Trivia Quiz On Diseases, Conditions And Medical Test!

1. A patient with a diagnosis of CVA presents with large balance and coordination deficits. The patient is ataxic and has minimal strength deficits. Upon reviewing the patient chart, you are not surprised to find that the area of the brain affected by the CVA is the

Cerebellum

Cerebrum left hemisphere

Frontal lobe

Broca’s area

The patient's presentation of large balance and coordination deficits, along with minimal strength deficits, is indicative of damage to the cerebellum. The cerebellum is responsible for coordinating voluntary movements, maintaining balance, and regulating muscle tone. Damage to this area can result in ataxia, which is characterized by uncoordinated movements and difficulties with balance and coordination. The other options, such as the cerebrum left hemisphere, frontal lobe, and Broca's area, are not primarily involved in motor coordination and would not explain the patient's symptoms.

Explanation

The patient's presentation of large balance and coordination deficits, along with minimal strength deficits, is indicative of damage to the cerebellum. The cerebellum is responsible for coordinating voluntary movements, maintaining balance, and regulating muscle tone. Damage to this area can result in ataxia, which is characterized by uncoordinated movements and difficulties with balance and coordination. The other options, such as the cerebrum left hemisphere, frontal lobe, and Broca's area, are not primarily involved in motor coordination and would not explain the patient's symptoms.

2. Diastasis recti can be a complication of pregnancy. Diastasis recti is

An incision made at the opening of the vagina to increase the diameter

When the embryo develops in the fallopian tube

A separation of the rectus abdominis muscle

When the placenta pulls away from the uterine wall

Diastasis recti is a condition where the rectus abdominis muscle, commonly known as the "six-pack" muscle, separates. This separation occurs along the midline of the abdomen and is often a result of the stretching and weakening of the abdominal muscles during pregnancy. It is not related to an incision made at the opening of the vagina, embryo development in the fallopian tube, or the placenta pulling away from the uterine wall.

Explanation

Diastasis recti is a condition where the rectus abdominis muscle, commonly known as the "six-pack" muscle, separates. This separation occurs along the midline of the abdomen and is often a result of the stretching and weakening of the abdominal muscles during pregnancy. It is not related to an incision made at the opening of the vagina, embryo development in the fallopian tube, or the placenta pulling away from the uterine wall.

3. A physical therapist is required to train a 71-year-old patient to ascend and descend a flight of stairs. The patient presents with a fractured left tibia and is weight-bearing as tolerated. There is a moderate weakness in the involved lower extremity secondary to the fracture. The most appropriate instructions are

“One step at a time, right foot first to ascend and to descend the stairs.”

“One step at a time, right foot first to ascend the stairs and left foot first to descend the stairs”

“Step over step slowly”

“One step at a time, left foot first to ascend and to descend the stairs”.

The correct answer is "One step at a time, right foot first to ascend the stairs and left foot first to descend the stairs." This is the most appropriate instruction because the patient has a fractured left tibia and moderate weakness in the involved lower extremity. By starting with the right foot when ascending the stairs, the patient can rely on the stronger leg to bear more weight and provide stability. Similarly, when descending the stairs, starting with the left foot allows the stronger leg to lead and provide support. This approach minimizes the strain on the fractured leg and reduces the risk of further injury.

Explanation

The correct answer is "One step at a time, right foot first to ascend the stairs and left foot first to descend the stairs." This is the most appropriate instruction because the patient has a fractured left tibia and moderate weakness in the involved lower extremity. By starting with the right foot when ascending the stairs, the patient can rely on the stronger leg to bear more weight and provide stability. Similarly, when descending the stairs, starting with the left foot allows the stronger leg to lead and provide support. This approach minimizes the strain on the fractured leg and reduces the risk of further injury.

4. A physical therapist is employed as a physician-owned physical therapy clinic that charges for treatment by the modality. One of the physicians who is an owner of the practice requests that all of his patients receive a minimum of heat, ultrasound and electrical stimulating during each treatment session. The therapist feels that in the majority of the physician's patients the modalities are of little clinical benefit. The most appropriate response would be to

Ignore the physician’s request and treat each patient as you feel is indicated

Discuss with the physician his rationale for requesting modalities on each patient

Report the physician’s conduct to the American Medical Association

Inform the physician he is abusing the health care system

The most appropriate response would be to discuss with the physician his rationale for requesting modalities on each patient. This is the best course of action because it allows for open communication and understanding between the therapist and the physician. By discussing the physician's reasoning, the therapist can express their concerns about the clinical benefit of the modalities and potentially find a compromise or alternative treatment approach that is more effective for the patients. Reporting the physician's conduct or accusing him of abusing the healthcare system without first having a conversation would not be constructive or professional.

Explanation

The most appropriate response would be to discuss with the physician his rationale for requesting modalities on each patient. This is the best course of action because it allows for open communication and understanding between the therapist and the physician. By discussing the physician's reasoning, the therapist can express their concerns about the clinical benefit of the modalities and potentially find a compromise or alternative treatment approach that is more effective for the patients. Reporting the physician's conduct or accusing him of abusing the healthcare system without first having a conversation would not be constructive or professional.

5. What could cause the right side of the pelvis to drop during the left stance phase of gait on a patient with left above-knee prosthesis?

Weak abdominal musculature

Weak gluteus medius

Weak gluteus maximus

All of these

Weak gluteus medius could cause the right side of the pelvis to drop during the left stance phase of gait in a patient with a left above-knee prosthesis. The gluteus medius is responsible for stabilizing the pelvis during gait, and if it is weak, it may not be able to adequately support the pelvis on the affected side. This can result in a drop or dip of the pelvis on the opposite side, leading to an abnormal gait pattern. Weak abdominal musculature and weak gluteus maximus may also contribute to this issue, but the specific mention of weak gluteus medius in the answer suggests that it is the primary cause in this scenario.

Explanation

Weak gluteus medius could cause the right side of the pelvis to drop during the left stance phase of gait in a patient with a left above-knee prosthesis. The gluteus medius is responsible for stabilizing the pelvis during gait, and if it is weak, it may not be able to adequately support the pelvis on the affected side. This can result in a drop or dip of the pelvis on the opposite side, leading to an abnormal gait pattern. Weak abdominal musculature and weak gluteus maximus may also contribute to this issue, but the specific mention of weak gluteus medius in the answer suggests that it is the primary cause in this scenario.

6. In which of the following sports would it be most beneficial to have a high percentage of slow-twitch muscle fibers?

Distance running

Weight lifting

Javelin

Alpine skiing

It would be most beneficial to have a high percentage of slow-twitch muscle fibers in distance running. Slow-twitch muscle fibers are better suited for endurance activities as they are more resistant to fatigue and can sustain prolonged contractions. Distance running requires a steady and continuous effort over a long period of time, making slow-twitch muscle fibers ideal for this sport.

Explanation

It would be most beneficial to have a high percentage of slow-twitch muscle fibers in distance running. Slow-twitch muscle fibers are better suited for endurance activities as they are more resistant to fatigue and can sustain prolonged contractions. Distance running requires a steady and continuous effort over a long period of time, making slow-twitch muscle fibers ideal for this sport.

7. A physical therapist working on a team with a physical therapist assistant would be incorrect in asking an assistant to perform which of the following tasks?

Modify treatment plan or goals

Apply and measure assistive or adaptive devices

Identify changes in treatment outcome

Administer therapeutic modalities

A physical therapist assistant is not qualified to modify treatment plans or goals as this is the responsibility of the physical therapist. The physical therapist assistant's role is to assist the physical therapist in implementing the treatment plan, not to make changes to it.

Explanation

A physical therapist assistant is not qualified to modify treatment plans or goals as this is the responsibility of the physical therapist. The physical therapist assistant's role is to assist the physical therapist in implementing the treatment plan, not to make changes to it.

8. A C6 quadriplegic would have all of the following muscles innervated EXCEPT the

Biceps

Deltoids

Triceps

Diaphragm

A C6 quadriplegic would have all of the mentioned muscles innervated except the triceps. This means that the biceps, deltoids, and diaphragm would still receive nerve signals and be able to function to some extent. However, the triceps muscle, which is responsible for extending the arm, would not receive innervation and therefore would be paralyzed or severely weakened in a C6 quadriplegic individual.

Explanation

A C6 quadriplegic would have all of the mentioned muscles innervated except the triceps. This means that the biceps, deltoids, and diaphragm would still receive nerve signals and be able to function to some extent. However, the triceps muscle, which is responsible for extending the arm, would not receive innervation and therefore would be paralyzed or severely weakened in a C6 quadriplegic individual.

9. A 63-year-old female referred to physical therapy for gait training suddenly loses her balance and falls to the floor. After rushing to the scene it becomes obvious that the patient is unconscious. Which of the following would be the most appropriate immediate response?

Secure and maintain an airway

File an incident report

Observe and record vital signs

Attempt to define the specific cause for the loss of consciousness

The most appropriate immediate response would be to secure and maintain an airway. This is because the patient is unconscious, and ensuring that their airway is clear and open is crucial for their survival. It is important to prioritize their breathing and oxygenation before moving on to other steps such as filing an incident report or observing vital signs. Attempting to define the specific cause for the loss of consciousness can be done after ensuring the patient's airway is secure.

Explanation

The most appropriate immediate response would be to secure and maintain an airway. This is because the patient is unconscious, and ensuring that their airway is clear and open is crucial for their survival. It is important to prioritize their breathing and oxygenation before moving on to other steps such as filing an incident report or observing vital signs. Attempting to define the specific cause for the loss of consciousness can be done after ensuring the patient's airway is secure.

10. Which sequence is most appropriate when descending stairs with crutches?

Crutches, injured leg, healthy leg

Crutches, healthy leg, injured leg

Injured leg, crutches, healthy leg

None of these

When descending stairs with crutches, the most appropriate sequence is to place the crutches first, followed by the injured leg, and then the healthy leg. This sequence ensures stability and support while going down the stairs. Placing the crutches first allows for balance, followed by the injured leg to take weight off it, and finally, the healthy leg is used to step down. This sequence minimizes the risk of further injury and provides the necessary support during the descent.

Explanation

When descending stairs with crutches, the most appropriate sequence is to place the crutches first, followed by the injured leg, and then the healthy leg. This sequence ensures stability and support while going down the stairs. Placing the crutches first allows for balance, followed by the injured leg to take weight off it, and finally, the healthy leg is used to step down. This sequence minimizes the risk of further injury and provides the necessary support during the descent.

11. The most common mechanism for an anterior talofibular ligament sprain is

Inversion and dorsiflexion

Inversion and plantarflexion

Inversion

Pronation, eversion, and dorsiflexion

An anterior talofibular ligament sprain is commonly caused by the combination of inversion (turning the foot inward) and plantarflexion (pointing the toes downward). Inversion causes the ligament to stretch and plantarflexion adds additional stress to the ligament, leading to a sprain. This mechanism is often seen in activities such as landing from a jump or stepping off a curb with the foot turned inward and the toes pointed downward.

Explanation

An anterior talofibular ligament sprain is commonly caused by the combination of inversion (turning the foot inward) and plantarflexion (pointing the toes downward). Inversion causes the ligament to stretch and plantarflexion adds additional stress to the ligament, leading to a sprain. This mechanism is often seen in activities such as landing from a jump or stepping off a curb with the foot turned inward and the toes pointed downward.

12. A therapist can obtain valuable information during an evaluation by using special orthopedic tests. Which of the following special tests is not performed with the patient in supine?

Anterior drawer test

Apley’s compression test

McMurray test

Patella apprehension test

Apley's compression test is not performed with the patient in supine. This test is used to assess the integrity of the meniscus in the knee joint. It involves the patient lying prone (face down) with the knee flexed at 90 degrees. The therapist then applies downward pressure on the heel while internally and externally rotating the tibia. This test helps to identify meniscal tears or other abnormalities in the knee joint.

Explanation

Apley's compression test is not performed with the patient in supine. This test is used to assess the integrity of the meniscus in the knee joint. It involves the patient lying prone (face down) with the knee flexed at 90 degrees. The therapist then applies downward pressure on the heel while internally and externally rotating the tibia. This test helps to identify meniscal tears or other abnormalities in the knee joint.

13. A patient is found to have limited knee extension. Which of the following mobilization techniques would be indicated?

Lateral glide of the patella

Caudal glide of the patella

Posterior glide of the tibia

Anterior glide of the tibia

Limited knee extension suggests a restriction in the anterior movement of the tibia. To address this restriction, an anterior glide of the tibia would be indicated. This technique involves applying a force in the anterior direction to mobilize the tibia and improve knee extension. Lateral glide of the patella, caudal glide of the patella, and posterior glide of the tibia would not specifically address the limited knee extension in this case.

Explanation

Limited knee extension suggests a restriction in the anterior movement of the tibia. To address this restriction, an anterior glide of the tibia would be indicated. This technique involves applying a force in the anterior direction to mobilize the tibia and improve knee extension. Lateral glide of the patella, caudal glide of the patella, and posterior glide of the tibia would not specifically address the limited knee extension in this case.

14. A patient is in supine with both lower extremities in a 90-degree straight-leg position. As the patient slowly lowers her extended legs toward the horizontal, there is an increase in lordosis of the low back. This notes marked weakness of the

Hip flexors

Back extensors

Hip extensors

Abdominals

As the patient lowers her extended legs towards the horizontal, there is an increase in lordosis of the low back. This indicates that the abdominal muscles, which help maintain the normal curvature of the spine, are weak. The lordosis is a natural curve in the lumbar spine, and when the abdominal muscles are weak, they are unable to support and stabilize the spine properly, leading to an increase in lordosis. This weakness of the abdominals can be observed in this position as the patient is unable to control the excessive curvature of the low back.

Explanation

As the patient lowers her extended legs towards the horizontal, there is an increase in lordosis of the low back. This indicates that the abdominal muscles, which help maintain the normal curvature of the spine, are weak. The lordosis is a natural curve in the lumbar spine, and when the abdominal muscles are weak, they are unable to support and stabilize the spine properly, leading to an increase in lordosis. This weakness of the abdominals can be observed in this position as the patient is unable to control the excessive curvature of the low back.

15. A therapist identifies excessive femoral neck anteversion during an evaluation of a patient diagnosed with trochanteric bursitis. This structure finding commonly results in

An increase in hip external rotation

An increase in hip internal rotation

An increase in hip extension

An increase in hip flexion

Excessive femoral neck anteversion refers to the inward twisting of the thigh bone at the hip joint. This structural finding commonly leads to an increase in hip internal rotation. This means that the patient's ability to rotate their hip joint inward is greater than normal. This can result in increased stress and irritation on the trochanteric bursa, leading to trochanteric bursitis. Therefore, an increase in hip internal rotation is the most likely outcome in this scenario.

Explanation

Excessive femoral neck anteversion refers to the inward twisting of the thigh bone at the hip joint. This structural finding commonly leads to an increase in hip internal rotation. This means that the patient's ability to rotate their hip joint inward is greater than normal. This can result in increased stress and irritation on the trochanteric bursa, leading to trochanteric bursitis. Therefore, an increase in hip internal rotation is the most likely outcome in this scenario.

16. A hemiplegic patient is observed during gait training. The patient performs sidestepping toward the hemiplegic side. The physical therapist may expect the patient to compensate for weakened abductors by

Hip hiking of the unaffected side

Lateral trunk flexion toward the hemiplegic side

Lateral trunk flexion toward the unaffected side

Hip extension of the hemiplegic side

The patient is observed sidestepping toward the hemiplegic side, indicating weakness in the abductors on that side. To compensate for this weakness, the patient may perform lateral trunk flexion toward the unaffected side. This movement helps shift the center of gravity towards the unaffected side and provides stability during gait training. Hip hiking of the unaffected side, lateral trunk flexion toward the hemiplegic side, and hip extension of the hemiplegic side would not effectively compensate for the weakened abductors.

Explanation

The patient is observed sidestepping toward the hemiplegic side, indicating weakness in the abductors on that side. To compensate for this weakness, the patient may perform lateral trunk flexion toward the unaffected side. This movement helps shift the center of gravity towards the unaffected side and provides stability during gait training. Hip hiking of the unaffected side, lateral trunk flexion toward the hemiplegic side, and hip extension of the hemiplegic side would not effectively compensate for the weakened abductors.

17. A patient one-week status post left total hip replacement is diagnosed with an acute deep vein thrombosis in the left calf. The physical therapist's role in the acute care of a deep vein thrombosis is

Continued gait training with an assistive device and partial weight bearing

Progressive resistive exercises for bilateral lower extremities

Patient is on bedrest with no active therapy to the left leg

Postural drainage and diaphragmatic breathing

The patient is diagnosed with an acute deep vein thrombosis in the left calf. In this condition, it is important to prevent further movement or activity that could dislodge the blood clot and potentially cause serious complications such as a pulmonary embolism. Therefore, the physical therapist's role in the acute care of a deep vein thrombosis is to ensure that the patient is on bedrest with no active therapy to the left leg. This helps to minimize the risk of the clot moving and causing harm to the patient.

Explanation

The patient is diagnosed with an acute deep vein thrombosis in the left calf. In this condition, it is important to prevent further movement or activity that could dislodge the blood clot and potentially cause serious complications such as a pulmonary embolism. Therefore, the physical therapist's role in the acute care of a deep vein thrombosis is to ensure that the patient is on bedrest with no active therapy to the left leg. This helps to minimize the risk of the clot moving and causing harm to the patient.

18. Typically drugs are administered through enteral or parenteral administration. Which of the following is an example of enteral administration?

Inhalation

Injection

Topical

Oral

Oral administration is an example of enteral administration. Enteral administration refers to the delivery of drugs through the gastrointestinal tract, specifically through the mouth and into the stomach or intestines. In the case of oral administration, drugs are taken by mouth and swallowed, allowing them to be absorbed into the bloodstream through the digestive system. This route is commonly used for medications such as tablets, capsules, or syrups that can be taken orally.

Explanation

Oral administration is an example of enteral administration. Enteral administration refers to the delivery of drugs through the gastrointestinal tract, specifically through the mouth and into the stomach or intestines. In the case of oral administration, drugs are taken by mouth and swallowed, allowing them to be absorbed into the bloodstream through the digestive system. This route is commonly used for medications such as tablets, capsules, or syrups that can be taken orally.

19. Exercise can cause a significant increase in the body's cardiac output. During exercise, there is a major redistribution of the elevated cardiac output. During mild to moderate exercise what changes would you expect to take place?

An increase in cerebral and coronary blood flow

An increase in cerebral and active muscle blood flow

An increase in coronary and active skeletal muscle blood flow

A decrease in cerebral and coronary blood flow

During mild to moderate exercise, the body's cardiac output increases to meet the increased demand for oxygen and nutrients in the muscles. This increase in cardiac output leads to a redistribution of blood flow. The coronary arteries, which supply blood to the heart muscle, dilate to increase blood flow to the heart. At the same time, the arteries supplying blood to the active skeletal muscles also dilate, allowing for increased blood flow to these muscles. Therefore, during mild to moderate exercise, there is an increase in both coronary and active skeletal muscle blood flow.

Explanation

During mild to moderate exercise, the body's cardiac output increases to meet the increased demand for oxygen and nutrients in the muscles. This increase in cardiac output leads to a redistribution of blood flow. The coronary arteries, which supply blood to the heart muscle, dilate to increase blood flow to the heart. At the same time, the arteries supplying blood to the active skeletal muscles also dilate, allowing for increased blood flow to these muscles. Therefore, during mild to moderate exercise, there is an increase in both coronary and active skeletal muscle blood flow.

20. The primary area of the residual limb used for weight-bearing in a below-knee prosthesis is the

Patella tendon

Distal end of the residual limb

Lateral tibial condyle

Fibular head

The primary area of the residual limb used for weight-bearing in a below-knee prosthesis is the patella tendon. This is because the patella tendon is a strong and sturdy structure that connects the patella (kneecap) to the tibia (shinbone). It is responsible for transmitting the forces from the thigh muscles to the lower leg, providing stability and support during weight-bearing activities. Therefore, utilizing the patella tendon as the weight-bearing area in a below-knee prosthesis ensures optimal weight distribution and improves the overall functionality and comfort of the prosthesis.

Explanation

The primary area of the residual limb used for weight-bearing in a below-knee prosthesis is the patella tendon. This is because the patella tendon is a strong and sturdy structure that connects the patella (kneecap) to the tibia (shinbone). It is responsible for transmitting the forces from the thigh muscles to the lower leg, providing stability and support during weight-bearing activities. Therefore, utilizing the patella tendon as the weight-bearing area in a below-knee prosthesis ensures optimal weight distribution and improves the overall functionality and comfort of the prosthesis.

21. A physical therapist is uncertain if the polarity is important when using high voltage current. Which of the following conditions would polarity consideration be particularly important?

Chronic pain

Protective muscle spasm

Muscle-disuse atrophy

Wound healing

Polarity consideration would be particularly important in wound healing. When using high voltage current for wound healing, the polarity of the current can affect the direction of ion flow and the stimulation of tissue repair. By using the correct polarity, the therapist can ensure that the current is directed towards the wound site, promoting healing and tissue regeneration.

Explanation

Polarity consideration would be particularly important in wound healing. When using high voltage current for wound healing, the polarity of the current can affect the direction of ion flow and the stimulation of tissue repair. By using the correct polarity, the therapist can ensure that the current is directed towards the wound site, promoting healing and tissue regeneration.

22. A patient sustained a deep partial-thickness burn to the left forearm. A reduction in the cellular and protein constituents of hypertrophic scarring can be accomplished through

Pressure garments

Passing range of motion

Surgical intervention only

Correct positioning

Pressure garments are commonly used in the treatment of hypertrophic scarring. These garments apply constant pressure to the affected area, which helps to flatten and soften the scar tissue. The pressure exerted by the garments can help to reduce the cellular and protein constituents of hypertrophic scarring, leading to improved healing and cosmetic outcomes. This non-invasive approach is often effective in managing hypertrophic scars and is typically used in combination with other treatment modalities such as range of motion exercises and correct positioning.

Explanation

Pressure garments are commonly used in the treatment of hypertrophic scarring. These garments apply constant pressure to the affected area, which helps to flatten and soften the scar tissue. The pressure exerted by the garments can help to reduce the cellular and protein constituents of hypertrophic scarring, leading to improved healing and cosmetic outcomes. This non-invasive approach is often effective in managing hypertrophic scars and is typically used in combination with other treatment modalities such as range of motion exercises and correct positioning.

23. A physical therapist performs a passive range of motion to a C7 quadriplegic. The patient's bilateral straight leg raise is to measure passively to 90 degrees. What should the physical therapist conclude about the patient's ability to perform activities of daily living?

The patient is at a functional range to perform long sit and activities of daily living.

The patient’s range of motion is beyond the expected limit for long sit and activities of daily living

The correct answer suggests that the patient needs a straight leg raise of 110-120 degrees in order to perform activities of daily living, such as long sit. This implies that the patient's current range of motion, which is measured passively to 90 degrees, is insufficient for performing these activities. Therefore, the physical therapist should conclude that the patient's ability to perform activities of daily living is limited due to their restricted range of motion.

Explanation

The correct answer suggests that the patient needs a straight leg raise of 110-120 degrees in order to perform activities of daily living, such as long sit. This implies that the patient's current range of motion, which is measured passively to 90 degrees, is insufficient for performing these activities. Therefore, the physical therapist should conclude that the patient's ability to perform activities of daily living is limited due to their restricted range of motion.

24. At what level is it realistic for a spinal cord injured patient to functional ambulate?

C7

T1

T6

L1

The correct answer is L1. At the L1 level, it is realistic for a spinal cord injured patient to functionally ambulate. The level of injury refers to the specific vertebra that is affected, and the higher the level of injury, the more severe the impairment is. At the L1 level, the patient still has control over their hip flexors and quadriceps, which allows for functional ambulation with the use of assistive devices such as braces or crutches.

Explanation

The correct answer is L1. At the L1 level, it is realistic for a spinal cord injured patient to functionally ambulate. The level of injury refers to the specific vertebra that is affected, and the higher the level of injury, the more severe the impairment is. At the L1 level, the patient still has control over their hip flexors and quadriceps, which allows for functional ambulation with the use of assistive devices such as braces or crutches.

25. Which diagnostic tool is used to identify intrinsic and extrinsic spinal cord lesions by injecting radiopaque material into the spinal canal?

Myelogram

Cerebral angiography

Computerized axial tomography

Nuclear magnetic resonance

A myelogram is a diagnostic tool used to identify intrinsic and extrinsic spinal cord lesions by injecting radiopaque material into the spinal canal. This procedure allows for the visualization of the spinal cord and surrounding structures on X-ray images. By injecting contrast material into the spinal canal, any abnormalities or blockages in the spinal cord or surrounding structures can be identified. Cerebral angiography is a different diagnostic tool used to visualize blood vessels in the brain, while computerized axial tomography and nuclear magnetic resonance are imaging techniques used to visualize different parts of the body but not specifically for identifying spinal cord lesions.

Explanation

A myelogram is a diagnostic tool used to identify intrinsic and extrinsic spinal cord lesions by injecting radiopaque material into the spinal canal. This procedure allows for the visualization of the spinal cord and surrounding structures on X-ray images. By injecting contrast material into the spinal canal, any abnormalities or blockages in the spinal cord or surrounding structures can be identified. Cerebral angiography is a different diagnostic tool used to visualize blood vessels in the brain, while computerized axial tomography and nuclear magnetic resonance are imaging techniques used to visualize different parts of the body but not specifically for identifying spinal cord lesions.

26. Which symptom is not a clinical manifestation of infection?

Fever

Lymph node enlargement

Intense pain

Abrupt onset of illness

Intense pain is not typically a clinical manifestation of infection. While fever, lymph node enlargement, and abrupt onset of illness are commonly associated with infections, intense pain is more likely to be a symptom of another condition such as injury or inflammation. Infections may cause discomfort or mild pain, but intense pain is not a typical symptom.

Explanation

Intense pain is not typically a clinical manifestation of infection. While fever, lymph node enlargement, and abrupt onset of illness are commonly associated with infections, intense pain is more likely to be a symptom of another condition such as injury or inflammation. Infections may cause discomfort or mild pain, but intense pain is not a typical symptom.

27. A serious complication of a contusion is myositis ossificans. Which of the following statements concerning myositis ossificans is not true?

Myositis ossificans occurs when the part of a hematoma is replace with bone

Myositis ossificans can be recognized by plain film radiographs

Myositis ossificans usually results from a single injury and not repetitive trauma

Myositis ossificans is believed to be caused by periosteal cells invading the hematoma following injury

Myositis ossificans usually results from a single injury and not repetitive trauma. This statement is not true because myositis ossificans can occur as a result of both single injuries and repetitive trauma. Myositis ossificans is a condition where bone forms within muscle tissue, typically as a result of trauma or injury. It can be recognized by plain film radiographs, and it is believed to be caused by periosteal cells invading the hematoma following injury. However, it is not limited to a single injury and can also occur due to repetitive trauma.

Explanation

Myositis ossificans usually results from a single injury and not repetitive trauma. This statement is not true because myositis ossificans can occur as a result of both single injuries and repetitive trauma. Myositis ossificans is a condition where bone forms within muscle tissue, typically as a result of trauma or injury. It can be recognized by plain film radiographs, and it is believed to be caused by periosteal cells invading the hematoma following injury. However, it is not limited to a single injury and can also occur due to repetitive trauma.

28. At what age should a child be able to sit unsupported?

7 months

8 months

10 months

12 months

A child should be able to sit unsupported at around 7 months of age. At this stage, their muscles and coordination have developed enough to support their body weight while sitting upright without any assistance. It is important for infants to achieve this milestone as it indicates the development of their core strength and balance, which are essential for further motor skills such as crawling and walking.

Explanation

A child should be able to sit unsupported at around 7 months of age. At this stage, their muscles and coordination have developed enough to support their body weight while sitting upright without any assistance. It is important for infants to achieve this milestone as it indicates the development of their core strength and balance, which are essential for further motor skills such as crawling and walking.

29. During an evaluation of a traumatic brain-injured patient the therapist notes the patient's mumbling phrases, which are non-purposeful in nature. As the physical therapist initiates a passive range of motion to the patient's lower extremities the patient attempts to strike the therapist in the head. According to the Ranchos Los Amigos Levels of cognitive functioning, this patient would be best described at the level.

II

III

IV

V

The patient's attempt to strike the therapist in the head indicates purposeful and aggressive behavior, which is characteristic of Level IV in the Ranchos Los Amigos Levels of cognitive functioning. At this level, the patient is able to respond to simple commands and demonstrate more complex and purposeful behavior, although they may still be confused and have difficulty with problem-solving and memory.

Explanation

The patient's attempt to strike the therapist in the head indicates purposeful and aggressive behavior, which is characteristic of Level IV in the Ranchos Los Amigos Levels of cognitive functioning. At this level, the patient is able to respond to simple commands and demonstrate more complex and purposeful behavior, although they may still be confused and have difficulty with problem-solving and memory.

30. A stroke patient is exercising in supine. As the therapist resists the adduction of the unaffected leg, the affected leg begins to adduct. This should be documented as

Souque’s phenomenon

Overextension phenomenon

Schunkel reflex

Raimiste’s phenomenon

Raimiste's phenomenon refers to the adduction of the affected leg when the therapist resists the adduction of the unaffected leg in a stroke patient exercising in supine position. This phenomenon is observed due to the abnormal muscle synergies and spasticity commonly seen in stroke patients. It is important to document this phenomenon as it can provide valuable information about the patient's motor control and impairments.

Explanation

Raimiste's phenomenon refers to the adduction of the affected leg when the therapist resists the adduction of the unaffected leg in a stroke patient exercising in supine position. This phenomenon is observed due to the abnormal muscle synergies and spasticity commonly seen in stroke patients. It is important to document this phenomenon as it can provide valuable information about the patient's motor control and impairments.

31. An above knee amputee is gait training with their prosthesis. The patient ambulates consistently with an abducted gait on the prosthetic side. All of the following may cause this gait pattern EXCEPT

High medial wall

Inadequate suspension

Excessive knee friction

Prosthesis is too short

The gait pattern of an abducted gait on the prosthetic side in an above knee amputee can be caused by several factors such as a high medial wall, inadequate suspension, and excessive knee friction. However, the prosthesis being too short would not typically cause this gait pattern.

Explanation

The gait pattern of an abducted gait on the prosthetic side in an above knee amputee can be caused by several factors such as a high medial wall, inadequate suspension, and excessive knee friction. However, the prosthesis being too short would not typically cause this gait pattern.

32. What is the first functional task that should be taught to a T2 spinal cord injured patient?

Rolling over

Self range of motion

Ambulation with long leg braces

Bed to wheelchair transfer

The first functional task that should be taught to a T2 spinal cord injured patient is rolling over. This task is important as it helps the patient gain independence and mobility in bed. Rolling over also helps prevent pressure ulcers and improves circulation. By mastering this task, the patient will be able to reposition themselves comfortably and reduce the risk of complications associated with immobility.

Explanation

The first functional task that should be taught to a T2 spinal cord injured patient is rolling over. This task is important as it helps the patient gain independence and mobility in bed. Rolling over also helps prevent pressure ulcers and improves circulation. By mastering this task, the patient will be able to reposition themselves comfortably and reduce the risk of complications associated with immobility.

33. A physical therapist is treating a 16-year-old football player who has recently recovered from a hamstring strain, which he injured while attempting a field goal two weeks ago. The therapist is concerned that the athlete will not follow through with the stretching exercises once he is released from therapy. Which statement would be considered inaccurate when describing the benefits of stretching to the football player?

Stretching will make football easier for you because it prepares you body for activity

Stretching will increase you range of motion in your kicking leg

Stretching will increase the tension in your leg and allow you to kick further

Stretching will help your coordination by allowing free and easy movement

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Explanation

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34. An increasing number of states offer consumers the ability to enter the health care system by going directly to a physical therapist. Which statement describing the effects of direct access is accurate?

Physical Therapist’s malpractice rates have sharply risen as a result of direct access.

Insurance carriers may deny claims without a physician’s signature in states with direct access.

Physical therapy has been overutilized in states with direct access.

Physicians are being alienated by physical therapists in states with direct access.

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Explanation

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35. Which statement concerning the anterior cruciate ligament is true?

It is maximally taut between 0-20 and 70-90 degrees of knee flexion

It resists posterior tibial displacement

It inserts on the medial femoral intercondylar notch

All of these

The correct answer is that the anterior cruciate ligament is maximally taut between 0-20 and 70-90 degrees of knee flexion. This means that the ligament is most stretched and under the most tension during these specific angles of knee movement. This information is important for understanding the function and biomechanics of the anterior cruciate ligament in stabilizing the knee joint.

Explanation

The correct answer is that the anterior cruciate ligament is maximally taut between 0-20 and 70-90 degrees of knee flexion. This means that the ligament is most stretched and under the most tension during these specific angles of knee movement. This information is important for understanding the function and biomechanics of the anterior cruciate ligament in stabilizing the knee joint.

36. What functional position should the metacarpophalangeal joint be placed to when designing a splint?

Complete extension

20-40 degrees of flexion

50-60 degrees of flexion

70-90 degrees of flexion

When designing a splint for the metacarpophalangeal joint, it should be placed in a position of 20-40 degrees of flexion. This position allows for optimal function and movement of the joint while still providing support and stability. It also helps to prevent stiffness and contractures in the joint.

Explanation

When designing a splint for the metacarpophalangeal joint, it should be placed in a position of 20-40 degrees of flexion. This position allows for optimal function and movement of the joint while still providing support and stability. It also helps to prevent stiffness and contractures in the joint.

37. Progress notes allow members of all health services to know what the patient is accomplishing in each given area. Which statement regarding physical therapy progress notes is not true?

Observations and recordings should be the result of tangible tests and measurements.

The progress note must contain patient identification, the date and the signature of the therapist.

Progress notes can include diagrams, graphs and flow sheets

Ogress notes should be written by physical therapists and not by other care providers such as physical therapist assistants.

Progress notes should not be written exclusively by physical therapists and not by other care providers such as physical therapist assistants. This statement is not true because progress notes can be written by any member of the healthcare team who is involved in the patient's care, including physical therapist assistants. Progress notes are important for communication and collaboration among healthcare professionals, and it is essential for all members of the team to contribute to the documentation process.

Explanation

Progress notes should not be written exclusively by physical therapists and not by other care providers such as physical therapist assistants. This statement is not true because progress notes can be written by any member of the healthcare team who is involved in the patient's care, including physical therapist assistants. Progress notes are important for communication and collaboration among healthcare professionals, and it is essential for all members of the team to contribute to the documentation process.

38. Postural drainage with percussion and vibration is indicated to a patient's lateral basal lung segments. Standard positioning for these lung segments is contraindicated secondary to the patient's inability to tolerate an increase in venous return. This position would best be modified by

Raising the head and neck to decrease venous return

Lying the patient in supine with the lower extremities declined

Positioning the patient in sidelying with a small decline in the head and chest

There is no possible modification to the positions which are effective

The patient's inability to tolerate an increase in venous return indicates that the patient is not able to handle a position that would cause blood to pool in the lungs. Therefore, raising the head and neck to decrease venous return would not be appropriate. Lying the patient in supine with the lower extremities declined would increase venous return and is contraindicated. Positioning the patient in sidelying with a small decline in the head and chest would allow for postural drainage while minimizing the increase in venous return, making it the best modification.

Explanation

The patient's inability to tolerate an increase in venous return indicates that the patient is not able to handle a position that would cause blood to pool in the lungs. Therefore, raising the head and neck to decrease venous return would not be appropriate. Lying the patient in supine with the lower extremities declined would increase venous return and is contraindicated. Positioning the patient in sidelying with a small decline in the head and chest would allow for postural drainage while minimizing the increase in venous return, making it the best modification.

39. A C4 quadriplegic is able to adduct the scapula using the

Middle trapezius

Serratus anterior

Subscapularis

Rhomboids

The middle trapezius muscle is responsible for adducting the scapula. In a C4 quadriplegic, the function of the upper extremities is affected, and they may have limited or no control over their muscles. However, the middle trapezius muscle is innervated by the spinal accessory nerve (CN XI), which arises from the cervical spinal cord segments C3 and C4. Therefore, even in a C4 quadriplegic, the middle trapezius muscle may still have some residual function, allowing for adduction of the scapula.

Explanation

The middle trapezius muscle is responsible for adducting the scapula. In a C4 quadriplegic, the function of the upper extremities is affected, and they may have limited or no control over their muscles. However, the middle trapezius muscle is innervated by the spinal accessory nerve (CN XI), which arises from the cervical spinal cord segments C3 and C4. Therefore, even in a C4 quadriplegic, the middle trapezius muscle may still have some residual function, allowing for adduction of the scapula.

40. Compression of any part of the central nervous system causing ischemia for greater than ____ minutes will result in the death of nervous tissue.

3-5

6-8

10-12

15-20

Compression of any part of the central nervous system causing ischemia for greater than 3-5 minutes will result in the death of nervous tissue. Ischemia refers to the restriction of blood supply to tissues, which can lead to a lack of oxygen and nutrients. The central nervous system, which includes the brain and spinal cord, is highly sensitive to ischemia. Without an adequate blood supply, the nervous tissue cannot function properly and will eventually die. Therefore, if compression lasts for more than 3-5 minutes, irreversible damage to the nervous tissue will occur.

Explanation

Compression of any part of the central nervous system causing ischemia for greater than 3-5 minutes will result in the death of nervous tissue. Ischemia refers to the restriction of blood supply to tissues, which can lead to a lack of oxygen and nutrients. The central nervous system, which includes the brain and spinal cord, is highly sensitive to ischemia. Without an adequate blood supply, the nervous tissue cannot function properly and will eventually die. Therefore, if compression lasts for more than 3-5 minutes, irreversible damage to the nervous tissue will occur.

41. A wheelchair designed for a paraplegic patient should include

Reclining frame

Elevating leg rests

Handrims with 12 vertical projections

Removable arms

A wheelchair designed for a paraplegic patient should include removable arms to provide flexibility and ease of use. This allows the patient to easily transfer in and out of the wheelchair, as well as facilitate activities that require more space or freedom of movement. Removable arms also make it easier for caregivers to assist the patient with tasks such as transferring or positioning. Overall, removable arms enhance the functionality and accessibility of the wheelchair for the paraplegic patient.

Explanation

A wheelchair designed for a paraplegic patient should include removable arms to provide flexibility and ease of use. This allows the patient to easily transfer in and out of the wheelchair, as well as facilitate activities that require more space or freedom of movement. Removable arms also make it easier for caregivers to assist the patient with tasks such as transferring or positioning. Overall, removable arms enhance the functionality and accessibility of the wheelchair for the paraplegic patient.

42. A patient with hemiplegia should be positioned in side-lying on their affected side early in rehabilitation. The advantages of this position include all of the following EXCEPT

Decrease in spasticity of the affected side

Elongation of the affected side

Improved gross motor coordination of the affected side

Increased physical awareness of the affected side

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Explanation

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43. A C4 quadriplegic patient requires a custom wheelchair upon discharge from the hospital. The patient's diaphragm is partially innervated. The most appropriate recommendations for proper seating are

Light weight manual wheelchair, upright frame, back extension, seat and back cushions

Folding reclining wheelchair, power chin control, seat and back cushions

Non-folding reclining wheelchair, power tongue control, underslung tray for ventilator

Upright power wheelchair, joystick hand control, seat cushion

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Explanation

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44. A therapist evaluates a patient placed in respiratory isolation. Which of the following diseases would require respiratory isolation?

Diphtheria

Pharyngitis

Pertussis

Hepatitis

Pertussis, also known as whooping cough, is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. It is characterized by severe coughing fits, which can make it difficult for patients to breathe. Due to its contagious nature and the potential for transmission through respiratory droplets, patients with pertussis need to be placed in respiratory isolation to prevent the spread of the disease to others. Diphtheria, another option, is also a respiratory disease that requires isolation, but it is not the correct answer in this case. Pharyngitis and hepatitis are not primarily respiratory diseases and do not require respiratory isolation.

Explanation

Pertussis, also known as whooping cough, is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. It is characterized by severe coughing fits, which can make it difficult for patients to breathe. Due to its contagious nature and the potential for transmission through respiratory droplets, patients with pertussis need to be placed in respiratory isolation to prevent the spread of the disease to others. Diphtheria, another option, is also a respiratory disease that requires isolation, but it is not the correct answer in this case. Pharyngitis and hepatitis are not primarily respiratory diseases and do not require respiratory isolation.

45. What type of suspension devices is appropriate for a below-knee prosthesis?

Thigh corset

Patella tendon bearing supracondylar suspension

Cup suspension

All of these

All of these suspension devices are appropriate for a below-knee prosthesis. A thigh corset is a type of suspension device that wraps around the thigh to provide support and secure the prosthesis. Patella tendon bearing supracondylar suspension involves using a supracondylar cuff that fits over the thigh and transfers weight through the patella tendon. Cup suspension involves using a cup-shaped device that fits over the residual limb and provides suction or vacuum suspension. Therefore, all three options are suitable for a below-knee prosthesis.

Explanation

All of these suspension devices are appropriate for a below-knee prosthesis. A thigh corset is a type of suspension device that wraps around the thigh to provide support and secure the prosthesis. Patella tendon bearing supracondylar suspension involves using a supracondylar cuff that fits over the thigh and transfers weight through the patella tendon. Cup suspension involves using a cup-shaped device that fits over the residual limb and provides suction or vacuum suspension. Therefore, all three options are suitable for a below-knee prosthesis.

46. A patient is referred to physical therapy diagnosed with right hip trochanteric bursitis. Which clinical finding is usually not associated with trochanteric bursitis?

Resisted abduction will reproduce symptoms

No function limitations in active range of motion

Positive Ober’s test

Joint play motions are limited in a capsular pattern

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Explanation

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47. A therapist completes an isokinetic evaluation of an 18-year-old male rehabilitating from a medial meniscectomy. The therapist notes that the patient produces 140 ft/lbs of force in the uninvolved quadriceps at 60 degrees per second. Assuming a normal ration of hamstrings to quadriceps strength, which of the following would be an acceptable hamstring reading at 60 degrees per second?

64 ft/lbs

84 ft/lbs

114 ft/lbs

154 ft/lbs

Based on the information provided, the therapist notes that the patient produces 140 ft/lbs of force in the uninvolved quadriceps at 60 degrees per second. Assuming a normal ratio of hamstrings to quadriceps strength, an acceptable hamstring reading at 60 degrees per second would be 84 ft/lbs.

Explanation

Based on the information provided, the therapist notes that the patient produces 140 ft/lbs of force in the uninvolved quadriceps at 60 degrees per second. Assuming a normal ratio of hamstrings to quadriceps strength, an acceptable hamstring reading at 60 degrees per second would be 84 ft/lbs.

48. Health maintenance organizations differ from a typical feel for service insurance providers in a variety of ways. Which of the following does not accurately describe health maintenance organizations?

Members are limited to receiving services from specific providers.

Payment to providers is often on a capitation or prospective basis.

Health maintenance organizations are responsible for the provision and accessibility of care

Health maintenance organizations (HMOs) do not provide services for a monthly fee that varies based on the amount of services utilized by each member. Instead, HMOs typically charge a fixed monthly premium, regardless of the amount of services used. This is one of the ways in which HMOs differ from other insurance providers. HMOs also restrict members to receiving services from specific providers, pay providers on a capitation or prospective basis, and are responsible for the provision and accessibility of care.

Explanation

Health maintenance organizations (HMOs) do not provide services for a monthly fee that varies based on the amount of services utilized by each member. Instead, HMOs typically charge a fixed monthly premium, regardless of the amount of services used. This is one of the ways in which HMOs differ from other insurance providers. HMOs also restrict members to receiving services from specific providers, pay providers on a capitation or prospective basis, and are responsible for the provision and accessibility of care.

49. Which activity does not normally develop between the 9th and 12th months of normal development?

Pincer grasp

Begins walking

Transfers objects from one hand to the other

Stand with high guard

Between the 9th and 12th months of normal development, infants typically develop the ability to transfer objects from one hand to the other. This is an important milestone in their motor skills development as it demonstrates their increasing coordination and dexterity. The pincer grasp, which involves using the thumb and index finger to pick up small objects, typically develops around 9-10 months. By the 12th month, most infants are able to stand with a high guard, using support to maintain balance. Walking usually begins around this time as well, with infants taking their first steps and gradually gaining confidence in their ability to walk independently. Therefore, the activity that does not normally develop between the 9th and 12th months is transferring objects from one hand to the other.

Explanation

Between the 9th and 12th months of normal development, infants typically develop the ability to transfer objects from one hand to the other. This is an important milestone in their motor skills development as it demonstrates their increasing coordination and dexterity. The pincer grasp, which involves using the thumb and index finger to pick up small objects, typically develops around 9-10 months. By the 12th month, most infants are able to stand with a high guard, using support to maintain balance. Walking usually begins around this time as well, with infants taking their first steps and gradually gaining confidence in their ability to walk independently. Therefore, the activity that does not normally develop between the 9th and 12th months is transferring objects from one hand to the other.

50. A patient presents with severe orthostatic hypotension. The most appropriate immediate technique to incorporate into treatment that will assist with standing is

Standing in parallel bars with increasing time intervals

Using a standing table

Standing in a pool

Tilt table with progressive vertical positioning

Standing in a pool is the most appropriate immediate technique to incorporate into treatment for a patient with severe orthostatic hypotension. The hydrostatic pressure exerted by the water helps to increase blood volume and improve circulation, which can alleviate symptoms of orthostatic hypotension. Additionally, the buoyancy of the water provides support and reduces the risk of falls or injury while standing. This technique allows the patient to gradually adjust to an upright position and build tolerance to standing, making it an effective intervention for orthostatic hypotension.

Explanation

Standing in a pool is the most appropriate immediate technique to incorporate into treatment for a patient with severe orthostatic hypotension. The hydrostatic pressure exerted by the water helps to increase blood volume and improve circulation, which can alleviate symptoms of orthostatic hypotension. Additionally, the buoyancy of the water provides support and reduces the risk of falls or injury while standing. This technique allows the patient to gradually adjust to an upright position and build tolerance to standing, making it an effective intervention for orthostatic hypotension.