MEYER 1 Flashcards

Question

A patient comes to the clinic with an injury to the skin as a result of exposure to excessive heat. Which of the following listed below will be the first response to this type of skin injury? A. The fluids will seep into the damaged tissue B. The blood vessels will become dilated and more permeable secondary to inflammation C. Phagocytic cells will remove dead cells and debridement of the area will occur D. Blood clotting will occur

Answer 1

B. When skin is damaged by excessive exposure to heat, the first stage is inflammation. Inflammation is a response to the injury or stress in which blood vessels dilate and become more permeable.

Answer 2

B. Disadvantages of isotonic exercise: loads muscle at the weakest point, momentum factor in lifting, does not develop accuracy at functional speeds.

Answer 3

C. The frontal lobe carries out the functions of personality and speech, as well as intelligence and motor activities. Vision is the responsibility of the occipital lobe. Sensory perception and interpretation are the responsibility of the parietal lobe. Hearing and speech are the responsibility of the temporal lobe.

Answer 4

C. Spina bifida myelocele is the most severe form of spina bifida. Soft tissue contained in the meninges describes spina bifida meningocele. Soft tissue contained in the spinal cord describes spina bifida myelomeningocele. A herniated sac contained in the spinal cord describes spina bifida syringomyelocele. Spina bifida occulta is a defective closure of the laminae of the vertebral column in the lumbosacral region without hernial protrusion of the spinal cord or meninges.

Answer 5

B. The axillary nerve would most likely be injured since it is in the location of the shoulder. Some fibers of the nerve also supply the capsule of the shoulder joint. The others would not be involved since they are located distally to the shoulder.

Answer 6

A. Vision and interpretation of visual data.

Answer 7

B. Most helpful for this patient would be to teach him or her rhythmic initiation. The patient would know how to initiate movement in using trunk control for transfers. This technique would help the patient to initiate movement from supine to sit or from left to right sidelying through using the trunk to roll.

Answer 8

A. With a lesion of the lateral cord brachial plexus, you would expect to find paralysis of the biceps, coracobrachialis, and the finger flexors. Paralysis of the deltoid would most likely be a result of an axillary nerve lesion. Paralysis of the hand intrinsic would involve the medial cord of the brachial plexus.

Answer 9

A. Alveoli are the sites of gas exchange in the pulmonary system. Alveoli consist of small outpouching of walls of alveolar space through which gas exchange takes place between alveolar air and pulmonary capillary blood.

Answer 10

C. Passive range of motion will affect pulmonary ventilation depending upon the number of joints involved.

Answer 11

A. Asthma will results in episodes of dyspnea, difficulty in breathing, “air hunger,” and difficulty in expiration.

Answer 12

C. Common pressure points in the sidelying position include the ears, shoulders, ribs, greater trochanter, medial and lateral condyles, and the ankles.

Answer 13

A. Loose-packed position is when the joint is in a resting position where the joint’s range of motion is under the least amount of stress. The maximum loose-packed position for the ankle joint would be 10° plantar flexion, midway between inversion and eversion.

Answer 14

D. A disadvantage of cemented hip is that it does require more bone tissue removal. Advantages of cemented hip would be that it allows for early weightbearing, surgeons report a 90% success rate, and there is less postoperative pain.

Answer 15

C. When the elbow joint is in midposition or semiprone, the joint will have the greatest advantage for optimum force output.

Answer 16

D. The combined action of the tendinous cuff muscles (SITS) would produce depression of the head of the humerus in the joint.

Answer 17

C. For paraplegic, prolonged standing with braces in a lordotic position would result in stretching of the hip extensors and iliofemoral ligament.

Answer 18

C. The axis motion that radial and ulnar deviation lies in would be the sagittal plane through the Capitate. All the other answer are incorrect.

Answer 19

B. Tensor fasciae latae would be the muscle responsible for tightness that would result in the hip joint remaining abducted and slightly flexed when lowered to the table. The tensor fasciae latae is one of the 10 muscles of the gluteal region, arising from the outer lip of the iliac crest, the iliac spine and the deep fasciae latae (also called tensor fascia femoris). Psoas major acts to flex and laterally rotate the thigh and to flex and to laterally bend the spine. Semitendinosus functions to flex the leg and rotate it medially after flexion and to extend the thigh. Rectus femoris functions to flex the leg.

Answer 20

C. A patient with pronated feet would demonstrate eversion of the calcaneus with a medial weight line. All other answers are incorrect.

Answer 21

A. Normal expansion at the xiphoid process should measure approximately 5 to 10 cm.

Answer 22

D. The hamstring muscle is any one of three muscles at the back of the thigh: medially, the semimembranous and the semintendinosus; and laterally, the biceps femoris. The hamstring is most active during midwsing to deceleration.

Answer 23

C. Heberden’s node is an abnormal cartilaginous or bony enlargement most frequently located in the distal interphalangeal joint of a finger, usually occurring in degenerative diseases of the joints.

Answer 24

C. Iliac crest is the most likely landmark to use in palpation of the L4 region.

Answer 25

B. You would expect weakness in the motor activities of wrist flexion, finger extension and elbow extension. You would not expect weakness in finger flexion because with a C7 nerve root impingement you would expect finger flexion motor activities to be intact and not involved.

Answer 26

D. In performing ultrasound under water, the most important safety feature is to have a ground fault interruption circuit so that the patient cannot be accidentally electrocuted.

Answer 27

D. The first priority in dealing with a newly admitted burn patient is to begin wound cleaning, debridement and sterile dressing. Sterile whirlpool is used in order to promote healing, control infection, and aid in loosening necrotic tissue, and making debridement easier. Sterile towels and dressing must also be used post whirlpool. It is extremely important to maintain a faultless sterile technique so that no cross infections occur.

Answer 28

C. When administering ultrasound under water, the sound head should be placed approximately 1 inch from the area to be treated, which in this case is the medial arch of the foot.

Answer 29

A. Hip flexion would not be an emphasis in a geriatric program, as typically this is not a limited range of motion seen in that age group. All other areas would be emphasized to reduce the limitations experienced by these patients.

Answer 30

C. Tibialis anterior, peroneus tertius and extensor hallucis longus are muscles that are active during the swing phase, acceleration stage. These muscles remain active throughout the entire stage to help shorten the extremity so it can clear the ground by holding the ankle in a neutral position.

Answer 31

B. With an impacted fracture there is a bone break in which the adjacent fragmented ends of the bone are wedged together. With a displaced fracture, a traumatic bone break takes place in which two ends of a fractured bone are separated from each other. An Intraarticular fracture involves the articular surfaces of joint.

Answer 32

C. During the swing phase, deceleration stage, the hamstring muscles contract to slow down the swing phase just prior to heel strike, thus permitting the heel to strike quietly in a controlled manner.

Answer 33

B. The normal conduction pathway for muscular contraction of the heart to follow is the right atrium, to the left atrium, to the ventricles.

Answer 34

A. The sinus mode, an area of specialized heart tissue, is located in the right atrium of the heart.

Answer 35

C. Pectus carinatum is best described as a sternum that is displaced anteriorly with increasing anterior posterior diameter.

Answer 36

D. The brachioradialis is responsible for forearm pronation, supination, and elbow flexion. Therefore, if the patient has an injury in the brachioradialis muscles, those movements would now be limited.

Answer 37

B. Flexor carpi ulnaris, which functions to flex and adduct the hand, does not have dual innervation. Flexor digitorum profundus, flexor pollicis brevis, and the lumbricales all have dual innervation by the median nerve and the ulnar nerve.

Answer 38

C. The group of muscles that attaches to the ischial tuberosity are as follows: semimembranosus, biceps femoris, and semitendinosus.

Answer 39

D. With a patient who has an injury involving the tibialis muscles, you can expect to have a deep peroneal nerve involved, as that is what innervates the anterior tibialis muscle.

Answer 40

C. The biceps correspond with the C5 reflex. The brachioradialis correspond with C6. The triceps corresponds with C7.

Answer 41

C. The facial nerve is the correct answer because the patient has a diagnosis of Bell’s palsy is a condition that causes paralysis of the facial nerve.

Answer 42

D. Flexor carpi ulnaris does not assist in pronation of the radioulnar joint. Muscles active in pronation include brachioradialis, pronator teres, pronator quadratus, and flexor carpi radialis.

Answer 43

A. A characteristic that is not typically seen with an upper motor neuron lesion is muscle atrophy. A patient with an upper motor neuron lesion typically has spasticity, hyperreflexia and Babinski sign is possible.

Answer 44

B. The median nerve innervates the second and third digits of the hand. The ulnar nerve is responsible for the fourth and fifth digits.

Answer 45

B. Lactic acid build-up following exercise will cause muscle fatigue. Glycogen and glucose are fuels used for exercise.

Answer 46

D. Maximum heart rate is calculated by 220 minus age. This number can be used to help determine target heart rate at which you want the patient to exercise when it is multiplied by 60% to 90%, depending on the level of exercise desired.

Answer 47

C. It would be indicative of hypertension if blood pressure readings were above 140/90. Typically, hypertension is indicated when three different readings are all 140/90 or above.

Answer 48

A. The radial nerve, which is the largest branch of the brachial plexus, arising on each side as a continuation of the posterior cord, is the nerve that passes through the anatomical snuffbox of the wrist. Therefore, if you were evaluating a patient who might have suffered an injury to the nerve crossing the anatomical snuffbox, you would evaluate the radial nerve. The median nerve is one of the terminal branches of the brachial plexus that extends along the radial portions of the forearm and hand and supplies various muscles and the skin of these parts. The ulnar nerve is one of the terminal branches of the brachial plexus that arises on each side from the medial cord of the plexus. The musculocutaneous nerve is one of the terminal branches f the brachial plexus.

Answer 49

B. At the subtalar joint of the ankle, eversion and inversion movements take place.

Answer 50

B. The radial nerve would most likely be injured, as it is in the closest proximity to the distal radius.

Answer 51

C. The carpometacarpal joint in the thumb is unique in that it is classified as a saddle joint. A saddle joint permits no axial rotation but allows flexion, extension, adduction, and abduction. The uniaxial joint is a synovial joint in which movement is only in one axis as with a pivot or hinge joint. A hinge joint is a synovial joint providing a connection in which articular surfaces are closely molded together in a manner that permits extension motion in one place.

Answer 52

D. Origin is the proximal attachment of a limb muscle. Tendon, one of many white, glistening fibrous bands of tissue that attach muscle to bone, refers to the tendinous structure. Insertion is the distal attachment of the muscle. The belly is the belly part of the muscle.

Answer 53

A. Electromyogram helps in diagnosing neuromuscular problems by applying surface electrodes or by inserting a needle electrode in to the muscle and observing electric activity with an oscilloscope and a loudspeaker. Arthroscopy is the examination if the interior of a joint, performed by inserting a specially designed endoscope through a small incision. An EKG (electrocardiogram) is a graphic record produced by an electrocardiograph. A myelogram is an x-ray film taken after injection of a radiopaque medium into the subarachnoid space to demonstrate any distortions of the spinal cord, spinal nerve roots, and subarachnoid space.

Answer 54

B. The midbrain, one of the three parts of the brainstem and lying below the cerebrum and just above the pons, is not considered one of the three major brain regions. The three major divisions of the brain region are (1) brainstem, which is the portion of the brain comprising the medulla oblongata, the pons, and the mesencephalon; (2) cerebellum, the part of the brain located in the posterior cranial fossa behind the brainstem; (3) cerebrum, the largest and uppermost section of the brain divided by a central sulcus into the left and right cerebral hemispheres.

Answer 55

A. The Valsalva maneuver is a forced expiratory effort against a closed airway, as when an individual holds his or her breath and tightens the muscles in a strenuous effort to move heavy object or to change position in bed. In pregnancy, the Valsalva maneuver both increases pressure on the pelvic diaphragm and causes fluctuations in venous return to the heart.

Answer 56

A. The main function of erythrocytes, also known as red blood cells, is to transport oxygen in the body. Erythrocytes are biconcave discs that contain hemoglobin confined within a lipid membrane. Erythrocytes originate in the marrow of the long bones.

Answer 57

A. The stimulus for testing flexor withdrawal is applied to the sole of the foot with the lower extremity in extended position to start.

Answer 58

A. An increase in extensor tone occurs when the patient’s position is supine for the tonic labyrinthine reflex. No specific stimulus is required and the response is dependent upon patient positioning. Prone increases flexor tone, sidelying increases extensor tone, and the other sidelying limb increases flexor tone in the nonweightbearing limb.

Answer 59

C. A positive response to bouncing a patient several times on the soles of the feet but not allowing his or her to bear weight is increased flexor tone in the lower extremities.

Answer 60

C. An incorrect or untrue statement regarding a cerebral palsy child be that the child the head into a normal position. Typically, a cerebral palsy child cannot hold or bring the head into a normal position. Such children cannot support themselves. Typically, they will demonstrate a scissors gait pattern. They will usually as either spastic, ataxic, or athetoid. They may be passive or stiff and cannot adjust the body position.

Answer 61

C. A malingerer is one who pretends to be ill to arouse sympathy or who Intentionally slows recuperation from a disorder to continue to receive insurance benefits or other emotional, or social benefits from the disorder. If the physical therapist suspects the patient is a malingerer, he or she should discuss the case in a teamwork approach and notify the physician. Negligence is failure to do what another reasonable practitioner would have done under similar circumstances. A hypochondriac is a person with a chronic, abnormal concern about his or her health. Paranoid patient has a mental disorder characterized by an impaired sense of reality and persistent delusions.

Answer 62

A. Allograft is the transfer of skin between the same species. It could involve a cadaver skin. An autograft is grafted skin from the same individual. A heterograft is s graft from an animal (e.g., a pig). Z-plasty is a surgical revision of a scar or closure of a wound using a Z-shape incision to reduce contractures of the adjacent skin.

Answer 63

D. Four-point gait pattern is a slow, stable gait pattern of left crutch, right crutch, and left leg. A three-point gait involves non weight-bearing sequence. The crutch advances first, then the uninvolved leg, then the crutch. A two-point gait requires more balance. The opposite crutch and leg advance simultaneously. A swing-though is used when both lower extremities are involved and a patient swings the crutches, and then hops on one leg.

Answer 64

D. Medication is not required to be listed in an initial evaluation according to the APTA Standards of Care.

Answer 65

D. Slump test is utilizing to determine whether an impingement of the nerve root is sustained in the thoracic lumbar region. Compression test is utilized to test for neurological pathology in the cervical spine at any level. Distraction test determines the effectiveness of traction, which may be used to alleviate pain. This is a complementary test to the compression test, as it is used to obtain the reverse effect. Ely’s test checks the L2 to L4 nerve root lever for impingement or for tightness of the rectus femoris.

Answer 66

D. A vertebrobasilar artery involvement will result in loss of consciousness, as well as the patient being comatose or in a vegetative state. The patient will have no ability to speak and may have either hemiplegia or quadriplegia.

Answer 67

B. Maintaining joint mobility through exercise and stretching, heat, and postural instruction is the best treatment for a patient with Marie-Strumpell disease (also named ankylosing spondylitis).

Answer 68

D. Deep pressure test is the least important when testing a patient for peripheral vascular disease. When testing a patient for peripheral vascular disease, the following would all be appropriate: rubor test, girth measurements, volumetric measurement, reactive hyperemia, and ischemia test.

Answer 69

D. Subscapularis is not a muscle that attaches to the greater tuberosity of the humerus but to the lesser tuberosity of the humerus. Supraspinatus, infraspinatus, and teres minor attach to the greater tuberosity of the humerus.

Answer 70

B. The most appropriate treatment to begin post surgery is massage. This would be correctly performed by doing the proximal segment first. You would not change the physician’s order consultation with the physician. You would proceed with ordering a garment for the patient if necessary.

Answer 71

D. When a patient questions you regarding a procedure performed by the physician, it would be appropriate to have the patient consult with the physician. Instruct him or her that you are not able to provide that information.

Answer 72

A. Subjective data collection is the process in which data relating to the patient’s problem is elicited from the patient. A patient who states that his chief concern is limited movement or loss of range of motion in the left shoulder is stating his own perception versus something that may be evaluated by objective standards. Therefore, this information should be placed under subjective in the SOAP note format.

Answer 73

A. The typical treatment temperature for paraffin is 50 C. The conversion to Fahrenheit is as follows: Fahrenheit = (temperature is Celsius x 9/5 + 32). Therefore, temperature in Fahrenheit is 50 x 90 = 450, divided by 5, which is 90 + 32 or 122° F.

Answer 74

A. The major components of a problem of a problem-oriented medical record are subjective, objective, assessment, and plan.

Answer 75

C. A disorder characterized by the growth of cartilage in the epiphyses of the bones resulting in the limbs remaining short and is transmitted as an autosomal dominant gene, is achondroplasia. Osteogenesis imperfecta is a genetic disorder involving defective development of the connective tissue. It is inherited as an autosomal dominant trait and is characterized by abnormally brittle and fragile bones that are easily fractures with minimal trauma. Fibrous dysplasia pertains to displacement of the osseous tissue within the affected bones. Bone tumor is any abnormal growth of tissue, benign or malignant.

Answer 76

D. Fibrous dysplasia is not another name for thyrotoxicosis, as this pertains to an abnormal condition characterized by the fibrous displacement of the osseous tissue within the affected bones. Grave’s disease, as well as primary and secondary hyperthyroidism, is also called thyrotoxicosis. The condition of hyperthyroidism is typically caused by secretions of the thyroid gland, which increases the metabolism rate, causing an increased demand for food to support metabolism.

Answer 77

A. Transcutaneous electrical nerve stimulation is the only type of stimulation that the patient can utilize 24 hours a day. The patient is set up in independent use of a TENS unit to assist in alleviating pain.

Answer 78

D. Interferential current stimulation is best described as a medium-frequency current, approximately 4000 Hz, which typically utilizes four electrodes in a crossed pattern on the patient. It is primarily used for pain relief and muscular spasms. Russian stimulation involves stimulation in the midrange frequency, typically 2400 to 2500 Hz. High-volt electric stimulation is typically set up with a rate of 50 to 120 Hz per 10 to 30 minutes period for acute pain.

Answer 79

D. Evaporative coolants or spray not significant lower tissue temperature below the surface. Evaporative coolants cause a chemical reaction that produces a cool felling on the outside surface of the skin. Ice massage, cryopressure, and ice towels all decrease swelling by decreasing tissue temperature.

Answer 80

B. Gluteus medius, gluteus minimum, and tensor fasciae latae are all muscle of hip abduction and their nerve innervation is the superior gluteal nerve. Inferior gluteal nerve is innervation for gluteus maximus. Psoas major, iliacus, and sartorius innervation from the femoral nerve and the lumbar plexus. Gluteus medius, gluteus minimus, and sartorius have innervation from the superior gluteal nerve and femoral nerve. Gluteus medius, gracilis, and pectineus have innervation from the femoral nerve and superior and the superior gluteal nerve.

Answer 81

D. The femoral, obturator, and inferior gluteal nerve are the correct answer, as the hip adductor muscles consist of the pectineus, gracilis, adductor longus, adductor brevis, and adductor magnus. Their innervation includes the inferior gluteal nerve for the gluteus nerve for the adductor brevis, adductor longus, adductor magnus, and gracilis.

Answer 82

C. Iontophoresis is a modality in which chemical substances are entered into the body with a direct current to decrease inflammation. Myoflex with ultrasound, phonophoresis, and ultrasound are treatments that may decrease inflammation but are not chemical substances placed into to body with a direct current.

Answer 83

C. Hypertonia is a condition characterized by excessive tone in the limbs, which are to both active and passive movement. Flaccidity is characterized by week, soft, and flabby muscles that lack normal muscle tone. Hypotonia is characterized by less than adequate muscle contractions and a state of decreased motor neuron excitability. Rigidity is a condition of hardness, stiffness, or inflexibility.

Answer 84

B. Convection is the transfer of heat energy by combining mechanism of fluid and conduction (e.g., diathermy, paraffin). Conversion does not exist. Conduction is heat transferred from one part of the body to another through molecular collision (e.g., hot packs). Radiation is heat transferred in the form of electromagnetic waves without heating the intervening medium (e.g., warming by the sun).

Answer 85

D. Grade-five mobilization is an example of a manual therapy technique that could not be performed by a physical therapist. Typically, it is performed by a physician with a patient under anesthesia. It is a manipulation of such force that it breaks the entire joint from being frozen. Grade-five mobilization is defined as a thrusting movement done at the anatomical limits of the joint.

Answer 86

D. Saunder cervical traction device is recommended for a patient with temporomandibular joint dysfunction (TMJ). The Saunders cervical traction device does not contact the jaw, thereby reducing further aggravation of the temporomandibular joints. Conventional cervical traction methods utilize head halters that fit under the chin anteriorly and on the occipital bone posteriorly. Even when care is taken to minimize the force on the chin, there is sufficient force to cause an undesirable effect on the temporomandibular joints.

Answer 87

C. A patient with paranoid would exhibit psychotic behavior, appearing suspicious, resentful, and rigid. Hypochondria is a disorder characterized by a chronic, abnormal concern about health. Hysteria is a state of tension or excitement characterized by unmanageable fear and temporary loss of control over the motions. Depression is an emotional state characterized by feelings of sadness, despair, emptiness, and hopelessness.

Answer 88

B. A patient with depression would appear pessimistic, irritable, lack self-confidence, and have a gloomy outlook on life. A psychopath is a person who has an antisocial personality disorder. . Schizophrenia is any one of a large group of psychotic disorder characterized by a gross distortion of reality, disturbances of communication, withdrawal from social interaction, and disorganized and fragmented thought, perception, and emotional reaction.

Answer 89

D. Intermittent mechanical traction is described as intermittent traction when there is typically a hold and rest period. Autotraction utilizes a special traction bench made up of two sections that can be individually angled and rotated. The patient applies traction by pulling with his or her own arms. With gravity lumbar traction, the lower border and the circumference of the rib cage are anchored through a specially made vest secured to the top of the bed. The patient is placed on a bed that is titled vertically, putting the patient in a position in which the free weight of the legs and hips exerts a traction force on the lumbar spine by gravity. With manual traction, the therapist grasps the patient and manually applies a traction force either for a few seconds or by a sudden quick thrust.

Answer 90

C. At level C4, a patient is able only to direct pressure-relief activities. At level C5, a patient is independent in pressure relief. At level C8, a patient is independent in pressure relief including wheelchair, and push-ups.

Answer 91

B. Sacral sparing occurs when the patient has paralysis and loss of sensation except in the sacral area. Cauda equina injury involves the lower end of the spinal cord at the first lumbar vertebra and the bundle of lumbar, sacral, and coccygeal nerve roots that emerge from the spinal cord and descend through the spinal canal of the sacrum and coccyx. Central cord syndrome occurs when there is damage to the central portion of the cord and an incomplete lesion. Typically, greater deficits are found in the upper extremities than the lower extremities upon evaluation. Brown-Sequard syndrome is a traumatic neurologic disorder resulting from compression of one side of the spinal cord, typically seen after a knife-type injury. There is also an incomplete lesion, which typically results in loss of motor function on the same side as the lesion and loss of pain and temperature on the opposite side.

Answer 92

A. The minimal level a patient can have to perform self-range of motion independently is C7. At C4 and C5, a patient can only direct range of motion. At C7 and C8, a patient is independent in range of motion.

Answer 93

B. Scleroderma is a relatively rare autoimmune disease affecting the blood vessels and connective tissue. It is characterized by fibrous degeneration of the connective tissue of the skin, lungs, and internal organs. Chronic contractures are an abnormal condition of a joint, characterized by flexion and fixation. Fibrositis is an inflammation of fibrous connective tissue, usually characterized by a poorly defined set of symptoms, including pain and stiffness of the neck, shoulder, and trunk. Myositis is an inflammation of muscle tissue, usually of the voluntary muscles.

Answer 94

C. Normal alignment of a patient from the later view would be the head in neutral position with the scapula flat against the upper back, and the shoulder in neutral position with the plumb line falling through the shoulder joint. Normal alignment from the posterior view would be the head in neutral position, scapula in neutral position, and level alignment in comparison to each other, with the plumb line falling straight through the thoracic and lumbar spine.

Answer 95

B. Functional performance of the lower extremity requires that a patient have a muscle grade of fair plus.

Answer 96

D. Testing bilaterally starting with the injured side first is an incorrect method of performing manual muscle testing. When performing manual muscle testing, it is appropriate to test bilaterally starting on the noninjured side and then comparing to the injured side. All other answers listed would be important in performing manual muscle testing. The following considerations should be followed when performing manual muscle test; (1) test bilaterally starting with the noninjured side; (2) isolate the muscle you are testing, line up the origin and insertion; palpate the muscle testing for contraction; (4) stabilize the proximal part – you must know proper hand position to isolate the muscle you are testing; (5) apply the correct amount of resistance for testing strength and, to receive maximum cooperation from the patient, inform him or her of the treatment you are performing.

Answer 97

A. A muscle grade of poor is defined as production of movement only in a gravity-eliminated position. A muscle grade of trace would be no movement but palpable twitching of the muscle contraction. A muscle grade of fair would be production of movement against gravity. A muscle grade of zero would be no palpable muscle contraction.

Answer 98

A. 36 degrees is the correct temperature conversion from Fahrenheit to Celsius. This is performed by the following: Celsius = (temperature in Fahrenheit - 32) x 5/9: (98 F - 32) = 66 x 5 = 330/9 = 36 C

Answer 99

B. A patient in coma would show no voluntary movement be unresponsive to stimulus, have no reflexes, and exhibit a positive Babinski response. The aftereffect of a cerebrovascular accident depends on the location and extent of ischemia. Paralysis, weak, speech defect, aphasia, and even death may occur. Patients in a stupor would exhibit a state of lethargy and unresponsiveness in which they seem unaware of their surroundings.

Answer 100

C. Agonist is a term defined as a muscle group whose contraction is considered to be the principal agent in producing a joint motion. Antagonist is defined as a muscle group that is noncontracting and passively elongated or shortens to permit the motion to occur. Concentric refers to a shortening in the contraction. Eccentric refers to elongation of the muscle during contraction.

Answer 101

C. Inverse square law states that the intensity of radiation from a light source varies inversely to the square of the distance from the source. Clinical application means the further the infrared light, for example, is moving from the patient, the greater the decrease in intensity will be.

Answer 102

A. A patient should only be seen once a week when receiving a third-degree erythemal dosage, which can produce tissue damage.

Answer 103

A. Standard deviation of the mean plus or minus one is graded based on the score of 68% of the students.

Answer 104

D. In order to perform an ethical research study, prior to starting the research a patient sign the informed consent document. Informing the patient that he or she has the right to terminate the experiment at any time, debriefing the patient following the experiment are necessary for a study to be ethical. However, an informed consent document must be signed first.

Answer 105

C. The most appropriate exercise for a patient in early stages of rehabilitation after a nonsurgical operation would be closed-chain isokinetic exercise such as a stair machine.

Answer 106

A. Bleeding should receive the first consideration if the patient has a wound. Direct pressure should be applied to stop bleeding. With shock, body temperature will accentuate the condition of shock. The correct body position should be arranged with the head and trunk level and the lower limbs elevated. Lastly, oxygen, if available, should be administered.

Answer 107

D. The American red cross has recently recommended calling 911 (EMS) before instituting CPR, because if the adult has suffered cardiac arrest, he will need defibrillation immediately to increase his chance of survival.

Answer 108

B. The social worker should be contacted to start discharge planning in cooperation with the patient, family, and physical therapist. The physician has already given you the order for discharge so it is not necessary to contact him or her first. The home health agency can be contacted later through the social worker. The patient’s family will also be contacted by the social worker in a team approach. Therefore, the social worker would be the correct person to contact first to get the ball rolling.

Answer 109

A. Given the information provided in this question, the patient is most likely experiencing heat cramps. Heat cramps are caused by depletion of both water and salt because of heat exhaustion. They usually occur after vigorous physical exertion in an extremely hot environment or under other conditions causing profuse sweating. Heat syncope results in weakness, fatigue, and loss of motor tone. The patient typically will have blurred vision and an elevated body temperature. Heat exhaustion results in fatigue, weakness, incoordination, and elevated body temperature. With heat hyperpyrexia, the patient becomes irrational, with muscle flaccidity and involuntary limb movements as well as seizures.

Answer 110

A. Strengthening for bed mobility for a C6 quadriplegic should emphasize major. The pectoralis major. The pectoralis major serve to flex, adduct, and medially rotate the arm in the shoulder joint.

Answer 111

A. When the stimulus is flexing the head, the positive reaction will result in arm flexion and extension. If the test stimulus had been extending the patient’s head, the positive response would then have arm extension and leg positive response would then have arm extension and leg flexion.

Answer 112

C. Utilizing the Rule of Nines, an anterior arm is assigned a value of 4.5% and an anterior leg a value of 9.0%. Therefore, the correct answer would be. 13.5%.

Answer 113

C. A Knight-Taylor spinal brace is utilized for fractures above the L3 region and a rigid, high-back brace. Lumbar corsets are made form canvas or both and are not utilized with a fracture. A Taylor spine brace is a semirigid brace that is used in thoracic and lumbar spine disease. A Jewett brace is a three-point brace that prevents hyperextension.

Answer 114

B. A resting hand splint is a static splint for wrist and hands, which is typically utilized with arthritic patients. It is designed to support the hand in a functional position. A wrist cock-up splint immobilizes the wrist but allows full range of motion in MCP flexion and thumb opposition and is utilized for inflammation. A static wrist splint immobilizes the wrist for protection. An ulnar/radial gutter is designed to control deviation of the wrist.

Answer 115

B. Utilizing the Rule of Nines, the percentage of burn listed for a child’s arm is 9% and for the leg 14%, so the correct answer is 23%.

Answer 116

B. Shoulder splints are used to immobilize the shoulder to promote healing of a brachial plexus injury. They can be designed to be placed in any degree of motion that is appropriate for optimal healing. A shoulder sling is designed to support the elbow but does not rest the shoulder for brachial plexus injury. An elbow splint is used to immobilize and protect the elbow. In the case of brachial plexus injury, you want some immobilization; you do not want free active range motion constantly.

Answer 117

A. The first step in performing an educational program to a company with repetitive motion injuries is to instruct the personnel in proper warm-up and stretching exercises as a prevention technique.

Answer 118

D. Pistoning of the socket is a gait deviation as a result of poor socket fit, weak suspension, and overly soft knee friction. Lateral whip is generally caused by a knee bolt alignment that is too medial. Rotation of the foot in heel strike is usually a result of too much toe-out or resistance on the heel cushion or plantar flexion bumper. Instability of the knee is most commonly caused by a plantar flexion resistance that is too high.

Answer 119

C. The most appropriate immediate treatment for a burn patient is passive of motion in extension, as well as emphasizing position of the elbow in full extension. This is dine to prevent flexion contractures. Depending upon the extent of the burn, whirlpool may be order for debridement.

Answer 120

C. An antalgic gait results when a patient will not bear weight on the injured lower extremity. Steppage gait results in the patient lifting the knee very high to clear the foot. Foot slap occurs when the patient has a weak or absent dorsiflexor and the foot slap down on the ground. Abducted lurch occurs when the patient leans over the hip to place the center of gravity over the hip. It is a compensatory technique for a gluteus medius muscle weakness.

Answer 121

A. You should contract the patient’s family and request that they come to the hospital. It is important for the patient to have support personnel there while being instructed in transfers into and out of a vehicle. If possible, use the actual vehicle in which the patient will be transported.

Answer 122

D. To perform proper chest physical therapy on the right middle lobe, the patient should be in the left sidelying position, rotated one-half turn backward, with the bed elevated 14 inches. Pillows may be places under the right hip, and percussion should be performed on the right side at nipple level.

Answer 123

C. When treating a wound patient, the least important to note in the progress notes is the strength of the hip muscles since you are primarily focusing on the wound and rehabilitation of wound healing.

Answer 124

B. Pulmonary edema produce dull percussion sound with wheezing and cracking upon auscultation. Atelectasis will produce dull percussion sounds and decreased breath sounds with auscultation. Pneumonia will produce dull percussion sounds, decreased breath sounds, and sounds of a pleural lung. Pneumothorax will result in hyperresonance, and increased breath sounds.

Answer 125

D. A correct example is dressing and undressing. This is one of the activities of daily living that would help retrain the patient in a functional activity.

Answer 126

A. When treating a patient 3 days postoperative, it would be appropriate for the patient to have monitored ambulation with no symptoms. Lower extremity ergometry x 15 or x 30 minutes, and upper extremity ergometry x 15 minutes would be too aggressive to start on a patient 3 days cardiac surgery.

Answer 127

B. Proprioception tests the patient’s ability to determine the direct position sense. Kinesthesia tests the patient’s ability to determine movement sensation. Graphesthesia test the ability of a patient to recognize letters and numbers written on the patient’s skin. Barognosis is the ability to determine the weight of an object.

Answer 128

D. Proper body mechanics for a post cesarean patient would be to get up from a lying down position by rolling over to the side, swinging the leg over the edge, and getting up slowly. When sitting, the patient should avoid soft chairs, as they are hard to get up from and have poor back support. When standing, the patient should keep the chin in and contract the abdominal muscles. When bending over, the patient should keep a curve in the low back with one foot in front of the other.

Answer 129

B. The upper abdominal reflex test involve thoracic 8,9,10. The lower abdominal reflex test involves thoracic 10, 11, and 12.

Answer 130

A. Bell’s palsy is a paralysis of the facial nerve resulting from trauma to the nerve, compression of the nerve by a tumor, or possibly, an unknown infection. The typical treatment is electrical stimulation direct current to the motor points of the facial muscles.

Answer 131

C. Teaching proper body mechanics is a psychomotor areas that deal with motor skills. Educational contracts are usually divided into three areas. First is cognitive, which deals with the information area; second is psychomotor, which deals with the motor skills; and third is affective, which deals with feelings.

Answer 132

B. An appropriate treatment program for a pediatric patient with cystic fibrosis would include both breathing exercises and postural drainage. This would be the most aggressive form of treatment for this patient that can be performed by a licensed physical therapist.

Answer 133

B. A patient with a capsular pattern of the hip will exhibit first a decreased range of motion in flexion, then abduction, and then internal rotation.

Answer 134

A. Observation of the patient’s posture while the body is in motion is an example of a dynamic balance coordination test. Having the patient perform a finger-to-nose-finger test to evaluate the quality of movement, testing the patient’s ability to judge distance and speed of movement by drawing a circle, and evaluating the quality of movement control and speed with the patient pointing are examples of nonequilibrium coordination.

Answer 135

A. The most effective form of treatment for chondromalacia would involve performing quadriceps exercises in extension so no further degeneration of the patellar surface occur.

Answer 136

D. Light touch would be appropriate to perform on a patient to determine if the protective sensations are in place. Deep pressure, proprioception, and two-point discrimination are examples of discriminative sensations.

Answer 137

A. Typically, no specific type of physical therapy is ordered for a patient with Down’s syndrome. The diagnosis of Down’s syndrome does not indicate a specific need for physical therapy. However, a patient with Down’s syndrome may be referred if he or she has some type of orthopedic problem unrelated to the diagnosis.

Answer 138

A. Inferior glide is the correct mobilization technique to perform to increase abduction of the glenohumeral joint. Posterior glide would increase flexion and glide would increase extension.

Answer 139

C. Cerebellar artery occlusion most likely results in coordination problems as well as ataxia. A middle cerebral artery lesion would result in motor and sensory aphasia, as well as hemiplegia. A posterior cerebral artery lesion would result in loss of superficial touch and deep sensation, as well as contralateral hemiparesis. A vertebral artery lesion would result in loss of consciousness or coma.

Answer 140

A. Limb synergies are necessary to the intermediate stage of recovery and should be encouraged to assist the patient. Brunnstrom’s suggestion for therapy emphasizes eliciting motor behavior in the sequence in which is not the same a s the sequence of normal maturation.

Answer 141

C. Huntington’s chorea is a hereditary condition characterized by chronic, progressive chorea and mental deterioration. No specific physical therapy treatment is required. In planning a treatment program for this patient, it would be appropriate to contract the family and suggest family education on the patient’s condition as well as working with support personnel.

Answer 142

C. Scaphoid pads can be used to support the longitudinal arch and to assist in correction of pes planus. A Thomas heel is a heel with an extended anterior medical border used to support the longitudinal arch and correct for flexible pes valgus. Rocker bottom builds up the sole over the metatarsal heads and allows additional push-off in weak or inflexible feet. Metatarsal bars take pressure off the metatarsal heads by building up the sole proximal to the metatarsal heads.

Answer 143

B. Myositis ossificans is a rare, inherited disease in which muscle tissue is replaced by bone. It begins in childhood with stiffness in the neck and back and progresses to rigidity of the spine, trunk, and limbs. If the disease is active, then rest is the treatment of choice. However, if the disease is inactive, heat and gentle exercises may be prescribed.

Answer 144

D. Leg slides would be the least appropriate exercise to begin on day 1 post cesarean. Diaphragmatic breathing, huffing, and pelvic floor exercises would all be appropriate to start on day 1.

Answer 145

C. The low-pressure mercury vapor lamp, otherwise known as cold mercury lamp, is utilized in application against the skin to kill bacteria. The hot mercury lamp is high-pressure mercury vapor lamp used for psoriasis skin. The ultraviolet lamp is used in the control of infectious air borne bacteria and viruses, and in the treatment of psoriasis.

Answer 146

C. Schizophrenia is a psychotic disorder in which the patient often has fragmented thoughts, bizarre ideas, and becomes withdrawn. Responses are usually inappropriate and demonstrate serve mood shifts. Paranoid is a psychotic disorder in which the patient has delusions of persecution or grandiosity and is typically suspicious in all situations with all people. The Depression is characterized by a feeling of sadness or helplessness. The patient typically has little drive for activity or achievement. Psychopathy is an antisocial personality disorder characterized by behavior patterns that lack moral and ethical standards.

Answer 147

B. Capsular end-feel is characterized by hard leather-like stoppage with slight give. This will occur in full normal range of motion. Bone-to-bone end-feel is typically occurs when performing passive range of motion and the bone contracts another bone. Empty end-feel is defined by a lack of stoppage to the joint. Springy block end-feel is defined by rebound movement felt at the end-range of passive range of motion. Two other end-feels include spasm end-feel and soft tissue approximation.

Answer 148

B. Flexor carpi ulnaris is innervated by the ulnar nerve. Flexor pollicis longus, flexor digitorum superficialis, and flexor carpi radialis are innervated by the median nerve.

Answer 149

A. The best position for a joint in order to palpate the muscle would be a loose-packed position.

Answer 150

A. The dorsal scapular and long thoracic nerve originate from the rami of the plexus. The subclavian nerve originated from the trunk of the plexus. The lateral pectoral and musculocutaneous nerve originated from the lateral cord. The medial pectoral and ulnar nerves originate from the medial cord.

Answer 151

B. A left hemisphere cerebrovascular injury would result in paralysis and weakness on the left side. A cerebellar injury would result in ataxia, dysmetria, asthenia, and tremors. A brainstem injury would result in paralysis bilaterally and loss of consciousness.

Answer 152

C. Direct current is he only type of current that could be utilized to stimulate a denervated muscle. Direct current is necessary to get a response when stimulating a denervated muscle.

Answer 153

C. In performing goniometric measurement of the internal or external rotator of the shoulder, the stationary arm should be parallel or perpendicular to the midline of the floor. The movable arm will then be longitudinally with the shaft of the ulna and the styloid process. The axis for measurement is over the olecranon process

Answer 154

A. One gram of fat yields 9 calories. One gram of protein yields 4 calories. One gram of carbohydrate yields 4 calories.

Answer 155

B. In order for distraction of the bodies to occur under lumbar traction, the therapist must apply traction from 40% to 50% of the body’s weight.

Answer 156

D. Salicylate is an anti-inflammatory drug that utilizes the negative condition. Hydrocortisone, lidocaine, and magnesium are positive.

Answer 157

A. To perform an eccentric contraction, the muscle must lengthen as it develops tension. This is done through negative repetition. Another example would be lowering a weight during a hard press.

Answer 158

C. Under no circumstances is a physical therapist assistant able to provide initial evaluations on inpatients or outpatients.

Answer 159

A. Forced expiratory volume is air amount that can be forcibly inspired after maximum inspiration. Forced inspiratory volume is the amount that can be forcibly inspired after maximum inspiration. Inspiratory capacity is the maximum volume inspired from the resting expiratory level. Tidal volume is the amount of air inspired and expired during a single breath.

Answer 160

D. Resting heart rate will decrease as a result of a cardiopulmonary training program that involves aerobic exercise.

Answer 161

A. Prolonged icing is utilized for the inhibition of muscle, while quick icing facilitates muscle.

Answer 162

C. Hypermobility is a precaution but not an absolute contraindication. Active inflammation, active infection, malignancy in the area of treatment, and recent are absolute contraindications to mobilization. Precautions include joint effusion, rheumatoid arthritis, osteoarthritis, and presence of a bony block. Indications include joint dysfunction, restriction of movement, and pain.

Answer 163

D. In a prenatal care program the patient is encouraged to avoid Valsalva’s maneuver both increases pressure on the pelvic diaphragm and causes fluctuations in venous return to the heart. Kegel exercises are exercises for strengthening muscles of the pelvic floor. Activities of daily living modifications and relaxation training are al appropriate in a prenatal patient’s program.

Answer 164

B. The dermis layer is composed largely of a fibrous connective tissue that will bind the epidermis to the underlying tissues. Contained within the dermis are blood vessels and nerves. The epidermis is the outer layer of the skin. It contains striated squamous epithelium cells. The epidermis functions to protect the underlying tissue against water loss, effects of harmful chemicals, and mechanical injury. The subcutaneous tissue is composed of adipose tissue.

Answer 165

A. Crutch ambulation with toe touch weight bearing would be the most appropriate response for day 2 of a second-degree medial collateral ligament injury.

Answer 166

B. A patient with a lesion of T9 to T12 should have the functional outcomes of vital capacity 80%, be independent with floor to wheelchair transfers, perform gait with bilateral KAFO, and a walker. A patient with a lesion of T1 to T5 should have functional outcomes of vital capacity 80%, be independent in bed mobility without special equipment, and possibly be independent with bilateral KAFO and parallel bars. A patient with a lesion of L4-L5 should have functional outcomes of vital capacity 80%, be independent in bed mobility without special equipment, independent in transfers to and from the floor, and independent on all level surfaces. A patient with a lesion of T6-T8 should have functional outcomes of vital capacity 80%, be independent in bed mobility without special equipment, independent in a manual wheelchair on all level surfaces.

Answer 167

C. Partial curl-up should not be performed secondary to not wanting to create a split of the rectus abdominis muscle that may develop before delivery. Diaphragmatic breathing, pelvic floor exercise, and postural instructions would be appropriate in a treatment program.

Answer 168

A. A first-class lever is best describe when the fulcrum is located between the weight and the applied force. Examples in the body would be the atlanto-occipital joint or the action of the triceps at the olecranon. An example of a second-class lever is pull of the brachioradialis muscle and wrist extensors on elbow flexion. With a third-class lever, the weight arm is longer than the force arm, designed for producing speed or for moving a small weight over a long distance. An example of a third-class level is the deltoid or glenohumeral joint. No fourth-class lever classification exists. Definitions: Fulcrum: point of rotation Force arm: distance of the lever between the joint (fulcrum) and muscle attachment – affect force Weight: resistance arm – distance of the lever between fulcrum and weight

Answer 169

B. Intolerance to treatment as indicated by low TcPCO2 values is an absolute contraindication to vibration of a neonate. Persisted fatal circulation, increased irritability during treatment, and bradycardia are considered precautions.

Answer 170

C. Internal tibial torsion produces symptoms of the distal aspect of the tibia rotated or twisted medially as compared with its proximal end. Anteversion results in the femoral neck rotated forward. Retroversion results in the femoral neck rotated posteriorly. In genu valgum, the tibia is angled laterally, causing the knees to come together.

Answer 171

B. For accurate crutch measurement, the patient should have approximately 20o to 30o of elbow flexion. This would be considered the one best answer. In a three-point gait pattern, weight is borne on the noninvolved leg, then on both crutches, then on the noninvolved leg. Touchdown and progression to full weight bearing on the involved leg are usual.

Answer 172

C. You should explain to the judge, or any patient, that as part of the physical therapist/client relationship, it would be unethical to accept a trip, although you appreciate his generosity.

Answer 173

D. Tinel’s sign is an indication of irritability of a nerve, resulting in a distal tingling sensation on percussion of a damaged nerve. The sign is often present in carpal tunnel syndrome and is produced by tapping over the median nerve on the volar aspect of the wrist.

Answer 174

A. A Chi-square is a statistical test for an association between observed data and expected data represented by frequencies. The test yields a statement of the probability of the obtained distribution having occurred by chance alone.

Answer 175

C. Hip flexion is the least emphasized movement since most patients have adequate hip flexion and even a tendency to develop contractures. Chin tucks, pectoralis stretch, and shoulder flexion would all be areas of emphasis to maintain range of motion in a geriatric center.

Answer 176

B. When a patient is 7 to 9 months old, he or she should be able to cruise while holding onto furniture and stand and begin to walk. At 18 months, a child should be able to sit on a small chair.

MEYER 1 Flashcards

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