Sbr Fortinberry Part 1

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Patient Quizzes & Trivia

Questions and Answers
  • 1. 

    1. A patient who suffered a myocardial infarction is participating in an exercise test. The therapist notes ST-segment depression of 1.7 mm on the patient‘s current rhythm strip. What is the most appropriate course of action?

    • A.

      A. Stop the exercise session immediately and send the patient to the emergency room.

    • B.

      B. Continue with the exercise session.

    • C.

      C. Contact the patient’s cardiologist about continuing exercise.

    • D.

      D. Stop the exercise session to take the patient’s heart rate and blood pressure.

    Correct Answer
    B. B. Continue with the exercise session.
    Explanation
    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.

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  • 2. 

    1. A patient reports throbbing pain in the lower extremities accompanied by trophic changes and diminished pulses. The pain is aggravated by activity and was not influenced by spinal movements. What source of pain is most likely responsible for these complaints?

    • A.

      A. Peripheral neuropathy

    • B.

      B. Restless leg syndrome

    • C.

      C. Vascular pain

    • D.

      D. Neurogenic pain.

    Correct Answer
    C. C. Vascular pain
    Explanation
    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.

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  • 3. 

    Whiplash injury from a rear-end collision would tear which of the following ligaments

    • A.

      A. Posterior longitudinal ligament (PLL)

    • B.

      B. Anterior longitudinal ligament (ALL)

    • C.

      C. Ligamentum nuchae

    • D.

      D. Ligamentum flavum

    Correct Answer
    B. B. Anterior longitudinal ligament (ALL)
    Explanation
    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).

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  • 4. 

    What shoulder view BEST demonstrate the greater tubercle?

    • A.

      A. External rotation

    • B.

      B. Internal rotation

    • C.

      C. Baby arm

    • D.

      D. Transthoracic

    Correct Answer
    A. A. External rotation
    Explanation
    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.

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  • 5. 

    The Waddell tests are used to identify

    • A.

      A. Pain of a nonorganic origin

    • B.

      B. Space occupying lesions

    • C.

      C. Balance and coordination functions

    • D.

      D. History of alcohol or substance abuse

    Correct Answer
    A. A. Pain of a nonorganic origin
    Explanation
    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.

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  • 6. 

    1. At what point in the gait cycle is the center of gravity the lowest?

    • A.

      A. Double support

    • B.

      B. Terminal swing

    • C.

      C. Deceleration

    • D.

      D. Midstance

    Correct Answer
    A. A. Double support
    Explanation
    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.

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  • 7. 

    1. A patient presents to an outpatient physical therapy clinic with a 140 degrees kyphoscoliotic curve. What is therapist greatest concern?

    • A.

      A. The patient’s complaint of low back pain

    • B.

      B. Gait deviations

    • C.

      C. Pulmonary status

    • D.

      D. Poor upright standing posture

    Correct Answer
    C. C. Pulmonary status
    Explanation
    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.

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  • 8. 

    1. A therapist is assessing radial deviation range of motion at the wrist. The correct position of the goniometer should be as follows: the proximal arm is aligned with the forearm and the distal arm is aligned with the third metacarpal. What should be used as the axis point?

    • A.

      A. Lunate

    • B.

      B. Scaphoid

    • C.

      C. Capitate

    • D.

      D. Triquetrum

    Correct Answer
    C. C. Capitate
    Explanation
    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.

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  • 9. 

    1. A therapist is screening a patient complaining of pain at the anterior left shoulder region. The pain is increased when the examiner instructs the patient to position the left arm by his side with the elbow flexed at 90 degrees and to actively supinate the forearm against resistance (provided by the examiner). What test is being performed?

    • A.

      A. Froment’s sign

    • B.

      B. Yergason’s test

    • C.

      Waldron test

    • D.

      D. Wilson test

    Correct Answer
    B. B. Yergason’s test
    Explanation
    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.

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  • 10. 

    1. A therapist is examining a patient with traumatic injury to the left hand. The therapist asks the patient to place the left hand on the examination table with the palm facing upward. The therapist then holds the second, third, and fifth digits in full extension. The patient is then asked to flex the fourth digit. What movement would be expected by a patient with an uninjured hand, and what muscle or muscles is the rapist resisting?

    • A.

      A. The fourth finger would flex at the distal interphalangeal (DIP) join only, and the muscle being restricted would be the flexor digitorum superficialis

    • B.

      B. The fourth finger would flex at the proximal interphalangeal (PIP) join only, and the muscle being restricted would be the flexor digitorum profundus

    • C.

      C. The fourth finger would flex at the DIP joint only, and the muscles being restricted would be the lumbricals

    • D.

      D. The fourth finger would flex at the PIP joint only, and the muscles being restricted would be the palmar interosseous

    Correct Answer
    B. B. The fourth finger would flex at the proximal interphalangeal (PIP) join only, and the muscle being restricted would be the flexor digitorum profundus
    Explanation
    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.

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  • 11. 

    1. A patient is in prone position with his head rotated to the left side. The left upper extremity is placed at his side and fully internally rotated. The left shoulder is then shrugged toward the chin. The therapist then grasps the midshaft of the patient’s left forearm. The patient is then instructed to “try to reach your feet using just your left arm” this movement is resisted by the therapist. This test is assessing the strength of what muscle?

    • A.

      A. Upper trapezius

    • B.

      B. Posterior deltoid

    • C.

      C. Latissimus dorsi

    • D.

      D. Triceps brachii

    Correct Answer
    C. C. Latissimus dorsi
    Explanation
    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.

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  • 12. 

    1. A patient is place in supine position with the knee in 90 degrees of flexion. The foot is stabilized by the therapist’s body on the examination table. The therapist then wraps his fingers around the proximal tibia so that the thumbs are resting along the anteromedial and the anterolateral margins. The therapist then applies a force to pull the tibia forward. What special test is being performed?

    • A.

      A. Pivot shift

    • B.

      B. Lachman’s shift

    • C.

      C. Anterior drawer

    • D.

      D. Posterior drawer

    Correct Answer
    C. C. Anterior drawer
    Explanation
    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.

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  • 13. 

    1. A patient presents to a therapist with an ankle injury. The therapist has determined that the injury is at the junction of the distal tibia and fibula. Which of the following functions most in preventing excessive external rotation and posterior displacement of the fibula?

    • A.

      A. Anterior inferior tibiofibular ligament

    • B.

      B. Posterior inferior tibiofibular ligament

    • C.

      C. Interosseous membrane

    • D.

      D. Long plantar ligament

    Correct Answer
    A. A. Anterior inferior tibiofibular ligament
    Explanation
    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.

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  • 14. 

    1. A physical therapist is examining a patient who complains of posterior ankle pain. The patient is positioned prone with the feet extended over the edge of the mat. The therapist squeezes the involved gastrocnemius over the middle third of the muscle belly. What test is the therapist performing? What indicates a positive test?

    • A.

      A. Thompson’s test, plantar flexion of the ankle

    • B.

      B. Homan’s test, plantar flexion of the ankle

    • C.

      C. Thompson’s test, no ankle movement

    • D.

      D. Homan’s test, no ankle movement

    Correct Answer
    C. C. Thompson’s test, no ankle movement
    Explanation
    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.

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  • 15. 

    1. A physical therapist is beginning a gait examination. During heel strike to foot flat on the right lower extremity. Which of the following does not normally occur?

    • A.

      A. The left side of the pelvis initiates movement in the direction of travel

    • B.

      B. The right femur medially rotates

    • C.

      C. The left side of the thorax initiates movement in the direction of travel

    • D.

      D. The right tibia medially rotates

    Correct Answer
    C. C. The left side of the thorax initiates movement in the direction of travel
  • 16. 

    1. When comparing the gait cycle of young adults to the gait cycle of older adult, what would a therapist expect to find?

    • A.

      A. The younger population has a shorter step length

    • B.

      B. The younger population has a shorter stride length

    • C.

      C. The younger population has a shorter period of double support

    • D.

      D. The younger population has a decrease in speed of ambulation

    Correct Answer
    C. C. The younger population has a shorter period of double support
    Explanation
    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.

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  • 17. 

    1. A physical therapy examination of an infant with osteogenesis imperfecta should include all of the following except

    • A.

      A. Pain

    • B.

      B. Passive ROM

    • C.

      C. Caregiver’s handling

    • D.

      Option 4

    Correct Answer
    B. B. Passive ROM
    Explanation
    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.

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  • 18. 

    1. The alar ligament stress test is considered positive if

    • A.

      A. Laxity is felt in neutral

    • B.

      B. Laxity is felt in extension

    • C.

      C. Laxity is felt in flexion

    • D.

      D. Laxity is felt in both flexion and extension

    Correct Answer
    D. D. Laxity is felt in both flexion and extension
    Explanation
    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.

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  • 19. 

    1. A physical therapist is assessing the posture of a 12 year old female with cystic fibrosis. All of the following are common postural abnormalities except

    • A.

      A. Thoracic kyphosis

    • B.

      B. Forward head posture

    • C.

      C. Scapular retraction

    • D.

      D. Cervical lordosis

    Correct Answer
    C. C. Scapular retraction
    Explanation
    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.

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  • 20. 

    1. A child loses balance and falls down whenever she tries to catch a ball thrown in her direction; otherwise the child can sit, stand, and walk well. The physical therapist would determine that the child has problem with

    • A.

      A. Development of higher lever balance skills

    • B.

      B. Protective reactions

    • C.

      C. Anticipatory postural control

    • D.

      D. Labyrinthine head righting

    Correct Answer
    C. C. Anticipatory postural control
    Explanation
    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.

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  • 21. 

    1. Nerve conduction velocity/EMG studies of motor nerves and NOT able to differentiate

    • A.

      A. Peripheral nerve disease form anterior horn cell disease

    • B.

      B. The specific location cord, nerve, root, plexus, or peripheral nerve

    • C.

      C. Neuromuscular junction disease form peripheral nerve disease

    • D.

      D. The specific cause or nature of the neural lesion

    Correct Answer
    D. D. The specific cause or nature of the neural lesion
    Explanation
    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.

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  • 22. 

    1. What is the difference in testing motor function when examining for a nerve root deficit versus a peripheral nerve deficit?

    • A.

      A. In peripheral nerve deficit, the motor weakness is evident more rapidly when applying resistance compared with nerve root deficit

    • B.

      B. In nerve root deficit, the motor weakness is evident more rapidly when applying resistance compared with peripheral nerve deficit

    • C.

      c. In peripheral nerve deficit, the motor weakness is evident more rapidly when applying resistance without gravity

    • D.

      D. In nerve root deficit, the motor weakness is evident more rapidly when applying resistance without gravity

    Correct Answer
    A. A. In peripheral nerve deficit, the motor weakness is evident more rapidly when applying resistance compared with nerve root deficit
    Explanation
    In peripheral nerve deficits, the motor weakness is evident more rapidly when applying resistance compared with nerve root deficits. This is because peripheral nerves directly innervate specific muscles, so any damage or dysfunction in the nerve will immediately affect the corresponding muscle's function. In contrast, nerve root deficits involve damage or compression of the nerve roots that exit the spinal cord, which can affect multiple muscles and may not manifest as rapidly or prominently as in peripheral nerve deficits.

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  • 23. 

    1. Which impairment occurs in carpal tunnel syndrome?

    • A.

      A. Atrophy of the hypothenar eminence

    • B.

      B. Paresthesia over the dorsal aspect of the hand

    • C.

      C. Decreased resistance thumb abduction

    • D.

      D. Decreased resisted forearm pronation

    Correct Answer
    C. C. Decreased resistance thumb abduction
    Explanation
    In carpal tunnel syndrome, the median nerve gets compressed as it passes through the carpal tunnel in the wrist. This compression can lead to weakness and decreased resistance in thumb abduction, which is the ability to move the thumb away from the palm. This is because the muscles responsible for thumb abduction are innervated by the median nerve. Atrophy of the hypothenar eminence and paresthesia over the dorsal aspect of the hand can also occur in carpal tunnel syndrome, but the specific impairment mentioned in the question is decreased resistance thumb abduction. Decreased resisted forearm pronation is not typically associated with carpal tunnel syndrome.

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  • 24. 

    1. The L4 deep tendon reflex is elicited at the

    • A.

      A. Achilles tendon

    • B.

      B. Femoral tendon

    • C.

      C. Medial hamstring tendon

    • D.

      D. Patella tendon

    Correct Answer
    D. D. Patella tendon
    Explanation
    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.

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  • 25. 

    1. A 25 year old football player fell on his shoulder vertically and violently stretched his neck in the opposite direction. He was later diagnosed with brachial plexus injury (Erb-Duchenne paralysis).His arm is hanging at his side in medial rotation in the “waiter’s tip” position. What results are expected from the neurologic examination?

    • A.

      A. Paralysis of the deltoid, triceps, wrist extensors (long and short carpi radialis), and finger extensors

    • B.

      B. Paralysis of all intrinsic muscles of the hand, flexors muscles (claw hand), loss of sensation over C8-T1 dermatomes, and Horner’s syndrome

    • C.

      C. Hypesthesia over C5-C6 and weakness of the deltoid, supraspinatus and infraspinatus, biceps, and brachioradialis muscles

    • D.

      Option 4

    Correct Answer
    C. C. Hypesthesia over C5-C6 and weakness of the deltoid, supraspinatus and infraspinatus, biceps, and brachioradialis muscles
    Explanation
    The correct answer is c. Hypesthesia over C5-C6 and weakness of the deltoid, supraspinatus and infraspinatus, biceps, and brachioradialis muscles. This is because the injury to the brachial plexus, specifically the C5-C6 nerve roots, would result in sensory loss (hypesthesia) and weakness in the muscles innervated by these nerve roots. The deltoid, supraspinatus, infraspinatus, biceps, and brachioradialis muscles are all innervated by the C5-C6 nerve roots, which would explain the observed symptoms in the football player.

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  • 26. 

    1. A patient presents to an outpatient physical therapy clinic with a severed ulnar nerve of the right upper extremity. What muscle is still active and largely responsible for the obvious hyperextension at the metacarpophalangeal (MCP) joints of the involved hand?

    • A.

      D. Extensor digitorum

    • B.

      C. Extensor carpi radialis brevis

    • C.

      B. Volar interossei

    • D.

      Option 4

    Correct Answer
    A. D. Extensor digitorum
    Explanation
    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.

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  • 27. 

    1. A patient presents to an outpatient facility with complaints of pain in groin area (along the medial left thigh). With manual muscle testing of the involved lower extremity, a therapist determines the following: hip flexion = 4+/5, hip extension = 4+/5, hip abduction = 4+/5, hip adduction =2+/5, hip internal rotation = 2+/5, and hip external rotation = 2+/5. Which nerve on the involved side is most likely injured?

    • A.

      A. Lateral cutaneous nerve of the upper thigh

    • B.

      B. Obturator nerve

    • C.

      C. Femoral nerve

    • D.

      Option 4

    Correct Answer
    B. B. Obturator nerve
    Explanation
    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.

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  • 28. 

    1. A mother comes to a physical therapist concerned that her 4 month old infant cannot sit up alone yet. Which of the following responses is the most appropriate for the therapist?

    • A.

      A. “your infant probably needs further examination by a specialist because, although its varies, infants can usually sit unsupported at 2 months of age”

    • B.

      B. “your infant probably needs further examination by a specialist because, although it varies, infants can usually sit unsupported at 3 months of age”

    • C.

      C. “this is probably nothing can be concerned about because, although it varies, most infants can sit unsupported at 8 months of age”

    • D.

      D. “this is probably nothing can be concerned about because, although it varies, most infants can sit unsupported at 5 months of age”

    Correct Answer
    C. C. “this is probably nothing can be concerned about because, although it varies, most infants can sit unsupported at 8 months of age”
    Explanation
    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.

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  • 29. 

    1. A patient is referred to the therapist with a diagnosis of arthritis. What type of arthritis would the therapist expect if the patient presented with the following signs and symptoms? (1) Bilateral wrist and knees are involved, (2) pain at rest and with motion, (3) prolonged morning stiffness, and (4) crepitus.

    • A.

      A. The patient has osteoarthritis

    • B.

      B. The patient has rheumatoid arthritis

    • C.

      C. The patient has degenerative joint disease

    • D.

      Option 4

    Correct Answer
    B. B. The patient has rheumatoid arthritis
    Explanation
    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.

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  • 30. 

    1. A patient presents to an outpatient clinic with complaints of shoulder pain. 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 what shoulder pathology?

    • A.

      Impingement

    • B.

      D. Labrum tear

    • C.

      B. Acromioclavicular joint separation

    • D.

      Option 4

    Correct Answer
    A. Impingement
    Explanation
    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.

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  • 31. 

    1. A physical therapist is assessing a 40 year old man’s balance and coordination. The following instructions are given to the patient: “Stand normally, with your eyes open. After fifteen seconds, close your eyes and maintain a normal stand posture.” Several seconds after closing his eyes, the patient nearly falls. What type of test did the patient fail?

    • A.

      A. Postural sway test

    • B.

      B. Non-equilibrium test

    • C.

      C. Romberg test

    • D.

      Option 4

    Correct Answer
    C. C. Romberg test
    Explanation
    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.

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  • 32. 

    1. A patient is referred to physical therapy with a history of temporomandibualr joint pain. The therapist notices that the patient is having difficulty closing his mouth against minimal resistance. With this information, which of the following muscles would not be a target for strengthening exercise to correct this deficit

    • A.

      A. Medial pterygoid muscle

    • B.

      B. Temporalis

    • C.

      C. Masseter

    • D.

      D. Lateral pterygoid muscle

    Correct Answer
    D. D. Lateral pterygoid muscle
    Explanation
    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.

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  • 33. 

    1. Using tests of neurologic status and motor function, an experienced physical therapist or pediatrician should be able to accurately diagnose cerebral palsy in all but the mildest cases by:

    • A.

      A. 3 months of age

    • B.

      B. 6months of age

    • C.

      C. 1 year of age

    • D.

      Option 4

    Correct Answer
    B. B. 6months of age
    Explanation
    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.

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  • 34. 

    1. Which of the following muscles would you not expect to be affected by a C6-C7 lesion?

    • A.

      A. Biceps brachii

    • B.

      B. Anterior deltoid

    • C.

      C. Infraspinatus

    • D.

      D. Triceps brachii d. Triceps brachii

    Correct Answer
    D. D. Triceps brachii d. Triceps brachii
    Explanation
    A C6-C7 lesion refers to damage or injury to the spinal cord at the C6 and C7 vertebrae levels. The triceps brachii muscle is innervated by the radial nerve, which arises from the C7 and C8 nerve roots. Since the C6-C7 lesion affects the spinal cord at the C7 level, it would not directly affect the triceps brachii muscle.

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  • 35. 

    1. Indicators of complex regional pain syndrome include all of the following except

    • A.

      A. Pain from superficial touch

    • B.

      B. Profuse sweating

    • C.

      C. Skin color changes

    • D.

      C. Skin color changes

    Correct Answer
    B. B. Profuse sweating
    Explanation
    Complex regional pain syndrome (CRPS) is a chronic pain condition that typically affects one limb, usually after an injury or trauma. The main symptoms of CRPS include severe pain, changes in skin temperature and texture, and swelling. Skin color changes, such as redness or blotchiness, are also common indicators of CRPS. However, profuse sweating is not typically associated with CRPS and is therefore not considered an indicator of the condition.

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  • 36. 

    1. What is the BEST order of these tests during neurologic patient examination

    • A.

      A. Cognition, sensation, range of motion (ROM), reflexes, spasticity testing, manual muscle testing (MMT)

    • B.

      B. Reflexes, MMT, cognition, sensation, ROM, spasticity testing

    • C.

      C. Cognition, sensation, spasticity testing, ROM, MTT, reflexes

    • D.

      Option 4

    Correct Answer
    A. A. Cognition, sensation, range of motion (ROM), reflexes, spasticity testing, manual muscle testing (MMT)
    Explanation
    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.

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  • 37. 

    The patient has dysdiadochokinesia. What is the best measure of patient function?

    • A.

      A. Drawing figure eight

    • B.

      B. Alternating pronation/supination

    • C.

      C. Rebound test

    • D.

      Option 4

    Correct Answer
    B. B. Alternating pronation/supination
    Explanation
    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.

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  • 38. 

    1. Upon observation, the patient has unilateral LEFT facial weakness. He is unable to smile or show his teeth on the left side. However, he is able to raise his left eyebrow. The physical therapist suspects

    • A.

      A. Peripheral cranial nerve 5 lesion

    • B.

      B. Central cranial nerve 5 lesion

    • C.

      C. Peripheral cranial nerve 7 lesion

    • D.

      D. Central cranial nerve 7 lesion

    Correct Answer
    D. D. Central cranial nerve 7 lesion
    Explanation
    The patient's inability to smile or show his teeth on the left side, along with the ability to raise his left eyebrow, suggests a central cranial nerve 7 lesion. This is because the facial nerve, which controls the muscles responsible for facial expressions, has both upper and lower motor neurons. A lesion in the central portion of the facial nerve would affect the upper motor neurons, leading to weakness on the contralateral side of the face (in this case, the left side). This is consistent with the patient's symptoms. Peripheral cranial nerve 7 lesions would typically result in weakness on the ipsilateral side of the face.

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  • 39. 

    1. During physical therapy examination, the patient has full ROM bilaterally. Muscle tone at rest appears normal bilaterally. Reflexes on the right side are 21. On the left they are 11. What is the next thing you should test for?

    • A.

      A. Repeat reflex testing with Jendrassik maneuver to enhance deep tendon reflex on the left

    • B.

      B. Spasticity testing on the left due to increased reflexes

    • C.

      C. Assess for associated reactions as patient has upper motion neuron syndrome findings on the left

    • D.

      Option 4

    Correct Answer
    A. A. Repeat reflex testing with Jendrassik maneuver to enhance deep tendon reflex on the left
    Explanation
    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.

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  • 40. 

    1. When performing an examination on a patient after traumatic spinal cord injury to determine the American Spinal Injury Association (ASIA) sensory level of injury a clinician tests

    • A.

      Proprioception

    • B.

      B. Kinesthesia

    • C.

      C. Pain

    • D.

      Option 4

    Correct Answer
    C. C. Pain
    Explanation
    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.

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  • 41. 

    1. During your cranial nerve examination of extraocular muscle function, you note that your vertical nystagmus during smooth pursuits. You suspect

    • A.

      A. Lesion of the optic nerve (cranial nerve II)

    • B.

      B. Posterior canal BPPV

    • C.

      Acoustic neuroma

    • D.

      D. Central nervous system lesion

    Correct Answer
    D. D. Central nervous system lesion
    Explanation
    Vertical nystagmus during smooth pursuits suggests a central nervous system lesion. Nystagmus is an involuntary eye movement that can be horizontal, vertical, or torsional. In this case, the vertical nystagmus indicates an abnormality in the brainstem or cerebellum, which are part of the central nervous system. Lesions in these areas can disrupt the normal coordination of eye movements. Other options such as optic nerve lesion, posterior canal BPPV, or acoustic neuroma are less likely to cause vertical nystagmus during smooth pursuits.

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  • 42. 

    1. Your patient presents with a nerve injury that causes the thenar eminence to be flattened because of muscle atrophy. The thumb is adducted and extended. You would want to test the muscles supplied by the

    • A.

      A. Ulnar nerve

    • B.

      B. Antebrachial nerve

    • C.

      C. Median nerve

    • D.

      D. Radial nerve

    Correct Answer
    C. C. Median nerve
    Explanation
    The patient's presentation of flattened thenar eminence, thumb adduction, and thumb extension indicates a nerve injury affecting the muscles supplied by the median nerve. The thenar eminence is primarily innervated by the median nerve, and atrophy in this area suggests damage to the muscles controlled by this nerve. Additionally, thumb adduction and extension are controlled by the median nerve. Therefore, testing the muscles supplied by the median nerve would be the appropriate course of action in this case.

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  • 43. 

    1. Your patient is a framer in a construction project. He has been wearing a heavy carpenter’s belt for the last month. He now complains of painful hypesthesia on the proximal anterior lateral high. He gets relief with sitting, and walking seems to aggravate his symptoms. The structure most likely producing these symptoms is the

    • A.

      A. Lateral femoral cutaneous nerve

    • B.

      B. Motor branch of the femoral nerve

    • C.

      C. Medial femoral cutaneous nerve

    • D.

      Option 4

    Correct Answer
    A. A. Lateral femoral cutaneous nerve
    Explanation
    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.

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  • 44. 

    1. Your patient complains of neck pain and peripheral symptoms. Radiographs revealed narrowing of the C4-C5 intervertebral foramen. The nerve root most likely involved would be the

    • A.

      A. C5 nerve root

    • B.

      B. C4 nerve root

    • C.

      C. C6 nerve root

    • D.

      Option 4

    Correct Answer
    A. A. C5 nerve root
    Explanation
    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.

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  • 45. 

    1. A physical therapist is conducting a screening examination on a patient with a suspected upper motion neuron lesion, deep tendon reflexes will be 

    • A.

      A. Hypoactive

    • B.

      B. Absent

    • C.

      C. Diminished

    • D.

      D. Hyperactive

    Correct Answer
    D. D. Hyperactive
    Explanation
    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.

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  • 46. 

    1. You are performing an examination on a 2 month old infant diagnosed with Klumpke’s palsy. The classic physical findings of a Klumpke’s palsy are

    • A.

      A. Lack of forearm supination, elbow extension, and wrist flexion

    • B.

      B. Lack of forearm supination, elbow flexion, and wrist extension

    • C.

      D. Lack of elbow extension, forearm pronation, and wrist flexion

    • D.

      Option 4

    Correct Answer
    C. D. Lack of elbow extension, forearm pronation, and wrist flexion
    Explanation
    The correct answer is d. Lack of elbow extension, forearm pronation, and wrist flexion. Klumpke's palsy is a condition that affects the lower brachial plexus, causing weakness or paralysis in the muscles of the forearm and hand. The classic physical findings of Klumpke's palsy include the inability to extend the elbow, pronate the forearm (turning the palm downwards), and flex the wrist. This is due to the damage or compression of the nerves that control these movements.

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  • 47. 

    1. A 16 year old male is diagnosed with a spinal tumor and has undergone surgery to resect the mass. After the procedure, the patient presents with variable motor paralysis and loss of pain and temperature sensation below the level of the injury. The patient would be diagnosed with what spinal cord syndrome?

    • A.

      A. Brown-sequard

    • B.

      B. Anterior cord

    • C.

      C. Posterior cord

    • D.

      Option 4

    Correct Answer
    B. B. Anterior cord
    Explanation
    The patient's symptoms of variable motor paralysis and loss of pain and temperature sensation below the level of the injury indicate damage to the anterior portion of the spinal cord. This is consistent with the diagnosis of anterior cord syndrome. In this syndrome, there is typically damage to the anterior spinal artery, leading to ischemia of the anterior portion of the spinal cord. This results in motor paralysis and loss of pain and temperature sensation, while preserving proprioception and vibration sense.

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  • 48. 

    1. A 5 year old male had an undiagnosed arteriovenous malformation and is recently hospitalized because of an acute brain bleed. The patient is not acknowledging individuals who stand on the left side of his bed, he does not respond to sensory a stimulus that is applied to the left side of his body, and he displays visual spatial deficits. What lobe of the brain has been affected by the stroke?

    • A.

      A. Right parietal

    • B.

      B. Left parietal

    • C.

      C. Frontal

    • D.

      Option 4

    Correct Answer
    A. A. Right parietal
    Explanation
    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.

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  • 49. 

    1. An infant is able to transition from quadruped to sitting, demonstrate a protective extension reaction in all directions except backwards, and pivots on belly in a prone positions. This infant is demonstrating gross motor skills at what chronological age?

    • A.

      A. 3 to 4 months

    • B.

      B. 5 to 6 months

    • C.

      C. 7 to 8 months

    • D.

      Option 4

    Correct Answer
    C. C. 7 to 8 months
    Explanation
    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.

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  • 50. 

    1. A two month old infant is diagnosed with left congenital muscular torticollis, which has resulted in plagiocephaly. This would result in

    • A.

      A. Flattening of the left frontal and left occipital regions

    • B.

      B. Flattening of the right frontal and left occipital regions

    • C.

      D. Flattening of the left frontal and right occipital regions

    • D.

      Option 4

    Correct Answer
    C. D. Flattening of the left frontal and right occipital regions
    Explanation
    Left congenital muscular torticollis is a condition where the neck muscles are tight and cause the head to tilt to one side. Plagiocephaly is a condition where there is flattening of the skull on one side. In this case, the left torticollis would cause the head to tilt to the left, resulting in pressure on the left frontal region and the right occipital region. Therefore, the correct answer is d. Flattening of the left frontal and right occipital regions.

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