Test 6 Flashcards
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:
UE:
Shoulder abduction, external rotation, elbow flexion, forearm supination, wrist flexion
LE:
Hip flexion abduction, external rotation, knee flexion, ankle df, inversion
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:
UE:
shoulder adduction, internal rotation, elbow extension, forearm pronation, wrist flexion
LE:
Hip extension, adduction, internal rotation, ankle pf
During normal heel strike, the forward hip is how flexed
25 degrees
L5-s1 spondylolisthesis, how would you align the patient in the saggital plane for a LSO.
Decrease lumbar lordosis
Decreasing lumbar lordosis causes lumbar flexion which is the most appropriate position to prevent progression and allows for healing pathology
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.
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
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
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.
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.
Add hip spica to the LSO
Radio graphic reading you note that the thoracic curve apex is located at T6. Which ox is appropriate
Milwaukee CTLSO
A PATIENT has a fixed forefoot varus. All of the following are considered compensatory strategies for a fixed forefoot varus malalignment
Pf first ray, subtalar pronation, tibial internal rotation
Visible by the eye- signs of scoliosis
Arm gap, shoulder asymmetry, pelvic obliquity, rib hump, prominent scapula
Normal treatment for a child with spina bifida
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
SIGNS for neuromuscular scoliosis
Right lumbar curve, left thoracic
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
Duschenne muscular dystrophy
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:
Convexity, concavity
When evaluating to see if a scoliotic curve is non-structural what will you notice with forced lateral side bending:
Rotational components of the curve will correct themselves
Which type of scoliotic curve would you expect to progress more given only the location of the curve:
Single lumbar, thracolumbar
Parkinson’s is chronic progressive disease of the CNS with degeneration of dopaminergic neurons. Four hallmark symptoms of Parkinson’s disease
Rigidity, bradykinesia, tremor, and impaired postural reflexes
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:
Compression of the long thoracic nerve
What are the characteristics of the congenital abnormality in infants called torticollis
Contracture of sternocleidomastoid, ipsilateral head tilt, contralateral head rotation
Which nerve innervating the rhomboid muscles and lavator scapulae
Dorsal scapular
Biomechanical principles for Sarmiento style fx ox
Multiple 3-point pressure, total contact, long lever arms, hydrostatic tissue loading
Pathologies that indicate for the need for medial longitudinal arch support in a functional foot ox
Plantar fasciitis, posterior tibialis tendon dysfunctions, knee OA in lateral compartment, pets Plano valgus
During swing phase of gait cycle what muscles are active to achieve df
Anterior tibialis, extensor hallucis longus, extensor digitorum longus
Choose all the pathologies that indicate the need for a first ray relief and lateral wedge in a functional foot ox.
Cave varus foot, peroneal tendon dysfunction, chronic lateral ankle sprains, jones fx
All that are found in scarpa’s triangle (femoral triangle)
Boundaries SAIL:
Femoral nerve, femoral artery, sartorius muscle, inguinal lymph nodes
Sartorius, adductor longus, inguinal ligments
What would you recommend for additions to an articulating AFO for drop foot and posterior lateral hyperextension thrust of the knee( mild tone present)
Elevation of the 2nd-5th MTP joints and digits, 1/4” heel/lateral wedge, PF STOP, metatarsal pad
What additions can you make to an AFO to decrease excessive pronation within the AFO
Extrinsic medial wedge, medial abolish tabl or trimline, sustentaculum tail pad
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:
Proximal to distal is regained - Knee extensors knee flexors
Having a patient perform a heel raise, screens what myotomal level:
Walking on heels myotomal level:
Heel raise: S1
Walk on heel: L4-5
A patellar tendon bearing AFO is indicated for which pathologies:
Charcot joint, avascular necrosis of talus, OA ankle, calceaneal fx
Pt. With flaccid ankle pf and df. Best double action ankle joint configuration
Pins in anterior and posterior channels, springs posterior, pins in anterior channel
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.
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.
Pt wearing a KAFO is seen in clinic the patient complains of anterior thigh pressure while sitting. What could be cause;
Mechanical knee joint is too distal in relation to the antatomical joint
Erector spinae when they act bilaterally the extend the vertebral column. When they act unilaterally what action do they perform:
Lateral bend the vertebral column
Axillary nerve innervates teres minor, what other muscle does it innervates
Deltoid
The nominate bone of the pelvic girdle is known as
Sacrum
At heel strike the knee joint is at____ while the ankle joint is at
At fulll extension, 90deg./ neutral
The deltoid muscle acts to abduct the shoulder with other muscle
Supraspinatus
Scoliosis bracing degree range
25-45 degree
