Variadas 11 Flashcards
(50 cards)
A patient exhibits pain and sensory loss in the posterior leg, calf and dorsal foot.
Extension of the hallux is poor, however the Achilles reflex is normal. What spinal level would you expect to be involved?
A. L4
B. L5
C. S1
D. S2
B
The Achilles reflex originates in the S1 and S2 nerve root
A patient scheduled for total hip replacement surgery is referred to physical therapy for. preoperative instruction. All of the following should be incorporated into the preoperative session except?
A. deep breathing and coughing exercises
B. gait training with an appropriate assistive device
C. basic precautions for eary bed mobility
D. proper use of an adduction pillow
D
A 26 year old male involved in a motorcycle accident sustains a T10 vertebral fracture.
The patient’s physician attempts to restrict forward thoracic flexion by using an externally applied device. Which of the following would be the most appropriate selection?
A. Minerva cervical thoracic orthosis
B. Philadelphia collar
C.stemal-occipital-mandibular immobilizer
D. thoracolumbar-sacral-orthosis
D
A therapist evaluates a patient diagnosed with an Achilles tendon injury. Which clinical finding is not indicative of a ruptured Achilles tendon?
A. negative Thompson test
B. absent Achilles reflex
C. lack of toe off during gait
D. a palpable defect in the musculotendinous unit
A
A physical therapist evaluates a patient’s hip range of motion. Which patter of limitation is typically considered to be a capsular pattern?
A. gross limitation of flexion, abduction and intemal rotation
B. gross limitation of flexion, adduction and external rotation
C. gross limitation of extension, abduction and extemal rotation
D. gross limitation of extension, adduction and internal rotation
A
A therapist provides exercise guidelines for a group of expectant mothers. Relative contraindications for exercise during pregnancy include all of the following except
A.diabetes
В.thyroid disease
C. history of precipitous labor
D. mild hypotension
D
A patient diagnosed with pure athetoid cerebral palsy would most likely demonstrate
A. disturbed sense of balance and faulty depth perception
B. hypertonicity, contractures and clonus
C. slow involuntary uncontrolled movements
D. severe intention tremor
C
A physical therapist instructs a patient to move her lower teeth forward in relation to the upper teeth. This motion is termed
A. protrusion
B. retrusion
C. lateral deviation
D. occlusal position
A
A CVA patient positioned in supine with legs flexed and arms clasped around his knees gently rocks back and forth. Expected therapeutic outcomes include all of the following except
A. decreased extensor spasticity in the lower extremities
В.inhibition of flexor spasticity in the upper extremities
C. protraction of the scapula
D. facilitation of extensor tone in the trunk
D
- What muscle controls the posilion of the ankle joint at heel strike?
A. eccentric contraction of the anterior tibialis
B. eccentric contraction of the gastroc-soleus
C. concentric contraction of the anterior tibialis
D. concentric contraction of the gastroc-soleus
A
Proper technique is essential when mobilizing a joint. Which of the following statements about mobilization is not true?
A. one joint at a time is moved in one direction
B. a joint is mobilized in the closed packed position
С.commence with grade | distraction when possible
D. the patient and the extremity to be treated should be placed in a comfortable position
B
The most appropriate goal when treating a patient receiving workers’ compensation
is
A. requiring attendance at scheduled physical therapy sessions
B.maintaining a formal patient/herapist relationship
C.attempting to satisfy the needs of the insurance provider
D. building confidence in the patient’s physical capabilities and control over the future
D
A 25 y.o male arrived at an outpatient clinic with chief complaints of R hip and medial knee pain. He denies any traumatic incident or episode leading to his pain and is not certain of how his pain began.
Q1) The physiotherapist performed a thorough evaluation and noticed that the pain in the hip is contributed from R groin. The therapist is very knowledgeable of nerves distributed to skin particularly over the medial femoral triangle. Which of the following nerves is MOST likely associated with the scenario?
A) Genitofemoral
B) Subcostal
C) Ilio-inguinal
D) Lateral cutaneous nerve of thigh
Answer is C
Ilio-inguinal nerve as it supplies skin over medial femoral triangle.
Genitofemoral supplies skin over the lateral part of the femoral triangle and also supplies anterior labia majora.
Subcostal nerve supplies skin at the hip region inferior to anterior part of iliac crest and anterior to greater trochanter.
Lateral cutaneous nerve of thigh supplies skin on anterior and lateral aspects of thigh.
A 25 y.o male arrived at an outpatient clinic with chief complaints of R hip and medial knee pain. He denies any traumatic incident or episode leading to his pain and is not certain of how his pain began.
Q2) Upon further assessment, the physiotherapist performed a 90-90 SLR test on R LE as the test was positive. The therapist assesses a patient’s gait on level surfaces and suspects possible deviation.
Which of the following is TRUE regarding this patient’s deviation?
A) Decrease step length on left side
B) Increase step length on right side as test result was negative
C) Increase stride length as test result was negative
D) Decrease step length on right side
Answer is D
Rationale:
decrease step length on the right side as the biceps femoris long head, semitendinosus and semimembranosus are exhibiting muscular tightness (90-90 deg SLR test) and acts as a hip extensor.
This would also affect the runner stride length in terms of decreasing the step length and also decrease his speed.
A basketball player presents to the physiotherapist after sustaining an injury. The ankle was forced into inversion while plantar flexed upon landing on a teammate’s foot after a spike at the basketball.
Based on the history mentioned above about the athlete, which ligament is most likely injured?
A. Calcaneofibular
B. Anterior talofibular
C. Anterior tibiofibular
D. Tibio-calcaneal
B
Iversion + pf
A basketball player presents to the physiotherapist after sustaining an injury. The ankle was forced into inversion while plantar flexed upon landing on a teammate’s foot after a spike at the basketball.
You have been asked to tape the ankle prophylactically before a basketball game to prevent ankle sprain. In what position should the ankle be slightly positioned in before taping to provide the most protection?
A. Inversion, plantarflexion, adduction
B. Eversion, dorsiflexion, abduction
C. Eversion, plantarflexion, adduction
D. Inversion, dorsiflexion, abduction
B
Tape in the opposite direction from the mechanism of injury
A 32-year-old male patient arrived at an outpatient clinic with R heel pain during activity. Upon, examination, the Physiotherapist noted the patient’s calcaneus is moving into eversion after heel strike. The PT would like to provide an orthotic that could help relieve pain. Which of the following orthotic would most likely benefit this patient?
A.Cushion heel
В.Rearfoot Varus post (medial wedge)
C.Rearfoot Valgus post (lateral wedge)
D. Forefoot (lateral wedge)
B
) A patient presents with pain in the right ankle which started after the patient tripped while playing football. During assessment, which type of end feel is to be expected with left ankle dorsiflexion in absence of any pathological finding?
A. Soft tissue approximation
B. Tissue stretch
C. Bone-to-bone
D. Empty
B
The PT then performs the following test: “Squeezing the calf in prone position” on a patient and notes that there is no response. PT can move the ankle in ROM passively. Which of the following is the most appropriate conclusion based on this finding?
A. Normal finding. All ligaments and tendons intact
B. 1st degree strain of tibiofibular ligament
C. 3rd degree strain of the Achilles tendon
D. Excessive tightness of the soleus muscle
C
Normal response: ankle goes to PF
Test is positive for achilles tendon strain in there is no movement with the test
You are examining a patient’s knee and observe the following findings: tenderness along the facets of the patella; crepitus with knee flexion; an alteration in the Q-angle; pain with squatting. Which of the following would likely be your provisional diagnosis?
A. Patellofemoral syndrome
B. Osteoarthritis of the tibia femoral joint
C. Osgood-Schlatter’s disease
D. Adaptive shortening of the iliotibial band
A
A 30 y.o. a female, who is a lab assistant by occupation, presents with a history of lower back pain and occasional neck pain since the last few months. She mentions having a h/o lesion to her dorsal scapular nerve in the past.
Q1) Which of the following muscles will the therapist NOT expect to be affected?
A) Levator Scapulae
B) Rhomboid major
C) Teres minor
D) Rhomboid minor
C
The dorsal scapular nerve supplies the Levator scapulae
Rhomboid major and minor;
Teres minor is supplied by the axillary nerve.
A 30 y.o. a female, who is a lab assistant by occupation, presents with a history of lower back pain and occasional neck pain since the last few months. She mentions having a h/o lesion to her dorsal scapular nerve in the past.
On evaluation the physiotherapist documents the presence of lordotic posture.
Which of the following statements would be MOST APPROPRIATE regarding postural deformities?
A) Short and strong lumbar erector spinae, upper trapezius with weak and elongated upper erector spinae and anterior abdominals
B) Short and strong upper erector spinae, hip flexors with elongated and weak lumbar erector spinae and middle and lower trapezius
C) Short and strong pectoralis major and minor and hip flexors with weak and elongated upper trapezius and lumbar erector spinae
D) Short and strong hip flexors and lower and middle trapezius with elongated and weak anterior abdominals and pectoralis major
A
With lordotic posture:Weak and elongated- Anterior abdominals, small muscles of lumbar spine (multifidus, rotators), lower and middle trapezius. upper (thoracic and cervical) erector spinae, hyoid muscles
Muscles commonly short and strong-Lumbar erector spine, hip flexors, upper trapezius, pectoralis major and minor, levator scapulae, sternocleidomastoid, scalenes, suboccipital muscles
A PT has recently started training a 40 year old male with right hemiplegia for sit to stand transfers.
Which of the following strategies does not generate forward momentum and needs to be discouraged?
A)Pushing-off with both hands on the support surface.
B)Moving shoulders forward by clasping hands with elbows extended.
C)Flexing the trunk to shift the weight forward.
D)Placing the feet well behind to generate forward momentum.
A
A patient with stroke typically demonstrates decreased forward movement and momentum. Focus should be laid on using strategies to generate forward momentum.
Pushing off with both hands on support surface is not effective in forward weight shift and should be discouraged.
Flexion at the trunk shifts the body mass forward.
Placing feet behind allows dorsiflexors to assist forward rotation.
Moving shoulders forward with clasped hands helps in forward weight shift to stand up.
A physical therapist is evaluating a patient with burn injuries on the right upper body. The skin on her forearm is reddish-white with presence of blanching and slow capillary refill. There are several broken blisters and the skin surface is wet.
On sensory testing, the patient is found to be sensitive to pressure, however she is insensitive to light touch and soft pinprick.
There is marked edema throughout the extremity.
The Physical Therapist should document this type burn as a:
A)Deep partial thickness
B)Subdermal
C)Superficial partial thickness
D)Epidermal
A
The patient presentation is suggestive of a deep partial thickness burn. With deep partial thickness burn, the skin appears waxy white with broken blisters. Deep partial thickness burns are sensitive to pressure but insensitive to light touch and there will be marked edema with a slow capillary refill.
Subdermal burns look charred in appearance. It will be evident that subcutaneous tissue is involved with muscle damage and neurological involvement.
Incorrect: Superficial partial thickness wounds appear bright pink or red with blanching and brisk capillary refill is present. The blisters are intact and the wound is typically moist. The wound will be sensitive to change in temperature and light touch.
There is presence of moderate edema.
Incorrect: Epidermal wounds are characterized by pink or red color with no blisters. The wound is typically dry and there is minimal edema.
