Tough Stuff Flashcards
1
Q
Normal WBC count
A
5,000-10,000
2
Q
What can refer pain to R inferior angle of scapula
A
Gallbladder
3
Q
What is the Crede Maneuver used for
A
Areflexive bladder
4
Q
What position helps GERD/hiatal hernia
A
L sidelying
5
Q
Where does the gallbladder refer pain to
A
- R neck
- R shoulder
- R inferior angle of scapula
- RUQ of abdomen
6
Q
Where does the liver refer pain to
A
- R neck
- R shoulder
- RUQ
***liver and gallbladder refer pain to similar areas
7
Q
Where does the lung/diaphragm refer pain to
A
L neck
L shoulder
8
Q
Where does the stomach refer pain to
A
center of chest
center of back
9
Q
Where does the pancreas refer pain to
A
LUQ
10
Q
Where do the kidneys refer pain to
A
R and L lower quadrants
IL shoulder
Flank pain
11
Q
Where does a peptic ulcer refer pain to
A
mid back
12
Q
Long term lithium use can lead to what
A
Osteoporosis
13
Q
Normal glucose levels
A
70-100
14
Q
Normal platelet levels
A
140,000-440,000
15
Q
What level = hyperglycemia/diabetic ketoacidosis
A
> 300
16
Q
Maximum carpet pile ADA
A
1/2 inch
17
Q
What would cause decrease or increase in Ca levels in the blood
A
Hypo-parathyroidism
Hyper parapthyroidsim
18
Q
What happens with Paget’s dz
A
Bone is turned over more often, increased risk of fx. Bone pain is common complaint.
19
Q
Decrease in cortisol level =
A
Addison’s disease
20
Q
Increase in cortisol level =
A
Cushing’s disease
21
Q
Buffalo Hump is commonly seen with what
A
Cushing’s disease
22
Q
Intolerance to cold is seen with which two metabolic/endocrine conditions
A
- Addison’s disease
- Hypothyroidism
23
Q
BEST test to diagnose an ACL injury
A
Lachman’s
24
Q
How to bias SLR for Tibial N
A
- Hip flex
- Knee ext
- Ankle DF
- Eversion
- Toe ext
25
How to bias SLR for Sural N
- Hip flex
- Knee ext
- Ankle DF
- Inversion
26
How to bias SLR for Peroneal N (fibular n)
- Hip flex
- Hip IR
- Knee ext
- Ankle PF
- Inversion
27
What glides to perform to perform opening of mouth (TMJ)
Anterior
| Inferior
28
How much elbow flexion while in the parallel bars
20 degrees
29
Describe the "screw home" mechanism with knee extension
The tibia laterally rotates during the final 20 degrees of knee extension
30
Capsular pattern at the thoracic spine
Equal lateral flexion and rotation
| Extension
31
End feel for Adhesive Capsulitis
Firm
32
Which side will the TMJ deviate to if there is an issue with the capsule
Ipsilateral
33
What position will the neck be in if the R SCM tears (torticollis)
R lateral flexion
L cervical rotation
Neck flexion
34
Capsular pattern at the shoulder
ER > Flex > IR
35
Capsular pattern at the hip
Flex > Abd > IR
36
Swan Neck Deformity
MCP flex
PIP ext
DIP flex
37
Boutonniere Deformity
MCP ext
PIP flex
DIP ext
38
What two tendons are involved with DeQuervain's
Extensor pollicis brevis
| Abductor pollicis longus
39
Active Compression/ O'Brien's Test best identifies what pathology
SLAP tear
40
Settings for Sensory TENS
```
Freq = 100 Hz
Duration = 100 microseconds
```
41
Settings for Motor TENS
```
Freq = 1-5 Hz (low)
Duration = 400 microseconds
```
42
What is thermal US used for (chronic/subacute or acute)
Chronic/subacute
43
What is nonthermal/pulsed US used for (chronic/subacute or acute)
Acute
44
What frequency for US to get deep structures
1 MHz
45
What frequency for US to get superficial structures
3 MHz
46
Settings for E-Stim for small muscles
Frequency = 20-30pps
| Pulse duration = 150- 350 microseconds
47
Settings for E-Stim for large muscles
Frequncy = 35-50 pps
| Pulse duration = 150- 350 microseconds
48
Settings for Russain E-Stim
Frquency = 50 pps
Pulse duration = 300-400 micorseconds
-50% duty cycle
49
Less than ____ on 5x STS test means fall risk
12
50
Less than ___on Berg Balance Scale means fall risk
50 (56 = max score)
51
More than ___on TUG means fall risk
13.5 sec
52
Which artery is affected with Wallenburg's Syndrome (lateral medullary syndrome)
PICA (ptosis, dry mouth, ataxic gait, vertigo, miosis, etc)
53
What artery is affected with Lateral pontine syndrome
AICA (hearing issues, IL facial sensation loss, falling toward side of lesion)
54
Jaw will deviate toward which side with CN5 lesion
Ipsilateral
55
Which cranial n is responsible for blink reflex
CN5 (trigeminal)
56
Facial muscles will deviate toward which side with a CN7 lesion
Contralateral
57
Uvula will deviate toward which side with CN10 lesion
Contralateral
58
Tongue will deviate toward which side with CN12 lesion
Ipsilateral
59
Posterior Cerebral Artery Syndrome will cause what
Homonymous hemianopsia
60
What score on the Glasgow coma scale means severe brain injury
8 or less
61
Which cranial neve is responsible for input of blink reflex
CN5
62
Which cranial nerve is responsible for output of blink reflex
CN7
63
Babinski will be seen until when
24 months (2 years)
64
What is the main orientation system from birth until 4 months
Vestibular (vision has not developed yet)
65
When does belly crawling start
7 mo
66
When does independent sitting start
6 mo
67
What will be seen with anterior cord syndrome
B loss of pain/temp and motor below the level of lesion
68
What will be seen with Brown Sequard Syndrome
- IL loss of vibration, fine touch, motor, and proprioception
- CL loss of pain/temp
69
What will be seen with central cord syndrome
UE involvement more than LE
Distal involvement more than proximal
Motor loss more than sensory loss
70
Weber's syndrome involves which artery
posterior cerebral artery
71
What will be seen with Weber's syndrome
CL hemiplegia
CL loss of pain/temp
IL vision loss
72
Verbal or visual cues with L sided stroke
Visual
73
Verbal or visual cues with R sided stroke
Verbal
74
Modified Ashworth:
| Catch/release at end ROM
1
75
Modified Ashworth:
| Catch/release and resistance throughout the rest of the ROM
1+
76
Modified Ashworth:
| Marked increase in tone thru the ROM but it moves easily
2
77
Modified Ashworth:
| Passive movement is difficult
3
78
Modified Ashworth:
| Affected part is rigid flex/ext
4
79
C5-C6 injury
Erb's palsy
80
Position for Erb's Palsy
Waiter's Tip:
| IR, elbow extension, adduction, pronation, winged scapula
81
C7-T1 injury
Klumpke's palsy
82
Position for Klumpke's palsy
Loss of hand intrinsics (claw hand)
83
Theory of motor learning:
| Focus is on normal movement, inhibition of abnormal tone/synergy
NDT (aka Bobath)
84
Theory of motor learning:
| Stronger parts of body used to stimulate and strengthen weaker parts of body....overflow concept
PNF
85
Theory of motor learning:
| Use of sensory stimulation to facilitate/inhibit responses
Rood
86
Theory of motor learning:
| encouraged pt's to learn synergies and then abolish synergies
Brunnstrom
87
LE flexor synergy
```
Hip flexion
Hip abduction
Hip ER
Knee flexion
Dorsiflexion
Inversion
Toe ext
```
88
LE extension synergy
```
Hip ext
Hip adduction
Hip IR
Knee extension
Plantar flexion
Inversion
Toe flex
```
89
LE spastic resting pattern
Knee extension
Equinus/valgus ankle
Great toe DF or excessive toe flexion
**there is also a LE flexion spastic resting pattern, but extension is most commonly seen
90
Normal ejection fraction
55-75%
91
Toxicity of which drug can lead to Cushing's Syndrome (buffalo hump, moon fact, ligament/tendon laxity)
Corticosteroids
92
Type of SLAP lesion:
| Degenerative Fraying, biceps tendon still intact
type 1
93
Type of SLAP lesion:
| Detachment of superior labrum/biceps from glenoid rim.
type 2
94
Type of SLAP lesion:
| most common type
type 2
95
Type of SLAP lesion:
| Bucket-handle tear of labrum, biceps tendon remains intact
type 3
96
Type of SLAP lesion:
| intra-substance tear of biceps tendon. Least common type
type 4
97
Tendonitis or bursitis?
AROM and PROM are painful
Bursitis
98
What muscles are responsible for opening of the mouth (aka depression)
- lateral pterygoid
- suprahyoid
- infrahyoid
99
What muscles are responsible for closing of the mouth (aka elevation)
- medial pterygoid
- temporalis
- masseter
100
Antalgic gait patttern
____ ipsilateral step length
____ contralateral step length
Normal
| Short
101
Difference between Smith and Colle's fractures
Both are distal radial fractures
Smith = when you land on dorsum of the hand
Colle's when you land on front of hand (FOOSH)
102
Fracture of one or more metacarpal bones
Boxer's fracture
103
When does midstance start and stop
Start: when opposite leg leaves the ground for swing
Stop: when heel off occurs on reference limb
104
What is involved with pronation of the foot
- rearfoot valgus
- calcaneal eversion
- PF/IR of the talar head
105
What is the compensation for rearfoot valgus
forefoot varus
106
What two deformities (one rearfoot and one forefoot) will lead to excessive pronation at midstance
1. ) Rearfoot valgus
| 2. ) Forefoot varus
107
What is involved with supination of the foot
- rearfoot varus
- calcaneal inversion
- DF/ER of the talar head
108
What is the compensation for rearfoot varus
forefoot valgus
109
What type of wedge would you use for forefoot varus
Medial wedge
110
What type of wedge would you use for forefoot valgus
Lateral wedge
111
What type of wedge would you use for rearfoot valgus
Medial (varus) post
112
What type of wedge would you use for rearfoot varus
Lateral (valgus) post
113
Will forefoot varus lead to pronation or supination of the foot
Pronation
**as a compensation
114
Willl forefoot valgus lead to pronation or supineation of the foot
Supination
**as a compensation
115
What is a Thomas heel used for
Pronated foot
116
Trunk lurching backwards during TST is due to what
hip flexor weakness (think about slingshotting leg forward)
117
Lack of DF at terminal stance will cause what
short CL step length
118
What two foot deformities can lead to pronation of the foot
Rearfoot valgus
| Forefoot varus
119
What occurs during vaulting and what is it due to
| What phase of the gait cycle does it occur during
When the CL limb plantar flexes to clear limb due to lack of knee flexion (stiff knee)
Occurs during initial swing
120
What is a Lisfranc amputation
When the metatarsals are removed but the tarsal bones are spared
121
What is a Chopart amputation
When the tarsal bones are removed and all that is left is the talus and calcaneus
122
What is a Syme's amputation
Removal of B malleoli, calcaneal fat pad is maintained and attatched to the distal tibia
123
Which type of suspension is best used for a patient who has undergone an AKA very recently, has CHF, and has a lot of volume changes
Lanyard
124
Prosthetic deviations:
| Causes of lateral trunk lean
- short prosthesis
- high medial wall
- abduction contracture
- weak hip abductors on prosthetic side
- short residual limb
125
Prosthetic deviations:
| Causes of circumduction
- prosthesis is too long
- too much friction in knee (aka knee is too stiff)
- socket is too small
- excessive plantar flexion of prosthetic foot
- weak hip flexors and adductors
- painful anterior distal residual limb
126
Prosthetic deviations:
| Buckling
-socket set forward in relation to the foot
-foot set in excessive DF
-stiff heel
prosthesis too long
-knee flex contracture
-hip flex contracture
-anterior limb pain
-decr quad strength
127
Will a stiff or soft heel cause buckling
| prosthetics
stiff heel causes buckling
128
Will a stiff or soft heel cause hyperextension
| prosthetics
soft heel causes knee hyperextension
129
Prosthetic deviations:
| Vaulting
- prosthesis too long
- inadequate sock suspension
- short residual limb
- foot in excessive PF
130
Prosthetic deviations:
| Rotation of forefoot at heel strike
- loose fitting socket
- inadequate suspension
- rigid SACH heel cushion
- short residual limb
131
Prosthetic deviations:
| Forward Trunk Lean
- socket too big
- poor suspension
- knee instability
- hip flexion contracture
- weak hip extensors
- pain with ischial weight bearing
132
Prosthetic deviations:
| Medial/Lateral Whip
- excessive rotation of the knee
- tight socket
- valgus in prosthetic knee
- improper alignment of toe break
- weak hip rotators
- knee instability
133
How often should you perform pressure relief
Every 15 min
134
Seat to floor height that is too low will cause what
increased pressure on ischial, poor ground clearance
135
Seat to floor height that is too high will cause what
feet not touching, so the patient will have to sit in a posterior pelvic tilt
136
Cervical traction:
| Force to use in intial session
8-10#
137
Lumbar traction:
| Force to use in initial session
30-40#
138
Lumbar traction in what position is best for herniated discs
prone
139
Lumbar traction:
| How much force to overcome soft tissue and friction resistance to achieve vertebral separation
30-50% of body weight
140
Lumbar traction:
| How much force for soft tissue relaxation
25-50% of body weight
141
Cervical traction:
| How much force for soft tissue relaxation
12-15#
142
ADA:
| When do you need a landing on a ramp (and how big should the ramp be?)
need a landing of 60" by 60" (5' by 5') for every 30" of run on a ramp
143
ADA:
| How big does a door opening have to be?
32 in
144
Scoliosis:
| Cobb angle that requires surgery
40 degrees
145
Scoliosis:
| Cobb angle that requires TLSO
20-35 degrees
146
Scoliosis:
| Cobb angle that requires close monitoring
10-20 degrees
147
ADA:
| Toilet seat height
17-19 in
148
ADA:
| Hallway width
36 in
149
6MWT MCID
50 meters
150
What type of precautions for:
| MRSA, VRE, GNB, C-diff
Contract (gloves and gown)
151
What type of precautions for:
| Influenza, RSV, Bordetella
Airborne (facemask and goggles)
152
What type of precautions for:
| TB, measles, chicken pox, herpes
Droplet (isolation room, respirator)
153
Proper donning and doffing order:
Don: gown, mask, face shield, gloves
Doff: gloves, gown, EXIT THE ROOM, face shield, respirator
154
How often to give someone NTG if they are having angina
3x 5 min apart
155
SCI:
| At what level can someone start to use a manual WC and not have to rely on power WC as much
C6
156
An ABI less than what means no compression due to arterial insufficiency
Less than 0.6
157
What type of adventitious breath sound will be heard in someone with cystic fibrosis
Ronchi (low pitched wheezing)
158
What type of adventitious breath sound will be heard in someone with CHF
Crackles (rales)
159
What type of adventitious breath sound will be heard in someone with asthma
Wheezes
160
What type of adventitious breath sound will be heard in someone with an upper airway obstruction
Stridor
161
What is defined as orthostatic hypotension
Drop in SBP by more than 20mmHG
OR
Drop in SBP and DBP by 10mmHg or more
162
What increases and decreases pain in someone with pericarditis
Increases: with neck or trunk movement
Decreases: with sitting up or leaning forward
163
Level of arousal:
| Conscious of internal or external stimulation
Aware
164
Level of arousal:
| Aware of self and environment. May still be disoriented or confused
Consciousness
165
Level of arousal:
State of unconscious in which there is neither arousal or awareness. Eyes remain closed and there or no sleep wake cycles
Coma
166
Level of arousal:
| State in which patients are not vegetative and do show intermittent signs of awareness
Minimally Responsive
167
Level of arousal:
Marked by return of the sleep/wake cycle and vital functions (respiration, digestion, and blood pressure). Patient may appear awake but is not aware of the environment
Vegetative state
168
How to bias the medial meniscus during McMurray's test
ER of tibia
| Valgus stress
169
How to bias the lateral meniscus during McMurray's test
IR of tibia
| Varus stress
170
What does Apley's test look at?
Meniscal damage
171
What score on the MMSE means severe dementia
below 9
172
What score on the 5x STS test means high risk of falls
12 sec
173
What score on the TUG means high risk for falls
More than 13.5 sec
174
Will apraxia be seen with R or L sided CVA
L sided CVA
175
How much cervical flexion should someone be in when doing cervical traction
25-30 degrees for C5-C7
| 0-5 degrees for C1-C4
176
Positive finding on Craig's test
angle is greater than 8-15 degrees
177
State of consciousness:
| Can only be aroused by vigorous stimuli
stupor
178
State of consciousness:
| Diminished arousal/awareness. Pt difficult to arouse, once aroused confused and little interest in envoirnment
Obtunded state
179
State of consciousness:
| Level of arousal decreased. Falls asleep quickly if not continually stimulated
lethargy
180
When does indepedent sitting and belly crawling emerge in a baby
6-7 months
181
lack of awareness of paralysis
anosognosia
182
cannot recognize objects presented
visual agnosia
183
lack of awareness of body structure/relationship of body parts
somatoagnosia
184
no idea how to perform something (picking up a toothbrush and trying to comb hair)
ideational apraxia
185
can only perform a task automatically and cannot perform it on demad
ideomotor apraxia
186
damage to what nerve would cause lateral wining of scapula
CN11 (spinal accessory nerve)
187
damage to what nerve would cause medial wining of scapula
long thoracic nerve (C5-C7)
188
actions of pectinues
hip flexion
| hip adduction
189
actions of gracilis
hip adduction
190
actions of sartorius
hip flexion
hip ER
knee flexion
191
What is innervated by the superior gluteal n (L4-S1)
- gluteus medius
- glutues minimus
- TFL
192
What is innervated by the inferior gluteal n (L4-S2)
Gluteus maximus
193
what nerve provides sensation to the 1st webspace of the foot
deep peroneal
194
What does the deep peroneal n innervate
- tibialis anterior
- EDL
- EHL
195
What does the superficial peroneal n innervate
-peroneus longus/brevis
196
the sural n is a branch of what nerve and what does it provide
branch of tibial n
| supplies sensation to lateral part of lower leg and lateral foot
197
What type of drugs can lead to rhabdomyolysis
Statins (antihyperlipidemia)
198
Ataxic breathing seen with brain stem lesion, stroke, neuron damage. Gasping and then no breathing and then gasping again
Biot's respiration
199
Rapid, deep breathing
Kussmaul breathing
200
What is Kussmaul breathing due to
metabolic acidosis
201
fast and deep breathing, slow breathing, then stop of breathing
cheyene stokes respiration
202
type of breathing in which the chest wall does NOT expand but the stomach rises
Paradoxical breathing (seen with SCI)
203
What drugs are given for asthma
Beta-agonists (causes bronchodilation and vasocontrcition)
204
Type of CHF where SV is low but the EF is preserved
Diastolic CHF
205
Type of CHF where SV is low and EF is low
Systolic CHF
206
What is the cause of diastolic CHF
chambers are stiff and thick so the L ventricle cannot fill well
207
What is the cause of systolic CHF
the chambers are stretched out and thin so the L ventricle cannot pump well
208
To decrease type 1 errors what do you need
high specificity
209
To decrease type 2 errors what do you need
high sensitivity
210
Sensitivity or specificity:
| gets the true positives
sensitivity
211
Sensitivity or specificity:
| gets the true negatives
specificity
212
what nerve will be affected with a midshaft humeral fx
radial n
213
what is an s3 heart sound indicative of
ventricular failure
214
what is an s4 heart sound indicative of
cardiomyopathy
215
what will increase the depth of penetration with US
incr freq will incr depth of penetration with US
216
normal INR in healthy people AND normal INR in those taking warfarin or blood thinner
1.1 is normal for healthy people
| 2-3 is normal for those on blood thinners
217
what is the function of the premotor area
visually guided movement
218
Decorticate vs decerebrate
```
Decorticate = UE in flex, LE in ext (lesion in diencephalon)
Decerebrate = all in ext (indicative of brain stem lesion)
```
219
Minimum and maximum height for handrails
```
minimum = 34 inches
maximum = 38 inches
```
220
what score on the MMSE means abnormal cognition
24/30 and below
221
when is the flexor withdrawal integrated
1-2 months
222
when is the traction reflex integrated
2-5 months
223
when is the palmar grasp reflex integrated
4-6 months
224
when is the moro reflex integrated
5-6 months
225
weak abdominals cause an anterior or posterior pelvic tilt
anterior
226
4 factors leading to an anterior pelvic tilt
- tight hip flexors
- tight spinal erectors
- weak glutes
- weak abdominals
227
5 factors leading to a posterior pelvic tilt
- weak hip flexors
- weak spinal erectors
- tight hamstrings
- tight abdominals
- tight glutes
228
what ligaments provide the primary restraint against horizontal shear force to the AC joint
superior and inferior capsular ligaments
| coracoclaviulcar ligament offers a secondary restraint
229
R or L sided brain injury:
| agnosia
Right
230
R or L sided brain injury:
| global aphasia
Left
231
R or L sided brain injury:
| speech/language issues
Left
232
R or L sided brain injury:
| apraxia
Left
233
what type of disk displacement in the mandible will cause limited ROM (less than 40-50mm), Ipsilateral deviation, and a hard end feeel as the mandibular condyle jams against the displaced disk
Anteromedial disk displacement
234
myxedema is common with what disease
hyperthyroidism
235
counternutation of the sacrum = ____ilium on sacrum rotation
anterior
236
nutation of the sacrum = _____ilium on sacrum rotation
posterior
237
how does the sacrum move with nutation
anteriorly and inferiorly
238
how does the sacrum move with counter nutation
posteriorly and superiorly
239
does anterior or posterior pelvic tilt lead to lumbar lordosis
anterior pelvic tilt leads to lumbar lordosis
240
what do tight hip flexors lead to during gait
decreased contralateral step length
241
what is a common side effect of alpha 1 blockers
orthostatic hypotension
242
prednisone is what type of drug?
What does it treat?
What can it lead to (side effects)?
a. ) corticosteroid
b. ) rhuematoid arthritis
c. ) Cushing's dz (moon face, HTN)
243
what type of dressing is good for neuropathic foot ulcers
antimicrobial
244
humeroulnar distal glide improves what
elbow flex
245
humeroulnar radial glide improves what
elbow flex
246
humeroulnar volar glide improves what
elbow flex
247
humeroulnar distraction improves what
elbow extension
248
open packed position of elbow
70 degrees flex
| 10 degrees supination
249
humeroulnar ulnar glide improves what
elbow extension
250
humeroulnar dorsal glide improves what
elbow extension
251
what does the talar tilt test?
inury to the calcaneofibular ligament
252
what does the external (lateral) rotation stress test test
injury to the syndesmosis
253
what does the anterior drawer test test?
injury to the anterior talofibular ligament
254
following symptoms: resting muscle pain, flu-like symptoms, and generalized weakness of the arms and legs. Which drug class is MOST responsible for the patient’s symptoms and presentation?f
Statins
255
rhabdomyolysis can occur with use of which drugs
statins
256
a seat depth that is too long will lead to what
posterior pelvic tilt
257
a seat depth that is too short will lead to what
pressure ulcers/sacral sitting
258
what body system should you be concerned about if someone presents with bilateral carpal tunnel
hepatic (liver)
possible liver cancer
259
ADA:
| how far should countertop be from floor
34 inches
260
ADA:
| how far should sink height be from floor
30 inches
261
ADA:
| best floor plan?
U shaped or L shaped
262
ADA:
| optimal turning radius
5 feet x 5 feet
263
unconscious patient with an absence of the pupillary light reflex suggests damage to
the midbrain
264
what does the pons assist with
assists with regulation of respiration rate and is associated with the orientation of the head in relation to visual and auditory stimuli
265
what does the medulla do
influences autonomic nervous activity, respiration/heart rate regulation, and reflex centers for vomiting, coughing, and sneezing
266
rationale for using hydrocolloids or hydrogels
provide for absorption of mild to moderate amounts of exudate while maintaining a moist wound environment to facilitate autolysis.
267
closed packed position at the hip
full hip extension, internal rotation, and abduction
268
prolonged use of heparin, coumadin, corticosteroids, and aspirin can lead to what
secondary osteoporosis
269
Biofeedback:
| high or low sensitivity when first starting for muscle relaxation
start with low
270
Biofeedback:
| high or low sensitivity when first starting for muscle strengthening
start with high
271
Cause of mallet finger
extensor tendon avlusion
272
Cause of Duputryen's contracture
fixed flexion deformity of 4th or 5th finger fascia, due to age
273
Cause of ape hand
median nerve palsy
274
Cause of Swan neck deformity
Loss of volar plate
275
Cause of Boutonniere deformity
Rupture of extensor hood
276
When is the gallant reflext integrated
12 months
277
When is the landau reflex integrated
begin at 3 months, fullly integrated at 2 years of age
278
When is the moro reflex integrated
28 wks gestation to 5 months of age
279
When is the plantar grasp reflex integrated
28 wks gestation to 9 months of age
280
Which test is best for TOS?
Adsons (disappearance of radial pulse when extending head and rotating toward affected shoulder)
281
What is blount's dz
disorder of growth plates in kids
-extreme varus with hyperextension
282
What 3 things are involved with talipes equinovarus
1. ) Forefoot adducted
2. ) Hindfoot varus
3. ) Ankle equinus
283
Gold standard test for determining if someone has a RTC tear?
Arthrogram
284
Increase in proportion of type 1 or type 2 fibers as we age
Increase in proportion of type 1 fibers
285
Concussion grade:
| transient confusion, no LOC. Mental status resolves in 15 min or less
grade 1
286
Concussion grade:
| transient confusion, no LOC. Sx last 25 min
grade 2
287
Concussion grade:
| LOC
grade 3
288
Which cranial nerve is the issue if the eye is stuck in elevation and abduction
CN4
289
Difficulty swallowing means which cranial nerve may be down
CN11
290
What part of the spinal cord does post polio syndrome affect
Anterior horn
291
Does GBS start in LE or UE
LE then goes up to upper extremity (ascending weakness for GBS)
292
Common cause of spina bifida
decrease in folic acid
293
Spina Bifida
open spinal cord, not covered with skin
-spinal nerve paralysis
Myelomeningocele
294
Spina bifida:
| Skin covered, no issues
Meningocele
295
What type of cues to use for someone who has had a L side stroke
visual
296
What type of cues to use for someone who has had a R side stroke
verbal
297
What is seen with Erb's palsy (C5-C6)
Waiter's tip position (shoulder add, ir elbow ext and pronation
298
What is seen with Klumpke's palsy (C7-T1)
Loss of hand intrinsics, claw hand
| -also Horner's Syndrome can occur due to T1 involvement
299
LE extensor synergy pattern
Hip ext, add, IR
Knee extension
PF, inv
Toe flex
300
LE flexor synergy pattern
Hip flex, abd, ER
Knee flexion
DF, Inv
Toe ext
301
LE PNF pattern:
| D1 flexion
Hip flex, add, ER
| Ankle DF, Inv
302
LE PNF pattern:
| D1 extension
Hip ext, abd, IR
| Ankle PF, Ev
303
LE PNF pattern:
| D2 flexion
Hip flex, abd, IR
| Ankle DF, Ev
304
LE PNF pattern:
| D2 extension
Hip ext, add, ER
| Ankle PF, inv
305
LE spastic resting pattern:
| Extension (this is the most common spastic resting pattern in the LE)
Knee extension
Equinus/valgus ankle
Great toe DF OR excessive toe flexion
306
Will Addison's dz cause too high or too low K+
too high K+ with Addison's
307
Will Cushing's dz cause too high or too low K+
too low K+ with Cushing's
308
Is S3 or S4 atrial gallop/cardiomyopathies
S4
309
Is S3 or S4 ventricular gallop
S3 (indicative of CHF)
310
How often should you measure HR/RPE when following the Bruce Protocol
Every 1 min
311
How often should you check BP when following the Bruce Protocol
At every stage (3 min)
312
Normal EKG changes during exercise
- P wave incr in height
- R wave decr in height
- ST segment becomes sharply upsloping
- QT interval shortens
- T wave decr in height
- J point become depressed
313
Abnormal EKG changes during exercise
- ST segment depression more than 1mm (ischemia)
- ST segment elevation more than 1mm
- Incr PR interval
- Missing Q wave
- Missing P wave
- Incr/decr wave time
314
Normal HR for babies to age 1
100-160 bpm
315
Normal HR for children 1 to 10
60-140 bpm
316
What occurs with the valsalva manuever
1. Decr in BP and incr in HR
Overshoots
2. Incr in BP and decr in HR
-due to overactivation of PNS/vagus n
317
What is a disadvantage of fluroscopy
high radiation (fluroscopy is a continuous x ray used to visual the heart and lungs)
318
An ABI less than ___means no compression
Less than 0.6
319
ABI less than __means arterial insuff
Less than 0.8
320
Pressures greater than __mmHg are contraindicated due to causing lymphatic collapse
45 mmHg
321
Short stretch bandages:
| ___resting pressure, ___working pressure
low resting pressure
| high working pressure
322
Should you decongest proximal or distal lymphatic segments first?
decongest proximal first
323
should stroke be proximal to distal or distal to proximal when performing lymphatic draininage?
distal to proximal
324
Contraindications for manual lymphatic drainage
- Acute infection (cellulitis)
- Acute DVT
- Malignancies
- Renal failure
- Cardiac edema
325
Will edema with lymphedema go away with elevation
no
326
Is R or L drainage area larger (lymphatic system)
L is larger
327
Do arterial or venous ulcer feel better with elevation
venous feels better with elevation
328
Do arterial or venous ulcers increase pain with dependency
pain incr with dependency with venous ulcers
329
Are arterial or venous ulcers more pain
arterial are more painful
330
Do arterial or venous ulcers have more drainage
venous have more drainage
331
Compression/unna boot is best for venous or arterial ulcers
venous
332
Are hydrogels absorptive
no, they are used for dryer wounds
333
Are hydrofibers absorptive
yes, they are the most absorptive
334
Is gauze absorptive
Yes
335
Can gauze be used for infected wounds?
Yes
336
WC prescription:
| Seat width
Hip width + 2 inches
337
WC prescription:
| Seat depth
Posterior thigh - 2 inches
338
WC prescription:
| Seat height
Leg length + 2 inches
339
WC prescription:
| hanging elbow angle
+ 1 inch for armrest height
340
Ergonomics while seated at work:
Chair height: feet on floor
Knee flexion to 90 degrees, elbows at 90 degrees
Shoulders in neutral
341
ADA guidelines:
| Doorway
Minimum is 32 inches
342
ADA guidelines:
| Carpet pile
Less than 1/2 inch pile
343
ADA guidelines:
| Hallway width
Minimum 36 inches
344
ADA guidelines:
| Wheelchair turning radius
60 inches
345
ADA guidelines:
| Bathroom sink
29-40 inches
346
Lumbar traction in what position is good for herniated disks
Prone
347
What poundage of traction to reduce muscles spasms in lumbar spine
25-50#
348
triad of sx for mitral valve prolapse
- dyspnea
- fatigue
- palpitations
349
How long should pressure garments be worn if a burn takes longer than 14 days to heal
23 hours
350
The ____glenohumeral ligament is the primary stabilizer against anterior translation in 90 deg of abd at ER (throwers position)
inferior
351
The ___glenohumeral ligament stabilizes against anterior translation with the arm in ER and less than 90 deg of abduction
middle
352
The ____glenohumeral ligament is an important inferior stabilizer
superior
353
Which glenohumeral ligaments helps with inferior stabilization
superior
354
Where is pain located with ulcerative colitis
left lower quadrant
355
Where is pain located with Crohn's colitis
right lower quadrant
356
Type of MS:
| steady functional decline and disease progression since onset with lack of discrete attacks
Primary progressive MS (PPMS)
357
Type of MS:
steady functional decline and disease progression since onset with occasional acute attacks where the periods between attacks are characterized by continuing disease progression
Progressive-relapsing MS (PRMS)
358
Type of MS:
attacks of neurological decline followed by full or partial recovery weeks or months later where the periods between relapses are characterized by lack of disease progression
Relapse-remitting MS (RRMS)
359
Type of MS:
| relapsing-remitting multiple sclerosis that progresses to steady functional decline with or without continued attacks.
Secondary progressive MS (SPMS)
360
Which is more severe Weckenbach or Mobitz 2?
Mobitz 2 (you want slow/stop exercise for mobitz 2)....for Weckenbach you want to monitor exercise
361
What precautions are needed for Ebola
contact
362
What precautions are needed for Rubella (mumps)
droplet
363
What precautions are needed for Rubeola (measles)
airborne
364
What 3 diseases require airborne precautions
TB, chickenpox, measles (Rubeola)
365
Is dependent edema seen in venous or arterial ulcers
venous
366
Is nystagmus and vertigo seen in unilateral or bilateral vestibular hypofunction
unilateral
367
How should the bed be positioned for someone with atelectasis
Trendelenburg
368
Is Trendlenburg bed ok for someone with CHF
no
369
Is Trendelenburg bed ok for someone with pulmonary edema
no
370
Is Trendelenburg ok for someone with atlectasis
yes
371
How should ankle pumps be performed in someone who has lymphedema
with the limb elevated
372
Should someone with lymphedema wear compression garments while exercising
yes
373
Is exercising in a pool good for someone who has low BP (orthostatic hypotension)
yes
374
Which muscles are usually weak in those with patellofemoral dysfunction
- hip abductors
- hip ERs
- hip extensors
375
Runners with achilles tendonitis often present with
- resting calcaneal inversion
| - excess pronation
376
f waves will be seen in a sawtooth pattern in place of P waves
atrial flutter
377
What artery is often involved with pusher syndrome
MCA
378
What muscles should be strengthened for someone with FAI?
- hip ERs
| - hip extenders (glute max)
379
What motion should be avoided with FAI
IR of hip
380
anteriorly displaced sternum and increased anterior to posterior dimension of the chest.
pectus carinatum
381
posteriorly displaced sternum and decreased anterior to posterior dimension of the chest as well as impaired respiration, which can cause difficulty breathing and shortness of breath
pectus excavatum
382
What does a Klenzak joint assist with
dorsiflexion
383
What is involved:
| torsional upbeating nystagmus in the left ear down position.
L posterior canal BBPV
384
which canal (ant or post) involved with downbeating torsional nystagmus
anterior canal involvement
385
How many deg of flexion should the neck be in for the supine roll test (tests the lateral canals)
30 deg of flexion
386
With a unilateral vestibular lesion, will the eyes beat towards or away from the affected side
Away
387
Will someone with an acute vestibular lesion fall away or toward side of lesion?
toward
388
What is the #1 reason for bilateral vestibular lesion
systemic drugs used to treat other conditions (chemotherapy)
389
What will someone with a bilateral vestibular lesion complain of
VERY off balance
Bouncing off the walls (oscillopsia)
--everything feels like it is bouncing
390
What will someone with a unilateral vestibular lesion complain most about
dizziness
391
What things do you look for to diagnose acute vestibular syndrome
HINTS
HI = head impulse test
N = nystagmus assessment
TS = test of skew deviation
392
Strokes of which two arteries will often lead to vertigo, nausea/vomiting
AICA/PICA
| also will lead to IL Horner's syndrome
393
Where is the talocrural joint the most stable
Full DF
394
What does it mean if S1 is absent
heart block
395
What does it mean if S2 is absent
aoritic stenosis
396
What does is mean if S3 is heard
CHF (can also be non pathological in athletes)
397
Arterial or venous ulcer:
| pain incr with leg elevation
arterial
398
Arterial or venous ulcer:
| pain incr with dependency
venous
399
Arterial or venous ulcer:
| pain decr with elevation
venous
400
Arterial or venous ulcer:
| pain decr with dependency
arterial
401
What kinds of foods make GERD worse
- coffee
| - fatty foods
402
Posterior hip precautions:
| Should you turn towards or away from surgical side while turning
turn away from surgcial side
403
Anterior hip precautions:
| Should you turn towards or away from surgical side while turning
turn towards surgical side
404
What does the suprascapular n (C5-C6) innervate
Supraspinatus, infraspinatus
405
What does the suprascapular n (C5-C6) provide sensory input to
GH capsule
406
What innervates trapezius and SCM
CN 11 (spinal accessory n)
407
What does the long thoracic n (C5-C7) innervate
Serratus anterior
408
What does the musculocutaneous n (C5-C6) innervate
Coracobrachialis, brachialis, biceps brachii
409
What nerve provides sensation to the lateral forearm
Musculocutaneous n (C5-C6)
410
What does the axillary n (C5-C6) innervate
Teres minor
| Deltoid
411
What nerve provides sensation to the proximal lateral arm
Axillary n (C5-C6)
412
Dull ache in the lateral shoulder what nerve should you suspect is the issue
Suprascapular n (C5-6)
413
What nerve roots does the radial n come from
C6-T1
414
What nerve is impacted with a midshaft humeral fx
radial n
415
What nerve is impacted with poor crutch use
radial n
416
What nerve provides sensory input to the 1st webspace of thumb
Radial n
417
What does the radial n (C6-T1) innervate
```
triceps brachii
brachioradialis
anconeus
ECRB
extensor digitorum
supinator
Abductor pollicis longus
Extensor pollicis brevis/longus
Extensor indicis
```
418
What does the median n (C5-T1) provide sensory input to
lateral hand (1st 3 digits and 1/2 of 4th)
419
What does the median n innervate
```
pronator teres
palmaris longus
flexor carpi radialis
flexor digitorum superficialis
flexor digitorum profundus
flexor pollicis longus
abductor pollicis longus
opponens pollicis
```
420
What nerve innervates supinator
radial n
421
What nerve innervates abductor pollicis longus
median n
422
What nerve innervates pronator teres
median n
423
What does the anterior interosseous n innervate (hint: there are 3 mm)
flexor pollicis longus
pronator quadratus
flexor digitorum profundus
424
Radial deviation weakness will be seen with injury to what nerve
median (C5-T1)
425
pronation weakness will be seen with injury to what nerve
median n
426
What nerve is injured:
| cannot make a fist (fingers 1-3 do not flex when trying to make a fist)
median n lesion
427
What nerve is injured:
| loss of lumbricals 3-4
ulnar n
428
What nerve is injured:
| at rest fingers 4 and 5 are flexed and the others are straight
ulnar n
429
What nerve levels for the ulnar n
C8-T1
430
What nerve innervates flexor carpi ulnaris
ulnar n
431
What nerve is injured:
| you cannot adduct the thumb
ulnar n
432
What does the ulnar n innervate
```
flexor carpi ulnaris
flexor digitorum profundus (medial half!)
ADDUCTOR POLLICIS
opponens digiti quinti
palmaris brevis
```
433
What does the femoral n innervate
Iliopsoas
Sartorius
Pectineus
Quads
434
What innervates gracilis
obturator n (L2-L4)
435
What nerve roots does the femoral and obturator n come from
L2-L4
436
What innervates pectineus
femoral n
437
What innervates sartorius
femoral n
438
What nerve dose the saphenous n come from
femoral n
439
What is normal on the reflex scale
2+
440
What is normal on the pulse scale
3+
441
Where does the saphenous nerve provide innervation
sensory to medial calf
442
What nerve provides sensation to the medial calf
saphenous n
443
What does the obturator n innervate
adductor longus/brevis
gracilis
adductor magnus
obturator externus
444
What nerve is injured:
| loss of hip ER and adduction
Obturator n
445
What does the superior gluteal n (L4-S1) innervate
Gluteus medius
Gluteus minimus
TFL
446
What does the inferior gluteal n (L5-S2) innervate
Gluteus maximus
447
What nerve is affected:
| posterior lean at initial contact
inferior gluteal n
448
What nerve is affected:
| trendelenburg gait
superior gluteal n
449
What nerve innervates gluteus medius
superior gluteal n
450
What nerve innervates gluteus max
inferior gluteal n
451
What nerve innervates the gastroc-soleus
tibial n
452
What nerve roots does the tibial n come from
L4-S3
453
What nerve does the sural nerve come from
Tibial n
454
What does the tibial n innervate
```
Gastroc
Soleus
Popliteus
Tibialis posterior
Flexor digitorum longus
Flexor hallucus longus
```
455
What nerve innervates tibialis posterior
tibial n
456
What does the common peroneal n split into
superficial peroneal
| deep peroneal
457
What nerve provides sensation to the first webspace of the foot
deep peroneal n
458
What nerve provides sensation to the lower leg and dorsum of the foot (except for the first webspace)
superficial peroneal n
459
What nerve innervates poplitus
tibial n
460
Where does the sural n provide innervation to
lateral side of lower leg, posterolateral lower leg, and lateral foot
461
What does the superficial peroneal n provide innervation to
peroneus longus/brevis
462
What does the deep peroneal n provide innervation to
TA
Extensor digitorum longus
Extensor hallucis longus
463
What nerve innervates TA
deep peroneal n
464
What nerve innervates peroneus longus/brevis
superficial peroneal n
465
Which n is injured:
| weak eversion
superificial peroneal n
466
Which n is injured:
| foot drop/lack of DF
deep peroneal n
467
The plantar nerve provides innervation to the intrinsics of the foot. What nerve does the plantar n arise from
tibial n
468
What nerve provides sensation to the heel
tibial nerve
469
Does the saphenous or sural nerve provide sensation to the medial lower leg
saphenous =medial
470
Does the saphenous or sural nerve provide sensation to the lateral lower leg
sural = lateral
471
What nerve innervates extensor digitorum longus and extensor hallucis longus
deep peroneal n
472
What is seen with trochlear n injury
inability to depress/adduct the eye
473
In a stroke is the upper or lower face more affected
lower face more affected
474
What is the only sensory change seen with Bell's palsy
sensation changes to the ant 2/3 of tongue
475
What provides sensation to the anterior 2/3 of tongue and posterior 1/3 of tongue
anterior 2/3 = facial n
| posterior 1/3= glossopharyngeal (CN 9)
476
What cranial n does sensory to post 1/3 of tongue, sensory to middle ear, and the gag reflex sensory portion
glossopharyngeal (CN9)
477
What is responsible for the motor portion of the gag reflex
CN10 (CN9 is responsible for the sensory portion)
478
What type of drug can be used to treat Meniere's dz
Diuretics
479
What cranial nerves provide the input and output portions of the blink reflex
```
Input = CN5
Output = CN7
```
480
pulmonic valve location
2nd IC space, L sternal border
481
aortic valve location
2nd IC space, R sternal border
482
tricuspid valve location
4th IC space, L sternal border
483
mitral valve location
5th IC space, midclavicular line
484
where is Erb's point located?
| what can be best heard at Erb's point?
Located: 3rd IC space, L sternal border
| Aortic and Pulmonic murmurs are best heard here
485
efficacy vs. effectiveness
```
efficacy = under ideal conditions
effectiveness = under real life conditions
```
486
Action of teres minor and teres major
```
Teres minor = ER of shoulder
Teres major (aka: little lat) = IR of shoulder
```
487
What nerve innervates flexor pollicis longus
median n
488
What nerve innervates abductor pollicis longus
radial n
489
Pain with painful arc 60-120 deg =
subacromial impingement
490
pain with painful arc at 170-180 deg =
AC joint issue
491
Positive Jobe's test =
supraspinatus injury (jobe's test = empty can)
492
Positive Hornblower's sign (Patte test) means what
teres minor injury
493
what type of end feel with subacrominal bursitis
empty
494
what type of end feel with mensicus tear
springy block
495
boggy end feel =
hemarthrosis
496
Is first 30-60 of shoulder elevated due to GHJ or scapulothoracic joint
GHJ
497
Opening or closing restriction?
| Difficulty SB to R and pain on R
closing (need to close)
498
Opening or closing restriction?
| Difficulty SB to R and pain in L
opening (need to open)
499
Opening or closing restriction?
| Difficulty SB to L and pain in R
opening (need to open)
500
Opening or closing restriction?
| Difficulty SB to L and pain in L
closing (need to close)
501
Are upglides or downglides the only thing actually possible in C-spine due to anatomical situation
upglides
502
How to glide to improve ER/IR in someone with adhesive capsulitis? (or anyone with capsular pattern in shoulder)
also....what is the capsular pattern in the shoulder???
posterior
ER > abduction > IR
503
3 contraindications for joint mobs
1. ) Joint effusion
2. ) Inflammation
3. ) Hypermobility
504
Following a flexor tendon repair which active movement should you try to prevent
active flexion
| want passive flexion, active extension
505
Sunburst pattern =
Ewings Sarcoma
506
Where does nodding occur
C1-occiput
507
Where does most of rotation come from
C1-C2`
508
degree to which data sets are different from each other
t-test
509
Assess goodness of fit between observed and expected values
Chi-squared test
510
Level of measurement?
| Weight
ratio
511
Level of measurement?
| temperature
interval
512
Level of measurement?
| Borg scale
ordinal
513
Level of measurement?
| RPE
ordinal
514
Level of measurement?
| MMT
ordinal
515
```
Level of measurement?
assistance level (minA,modA, etc)
```
ordinal
516
Level of measurement?
| blood type
nominal
517
Looks at strength of relationship between 2 variables
Correlation coefficient (r)
518
Used as a predictor/forecaster of data points
Regression analysis
519
What does this describe? (research/statistics)
Predicting VO2 max based on an exercise stress test
regression analysis
520
Represents variance from mean
Standard deviation (68-95-99.7)
521
Analyzes variance inside groups to determine whether the means of several groups are equal.
ANOVA testing
522
Key differences (2) between ANOVA and T test
ANOVA looks at mean and variance, while t-test only looks at mean
ANOVA used for 3+ data groups
523
Sensitivity or Specificity?
| good at catching positives
sensitivity
524
Sensitivity or Specificity?
| good at catching negatives
specificity
525
what is p-value compared to to determine significance
alpha level
526
higher than ____ is a positive liklihood ratio
1
527
lower than ____is a negative likelihood rati
1
528
indicates how far an item deviates from the population mean in terms of SDs
Z-score
529
the probability of rejecting the null hypothesis when the null is true (false positive/type 1 error)
alpha level
530
the probability that the results are merely due to chance if the null hypothesis is true
p-value
531
p-value less than ___ means statistical sig
0.05
532
What is this?
| 95% of the data set falls between two numbers
Confidence interval (usually set at 95%)
533
do you want a high or low alpha when safety is critical?
low alpha
534
number of patients who need tx to prevent 1 bad outcome
Number needed to treat (NNT)
535
Is a high or low number needed to treat (NNT) good or bad
low is better
536
What is the ideal Number needed to treat
1
537
what does an arterial line (a-line) do?
measures BP in real time
Can also get arterial blood gas analysis
**this is directly in an artery
538
when are chest tubes commonly seen
following open heart surgery or post-trauma t
*keep below level of lungs
539
purpose of NG tube
to deliver meds and nutrition via nose into stomach
540
how deep should compression depth be for adults?
| for kids?
adults: 2 hands in center of chest, go AT LEAST 2 in deep
kids: 2 fingers on center of chest, only 1.5 inches deep
541
when is a positive pressure room used?
those with severely compromised immune system
-neutropenia, HIV, cancer, organ transplant pts
542
2-24 heel raises = what MMT score for plantar flexors
4/5
543
how many heels raises do you need to do to achieve 5/5 MMT for plantar flexors
25
544
Do you let HOB go below ___degrees if they have a nasoentric tube
30 deg
545
need to place HOB below __degrees to prevent risk of aspiration
30 deg
546
sign of symptom?
| things you see/observe
sign
547
sign or symptoms?
| things pt reports
symptom
548
function of poplitues muscles
flexion of knee
| IR of tibia
549
what cranial nerve is AICA associated with?
CN 7 (IL facial sensation issues with
550
what cranial nerve is PICA (Wallenburg's/lateral medullary syndrome) associated with?
CN 9
551
What cranial nerve is medial medullary syndrome associated with
CN12
552
R or L MCA stroke: Broca's aphasia
right
553
R or L MCA stroke: Werneicke's aphasia
left
554
what is a main side effect of levodopa (sinemat)
orthostatic hypotension
555
what is a main side effect of anticholinergics
dry mouth, blurred vision, constipation
