Midterm

Question 1

1. Why does instructor Moor recommend placing the lateral Carlson (Sabolich) Modification 1 1/2” above the apex of the lateral malleolus?
   a. Just to be different
   b. To avoid a sensory nerve that courses over the distal shaft of the fibula that can be impinged in some individuals.
   c. Because it impinges on the sciatic nerve causing paralysis of the ankle dorsiflexors
   d. All of the above
   e. b and c

Answer 1

b. To avoid a sensory nerve that courses over the distal shaft of the fibula that can be impinged in some individuals.

Question 2

What mid-foot bone may need to be relieved for a patient presenting with ERD?

a. navicular
b. Medial Malleolus
c. Cuboid
d. Plantar surface of the 1st met head
e. lateral calcaneus

Answer 2

c. Cuboid

Question 3

Which joint of the foot that primarily provides the dorsi and plantar flexion?

a. Midtarsal joint
b. subtalor joint
c. talocrual joint
d. metatarsal phalangeal
e. none of the above

Answer 3

c. talocrual

Question 4

Internal rotatory deformity includes the following:

a. calcaneal varus, mid-pronation and forefoot adduction
b. Calcaneal valgus, mid supination, and forefoot abduction
c. Calcaneal varus, mid supination and forefoot adduction
d. Calcaneal valgus, mid pronation and forefoot abduction

Answer 4

d. Calcaneal valgus, mid pronation and forefoot abduction

Question 5

True or false: 3 point forces that control forefoot adduction in UCBLs is two forces on the lateral side with one on the medial side.

Answer 5

False

Question 6

What three point force system will control genu-valgum?

Answer 6

Proxiaml lateral force pushing medially
Distal lateral force pushing medially
Lateral pushing force at the knee

Question 7

True or false: FRO AFOs are effective in controlling 15 degrees of knee flexion

Answer 7

True

Question 8

What is the defintiion of intrinsic posting?

a. change to the model by either adding or removing of material that repositions
b. Adding padding to control ERD
c. Adding material to the outside of the orthosis for control of positioning
d. Innately good

Answer 8

a. change to the model by either adding or removing of material that repositions

Question 9

True or false: A posterior extrinsic post on a solid ankle or 90 degree stop AFO can be used to limit knee hyperextension.

Answer 9

True

Question 10

True or false: a torn ACL allows the femur to slide posteriorly on the tibial plateau and can lead to damage to the meniscus

Answer 10

True

Question 11

What are/is the primary stabilizers of the knee?

a. Ligaments
b. knee orthoses
c. muscles
d. patella

Answer 11

c. Muscles

Question 12

True or false: Even thou instructor Moor does not agree, the Atlas states that the proximal trimline for a FRO terminates from the distal to mid-patella.

Answer 12

True

Question 13

According to M=FxD, what factors affect the moment at the knee in FRO AFOs?

a. Height of the anterior trimline
b. weight of the individual
c. length of the toe lever arm
d. length of the tibia
e. b and c

Answer 13

e. b and c

Question 14

When hand casting for a right IRD _______?

a. the right hand is grabbing the calcaneus and torqueing it to reduce valgus
b. the left hand is pushing the forefoot into abduction
c. the right hand is grabbing the calcaneus to torque it to reduce the valgus
d. the right hand is pushing the forefoot into adduction
e. a and d

Answer 14

a. the right hand is grabbing the calcaneus and torqueing it to reduce valgus

Question 15

True or false: To calculate the shoe heel height take the measured difference of the heel and forefoot sole thickness.

Answer 15

True

Question 16

True or false: The AFO mold is placed with the metatarsal heads at the edge of the table, blocks, of the appropriate shoes heel height, are placed under the heel, and the tibial inclination jig is aligned with the mid-sagittal line of the lower section of the mold to get the corrected position.

Answer 16

False

Question 17

True or false: Functional tone is a baseline postural tone that aligns and supports the body in a functional anti-gravity position.

Answer 17

True

Question 18

True or false: Spasticity is a hypersensitive deep tendon reflex loop.

Answer 18

True

Question 19

Spastic hemi-plegia is when____.

a. poor control of body and limbs
b. tone is exhibited on one side of the body
c. slow writhing movements
d. four limbs involved
e. two limbs involved

Answer 19

b. tone is exhibited on one side of the body

Question 20

What most likely additional complication might you see in a patient with choreoathetosis?

a. PF contractions
b. rigidity
c. ligament laxiety
d. flaccidity
e. DF contractions

Answer 20

c. ligament laxiety

Question 21

Match the disease associated with the tone below
a. choreoathetosis
b. rigidity
c. flaccidity
d. spasticity
e. hypotonus
Unregulated movement
Parkinson's
Spina Bifida
Cerebral palsy
Dance like movement

Answer 21

Unregulated movement: e. hypotonus
Parkinson's: b. rigidity
Spina Bifida: c. flaccidity
Cerebral palsy d. spasticity
Dance like movement: a. choreoathetosis

Question 22

What is the advantage of the Tardieu spasticity measuring scale over the Ashworth or modified Ashworth scale.

a. It is simpler using only a 0 to 4 scale
b. it accounts or any underlying contractions
c. It only measures fast resistance to stretch
d. it is a 0 to 3 scale with 3 showing spontaneous tone with little provocation
e. it only measures resistance to stretch

Answer 22

b. it accounts or any underlying contractions

Question 23

True or false: Usually the best design device for clonus is a spring assisted DF AFO.

Answer 23

False

Question 24

True or false: Rigidity is a bidirectional hypertonicity where the agonist and antagonist is relatively equal.

Answer 24

True

Question 25

Contraindication for the spiral AFO include: a. required total contact b. expected need for frequent adjustments (such as charcot foot) c. patients with spasticity d. all of the above e. none of the above

Answer 25

d. all of the above

Question 26

Indications for a laminated articulated FRO: a. works well for neuropathic patients due to its ease of adjustment b. is effective for knee hyperextension because its primary function is to create knee flexion moment c. works for patients with a knee flexion contraction of 25 degrees since it provides a knee extension moment d. allows for more normal gait patterns and step length by not unnecessarily blocking plantarfexion. e. none of the above

Answer 26

d. allows for more normal gait patterns and step length by not unnecessarily blocking plantarfexion.

Question 27

Advantages of plastic AFOs____: a. easy to create energy response b. plastic is easily modified for adjustments c. ease of fabrication d. all of the above e. b and c

Answer 27

e. b and c

Question 28

Why is it important to use a CROW for Dx of charcot joint? a. because it is neurologically intact b. because of concerns for circulation c. It is a progressive degenerative arthropathy which needs to be immobilized d. none of the above

Answer 28

c. It is a progressive degenerative arthropathy which needs to be immobilized

Question 29

``` CROW stand for a. a specialty orthosis for black birds b. Charcot restraint orthotic walker c. crouch restraint orthotic walker d. charcot resilient orthotic walker charcot resistant orthopedic walker ```

Answer 29

b. Charcot restraint orthotic walker

Question 30

The most important benefit for the leather closure CROW boot is ______: a. it cannot cut off circulation b. adjustability for changes in edema c. ease of donning d. all of the above e. none of the above

Answer 30

b. adjustability for changes in edema

Question 31

True or false: Advantages of having an articulated FRO is the ability to optimize alignment, with the potential of not affecting other gait parameters.

Answer 31

True

Question 32

An indication for the PTB axial loading orthosis is _____: a. Poor circulation b. knee instability c. foot fractures d. proximal tibia fx e. cosmesis

Answer 32

c. foot fractures

Question 33

True or false: The corset styled axial loading AFO has a benefit of breathability, but one needs to be aware of circulation issues due to the total circumferential loading to soft tissue.

Answer 33

True

Question 34

The purpose of CROW boots include______ a. protect limb from further fractures b. immobilize joints to allow healing c. can accomodate for ulcerations d. rocker bottom replaces immobilized joints and reduces force on the limb e. all of the above

Answer 34

e. all of the above

Question 35

Foot slap is ______ a. weak PF muscles b. Seen in terminal stance c. weak DF muscles d. seen in midstance e. c and d

Answer 35

c. weak DF muscles

Question 36

True of false: Drop foot in terminal stance can be caused by weak dorsi flexors.

Answer 36

false

Question 37

If a patient is walking on their toes it could be an indication of _____ a. PF contraction b. flaccidity c. DF contraction d. Spasticity e. a and d

Answer 37

e. a and d

Question 38

If a patient is walking with little hip or knee flexion, it could indicate _______ a. extensor synergy b. flexor synergy c. a need for a FRO to reduce knee flexion if it is less than 20 degrees d. weak DF e. b and c

Answer 38

a. extensor synergy