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AAT I > Written Midterm > Flashcards

Written Midterm Flashcards

1
Q

What does Pocket to Pocket mean?

A

The Doctor’s front pocket should approximately line up with the patients back pocket

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2
Q

When performing a side posture adjustment to correct a lumbar rotation restriction, It is important to maintain tension on the patients shoulder in which direction?

A

Superiorly and Posteriorly

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3
Q

When palpating right to left on the spinous process of L4 you feel a hard end feel. When palpating left to right on the spinous process of L4 you feel a springy end feel. What SCP should you contact to correct this restriction ?

A

L-Mamillary process of L4

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4
Q

When should you pull your patient off their shoulder (the one contacting the table) ?

A

After you set the pelvis

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5
Q

T/F: When a patient has contraindications to HVLA adjusting/ Manipulation, you may still be able to mobilize the joint

A

True

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6
Q

The adjustment occurs in the ______

A

A. Mobilization Zone
B.Neutral Zone
C.Paraphysiological space
D. Plastic zone

C.Paraphysiological space

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7
Q

Mobilization occurs between which two Barriers?
A. Elastic and anatomical
B.Elastic and plastic
C.Physiological and Elastic
D.Physiologic and Plastic

A

C.Physiologic and Elastic

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8
Q

When performing an HVLA adjustment, you must breech the _____.
A.Elastic and anatomic barriers
B.physiologic and elastic barriers
C.Plastic Zone
D.Physiologic barrier only

A

B.Physiologic and elastic barriers.

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9
Q

Mrs. Covidia presents to your office complaining of “right hip pain” that has been constant for the past few days. When asked to point to the pain, she places her hand over her right sacroiliac joint. Upon visual inspection/static palpation, you notice that the left leg is long compared to the right leg and the right PSIS is tender and more prominent than the left. Motion palpation reveals a right sacroiliac extension restriction with a hard end-feel when motioning the right ilium P-A. Which of the following is the most likely listing for these findings?
a. AGR R-Ilium
b. L-SB-P
c. AGR L-Ilium
d. R-SB-P

A

A. AGR R-Ilium

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10
Q

Mr. Smith arrives to your office complaining of bilateral low back pain (LBP). When asked to point to the pain, he places both of his hands on his low back covering the entire lumbar spine. Upon visual inspection/static palpation of the lumbar spine, you observe a hypolordosis with an increase in muscle tonicity bilaterally. The patient’s right leg appears short as compared to the left leg when lying prone. Motion palpation reveals a hard end feel when palpating right to left on the spinous process of L2, while motioning the spinous left to right reveals a springy end-feel. Which of the following is the most likely listing?
a. LRR-L2
b. LP-L3
c. RP-L3
d. RRR-L2

A

D.RRR-L2

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11
Q

Mrs. Covidia presents to your office complaining of “left hip pain” that has been constant for the past few days. When asked to point to the pain, she places her hand over her left sacroiliac joint. Upon visual inspection/static palpation, you notice that the right leg is long compared to the left leg and the left PSIS is tender and more prominent than the right. Motion palpation reveals a left sacroiliac extension restriction with a hard end-feel when motioning the left ilium P-A. Which of the following is the most likely listing for these findings?
a. AGR L-Ilium
b. AGR R-Ilium
c. R-SB-P
d. L-SB-P

A

A.AGR L-Ilium

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12
Q

Your patient is complaining of local “right hip pain” which is exacerbated by sitting for more than 30 minutes. When asked to point to the pain, the patient places their hand over their right sacroiliac joint. Inspection/static palpation reveals tenderness around the entire right SI joint and a left short leg as compared to the right. You also detect a hard end-feel when palpating the right sacral base anteriorly. Which of the following is the most likely listing? Make sure your answer has the correct letters for the abbreviated listing.
a. RRRROA
b. RRRLOA
c. RRLOA
d. RRROA

A

C.RRLOA

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13
Q

PROM (Passive range of motion) should always be _____ AROM (Active range of motion)

A. Less than
B.equal to
C.Greater than

A

Greater than

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14
Q

T/F: Since it is safe to adjust a healthy joint, once you have correctly identified a subluxation/motion restriction, it is safe to adjust that subluxation/motion restriction.

A

False

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15
Q

Which of the following conditions require referral to a vascular surgeon?
a. Aneurysm
b. Osteopenia
c. Tumors
d. Space occupying lesions

A

A.Aneurysm

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16
Q

Mrs. Smith arrives at your office with an exacerbation of right sacro-iliac pain. During motion palpation you detect a hard end-feel when palpating P-A on the right PSIS as compared to the left. Which of the following is the correct motion restriction listing? Choose the best answer.
a. AGR R-Ilium
b. PGR R-Ilium
c. R-AS Ilium
d. CRRLOA

A

A.AGR R-Ilium

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17
Q

When adjusting a P-I ilium in side posture, the tissue pull should mostly be _____.
A. I-S
B. M-L
C.L-M
D.S-I

A

A.I-S

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18
Q

Upon examination of your patient’s sacrum, you detect a RRLOA. What is the correct contact point for the side posture set up taught in lab?
a. L-calcaneal
b. L-pisiform/hypothenar
c. R-calcaneal
d. R-pisiform/hypothenar

A

B. L-Pisiform/ Hypothenar

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19
Q

A new patient, Mr. Jones, presents with bilateral LBP from L3-L5 and tenderness over the SI joints bilaterally. Upon examination/palpation of the sacrum, you detect a RRLOA. How might you have detected this motion restriction?
a. While palpating P-A on the right sacral base
b. While palpating P-A on the right sacral apex
c. While palpating P-A on the left sacral base
d. While palpating P-A on the left sacral apex

A

A. While palpating P-A on the right sacral base

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20
Q

You have detected a R-SB-PS during an examination of your patient’s sacral biomechanics. Which of the following is the correct contact point for the side posture set up taught in lab?
a. L-SB
b. R-SB
c. R-pisiform/hypothenar
d. L-pisiform/hypothenar

A

D. L-Pisiform/ Hypothenar

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21
Q

Most patients that present with disc herniation(s) are ________ years old.
a. 30-50
b. over 50
c. 50-70
d. 40-60

A

A.30-50

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22
Q

Which of the following patient presentations demonstrate an antalgic gait?
a. A patient with left sciatica leans to the right when walking to decrease pain/sciatica symptoms
b. A patient with left sciatica leans to the right to stretch the lumbar musculature on the left.
c. A patient with left sciatica leans to the left when walking to decrease pain/sciatica symptoms
d. A patient with left sciatica leans to the left to stretch the lumbar musculature on the left.

A

a. A patient with left sciatica leans to the right when walking to decrease pain/sciatica symptoms

23
Q

A test with high sensitivity means that __________.
a. Patients who test negative for a condition are less likely not to have the condition.
b. Patients who test negative for a condition are more likely not to have the condition.
c. Patients who test positive for a condition are more likely to have the condition.
d. Patients who test positive for a condition are less likely to have the condition

A

b. Patients who test negative for a condition are more likely not to have the condition.

24
Q

A new patient reports to your office complaining of constant LBP bilaterally L1-L5 with pain in both SI joints which began approximately one year ago insidiously. She also reports bilateral thoracic pain and pain that travels from her low back up into her thoracic spine and into both arms. When you attempt to palpate the lumbar spine your patient cannot tolerate light pressure stating that it is too painful and jumping off the table with even light pressure. Taking this into consideration, you should consider _______.
a. your patient has prostate cancer
b. your patient probably has cancer
c. your patient may be experiencing psychological distress that may be causing/amplifying her pain.
d. your patient may have ankylosing spondylitis

A

c. your patient may be experiencing psychological distress that may be causing/amplifying her pain.

25
Q

Mrs. Jones, an otherwise healthy 32 year old female, returns to your office 6 weeks after delivering a healthy baby boy. She explains that she had a c-section procedure to deliver the baby after 18 hours of difficult labor. She reports mid line back pain at the thoracolumbar junction which began a few hours after giving birth and has been getting worse since it began. Her pain is currently 7/10 on a pain scale. She also reports that she thinks she may have a sinus infection since she has been running a low grade fever for the past few weeks. Upon examination, you detect severe muscle spasm and tenderness from T8 to L5 bilaterally. Given this patient’s history, which of the following is the most appropriate diagnosis?
a. Spinal infection
b. Fractured coccyx
c. Lumbar sprain/strain
d. Spinal stenosis

A

A. Spinal Infection

26
Q

If a patient presents to your office with LBP and a history of successful removal of a malignant melanoma 6 months ago, which of the following is the most appropriate action?
a. Order imaging before adjusting to assess for a malignant neoplasm of the spine.
b. After completing the physical exam, perform soft tissue work on the patient to see if they have a decrease in pain following the treatment as this is an indication that the LBP is probably mechanical in nature.
c. Refer the patient to a dermatologist, as they may be having referred pain from other melanomas
d. After completing the physical exam, adjust the patient to see if they have a decrease in pain following the adjustment as this is an indication that the LBP is probably mechanical in nature.

A

A. Order imaging before adjusting to assess for a malignant neoplasm of the spine

27
Q

A 30 year old female, a new patient, arrives at your office complaining of sharp bilateral local LBP which began approximately two weeks ago. The pain is intermittent bothering her several times per day. While taking a patient history, you discover that your patient does not drink water… ever. She says she just doesn’t like water and she drinks tea and sodas instead. When you ask about constitutional symptoms giving specific examples, you discover that your patient has also been experiencing painful urination. Thinking about the “big picture” and based on the patient history above, it is important to consider that your patient’s low back pain may be _____.
a. caused by a disc herniation.
b. a referred pain from the kidneys.
c. a referred pain from the prostate.
d. referred pain from an abdominal aneurysm.

A

B. A referred pain from the kidneys

28
Q

A test with high specificity means that __________.
a. Patients who test negative for a condition are less likely not to have the condition.
b. Patients who test negative for a condition are more likely not to have the condition.
c. Patients who test positive for a condition are more likely to have the condition.
d. Patients who test positive for a condition are less likely to have the condition

A

C. Patients who test positive for a condition are more likely to have the condition

29
Q

Which of the following types of cancer are the 3 most likely to metastasize to the spine? MACA (there are 3 correct answers)
a. Prostate cancer
b. Breast cancer
c. Skin Cancer
d. Lung cancer

A

a. Prostate cancer
b. Breast cancer
d. Lung cancer

30
Q

A new patient presents to your office with chronic LBP (VAS 8/10) which began approximately 3 months ago and has been getting worse since it began. The patient is a 38 year old female with a history of breast cancer. She has been seeing a massage therapist for the past 6 weeks and although she experiences a slight decrease in pain (from VAS 8/10 to VAS 7/10) following a massage, the relief only lasts 1-2 hours. You should be suspect that ______ may be causing your patient’s pain. Choose the best answer.
a. a sprain strain
b. facet syndrome
c. osteomyelitis
d. a malignant neoplasm

A

D. A malignant neoplasm

31
Q

Which of the following are red flags for cancer? MACA
a. Pain that is relieved when recumbent
b. Age over 50 years old
c. Pain at night while trying to sleep
d. Weight loss after beginning a regular exercise program
e. Pain that lasts longer than 30 days

A

b. Age over 50 years old
c. Pain at night while trying to sleep
e. Pain that lasts longer than 30 days

32
Q

Your patient is complaining of bilateral sacroiliac joint pain with tenderness over the SI joints bilaterally and right lower lumbar area. Upon examination/palpation you find a rotation restriction around the transverse axis. Choose the correct SCP for the side posture set up taught in lab.
a. middle of the sacral apex
b. right sacral base
c. R-calcaneal
d. middle of the calcaneal
e. middle of the sacral base

A

e. middle of the sacral base

33
Q

Mrs. Smith arrives at your office with an exacerbation of right sacro-iliac pain. During motion palpation you detect a hard end-feel when palpating P-A on the right PSIS as compared to the left. Which of the following is the correct motion restriction listing? Choose the best answer.
a. AGR R-Ilium
b. R-AS Ilium
c. PGR R-Ilium
d. CRRLOA

A

A. AGR R-Ilium

34
Q

Your patient is experiencing lumbo-sacral pain intermittently. Upon examination/palpation you notice that the patient has a hypolordosis and tenderness over the entire sacral base and L5 bilaterally. You also find a posterior sacral base with a hard end-feel when motioning the sacral base P-A. Choose the correct CP for correcting this restriction using the side posture set up taught in lab.
a. R-calcaneal if your patient is in left side posture
b. R-pisiform/hypothenar if your patient is in right side posture
c. L-pisiform/hypothenar if your patient is in right side posture
d. R-calcaneal if your patient is in right side posture

A

d. R-calcaneal if your patient is in right side posture

35
Q

Upon examination/palpation of your patient’s sacrum, you detect an RRROA. What is the correct contact point for the correction of this restriction using the side posture set up taught in lab?
a. L-SB
b. R-SA
c. L-pisiform/hypothenar
d. R-SB
e. R-pisiform/hypothenar

A

a. L-SB

36
Q

Mr. Smith arrives to your office complaining of bilateral low back pain (LBP). When asked to point to the pain, he places both of his hands on his low back covering the entire lumbar spine. Upon visual inspection/static palpation of the lumbar spine, you observe a hypolordosis with an increase in muscle tonicity bilaterally. The patient’s right leg appears short as compared to the left leg when lying prone. Motion palpation reveals a hard end feel when palpating right to left on the spinous process of L2, while motioning the spinous left to right reveals a springy end-feel. Which of the following is the most likely listing?
a. RP-L3
b. LRR-L2
c. LP-L3
d. RRR-L2

A

d. RRR-L2

37
Q

How should the right ilium move during right sacroiliac flexion?
a. anterior-inferior
b. posterior-superior
c. posterior-inferior
d. anterior-superior

A

C. posterior-inferior

38
Q

of the following motions occur during normal lumbosacral extension?
a. L5 extends as the sacral base extends.
b. L5 extends as the sacral apex glides anterior.
c. L5 extends as the sacral base flexes.
d. L5 flexes as the sacral base extends.

A

C.L5 extends as the sacral base flexes

39
Q

Spinal stenosis can result from hypertrophic degenerative changes of the _____. Choose the best answer.
a. IVD’s, facets, and TVP’s
b. IVD and facets
c. IVD’s, facets and ligamentum flavum
d. IVD’s, spinous process, and TVP’s

A

C. IVD’s, facets, and ligamentum flavum

40
Q

Which of the following represents appropriate treatment for a musculoligamentous injury?
a. Limit motion to decrease inflammation
b. Exercises that reproduce the patient’s pain… no pain no gain.
c. Referral to an orthopedist since chiropractors cannot treat musculoligamentous injuries.
d. Gentle stretches and/or exercises as long as they do not exacerbate the patient’s symptoms

A

D.Gentle stretches and/or exercises as long as they don’t exacerbate the patients symptoms

41
Q

Lumbar radiculopathy is typically ______.
a. unilateral
b. caused by leg pain
c. bilateral
d. accompanied by bowel/bladder incontinence

A

A.Unilateral

42
Q

A new patient arrives at your office complaining of local LBP which began one week ago after carrying 12 pieces of plywood up the attic stairs to deck his attic. When asked to point to the location of pain, he covers his low back bilaterally with both hands and explains that he only gets relief when he lays down. Patient examination reveals lumbar hypolordosis, and taut and tender fibers bilaterally L1-L5 with bilateral erector spinae spasm in the lumbar region. Based on this information, you are thinking this patient may have a ______.
a. Spinal infection
b. Lumbar sprain strain injury
c. Lumbar malignant neoplasm
d. spinal stenosis

A

B.Lumbar sprain strain injury

43
Q

LBP can be caused by which of the following conditions? Choose the best answer.
a. Systemic conditions
b. LBP can be caused by musculoskeletal, visceral, and systemic conditions.
c. Visceral conditions
d. Musculoskeletal conditions

A

B. LBP can be caused by musculoskeletal, Visceral, and systematic conditions

44
Q

Pain originating from the lumbar facets _________.
a. does not radiate
b. typically radiates down the leg to the foot
c. may radiate into the buttocks and thighs
d. frequently causes sciatica

A

C.May radiate into the buttocks and thighs

45
Q

Mrs. Covidia is a well nourished 58 year old female who presents to your office complaining of low back pain. You notice that her gait is very unsteady as she walks in your office. When you ask the patient how long she has been feeling unsteady, she explains that it began with the onset of low back pain when she was leaning forward pick up her bag off of the front floor board of her car a few days ago. Which of the following is the most appropriate action?
a. Unsteady gait is a red flag for LBP. Proceed with caution being careful not to aggravate the patient’s condition during the physical exam.
b. Explain to the patient that unsteady gait is a typical finding in patient’s with cancer and refer to an oncologist.
c. Explain to the patient that unsteady gait is a typical finding in patient’s with compression fractures and refer out for orthopedic consultation.
d. Explain to the patient that she should feel more steady after the adjustment and removal of nerve interference.

A

a. Unsteady gait is a red flag for LBP. Proceed with caution being careful not to aggravate the patient’s condition during the physical exam.

46
Q

Which of the following may irritate a nerve root?
a. decreased blood supply to the nerve root
b. mechanical pressure from a bulging/herniated disc
c. chemical changes
d. All of the choices are correct

A

D. All the choices are correct

47
Q

The knee flexors are a group of muscles stimulated by a single spinal nerve, ____.
a. L5
b. L4
c. S1
d. L3

A

A.L5

48
Q

Which of the following is true regarding musculoligamentous injuries?
a. They are a common cause of LBP
b. They are caused by tearing and or stretching of soft tissues.
c. They can result from faulty biomechanics.
d. All of the choices are correct.

A

D.All the choices are correct

49
Q

You have detected a “hard end-feel” when springing a lumbar spinous process left to right and a “springy end-feel” when springing right to left on the same spinous process. Which of the following is the correct patient position?
a. right side-lying position
b. left side-lying position

A

Left side-lying

50
Q

You have detected a “hard end-feel” when springing a lumbar spinous process right to left and a “springy end-feel” when springing left to right on the same spinous process. Which of the following is the correct patient position?
a. right side-lying position
b. left side-lying position

A

Right side-lying

51
Q

The listing: RRTA describes the same restriction as a _______.
a. Counter-rotation restriction
b. RRROA
c. Nutation restriction
d. CRRTA

A

C.Nutation restriction

52
Q

When you find a RRR L3, you would expect to feel more joint restriction when palpating ________ on the spinous process.
a. left to right
b. right to left

A

Right to left

53
Q

When you set up to adjust a RRR-L3, the patient should be in _____.
a. RSP
b. LSP

A

RSP

AAT I (2 decks)

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