Review Flashcards
Dupuytren’s Contracture
A contracture of the palmar fascia of the hand which results in a flexion deformity of involved MCP and PIP joints. This deformity most commonly affects the fourth and fifth digits. The condition is characterized initially by nodules and thickened tissue near the distal palmar crease in the palm region below the ring finger and little finger. This area is often tender and sensitive to pressure.
If a patient is unable to prevent hyperextension while picking up objects from a surface what is the best way to improve this?
In order to eliminate hyperextension of the spine, it may be necessary to modify the workstation. The most reasonable modification would be to utilize an elevated platform in order to minimize the height of the conveyor belt.
A patient with a T10 paraplegia is being discharged from rehab. What AD is most essential?
A wheelchair. For community ambulation due to the inc energy expenditure associated with ambulation. The lower abdominals and intercostals would be the lowest innervated muscles.
Most appropriate position for initially performing pelvic floor exercises:
Supine- kegel exercises or isometric contractions of the pelvic floor are often utilized as part of a treatment program for incontinence. Supine and sidling are the typical gravity-assisted positions to initiate strengthening. A patient may also use a gravity-assisted position where the hips are above the level of the heart such as supported bridging or on elbows and knees in order to have gravity assist the contraction.
A patient has burns on over 25 percent of their body due to a fire. The patient exhibits hypovolemia, which would most likely affect what lab value?
Hematocrit- the volume of percentage of red blood cells in the whole blood. It rises immediately after a severe burn and gradually decreases with fluid replacement.
A patient post-knee surgery presents with an extension lag. What would not be a likely cause of this issue?
Bony obstruction-would not produce an extension lag since PROM and AROM would be equal. The bony obstruction would affect both of these. Patient apprehension, muscle weakness, and pain could cause the lag as we would see AROM be affected.
A PTA observes a wound on the dorsum of a patient’s forearm. The wound area is mottled with red and covered in blisters. The PTA informs the patient it should take about 3 weeks to heal. What type of burn would this likely be?
Superficial partial-thickness burn- involves the epidermis and the upper portion of the dermis. The involved area may be extremely painful and exhibit blisters. Healing occurs with minimal to no scarring in 5-21 days.
A PTA is applying iontophoresis for lateral epicondylitis. The PTA uses dexamethasone with a current intensity of 3mA for 20 minutes. How often during the treatment should you check the skin?
Every 3-5 minutes to detect an adverse reaction and take the necessary corrective action.
A PTA completes a posture screening and gross ROM test on a patient with patella tendonitis. THE PTA finds the patient has extremely limited LE flexibility especially in the hip flexors. What common structural deformity is often associated with tight hip flexors?
Lordosis- refers to an excessive curvature in the spine in an anterior direction, usually identified in the cervical or lumbar spine. Tight hip flexors are often associated with excessive lordosis (anterior pelvic tilt) due to the origin and insertion of the hip flexors.
A PTA attempts to assess the motor component of the axillary nerve by conducting a resistive test. What muscle would be most appropriate to test?
Teres minor- innvervated by the axillary nerve (C5, 6). The muscle acts to laterally rotate the shoulder joint and stabilize the head of the humerus in the glenoid cavity.
A PTA is asked by a nurse to transfer a patient recently admitted to the ICU. What is the MOST appropriate method to confirm the patient’s identity prior to completing the transfer?
Examine the patient’s ID bracelet- allows the PTA to definitively determine the patient’s identity. The bracelet is typically applied immediately upon admission to the hospital and is not removed until discharge.
A PTA performs postural drainage to the anterior basal segments of the lower lobes. During treatment, the patient suddenly complains of dizziness and mild dyspnea. What is the MOST appropriate action?
Elevate the patient’s head- these symptoms are signs of intolerance to the head down postural drainage position require. Elevating the head will likely relieve the symptoms.
A patient status post Colles’ fracture is referred to PT. The patient has mod edema in her fingers and the dorsum of her hands and complains of pain during AROM. What is the most appropriate method to quantify the patient’s edema?
Volumetric measurements- would displace more water than the contralateral extremity due to the involved limb’s inc volume.
A PTA works with a 5 year old boy with Duchenne MD. The chart indicates he was diagnosed <1 year ago. What would most likely occur first?
Proximal muscle weakness- muscle weakness and atrophy begin in the proximal muscles of the Les and pelvis, then progress to the muscles of the shoulders and neck, followed by loss of UE and breathing muscles.
A PTA completing a balance assessment positions a patient in standing prior to administering the Romberg test. When administering this test, it would be most important to determine what?
The amount of sway present during the testing period- determines whether the Romberg test is positive or negative. A positive test is characterized by a patient being able to stand with no more than minimal sway with the eyes open, but presents with inc instability or falls with the eyes closed.
A PTA reviews the chart of a patient diagnosed with PAD prior to initiating treatment. Which objective finding would most severely limit the patient’s ability to participate in an ambulation program?
Signs of resting claudication- claudication pain is a symptom of ischemia of the LE muscles caused by PAD. Resting claudication pain is typically considered a contraindication to exercise with PAD and may be an indication that the disease process is more advanced.
A PTA observes a transtibial amputation patient ambulating. The PTA notices the patient cannot maintain full knee extension during the loading response on the prosthetic side. What is the most likely rationale for this observation?
Alignment of the foot into excessive dorsiflexion- if the prosthetic foot is aligned into excessive dorsiflexion, there is potential for knee instability during the loading response. The excessive DF creates a flexion moment at the knee upon loading on the prosthetic side.
A PTA treats a patient wearing a shoe that incorporates a rocker bottom. This type of modification would be most beneficial for a patient with…?
Hallux rigidus- refers to degenerative arthritis due to bone spurring that affects the first metatarsophalangeal joint. Patients with this experience pain with walking and bending.
A PTA intends to use compression therapy as part of a patient’s POC. What patient would be least likely to receive this treatment?
A 68 year old male with LE edema due to CHF- edema of the limbs is an indication for compression therapy. However, in patients with CHF, compression therapy should not be used since the movement of fluid from the periphery back to the heart may further inc the stress on an already failing heart.
A PTA works with a patient 6 weeks s/p THA (posterolateral approach). The patient’s medical history includes Graves’ disease. What intervention should the PTA avoid when treating the patient?
Ambulation in a warm therapy pool- the warm therapy pool would make this intervention inappropriate since patients with Graves’ disease have an accelerated metabolic rate and are often intolerant of warm environments.
Where would the PTA palpate to assess if perfusion to the foot has been affected?
Posterior to the medial malleolus to access the posterior tibial artery.
A tennis player is referred to PT after being diagnosed with median nerve entrapment. The patient’s chief complaints include paresthesias in the hand and progressive weakness. Which muscle would most likely contribute to the entrapment?
Pronator teres- the median nerve arises from the cubital fossa and passes between the two heads of the pronator teres. As a result, the pronator teres can be a possible source of median nerve entrapment.
A PTA elects to use mechanical lumbar traction for a patient with a back injury. The goal is to decrease the patient’s muscle spasm. What is the most appropriate force?
25% of the patient’s BW
What is the highest spinal cord injury level where the activity of driving an adapted van would be a realistic independent functional outcome?
C6- UE muscles required to drive an adapted van with hand controls would be innervated
A PTA reviews the results of a pulmonary function test. Assuming normal values, which of the following measurements would normally be the greatest?
Vital capacity- comprised of inspiratory reserve volume, tidal volume, and expiratory reserve volume.
What side effect would most likely be present due to chronic use of levodopa?
Choreoathetosis- a type of dyskinesia characterized by uncontrolled, involuntary movements. The onset of dyskinesias can occur as soon as three months after first receiving levodopa therapy.
A 74-year-old female indicates she has experienced increased urinary incontinence this past year. What physiological change is most commonly associated with this condition in adults?
Decreased urge sensation- the bladder becomes full, but due to decreased bladder sensitivity the older adult may not recognize this and as a result experiences incontinence.
A PTA observes that a patient has difficulty controlling the affected LE during the loading response. This phase is characterized by:
increased quadriceps activity and decreased hamstrings activity
What is the most appropriate rate to release the pressure when taking BP?
2-3 mm Hg per second
A PTA observes the standing posture of a patient from a lateral view. If the patient has normal anatomical alignment, a plumb line would fall:
slightly anterior to a midline through the knee
A PTA treats a patient with complete C6 tetraplegia. During the treatment, the patient makes a culturally insensitive remarks that the PTA finds offensive. What is the most appropriate action?
Inform the patient that the remark was offensive and continue treatment.
