L2: Physical Examination Flashcards
(116 cards)
1
Q
______ is an increase in physical size and dimensions relative to maturity
A
Growth
2
Q
TRUE OR FALSE: When a patient suffers from any pediatric conditions, the growth is impeded.
A
False
This contradicts the Maturationist theory wherein pediatric development is defined as something that is natural and automatic.
3
Q
Which of the following has the FASTEST growth in infancy?
A. head
B. trunk
C. extremity
A
A & B
4
Q
Which of the following has the FASTEST growth in a 1 y/o child?
A. head
B. trunk
C. extremity
A
C. extremity
5
Q
Which of the following has the FASTEST growth in adolescence?
A. head
B. trunk
C. extremity
A
B. trunk
6
Q
Which of the following has the FASTEST growth in puberty?
A. head
B. trunk
C. extremity
A
C. extremity
7
Q
Arrange the following objective examination in its correct sequence.
I. Behavior
II. Psychosocial
III. Postural analysis
IV. Reflexes
V. Palpation
A
V-I-III-IV-II
NOTE: This is not the exact arrangement of the objective examination. Kindy review the sequence in totality.
8
Q
Arrange the following objective examination in its correct sequence.
I. ADLs
II. Gross motor skills
III. Vital signs
IV. Sensory-perceptual skills
V. Special tests
A
III-IV-V-II-I
NOTE: This is not the exact arrangement of the objective examination. Kindy review the sequence in totality.
9
Q
Arrange the following objective examination in its correct sequence.
I. Ocular inspection
II. Sensorimotor skills
III. Palpation
IV. Gait analysis
V. Anthropometric measurements
A
I-III-II-V-IV
NOTE: This is not the exact arrangement of the objective examination. Kindy review the sequence in totality.
10
Q
What is the average head circumference of a pediatric patient at birth?
A
34-35cm
11
Q
Anterior fontanelles closes at _____
A
18 months
12
Q
At approximately what age do you start taking BP?
A
3 y/o
Source: Quizlet
13
Q
SCENARIO: A PT evaluates a child with cerebral palsy. In sitting, PT fully supports the child from behind, then slowly widens the space between the child and herself by leaning back. The PT notices that the head falls back with the PT’s body. PT lifts it back, but the patients head falls back again. Document the finding.
A
O: Gross Motor Skills> Poor Head Control in sitting
14
Q
SCENARIO: A PT evaluates a child with cerebral palsy. In prone, the child was able to lift and maintain the head in an extended position when trying to look from above. Document the finding.
A
O: Gross Motor Skills > Good Head Control
15
Q
SCENARIO: A PT evaluates a 1y/o child with cerebral palsy. In sitting, the child requires maximal support to maintain balance. Document the finding.
A
O: Gross Motor Skills > (-) Static Sitting Balance
16
Q
SCENARIO: A PT evaluates a 1y/o child with cerebral palsy. When trying to pulling the child into a sitting position, you noticed that the child was unable to lift their head. So, the PT lifts the child’s head, and he was able to maintain the position. Document the finding.
A
O: Gross Motor Skill > Fair Head Control
17
Q
What is the normal duration for activity tolerance, whether in sitting, standing, or other positions?
A
> 45 minutes
Note: This is not the standard quantifies. However, it is used a guide.
18
Q
TRUE OR FALSE: Spasticity is under Palpation in the objective assessment.
A
False. In pediatrics, it will be under sensorimotor skills
19
Q
______ is the ability to hold that body part upright against gravity (head, trunk, pelvis)
A
Control
20
Q
TRUE OR FALSE: There is no standardized approach to the examination of the pediatric patient.
A
True
It should be tailored to the age and developmental level of the child
21
Q
Optimum position for measuring height in pedia pts
A
Supine (from vertex to medial malleolus)
22
Q
What alternative way may a PT measure the height of a child in cases of a severe LE deformity?
A
90 SH abduction with elbow extended (measured from tip to tip of 3rd finger)
23
Q
_____ is defined as the onset of puberty in girls younger than 8 years and boys younger than 9 years of age.
A
Precocious puberty
24
Q
scenario: A PT start mx with a 1 y/o child with cerebral palsy. PT tries to carry the child in her shoulder, but the child face away and hugs his mother tightly. Document the finding.
A
O: Behavior > (+) separation anxiety
25
Scenario: A 6 y/o child was sent for PT Eval and Mx. PT gives the child a puzzle to be done for 5 minutes. In less than a minute, the child throws a tantrum due to task difficulty. Document the finding.
O: Behavior> Poor Frustration Tolerance
Note: 0-60 seconds (1 minute) is 25% of the task duration.
26
Modified MMT for Children Grading.
Against Gravity
3
27
Modified MMT for Children Grading.
Trace
1
28
Modified MMT for Children Grading.
With Resistance
4
29
Modified MMT for Children Grading.
No movement
0
30
Modified MMT for Children Grading.
Gravity Eliminated
2
31
Modified Ahsworth Scale of Muscle Spasticity
Affected part is rigid in flexion/extension
4
32
Modified Ashworth Scale of Muscle Spasticity.
Slight increase in muscle tone, manifested by a catch, followed by minimal resistance in less than half of the ROM
1+
33
Modified Ahsworth Scale of Muscle Spasticity
Considerable increase in muscle tone, passive movement difficult
3
34
Modified Ahsworth Scale of Muscle Spasticity
Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the ROM
1
35
Modified Ahsworth Scale of Muscle Spasticity.
No increase in tone
0
36
Modified Ahsworth Scale of Muscle Spasticity
More marked increase in muscle tone through the most of the ROM but affected part is easily moved
2
37
TRUE OR FALSE: A resting heart rate of 190bpm is normal for a newborn baby. A resting heart rate of 140bpm is normal for a 3/yo child.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
C. Only the 1st statement is true
NV newborn: 70-190bpm
NV 3y/o: 80-125bpm
38
TRUE OR FALSE: A RR of 17 is normal for a 10 y/o child. A RR of 17 is normal for a 16 y/o child.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
NV 10y/o: 16-22cpm
NV 16y/o: 15-20cpm
39
What is the normal pulse rate range for 10y/o children?
70-110
40
What is the normal temperature range for 10y/o children?
36.4-37
41
What is the normal blood pressure range for 10y/o children?
90/55 to 120/84
42
What is the most important objective assessment?
Play Behavior
43
What is the healthy attention span?
1 hour and 30 minutes
44
TRUE OR FALSE: ROM assessment is done similar to how a PT performs this on an adult.
True
45
Newborn c large head, prominent abdomen, and short trunk and extremities
A. Normal
B. Abnormal
A. Normal
46
A 3y/o c VS of 35 cpm.
A. Normal
B. Abnormal
B. Abnormal
NV for 3y/o: 20-30
NOTE: Do NOT use the word "abnormal" when dealing with patients. The term was solely used to inform that there is a delay or deviation in the standard growth development.
47
A 8-month old child who has good pelvic control in standing
A. Normal
B. Abnormal
A. Normal
NOTE: Having an early achieved developmental milestone does NOT mean that a child grew problematically.
48
An infant is usually very tolerant of
gentle physical handling by a stranger until about _____ of age, when stranger anxiety develops.
9 months
49
TRUE OR FALSE: In myopathies and collagen diseases, cardiac auscultation should be performed because of the possibility of associated heart disease.
True
Source: Molnar 4th ed.
50
SCENARIO: A PT prompted the child to reach for toys using both hands sideway to the right in supine. The child needs the PT to push on the px’s shoulders to complete the task. Upon pushing, the PT notes that the child is “heavy” and doesn’t seem to follow even if it is evident that the child wants the toy.
Document the finding.
O:> FA> (2) rolling supine → ® sidelying c +1 assist on
shoulders
51
SCENARIO: Though with gait deviations, a child with CP is observed to walk independently inside the facility. However, the father reports that the child uses walker for school.
Document the finding.
O:> FA> GMFCS II
52
SCENARIO: A PT wants to know a patient’s skills. When PT positioned the child in sitting, the PT needs to position the child’s head upright and notes that the child can do this without external support for almost 10 minutes. However, when the child was pushed forward, the child’s head bent and lagged forward.
Document the finding.
O:> GMS> F head control in sitting
53
SCENARIO:A child was able to look for a toy using head while sitting without falling. However, when the child tries to reach for toys beyond arm’s length, the child falls.
Document the finding.
O:> GMS> F dynamic sitting balance
54
SCENARIO: A 5-year old child diagnosed with CP Spastic (L) hemiplegia was instructed to reach overhead for toy fruits using his (L)
UE. The PT decides to do the task in supine and in sitting. The PT notes that the child is able to do the task both in sitting and in supine. How do you document the finding?
O:> Sensorimotor Skills>FMT>(+) voluntary movements
○ (L) UE: able to reach for toys overhead in sitting & supine
55
SCENARIO: A 2-year old child was diagnosed to have CP Spastic Quadriplegia. The PT notes that the elbow is fully bent and tried to straighten the px’s elbow quickly then slowly. In quickly straightening the elbow, the PT only felt resistance on the last 10 degrees of extension. However, when the PT slowly straightened the elbow from a fully bent position, the PT notes that it is easier to move the limb. The PT does the same on the other limb and observed the same results. How do you document the findings?
O:> Sensorimotor Skills> Tone Assessment> (+) grade 1 spasticity on (B) UE (sing Modified Ashworth Scale)
56
SCENARIO: A child was instructed to walk over small toy soldiers for 10 meters. The PT notes that the child has difficulty in walking and on the 2nd meter, the child cried and displayed tantrums and doesn’t want to continue with the task even when promised with rewards. How do you document this?
O:> Behavior> P frustration tolerance
57
TRUE OR FALSE: A child triples his initial weight by 5 months. Afterwards, there is an additional 2kg of weight annually.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
D. Only the 2nd statement is true
NOTE: tripling of initial weight happens at 12 months. Afterwards, there is an additional 2kg of weight annually.
58
How many grams do a baby normally have upon birth?
3400 gm
59
TRUE OR FALSE: A baby's weight double his initial wt after 5 months.
True
60
1. new born c 35cm head circumference
2. 21 month baby c 75 cm height
3. 4 month old baby who has 40cm head circumference
A. Normal
B. Abnormal
1. A
2. A
3. A
NOTE: As long as there is no 2 standard deviations from normal length, height, or circumference, it will be considered as normal.
Do NOT use the word "abnormal" when dealing with patients. The term was solely used to inform that there is a delay or deviation in the standard growth development.
61
1. 6 y/o child who grows 5cm annually
2. 12 month old baby who has 53cm head circumference
3. 16 y/o child who grows 5 cm annually
A. Normal
B. Abnormal
1. A
2. B
3. A
NOTE: Early school age is between 6-12 and they grow ~5cm annually.
REMINDER: Do NOT use the word "abnormal" when dealing with patients. The term was solely used to inform that there is a delay or deviation in the standard growth development.
62
1. Newborn c 20 cm height
2. 4 y/o c 100 cm height
3. Mature child c 57cm head circumference
A. Normal
B. Abnormal
1. B
2. A
3. A
NOTE: Do NOT use the word "abnormal" when dealing with patients. The term was solely used to inform that there is a delay or deviation in the standard growth development.
63
Enumerate the assessments done in the sub heading of "visual" in sensoriperceptual skills.
1. threat
2. tracking
3. localization
64
Enumerate the assessments done in the sub heading of "tactile" in sensoriperceptual skills.
1. light touch
2. pain
3. pressure
65
TRUE OR FALSE: Only localization of sound is tested in pediatric patients for its subheading in sensoriperceptual skills.
True
66
Functional Balance Grading
Able to maintain balance without support; accept maximal challenge & can weigh shift in all directions
Normal (N)
67
Functional Balance Grading
Requires maximal support to maintain balance
Zero (0)
68
Functional Balance Grading
Able to maintain balance s support; can’t
tolerate challenge & maintain balance while
shifting weight
Fair (F)
69
Functional Balance Grading
Able to main balance s support; accepts mod
challenge & can shift weight, although
limitations are evident
Good (G)
70
Functional Balance Grading
Requires support to maintain balance
Poor (P)
71
EVALUATION OF MOBILITY AND TRANSFERS. Give the grading of the following findings.
1. Moderate assistance required
2. Supervision
3. Complete independence
1. 3
2. 5
3. 7
72
EVALUATION OF MOBILITY AND TRANSFERS. Give the grading of the following findings.
1. Modified independence
2. Total assistance required
3. Minimum assistance required
4. Maximum assistance required
1. 6
2. 1
3. 4
4. 2
73
UE Gross Motor Function Classification System.
1. Starting with the arms at the sides, the patient can abduct the arms in full circle
2. Cannot raise the hand above the head but can only raise an 8 oz glass of water
3. Can raise hand to mouth but not an 8 oz glass of water
1. 1
2. 3
3. 4
74
UE Gross Motor Function Classification System.
1. Cannot raise hand to mouth but can hold a pen or pick-up pennies
2. Can raise the arms above the head only by flexing the elbow
3. Cannot raise hand to mouth and has no useful hand function
1. 5
2. 2
3. 6
75
LE Gross Motor Function Classification System.
1. Walks and climbs stairs without assistance
2. Walks in long leg brace but requires assistance for balance
3. Walks unassisted but cannot rise from chair or climb stairs
1. 1
2. 7
3. 5
76
LE Gross Motor Function Classification System.
1. Walks and climbs stairs with aid of railing
2. Stands in long leg brace but unable to walk with assistance
1. 2
2. 8
77
LE Gross Motor Function Classification System.
1. Walks only with assistance or walk indep with brace
2. Wheel-chair borne
3. Walks and climbs stairs slowly with aid of railing
1. 6
2. 9
3. 3
78
LE Gross Motor Function Classification System.
1. Confined to bed
2. Walks unassisted and raise from chair but can't climbs stairs
1. 10
2. 4
79
TRUE OR FALSE: Ortolani test is done first before Barlow's.
False
Dislocate then relocate
80
What procedure/ movement is done during Ortolani's sign?
Pt flexes, abducts, and externally rotates hip.
81
What procedure/ movement is done during Barlow's Maneuver?
1. PT brings hip into abduction while middle finger applies a forward pressure behind the greater trochanter
2. PT then uses thumb to apply pressure backward and outward on inner thigh
82
Barlow's sign will be considered as positive when?
(+) if click, clunk, or jerk over femoral head is felt as it slips forward in the first step, hip was dislocated
(+) if femoral head slips out over posterior lip of acetabulum ins step 2, and reduces again when pressure is removed, hip is unstable or dislocatable
83
What procedure/ movement is done during Allis Test?
1. PT flexes pt’s hips and knee while both feet remain in contact with examining table
NOTE: Allis test is also known as Galeazzi Test/ Sign
84
Ortolani's sign will be considered as positive when?
1. resistance is felt in 1st 30º-40º abduction and a click is felt in the hip as the dislocated femoral head is reduced.
OR
2. if click, clunk, jerk; indicates hip has reduced
85
When will Galeazzi's sign be considered positive and what does it indicate?
(+) if one knee is higher than the other
Indicates: femoral shortening as in congenital hip dislocation; or tibial shortening
86
What procedure/ movement is done during Dupuytren’s Test?
1. PT flexes the knee and hip to 90º
2. Femur is pushed down onto examining table
3. Then, femur and leg are lifted up and away from the table
Note: this is also known as telescoping or piston test
87
Dupuytren’s Test will be considered as positive when?
(+) if a lot of relative movement occurs
NOTE: this indicates a dislocated hip
88
Prone hip extension test, also known as staheli test evaluate for what?
hip flexion contracture
Source: OrthoFixar
89
_____ is commonly used to identify isolated gastrocnemius contracture associated with several foot and ankle pathologies. It differentiates gastrocnemius tightness from an achilles tendon contracture by evaluating ankle dorsiflexion with the knee extended and then flexed
Silfverskiöld test
Source: Physiopedia
90
To measure the head circumference of a child, which anatomical landmarks must be used?
1. glabella
2. supraorbital ridges
3. occipital protuberance posteriorly
91
If the child weighs below what is expected on its ideal body weight according to age, what will be this documented as?
O: OI > P/N Body Built
92
If a child is near the borderline of the acceptable body weight, what will be this documented as?
O: OI > F/N Body Built
93
What alternative method is used for crutch height measurement?
ask the pt to abduct SH to 90 degrees with elbow flexed to one side, while the other side is in 90 degrees SH abduction with elbow extended. From here, measure from the tip of olecranon process to the third finger.
94
If a child is classified between the spectrum of its normal age based from his weight, what will be this documented as?
O: OI > W/N Body Built
95
Scenario: A PT observed that a pt drools whenever her head is in a flexed position. Other than that, there is no evident drooling in different head positions. Document this finding.
O: OI > (+) Mild Drooling during cervical flexion (may also add quantifier)
96
When a child drools in all head directions, what will this be documented as?
O: OI > (+) Profuse Drooling on all directions
97
When a child drools in 2 head positions. This is during chin to chest and ear to shoulder movements. What will this be documented as?
O: OI > (+) Moderate Drooling on cervical flexion and lateral flexion
98
The ____ is expected to fuse by 1⁄2 month
Posterior fontanelle
NOTE: Other sources say around 1-2months
99
Identify the grading of poor, fair, and good concentration span.
Poor – unable to return to task even with prompting
Fair – able to return with prompting
Good – not distracted or can easily return to task without prompting
100
TRUE OR FALSE: The normal attention span for a 18 month-old baby is around 1 minute. For a 2 y/o, is is about 2 minutes
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
C. Only the 1st statement is true
2-3 y/o= 3 minutes
101
TRUE OR FALSE: Attention span is the amount of time a patient can sustain an activity. A 10y/o child must have 45-60 minutes of attention span.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
102
This is referred to as a purely extended
posture.
opisthotonus
103
What is the normal range of temperature for a 3y/o child?
36.9-37.5
104
What is the normal range of blood pressure for a 3 y/o child?
78/46-114/78
105
What is the normal range of pulse rate for a 16 y/o child?
55-100
106
36.4-37.1 is the normal range of temperature for a 16 y/o child. 90/70-120/100 is the normal range of blood pressure for a 16 y/o child.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
C. Only the 1st statement is true
NV: 104/60-120-84
107
37-37.6 is the normal range of temperature for a newborn child. 25-50 is the normal range of RR for a newborn child.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
108
TRUE OR FALSE: A BP of 50/25-52/30 is normal for a newborn baby.
True
109
TRUE OR FALSE: A bald spot or area of short, thinning hair over the anterior skull is a sign of weak neck muscles, most likely associated with generalized weakness.
False
This is seen in the posterior skull
110
TRUE OR FALSE: New born infants have a prominent abdomen. They also have a head that is relatively larger
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
111
TRUE OR FALSE: A PT may know that a child is attentive when it reacts to an auditory stimulus. A PT may know that a toddler is attentive when he responds to calls of his name.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
A. Both statements are true
112
A full-term infant has a full ROM upon birth. Conversely, a preterm infant tends to lack as much as 25° of elbow extension and 30° of hip extension.
A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true
B. Both statements are false
Interchanged. Pre-term babies have full ROM due to lower muscle tone.
113
The following positions may test trunk control, EXCEPT:
A. supine
B. prone
C. sitting
D. rolling over
E. NONE
A. supine
114
The following positions may test pelvic control, EXCEPT:
A. prone
B. standing
C. kneeling
D. quadruped
E. NONE
A. prone
115
The following positions may test balance and tolerance control, EXCEPT:
A. sitting
B. standing
C. kneeling
D. quadruped
E. NONE
D. quadruped
116
Enumerate the time range of poor, fair, and good tolerance grading.
Poor (P): <15 mins
Fair (F):16 - 30 mins
Good (G): 31 - 45 mins
