APK DAY 8 Flashcards
(38 cards)
1
Q
- A patient with a C6 spinal cord injury is evaluated in the clinic. Which objective finding is the strongest indication that the spinal cord injury is NOT complete?
a. Weakness of the brachioradialis
b. Intact sensation on the lateral portion of the shoulder
c. Diminished sensation on the hypothenar eminence
d. Absent triceps reflex
e. Weakness of the biceps muscle
A
C
2
Q
- The following are expected in a C4 lesion, EXCEPT:
a. Can provide minimal assistance, therefore dependent in bed mobility
b. Involves the diaphragm and trapezius
c. Chin control can be used to control power wheelchair
d. Can assist with all transfers
e. Dependent in all transfers
A
D
2
Q
- The following statements describe the “Screw-Home Mechanism” of the knee EXCEPT when _______.
i. Seated and a person flexes his knee, the tibia goes into internal rotation to unlock the knee.
ii. Standing from a seat the femur goes into internal rotation during the last few degrees of flexion.
iii. Standing from a seat the femur goes in external rotation during the last few degrees of extension
iv. Seated and a person flexes his knee, the femur goes into external rotation at the last few degrees of extension.
a. III
b. I
c. II and III
d. II and IV
A
C
3
Q
- Despite the presence of third cranial nerve paralysis, it was determined upon examination, that the eye is able to rotate inward, indicating that the superior oblique muscle is intact. This indicates that cranial nerve
a. III is also denervated.
b. IV is partially denervated.
c. III is only partially denervated.
d. IV is intact.
A
D
4
Q
- Which of the following statements describe Horner’s syndrome?
i. Pupil of the eye on injured side is miotic due to dilator paralysis
ii. Partial ptosis due to denervation of levator palpebrae superioris
iii. Anhidrosis and vasodilation on affected side
iv. Complete ptosis and vasodilation on unaffected side
a. III only
b. II, III and IV
c. I, II and III
d. I and IV
e. IV only
A
C
5
Q
- The following are true of the femoral artery EXCEPT
a. if the common iliac or external iliac artery is partially occluded, the femoral artery pulse may be diminished.
b. the femoral vein lies medial to the femoral artery and is a clinical site for venous puncture.
c. passes under the inguinal ligament at about its midpoint.
d. the femoral nerve lies lateral to the femoral artery.
e. palpable just superior to the inguinal ligament, at a point halfway between the anterior superior iliac spine and the pubic tubercle.6. The following are true of the femoral artery EXCEPT
a. if the common iliac or external iliac artery is partially occluded, the femoral artery pulse may be diminished.
b. the femoral vein lies medial to the femoral artery and is a clinical site for venous puncture.
c. passes under the inguinal ligament at about its midpoint.
d. the femoral nerve lies lateral to the femoral artery.
e. palpable just superior to the inguinal ligament, at a point halfway between the anterior superior iliac spine and the pubic tubercle.
A
E
5
Q
- Nerve primarily responsible for ankle plantar flexion
a. Obturator
b. Sciatic
c. Femoral
d. Tibial
e. Peroneal
A
D
5
Q
- Which of the following statements is true concerning muscles acting in hip flexion?
a. The hip flexors are inactive during abdominal sit ups
b. Their maximum isometric torques are greatest when the hip is extended
c. The iliopsoas is the only hip flexor that can produce enough tension to flex the hip beyond 90 degrees with the subject in sitting position
d. Their minimum isotonic torque occurs when the hip is flexed8. Which of the following statements is true concerning muscles acting in hip flexion?
a. The hip flexors are inactive during abdominal sit ups
b. Their maximum isometric torques are greatest when the hip is extended
c. The iliopsoas is the only hip flexor that can produce enough tension to flex the hip beyond 90 degrees with the subject in sitting position
d. Their minimum isotonic torque occurs when the hip is flexed
A
A
5
Q
- Which of the following are treatment philosophies of neuropathic arthropathy (or Charcot’s joint)?
i. Treatment is mainly palliative
ii. Immobilization and joint protection are two important principles of treatment
iii. Where conservative management fails, joint replacement is performed
iv. Where conservative management fails, surgical fusion is recommended
v. Whenever possible, the underlying neurologic disorder should be treated
a. I, II and V
b. II, IV and V
c. I, III and IV
d. I, II and IV
A
B
6
Q
- A patient is unable to extend the knee in the sitting position or perform straight leg raising when supine. This may be due to weakened or paralyzed ________.
a. Gluteus maximus
b. Quadrates femoris
c. Iliopsoas
d. Quadriceps femoris
A
D
6
Q
- Which of the following statements is true in motions of the knee?
a. Accessory motions are normally produced when the knee is in full extension
b. Axial rotation occurs best when the knee is extended
c. Terminal rotation of the knee is a locking mechanism observed during the last 20 degrees of knee extension
d. The axis for flexion and extension is clinically approximated as directed through the center of the lateral and medial condyles of the femur10. Which of the following statements is true in motions of the knee?
a. Accessory motions are normally produced when the knee is in full extension
b. Axial rotation occurs best when the knee is extended
c. Terminal rotation of the knee is a locking mechanism observed during the last 20 degrees of knee extension
d. The axis for flexion and extension is clinically approximated as directed through the center of the lateral and medial condyles of the femur10. Which of the following statements is true in motions of the knee?
a. Accessory motions are normally produced when the knee is in full extension
b. Axial rotation occurs best when the knee is extended
c. Terminal rotation of the knee is a locking mechanism observed during the last 20 degrees of knee extension
d. The axis for flexion and extension is clinically approximated as directed through the center of the lateral and medial condyles of the femur
A
C
7
Q
- The following findings are compatible with a left hemisection of the T10 cord level EXCEPT
a. absent pain and temperature on the right side of the trunk at the level of the umbilicus.
b. complete paralysis of the left lower rectus abdominis.
c. absent pain and temperature sensation on the left side of the trunk at the level of the umbilicus.
d. absent pain and temperature sensation on the right anterior thigh area.
A
C
8
Q
- LD is a 35-year-old male who came in for weakness and pain of the left lower extremity of one-week duration. Past medical history is unremarkable except for (+) history of poliomyelitis at age 7 years. Pertinent physical examination revealed (+) left lower atrophy with note of leg length discrepancy. What is the most likely diagnosis? (KRISTAN)
a. Post-polio syndrome
b. Guillain-Barre Syndrome
c. Charcot-Marie-Tooth Disease
d. Spinal cord injury
A
A
9
Q
- In the foot, the contribution of the first metatarsal head to weight bearing is
a. 1/6
b. 1/5
c. 2/5
d. 2/6
e. 1/7
A
D
10
Q
- Sensation to the middle finger is supplied by neurologic level
a. C8
b. C6
c. C7
d. T1
e. C5
A
C
11
Q
- A client with a confirmed posterior cruciate ligament tear is able to return to full dynamic activities following rehabilitation. The following serve as a secondary restraint to the posterior cruciate ligament EXCEPT
a. Popliteus.
b. medial collateral ligament.
c. lateral collateral ligament.
d. iliotibial band.
A
D
12
Q
- An example of telereceptor
a. The ear
b. A free nerve ending
c. Tropomyosin
d. The carotid baroceptor
e. A muscle spindle
A
A
12
Q
- The following statements describe the pelvic girdle and femur EXCEPT:
a. The pelvic girdle consists of two innominate bones: the sacrum and coccyx
b. The iliofemoral ligament firmly connects the femur’s proximal end to the ilium
c. Gliding and cartilaginous joints allow no movement whatsoever in both sexes
d. The ilium, ischium and symphysis pubis make-up each hip bone
e. The pubic portion of the innominate bones fusing to form the symphysis pubis is of the cartilaginous joint type.
A
C
13
Q
- These muscles are supplied by branches of 7th cranial nerve EXCEPT ______.
a. Nasalis
b. Mentalis
c. Levator palpebrae superioris
d. Orbicularis oculi
A
C
14
Q
- For the anterior and lateral spinothalamic tract, _______________.
a. The anterior spinothalamic predominantly controls pressure while the anterior spinothalamic controls touch
b. The lateral spinothalamic predominantly controls pain while the anterior spinothalamic controls temperature
c. The third order neuron of both tracts will have its cell body at the thalamus
d. The anterior spinothalamic tract is uncrossed while the lateral spinothalamic tract is predominantly crossed.
A
C
14
Q
- Which statement explains why visceral pain is referred to a somatic structure?
a. Somatic and visceral afferents project to different spinothalamic neurons
b. Somatic efferents project to the decreased threshold of somatic structures
c. Impulses from the viscera increase the threshold of spinothalamic neurons
d. The pain is referred to the somatic structure with the same embryonic origin
A
D
14
Q
- During heavy exercise, there is an increase in sympathetic activity. This would result in vasoconstriction of the blood vessels in the following organ/s EXCEPT:
a. Splanchnic organs
b. Skeletal muscle
c. Kidneys
d. Liver
A
B
15
Q
- What is the average length of the spinal cord in the adult?
a. 40 to 42 inches
b. 33-35 cm
c. 33-35 inches
d. 43-45 cm
e. 43-45 inches
A
D
16
Q
- Which of the following nerves is NOT a true peripheral nerve, but an evaginated fiber tract of the diencephalons?
a. Optic
b. Auditory
c. Oculomotor
d. Olfactory
e. Trochlear
A
A
17
25. Fracture of the second lumbar vertebra will involve which spinal cord segment?
a. L2
b. L1
c. T12
d. L4
A
18
29. Which is a characteristic of the intrinsic muscles of the foot?
a. Their major function include supporting the arches in walking and running
b. Their proximal attachments are either in the tibia or fibula
c. Their distal attachments are either in the tibia or fibula
d. All but one are located in the plantar surface
A
18
26. A T10 female with complete paraplegia will
a. Have normal orgasm
b. Experience labor pain
c. Still be capable of having children
d. Not be able to bear children
e. Have decreased libido
C
19
27. In central cord syndrome, ______________.
a. Associated with congenital narrowing of the spinal canal
b. Occurs with flexion injuries of the neck
c. Sensory deficits are more severe than motor impairments
d. Motor function of the lower extremity is more affected than that of the upper extremity.
A
20
28. In a C6 lesion, the following may be expected of the client, EXCEPT:___________.
a. Bed mobility independent
b. Involves the deltoid, biceps, rhomboids, supinator and supraspinatus
c. Involves the wrist extensors, latissimus dorsi, pectoralis, serratus anterior, pronator teres and teres minor.
d. Can assist in independent transfers
B
21
30. Which objective finding is the strongest indication that a C6 spinal cord injury is not complete?
a. Intact sensation on the lateral portion of the shoulder
b. Weakness of the biceps muscle
c. Absent triceps reflex
d. Diminished sensation on the hypothenar eminence
D
22
31. What dermatome is used to test C7?
a. Middle finger
b. Forearm
c. Apex of the axilla
d. Thumb
A
23
32. Sensation in the anterolateral aspect of the thigh is innervated by what nerve?
a. Medial femoral cutaneous
b. Lateral femoral cutaneous
c. Sural
d. Saphenous
B
24
33. Sensation to the middle finger is supplied by neurologic level __________.
a. C6
b. C5
c. C7
d. C8
C
25
34. In a C5 lesion, the following may be expected of the client, EXCEPT: _____________.
a. Can give minimal to moderate assistance resulting in bed mobility dependency
b. Can assist with limited transfers due to involved musculature
c. Can propel manual wheelchair on level surfaces with the assistance of projection hand rims
d. Involves the deltoid, biceps, rhomboids, supinator and supraspinatus
B
26
35. While there are eight nerves that exit the cervical spine, there are only seven cervical vertebrae. Where does the first thoracic nerve exit?
a. Above the second thoracic vertebra
b. Below the first thoracic vertebra
c. Above the first thoracic vertebra
d. Below the second thoracic vertebra
e. Below the seventh cervical vertebra
B
27
36. Which of the following statement is NOT true of the knee joint?
a. Stability is provided by the tissues, ligaments, muscles and cartilage
b. Can sustain vertical force up to six times the body weight
c. Requires co-contraction of front and back muscles to support the body weight in the erect position
d. A trochoginglimus joint with two degrees of freedom of motionV
C
27
38. Chiasmal lesions could result in the following visual field defects EXCEPT:
a. Chiasmal lesion produces bitemporal hemianopsia
b. Lesion of the right optic tract results in right homonymous hemianopsia
c. Lesion involving both the optic nerve and the chiasm produces ipsilateral blindness
d. Transaction of the optic nerve results in ipsilateral monocular blindness
e. A temporal field defect in the other eye is a result of a lesion involving both optic nerve
B
27
37. The quadriceps muscle represents the _________ myotome.
a. L1
b. L5
c. L2
d. L3
e. L4
D
