Variadas 4

Question 1

PT is teaching the patient to ascend a curb with wheelchair. Which of the following is the correct technique to ascend a curb?

A) Patient pushes handrims forward and leans forward while PT stands behind

B) Patient pushes handrims forward and leans forward while PT stands in front

C) Patient pushes handrims backwards and leans backward while PT stands behind

D) Patient pushes handrims backwards and leans backward while PT stands in front

Answer 1

A) Patient pushes handrims forward and leans forward while PT stands behind

Question 2

Intercostals are innervated from…..

Answer 2

Intercostals are innervated from T1 to T11

Question 3

abdominals are innervated from…

Answer 3

T7-L1

Question 4

What are the strongest study design levels?

Answer 4

1- Systematic Reviews

2- Randomized Controlled Trials

3- Non-randomized Controlled Trials

4- Observational Studies with Comparison Groups

5- Case Series & Case Reports

6- Expert Opinion

Question 5

Systemic
Inflammatory
Symetrical
More joints
Pain more than 30min

OA or RA

Answer 5

RA

Question 6

Localized
Degeneration of cartilage
Can be symetrical or not
One joint
Pain less than 30min

OA or RA

Answer 6

OA

Question 7

Compensated Trendelenburg

Answer 7

Compensated Trendelenburg will show same side trunk bend on stance leg (side of Gmed
Weakness)

Question 8

Uncompensated Trendelenburg will show…

Answer 8

Uncompensated Trendelenburg will show opposite side pelvic drop

Question 9

Thermal Effects - Tissue depth mais q 5cm

Frenquencia:
Duty cycle:
Intensity:
Duration:

Answer 9

Frequency: 1mhz
Duty cycle: 100%
Intensity: 1.5- 2.0 w/cm2
Duration:2x ERA (5-10min)

Question 10

Non Thermal Effects - Tissue depth mais q 5cm

Frenquencia:
Duty cycle:
Intensity:
Duration:

Answer 10

Frequency: 1mhz
Duty cycle: 20%
Intensity: 0.5 - 1.0 w/cm2
Duration:2x ERA (5-10min)

Question 11

Pos op precautions for tunnel do carpo surgery

Answer 11

Avoid active wrist flexion past neutral

Avoid active finger flexion with wrist flexed during 10 days pos op

Question 12

What is the capsular pattern of the shoulder?

Answer 12

Er( lateral rotation), abd, internal (medial) rotation

Question 13

What is the capsular pattern of the spine?

Answer 13

Side flexion and rotation equally limited then extension

Question 14

What is the capsular pattern of the hip?

Answer 14

Flexion, abd , medial(internal) rotation. Order can vary

Question 15

What is the capsular pattern of the knee?

Answer 15

Flexion, extension

Question 16

What is the capsular pattern of the TMJ

Answer 16

Opening

Question 17

Muscle atrophy, hair loss, pale skin, shiny, cold feet.
Venous or arterial?

Answer 17

Arterial

Question 18

Pain in legs, swelling,change in skin, ulcers
Venous or artery?

Answer 18

Venous

Question 19

patient in supine position, therapist bends patient ‘s knee, laterally rotates the tibia and extends the knee.

What is the name of the test and which structure is being tested?

Answer 19

Mc Murray test
Medial meniscus

Question 20

IR of the tibia + varus stress
What meniscus is being tested and what is the test name?

Answer 20

Mc murray test
Lateral meniscus

Question 21

ER of the tibia + valgus stress
What meniscus is being tested and what is the test name?

Answer 21

My murray test
Medial meniscus

Question 22

Why is Apley’s test performed?

Answer 22

Apley’s test is performed in prone lying to distinguish between a ligament injury and meniscus injury.

Question 23

When is MC Murray test considered positive?

Answer 23

McMurray test is considered positive for a loose fragment or a torn meniscus if there is a snap or click which can be accompanied by pain.

The test is not positive if:

there is hypermobility or excessive movement finding

only pain is found

Only ROM limitation is found

Question 24

Which of the following causes are NOT a form of secondary lymphedema?

Infection

Milroy’s disease

Fibrosis

Chronic venous insufficiency

Answer 24

Milroy’s disease is correct as it is a primary form of lymphedema. Primary lymphedema is the result of insufficient development (and congenital malformation of the lymphatic system.

Secondary lymphedema is a result of an injury to the lymphatic system. Forms of secondary lymphedema are surgery, inflammation or infection, obstruction, or fibrosis, combined venous-lymphatic dysfunction (chronic venous insufficiency)

Question 25

What is the purpose of the Berg scale and what are the scores?

Answer 25

Used to assess static and dynamic balance and determine risk of fall in adults.

The max score is 56.

0-20 high fall risk
21-40 medium fall risk
41-56 low fall risk

Question 26

How long does the pt have to follow the hip precautions?

Answer 26

6weeks
6-8weeks if gluteous m was incised. No resisted or antigravity hip abd

Question 27

Flat foot…
Which biomechanical abnormality is present in this deformity?

Answer 27

In a flat foot or hypermobile foot, talus is planterflexed and addicted along with everted calcaneus.

Question 28

Cavus or supinated foot. What is the biomechanical presentation?

Answer 28

Dorsiflexion and abduction of talus is found in cavus or supinated foot.

Question 29

PT wants to prescribe a orthotic correction for her right flexible pronated foot. Which of the following is the best choice for correcting the biomechanical faults?

A) Heel cushion
B) Curved Last of shoe
C) Varus post
D) Valgus post

Answer 29

Answer: C

Since patient is having a flexible pronated foot, a medical wedge or varus post will work best to prevent or correct the deformity.

Incorrect: A - Heel cushion is prescribed in heel spurs of planter fasciitis.

B - Curved last will accentuate the deformity. To correct pronation, a straight last is needed.

D - Valgus post or lateral wedge is prescribed in rigid pronated foot

Question 30

Anterior shin splints- whhere is the pain?
What are the movements that will cause pain?

Answer 30

Pain in anterior shin splints is present on anteromedial aspect of lower leg

Pain is reproduced by resisted dorsiflexion and inversion and passive planterflexion and eversion.

Question 31

How is the presentation for anterior compartment syndrome?
What’s the possible cause?

Answer 31

Anterior compartment syndrome presents with acute pain and swelling along with neurological signs of tingling and loss of sensation.

Often caused by trauma, fall or muscle hypertrophy.

Question 32

Where is the pain for medial/posterior stress syndrome?

What muscles are affected by?

Which movements cause pain?

Answer 32

Medial tibial stress syndrome, also known as posterior shin splints presents with pain on posteromedial aspect of middle or lower thirds of lower leg.

It often starts because of overuse of tibialis posterior or soleus which works eccentrically to control foot pronation due to sudden increase in training or running on uneven terrain with underlying pronated foot.

Pain is reproduced on resisted plantarflexion and inversion and passive dorsiflexion and eversion.

Question 33

What is Morton’s metatarsalgia (Morton’s neuroma) ?

Which toes does it affect?

Answer 33

Morton’s metatarsalgia (Morton’s neuroma) refers to the formation of an interdigital neuroma as a result of injury to one of the digital nerves.

Usually, it is the digital nerve between the third and fourth toes,

Question 34

How is performed the test for Mortom
Neuroma?

Answer 34

Squeezing the metatarsal bones together elicits pain because of the pressure on the digital nerve.

On palpation, pain is more likely to be between the bones rather than on the bone. The condition tends to occur more frequently in women than in men

Question 35

Which of the following is not a precaution during examination of a pregnant woman?

A) No supine position for greater than 5 minutes at any one time.

B) Keep a wedge/rolled towel under left hip.

C) Rise slowly from lying down or sitting to standing.

D) Caution with lower limb muscle length testing.

Answer 35

Correct Answer: B

Wedge or rolled towel is to be kept under Right hip to lessen the effects of uterine compression on abdominal vessels and to improve cardiac output. The wedge turns the patient slightly towards the left.

Incorrect Answers:
A, C & D are the precautions followed during examination and exercises in pregnancy.

Question 36

A physical therapist is working with a 47-year-old female patient who is a secretary at the local law firm. The physical therapist wants to utilize aquatic therapy for this patient. Which of the following options listed is NOT a contraindication to use aquatic therapy?

1- Uncontrolled seizures
2- Fear of water
3- Severe peripheral vascular disease
4- Open wounds without occlusive dressing

Answer 36

2- Fear of water

Fear of water is a precaution for aquatic therapy.
The other answers are all contraindications for aquatic therapy.

Question 37

The examination findings reveal the SLR test is +ve. At what degree of SLR, the patient had pain…?

Answer 37

Pain between 30 and 60 degree considered +ve SLR.

There is no dural movement between 0-30 degrees. Practically no deformation of roots occurs above 70 degree. The pain is probably the joint pain.

Question 38

A patient with latissimus dorsi and lower trapezius weakness would have the most difficulty performing which of the following activities?

A. four point gait with Lofstrand crutches
B. three point gait with a straight cane

C.swing through gait with axillary crutches
D. wheelchair propulsion

Answer 38

C

Question 39

A patient performs bridging in supine as part of an exercise program. The therapist increases the difficulty by applying resistance as the patient maintains the bridge position. Resisted bridging reinforces the coactivation of the?

A. hip extensors, abductors, knee flexors
B. hip flexors, abductors, knee extensors

C. hip extensors, adductors, knee extensors
D. hip flexors, adductors, knee flexors

Answer 39

A

Question 40

A therapist attempts to obtain information on the integrity of the C7 dermatome. The most appropriate location to assess the dermatore is the?

A. little finger and unar border of the hand
B. lateral forearm and thumb
C. palmar distal phalanx of the middle finger
D. medial forearm

Answer 40

C

Question 41

• A quadriceps strain may be caused by all of the following except

A. sudden forceful flexion of the hip with the knee extended

B. an overstretch of the quadriceps with the hip in extension and the knee flexed

C.inadequate quadriceps length

D.an imbalance between the quadriceps muscles

Answer 41

A

Question 42

A patient is referred to physical therapy after sustaining a complete tear of the anterior cruciate ligament. The patient’s ligament injury is best described as a…

A. grade I sprain
B. grade Ill sprain

C. grade I strain
D. grade lll strain

Answer 42

B

A sprain is an injury to the ligaments and capsule of a joint in the body

. A strain is an injury to muscles or tendons.

Question 43

A patient sustained a knife wound which severed the distal lateral cord of the brachial plexus. EMG testing reveals no damage to the median nerve. This injury will result in impairment of

A. elbow flexion and forearm supination

B. elbow extension and forearm pronation

C. shoulder flexion and abduction

D. shoulder exteral rotation

Answer 43

A

Question 44

A physical therapist observes a patient’s static posture. The therapist identifies that the patient has a forward head posture. All of the following can contribute to forward head posture except _?

A. excessive cervical lordosis

B.light cervical extensors, upper trapezius and levator scapulae

C. elongated cervical flexor muscles

D. stretched posterior cervical ligaments and extensor muscles

Answer 44

D

Question 45

Tissues of high collagen content are affected to a greater extent by ultrasound energy.
Which tissue would you expect to absorb the most ultrasound energy?

A. bone
B. muscle
C. tendon
D. skin

Answer 45

A

Question 46

Biophysical effects of ultrasound include thermal and nonthermal effects. The amount of heat produced using ultrasound is least dependent upon _

A. the intensity
B. the duration of exposure

C. the choice of coupling agent
D. the size of the area sonated

Answer 46

C

Question 47

A physical therapist observes a patient ambulating in the clinic. The therapist notes that the patient’s pelvis drops on the left during left swing phase. This deviation is usually caused by weakness of the?

A.left gluteis medius
B. right gluteus medius

C.left gluteus minimus
D. right gluteus minimus

Answer 47

B

Question 48

An exercise test is performed on a patient diagnosed with ischemic heart disease. An appropriate reason for terminating the test includes all of the following except…

A.failure of heart rate or systolic blood pressure to rise or fall with increasing effort

В.systolic blood pressure exceeding 150 mm Hg or diastolic blood pressure exceeding 90 mm Hg

C.any adverse change in the patient’s appearance or attitude

D. increasing anginal symptoms

Answer 48

B

Question 49

149. A physical therapist evaluates the reflex status of a patient. The therapist should use which technique to assess the patient’s superficial reflexes?

A. brushing the skin with a light feathery object

B. percussing a muscle over the musculotendinous junction

C. stroking the skin with a noncutting, but pointed object

D. tapping a tendon or bony prominence

Answer 49

C

Question 50

Patients with cervical rib syndrome can experience tingling and numbness throughout the upper extremity when carrying heavy objects at their side. Which structures are commonly affected by the cervical rib?

A. common carotid artery and inferior trunk of the brachial plexus

B. common carotid artery and superior trunk of the brachial plexus

C. subclavian artery and inferior trunk of the brachial plexus

D. subclaviar; artery and superior trunk of the brachial plexus

Answer 50

C

Question 51

A patient complains of pain in the right hip while she is ambulating. Upon examination, you notice that the patient has a significant drop of the left hip while in midstance on the right leg.

The MOST appropriate treatment for this impairment would be:

1. Standing hip abduction of the left leg.
2. Standing hip abduction of the right leg.
3. Standing flexion of the left leg.
4. Standing flexion of the right leg.

Answer 51

1. This is the most correct answer. The patient is demonstrating a Trendeleburg gait with the weakness on the right hip abductors. The trick (and this is very true in the clinical world) is that while standing on the involved hip and abducting the opposite, you are loading the right hip (closed-chain) more than the left hip (open chain). Thus you are MORE effective at strengthening the right hip abductors by using the closed chain exercise.

Question 52

A patient presents to the clinic with right shoulder pain and complains of difficulty reaching overhead, with pain especially from 60-120 degrees of shoulder flexion. Which special test would be MOST informative for this set of symptoms?

1-Neer Test
2-Empty Can Test
3-Crossover Test
4-Push Off Test

Answer 52

The correct answer is:
1. This is the correct answer. The Neer Test is a test for subacromial impingement and is typically associated with the painful arc.

2. The Empty Can Test assesses supraspinatus pathology.
3. The Crossover Test checks for AC Joint pathology
4. The Push Off Test assesses strength and intygrity of the subscapularis, one of the rotator cuff muscles.

Question 53

A 32 year old female presents to the clinic complaining of left shoulder pain. The patient’s symptoms include pain with reaching and limited motion in all planes. The patient’s symptoms have been progressively worsening over the last month. What would be the MOST effective initial treatment?

1. Refer the patient to their primary care provider for intracapsular corticosteroid injections.
2. Begin gentle progressive stretching exercises with the focus on increased active range of motion.
3. Initiate rotator cuff strengthening exercises, focusing on external rotation.
4. Instruct the patient on Côdman pendulum exereises and apply a moist heat pack.

Answer 53

1. While corticosteroid injections can be a helpful to achieve short term results, there is little evidence they have long term effects.
2. This is the most correct answer. An effective treatment program for adhesive capsulitis should use gentle progressive stretching as the primary treatment.
3. This is not appropriate considering the symptoms of adhesive capsulitis.
4. This is not appropriate.

Question 54

A physical therapist is evaluating a 50 year old patient with a generally swollen right leg. The patient does not report any trauma to the leg and describes the swelling as increasing gradually over the last 12 months. The swelling is non-pitting, primarily below the knee. The leg is not red or hot, and the patient indicates that his leg just feels “heavy.” What is the MOST likely origin of the swelling?

1. Systemic infection
2. Chronic inflammation
3. Congestive heart failure
4. Lymphedema

Answer 54

4

1. Swelling from a systemic infection would not be insidious over 12 months (thus acute) and would be associated with redness and hotness.
2. Swelling from chronic inflammation would likely be associated with some type of trauma or pain, and is not the MOST appropriate response.
3. Congestive heart failure can cause swelling, but is more likely to be pitting and more generalized
4. Lymphedema is the correct answer. This condition is typically associated with a “heaviness” that appears gradually and usually involves non-pitting edema.

Question 55

A physical therapist is evaluating a patient with pain that radiates throughout his lower extremities. The patient has significant foot drop while ambulating and complains of numbness and tingling extending from the great toe up to the knee along the anterior leg. What is the MOST likely pathology underlying these symptoms?

1. Sciatic nerve entrapment
2. Deep peroneal nerve inflammation
3. Tibial nerve entrapment
4. L5 nerve root entrapment

Answer 55

4

1. Sciatic nerve entrapment can occur and cause symptoms radiating down the posterior leg. Foot drop is not common with this condition.
2. Deep peroneal nerve inflammation can lead to drop foot; however the deep peroneal nerve only innervates a small portion of the dorsum of the foot, thus eliminating this choice.
3. Tibial nerve entrapment would affect the posterior leg, extending to the heel. Motor loss would be present in the plantarflexors.
4. This is the correct answer. Tibialis anterior weakness and sensory loss along the anterior leg below the knee are the most common signs of L5 nerve root entrapment.