Test 6

Question 1

A patient has sustained a stroke and you note that he has a flexion synergy pattern in his upper extremity and lower extremity. Pick the best answer that describes both synergy patterns:

Answer 1

UE:
Shoulder abduction, external rotation, elbow flexion, forearm supination, wrist flexion
LE:
Hip flexion abduction, external rotation, knee flexion, ankle df, inversion

Question 2

A patient has sustained a stroke and you not that he has a extension synergy pattern in his upper ex. And lower ex. What is the presentation:

Answer 2

UE:
shoulder adduction, internal rotation, elbow extension, forearm pronation, wrist flexion
LE:
Hip extension, adduction, internal rotation, ankle pf

Question 3

During normal heel strike, the forward hip is how flexed

Answer 3

25 degrees

Question 4

L5-s1 spondylolisthesis, how would you align the patient in the saggital plane for a LSO.

Answer 4

Decrease lumbar lordosis
Decreasing lumbar lordosis causes lumbar flexion which is the most appropriate position to prevent progression and allows for healing pathology

Question 5

It’s is early in the recovery phase of a patient with a L3 complete spinal cord injury, what is expected outcome would most likely.

Answer 5

Some recovery of function since damage is to peripheral nerve root.

Spinal cord ends at level L1 at the conus medularis from L1 distal( cauda equine lesion) a spinal cored injury would be damage to the peripheral nerve. Some recovery can be expected. A spastic bladder would be associated with an uppper motor injury

Question 6

L1 complete spinal cord injury along with another another patient that has an L4 spinal cord injury. What would you expect most appropriate for theses patients and ambulation tolerance respectively

Answer 6

L1- independent ambulation which knee ankle foot orthosis (KAFO) household distance (ILIOPSOAS WEAKNESS- L2 inervation
L4 ankle foot orthosis community ambulatory independent -weakness in ankle df-anterior tib.

Question 7

Patient has bilateral pars fx at L5 and is currently utilizing a custom polymer overlapping style LSO which decreased lumbar lordosis. The physician is not satisfied with the orthosis results and wants to know what you can do to further immobilize the fx site.

Answer 7

Add hip spica to the LSO

Question 8

Radio graphic reading you note that the thoracic curve apex is located at T6. Which ox is appropriate

Answer 8

Milwaukee CTLSO

Question 9

A PATIENT has a fixed forefoot varus. All of the following are considered compensatory strategies for a fixed forefoot varus malalignment

Answer 9

Pf first ray, subtalar pronation, tibial internal rotation

Question 10

Visible by the eye- signs of scoliosis

Answer 10

Arm gap, shoulder asymmetry, pelvic obliquity, rib hump, prominent scapula

Question 11

Normal treatment for a child with spina bifida

Answer 11

Prevent contracture due to neurogenic deformities
With hydrocephalus decompress and place shunt in place
Prevent pressure sores
FIT patients with an ankle foot ox and a TLSO

Question 12

SIGNS for neuromuscular scoliosis

Answer 12

Right lumbar curve, left thoracic

Question 13

Growers signs is seen when a person getting up form the floor, walking hands up his legs to get upright. Most common dx where this is seen

Answer 13

Duschenne muscular dystrophy

Question 14

When examining a scoliosis radiograph, the vertebral body is seen to rotate towards the _____ in relation to the curve and the spinous process is seen to rotate towards the _____in relation to the curve:

Answer 14

Convexity, concavity

Question 15

When evaluating to see if a scoliotic curve is non-structural what will you notice with forced lateral side bending:

Answer 15

Rotational components of the curve will correct themselves

Question 16

Which type of scoliotic curve would you expect to progress more given only the location of the curve:

Answer 16

Single lumbar, thracolumbar

Question 17

Parkinson’s is chronic progressive disease of the CNS with degeneration of dopaminergic neurons. Four hallmark symptoms of Parkinson’s disease

Answer 17

Rigidity, bradykinesia, tremor, and impaired postural reflexes

Question 18

You see a patient who describes pain in her shoulder after chopping wood. You find on physical examination weakness with shoulder flexion and you not scapular winging. The patient’s problem could be accounted by with most likely:

Answer 18

Compression of the long thoracic nerve

Question 19

What are the characteristics of the congenital abnormality in infants called torticollis

Answer 19

Contracture of sternocleidomastoid, ipsilateral head tilt, contralateral head rotation

Question 20

Which nerve innervating the rhomboid muscles and lavator scapulae

Answer 20

Dorsal scapular

Question 21

Biomechanical principles for Sarmiento style fx ox

Answer 21

Multiple 3-point pressure, total contact, long lever arms, hydrostatic tissue loading

Question 22

Pathologies that indicate for the need for medial longitudinal arch support in a functional foot ox

Answer 22

Plantar fasciitis, posterior tibialis tendon dysfunctions, knee OA in lateral compartment, pets Plano valgus

Question 23

During swing phase of gait cycle what muscles are active to achieve df

Answer 23

Anterior tibialis, extensor hallucis longus, extensor digitorum longus

Question 24

Choose all the pathologies that indicate the need for a first ray relief and lateral wedge in a functional foot ox.

Answer 24

Cave varus foot, peroneal tendon dysfunction, chronic lateral ankle sprains, jones fx

Question 25

All that are found in scarpa’s triangle (femoral triangle)

Boundaries SAIL:

Answer 25

Femoral nerve, femoral artery, sartorius muscle, inguinal lymph nodes

Sartorius, adductor longus, inguinal ligments

Question 26

What would you recommend for additions to an articulating AFO for drop foot and posterior lateral hyperextension thrust of the knee( mild tone present)

Answer 26

Elevation of the 2nd-5th MTP joints and digits, 1/4” heel/lateral wedge, PF STOP, metatarsal pad

Question 27

What additions can you make to an AFO to decrease excessive pronation within the AFO

Answer 27

Extrinsic medial wedge, medial abolish tabl or trimline, sustentaculum tail pad

Question 28

Pt. With guillian-barre syndrome. Pt has weak knee extensors, knee flexors, ankle pf, df. What muscles groups would you expect to regain strength first if the syndrome begins to remit:

Answer 28

Proximal to distal is regained - Knee extensors knee flexors

Question 29

Having a patient perform a heel raise, screens what myotomal level:

Walking on heels myotomal level:

Answer 29

Heel raise: S1

Walk on heel: L4-5

Question 30

A patellar tendon bearing AFO is indicated for which pathologies:

Answer 30

Charcot joint, avascular necrosis of talus, OA ankle, calceaneal fx

Question 31

Pt. With flaccid ankle pf and df. Best double action ankle joint configuration

Answer 31

Pins in anterior and posterior channels, springs posterior, pins in anterior channel

Question 32

Pt. Seen in clinic with flaccid ankle pf, df. The pt. Also buckles at the knee during loading response/heel strike. You have recommend a conventional afo with doubleaction ankle joints. What would be the most appropriate configuration of ankle joint.

Answer 32

Spring posterior channel and pins in the anterior channel

Spring in post. Will allow controlled pf during LR where keeping the GRF anterior to joint decreasing buckling.

Question 33

Pt wearing a KAFO is seen in clinic the patient complains of anterior thigh pressure while sitting. What could be cause;

Answer 33

Mechanical knee joint is too distal in relation to the antatomical joint

Question 34

Erector spinae when they act bilaterally the extend the vertebral column. When they act unilaterally what action do they perform:

Answer 34

Lateral bend the vertebral column

Question 35

Axillary nerve innervates teres minor, what other muscle does it innervates

Answer 35

Deltoid

Question 36

The nominate bone of the pelvic girdle is known as

Answer 36

Sacrum

Question 37

At heel strike the knee joint is at____ while the ankle joint is at

Answer 37

At fulll extension, 90deg./ neutral

Question 38

The deltoid muscle acts to abduct the shoulder with other muscle

Answer 38

Supraspinatus

Question 39

Scoliosis bracing degree range

Answer 39

25-45 degree