Deck 17

Question 1

A patient presents with a six-week history of occipital headaches with associated intermittent numbness in the occipital region, and significant limitations with AROM in all planes of motion in the cervical spine. Over the last week, the patient has started to notice some reported clumsiness with gait. Which of the following diagnoses is most likely for this patient?

A. Atlas fracture
B. Cervical myelopathy
C. Vertebral basilar artery insufficiency
D. Upper cervical ligamentous instability

Answer 1

D. Upper cervical ligamentous instability

Question 2

Likely to see occipital numbness along with occipital HA, significant ROM limitations, and s/s of cervical myelopathy with this pathology

Answer 2

upper cervical ligamentous instability

Question 3

Which of the following surgical procedures is associated with a higher risk for carpal tunnel syndrome?

A. Cervical fusion
B. Hysterectomy
C. Kidney Transplant
D. Removal of thyroid

Answer 3

B. Hysterectomy

Question 4

Which of the following special tests is included as a variable in the clinical prediction rule for the diagnosis of carpal tunnel syndrome?

A. Carpal compression test
B. Phalen test
C. Tinel test for median n.
D. None of the above

Answer 4

D. None of the above

Question 5

A physical therapist knows the criteria for the clinical prediction rule for the diagnosis of carpal tunnel syndrome. However, he wants to know which of the criteria has the best sensitivity. Of the following, which has the best sensitivity?

A. Age
B. Median nerve sensation of the thumb
C. Symptom Severity Scale score greater than 1.9
D. Wrist ratio index greater than 0.67

Answer 5

D. Wrist ratio index greater than 0.67

Question 6

Wrist ratio index greater than 0.67

Sensitivity

Answer 6

93%

Question 7

A physician has diagnosed a patient with cervical myelopathy and referred her to physical therapy. The physical therapist is asking some follow-up questions and gathering his own objective findings. Which of the following findings would be most helpful for diagnosis?

A. Blood pressure greater than 160/95
B. Dizziness or light-headedness related to neck movement
C. Unexplained weight loss
D. Urinary retention

Answer 7

D. Urinary retention

Question 8

BP > 160/95 would point to these, NOT cervical myelopathy

Answer 8

inflammatory condition

systemic disease

Question 9

Corticosteroid injections have been given to a patient with severe bilateral carpal tunnel syndrome. The patient received one injection in each wrist/hand. Which is true regarding the use of corticosteroid injections for carpal tunnel syndrome?

A. Corticosteroid injections are effective for approximately one month, but symptom relief after that point is unknown
B. Oral corticosteroids are much more effective than corticosteroid injections, so the patient should have been given oral corticosteroids instead of the injections
C. The patient should receive another corticosteroid injection in each wrist/hand in six weeks because two injections have greater clinical benefit than one
D. Surgery is the only proven method of significant pain relief, so the patient should have undergone surgery instead

Answer 9

A. Corticosteroid injections are effective for approximately one month, but symptom relief after that point is unknown

Question 10

A patient who originally was thought to have carpal tunnel syndrome was correctly diagnosed as having anterior interosseous nerve entrapment. Which of the following muscles will be weak with anterior interosseous nerve entrapment, but not weak with carpal tunnel syndrome?

A. Flexor digitorum profundus
B. Flexor digitorum superficialis
C. Flexor pollicis longus
D. Pronator quadratus

Answer 10

D. Pronator quadratus

Question 11

A patient has persistent pain/numbness in the thumb, index finger, and middle finger. She reports that the pain/numbness increases with keyboarding or needlepoint, but no other activities seem to trigger her symptoms. Which of the following is most likely the issue?

A. Compression of the C6 nerve root
B. Compression of the nerve in Guyon’s canal
C. Compression of the nerve in the carpal tunnel
D. Compression of the nerve in the cubital tunnel

Answer 11

C. Compression of the nerve in the carpal tunnel

Question 12

A physical therapist is working on strengthening with a patient who tore his posterior cruciate ligament two weeks ago. It was a full-thickness tear, but he has not had a surgery for the injury. Which of the following muscles should be strengthened to assist with stability of the knee and reducing the potential for excessive posterior translation?

A. Biceps femoris
B. Popliteus
C. Quadriceps femoris
D. Semimembranosus

Answer 12

B. Popliteus

Question 13

Popliteus helps resist which forces on the tibia?

Answer 13

posterior forces

Question 14

Which of the following does not reside in the carpal tunnel?

A. FCR tendon
B. FDP tendon
C. FDS tendons
D. FPL tendon

Answer 14

A. FCR tendon

Question 15

A physical therapist is working to rule in a lateral meniscal tear. Which of the following special tests is the best at ruling in tears?

A. JL tenderness
B. McMurray test
C. Thessaly test at 5˚ flexion
D. Thessaly test at 20˚ flexion

Answer 15

A. JL tenderness

Question 16

Palpating the lateral jt line has a specificity of for ruling in meniscal tears

Answer 16

97%

Question 17

Which of the following statements is NOT true regarding the menisci of the knee?

A. The lateral meniscus attaches to the anterior cruciate ligament, the lateral collateral ligament, and the posterior cruciate ligament
B. The lateral meniscus attaches to the anterior and posterior cruciate ligaments and the popliteus, but not to the lateral collateral ligament
C. The medial meniscus attaches to the anterior cruciate ligament, the medial collateral ligament, and the posterior cruciate ligament
D. The medial meniscus has a strong capsular attachment

Answer 17

A. The lateral meniscus attaches to the anterior cruciate ligament, the lateral collateral ligament, and the posterior cruciate ligament`=

Question 18

A physical therapist assesses for a medial collateral ligament tear via the valgus stress test at 0 degrees. The patient had approximately 6–10 millimeters of separation between the femur and tibia during the test. What does this signify?

A. Abnormal
B. Nearly normal
C. Normal
D. Severely abnormal

Answer 18

A. Abnormal

Question 19

If an isolated posterolateral corner injury occurs, which of the following positions will most successfully assess the injury?

A. 0˚ knee flex
B. 30˚ knee flex
C. 60˚ knee flex
D. 90˚ knee flex

Answer 19

B. 30˚ knee flex

Question 20

For a PLC injury, maximal varus and ER will be best assessed where?

Answer 20

30˚ flex

Question 21

A physical therapist is treating a patient with a posterolateral corner injury and is measuring the difference in tibial external rotation between a patient’s injured left knee and healthy right knee. The patient has a difference of 4 degrees between the knees. What grade of injury has this patient sustained on the left knee?

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

Answer 21

A. Grade I

Question 22

A grade I PLC injury means the difference in tibial ER is

Answer 22

< 5˚

Question 23

Grade II PLC injury has difference in tibial ER of

Answer 23

5-10 deg

Question 24

Grade III PLC injury has difference in tibial ER of

Answer 24

> 10˚

Question 25

Grade IV PLC injury has difference in tibial ER of

Answer 25

trick question: there is no grade IV PLC injury

Question 26

A physical therapist is working on improving knee flexion and overall lower extremity strength in a patient who has undergone an anterior cruciate ligament reconstruction. Which intervention approach will exhibit the best outcomes with improved knee flexion and overall lower extremity strength? A. Balance and proprioceptive exercises B. Balance and proprioceptive exercises plus lower extremity strengthening C. Lower extremity strengthening only D. Range-of-motion exercises only

Answer 26

B. Balance and proprioceptive exercises plus lower extremity strengthening

Question 27

In trying to rule in subacromial impingement, which of the following special tests is most helpful? A. Painful arc B. Empty can test C. HK test D. Neer impingement test

Answer 27

B. Empty can test | higher specificity

Question 28

Patients under anesthesia who have adhesive capsulitis will exhibit range of motion that is equal to the range of motion that is present when the patient is awake in what stages of adhesive capsulitis? A. Stages 1 and 2 B. Stages 2 and 3 C. Stages 3 and 4 D. There are no two stages where patients will show similar results under anesthesia or awake in regard to range of motion.

Answer 28

B. Stages 2 and 3

Question 29

When integrating the use of manual therapy into an intervention plan for a patient with adhesive capsulitis, a physical therapist uses joint mobilization. The patient is moderately irritable, so the physical therapist is deciding what type of techniques to use. Which of the following is appropriate regarding manual therapy use with patients who exhibit moderate irritability? A. End-range techniques into tissue resistance can be integrated, but only low amplitude should be employed B. Only low-intensity techniques should be used, and there should be no movement into tissue resistance C. Techniques that progress into tissue resistance can be incorporated as long as there is not pain after the intervention D. Until the patient is in the low irritability classification, very little joint mobilization should be incorporated; instead, passive range of motion is appropriate

Answer 29

C. Techniques that progress into tissue resistance can be incorporated as long as there is not pain after the intervention

Question 30

What is currently known in regard to stretching for patients with adhesive capsulitis? A. Stretching at least two times per day will result in the most positive gains in range of motion B. Stretching beyond limits of a patient's pain can result in poor overall outcomes C. Stretching for sixty seconds with at least two repetitions per stretch will decrease pain and improve range of motion D. Stretching should only be implemented in those who exhibit low irritability

Answer 30

B. Stretching beyond limits of a patient's pain can result in poor overall outcomes