NPTE Board Prep

What type of fracture involves landing on a flexed wrist causing dorsal dislocation?

Smith's fracture (garden spade deformity)

Ape hand is associated with which nerve?

median nerve

What intrinsic muscles of the hand are innervated by the median nerve?

LOAF

Lateral 2 lumbricals

Opponens pollicis

abductor pollicis brevis

flexor pollicis brevis

If someone shows a steppage gait pattern, which nerve is likely effected?

deep fibular nerve

lesion of which nerve would result in complete loss of corneal reflex on both sides?

trigeminal nerve

Excessive plantarflexion during gait causes what at the knee?

knee hyperextension

What specific motions are involved with supination of the foot?

IPAD

inversion, plantarflexion, adduction

What specific motions are involved with pronation of the foot?

EDAB

eversion, dorsiflexion, abduction

When do you used closed chain vs open chain?

closed chain for functional strength

open chain for ROM and mobility

How would you glide the proximal radius if there is a limit in pronation?

proximal radioulnar joint glides posterior for pronation

what muscle is the main one functioning from 180-90 degrees of shoulder flexion?

biceps eccentrically

What are the upward scapular rotators?

serratus anterior, upper and lower traps

What are the downward scapular rotators?

rhomboids, levator scapulae, pec minor

Describe squinting vs frog-eyed patellae

squinting = femoral anteversion

frog-eyed = femoral retroversion

What is the function of the frontal lobe of the brain?

A CEO

aphasia (Broca's)

Controls, plans, programs

Emotional, behavior control, personality

Olfaction

What is the function of the temporal lobe?

hearing and language comprehension

Wernicke's aphasia

What type of aphasia is broken speech, expressive, and non fluent?

Broca's

What type of aphasia is receptive, unable to understand, and fluent?

Wernicke's

how do you communicate with Broca's aphasia?

yes and no questions

how do you communicate with Wernicke's aphasia?

gestures and demonstrations

What is the main function of the parietal lobe?

sensory integration and perception

neglect

where is each cranial nerve located?

1,2 in cerebrum

3,4 in midbrain

5-8 in pons

9-12 in medulla

What two cranial nerves play a role in the pupillary light reflex?

CN2 and CN3

what is the function of cranial nerve 3?

eye movement up, in, up and in

open eyelid

constrict pupil

damage to what cranial nerve causes lateral strabismus?

CN3

damage to what cranial nerve causes ptosis?

CN3

What is the function of cranial nerve 4?

eye movement down and in

What provides hot and cold sensation to anterior 2/3 of tongue?

CN5

what CN performs jaw jerk and chewing?

CN5

what CN provides taste to the anterior 2/3 of the tongue?

CN7

what CN does lacrimation and salvation?

CN7

which side does the jaw typically deviate towards in a cranial nerve 5 injury?

the side of the lesion

How do you interpret Rinne's test?

AC>BC is normal or sensorineural

BC>AC is conductive

How do you interpret Weber's test?

Sensorineural deafness: sound is heard louder on the side of the intact ear

Conductive deafness: sound is heard louder on the side of the affected ear

What performs afferent gag reflex?

CN9

what performs efferent gag reflex?

CN10

what does posterior 1/3 of tongue taste and temperature?

CN9

If a patient has a R deviated uvula, what CN is effected?

L CN10

which was does the tongue point with CN12 damage?

towards the side of lesion

What is the best measurement for metabolic workload?

rate pressure product

what is a normal distance for 6MWT test?

400-700 meters

What values are elevated at high altitudes?

RBC count, HR, BP, CO

What occurs with high altitude acclimatization?

HR increase, BP normal, CO normal, SV decrease

What does acclimatization typically start at high altitudes?

after 3 weeks

What values are decreased with aquatic therapy?

HR, BP, VO2, vital capacity, weight-bearing, edema

what values are increased with aquatic therapy?

cardiac output, SV, work of breathing, muscle strength and endurance

What are the weight bearing percentage levels in aquatic therapy?

C7- 10%

Xiphoid process- 33%

ASIS- 50%

Where is each heart valve auscultated?

A2, P2, T4, M5

The lub sound is the closing of which valves?

bicuspid and tricuspid

Where is each heart sound heard the loudest?

S2 at the base of the heart

S1 at the apex of the heart

Where are S1 and S2 heard equally?

Erb's pint

What values are increased in an obstructive lung disorder?

RV, TLC, FRC

According to the GOLD scale for COPD, what is classified as mild?

>80% FEV1,

According to the GOLD scale for COPD, what is classified as moderate?

50-80% FEV1,

According to the GOLD scale for COPD, what is classified as severe?

30-50% FEV1,

According to the GOLD scale for COPD, what is classified as very severe or chronic respiratory failure?

Vesicular lung sounds

insp>exp

over most of the lungs

Bronchovesicular lung sounds

insp=exp

1st and 2nd interspace anteriorly and between scapula

Bronchial lung sounds

exp>insp

over manubrium

Tracheal lung sounds

insp=exp, over trachea

Ronchi breath sounds

continuous low-pitched

COPD, bronchiectasis, pneumonia

Wheeze breath sounds

high pitched expiration

obstructive conditions

Crackles breath sounds

brief, discontinuous popping

edema or fluid

pleural rub breath sounds

rubbing sandpaper

pleural inflammation

A gait cycle is _% stance and _% swing

60% stance, 40% swing

when do anterior muscles of the LE work during gait?

when trying to progress forward

when do posterior muscles of the LE work during gait?

when trying to get the foot off of the ground

What is the normal ROM needed for stance phase of gait?

Hip- 0-30 flexion, 0-20 extension

Knee- 40 flexion

Ankle- 10 DF, 20 PF

What is the normal ROM needed for swing phase of gait?

Hip- 20-30 flexion

Knee- 60 flexion

Ankle- neutral DF, 10 PF

What is the normal average gait speed?

3.1 mph

What happens to LE ROM requirements when you run?

everything doubles

During gait, if a joint motion occurs early, the muscle is likely...

tight

During gait, if a joint motion occurs later, the muscle is likely...

weak

How do adductors vs abductors stabilize the pelvis during gait?

adductors concentrically

abductors eccentrically

What is the magnet rule in gait?

patients lean towards their weakness in the stance phase and away from it in the swing phase

With a R knee amputation, where does the COM move?

to the left and higher up

What do low prosthetic walls correlate with?

weak muscles

What do high walls correlate with?

tight muscles

What doe an inadequate assist correlate with?

weak muscles

What does an inadequate stop correlate with?

spastic muscles

When a patient is highly at risk for hip contractures, what motion should the MOST avoid?

flexion and abduction

Describe the flow of lymph thru the body

CV NoTeD

capillaries to vessels to nodes to trunks to ducts and then into subclavian veins

What causes lymphedema (physiologically)

lymphatic load > transport capacity

how does venous insufficiency cause lymphedema?

increases lymphatic load

how does lymph node removal cause lymphedema?

decreases transport capacity

Primary lymphedema types

Milroys, Lymphedema praecox (Meige), lymphedema tarda

Milroys

congenital

0-2 years onset

Lymphedema Praecoex (Meige)

congenital

10-20 years onset

MOST COMMON

Lymphedema tarda

congenital

>35 years

Filariasis

lymphedema from a parasitic infection or mosquitoes

What is the worst type of edema?

Weeping edema

A positive stemmer's sign is indicative of

at least stage 2 lymphedema

What is the pitting edema grading scale?

1+: 0 sec or 0-1/4 in

2+: 0-15 sec or 1/4-1/2 in

3+: 15-30 sec or 1/2-1 in

4+: more than 30 sec or more than 1 in

What is more painful, lymphedema or lipidema?

lipidema

What is the best way to measure a proximal limb with lymphedema?

girth

What is the best way to measure a distal limb with lymphedema?

volumetric

What measurement for lymphedema is best pre and post surgery?

bioimpedance

what is the best test for the integrity of the lymphatic system?

lymphoscintigraphy (during rest and exercise)

What are signs of abnormal lymph nodes?

tender (infection), hard (malignancy), immobile (malignancy)

Lymphangitis

inflammation of lymph vessels (Streaks)