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NPTE > Readings (Days 60-70) & Lectures 21-25 > Flashcards

Readings (Days 60-70) & Lectures 21-25 Flashcards

1
Q

Tract that is intact w Anterior Cord Syndrome

A

DCML

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2
Q

DCML is affected in which cord syndromes?

1.
2.
3.

A
  1. Posterior cord syndrome
  2. Brown sequard syndrome
  3. Large lesion central cord syn drome
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3
Q

A spastic bladder is seen in pts w (UMN/LMN) and injury (above/below) S2 sacral segments

A

UMN, above

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4
Q

A flaccid bladder is seen in pts w (UMN/LMN) and injury (above/below) S2 sacral segments

A

LMN; below

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5
Q

pressure on abdomen to void

A

crede’s maneuver

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6
Q

pressure on bladder to void

A

Valsalva maneuver

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7
Q

A patient with an injury at T7 vertebral level is in inpatient rehabilitation. He asks his physical therapist what to expect with their bladder control. Which of the following statements MOST accurately classifies the bladder dysfunction as well as treatment needed for this patient?

A. Spastic urinary dysfunction, Suprapubic tapping

B. Flaccid urinary dysfunction, Suprapubic tapping

C. Spastic urinary dysfunction, Crede’s maneuver

D. Flaccid urinary dysfunction, Valsalva maneuver

A

A

T7= UMN= spastic= suprapubic tapping

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8
Q

intervention used for spastic bladder UMN injury

A

suprapubic tapping

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9
Q

intervention used for flaccid bladder, LMN injury

A

valsalva or crede’s maneuver

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10
Q

A patient has been diagnosed with C8 ASIA A injury. Which of the following is MOST appropriate about the clinical presentation of this patient?

A. Patient will be able to transfer independently on level surfaces

B. All sensation will be present at S4-S5 level

C. Patient will not be able to perform elbow flexion and wrist extension

D. Some motor function will be present at S4-S5 level

A

A

ASIA A - complete SCI
No sacral sparing, No S or M S4/S5

Become independent at C7

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11
Q

What is the angle range with which the WC should be from the mat edge for transfers?

____ - ____ degrees

A

20-45

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12
Q

“RLA RCA”

A

RLA (Ranchos Los Amigos)

RCA= Response, Confused, Appropriate

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13
Q

What are the 3 stages in the “R” of “RLA RCA”?

A
  1. No response
  2. Generalized response
  3. Localized response
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14
Q

What are the 3 stages in the “C” of “RLA RCA”?

A
  1. Confused agitated
  2. Confused inappropriate
  3. Confused appropriate
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15
Q

What are the 2 stages in the “A” of “RLA RCA”?

A
  1. Automatic appropriate
  2. Purposeful appropriate
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16
Q

RLA stages 1-8

A
  1. No response
  2. Generalized response
  3. Localized response
  4. Confused agitated
  5. Confused inappropriate
  6. Confused appropriate
  7. Automatic appropriate
  8. Purposeful appropriate
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17
Q

“5S= 6G”

A

RLA interventions

LEVEL 5= S= Socialize
Level 6= G= Goal oriented

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18
Q

Which RLA level is the pt in a Coma?

A

RLA level 1

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19
Q

Which RLA level?

Non-purposeful whole body, vocal inconsistent

A

RLA Level 2

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20
Q

Which RLA level?

Follows simple commands- close eyes, squeeze hand

Purposeful movement
Local and specific
Inconsistent

A

Level 3 RLA

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21
Q

Which RLA level?

Aggressive, confabulations, no long or short term memory

Should use closed environment, consistency, orient pt, give options

A

Level 4 RLA

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22
Q

Which RLA level?

-Responds consistently to simple commands
-Responds inconsistently to complex commands
-socialize for short periods
-Inappropriate use of new objects
-Can’t learn new tasks

A

Level 5 RLA

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23
Q

Which RLA level?

-Follows simple instruction easily
-Goal oriented behavior with external input
-Carryover of previous skills present

A

RLA Level 6

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24
Q

Which RLA level?

-Oriented in home & hospital
-Daily routine automatic but robot like
-Judgement impaired
-Able to initiate social or recreational activity with structure

A

RLA level 7

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25
Q

Which RLA level?

-Carryover of new skills present
-Impaired judgement in emergency
-good judgement normally

A

RLA level 8

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26
Q

25 y/o Male in IP rehab has a TBI status post motorcycle accident with ejection 25 days ago.

Upon further examination, the patient seems to be in a heightened state of activity and is making up stories. They are not coordinating with the therapist at all. The PT would MOST likely classify this patient on the LOCF as:

A. Level VI
B. Level IV
C. Level V
D. Level III

A

B

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27
Q

25 y/o Male in IP rehab has a TBI status post motorcycle accident with ejection 25 days ago.
Upon further examination, the patient seems to be in a heightened state of activity and is making up stories. They are not coordinating with the therapist at all.

Which of the following strategies will be MOST beneficial while working with the patient?

A. Having a different PT work with the patient every day so he gets used to meeting new people
B. Involving patient in group therapy so he can make friends
C. Informing the patient two days in advance about what to expect in the next few PT sessions
D. Giving the patient two options and having the patient select one

A

D

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28
Q

25 y/o Male in IP rehab has a TBI status post motorcycle accident with ejection 25 days ago.

Upon further examination, the patient seems to be in a heightened state of activity and is making up stories. They are not coordinating with the therapist at all.

As the patient continues to
improve, the therapist decides to progress with patient’s gait training. Which of the following is LEAST appropriate about guarding the patient?

A. Therapist should stand behind the patient at all times

B. One of the therapist’s hands
should be placed posteriorly on the guarding belt

C. Therapist’s one hand should be anterior to, but not touching, the patient’s right shoulder

D. Therapist must maintain a wide BOS

A

A, should be posterolateral

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29
Q

The Labyrinth is made up of ________ & __________

A

semicircular canal and otolith organs

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30
Q

Vestibular pathologies that are Peripheral are _______ related and those that are central are _____ related

A

Labyrinth; Brain

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31
Q

There are __ Semicircular canals and __ Otolith organs

A

3;2

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32
Q

What are the otolith organs?

A

Saccule
Utricle

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33
Q

Name the semicircular canals

A

Anterior
Posterior
Horizontal

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34
Q

Paroxysmal means….

A

comes and goes

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35
Q

What is the most common disorder resulting in dizziness in the older population?

A

BPPV

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36
Q

Mechanical disorder caused by otoconia displaced from the macula of the utricle

A

BPPV

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37
Q

When the otoconia is dislodged from the utricle and ends up in the semicircular canals

A

BPPV

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38
Q

involuntary, rapid and repetitive movement of the eyes

A

Nystagmus

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39
Q

CupuLOlithiasis

A

LOnger in duration

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40
Q

BPPV that is short in duration (<1 min)

A

Canalithiasis

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41
Q

BPPV that is persistent in duration (>1 min)

A

Cupulolithiasis

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42
Q

Most common canal for BPPV

A

Posterior canal BPPV

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43
Q

Test in which the pt’s head is turned 45 deg toward affected ear in sitting position, quickly moved to supine with head extended (20-30 deg) and rotates 45 deg toward ear

A

Dix-Hallpike Test

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44
Q

“PUP”

A

Posterior Canal= Upbeating torsional nystagmus

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45
Q

Downbeating torsional nystagmus is indicative of

A

Anterior canal BPPV

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46
Q

A patient presents with chief concerns of dizziness with rolling in bed and bending forward to load the dishwasher. She has had two falls so far. On assessment, the patient tests positive for the Dix-Hallpike test on the right side for posterior canalithiasis. Which of the following is MOST likely expected to be present in this patient?

A. Downbeating torsional nystagmus for 120 seconds
B. Upbeating torsional nystagmus for 70 seconds
C. Downbeating torsional nystagmus for 10 seconds
D. Upbeating torsional nystagmus for 40 seconds

A

D

R upbeating (posterior “PUP)
Canal= <1 min

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47
Q

Treatment for canalithiasis

A

Epley maneuver

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48
Q

5 Letter Words

CANAL
EPLEY

A

Epley treats Canal- ithiasis

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49
Q

Treatment where pt head is rotated 45 deg to symptomatic side and 30 deg below horiztonal, rotated 45 deg to other side, roll to sidelying on uninvolved side, nose down, slowly sit up keeping chin tucked and rotated

A

Epley Maneuver

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50
Q

Treatment for Cupulolithiasis

A

Semont/Liberatory Maneuver

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51
Q

6 Letter words

CUPULO
SEMONT

A

Semont treats Cupulo-lithiasis

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52
Q

BPPV Treatment where the head is rotated 45 deg to the L, pt then moved from sitting to R side lying and stays there for 1 min, then moves 180 deg from R to L sidelying, hold for 1 min, return to sitting

A

Semont/Liberatory Maneuver

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53
Q

non-specific treatment for BPPV that treats either side and can be used for HEP

A

Brandt Daroff Exercise

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54
Q

nystagmus towards the ground =

A

geotrophic= canalithiasis

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55
Q

nystagmus away from ground =

A

ageotrophic, Cupulolithiasis

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56
Q

Test where pt is in supine, head in 20 deg cervical flexion, turned 90 deg to one side, then to neutral, then 90 deg to other side, and back to neutral

A

supine roll test

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57
Q

For geotrophic canalithiasis is the more intense or less intense side the affected side?

A

more intense

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58
Q

For ageotrophic cupulolithiasis is the more intense or less intense side the affected side?

A

less intense

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59
Q

If a pt tests:

-Neg on Dix hallpike

and on the supine roll:

-R geotrophic intense
-L geotrophic less intense

What is the likely diagnosis?

A

R canalithiasis

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60
Q

If a pt tests:

-Neg on Dix hallpike

and on the supine roll:

-R ageotrophic intense
-L ageotrophic less intense

What is the likely diagnosis?

A

L Cupulolithiasis

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61
Q

BBQ Roll is AKA

A

Canalith Repositioning Maneuver (CRM)

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62
Q

Treatment for horizontal canal BPPV

A

BBQ roll/CRM

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63
Q

Intervention where pt is placed 20 deg cervical flexion, head 90 deg to one side, then rotated to neutral in supine, then 90 deg to other side, and then prone

A

BBQ roll/CRM

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64
Q

A physical therapist is treating a patient with presence of geotropic nystagmus on head turns in the supine position. The nystagmus was weaker on the right side. Which of the following is the MOST APPROPRIATE sequence of administering the intervention for these symptoms?

A. Canalith repositioning maneuver with head in 20 deg extension, head turn to 90 deg to right, then moved to the left, then get the patient in prone position with neck in flexion and finally sit the patient up

B. Canalith repositioning maneuver with head in 20 deg flexion, head turn to 90 deg to left, then moved to the right, then get the patient in prone position with neck in flexion and finally sit the patient up

C. Canalith repositioning maneuver with head in 20 deg extension, head turn to 90 deg to left, then moved to the right, then get the patient in prone position with neck in flexion and finally sit the patient up

D. Canalith repositioning maneuver with head in 20 deg flexion, head turn to 90 deg to right, then moved to the left, then get the patient in prone position with neck in flexion and finally sit the patient up

A

B

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65
Q

What do abnormal smooth pursuits and saccades indicate?

A

Central vestibular pathology

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66
Q

Responsible for maintaining focus on an image during rapid head movements

A

VOR

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67
Q

T or F: VOR is intact in BPPV

A

T

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68
Q

Diplopia, difficulty swallowing are examples of _______ vestibular pathology

A

central

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69
Q

hearing loss, fullness in ears, tinnitus, are examples of _______ vestibular pathology

A

peripheral

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70
Q

A PT is assessing a patient with chief concerns of dizziness and loss of balance. Presence of which of the following findings during assessment will MOST likely lead the therapist to refer the patient to a physician?

A. Mild ataxia
B. Positional testing reproducing the nystagmus
C. Sudden onset of ringing in the ears
D. Pendular nystagmus

A

D

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71
Q

Pendular nystagmus

A

eyes oscillate at equal speeds

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72
Q

jerk nystagmus

A

nystagmus will incorporate slow and fast phases

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73
Q

inflammation of the vestibulocochlear n

A

Vestibular Neuritis

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74
Q

Vestibular Neuritis and Labyrinthitis are examples of ______ vestibular disorders

A

peripheral

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75
Q

Which peripheral vestibular disorder may also include hearing loss and tinnitus?

A

Labyrinthitis

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76
Q

overproduction of fluid within the ear causing an increase in pressure and vertigo

A

Meniere’s disease

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77
Q

slow growing tumor that develops from the balance and hearing nerves supplying the inner ear

A

Acoustic Neuroma/Vestibular Schwannoma

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78
Q

Acoustic Neuroma/Vestibular Schwannoma

A

slow growing tumor that develops from the balance and hearing nerves supplying the inner ear

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79
Q

Meniere’s disease

A

overproduction of fluid within the ear causing an increase in pressure and vertigo

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80
Q

VORx1

A

just head moves; target still

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81
Q

VORx2

A

head and target move

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82
Q

Female 50 y/o in OP Ortho for dizziness while walking and with head turns. Past hx of BPPV. PT exam reveals hearing loss on L side, positive head impulse test, negative dix-hallpike and negative log roll test.

The PT decides to not refer the
patient the patient to an MD,
which of the following LEAST
likely to be present?

A. Veering to one side with
head turns while walking
B. Abnormal Smooth pursuits C. 2 falls in last 3 months
D. Nystagmus that subsides
quickly

A

B, abnormal smooth pursuits seen with Central vestibular pathology

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83
Q

Female 50 y/o in OP Ortho for dizziness while walking and with head turns. Past hx of BPPV. PT exam reveals hearing loss on L side, positive head impulse test, negative dix-hallpike and negative log roll test.

What is the MOST likely diagnosis in this case?

A. R BPPV
B. Vestibular neuritis
C. Labrynthitis
D. Meniere’s disease

A

C, hearing loss

Meniere’s would be fullness of ear and vestibular neuritis has no hearing loss

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84
Q

Female 50 y/o in OP Ortho for dizziness while walking and with head turns. Past hx of BPPV. PT exam reveals hearing loss on L side, positive head impulse test, negative dix-hallpike and negative log roll test.

Which of the following is the MOST appropriate initial intervention for this patient?

A. Balance exercises
B. VOR x 1 in sitting
C. VOR x 2 in standing
D. Refer the patient to a physician

A

B, VORx2 too advanced, balance exercises too general, referral not necessary

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85
Q

best scientific evidence, clinical experience, patient values=

A

evidence based practice

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86
Q

What type of study has several articles covering many different populations?

A

Meta Analysis

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87
Q
A
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88
Q

1.
2.
3.
4.
5.
6.
7.

A
  1. Meta Analysis
  2. Systematic Review
  3. Randomized Controlled Trials
  4. Cohort Studies
  5. Case Control Studies
  6. Cross Sectional Studies
  7. Case Series/Case Reports
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89
Q

“MSR CO CA CRO CA”

A

Levels of Evidence

  1. Meta Analysis
  2. Systematic Review
  3. Randomized Controlled Trials
  4. Cohort Studies
  5. Case Control Studies
  6. Cross Sectional Studies
  7. Case Series/Case Reports
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90
Q

Gold standard of clinical information, highest form of evidence

A

Meta-Analysis, Systematic Reviews

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91
Q

study in which all studies included have a statistical analysis

A

meta analysis

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92
Q

a study that is basically a summary of all included papers

A

systematic review

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93
Q

Study used to determine efficacy of an intervention

A

Randomized Control Trials (RCTs)

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94
Q

Study in which information is collected from random samples and random populations to reduce bias

A

RCTs

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95
Q

Observational study that compares a cohort who share a common characteristic with and without the intervention

A

Cohort study

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96
Q

Two PT students are reviewing the literature to determine efficacy of body weight support training in people with a spinal cord injury. According to levels of evidence, which studies provide the LEAST evidence supporting use of body weight support training?

A. Cohort studies
B. Randomized controlled trials C. Clinical case series
D. Cross sectional studies

A

C, “MSR CO CA CRO CA”

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97
Q

Study that compares a group of individuals with a specific condition with a group of people without the same condition (controls)

A

Case Control Study

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98
Q

Observation study where data is collected from a population or a representative subset at a single point in time

A

Cross sectional study

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99
Q

Observational research design that involves repeated observations or measurements of the same individuals or groups over an extended period of time

A

Longitudinal studies

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100
Q

Study that is a document clinical case of a single patient or a series of patients

A

Case Series/Case Report

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101
Q

Three DPT students are looking at effects of drugs on falls. The students are using data from previous patient medical records to compare drug usage in fallers and non-fallers. Which of the following will be the MOST appropriate study design?

A. Clinical case report
B. Retrospective cohort
C. Randomized controlled trials D. Prospective cohort

A

B, looking at something that’s already happened

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102
Q

What kind of study collects data as circumstances change?

A

Prospective cohort study

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103
Q

collecting and analyzing non-numerical data

A

qualitative research

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104
Q

collecting and analyzing numerical data

A

quantitative research

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105
Q

Which of the following instruments is MOST appropriate for measuring patients’ quality of life?

A. Dynamic Gait Index (DGI)
B. Oswestry low back pain disability index (ODI)
C. Timed up and go test (TUG) D. Medical Outcomes Study 36-item short form (SF-36)

A

D

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106
Q

What type of data can be nominal or ordinal?

A

Qualitative

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107
Q

What type of data can be discrete or continuous?

A

Quantitative

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108
Q

“NOn-parametric”

A

NOn-parametric= Nominal & Ordinal

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109
Q

Gender and blood types are examples of ______ data

A

nominal

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110
Q

MMT grades, level of assistance, joint laxity grades are examples of _____ data

A

Ordinal

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111
Q

Data that can be classified into mutually exclusive categories within a variable

A

nominal data

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112
Q

Data measures in rank where the order of the variables matters

A

ordinal data

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113
Q

Data where the difference between two values is meaningful; holds no true zero and can represent values below zero

A

Interval data

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114
Q

Temperature and IQ Test scores are examples of _____ data

A

Interval

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115
Q

Data where all the properties of an interval variable and a clear definition of zero

A

Ratio data

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116
Q

“Rati0”

A

RatiO= True 0

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117
Q

Height, money, age, and weight are examples of _____ data

A

Ratio data

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118
Q

A researcher is collecting ROM data on volleyball players during shoulder abduction motion. The results of the tests are BEST categorized as which of the following types of data?

A. Interval data
B. Ordinal data
C. Nominal data
D. Ratio data

A

D

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119
Q

The extent of the research instrument to consistently have the same results when used in the same situation on repeated occasions

A

Reliability

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120
Q

Intra-rater reliability

A

within itself; test performed by 1 person several times

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121
Q

Inter-rater reliability

A

between individuals; test performed by 2 or more individuals on different subjects for testing 1 variable

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122
Q

test performed by 2 or more individuals on different subjects for testing 1 variable

A

Inter-rater reliability

123
Q

test performed by 1 person several times

A

intra-rater reliability

124
Q

Test-retest reliability

A

machine, device, or test you’re using; same test to the same individuals on two occasions

125
Q

same test to the same individuals on two occasions

A

test-retest reliability

126
Q

A physical therapist performed a balance test using a new equipment on a healthy individual. The same PT repeated the same test following a week after initial assessment. Which is the most important factor responsible for the success of this assessment?

A.Test-retest reliability
B. Intra-rater reliability
C. Inter-rater reliability
D. Content validity

A

A

127
Q

extent to which the instruments used in the experiment measure exactly what you want them to measure

A

validity

128
Q

Content validity

A

Test should measure specifically what the patient problem is

129
Q

validity

A

extent to which the instruments used in the experiment measure exactly what you want them to measure

130
Q

Test should measure specifically what the patient problem is.

A

content validity

131
Q

Test should measure what it’s supposed to measure

A

Construct validity

132
Q

Construct validity

A

Test should measure what it’s supposed to measure

133
Q

Goniometer measuring ROM only is an example of _________

A

construct validity

134
Q

Using a TUG to test functional balance and fall risk is an example of ________

A

content validity

135
Q

What is the strongest form of validity?

A

Concurrent validity

136
Q

Concurrent validity

A

Test performed and compared to the GOLD standard test and
results are matched

137
Q

Test performed and compared to the GOLD standard test and
results are matched

A

Concurrent validity

138
Q

Heart rate measured by peripheral pulse being compared with ECG readings is an example of ________

A

Concurrent validity

139
Q

Special tests for ligaments compared to MRI is and example of _______

A

Concurrent validity

140
Q

Weakest form of validity

A

Face validity

141
Q

Face validity

A

The outcome measure should measure what is looks like it will measure related to patient problem

142
Q

The outcome measure should measure what is looks like it will measure related to patient problem

A

Face validity

143
Q

A researcher performed hand grip testing manually on a patient who had a stroke and compared the outcomes to that of computerized handheld dynamometer. What type of validity is the researcher trying to establish?

A. Content validity
B. Construct validity
C. Face validity
D. Concurrent validity

A

D, comparing to GOLD standard

144
Q

Type I Error “P”

A

“I” can be converted to “P”= false Positive

145
Q

Type II Error “N”

A

“II” can be converted to “N”

146
Q

incorrectly rejecting a true null hypothesis (false positive)

A

Type I error

147
Q

Type I error

A

incorrectly rejecting a true null hypothesis (false positive)

148
Q

Failing to reject a false null hypothesis (false negative)

A

Type II error

149
Q

Type II error

A

Failing to reject a false null hypothesis (false negative)

150
Q

Ability of a diagnostic test to identify true disease without missing anyone by leaving the disease undiagnosed

A

Sensitivity

151
Q

Sensitivity

A

Ability of a diagnostic test to identify true disease without missing anyone by leaving the disease undiagnosed

152
Q

Ability of a diagnostic test to be correctly negative in the absence of disease without mislabeling anyone

A

Specificity

153
Q

helps to rule conditions out

A

sensitivity

154
Q

helps to rule conditions in

A

specificity

155
Q

Accurate test in understanding presence of disease OR that the pt has the condition

A

sensitivity

156
Q

Accurate test to determine absence of disease OR ensure that the person is healthy

A

Specificity

157
Q

A PT is using a new special screening test to help determine if a tennis player has a rotator cuff tear among other possibilities. The test has a very high sensitivity of 0.93 (or 93%). If the results of the test are negative, the PT should:

A. Try another special test for rotator cuff tear
B. Consider the test results inconclusive
C. Rule in rotator cuff tear
D. Rule out rotator cuff tear

A

D

158
Q

A physical therapist is evaluating the sensitivity of the Kleiger’s test in a group of ballet dancers. Which of the following results indicates a true positive finding?

A. Patients with a history of ankle pain and medial ankle sprain will test negatively

B. Patients with a history of ankle pain and medial ankle sprain will test positively

C. Patients with no history of ankle pain and medial ankle sprain will test negatively

D. Patients with no history of ankle pain and medial ankle sprain will test positively

A

B

159
Q

If the test is negative and you can rule out the disease, then the test has high _________

A

Sensitivity

SnOUT

160
Q

If the test is positive and you can rule the disease in, then the test has high_________

A

Specificity

SpIN

161
Q

A PT is using a new special screening test to help determine if a tennis player has lateral epicondylitis among other possibilities. The test has a specificity of 0.91. If the results of the test are positive , the PT should?

A. Try another special test for lateral epicondylitis

B. Consider the test results inconclusive

C. Rule in lateral epicondylitis

D. Rule out lateral epicondylitis

A

C

162
Q

TP/(TP + FN) =

A

Sensitivity

True positive/ (True positive + false negative)

163
Q

TN/ (TN + FP)=

A

Specificity

True negative/ (True Negative + False Positive)

164
Q

A researcher is collecting data on 100 patients with venous insufficiency. Out of the 100 patients with venous insufficiency, 70 patients had a positive doppler test and 30 patients had a negative doppler test. What is the sensitivity of the test?

A. 20% B. 80% C. 40% D. 70%

A

D

TP= 70%
FN= 30%

Sn= TP/(TP+FN)
Sn= 70/(70+30)
Sn= 70/100

165
Q

tools designed to improve decision making in clinical practice by assisting practitioners in making a particular diagnosis, establishing a prognosis, or matching patients to optimal interventions based on a parsimonious subset of predictor variables from the history and physical examination.

A

clinical prediction rules

166
Q

A 67-year-old patient, who had a total hip replacement one week ago, reports a new onset of calf pain. Which of the following findings should be reported to the physician immediately in suspicion of DVT?

A. Bedridden for more than 3 days, history of DVT, calf swelling more than 3mm on symptomatic side and active cancer

B. History of hip arthritis, swelling around the hip joint

C. B/L pitting edema and painful straight leg raises

D. Trochanteric bursitis, painful hip internal rotation and swelling on lateral
side of hip

A

A

167
Q

T or F: A Wells criteria score of >/= 2 is indicative of a likely DVT

A

T

168
Q

T or F: A Wells criteria score of <2 is indicative of a likely DVT

A

F, score >/= 2 is likely DVT

169
Q

Previously diagnosed DVT, active cancer, paralysis/paresis, bedridden 3 days, major surgery last 3 months, calf tenderness, LE swelling, unilateral calf swelling >3 cm, Unilateral pitting edema, collateral superficial veins

A

Wells Criteria

170
Q

A 45-year-old male presents to the clinic with ankle pain. Which of the following finding indicates that the patient needs to be referred out for imaging?

A. Reduced ROM of ankle dorsiflexion

B. Pain on palpation over tip of lateral malleoli

C. Reduced strength of ankle dorsiflexors

D. Pain on palpation over the talus

A

B

171
Q

Ottawa Ankle Rules

A

-Bone tenderness @ post. edge of distal 6 cm or tip of lat malleolus

-Bone tenderness at post. edge of distal 6 cm of medial malleolus

-Inability to WB 4 steps

-Bone tenderness at navicular

-Bone tenderness at base of 5th MT

172
Q

-Bone tenderness @ post. edge of distal 6 cm or tip of lat malleolus

-Bone tenderness at post. edge of distal 6 cm of medial malleolus

-Inability to WB 4 steps

-Bone tenderness at navicular

-Bone tenderness at base of 5th MT

A

Ottawa Ankle Rules

173
Q

the outcome or variable of interest in an experiment or study

A

dependent variable

174
Q

Variable that is manipulated or changed by the
researcher to observe its effect on the dependent variable

A

independent variable

175
Q

Considered as an independent variable in an analysis; a potential source of variation or
confounding factor that potentially influences the dependent variable

A

Covariate

176
Q

Which data is more powerful, parametric or non-parametric?

A

Parametric

Equal distribution, normal distribution, randomization of sample, quantitative data

177
Q

Parametric or non-parametric: Equal distribution, normal distribution, randomization of sample, quantitative data, more powerful

A

Parametric data

178
Q

Parametric or non-parametric: Unequal distribution, no randomization of sample, non-normal distribution, Qualitative data, less powerful

A

Non-parametric data

179
Q

Compares the difference between 2 matched groups

Ex. 20 athletes before and after an intervention

A

Paired T Test

180
Q

Compares the difference between 2 independent groups

Ex. 20 athletes vs 20 non-athletes

A

Independent samples T-test

181
Q

Directional hypothesis, 1 end of distribution, either positive or negative

A

1 tailed T-Test

182
Q

Non-directional, 2 ends of distribution, both positive and negative

A

2 tailed T-test

183
Q

At least 3+ independent groups compared on 1 intervention

A

One-way ANOVA

184
Q

At least 3+ independent groups compared on 2 interventions

A

Two-way ANOVA

185
Q

Effect of strength training on 3 equal groups: 30 athletes, 30 obese, 30 overweight is an example of what ANOVA?

A

one way ANOVA

186
Q

Effect of strength training and gender on 3 equal groups: 30 athletes, 30 obese, 30 overweight is an example of what ANOVA?

A

two-way ANOVA

187
Q

Individuals measured over time is an example of what ANOVA?

A

Repeated measures ANOVA

188
Q

The effect of three different diets on weight loss measured at baseline, 2 weeks, and 4 weeks is what kind of ANOVA?

A

Repeated Measures ANOVA

189
Q

parametric test that examines whether there are significant differences among the means of two or more groups while statistically controlling for the influence of one or more continuous covariates

A

ANCOVA

190
Q

AnCOva

A

Extension of ANOVA with COvariate being controlled

191
Q

A PT is looking at squat activity in 20 obese and 20 normal weight patients. Both groups performed 10 bilateral squats at 100-degrees of knee flexion. The PT hypothesizes that knee moments will be higher in obese. Which is the MOST appropriate test?

A. One way ANOVA
B. Two-way ANOVA
C. One tailed t-test
D. Two tailed t-test

A

C, 2 equal groups= parametric test- T-test= individual groups
A & B require 3+ groups
D- we don’t know the direction

192
Q

Are ANOVAs and T-tests parametric or non-parametric tests?

A

Parametric

193
Q

Are Chi Square tests, Mann Whitney U tests, and Kruskal Wallis Tests Parametric or non-parametric?

A

Non-parametric

194
Q

Non-parametric test that Uses nominal/categorical data to find a difference between groups

A

Chi Square Test

195
Q

Do parametric or non-parametric tests use and unequal distribution of data?

A

Non-parametric

196
Q

Use of continuous or ordinal data to test the null hypothesis with two independent
samples from the same population for a non-parametric test

A

Mann Whitney U Test

197
Q

3 or more groups compares in a non-parametric test

A

Kruskal Wallis Test

198
Q

A study is looking at effects of different exercise options for a patient with knee OA. The study compared pool exercise, treadmill walking, and ankle weights on knee pain in three equal groups of 30 adults each. An appropriate statistical test to assess the effectiveness of treatment in three groups is:

A. K Wallis test
B. Two paired t-tests
C. ANOVA
D. Chi square

A

C, 3 equal groups=parametric= ANOVA, 3 different interventions

A= non-parametric w unequal groups

B= 2 equal groups

D= 2 unequal groups, nominal data

199
Q

In a research study on patients who are obese with THA, a correlation coefficient (r) of +0.80 was found for the relationship between weight and BMI. Which of the following interpretations of this finding is MOST appropriate?

A. Weight and BMI have a high positive correlation

B. 80 percent of the variability in BMI can be accounted for by weight

C. 80 percent of the variability in weight can be accounted for by BMI

D. There are no significant differences between the weight and BMI level

A

A, +0.80= positive and high (0.76-1.00)

200
Q

measurement of the degree or strength of a relationship

A

correlation

201
Q

Used to determine how one variable affects another and is expressed in the form of an equation

A

Regression

202
Q

A PT collected data on patients with THA and plotted the relationship of trunk flexion with waist circumference. The regression plot showed a R square value of 0.64 (See picture). What is the best way to describe the slope?

A. Weak positive slope
B. Weak negative slope
C. Strong positive slope
D. Strong negative slope

A

D

203
Q
A
204
Q

1.
2.
3.
4.
5.
6.
7.
8.

A
  1. SA Node
  2. AV Node
  3. AV Bundle
  4. L & R bundle branches
  5. Purkinje Fibers
  6. L atrium
  7. L ventricle
  8. Apex
205
Q

What tells the Atria to contract?

A

the SA Node

206
Q

What connects the atria and ventricle and tells the ventricle to contract?

A

AV Node

207
Q

Where does the pulse of the heart go through?

A

AV bundle

208
Q

Steps of the conduction of the heart:

A

-SA node tells atria to contract
-AV node connects the atria and ventricle and tells ventricle to contract
-Pulse goes through the AV bundle
-To the bundle of His
-to Purkinje fibers
-heart contracts

209
Q

A clinician is auscultating a patient’s lungs. During auscultation the clinician hears low pitched gurgling and snoring sounds. Which of the following sounds is the clinician MOST likely hearing?

A. Vesicular
B. Wheezes
C. Bronchial
D. Rhonchi

A

D

A= low pitch, normal
B= high pitch whistling
C= loud, hollow, echoing sounds (Normal)

210
Q

Vesicular breath sounds

A

low pitch, normal

211
Q

low pitch, normal breath sounds

A

vesicular breath sounds

212
Q

wheezes

A

high pitch whistling

213
Q

high pitch whistling breath sounds

A

wheezes

214
Q

loud, hollow, echoing breath sounds (normal)

A

Bronchial breath sounds

215
Q

Bronchial breath sounds

A

loud, hollow, echoing breath sounds (normal)

216
Q

Snoring, low pitch breath sounds

A

Rhonchi

217
Q

Rhonchi

A

Snoring, low pitch breath sounds

218
Q

A patient with dyspnea on exertion and has an FEV1 /FVC ratio of 65%. They report chest tightness and frequent coughing. Which lung volume would be decreased compared to a patient with a healthy pulmonary system?

A. Functional residual capacity B. Residual volume
C. Total lung capacity
D. Expiratory reserve volume

A

D

219
Q

What is the cutoff for an FEV1/FVC ratio for Obstructive pulmonary disease?

A

<70%

220
Q

What is the cutoff for an FEV1/FVC ratio for Restrictive pulmonary disease?

A

> 80%

221
Q

an FEV1/FVC ratio <70%=

A

obstructive pulmonary disease

222
Q

an FEV1/FVC ratio >80%=

A

restrictive pulmonary disease

223
Q

how does the Inspiratory Reserve Volume for those with obstructive pulmonary disease compare to those who are healthy?

A

Same

224
Q

How do RV, TLC, and TV for pts w obstructive pulmonary disease compare to those who are healthy?

A

RV= inc
TLC= inc
TV= inc

225
Q

What happens to the Expiratory reserve volume for ppl w obstructive pulmonary disease?

A

Dec

226
Q

A patient with stable angina is participating in outpatient cardiac rehabilitation. When the physical therapist auscultates the patient’s heart, they hear an S4 heart sound. When can this heart sound be heard and what condition does it MOST LIKELY indicate?

A. Abnormal sound heard in early diastole; congestive heart failure

B. Abnormal sound heard in late diastole; congestive heart failure

C. Abnormal sound heard in early diastole; myocardial infarction

D. Abnormal sound heard in late diastole; hypertension

A

D,

B= S3 abnormal heart sound

227
Q

S4 abnormal heart sound can be hear in

A

late diastole

228
Q

S4 abnormal heart sound is indicative of

A

MI, HTN

229
Q

S4 abnormal heart sound is AKA

A

“atrial gallop”

230
Q

S3 abnormal heart sound is AKA

A

“ventricular gallop”

231
Q

When can S3 abnormal heart sound be heard?

A

early diastole

232
Q

S3 abnormal heart sound is indicative of…

A

congestive heart failure

233
Q

S3 & S4 are always associated with….

A

diastole

234
Q

depolarization=

A

contract

235
Q

repolarization=

A

relax

236
Q

Record of the electrical activity of the heart

A

ECG

237
Q

Atrial depolarization is shown on the ECG as the ______

A

P wave

238
Q

P wave

A

atrial depolarization (contraction)

239
Q

QRS complex

A

ventricular depolarization and atrial repolarization

240
Q

ventricular depolarization and atrial repolarization is shown on the ECG as the __________

A

QRS complex

241
Q

T wave

A

ventricular repolarization (relaxation)

242
Q

ventricular repolarization is shown on the ECG as

A

T wave

243
Q

What can indicate myocardial ischemia on the ECG?

A

ST segment depression

244
Q

PR Interval

A

how much time it took the atria to contract & send signal to ventricle

245
Q

how much time it took the atria to contract & send signal to ventricle

A

PR Interval

246
Q

A PT examines the output from a single lead electrocardiogram of a patient in an inpatient clinic. The six-second ECG strip is shown in picture below. The PT should determine the heart rate of the patient as?

A. 110 beats per minute
B. 70 beats per minute
C. 90 beats per minute
D. 60 beats per minute

A

C

9 Rs
9 x 10= 90 bpm

247
Q

30 Large boxes on ECG=

A

6 seconds

248
Q

1 small box on ECG=

A

0.2 seconds

249
Q

How do you calculate HR on ECG?

A

Count off 30 large boxes (6 seconds), count # of R waves, and multiply by 10

250
Q

AV Heart blocks:

1st degree:
2nd degree:
3rd degree:

A

1st degree: delay in conduction
2nd degree: partially blocked conduction
3rd degree: fully blocked conduction

251
Q

What does a 1st degree AV Block look like on the ECG?

A

PR interval > 1 large box

252
Q

2nd degree AV Block Type 1 is AKA

A

Wenckenbach

253
Q

2nd degree AV block Type 2 is AKA

A

Mobitz II

254
Q

Type 1 2nd degree AV Block (Wenckenbach)

A

PR interval gets progressively longer every beat until the QRS is dropped (AV node disease)

255
Q

What type of AV block?:

PR interval gets progressively longer every beat until the QRS is dropped (AV node disease)

A

Type 1 2nd degree AV Block (Wenckenbach)

256
Q

Type 2 2nd degree AV Block (Mobitz II)

A

PR intervals constant & QRS is dropped intermittently (Bundle of His & Purkinje disease)

257
Q

What type of AV block?:

PR intervals constant & QRS is dropped intermittently (Bundle of His & Purkinje disease)

A

Type 2 2nd degree AV Block (Mobitz II)

258
Q

A 50-year-old male patient is diagnosed with a Mobitz Type II Wenckebach heart block. What would a physical therapist expect to find on the ECG strip?

A. An increase in PR interval lengths with no dropped beats

B. No relationship between P waves and QRS complexes

C. A gradual increase in PR interval length in all the beats preceding a dropped beat

D. Normal PR intervals in all the beats preceding a dropped beat

A

D

A= 1st degree
B= 3rd degree
C= predictable dropped beat, Type 1

259
Q

What type of AV block occurs when the Atria and Ventricles are not communicating?

A

3rd Degree AV block

260
Q

3rd Degree AV block

A

Atria and Ventricles are not communicating

261
Q

Call 911 for which type of AV block?

A

3rd degree

262
Q

The heart block poem

A

If the R is far from P,
Then you have a first degree

Longer, longer, longer drop!
Then you have a wenckenbach

If some Ps don’t get through, then you have a Mobitz II

If Ps and Qs don’t agree, then you have a third degree

263
Q

Male 55 y/o in OP ortho, CABG surgery 6 months ago. Pst medical Hx of MI, metabolic syndrome, hx of smoking x 15 yrs. Has HTN, 30 BMI, uses Beta blockers, Aspirin.

Vitals:
Resting BP: 133/88 mmHg
HR: 70 bpm
RR: 24 breaths/min

He experiences SOB while ambulating inclined surfaces.

While performing an exercise tolerance test on this patient, the PT sees the ECG pattern as shown. What is the MOST appropriate diagnosis?

A. First degree heart block
B. Mobitz type I heart block
C. Mobitz type II heart block
D. Third degree heart block

A

B, (wenckenbach)

PR intervals progressively longer then QRS drops expectedly

264
Q

Male 55 y/o in OP ortho, CABG surgery 6 months ago. Pst medical Hx of MI, metabolic syndrome, hx of smoking x 15 yrs. Has HTN, 30 BMI, uses Beta blockers, Aspirin.

Vitals:
Resting BP: 133/88 mmHg
HR: 70 bpm
RR: 24 breaths/min

He experiences SOB while ambulating inclined surfaces.

During exercise tolerance test, PT sees Wenckenbach heart block on ECG.

The PT’s BEST response should be to:

A. Stop the treadmill session
immediately and call the cardiologist

B. Continue without any
modifications and monitor ECG

C. Reduce the treadmill speed and monitor ECG

D. Stop the treadmill, have the
patient rest, and then resume at a lower intensity

A

C

265
Q

Male 55 y/o in OP ortho, CABG surgery 6 months ago. Pst medical Hx of MI, metabolic syndrome, hx of smoking x 15 yrs. Has HTN, 30 BMI, uses Beta blockers, Aspirin.

Vitals:
Resting BP: 133/88 mmHg
HR: 70 bpm
RR: 24 breaths/min

He experiences SOB while ambulating inclined surfaces.

During exercise tolerance test, PT sees Wenckenbach heart block on ECG.

Patient did not come for PT for 3 consecutive visits. On following up with the patient’s caretaker, he mentioned that the patient was taken to the emergency room as he was experiencing increased shortness of breath at rest and cough with no evident peripheral edema. Which of the following is MOST LIKELY causing the patient’s symptom?

A. Biventricular heart failure
B. Right-sided heart failure
C. Cor pulmonale
D. Left-sided heart failure

A

D, lung respiration sx (L side usually pushes blood out to body)

B= would have edema cause (R side normally collects blood)

266
Q

ST segment depression is indicative of

A

myocardial ischemia

267
Q

ST segment elevation is indicative of

A

myocardial infarction

268
Q

A 58-year-old male is performing a Bruce protocol in your clinic with ECG leads attached. During the protocol, the PT sees the picture shown below. What is the MOST likely diagnosis and intervention?

A. Myocardial ischemia that has an elevation of the ST segment greater than 1 mm and the PT should stop the protocol

B. Myocardial infarction that has an elevation of the ST segment less than 1 mm and the PT should stop the protocol and call 911

C. Myocardial ischemia that has an elevation of the ST segment less than 1 mm and the PT should stop the protocol

D. Myocardial infarction that has an elevation of the ST segment greater than 1 mm and the PT should stop the protocol and call 911

A

D

269
Q

Atrial Tachycardia= ____- ____ bpm

A

100-250

270
Q

100-250 bpm is indicative of

A

atrial tachycardia

271
Q

Atrial flutter = ____-___ bpm

A

250-350 bpm

272
Q

250-350 bpm

A

Atrial flutter

273
Q

Atrial fibrillation = ___-_____ bpm

A

400-600

274
Q

400-600 bpm

A

Atrial fibrillation

275
Q

What happens when the Atria started earlier than usual or didn’t wait for the ventricle to relax?

A

Premature atrial contraction (PAC)

276
Q

Premature atrial contraction (PAC)

A

Atria started earlier than usual or didn’t wait for the ventricle to relax

277
Q

Atrial Tachycardia

A

Atria contracts 3 times to generate same amount of blood for 1 contraction

278
Q

What happens when Atria contracts 3 times to generate same amount of blood for 1 contraction

A

Atrial Tachycardia

279
Q

What happens when the atria contracts super fast, and the ECG has saw-toothed appearance?

A

Atrial Flutter

280
Q

Atrial Flutter

A

atria contracts super fast, and the ECG has saw-toothed appearance

281
Q

What happens when it takes about 10 times the amount of contractions for the Atria to send blood to the ventricle?

A

Atrial fibrillation (STOP EXERCISE)

282
Q

Atrial fibrillation (STOP EXERCISE)

A

takes about 10 times the amount of contractions for the Atria to send blood to the ventricle

283
Q

What is the arrow pointing to?

A

PAC premature atrial contraction

284
Q

Interpret the ECG

A

Atrial tachycardia

285
Q

Interpret the ECG

A

Atrial flutter

286
Q

Interpret the ECG

A

Atrial fibrillation

287
Q

A PT is ambulating a 75-year-old male who is in recovering from a prostatectomy procedure. The patient reports palpitations, shortness of
breath and fatigue. What should be the interpretation and immediate action according on the ECG strip shown below?

A. Ventricular fibrillation; Call for a defibrillator

B. Premature ventricular contractions; Take
him to his bed and monitor for changes
in ECG

C. Atrial Fibrillation; Stop exercise and report to the physician

D. 3rd degree heart block; activate emergency

A

C

288
Q

A physical therapist is performing joint mobilization on a patient in the outpatient clinic. The PT notes the electrocardiogram in the photograph. The physical therapist’s INITIAL response should be to:

A. Continue with joint mobilizations at same intensity

B. Continue with joint mobilizations at a lower intensity

C. Stop the treatment and monitor ECG for 10 minutes

D. Activate the emergency system or call 911

A

D, ventricular fibrillation, QRS waves are all over trying to keep up using the blood that is there

289
Q

Interpret the ECG

A

PVCs (Premature ventricular contractions)

290
Q

What does this represent?

A

Bigeminy, 1 normal beat followed by 1 PVC

291
Q

What does this represent?

A

Trigeminy, 2 normal beats followed by 1 PVC

292
Q

What does this represent?

A

Couplet, 2 consecutive PVCs together with no normal beat between them

293
Q

PVCs happen when

A

ventricle contracts before the atria

no P, wide QRS

294
Q

What is it when ventricle contracts before the atria

no P, wide QRS

A

PVCs

295
Q

PVCs that occur 3 or more in a row

A

Ventricular tachycardia

296
Q

Ventricular tachycardia

A

PVCs that occur 3 or more in a row

297
Q

Bigeminy

A

1 normal beat followed by 1 PVC

298
Q

Trigeminy

A

2 normal beats followed by 1 PVC

299
Q

Couplet

A

2 consecutive PVCs together with no normal beat between them

300
Q

Multifocal PVC

A

more than 1 PVC present and 2 do not appear similar in configuration (911)

301
Q

more than 1 PVC present and 2 do not appear similar in configuration (911)

A

Multifocal PVC

302
Q

A patient one month post myocardial infarction is being seen in a clinic. When increasing the patient to 5 METS of workload, the therapist notes that the ECG reads 1 unifocal PVC. The PT’s IMMEDIATE action should be:

A. Continue to exercise and increase the intensity

B. Stop exercise because patient is undergoing ischemia

C. Keep exercising at a lower intensity, consultation with physician is not required here

D. Stop exercise and consult with physician before starting any exercise

A

C

303
Q

STOP EXERCISE AND CALL EMS IF THESE ARE ON ECG:

A
  • more than 6 PVC in one minute
  • 3 degree AV block
  • More than 2-4 couplets/ min
  • 3 or more PVC in a row
  • V Tach
  • V Fib
  • ST depression >2 mm
  • ST elevation >1mm
  • Multi focal PVC

NPTE (10 decks)

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