Deck 25

Question 1

Of the following, which is not a variable from the clinical prediction rule for the use of thoracic manipulation for those who have shoulder pain?

A. Negative Neer Impingement Test
B. Patient reports not taking any medications of any kind for shoulder pain
C. Pain-free flexion greater than 127 degrees
D. Symptoms present for less than 90 days

Answer 1

C. Pain-free flexion greater than 127 degrees

Question 2

What is the CPR for use of thoracic manipulation of those who have shoulder pain?

Answer 2

(-) Neer Impingement test
pt not taking any medications for shoulder pain
pain free flexion < 127˚
sx presents x 90 days
....one other one I don't know

Question 3

A patient is referred to physical therapy with Parsonage-Turner syndrome. Of the following, which is true regarding this pathology?

A. Pain is the primary symptom of this diagnosis throughout the course of the disorder
B. Parsonage-Turner syndrome is not self-limiting, and intervention is required in order to address symptoms
C. The first symptom is weakness in the upper extremity
D. Weakness of muscles will often occur in a peripheral nerve distribution

Answer 3

D. Weakness of muscles will often occur in a peripheral nerve distribution

Question 4

When looking at the range-of-motion values, which of the following is most important for helping determine if a patient may have cervical radiculopathy?

A. The patient has 50 degrees of cervical rotation bilaterally
B. The patient has 50 degrees of painful cervical rotation to the right
C. The patient has full cervical extension
D. The patient has peripheralization of symptoms into the dorsal wrist with cervical extension

Answer 4

B. The patient has 50 degrees of painful cervical rotation to the right

Question 5

If an individual who had a diminished C7 deep tendon reflex also had a sensory deficit, where would the sensory deficit most likely be located?

A. Dorsum of middle finger
B. Lateral deltoid
C. Lateral thumb
D. Medial side of little finger

Answer 5

A. Dorsum of middle finger

Question 6

A 72-year-old female is referred to physical therapy for left cervical radiculopathy. Upon examination, the physical therapist is not convinced that cervical radiculopathy is the correct diagnosis. The patient does have left-sided neck pain, but she indicates that she gets numbness and tingling down her arm into her little finger. The numbness and tingling happens sporadically and does not change with an activity or position change. The physical therapist also observes that the patient has atrophy of her anterior forearm musculature. Based on the subjective and objective data, which of the following diagnoses is most likely?

A. Angina
B. Medial epicondylitis
C. Pancoast tumor
D. Primary bone cancer

Answer 6

C. Pancoast tumor

Question 7

A 48-year-old female patient is seen in physical therapy for rib and left shoulder pain. In her second week of physical therapy, she tells the physical therapist that the pain has been increasing and that it is making her very anxious. She also feels like she has been far more tired than usual, and her GERD has gotten much worse. What should the physical therapist do?

A. Educate the patient on deep breathing techniques for her anxiety that will also assist the patient in decreasing her rib pain
B. Refer the patient back to her referring physician for further medical assessment
C. Refer the patient for a psychology/psychiatry consult due to her anxiety
D. Treat the patient with modalities for this session to calm down her symptoms

Answer 7

B. Refer the patient back to her referring physician for further medical assessment

Question 8

A patient being seen for left shoulder pain presents to physical therapy with a reported body temperature of 100.9 degrees Fahrenheit. The physical therapist decides to take all vitals on the patient, and blood pressure, respiratory, and pulse rate are all normal. What is the correct course of action for the physical therapist?

A. Ask the patient about recent weight loss, recent night pain, and prior history of cancer because this finding points toward a possible neoplasm
B. Document all vital signs, including body temperature, blood pressure, and respiratory and heart rate, as normal in the patient’s chart for his daily systems review
C. Document the 100.9 degrees Fahrenheit temperature, as well as the normal findings from blood pressure, respiratory rate, and pulse rate, and continue to monitor the patient’s symptoms at each visit
D. Refer the patient to his referring physician because he is showing signs of inflammatory disease with this high body temperature

Answer 8

C. Document the 100.9 degrees Fahrenheit temperature, as well as the normal findings from blood pressure, respiratory rate, and pulse rate, and continue to monitor the patient’s symptoms at each visit

Question 9

A patient is seen postoperatively after a revision of an open repair for a rotator cuff tear. The patient’s initial surgery failed due to early active range of motion with one particular muscle. Which muscle, if used actively before 6–8 weeks after surgery, can lead to failure of an open rotator cuff repair?

A. Biceps
B. Deltoid
C. Infraspinatus
D. Supraspinatus

Answer 9

B. Deltoid

Question 10

During an open RTC repair, there is splitting and detachment of this muscle

Answer 10

deltoid

Question 11

A 16-year-old male is referred to physical therapy with a stinger and is consequently diagnosed with Klumpke’s palsy. The patient describes symptoms in his hand, with grasp mainly affected. He states it is difficult to hold onto any objects that require him to use fine motor skills. Which of the following regions of the brachial plexus was impacted to create the patient’s symptoms?

A. Anterior division
B. Inferior trunk
C. Medial cord
D. Posterior division

Answer 11

B. Inferior trunk

Question 12

Which acromion shape contributes most to the possible development of a rotator cuff tear?

A. Type I
B. Type II
C. Type III
D. Type IV

Answer 12

C. Type III

Question 13

A female patient reports an insidious onset of left shoulder pain one day prior to referral to physical therapy. She has a history of abdominal pain, and on the morning of the examination/evaluation, she feels cramping in her stomach that began the night before and comes in waves. The patient has struggled with infertility and reproductive issues since she was a teenager, and the physical therapist feels the patient should be seen for immediate medical attention. Which of the following is the most likely cause of the medical emergency?

A. Ectopic pregnancy
B. Endometriosis
C. Nonruptured ovarian cyst
D. Pelvic inflammatory disease

Answer 13

A. Ectopic pregnancy

Question 14

A patient is diagnosed with a neurapraxia, and a physical therapist is working on regaining sensation. Which of the following is true regarding neurapraxia?

A. A patient with a neurapraxia will have difficulty regaining sensation due to the severity of the injury
B. In neurapraxia, there is no Wallerian degeneration
C. Surgery is required in order to regain function in patients with a neurapraxia
D. This patient will not have any motor issues due to the injury

Answer 14

B. In neurapraxia, there is no Wallerian degeneration

Question 15

Neurapraxia occurs when the axon is

Answer 15

separated from the cell body

Question 16

A patient who sustained an ankle sprain two days prior to his physical therapy examination/evaluation is positive on the anterior drawer test and the talar tilt test. The individual also has very localized edema and has some difficulty walking without an assistive device. What grade of sprain does this patient have, according to the West Point Ankle Sprain Grading System?

A. Grade I
B. Grade II
C. Grade III
D. Grade IV

Answer 16

B. Grade II

Question 17

A patient sustains an inversion ankle sprain and has involvement of the inferior extensor retinaculum. Of the following, which bony structure does the extensor retinaculum attach to?

A. Calcaneus
B. Cuboid
C. Lateral cuneiform
D. Tibia

Answer 17

A. Calcaneus

Question 18

The inferior extensor retinaculum originates where (foot)

Answer 18

tip of lateral malleolus

Question 19

The inferior extensor retinaculum (foot) inserts where

Answer 19

sinus tarsi

lateral calcaneus

Question 20

A patient with a history of chronic ankle sprains experiences clicking in his ankle and feels he may have instability. Before the physical therapist goes into further examination for ankle instability, she asks further questions. The most obvious finding that leads the therapist to believe the patient has instability is clicking over the lateral side of the ankle. She feels there is another physical therapy diagnosis present after examination/evaluation. Which structure is most likely contributing to this clicking?

A. Anterior talofibular ligament
B. Fibularis longus tendon
C. Deltoid ligament
D. Tibialis posterior tendon

Answer 20

B. Fibularis longus tendon

Question 21

A 62-year-old female presents to physical therapy one week after an insidious onset of aching neck pain and burning pain around the left medial scapula after a tennis game (patient points to the T6–T9 region). She also says she gets an ache and some intermittent numbness and tingling in her left thumb, sometimes spreading to the index finger. She states she is feeling weak with certain activities, specifically if she has to lift something up, because her “biceps just can’t do anything anymore.” In addition, the patient has decreased strength in the deep neck flexors, middle and lower trapezius, and serratus anterior. Active range of motion is full for flexion, extension, and side flexion bilaterally, but the patient has limited left rotation to 45 degrees due to pain that radiates to the medial scapula. The shoulder abduction, Spurling, and distraction tests are all positive. The patient’s symptoms around the medial border of the scapula are likely due to:

A. C5–C6 pathology
B. C6–C7 pathology
C. T2–T3 pathology
D. T4–T5 pathology

Answer 21

B. C6–C7 pathology

Question 22

A 62-year-old female presents to physical therapy one week after an insidious onset of aching neck pain and burning pain around the left medial scapula after a tennis game (patient points to the T6–T9 region). She also says she gets an ache and some intermittent numbness and tingling in her left thumb, sometimes spreading to the index finger. She states she is feeling weak with certain activities, specifically if she has to lift something up, because her “biceps just can’t do anything anymore.” In addition, the patient has decreased strength in the deep neck flexors, middle and lower trapezius, and serratus anterior. Active range of motion is full for flexion, extension, and side flexion bilaterally, but the patient has limited left rotation to 45 degrees due to pain that radiates to the medial scapula. The shoulder abduction, Spurling, and distraction tests are all positive.

In helping make a physical therapy diagnosis, the physical therapist feels he is missing one piece of information. Which of the following is most helpful in determining an appropriate physical therapy diagnosis?

A. Deep tendon reflex findings for upper extremity
B. Palpation findings
C. Results of joint mobility assessment
D. Upper limb tension test findings

Answer 22

D. Upper limb tension test findings

Question 23

A 62-year-old female presents to physical therapy one week after an insidious onset of aching neck pain and burning pain around the left medial scapula after a tennis game (patient points to the T6–T9 region). She also says she gets an ache and some intermittent numbness and tingling in her left thumb, sometimes spreading to the index finger. She states she is feeling weak with certain activities, specifically if she has to lift something up, because her “biceps just can’t do anything anymore.” In addition, the patient has decreased strength in the deep neck flexors, middle and lower trapezius, and serratus anterior. Active range of motion is full for flexion, extension, and side flexion bilaterally, but the patient has limited left rotation to 45 degrees due to pain that radiates to the medial scapula. The shoulder abduction, Spurling, and distraction tests are all positive.

The physical therapist documents his physical therapy diagnosis to be cervical radiculopathy and is working on choosing an appropriate first-day intervention. He thinks mechanical traction may be the best option for this patient. Which pieces of objective data from this cluster are missing in this patient’s examination and evaluation to help make the decision to use mechanical traction?

A. Joint mobility assessment and deep tendon reflex findings
B. Joint mobility assessment and pain level during activity
C. Joint mobility assessment and palpation findings
D. Joint mobility assessment and upper limb tension test results

Answer 23

D. Joint mobility assessment and upper limb tension test results

Question 24

A 62-year-old female presents to physical therapy one week after an insidious onset of aching neck pain and burning pain around the left medial scapula after a tennis game (patient points to the T6–T9 region). She also says she gets an ache and some intermittent numbness and tingling in her left thumb, sometimes spreading to the index finger. She states she is feeling weak with certain activities, specifically if she has to lift something up, because her “biceps just can’t do anything anymore.” In addition, the patient has decreased strength in the deep neck flexors, middle and lower trapezius, and serratus anterior. Active range of motion is full for flexion, extension, and side flexion bilaterally, but the patient has limited left rotation to 45 degrees due to pain that radiates to the medial scapula. The shoulder abduction, Spurling, and distraction tests are all positive.

The physical therapist chooses to use mechanical traction for a first-day intervention. What parameters are most appropriate for this individual?

A. 15 minutes of intermittent traction (60 seconds on, 20 seconds off) with an initial pull of 10–12 pounds
B. 15 minutes of static traction (60 seconds on, 20 seconds off) with an initial pull of 10–12 pounds
C. 10 minutes of intermittent traction (50 seconds on, 10 seconds off) with an initial pull of 10–12 pounds
D. 10 minutes of static traction (50 seconds on, 10 seconds off) with an initial pull of 10–12 pounds

Answer 24

A. 15 minutes of intermittent traction (60 seconds on, 20 seconds off) with an initial pull of 10–12 pounds

Question 25

Per Rainey et al. CPR, those who meet the criteria for cervical traction should be treated with parameters of 15 mins IMT 60/20 with initial pull of 10-12# and progress to a max of

Answer 25

40#

Question 26

Based on current evidence, which of the following strengthening exercises is most appropriate to be used after and along with mechanical traction?

A. Biceps curls
B. Deep neck flexor strengthening in supine
C. Lower trapezius strengthening in prone
D. Serratus anterior punches in supine

Answer 26

B. Deep neck flexor strengthening in supine