question

Neurogenic Claudication S/Sx

answer

weakness, cramping, pain in legs exacerbated w/activity

question

High Guard position - Infant

answer

arms held near shoulder level w/retraction of scapulae rhomboid mm important for retracting scapulae

question

Treating pt w/cerebral palsy. Limited experience. Most appropriate action:

answer

Co-treat w/other therapist. External assistance as well as improving skills w/particular pt population

question

Stroke involving cerebellar artery S/Sx

answer

impaired ability to execute accurate, smooth, controlled movements dysarthria due to motor component of slurred speech and speech articulation

question

Clinical presentation of excessive involuntary and extraneous movements including hemiballismus. Where is lesion?

answer

basal ganglia

question

Dyspraxia

answer

developmental coordination disorder slow movement times, poor motor sequencing, poor motor memory, perceptual problems crowded hallway will be most difficult school related activity due to having to maintain balance, change surfaces, and avoid obstacles

question

TBI and Positive Support Reflex

answer

PSR - increase in extensor tone through LEs and trunk use therapeutic ball to allow supported trunk flexion when standing which helps avoid reflex

question

Pusher Syndrome

answer

significant lateral deviation toward the hemiplegic side or away from the lesion side

question

Hoffman's Reflex

answer

tapping or snapping the nail of the middle finger abnormal repsonse = flexion of the first finger and thumb

question

Brunnstrom's Stages of Recovery - #6

answer

disappearance of spasticity and the ability to complete isolated joint movements in a coordinated fashion

question

Brunnstrom Stage 4

answer

movement patterns beginning outside of synergy patterns and diminished spasticity

question

Which child reflex make neck flexion difficult while in a supine position?

answer

symmetrical tonic labyrinthine reflex (promotes tendency for extension when in supine)

question

Objective finding with 5 month old child progressing from propped sitting to ring sitting?

answer

increased strength of trunk extensors to allow for more upright sitting (propped sitting - forward trunk flexion w/ UEs for support)

question

Glasgow Coma Scale

answer

Review!

question

TBI pattern of spasticity w/UMN lesion

answer

UE scapula - retraction/downward rotation shoulder - adduction/internal rotation elbow - flexion/pronation wrist - flexion finger - flexion/adduction

question

Type of wheelchair needed for a pt w/ an incomplete SCI who is very active and relies on a wheelchair as her primary mode of transportation

answer

lightweight chair with a rigid frame lightweight - easier to propel/manuever rigid frame - durability and strength

question

What muscles are activated during a hip strategy in response to backward sway?

answer

paraspinals and hamstrings

question

What muscles are activated during a hip strategy in response to forward sway?

answer

quadriceps and abdominals

question

Ankle strategy mm activation with forward sway

answer

gastroc, paraspinals, hamstrings

question

Ankle strategy mm activation with backward sway

answer

abdominals, quadriceps, tibialis anterior

question

Receptor type responsible for sensations of touch, pressure, itch, tickle, vibration, and discriminative touch

answer

mechanoreceptors

question

Receptor type responsible for position sense, proprioception, muscle tone, and movement

answer

deep sensory receptors

question

Receptor type responsible for perception of pain

answer

nociceptors

question

Receptor type responsible for changes in temperature

answer

thermoreceptors

question

Notice inconsistencies in patient during examination in work hardening program. What should you do?

answer

avoid discussing identified inconsistency with patient continue to monitor during future treatment sessions

question

Primary purpose of Phenobarbital medication?

answer

prevent seizures may also cause sedation, nystagmus, vitamin deficiencies, and ataxia

question

PNF technique to improve forward stooped posture

answer

D2 flexion - pulling out the sword

question

Most important factor to determine when administering the Romberg test on a patient

answer

amount of sway present during the test

question

Most appropriate location to elicit the bracioradialis reflex

answer

styloid process of the radius

question

Sitting Balance - Poor Grade

answer

person unable to maintain balance in sitting without external support or assistance

question

Sitting Balance - Fair Grade

answer

able to maintain balance in sitting unsupported, but cannot accept any challenge or go outside BOS

question

Sitting Balance - Good Grade

answer

able to sit unsupported, move in/out of BOS, accept some challenge

question

Sitting Balance - Normal Grade

answer

sit unsupported, move in/out of BOS, accept maximal challenge without LOB

question

Which action would facilitate elbow extension in a patient with hemiplegia?

answer

turn head to the affected side ATNR reflex

question

Pt with BPPV. Most beneficial treatment option?

answer

canalith repositioning maneuvers

question

Screening tool used for BPPV

answer

Dix-Hallpike manuever

question

Cognitive Assessment used by PT asking pt to count from 1 to 25 by increments of 3. Which cognitive function is being assessed?

answer

attention

question

Cognitive assessment: Constructional ability

answer

asking a person to copy figures consisting of varying sizes and shapes or to draw a clock

question

Cognitive assessment: Abstract Ability

answer

asking a person to describe similarities or differences between 2 objects; interpret a common proverb

question

Pt with TBI; bothered by diplopia. What is the most appropriate way to address diplopia?

answer

place a patch over one of the patient's eyes - diplopia is double vision due to defective function of the extraocular muscles

question

Anterolateral Spinothalamic system function

answer

pain, temperature, light touch, pressure

question

Somatoagnosia

answer

impairment of body schema where there is a lack of awareness of a body structure and its relationship to other body parts, to oneself or others - Ex: pt attempting to brush hair, doesn't realize that mirror image is not the true body part

question

Associated reaction where resistance to flexion of the UE causes flexion in the involved LE

answer

homolateral synkinesis

question

Associated reaction when the involved LE abducts or adducts with applied resistance to the uninvolved LE in the same direction

answer

Ramiste's phenomenon

question

Associated reaction that produces extension and abduction of involved fingers when involved UE is raised above 100 degrees with the elbow extended

answer

Souque's phenomenon

question

Objective finding where patient is unable to heel walk; may indicate damage to what neuro structure?

answer

corticospinal tract

question

Which therapeutic exercise technique would allow a patient to improve dynamic stability with lateral weight shifting in prone on elbows?

answer

approximation - facilitate contraction and stability through joint compression

question

Which bony landmark would be most appropriate to utilize when formally measuring distance with a Functional Reach Test?

answer

third metacarpal - pt's hand in fist

question

Which screening tool examines a patient's ability to perform a variety of activities of daily living independently?

answer

Barthel Index - looks at 10 ADLs, 0-100 scoring in increments of 5. Score = 100 = independent

question

Cremasteric Reflex

answer

stroke skin of the superior and medial thigh - causes testicle on that side to come up - caused by UMN/LMN disorders as well as L1-L2 level injury

question

Which area of the brain is responsible for perception?

answer

somatosensory cortex - responsible for complex processing of sensory information - touch, temperature, pain, sterognosis, position sense

question

Myotome tested when asking patient to squeeze a piece of paper between the index and middle fingers?

answer

T1 myotome - ulnar nerve - weakness of finger abduction and adduction

question

Muscle groups that are most instrumental when performing pull to sit manuever with infant?

answer

abdominals, cervical flexors, hip flexors - all contribute to generate flexion moment to overcome force of gravity

question

What is controlled mobility?

answer

ability to move within a weight bearing position or rotate around a long axis - 3rd stage of mobility

question

What is most likely rationale for child with down syndrome sitting in "W" sitting position?

answer

decreased core strength - children with D.S have poor core strength that can impact ability to maintain static and dynamic postures - "W" sitting increases BOS and requires less trunk control and balance

question

Pt with CVA - hip flexion 3+/5, hip extension 3/5, knee flexion/extension - 3+/5, ankle dorsiflexion 2+/5, inversion/eversion - 1/5. Most appropriate orthosis:

answer

plastic articulating AFO due to pt's high hip/knee strength - metal AFO used for sensory/tone deficits

question

Cranial nerve responsible for taste on anterior 2/3 of tongue

answer

- CN VII - facial nerve

question

The spinothalamic tract is responsible for what sensations?

answer

- light touch - temperature - pain perception

question

Dorsal column-medial lemniscus tract function

answer

- proprioception - stereognosis - kinesthesia - Posterior cord syndrome impairment

question

What is the spinal cord level at which independent transfers with a sliding board would be feasible?

answer

C6 - patient will have wrist extension, shoulder flexion, elbow flexion

question

EMG reveals denervation of flexor pollicus longus, flexor digitorum profundus, and pronator quadratus mm. Most likely associated with what pathology?

answer

anterior interosseous syndrome - characterized by injury to the anterior interosseous nerve being trapped or pinched between the two heads of the pronator teres mm

question

Use of phonetics with patient with a CVA with speech and language deficits. Intervention most essential for patient diagnosed with:

answer

dysarthria - motor disorder of speech - affects muscles used to articulate words and sounds

question

A patient reports fatigue, proximal upper extremity weakness, and double vision that increases in intensity as the day progresses. The patient demonstrates bilateral ptosis of the eyelids, difficulty chewing, dysphagia, and inability to raise the eyebrows. Which of the following conditions is MOST likely present?

answer

myasthenia gravis

question

Which of the following factors is MOST important when considering footwear for a patient with diabetes?

answer

Snug fit around the heel - prevent friction forces on heel

question

A patient who has meralgia paresthetica has been referred to physical therapy. Which of the following clinical features is MOST likely to be assessed by the physical therapist during the examination?

answer

Sensation of the lateral aspect of the thigh - Meralgia paresthetica is an entrapment or injury to the lateral femoral cutaneous nerve, a purely sensory nerve. Injury effects sensation to the lateral thigh.

question

The patient is unable to flex the distal phalanx of the thumb and index fingers (1st and 2nd digits) is caused by compression of what nerve?

answer

anterior interosseous nerve

question

A patient reports upper extremity numbness and tingling that extends from the neck to the thumb and index finger (1st and 2nd digits). Which of the following shoulder positions would MOST likely exacerbate the patient's symptoms?

answer

Lateral (external) rotation with abduction

question

Lesion of the long thoracic nerve will cause what type of asymmetrical scapula positioning?

answer

winging of scapula

question

Which of the following activities should be the PRIMARY emphasis of a physical therapy treatment program for a child who has athetoid cerebral palsy?

answer

Facilitating cocontraction patterns and encouraging control in voluntary movement gradation

question

A patient with a transtibial amputation is being treated by a physical therapist for gait training with a prosthesis. The patient reports tingling and shooting pain at the end of the residual limb. The pain occurs whether or not the patient is wearing the prosthesis. The pain is MOST likely caused by which of the following?

answer

a neuroma - collection of axons and fibrous tissue that can cause sharp, shooting, and localized pain. It is part of the natural repair process

question

A patient being evaluated for a C4-C5 herniated disc also reports having periodic dizziness. Which of the following actions should the physical therapist perform INITIALLY?

answer

Ask questions about the precipitating factors for the dizziness

question

Which of the following types of practice is MOST appropriate for long-term motor learning for a patient with a cerebrovascular accident?

answer

Varied task practice with variable time intervals - random practice provides a higher level of contextual interference that requires the individual to retrieve practice from memory stores

question

A physical therapist is treating a person who had a cerebrovascular accident and is unable to support full weight on the affected lower extremity. The patient's primary goal is to return to walking independently. Which of the following is the MOST effective intervention?

answer

Treadmill training with a harness and partial body-weight support - important to start upright walking

question

Hoehn and Yahr Classification of Disability scale Stage IV

answer

moderate to severe disability with Parkinson's

question

A patient who has a C5 complete spinal cord injury suddenly reports light-headedness and ringing in the ears while sitting upright in a wheelchair. Which of the following conditions is MOST likely present?

answer

orthostatic hypotension

question

An infant's family has just been referred to physical therapy for discharge instructions following surgical repair of an L5 myelomeningocele. Which of the following is MOST critical for the family to learn before leaving the hospital?

answer

Signs of increased intracranial pressure - hydrocephalus is common sign of meningocele

question

A patient with a mild hemiparesis is able to stand and walk independently with a quad cane, but reports difficulty transferring from sitting to standing. A physical therapist is MOST likely to find the cause of the difficulty by testing the patient's:

answer

lower extremity strength - harder for sit to stand then ambulation only

question

A physical therapist examines a patient with a left transfemoral amputation and an acute episode of low back pain. Which muscle can the therapist test for S1 nerve root function on the patient's left side?

answer

gluteus medius - innervated by the superior gluteal nerve (L5, S1)

question

The BEST approach for examining anticipatory postural control is to observe the positional changes of the trunk while the patient is:

answer

reaching for an object

question

A physical therapist is treating a patient with a traumatic brain injury who has severe cognitive impairments and bilateral hip and knee flexion contractures. The MOST appropriate intervention to treat the patient's contractures is:

answer

prolonged stretch technique

question

A patient with a brainstem infarction resulting in left lateral medullary syndrome is MOST likely to demonstrate which of the following symptoms?

answer

Loss of pain and temperature sensation in the right side of the body - spinothalamic tract involving pain and temperature lies in lateral aspect of spinal cord

question

A patient with complete C6 tetraplegia reports a 3-day history of increased lower extremity spasticity, left shoulder pain, and fever. Which of the following conditions is MOST likely responsible for these findings?

answer

urinary tract infection - can influence spasticity, almost always involves fever, and can refer pain to ipsilateral shoulder

question

Which of the following activities tests a patient's limits of stability in standing position?

answer

Measure how far the patient can reach without losing balance - limit of stability in any direction is how far outside the base of support a person can move without losing balance

question

Which of the following tools is MOST appropriate for assessing progress in an 8-year-old child who has cerebral palsy with spastic quadriplegia and limited mobility?

answer

Gross Motor Function Measure (GMFM) - constructed to evaluate progress over time in children with cerebral palsy

question

Bruininks-Oseretsky Test of Motor Proficiency

answer

test of motor function for children 4 to 21 years of age. test is primarily constructed to assess motor coordination and balance

question

A patient sustained a cervical hyperextension injury that caused bleeding into the central gray matter of the lower cervical spinal cord. Which of the following descriptions BEST reflects the highest level of function the patient is likely to achieve?

answer

Ability to walk but difficulty with distal upper extremity and hand function - example of central cord syndrome - more trouble with UEs than LEs

question

For a patient with a lesion proximal to the dorsal root ganglion, a sensory nerve conduction velocity test will reveal that conduction times are:

answer

within normal limits - only measures the distal component of a peripheral nerve

question

After a 30-day backpacking trip, a patient has pain over the lateral aspect of the shoulder. Upon examination of the patient, the physical therapist notes weakness of elbow flexion and shoulder abduction on the same side as the pain. A lesion at which of the following sites is MOST likely the source of these symptoms?

answer

Upper trunk of the brachial plexus - damage to C5/C6 nerve roots

question

A patient with myasthenia gravis has been transferred from intensive care to an acute care neurology unit after a myasthenic crisis. Which of the following physical therapy interventions is MOST appropriate for the patient?

answer

deep breathing exercises - acute care setting, deep breathing and coughing should be encouraged

question

A 30-year-old female is seen in physical therapy secondary to benign paroxysmal positional vertigo. Which of the following physical therapy treatments would MOST benefit this patient?

answer

canalith repositioning manuevers - Dix-Hallpike manuever is diagnostic tool not intervention

question

A patient with complete C6 tetraplegia is learning how to perform a wheelchair to mat transfer. Which of the following muscles can effectively lock the patient's elbows during the transfer?

answer

anterior deltoids - with appropriate hand placement in WB position, shoulder flexion can lock the elbow in extension

question

A physical therapist works with a patient rehabilitating from a stroke on strategies to compensate for form-constancy dysfunction. Which strategy would be the MOST appropriate based on the stated objective?

answer

use tactile cues to feel objects in various positions to increase familiarity with the object - pt's with form-constancy dysfunction have difficulty attending to subtle variations in form or changes in form such as a size variation of the same object

question

A physical therapist designs an exercise program for a patient diagnosed with a lower motor neuron lesion. The patient often exhibits a short attention span and when fatigued the therapist has noted a sharp drop off in performance. What type of practice would be the MOST appropriate based on the patient's current status?

answer

distributed practice - Distributed practice is defined as a session in which the amount of rest between trials is equal to or greater than the amount of practice time in a trial. Since the patient has a short attention span and a drop in performance with fatigue, this type of practice would be the most appropriate

question

A physical therapist talks with a mother holding her three-month-old infant. During the conversation the mother loses control of the baby's head, suddenly dropping it into extension. What reflex would this action MOST likely elicit?

answer

Moro Reflex - stimulated by a sudden change in the position of the head relative to the trunk

question

A physical therapist treats a patient diagnosed with central cord syndrome following a motor vehicle accident. Which mechanism of injury is MOST often associated with the diagnosis?

answer

hyperextension of the cervical spine - Traumatic cervical hyperextension is most commonly associated with central cord syndrome. The resultant injury typically involves the spinothalamic tract, corticospinal tract, and dorsal columns

question

A physical therapist administers an electrotherapy treatment for the purpose of muscle reeducation. According to the strength duration curve, which of the following BEST describes the order of nerve fiber recruitment as the amplitude is increased?

answer

sensory fibers, motor fibers, pain fibers - Sensory fibers require the lowest amplitude to depolarize and pain fibers require the greatest amplitude to depolarize

question

Antispasticity Agents Side effects

answer

- reduce hypertonicity and spasticity - Baclofen S.E : hypotonicity, generalized weakness, confusion, sedation, dizziness, and liver toxicity

question

Dopamine Replacement Agents Side Effects

answer

- reduce symptoms associated with PD - Levodopa S.E : arrhythmia, gastrointestinal distress, mood changes, dyskinesia, hypotension, and fatigue

question

Antiepileptic Agent Side Effects

answer

- reduce/manage seizure activity - Gabapentin S.E : ataxia, behavioral changes, gastrointestinal distress, headache, blurred vision, and weight gain

question

Muscle Relaxant Agents Side Effects

answer

- reduce muscle spasm due to musculoskeletal or peripheral nerve injury - Diazepam S.E. : sedation, dizziness, nausea, vomiting, and dependence

question

A 21-year-old male has a complete spinal cord injury at the L2 level. The patient is independent with wheelchair use and has returned to independent living in the home and community. The patient is otherwise healthy and expresses a desire to begin gait training. The goal of the gait training is to enable the patient to independently:

answer

ambulate within his home environment with knee-ankle-foot orthoses - could realistically ambulate short distances with KAFOs and assistive device

question

Berg Balance Scale

answer

0-5 point scale - max score of 56 points - screen for risk of falling

question

A physical therapist determines that a patient has no sensation below the L2 dermatome after completing a sensory examination. The patient was admitted through the emergency room 14 days ago secondary to a motor vehicle accident. What is the MOST likely rationale for the patient's current condition?

answer

the patient has a complete transection of the spinal cord - only injury which would inhibit sensory information from all ascending pathways. This would result in the patient having no sensation below the level of the lesion

question

Posterior Cord syndrome/Dorsal column lesion

answer

- lose the sensations of discriminative touch, pressure, vibration, kinesthesia, and proprioception

question

Anterior Cord syndrome/Spinothalamic column lesion

answer

- lose the sensations of pain, temperature, and crude touch

question

A patient diagnosed with complete L3 paraplegia begins gait training with custom orthotics in an acute rehabilitation hospital. Which muscle would not contribute to the fluidity of the patient's gait?

answer

semitendinosus - essential to the performance of functional activities such as rising from a chair and stair climbing and derives its primary innervation from the L5-S1 nerve roots and the tibial nerve

question

A 35-year-old female is referred to physical therapy for rehabilitation after sustaining an injury to her left knee and lower leg in an automobile accident six weeks ago. Sensory evaluation revealed some loss of superficial tactile sensation over the posterolateral aspect of the lower leg and heel. What peripheral nerve would MOST likely be involved?

answer

sural nerve - branch of the tibial nerve which supplies sensation to the posterolateral aspect of the lower leg and lateral foot

question

A physical therapist works with a 40-year-old male who is status post stroke. The patient reports having difficulty clearing his leg when taking a step. When observing his gait, it is clear that the patient advances his leg by hip hiking. Which of the following activities would be the MOST beneficial to improve the patient's motor control during swing?

answer

marching in place when standing - Marching addresses all muscles involved in the swing phase of gait

question

A patient sustained a T10 complete spinal cord injury. Which of the following wheelchair-to-bed transfer techniques is MOST appropriate for the patient?

answer

sit pivot transfer - pt has partial to full innervation of trunk musculature and should be able to independently perform sit pivot transfer

question

Which of the following functions is MOST likely to be impaired in a patient who has a pontine infarct?

answer

jaw movement - Observed jaw deviation during mastication results from an insult to the trigeminal nerve, which originates in the pons

question

A patient who has an L1 spinal cord injury (ASIA Impairment Scale A) is working toward independent walking with knee-ankle orthoses and forearm crutches. When walking with crutches, the patient is unable to achieve neutral hip extension. Which of the following interventions would BEST address this problem?

answer

stretching the hip flexors

question

A patient has impaired sensory and motor function of the left limbs and the left side of the face. The patient is unable to sit independently. In which of the following regions of the nervous system is the lesion MOST likely located?

answer

Cerebrum - a lesion in most areas of the brainstem would have facial signs contralateral to the limb signs

question

During a gait training session, a patient who has Parkinson disease exhibits freezing episodes when attempting to negotiate turns. Which of the following training methods would be MOST beneficial for the patient?

answer

Visual cue on the floor - Visual stimuli have been shown to be effective in overcoming freezing episodes in patients with Parkinson disease

question

A patient who is a waiter has hand pain when carrying trays overhead. Which of the following nerve tension tests is MOST likely to have a positive result?

answer

ulnar nerve - overhead positioning of carrying food trays is similar to the end position of the ulnar nerve tension test

question

A patient complains of cervical muscle tightness and headaches originating in the back of the head. Which of the following nerves is MOST likely involved?

answer

Lesser occipital - a cutaneous nerve supplying the skin of the neck and scalp posterior superior to the auricle

question

A patient has a cerebellar dysfunction that affects both the trunk and the limbs. During examination, which of the following findings will MOST likely be observed?

answer

Impairments in the timing of muscle activation - Cerebellar dysfunction is characterized by delays in initiating and timing of movements - demonstrated by deficits in speed, amplitude of displacement, directional accuracy, and force of movement

question

Landau Reflex

answer

elicited by supporting the infant horizontally in prone position. The expected response is that the infant will extend the neck and trunk

question

Which of the following is the normal equilibrium response of a patient tilting side to side while seated on a rocker board?

answer

Concavity of the trunk and shoulder abduction on the upward side

question

A patient who had a cerebrovascular accident 4 days ago is being taught to roll to the uninvolved side. Which of the following motions should the physical therapist advise the patient to AVOID?

answer

Pushing against a supporting surface with the uninvolved foot. - motion will encourage extension of the trunk when rolling. The patient should be taught motions that encourage flexion of the trunk

question

During an intervention session with a patient who had a recent onset of hemiplegia, a physical therapist plans to focus on transfers to and from a wheelchair, a bathtub, and an automobile. Which of the following methods should be MOST effective for long-term retention of these skills?

answer

Practice the activities in random order - critical factor in improving learning is that the subject must do something different on consecutive trials

question

An appropriate long-term goal for a young adult with a C6 spinal cord injury and no additional complicating factors is:

answer

completing sliding board transfers to a level surface independently

question

Which of the following clinical findings is MOST likely to be associated with a C7 nerve root lesion?

answer

Inability to extend the elbow against gravity

question

Which of the following findings BEST describes a positive result of the median nerve tension test?

answer

Reproduction of symptoms in the volar (palmar) and radial side of the hand

question

Which of the following conditions would MOST likely be experienced by a 7-year-old patient who has a tethered spinal cord?

answer

Bladder dysfunction

question

A school-based physical therapist receives a referral to evaluate a 6-year-old child who falls frequently. Based on the teacher's description, the therapist suspects that the child has developmental coordination disorder. Which of the following observations would BEST support this diagnosis?

answer

Inaccuracy when throwing a ball short distances

question

A patient sustained multi-trauma injuries including a closed head injury approximately two months ago in a motor vehicle accident. The patient is working with the therapist on high level balance activities, but has difficulty with activities such as riding a bicycle and jogging. His wife states that he struggles to play the saxophone despite having done so for years prior to the accident. These deficits BEST represent:

answer

procedural memory loss - known as implicit memory, is the most basic and primitive form of memory - type of memory an individual has for procedures or "how to" knowledge for basic associations between stimuli and responses

question

A patient presents with tetraplegia and locked-in syndrome after sustaining a CVA. The patient is unable to speak, but cognitively remains intact. The MOST likely artery involved with the CVA is the:

answer

vertebral-basilar artery - Severe impairment can cause locked-in syndrome, coma or vegetative state

question

A physical therapist reviews common characteristics of central cord syndrome prior to initiating an examination. Which of the following BEST describes the typical clinical presentation?

answer

distal upper extremities are most severely affected

question

A physical therapist treats a patient diagnosed with Guillain-Barre syndrome in an acute care hospital. Based on the condition's typical clinical presentation, the therapist should anticipate that the patient will demonstrate:

answer

incoordination - GBS presents w/muscle weakness, clumsiness, and dyskinesia

question

An elderly resident of an assisted living facility's memory impairment wing repeatedly folds baskets of clean laundry each day. A family member asks why this task is not performed by the facility's staff. A staff member explains that engaging in the task is part of the resident's care plan intended to assist with:

answer

maintaining the resident's sense of purposefulness - performance of familiar repetitive tasks can be effective in assisting a patient with dementia to maintain a sense of purpose and has been shown to reduce agitation and restlessness

question

A physical therapist attempts to complete an initial interview with a patient who recently sustained a CVA. The patient responds to questions in long, complex sentences, although his words often seem unrelated and non-sensical. The patient is MOST likely experiencing:

answer

fluent aphasia - difficulty with comprehension of language - Patients are typically unable to understand others and are usually unaware that they are not understood

question

A physical therapist works with a patient diagnosed with anterior interosseous syndrome. While examining the patient, what activity would the therapist expect to be the MOST difficult for the patient to perform?

answer

pinching together the tips of the index finger and thumb

question

A patient reports that sleeping on his stomach reduces his lower extremity sciatic radicular pain complaints, but makes his lower back more uncomfortable. The MOST likely etiology of the patient's sciatic radiculopathy is:

answer

L5 disk herniation - Prone positioning often results in decreased radicular complaints and increased centralization of discomfort

question

The mother of a three-year-old patient born with S1 myelomeningocele reports that the child will begin attending a morning pre-school. She is concerned, however, about managing the child's neurogenic bladder. Which of the following is MOST appropriate to assist the child in maintaining urinary continence?

answer

clean intermittent catheterization every four hours - recommended for routine management of a neurogenic bladder

question

A patient with a spinal cord injury presents with decreased upper and lower extremity strength and sensation. The therapist notes that strength is greater in the lower extremities compared to the upper extremities. The clinical presentation is MOST consistent with:

answer

central cord syndrome

question

A physical therapist attempts to select a non-equilibrium test of coordination for a patient with a cerebellar disorder. Which of the following tests would be the MOST appropriate?

answer

finger to nose - test done in sitting which is considered non-equilibrium

question

A physical therapist evaluates a patient that exhibits balance deficits during gait. The therapist elects to use a functional balance test to formally assess the patient's balance. The MOST appropriate assessment to utilize would be the:

answer

Tinetti - measures balance and gait using an ordinal scale of 0-2

question

A physical therapist treating a four-year-old patient with cerebral palsy receives orders for ambulation with a pediatric walker. The patient does not crawl, but will scoot on the buttocks as a means of mobility and tolerates a standing frame. The MOST appropriate activity to work towards the goal of ambulating with a pediatric walker is:

answer

tricycle - precursor to ambulation with a pediatric walker - promotes weight shifting through the pelvis, lower extremity dissociation, and an upright posture with bilateral hand use.

question

A physical therapist treats a patient diagnosed with multiple sclerosis using Frenkel's exercises. The PRIMARY purpose of this intervention is to improve:

answer

coordination - Frenkel's exercises, originally designed for sensory ataxia, are commonly used in the treatment of multiple sclerosis - regaining control of movement through cognitive compensatory strategies

question

A patient diagnosed with spina bifida ambulates household distances using crutches and a reciprocating gait orthosis. The patient has a lesion at the upper lumbar neuro-segmental level. During treatment, the patient can be expected to demonstrate:

answer

Hip flexor and hip adductor strength - demonstrate variable hip flexor and hip adductor strength - absence of hip extension, hip abduction, and all knee and ankle movements

question

A patient with BPPV presents with an upbeat nystagmus during the Dix Hallpike Maneuver.The nystagmus is provoked with the head turned to the left. What is the BEST maneuver to help resolve this patient's symptoms?

answer

Epley maneuver starting with head turned to the left

question

A therapist treated a patient with a T6 complete spinal cord injury in the acute rehabilitation setting. During the session, the patient demonstrated signs of autonomic dysreflexia, so the therapist sat the patient up and dangled the legs. The nurse emptied the Foley catheter bag, and the symptoms resolved in less than 5 minutes. What is the therapist's professional responsibility with this occurrence of autonomic dysreflexia?

answer

Call the doctor and wait for orders to continue participation in therapy - due to severeness of AD, Dr needs to be called to be informed

question

A patient with complex regional pain syndrome complains of excruciating pain beyond 10 /10 with drying of the foot with a towel or wearing socks. During the neurological exam, the patient flinches with light touch in the lower extremity. This patient is MOST likely experiencing:

answer

allodynia - abnormally painful response to normal stimuli

question

A patient with the diagnosis of a T6 SCI has been on the inpatient rehab unit for 10 days. At the team meeting, the occupational therapist stated that independence with LE dressing has been limited by poor balance in long sitting. What ROM at the hamstrings is MOST likely to promote a stable base in long sitting?

answer

110 degrees - optimal range of motion for hamstrings in order to balance the proper length and tension is 100-110 degrees

question

A physical therapy order is received to evaluate a patient on the acute unit. A review of the CAT scan in the chart confirms that the patient had an ischemic infarct in the right cerebellum. What signs and symptoms are MOST likely to be present?

answer

Vertigo, leaning to right side, decreased pain and temperature sensation on the left side - pain and temperature will be opposite, but balance and voluntary movements are on the same side as the lesion

question

A patient presents with complaints of losing balance, especially when getting up to use the bathroom in the dark. The therapist administers the Clinical Test for Sensory Interaction on Balance (CTSIB), and the patient is most challenged by Conditions 5 and 6. What is the MOST likely cause of this patient's loss of balance?

answer

Benign Paroxysmal Positional Vertigo - conditions 5 and 6 are dependent on all 3 systems, so the vestibular system being affected will not allow the patient to maintain balance under the conditions of eyes closed on a foam surface and eyes closed on a foam surface with visual conflict dome

question

A patient presents 6 weeks post cerebrovascular accident. The patient's caregiver reports the patient does not use the affected upper extremity for any functional tasks at home. The patient is able to move the hand, wrist, and arm against gravity during manual muscle testing of the upper extremity. What initial technique would be MOST beneficial for this patient?

answer

constraint induced therapy - patient refuses to use the affected limb after a stroke but can move against gravity, so there are muscle contractions present - constraint-induced movement therapy will force the affected limb to perform daily tasks and possibly affect the neural plasticity of the brain

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