ScoreBuild exam 1 + PEAT retired (gode notater)

Ratio, nominal, ordinal, interval... put data into these fouur categories

Ratio (true zero!)- height and weight

Ordinal- scale of sensation, balance, MMT scores

Nominal- gender, blood type, dx

Interval (no true zero)- temperature

Elbow ROM : saying 15-0-90 means what?

Pt has 15 degrees of hyperextension annd 90 degrees of flexion

Hold relax, rhythmic stab, and contract relax all are trying to do what?

Increase ROm

Heteroptrophic ossification commonly occures after what? And give an example of objective finding?

Occurs after head injury. And example would be limited elbow ext. with hard end feel

Most common hemodialysis Rx?

3x/wk for 4 hours

Extension progression of MDT.

1 prone with pillow

2 prone

3 prone on elbows

4 prone press up

5 standing extension

Ankylosing spondilitis results in what posture? And what strengthening exer is most important?

Thoor. Kyphosis and flat lumbar spine.... so doing back extension exer is most immportant

At loading response , what do quads and hams do?

Quads increase, hams decrease

From IC to midstance, the quads have to work to keep the knee from over flexing. What compensation would someone likely have if they had a femoral nerve injury limiting the quads?

Forward trunk lean and maybe excess PF of the ankle

Functioonal reach test- which landmark do you use for measuring?

3rd metacarpal

Brachial plexus injury but good UE strength and fx tibia with PWB status.... what AD would be most appropriate?

Not axillary crutches (brachial plexus excacerbation) or walker with platform ( too much stability- pt has good UE strength!!!)...

So use loftstrand cruutches!!

Beta blockers do what to the heart?

Decrease HR, BP, contractility

Name the grades of acl tears, and what provides the most reason for getting aCL sx?

1- mild tear

2- mod tear

3- complete tear

* functional instability is the best reasson to get sx! Cause many people are able to function at high levels without acl's.

What is barthel index for?

ADL ability- 0-100, and a 100 score means a person is totally I in ADL's.

Balance assessment- what is normal, good, fair, and poor?

Normal- able to weight shift in all directions, maintain balance in standing, and accept max perturbations

Good- maintain balance without suupport, accept mod perturbations

Fair- balance without support, cannot weight shift without losing balance

Poor- needs assistance with standing, cannot weight shift or accept perturb

T12 or above lesions- what do pts need to assist with respiration in sitting?

Abd binders

Primary mm for inspiration and expiration?

Insp- diaphragm and ext. intercostals

Exp- abd. And internal intercostals

If abdominals and intercostals are taken out, (such as in a t2 lesion), then what is the most appropriate position to place the pt in to measure chest excursion in?

Supine, bc sitting is too hard, and sidelying allows one side of the thorax to be supported

When to do a reverse Total shoulder arthroplasty vs. a regular TSA?

When supraspinatus (RC) is irreparable, bc now the delt can still do a good job of elevating the arm even without RC mm.

*Reverse when Rotator cuff is bad!!!

Out of peripheral nerve, lumbar nerve root, spinal cord transection, and L hemisphere stroke; which would likely cause entire R LE sensory impairment?

L CVA. Spinal nerve roots and peripheral nerves would cause loss in dermatome and distribution of involved nerve. And spinal cord transection would cause B impairments.

Apophisitis of the ASIS, AIIS, ischial tub, and iliac crest. Match them with common MOI's.

- ASIS- sprinter out of starting blocks (sartorius- hip extended and knee flexed)

- AIIS- soccer player kicking soccer ball

- Ischial tub- hurdller (hamstrings when hip is flexed and knee is extended)

- iliac crest- tennis player (glut med, abd, and tfl)

How to stim abd and cremaster reflexes?

Stroke skin above inguinal and beneath costal for abd, and stroke skin superior and medial thigh for cremaster

Most common tube for short term feeding?/

NG

After prolonged bed rest and right after sitting a pt, what is the most importannt measure to take?

Systolic BP

Normal pH of the skin is ....

3-4.

Wrist motion that enables palpation of the lunate? Of the scaphoid?

Flexion for lunate, and ulnar deviation for scaphoid

Problems with perception after CVA... which anatomical region is likely affected btw somatosensory, primary motor cortex, BG, and cerebellum?

Somatosensory

Pulmonary fibrosis, chronic bronchitis are different from emphysema how?

Pulm fibrosis and bronchitis are restrictive lung diisorders while emphysema is COPD type ( TLC increased and expiration is limited)

MS types- describe

Primary progressive: continuous worsening of sx since onset

Secondary progressive: initial onset of relapsing remitting, followed by progression of disease at variable rate with minor relapses and remissions

RELAPSING REMITTING: most commonn. Relapses, acute exacerbation, remissions, periods without sx or worsening oof disease

Progressive relapsing: disease progresses between relapses. Progression of disease from initial onset, and acute relapses

Performing leg curl, which ham tendons would be most prominent?

Semitendonosis and biceps femoris

Difference btw mobility and controlled mobility

Mob= ability to start mvmt thru a functional ROM

Controlled mob= ability to move within a WB position or rotate around a long axis

*stages of motor control= mob, stab, controlled mob, skill

US normal sensations, and abnormal sensations

Dull warming is normal, but a slight burning is abnormal!

* check the coupling agent if pt gets a slight burning.

W/C type for C4-C8 peeps

C4- sip and puff controls manual

C5- manual with hand rim projections

C6-7= manual with friction surface handrims

C8 and below- standard hand rim manual W/C

Trans tib-- pt has excess flexion from IC to mid stance.. what could be the prob?

Socket is aligned in excess flexion

Prosthesis is too long

During and post exer, what should systolic and diastolic BP do?

Systolic should raise during, and then decrease after exer

Diastolic should remain stable throughout

Postural positions for 1- R and L upper lobes, 2- R middle lobe, 3- anterior segments of L and R upper lobes, and 4- superior segements of R and L lower lobes

1- sitting leaning back 30-40 degrees

2- head down on L side, 1/4 turn backward

3- supine with 2 pillows under knees

4- prone with 2 pillows under hips

Most common accepted value of quad-hamstring strength? What about it speeds (isokinetic) approach 200 degrees/sec?

- 3:2

1:1 if speeds get real fast

How much lumbar traction totreat spasm? How much lumbar traction to get mech. Separation?

- 25%

50%

If a pt is dehydrated, what might his hematocrit and hemoglobin be?

Increased

An increased blood urea nitrogen level can mean what?

Dehydration

Pt s/p trans tibial amp and no complications would utilize what kind of tx from W/C to mat table?

Stand pivot. Not slideboard... because he is still able to WB thru his good leg. Use a slideboard when both legs are bad.

Anterior GH instability- what position would be most provocative?

Lotsa ER (it places lots of stress on the anterior structures)

With abd pain maybe referring to shoulder, what is the proper order of assessment btw sup. Palpation , deep palp, percussion, and auscultation?

Auscultation should occur before percussion and sup and deep palpation

With testing of supinator and trying to isolate it and take out biceps, which position would u put the elbow in?

A totally flexed position!- take the biceps out by totally shortening it

Primmary purpose of an art line

Measure BP

Steps of the slump test for neural povocation

1- pt flexes their thoracic and lumbar spine

2- pt flexes cervical spine and PT does OP

3- pt extends knee

4-PT provides passive OP to DF the ankle

Forefoot varus

1st met is higher than the 5th met

Inverted position of the forefoot in relationship to the rearfoot with sub-t neutral.

*pts with low arches has forefoot varus

When performing sensory exams on a pt with a suspect neuro lesion, which sensations should you assess first?

Spinothal sensations! (Superficial sensations)- non disc. Touch and pressure, pain and temp

Next do deep sensations- vibration, proprio, kinesthesia

Last do 2 poinnt disc.- which is a combined cortical sensation

Preffered method to examine and documennt ataxia

Finger to nose test

Swan ganz catheter function

Goes thru a vein and eventually into pulm art.

*fxns to provide continuous measurements of pulmonary artery ppressure

Hickman catheter fxn

Inserts into R atrium

- removal of samples, admin of drugs, central venous pressure monitor

Central venous pressure catheter

Measures pressure ass. With filling of R ventricle (Diastolic pressure)

Art. Line fxn

Measure BP or get blood samples

With a DF assist orthotic (posterior leaf spring), pts would need what at the ankle?

Medial/lateral stability

W/C components for the following impairments: postural hypotension, LE edema, flaccid L UE

- solid seat and back

- elevating legrests

- arm board

BPH and prostatitis S&S

BPH= urge to urinate frequently, dribbling, weak stream, hesitancy of urination. Lower abd, low back, and thigh pain

Prostatitis= painful ejac and urination

Heel off to toe off during gait cycle requires how much DF and PF respectively?1

15 degrees of DF at heel off and then 20 degrees of PF at toe off

Where would u place hands to facilitate lingula expansion?

Left side of chest below axilla

Common clinical presentation of emphysema?

Barrel chested, enlarged thorax

Small and large electrodes- which one has more electrode resistance?

Small- so use large electrodes if you wanna minimize your resistance

providinng manual assisted cough techniques to a sci pt in supine - place hands where?

Epigastric area- but dont place hands on xiphoid (painful) or bely button (too low)

L sided heart failure commonly have what traits?

- pulm edema

- pink frothy sputum with COUGH

- msc weakness, decreased exer tolerance

*R sided failure have dependent edema

common MET values

1 mph walk= 1 met

3 mph walk= 3 mets

5 mph jog= 7-8 mets

10 mph bike= 5-6

Dysarthria=?

UMN lesion. Affects msc's used to articulate words and sounds.

*slurred speech and bad articulation... phonetics practice in the POC will help

Common S&S of anemia

*SOB

*heart palpitations

-pallor and cyanosis and cool skin

- weakness and malaise

Common S&S of HTN?

Blurred vision

HA

Dizziness

Msc pain ?

Bone pain?

Nerve root pain

Vascular pain?

Msc= Cramping, dull , aching

Bone= Boring, Deep, intolerable, highly localized

Nerve root= Sharp , Shooting, burning

Vascular= Throbbing, diffuse, aching, poorly localized

Medial and lateral plantar nerves (branch of tibial n. )proviide sensation to what?

Sole of foot

Plantar surface of the toes

Foot progression angle- negative values mean what? And positive values mean what?

- = in toeing

+= out toeing

Appendicitis vs. diverticulitis S&S

They are similar in that both have nausea and loss of appetite, however...

*appendicitis would be R lower quadrant pain and diverticulitis would be L lower quadrant pain

W/C components... what is good about power tilt for SCI pt?

-pressure relief

- less likely than recline to elicit spasticity

Best way to minimize aspiration risk

Moist warm food vs. thin liquids

Have pt align posture with chin tucked

Total loss of vestibular fxn... what should a therapist work with a pt on?

Improving gaze stability

Toe clips on bikes will...

Improve hamstring strengthening/demand

What is the apex and base of the patella? Also tightness in what aspect of the patella would cause the apex of the patella to move medially during a passive medial patellar glide?

Apex= inferior pole, base= superior pole

Superolateral tightness would cause the apex of the patella to move medially

R-R MS... what will the patient experience over time??

Acute worsening, followed by improvement and disease stability

Spleen enlargement/infection S&S are what

Left upper ab quadrant pain

Left flank pain

Mid back pain

When u exercise vigorously, your respiration rate does what in order to do what?

Increases in order to raise blood pH levels

Hiatal hernia- what is it and where might it cause referred pain

Hernia of stomach--> up thru diaphragm into thoracic cavity.

Referred pain to SHOULDER

Contraindications to aquatic physical therapy

U FISH

Fluids not contained (menstruation, open wounds, b and b uncontrolled)

Uncontrolled seizures in the last year

Heart failure/unstable angina

Severe PA and kidney disease

Infections (water or airborne)

Slipped cap femoral epiphysis- what is the clinical presentation?

Limited IR and abduction

Inferior glenohumeral ligament is important why?

-best restraint against anterior and posterior dislocations

- most important stabilizing structure in OH movement

Lower Trapezius Action

- scap adduction, upward rotation, and depression

DMD long term mobility px

Power W/C- a person wouldn't even be able to do a manual W/C

What reflexive response should occur when an individual experiences an increase in BP? 3 things...

Bradycardia

Vasodilation

Decreased Q

Healthy person with trans tibial amp can achieve what level?

Unveven surface walking

No AD

Sports

High level leisure activities (high impact too!)

Chronic use of corticosteroids can lead to what 2 things?

- increased risk of infection (bc body's inflammatory response is lessened)

- hyperglycemia

Difference btw neuropathic ulcers and pressure ulcers

Pressure ulcers occur over bony prominences

Pressure does not have loss of protective sensation

*neuropathic has loss of protective sensation (can't detect monofilament) and it doesn't usually happen over bony prominences. Also it usually has thick callused border

STNR interferes with what important functional ability for a child?

Crawling reciprocally

Partial thickness burn pt, MD has ordered ROM exercises. What should u do if the ppt can only go 1/3 of the ROM?

Do AAROM. Doon't just continue with AROM. You need to move thru as much ROM as possible to avoid contractures

Where to place counterforce brace for a lat epi pt?

Over the wrist extensors. (Maybe just distal to the elbow)

Unresponsive adult- what is the most important factor of survival?

Time to defibrillation

Unresponsive adult- what immediately should you do if you see him

Activate emergency response

Then begin chest compressions

Best way to determine the impact of pain on the lifestyle and daily functioning of a pt

Standardized disability questionnaire!

Bc pain is subjective- only a pt knows the effect that pain truely has on his life

Modified ashwoorth scale is used to measure...

Spasticity

1 tailed t test. Alpha is 0.05, and critical value of rejecting the null is 1.645 when comparing a sample pop and a test pop. The statistical test result was 1.95 . What does this mean?

Statistical significance- there is a difference btw sample and test pop.

Blocked practice is good for what? Random practice is good for what?

B- initial performance will be better

R- performance over time will be better. Better RETENTION is achieved practicing in random too

SCI vs. n root injury.... what is one thing that will be different?

DTR's will be absent in SCI, but normal in n. Rooot

Decreased pain and temp sensation- can this occur in n root injury?

Yes

Pusher's syndrome- what is a way to decrease pushing? Is this technique ok to do in transfers???

Hands clasped together

Yes this technique is fine to use for transfers because it keeps them straight up more!!