidase
C. Copper
D. Calcium

Which medical ion (+) is used for Edema reduction?

A. Dexamethasone
B. Lidocaine
C. Iodine
D. Hyaluronidase

Which medical ion (+) is used for muscle spasm?

A. Water
B. Calcium/Magnesium
C. Lidocaine/Xylocaine
D. Zinc

Which medical ion (+/-) is used for hyperhidrosis?

A. Water
B. Zinc
C. Copper
D. Salicylate

Which indication for TENS would use these settings:

Pulse frequency= 100 pps
Pulse duration= 50-100 usec
Amp= Comfy tingling
Tx time= 20-30 mins/during activity

A. Brief intense
B. Noxious
C. Acupuncture like (low rate)
D. Acute pain (high rate)

Which indication for TENS would use these settings:

Pulse frequency= <10 pps
Pulse duration= >150 usec
Amp= visible twitch
Tx time= 20-45 mins

A. Brief intense
B. Noxious
C. Acupuncture like (low rate)
D. Acute pain (high rate)

Which indication for TENS would use these settings:

Pulse frequency= 100 pps
Pulse duration= >150 usec
Amp= strong muscle twitch
Tx time= <15 mins

A. Brief intense
B. Noxious
C. Acupuncture like (low rate)
D. Acute pain (high rate)

Which indication for TENS would use these settings:

Pulse frequency= 100 pps (high); 1-5 pps (low)
Pulse duration= >250 up to 1 usec
Amp= painful stimulus
Tx time= 30-60 sec

A. Brief intense
B. Noxious
C. Acupuncture like (low rate)
D. Acute pain (high rate)

A pt presents with partial- and full-thickness burns on the chest region. The treating PT decides to apply TENS before debridement to modulate pain. Which TENS mode should provide the BEST relief?

A. High rate TENS
B. Brief Intense TENS
C. Noxious TENS
D. Conventional TENS

To increase pt comfort would you INC or DEC the following?

Ramp time=
Pulse duration=
Electrode size & quality=
Pulse frequency=
On time=
Off time=

Ramp time= INC
Pulse duration= DEC
Electrode size & quality= INC
Pulse frequency= INC
On time= DEC
Off time= INC

The amount of energy delivered per unit area (W/cm2) is the _________ with ultrasound

A. frequency
B. intensity
C. Duty cycle

The number of cycles per second (1 MHz or 3 MHz) with ultrasound is the _________

A. frequency
B. intensity
C. Duty cycle

The on time divided by the on time + off time with ultrasound is the ________

A. frequency
B. intensity
C. Duty cycle

1 MHz or 3 MHz for superficial ultrasound?

3 MHz

1 MHz or 3 MHz for deep ultrasound?

1 MHz

Pulsed duty cycle for ultrasound=

A. 20-50%
B. 100%

Continuous Duty Cycle for ultrasound=

A. 20-50%
B. 100%

For acute pain, do you want to use continuous or pulsed ultrasound?

pulsed

Female 59 y/o with onset of L lateral ankle pain following rolling her ankle during pickleball 2 days ago. She’s having difficulty weight bearing, L ankle edema, osteoporosis, fibromyalgia, negative xrays, pain currently 4/10 with weight bearing 6/10.

Which of the following parameters is the MOST appropriate for use of ultrasound on this patient?

A. 50% duty cycle, 3 MHz, 0.5 w/cm2

B. 20% duty cycle, 1 MHz, 1.0 w/cm2

C. 100% duty cycle, 1 MHz, 1.5 w/cm2

D. 50% duty cycle, 3 MHz, 2.0 w/cm2

During ultrasound treatment, the pt reports feeling a deep heat over the lateral malleolus. What is the MOST appropriate response of the PT?

A. Dec the intensity and continue moving the head at same speed

B. Educate pt that her fibromyalgia may be causing discomfort of the soundhead moving over the area

C. Inc the intensity and add more coupling medium

D. Turn off ultrasound and immediately call physician

The PT would like to work on improving the pt’s tolerance for WB into the L LE. Which of the following exercises is MOST appropriate to initiate weight bearing at this time?

A. Supine bridges
B. Standing alternating stair taps
C. B stance airex balance
D. Lightweight B leg press machine

What position do you want the pt in for lumbar traction if they have a posterior disc herniation

prone (more extension or lumbar neutral)

For disc protrusion, spasm, and elongation with lumbar traction, what percentage of bodyweight should be used?

25%

For joint distraction with lumbar traction, what percentage of bodyweight should be used?

50 lbs or 50%

For cervical traction, what should be the initial amount of force used?

7-9 lbs

For disc protrusion, spasm, and elongation with cervical traction, how many pounds of force are needed?

11-15 lbs

For joint distraction with cervical traction, how much force is needed?

20-29 lbs or 7% bodyweight

A pt presents to clinic w a posterior herniated nucleus pulposus at L2-3. During the traction treatment in supine, the pt reports increased hip and leg pain. Which of the following actions is MOST appropriate for the PT to take?

A. Change the position of the pt to sidelying
B. Refer the pt back to physician
C. Change position of pt to prone
D. Reduce traction force to 15% of bodyweight

For EMG Biofeedback, the treatment for muscle relaxation requires ________ sensitivity

low

For EMG Biofeedback, the treatment for muscle re-education requires ________ sensitivity

high

For EMG Biofeedback, the treatment for muscle relaxation requires electrodes placed ________

For EMG Biofeedback, the treatment for muscle re-education requires electrodes placed ________

far apart

“Sit close to dog, whisper sweet nothings”
“Sit close, talk low”

EMG biofeedback

muscle relaxation= electrodes close together, low sensitivity

“loud toddler, jump off couch far from dog”

EMG biofeedback

high volume, electrodes far apart

A 57 y/o male pt is having difficulty with walking. The PT documents the knee extension strength to be 2-/5 and prescribes EMG biofeedback to help increase motor recruitment. Which of the following protocols is the MOST appropriate to increase motor recruitment for the knee extensors?

A. Begin w electrodes close together and biofeedback sensitivity is low

B. Begin w electrodes widely spaced and biofeedback sensitivity low

C. Begin w electrodes widely spaced and biofeedback sensitivity high

D. Begin w electrodes close together and biofeedback sensitivity high

inability to recognize familiar objects despite normal function of the eyes and optic tracts

Visual agnosia

Inability to recognize an object that is handed to them with vision occluded

Tactile Agnosia

disease of the bone that leads to decreased mineral content and weakening of the bone

osteoporosis

T-score of bone mineral density scan for someone with osteoporosis

-2.5 or less

Normal bone mineral density

-1.0 or higher

Osteopenia bone mineral density

-1.0 to -2.4

Aerobic Exercise recommendations for osteoporosis:

____ days/wk
___ mins of mod intensity or ____ mins of vigorous intensity

5+ days/wk
30 mins of mod intensity or 20 mins of vigorous intensity

Resistance Exercise recommendations for osteoporosis:

____ days/wk
____ to ____ reps

2-3 days/wk; day rest between
8-12 reps

Sitting independently by what age is a good prognosis for ambulation for a child with CP?

2 yrs

neural tube defect resulting in vertebral and/or spinal cord malformation

Spina bifida

T or F: Duchenne’s Muscular dystrophy involves proximal to distal weakness that is progressive

otolith organs

saccule and utricle

Otolith organs respond to _______ acceleration

linear

The semicircular canals respond to _______ movement

angular

Responsible for maintaining stability of an image on the fovea of the retina during rapid head movements

VOR

Test where pt fixates on a near target (PT nose), keeping their eyes on the nose, their head is manually rotated using small-amplitude moderate-velocity and high-acceleration angular impulse.

Positive test: eyes move off of target, re-corrective saccade

Head Impulse Test (HIT)

Test where pt is moved from long sitting with head rotated 45 deg to one side, to supine with head ext 30 deg. Observe nystagmus.

Dix Hallpike

Test where pt is in supine with head flexed 20 deg, rapid rotations to the sides are done separately and PT observes nystagmus and vertigo

Roll test

Test where pt is asked to “read the lowest line you can see” on the acuity chart. The pt then attempts to read the chart while PT moves their head horizontally at a frequency of 2 Hz.

Positive: eyes not stable in space during head movement with 3 line or more decrement

Dynamic Visual Acuity Test (DVA)

Normal result on the DVA or Dynamic Visual Acuity Test

head movement causes no change or less than one line difference

If a pt’s head is rot 45 deg to the L, placed in the dix-hallpike position w L ear to ground, head is then rotated 90 deg to R (maintaining 30 deg ext), then rolled onto R side, slowly brought into sitting with head rot 45 deg to R. Which side is being tested and what is the intervention?

L side is being tested, Canalith Repositioning Maneuver (CPM)

exercises used to improve the VOR and other systems used to assist gaze stability with head motion

Gaze stability exercises

With pt head rotated 45 deg to L, PT helps pt into R sidelying and stays here for 1 min, the pt then rapidly moves 180 deg to L sidelying (head remaining in same position). After 1 min in this position, pt is returned to sitting. What side is being tested and what is the intervention being used?

R posterior BPPV, Liberatory (semont) maneuver

What is being described below?:

Pt in sitting turns head 45 deg to R, then quickly lies down on oppo shoulder (L) for 30 seconds or until vertigo stops, slowly return to start position maintaining head rotated to R. Now head is turned 45 deg to L and lays down on R shoulder for 30 sec.

Repeat 10-20 times 3x/day until without sx for 2 consecutive days

Brandt Daroff Exercises for Posterior BPPV

T or F: Hyperkalemia is usually observed w chronic toxicity or in patients taking diuretics

F, hypo

T or F: Hyperkalemia is the usual electrolyte abnormality precipitated by digoxin toxicity. Usually in acute setting.

Steroid injections weaken _____ & ______

tendons and ligaments

What drugs have side effects of Rhabdomyolysis?

Statins to treat high cholesterol

Brainscape's Knowledge GenomeTM

Readings (Day 41-50) & Lectures 12-15 Flashcards

Brainscape's Knowledge Genome^TM