Sbr Fortinberry Part 1

The patient failed the Romberg test. The Romberg test is used to assess a person's ability to maintain balance and coordination while standing with their eyes closed. In this case, the patient nearly falls after closing his eyes, indicating a lack of balance and coordination in the absence of visual input. This suggests a potential issue with proprioception, which is the ability to sense the position and movement of one's body.

Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways. The bronchioles, which are small airways in the lungs, are most affected by asthma. When a person with asthma is exposed to triggers such as allergens or irritants, the bronchioles become inflamed and constricted, making it difficult for air to flow in and out of the lungs. This leads to symptoms such as wheezing, shortness of breath, and coughing. Therefore, the bronchioles are the part of the respiratory system that is most affected by asthma.

The best measure of patient function in this case is alternating pronation/supination. Dysdiadochokinesia refers to the impaired ability to perform rapid alternating movements. The patient's ability to alternate between pronation (turning the palm downward) and supination (turning the palm upward) can provide insight into their motor coordination and function. The other options, such as drawing a figure eight or performing a rebound test, may assess different aspects of motor function but may not specifically target dysdiadochokinesia.

The therapist notes ST-segment depression of 1.7 mm on the patient's current rhythm strip. ST-segment depression is indicative of myocardial ischemia, which is a decreased blood supply to the heart muscle. However, in this case, the ST-segment depression is only 1.7 mm, which is considered a mild change. If the patient is asymptomatic and stable, it is safe to continue with the exercise session. However, close monitoring should be done to ensure the patient's condition does not worsen.

The therapist's greatest concern in this case would be the patient's pulmonary status. A kyphoscoliotic curve refers to an abnormal curvature of the spine that can affect the shape of the chest cavity. This can lead to decreased lung capacity and respiratory function, potentially causing breathing difficulties and other pulmonary issues. Therefore, it is crucial for the therapist to assess and monitor the patient's pulmonary status to ensure appropriate intervention and prevent further complications.

In this test, the patient is in a prone position with their head rotated to the left side. The left upper extremity is fully internally rotated and placed at the side. The left shoulder is then shrugged toward the chin. The therapist grasps the midshaft of the patient's left forearm and instructs them to try to reach their feet using just their left arm, while the therapist resists this movement. This test is assessing the strength of the latissimus dorsi muscle, as it is responsible for shoulder adduction and extension, which is necessary for reaching the feet in this position.

The patient's symptoms of painful hypesthesia on the proximal anterior lateral thigh, which are relieved with sitting and aggravated by walking, suggest the involvement of the lateral femoral cutaneous nerve. This nerve supplies sensation to the lateral thigh and can be compressed or irritated by the heavy carpenter's belt the patient has been wearing. The motor branch of the femoral nerve does not typically cause sensory symptoms, and the medial femoral cutaneous nerve supplies sensation to the medial thigh, not the lateral thigh. Therefore, the most likely structure producing these symptoms is the lateral femoral cutaneous nerve.

In a patient with a suspected upper motor neuron lesion, deep tendon reflexes are expected to be hyperactive. This is because an upper motor neuron lesion disrupts the inhibitory signals that normally regulate the reflex arc, leading to an exaggerated response. Hypoactive or absent reflexes would be more indicative of a lower motor neuron lesion, while diminished reflexes may suggest a peripheral nerve injury.

The correct answer is b. Yergason's test. Yergason's test is used to assess the integrity of the long head of the biceps tendon. In this test, the patient is instructed to position the arm by their side with the elbow flexed at 90 degrees and to actively supinate the forearm against resistance. If pain is elicited during this movement, it suggests a possible pathology or injury to the long head of the biceps tendon. This test helps the therapist in diagnosing and determining the appropriate treatment for the patient's shoulder pain.

Beta blockers are medications that block the effects of adrenaline on the body, including the heart. They slow down the heart rate and reduce its workload, making it easier for the heart to pump blood. In a patient starting therapy with beta blockers, the medication can cause a decrease in heart rate during exercise compared to the heart rate before exercise. This is a desired effect of beta blockers, as it helps to manage conditions such as high blood pressure, angina, and arrhythmias.

The therapist observes a painful arc between 70 degrees and 120 degrees of active abduction in the involved shoulder. This finding is most indicative of impingement. Impingement occurs when the tendons of the rotator cuff become irritated or inflamed as they pass through the narrow space between the acromion (part of the shoulder blade) and the humeral head (upper arm bone). This can cause pain and limited range of motion, particularly during certain movements such as active abduction.

The best order of tests during a neurologic patient examination is to start with assessing cognition, as this provides an overall baseline of the patient's mental function. Next, assessing sensation is important as it helps determine if there are any abnormalities or deficits in the patient's ability to perceive touch, pain, or temperature. Range of motion (ROM) should be assessed next to evaluate the patient's ability to move their joints freely. Reflexes should be tested after ROM, as they provide information about the integrity of the patient's nervous system. Spasticity testing should follow, as it helps identify any abnormal muscle tone. Finally, manual muscle testing (MMT) should be performed to assess the strength of the patient's muscles.

The patient's reflexes are asymmetrical, with higher reflexes on the right side compared to the left. This suggests a potential issue with the reflexes on the left side. To further evaluate this, the next step would be to repeat reflex testing with the Jendrassik maneuver. This maneuver involves the patient clasping their hands together and trying to pull them apart while the reflex is being tested. It is used to enhance the deep tendon reflexes and can help to elicit a response on the left side if it was not initially present.

In this scenario, the therapist is performing the Anterior Drawer test. This test is used to assess the stability of the anterior cruciate ligament (ACL) in the knee. By stabilizing the foot and applying a forward force on the proximal tibia, the therapist can detect any excessive anterior translation of the tibia, indicating a possible ACL tear. The position of the fingers and thumbs along the anteromedial and anterolateral margins of the tibia helps to guide and control the force applied during the test.

In a rear-end collision, the head is forcefully thrown forward and then rapidly whipped back, causing a whiplash injury. The anterior longitudinal ligament (ALL) runs along the front of the vertebral bodies and helps to stabilize the spine. The sudden and forceful movement of the head in a rear-end collision can cause tearing or damage to the ALL. This is why the correct answer is b. Anterior longitudinal ligament (ALL).

During the double support phase of the gait cycle, both feet are in contact with the ground. This phase occurs when one foot is in the stance phase (supporting the body weight) and the other foot is in the swing phase (moving forward). The center of gravity is lowest during double support because the body is in a stable position with both feet providing support. This allows for better balance and reduces the risk of falling.

MRI studies of the knee typically include three planes of study, which are sagittal, coronal, and axial. The medial oblique plane is not one of the conventional planes used in MRI studies of the knee.

Angina is a condition characterized by chest pain or discomfort caused by reduced blood flow to the heart muscles. Sublingual nitroglycerin is a medication that helps to relieve the symptoms of angina by relaxing and widening the blood vessels, allowing more blood to flow to the heart. It is commonly used as a fast-acting treatment for angina attacks and is usually carried by angina patients at all times in case of an emergency. The other options, such as the nitroglycerin patch, ACE inhibitors, and digoxin, may be prescribed for long-term management of angina but are not typically used during an acute attack.

The anterior inferior tibiofibular ligament is the correct answer because it is responsible for preventing excessive external rotation and posterior displacement of the fibula. This ligament connects the distal tibia and fibula on the anterior side, providing stability and limiting movement in these directions. The other options do not specifically address these movements or are not located at the junction of the distal tibia and fibula.

A therapist would expect to find that the gait cycle of younger adults has a shorter period of double support compared to older adults. This means that younger adults spend less time with both feet on the ground during each step, indicating a more efficient and stable gait pattern. Older adults often have a longer period of double support as they may have decreased balance and stability, leading to a slower and more cautious walking pattern.

The patient's symptoms indicate a stroke affecting the right parietal lobe. The right parietal lobe is responsible for processing sensory information, spatial awareness, and attention. The patient's lack of response to sensory stimuli on the left side of his body and his visual spatial deficits suggest that the stroke has affected this area of the brain.

The patient's symptoms of throbbing pain in the lower extremities, trophic changes, and diminished pulses suggest a vascular etiology. Vascular pain is typically caused by inadequate blood flow to the affected area, leading to tissue ischemia and subsequent pain. The aggravation of pain by activity further supports this diagnosis, as increased demand for blood flow exacerbates the ischemia. Peripheral neuropathy, restless leg syndrome, and neurogenic pain are less likely to present with trophic changes and diminished pulses.

Nerve conduction velocity/EMG studies of motor nerves are not able to differentiate the specific cause or nature of the neural lesion. These studies can provide information about the integrity and function of the nerves, but they cannot determine the underlying cause or nature of the lesion. Other diagnostic tests and evaluations may be required to identify the specific cause or nature of the neural lesion.

The patient's presentation of bilateral involvement of the wrists and knees, pain at rest and with motion, prolonged morning stiffness, and crepitus suggests rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease that causes inflammation in the joints, leading to pain, stiffness, and swelling. It commonly affects the small joints of the hands and feet, including the wrists and knees. The presence of crepitus, which is a grinding or popping sensation in the joints, is also a characteristic feature of rheumatoid arthritis.

If a patient with angina pectoris experiences pain during exercise therapy and the pain does not subside after using three tablets of sublingual nitroglycerin, it could be a sign of a true heart attack. In such a situation, it is crucial to call 911 immediately for emergency medical assistance. Delaying medical intervention can be life-threatening for the patient.

In an uninjured hand, when the therapist holds the second, third, and fifth digits in full extension and asks the patient to flex the fourth digit, the expected movement would be flexion at the proximal interphalangeal (PIP) joint only. The muscle being restricted in this movement is the flexor digitorum profundus.

The patient with the least chance of survival is the 13-year-old male with 60% total body surface area (TBSA) burns and inhalation injury. Inhalation injury can cause damage to the airways and lungs, leading to respiratory distress and complications such as pneumonia and respiratory failure. Combined with the extensive burns, this patient's injuries are severe and pose a significant risk to their survival. The other patients have lower percentages of TBSA burns or less severe injuries, making their chances of survival higher compared to the 13-year-old male.

The question asks for the plane of study that is not one of the conventional planes in CT studies of the knee. The conventional planes typically include the sagittal and coronal planes. Therefore, the correct answer is a. Condylar oblique, as it is not one of the conventional planes used in CT studies of the knee.

The patient's symptoms and manual muscle testing results suggest a weakness in hip adduction and hip internal and external rotation on the involved side. The obturator nerve innervates the muscles responsible for these movements, making it the most likely nerve to be injured in this case. The other nerves listed (lateral cutaneous nerve of the upper thigh and femoral nerve) do not innervate the specific muscles involved in this patient's weakness.

The lateral pterygoid muscle is not a target for strengthening exercise to correct the patient's difficulty in closing their mouth against minimal resistance. The lateral pterygoid muscle is responsible for opening the mouth and moving the jaw side to side, not for closing the mouth. Strengthening exercises for the medial pterygoid muscle, temporalis, and masseter would be more appropriate to address the patient's deficit in closing their mouth.

When performing an examination to determine the ASIA sensory level of injury in a patient with traumatic spinal cord injury, the clinician tests for pain. This is because pain sensation is an important indicator of sensory function and can help determine the level and severity of the injury. Testing for pain involves applying stimuli such as pinpricks or temperature changes to different areas of the body and assessing the patient's response. This information is crucial for diagnosing and planning appropriate treatment for the patient.

The child's ability to sit, stand, and walk well indicates that her basic balance skills are intact. However, her difficulty in catching a ball suggests a problem with anticipatory postural control. Anticipatory postural control refers to the ability to adjust and maintain balance in preparation for a voluntary movement, such as reaching out to catch a ball. The child's inability to do so indicates a deficit in this specific aspect of balance control.

The Waddell tests are a series of physical tests used to assess the presence of nonorganic or psychogenic pain. These tests evaluate various physical responses to determine if the reported pain is consistent with a physiological cause or if it is more likely to be influenced by psychological factors. By identifying pain of a nonorganic origin, healthcare professionals can better understand and address the underlying factors contributing to the patient's pain experience.

The correct answer is c. Capitate. The capitate bone is located in the center of the wrist and is aligned with the third metacarpal bone. Placing the axis point of the goniometer on the capitate bone allows for an accurate measurement of radial deviation range of motion at the wrist.

The ankle should be slightly positioned in eversion, dorsiflexion, and abduction before taping to provide the most protection against ankle sprain. Eversion helps to stabilize the ankle joint, dorsiflexion helps to prevent excessive plantar flexion which can lead to sprains, and abduction helps to prevent excessive inward rolling of the ankle. This position allows for optimal support and stability during physical activity, reducing the risk of injury.

The most appropriate response for the therapist is option c. This is because it acknowledges that the age at which infants can sit unsupported can vary, but reassures the mother that it is usually not a cause for concern until around 8 months of age. This response provides the mother with information about the typical developmental timeline for sitting up and alleviates any immediate worries she may have about her infant's progress.

Based on the patient's symptoms of left shoulder and neck pain that worsen with certain activities and improve with rest, it is likely that the musculoskeletal system is involved. The symptoms are specifically triggered by lifting heavy objects, shoveling dirt, and walking fast, suggesting that the muscles and bones in the neck and shoulder area are strained or injured. The patient's high blood pressure and shortness of breath may be unrelated or secondary to the musculoskeletal issue. Therefore, the correct answer is c. Musculoskeletal.

Scapular retraction is not a common postural abnormality in individuals with cystic fibrosis. Thoracic kyphosis, forward head posture, and cervical lordosis are all commonly seen in individuals with cystic fibrosis due to the effects of the disease on the musculoskeletal system. Scapular retraction refers to the pulling back of the shoulder blades, which is not typically associated with cystic fibrosis.

This infant is demonstrating gross motor skills at 7 to 8 months of age. At this age, infants are typically able to transition from quadruped to sitting, demonstrate a protective extension reaction in all directions except backwards, and pivot on their belly in a prone position. These milestones indicate the development of their gross motor skills, which are the abilities to use their large muscles for movement and coordination.

The greater tubercle is a prominent bony projection on the humerus bone. External rotation of the shoulder refers to the movement of rotating the arm away from the body, which allows for the greater tubercle to be more visible and palpable. Therefore, external rotation would provide the best view to demonstrate the greater tubercle.

The L4 deep tendon reflex is elicited at the patella tendon. The patella tendon reflex, also known as the knee jerk reflex, is a monosynaptic reflex that involves the contraction of the quadriceps muscle in response to a tap on the patella tendon. This reflex is controlled by the L4 spinal nerve, which sends signals to the quadriceps muscle to contract and extend the leg. The other options listed (Achilles tendon, femoral tendon, medial hamstring tendon) do not elicit the L4 deep tendon reflex.

Stimulation of CN X, also known as the vagus nerve, will cause a decrease in heart rate. This is because the vagus nerve is responsible for parasympathetic innervation of the heart, which leads to a decrease in the firing rate of the SA node and a subsequent decrease in heart rate. Sinus bradycardia refers to a heart rate less than 60 beats per minute, and it is the result of increased vagal tone. Therefore, option b is the correct answer.

It is recommended for an asthmatic patient to use the inhaler about 20 minutes before exercising in a cool environment. This allows enough time for the medication to take effect and open up the airways, making it easier for the patient to breathe during exercise. Using the inhaler too early may result in the effects wearing off before the exercise begins, while using it just at the beginning of exercise may not provide enough time for the medication to take full effect. Therefore, using the inhaler about 20 minutes before exercise is the most appropriate timing.

Statin drugs lower cholesterol by inhibiting HMG-CoA reductase. HMG-CoA reductase is an enzyme involved in the production of cholesterol in the liver. By inhibiting this enzyme, statin drugs reduce the amount of cholesterol that is synthesized in the body. This leads to a decrease in overall cholesterol levels in the bloodstream.

The therapist is performing Thompson's test by squeezing the involved gastrocnemius over the middle third of the muscle belly. A positive test is indicated by no ankle movement.

A physical therapy examination of an infant with osteogenesis imperfecta should include assessing for pain, evaluating the caregiver's handling techniques, and examining the infant's overall condition. Passive range of motion (ROM) exercises may not be appropriate for infants with osteogenesis imperfecta due to their fragile bones. These exercises could potentially cause fractures or further damage. Therefore, passive ROM should be excluded from the examination.

An experienced physical therapist or pediatrician should be able to accurately diagnose cerebral palsy in all but the mildest cases by 6 months of age. This is because by this age, the child's neurologic status and motor function would have developed enough to allow for a proper assessment and diagnosis. Early diagnosis is important for early intervention and treatment, which can greatly improve the child's outcome.

The alar ligament stress test is used to assess the integrity of the alar ligaments in the cervical spine. These ligaments are responsible for stabilizing the atlantoaxial joint, which allows for rotation of the head. In a positive test, laxity or excessive movement is felt in both flexion and extension of the neck. This indicates that the alar ligaments are not providing adequate stability to the joint, which can be a sign of ligamentous injury or instability.

The narrowing of the C4-C5 intervertebral foramen suggests that there is compression or impingement of the nerve root at that level. Since the C5 nerve root exits the spinal cord at the C4-C5 level, it is the most likely nerve root to be involved in this case. The symptoms of neck pain and peripheral symptoms are consistent with the compression of the C5 nerve root.

The correct answer is d. Extensor digitorum. The extensor digitorum muscle is responsible for extending the fingers at the metacarpophalangeal (MCP) joints. In a patient with a severed ulnar nerve, the extensor digitorum muscle would still be active and able to perform this function. The other options listed (extensor carpi radialis brevis and volar interossei) are not primarily responsible for hyperextension at the MCP joints.