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PEAT 1.

2
patient prone, knee flexed, pointing the toes to the ceiling = toes slightly invert
What is the reason for this?
ANS: Tibialis posterior substitution

Anterior pelvic tilt = Which muscles are weak?


 ANS: Rectus abdominis and Gluteus max are lengthened and weak

What can help with orthostatic hypotension


ANS: ankle pumps before standing
Knee flexion contracture of the right side will cause what gait issue on the left side?
ANS: hip hiking to clear the swinging leg
Management of heterotrophic ossification
ANS: Gentle stretching of the affected tissue
preforming submaximal cycle ergometer will result in constant values in:
 oxygen consumption
 systolic pressure
 diastolic pressure
 heart rate
ANS: Diastolic pressure

Numbness, tingling, paresthesia in both feet. Stock-and-glove symptoms, diminished ankle reflexes, loss of pain and temperature,
Decreased strength in both feet

> Knee-jerk reflexes are not affected

 Neuropathy
 Nerve root compression L4-L5
 PVD
 Claudication

ANS: Neuropathy
wound with: red granulation tissue, no eschar, no order, minimal serosanguinous drainage

what type of wound care?


 thin occlusive film, change as needed
 hydrocolloid film, change as needed
 wet to dry on normal gauze
 pulsed lavage with sharp debridement
ANS: hydrocolloid film is uses for wounds with mild - moderate drainage with no infection

What hip glide is this: what movement does it help with?


ANS: Hip inferior glide, and this helps improve hip flexion

Localized pain in the lower back and hip region, tingling radiating to the posterior thigh, pain increases with hip medial rotation is a
symptoms of what?
ANS: Piriformis syndrome

patient who cant walk and talk at the same time has a problem with what?
ANS: This finding suggests the individual is struggling with the introduction of a secondary task (conversation), which may
interfere with performance of a primary task (walking). Individuals who must devote extra attention to walking are unable to perform
the two tasks simultaneously

Best self-assessment tool for a patient with coronary artery disease.


ANS: rating of perceived exertion

Myelomeningocele of L2 (L1-L2) - what will their walking ability be?


expected levels of mobility at:
 L4 - L5
 L3 - L4
 Thoracic level

ANS: A child who has L1–L2 level myelomeningocele would be expected to walk short distances in the home.
 Walking in the home and community using only ankle-foot orthoses would be possible for a child who has a L4–L5
myelomeningocele, not a L2 lesion.
 A child who has a L3–L4 myelomeningocele would be expected to achieve community ambulation using knee-ankle-foot
orthoses.
 Standing in a parapodium would be an appropriate prognosis for a child who has a thoracic-level myelomeningocele.

Electromyographic biofeedback (EMG) measures what?


ANS: Muscle activity

correcting thoracic kyphosis elongates with muscles?


ANS: Sternocleidomastoid

Insidious onset of pelvic and hip pain that is relieved with passing Gas?
ANS: Crohn's disease

Non-specific neck pain risk factors/differential diagnosis?


ANS: MI - myocardial infarction
C5 radiculopathy would have weakness in what?
ANS: Shoulder abduction

Rotator cuff repair progress (goal) 4 months post-surgery


ANS: be able to lift 5lbs, 20 times above shoulder level

Which modality of the biofeedback should be used in order to prevent overactivity of recruiting muscles?
ANS: Increase the sensitivity (gain)

inappropriate Anti-diuretic hormone secretions effects which system?


ANS: Anti-diuretic hormone helps to control blood pressure by acting on the kidneys and the blood vessels

So it effects the Cardiovascular system.

Syndrome of inappropriate antidiuretic hormone results in fluid volume excess, so it may cause hypertension and arrhythmias,
which require monitoring as activity levels change. Also the physical therapist may observe distended neck veins or a visible
jugular pulse

Calcaneus, forefoot, and subtalar joint positions in a "collapsed arch" or pes planus foot pronation
ANS: Valgum, Abduction, Eversion

The subtalar joint's main components with this are eversion and abduction. The midtarsal joint (the transverse tarsal joints) also
everts. In stance, the calcaneus is excessively everted from midline, which is a valgus position. With pronation there is also
associated abduction of the forefoot.

Dysdiadochokinesia
ANS: The inability to perform rapid alternating muscle movements

Interrater reliability vs. Interrater reliability vs. criterion-related validity


Intrarater reliability consistency of measurements made by the same examiner on different occasions

Interrater reliability consistency of measurements between two different examiners

criterion-related validity justifies the validity of an instrument by comparing it to a gold standard of measurement

What modification on a stationary bike would help with hamstring strengthening?


ANS: Toe clips can limit ankle motion, thereby allowing for increased knee flexion force to facilitate hamstring strengthening

What does an ST segment displacement indicate?


ANS: Myocardial infarction (MI)

Shoulder abduction strength of 4/5, but difficulty with abduction means what?
ANS: when there is no pain, but weakness, it is a nerve injury

Pediatric anterior groin pain radiating down the anterior thigh and knee
:NO ANS

Dermatome and myotome symptoms of L4-L5 disc bulge


ANS: pain in the dorsal of the foot with weakness in great toe extension

Ideomotor disorder
ANS: Ideomotor apraxia is the inability to perform purposeful movements when there is no loss of sensation, strength,
coordination, or comprehension. Frequently, patients who have ideomotor apraxia will be unable to perform a motor task on
command but will be able to perform the task when they are left on their own

What happens immediately to the blood PH as a response to vigorous exercise


ANS: > Respiration rate to raise blood pH levels <
Vigorous exercise produces lactic acid, which would lower the pH of blood unless compensatory mechanisms are in place.

Increasing RR reduces the alveolar partial pressure of arterial carbon dioxide (PaCO2), resulting in more alkalinity in the blood to
prevent an imbalance

Hip is flexed, slightly adducted, and laterally rotated. No abduction ability, and painful internal rotation.
ANS: Dislocated hip

High ESR and low RBC


ANS: High ESR is indication of high inflammatory state in the body = RA

Pain in the distal, posterior, medial aspect of leg. worse in the morning, eases, then worsens throughout the day.
ANS: posterior tibialis tendonitis

Spondelysthesis is defect in what?


ANS: pars interarticularis

Bigeminy
Couplets
Multifocal PVC's
Ventricular tachycardia
ANS: PVC (premature ventricular contraction) every other heart beat

insidious onset of pain in the lateral forearm and hand, worsens with neck extension
ANS: C6 radiculopathy

Which nerve extends the wrist and long extensor of digits?


ANS: Radial nerve
Q A
Which mobilization helps with : dorsally to promote wrist flexion or
wrist extension? palmar (volar) to promote wrist extension

factors to measure myocardial blood pressure + heart rate


oxygen demand
Reflexes in response to high N/A
blood pressure
What test is this? what is it Phalen's test
used for?
used to diagnose carpel tunnels syndrome
(reverse prayer sign)

gaze evoked nystagmus in ------------


MS, what is the best test to
determine the cause of this?
Proprioception, 2 point Posterior/Dorsal column
discriminations, and vibration -
which part of the spinal cord
has a lesion?
Atlantooccipital joint ROM Flexion/Extension of the head on the neck
Which ankle glide is used to Posterior talar glide
improve dorsiflexion ROM?
anterior shoulder dislocation anterior capsule, subscapularis, anterior glenoid labrum
(horizontal abduction, lateral
rotation).
falling on extended wrist, with Scaphoid fracture
pain between flexor and
extensor of the first digit
Symptoms of a right CVA  judgement
 impulsiveness
 short attention span
 spetial awareness issues
 visual field deficits
 impaired time concept
testing the compression of the  extension and right sided flexion
right lumbar facet would be
with movementes?
postural drainage for a  laying prone with the pillows under the pelivs
posterior lower lobes of the
lungs
Which cardiopulmonary ….
values change with COPD
and emphysema?
posture for desk jobs ;;;;;;
Gait deviation with sciatic Decreased ankle dorsi flexion
nerve problems
Nerve root and lymph node  Cryotherapy or moist heat pack? ****
involvement for patients with
cancer
Diminished elbow reflexes is C7 compression
due to
VO2 Blood test indication of …..
prostate cancer max for MS
patients
Blood test indication of LOW PSA
prostate cancer
Facial nerve functions (CNVII) facial expressions and movement
Cranial nerve V is responsible Cranial nerve 5 is the trigeminal nerve, responsible
for what? for sensation on the whole face, and muscles
of mastication
anticipatory postural control responding to an unexpected perturbation while standing
Stages of the motor learning …..
process
Dix Hallpike maneuver a bedside test/maneuver that is used to diagnose BPPV
(benign paroxysmal positional vertigo)
Vestibular ocular assessment used to diagnose symptoms of concussion
Drugs: 1- Gold sodium thiomalate is categorized as a disease-
modifying antirheumatic drug
 gold sodium thiomalate
(Myochrysine) 2- Flurbiprofen is not a disease-modifying, but is a
 Flurbiprofen (Ansaid) nonsteroidal anti-inflammatory drug
 Etodolac (Lodine)
 Aspirin 3- Etodolac is a nonsteroidal anti-inflammatory drug

4- Aspirin is a nonsteroidal anti-inflammatory drug

Unifocal pvc during PT Unifocal PVC is not dangerous and pt session can
session continue lightly with monitoring the electrocardiogram
one of the main symptoms of Decreased level of arousal and alertness will cause
brain stem injury slow progress of a patient with brain stem injury
types of exudates:  Serous – a clear, thin and watery plasma. It’s
normal during the inflammatory stage of wound
 serous healing, and smaller amounts are considered
 sanguineous normal. However, a moderate to heavy amount
 serosanguineous may indicate a high bioburden.
 purulent  Sanguineous – a fresh bleeding, seen in deep
partial- and full-thickness wounds. A small amount
 Proteinaceous
is normal during the inflammatory stage.
 Serosanguineous – thin, watery and pale red to
pink in color.
 Seropurulent – thin, watery, cloudy and yellow to
tan in color.
 Purulent – a thick and opaque exudate that is tan,
yellow, green or brown in color. It’s never normal in
a wound bed, and is often associated with infection
or high bacteria levels.
 Proteinaceous exudate is exudate composed of a
high proportion of protein. It is not typically green in
color or foul-odored
What is the most important Pain is most important to assess, because pain limiting
thing/first thing to assess on a range of motion can lead to a frozen shoulder and
patient who has had a more pain
mastectomy? post op
2 main areas at risk of 1- Applying cold directly over the superficial main branch
Neuropraxia as a result of ice of a nerve, such as the fibular (peroneal) nerve at the
massage lateral knee, may cause a nerve conduction block

2- When applying ice to the posterolateral elbow (not


medial elbow), the physical therapist should monitor for
signs of radial nerve conduction block

Normal LDL levels below 100


Symptoms of metabolic Headache, fatigue, and muscular twitching are signs and
acidosis symptoms of metabolic acidosis
signs and symptoms of Metabolic syndrome consists of signs and symptoms that
metabolic syndrome are actually risk factors and are strongly linked to type 2
diabetes, cardiovascular disease, and stroke. Metabolic
syndrome is characterized by abdominal obesity (waist
size > 40 in (101.6 cm), high triglycerides levels, high low-
density lipids and low high-density lipids cholesterol
values, and elevated blood pressure (> 130/85 mm Hg)
Symptoms of metabolic Confused mental state, weakness, and nausea are signs
alkalosis and symptoms of metabolic alkalosis
What do each of these means: 1. Induration is due to local edema in the tissue, causing
firmness of the skin
1. Induration 2. Ecchymosis is a darkish discoloring of the skin
2. Ecchymosis 3. maceration, which is characterized by a white wrinkled
3. Maceration appearance of the skin
4. Hyperkeratosis 4. Hyperkeratosis involves thickening of the skin.

When positioning the patient The scapula should be in a protracted position


on the hemiplegic side, what
should be considered?
Which muscles are shortened shortened
when the pelvis is in an
anterior tilt? iliopsoas
erector spinae
which ones are lengthened? sartorius
latissimus dorsi

Lengthened

rectus abdominis
gluteus maximus

Weakness of the bicep motions of hip extension, knee flexion, and lateral
femoris would manifest in (external) rotation of the tibia
what motions of the leg
Heterotopic ossification Heterotopic ossification (HO) is the presence of bone in
soft tissue where bone normally does not exist.

> gentle stretching is indicated, maintaining optimal


wheelchair positioning
avoid vigorous stretching

maximal elbow isometric week 4


exercises are indicated at
what week post shoulder
repair surgery
what is this ECG showing?

V-fib, and its a medical emergency

Knee tests 1- Varus = lateral collateral ligament

 Varus test 2- McMurray = Meniscus injuries


 McMurray test
 patellar compression 3- Patella femoral compression = patella femoral joint
test
 Lachman's test 4- Lachman = Anterior cruciate ligament integrity

Pivoting on a planted foot with Anterior cruciate ligament


an extended knee is
mechanism of injury to which
knee structure?
Nail issues and indications: 1- Lung cancer - chronic hypoxia

2- Liver dysfunction
 Extreme clubbing
 Transverse 3- Renal failure
depressions (Beau
lines), or a nail bed that
is white and extends
2/3s of the length of
the nail
 Short transverse lines
across the nail (Mees
lines) or a brownish
distal one-third end of
the nail (half-and-half
nails)

Murphy's test Percussion over the costovertebral space causes pain

=> kidney disorder

Important info prior to patient Patients present level of function according to the
home visit patient themselves and all involved disciplines
1- Cervical radiculopathy 1. Cervical radiculopathy (injury to the nerve root)
presents with unilateral motor and sensory symptoms into
2- Cervical myelopathy the upper limb, with muscle weakness in the myotome,
sensory alteration in the dermatome, and reflex
hypoactivity.

2. Cervical myelopathy (injury to the spinal cord itself)


presents with spastic weakness, paresthesia, and
possible incoordination in one or both lower limbs, and
well as sphincter dysfunction.

Brachial plexus lesions Brachial plexus symptoms are more localized to the
shoulder and neck. Cervical positions do not change
brachial plexus symptoms. Weakness in the myotome
and sensory alteration in the dermatome are common.
Peripheral nerve root lesions Peripheral nerve lesions typically do not present with
pain. Weakness and sensory symptoms are specific to
the nerve involved.
Apgar score for newborns  Heart rate
 Color
 Respiration
 Muscle tone
 Reflex irritability

How to get a patient with gradually decrease the number of verbal cues
limited recall to do 3 exercises
independently?
Latissimus dorsi is responsible  Latissimus dorsi is responsible for Extension and
for what shoulder movement? Medial rotation

 To stretch it = Flexion and (lateral) external rotation


What motion of the GH joint
applies maximal stretch?

Quality assurance Peer review of patient care notes is a measure of


quality
Productivity analysis A measure of financial efficiency of labor costs;
Utilization review Utilization review is an external review of the necessity
of patient care
Accreditation review The accreditation process is a voluntary process of
quality measurement against an external set of
standards
Which muscles do not need Hip flexors are often short due to the lordotic posture of
strengthening, pregnant mothers.
but lengthening post-partum
What do PT's work on with Improving gaze stability is a well-studied mechanism for
complete vestibular recovery from loss of vestibular function
loss/recovery?
What stationary bike Raising the handlebars of a bike brings the patient more
modifications challenge the upright for increased trunk control and balance challenge
core, trunk, and balance
Tilting the seat forward on a bike extends the hips and,
therefore, places increased load on the trunk
In order to unlock the knee lateral (external) rotation of the femur on the tibia
from full extension in stance,
what needs to occur (femur,
tibia, patella)?
What is important before Determination that the patient is mentally alert and has
preforming biofeedback intact thought processes regarding treatment should
precede other treatment procedures
appropriate patient guarding Placing one hand on the gait belt and one hand on the
when teaching how to use patient's shoulder is the correct technique to best facilitate
crutches? ambulation activity with crutches and provide appropriate
guarding
Symptoms of a tethered cord Changes in bowel and bladder function, increased
spasticity, back pain.
Symptoms of UTI Urinary frequency, dysuria, and pyuria.
Symptoms of Arnold-Chiari Weakness, pain, sensory changes, vertigo, diplopia, and
malformation ataxia.
Flaccid arm/Shoulder The most common type of subluxation is an inferior
subluxation may cause what subluxation. Weakness and the weight of a heavy arm
type of dislocation result in downward rotation of the scapula
ipsilateral Left posterior Left hip flexion contraction would help assist pelvic
innominate, what isometric hip correction
contraction would help?
ACE inhibitors cause what drop in systolic and dyastolic BP
change in BP
excessive fatigue and sitting Fatigue, which was evident during warm-up, may have
with elbows resting on knees, worsened after the activity. The patient's preferred
are indicative of what? position after the activity increases the effectiveness of
the pectoralis and serratus anterior muscles to act as
accessory muscles of inspiration by fixing their insertions,
thereby improving breathing and minimizing fatigue
intolerance with passive SLR With the straight leg raise, the hamstrings are stretched
is due to pain, reason? across both joints at the same time. Because no limitation
is noted in the hip or knee joints, the limitation would be
due to the hamstrings
Tx for a patient with complex Active range of motion, functional training, and
regional pain syndrome with a transcutaneous electrical nerve stimulation
TBI
Swimming exercise  patient with an open wound (that are unable to
contraindication dress with a waterproof dressing)
 Severe kidney disease

> MS patients, epilepsy patients, may still participate with


medication and close monitoring

What measure is used for Amount of time until the heart rate returns to
fitness and conditioning after baseline after exercise
exercise
Stress incontinence Stress incontinence is essentially due to insufficient
strength of the pelvic floor musculature. Pelvic floor
dysfunction is most often caused by a weakening of the
pelvic floor structures as a result of childbirth or
overstretching of the muscles
symptoms of a hip dislocation severe groin and lateral hip pain and the hip held in
abduction
Symptoms of avascular The clinical indicators avascular necrosis of the femoral
necrosis of the femoral head head include pain in the groin, proximal thigh, or buttock
area that is usually exacerbated by weight-bearing
Symptoms of a slipped capital recent onset of knee pain, hip is in slight flexion,
femoral epiphysis adduction, and lateral (external) rotation. Examination
shows no medial (internal) hip rotation and abduction,
with increasing pain on abduction
Babinski reflex indicating an the great toe extends while the other toes plantar flex and
upper motor neuron lesion splay
What methods is the MOST Provide frequent feedback during the initial trials of the
effective way to encourage a movement
patient who is learning a new
movement pattern
Nerve conduction velocity test Nerve conduction velocity testing is most useful in the
indications evaluation of peripheral nerve or lower motor neuron
status.

i.e. Carpal tunnel syndrome

MOST appropriate exercise to active lumbar extension in prone


help resolve an acute lumbar
disc posterior derangement
Deltoid ligament sprain Location of the deltoid ligament is the medial ankle.
indication Tenderness with palpation of the medial ankle is more
suggestive of an eversion ankle sprain.
Tarsal tunnel syndrome Tarsal tunnel syndrome presents with pain/numbness in
the medial ankle radiating into the plantar aspect of the
foot only
Plantar fasciitis Plantar fasciitis presents with pain and tenderness
located on the medial calcaneal tubercle. Pain that is
worse in the morning and decreases with activity is
suggestive of plantar fasciitis. Periods of inactivity are
followed by increased pain as activity is recommenced.
Movement contraindication for Lateral (external) rotation to 50° with the shoulder
a post 1-week anterior abducted to 80°
shoulder dislocation
Which structure is a restraint The inferior glenohumeral ligament is the primary restraint
to the anteroinferior translation against anterior and posterior dislocations and is the most
of the humeral head in important stabilizing structure in the overhead movement
overhead activities
What kind of issues with the Insufficient socket flexion can cause lordosis of the
prosthesis can cause a lumbar lumbar spine
lordosis during push off
Which of the following Serratus anterior
muscles should be
strengthened to reduce
scapular winging?
MS patient has motor and The therapist should determine which sensory system is
sensory impairments with contributing to the patient's postural dyscontrol. Assessing
gaze-evoked nystagmus and sensory conditions of vision, vestibular function, and
vertigo. What test is best to somatosensation in a systematic fashion, such as by
use to determine the cause? conducting the Clinical Test for Sensory Interaction in
Balance (CTSIB), will help determine which system is
contributing to the balance dysfunction
Patient was taught how to go Measuring retention at the beginning of a treatment
up and down the stairs using a session or after a rest period can minimize variables
cane, how can the PT associated with temporary improvement of performance,
determine if they have so that the physical therapist can determine if learning
retained this skill or not, when has been retained
should they be tested?
Ulcers on the planter part of The ulcer is located on the plantar surface of the foot. It
the foot due to reduced has a thick callus border. The patient has decreased
sensation cause what type of protective sensation, which is associated with peripheral
ulcers? neuropathies. Based on these findings, the wound is
a neuropathic ulcer
How to monitor patients heart Alternatives to heart rate monitoring, such as the rating of
rate when on beta blockers perceived exertion scale, should be used due to the
blunted heart rate response to exercise while taking beta-
blockers
Signs of dermatitis Generally, dermatitis includes the presence of papules,
vesicles, blisters, or ulcerations

> No fever, malaise, chills

Cellulitis Cellulitis signs/symptoms include pain, redness,


tenderness, edema, and, at times, fever, chills,
tachycardia, headache, and hypotension

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