Week 2

Question 1

Define patient history

Answer 1

information obtained from the patient regarding past and present conditions related to why the patient is seeking the services of a PT

Question 2

Why is patient history along with the review of systems important?

Answer 2

Because they are crucial for differential diagnoses and decision making to decide if the PT will: treat, refer, or co-manage the patient

Question 3

What does a PT interview establish?

Answer 3

1) Insight into medical diagnosis
2) A working hypothesis
3) Plan of action for the remainder of the encounter
4) Establish rapport and display competency
5) Empower the patient to play an active role in rehab

Question 4

List some interviewing techniques

Answer 4

1) Open ended questions
2) Closed ended questions
3) Funnel questions
4) Paraphrasing technique
5) Follow up questions

Question 5

List important categories to cover in the patient interview

Answer 5

1) General demographics (age, gender, occupation…)
2) Chief complaint, pain type, and pain level (why they are here)
3) Medical history & functional status (personal and environmental)
4) goals with PT
5) Any questions or topics I as a PT may have missed

Question 6

Give examples of different types of pain

Answer 6

1) Vascular: throbbing, pulsing
2) Neurogenic: Sharp, stinging
3) Musculoskeletal: Sore, deep
4) Emotional: Tiring, exhausting

Question 7

What is a systems review?

Answer 7

1) “Vitals” brief examination of the anatomical and physiological status of the cardio/pulm, integumentary, musculoskeletal, and neuromuscular systems “movement system”
2) Examination of communication ability, cognition and learning style/needs of the patient

Question 8

What is the role of a PT in screening?

Answer 8

It is NOT to diagnose medical disease, but to gather signs and symptoms to decide if the patient needs to be referred (proper documentation is a must)

Question 9

What is the purpose of a systems review?

Answer 9

1) Look beyond the chief complaint
2) Overview of the whole person
3) Determine if a consultation/referral is needed
4) Guide the PT in selecting tests and measures

Question 10

Give examples of Cardio/Pulm system tests

Answer 10

1) Heart rate
2) BP
3) Respiratory rate
4) Oxygen saturation
5) Edema

Question 11

Give examples of integumentary systems tests

Answer 11

1) Scars
2) Skin color (pale, cyanosis, redness)
3) Integrity (wound, moles)

Question 12

Give examples of musculoskeletal system tests

Answer 12

1) Height
2) Weight
3) Gross ROM
4) Gross strength
5) Gross symmetry (posture)

Question 13

Give examples of neuromuscular system tests

Answer 13

1) Gross coordinated movements (balance, transitions)
2) Motor function (fine movement, reflexes)
3) Sensation (touch, pain/temperature)

Question 14

What do you look for when checking mental status?

Answer 14

1) Alertness (alert, lethargic, obtunded, comatose)
2) Orientation (the patient knows their name, place, time, and situation)

Question 15

Define posture (biomechanics)

Answer 15

A composite of the positions of all joints at a given point in time

Question 16

What is a correct posture?

Answer 16

position in which minimum stress is applied to each joint & muscles work most efficiently
*Viewed as a kinematic chain
*A state of equilibrium

Question 17

What is a faulty posture?

Answer 17

any position that increases stress to the joints, muscles, and tendons.

Question 18

What are the objectives of a postural assessment?

Answer 18

1) Determine if a person assumes a habitual position(s) that place strain on musculoskeletal system.
2) Does the posture represent an underlying pathology
3) Formulate objectives for further examination
4) Determine if habitual postures limit a patient’s function and their ability to engage in necessary or desired activities

Question 19

Define center of gravity

Answer 19

The center of an object’s weight distribution, where the force of gravity can be considered to act. (Just anterior of S2 in humans, but changes when position changes)

Question 20

Static equilibrium

Answer 20

Total forces acting on the body are equal

Question 21

Describe the effects for gravity on posture

Answer 21

*When the line of gravity falls through a joint axis, no motion occurs (it is stable).

*When the center of gravity of a body segment falls anterior to the joint axis, body segment moves in an anterior direction.

*When the center of gravity of a body segment falls posterior to the joint axis, body segment moves in a posterior direction.

Question 22

Describe how gravity falls in the joint axis (Hip and downwards) in normal alignment

Answer 22

gravity falls anterior to ankle and knee joint axes and posterior to hip, creating ankle dorsiflexion, knee extension, and hip extension moments

Question 23

How are gravitational moments acting on the spine are normally?

Answer 23

Passively unless they are chronic spinal misalignments which needs increased mm activity

Question 24

Describe base of support

Answer 24

The area beneath an object or person that includes every point of contact that the object or person makes with the supporting surface. (Increasing BOS helps stabilize posture and balance)

Question 25

List some factors that affect posture

Answer 25

1) structural factors
2) age
3) physiological
4) pathological
5) social/cultural

Question 26

How would you describe the primary cervical curve while developing in the uterus?

Answer 26

Kyphotic

(The secondary lordotic and cervical curves develop with head raising and kneeling/standing developmental milestones)

Question 27

Is Femoral Anteversion is normal in infants?

Answer 27

Yes, it causes Toeing in and Genu Varus but both (typically) decrease with age

Question 28

What are some common postural changes associated with aging?

Answer 28

1) Loss of height due to dehydration of vertebral discs causes increased thoracic kyphosis and lumbar lordosis.
2) Combined with abdominal weakness these changes result in an abdominal protrusion

Question 29

List some common postural deviations during pregnancy

Answer 29

1) increased lordosis and kyphosis
2) Increase pelvic tilt
3) Center of gravity shifts forward

Question 30

When we observe the person from the front (anterior view) or the back (posterior view), what are we looking for?

Answer 30

we’re standing in the sagittal plane to observe asymmetries/deviations in the coronal or frontal plane.

Question 31

What does the plumb line (line of gravity) do?

Answer 31

Dissect the body into symmetrical halves

Question 32

When observing the person from the frontal plane, list the major landmarks in the plumb line goes through (in normal, optimal alignment)

Answer 32

*Through External Auditory Meatus
*Anterior to Atlanto-Occipital Joint
*(skull to 1st cervical vertebrae)
*Through Cervical vertebral bodies
*Through the Acromion Process of the shoulder
*Anterior to Thoracic vertebrae
*Through Lumbar vertebral bodies and anterior to Sacrum
*Slightly posterior to axis of hip (through Greater Trochanter)
*Slightly anterior to axis of knee (just behind the patella
*Slightly anterior to ankle (lateral malleolus)

Question 33

How would you assess leg length?

Answer 33

Measure from ASIS of pelvis to Medial Malleolus of ankle. Then have the pt bend their knees while in a prone position to differentiate between a shortened tibia or a shortened femur

Question 34

How would you measure normal patellar alignment?

Answer 34

Q angle:
1) Draw a line from the ASIS to the midpoint of the patella, extend the line distally
2) Draw a line from the midpoint of the patella to the tibial tuberosity

(Normal Q angle in females is 15-20 while in males its 5-10)

Question 35

How would you check for normal foot alignment?

Answer 35

Assess the normal arch of foot represented by the FEISS line which connects lower border of medial malleolus and head of 1st metatarsal bone.
The Navicular bone normally falls on this line in NWB position
*Below (distal to line = pronated foot
*Above line (proximal to) = supinated foot

Question 36

What are these postural deviations?

Answer 36

B) kyphotic scoliosis
C) flat back
D) sway back

Question 37

Name these 4

Answer 37

1) Thoracic curve
2) Thoracolumbar curve
3) Lumbar curve
4) Double major curve

Question 38

What are these 2 conditions?

Answer 38

1) Patella Baja
2) Patella Alta

Question 39

Describe the knee alignments here

Answer 39

1) Genu Valgus “knock knees”
2) Normal
3) Genu Varus “bow legged”

Question 40

What is Genu Recurvatum?

Answer 40

Knee hyperextension

Question 41

Name these foot misalignments

Answer 41

1) Pes Cavus
2) Pes Planus

Question 42

What are these toe conditions?

Answer 42

A) Claw toes
B) Hammer toes
C) Mallet toes

Question 43

What are these toe conditions?

Answer 43

1) Morton’s toes
2) Hallux valgus