PTRS 703 Applied Anatomy KUMC exam 1

What is the normal grade value for a monosynaptic reflex response?

0

1

2

3

4

5

2

An upper motor neuron lesion in a monosynaptic reflex causes a(n)?

normal reflex

exaggerated (hyper) reflex

depressed (hypo) reflex

exaggerated (hyper) reflex

A lower motor neuron lesion in a monosynaptic reflex causes a(n)

normal reflex

exaggerated (hyper) reflex

depressed (hypo) reflex

depressed (hypo) reflex

A 2+ graded symmetrical response from a monosynaptic reflex causes a(n)

normal reflex

exaggerated (hyper) reflex

depressed (hypo) reflex

normal reflex

_______ Ia fibers send the muscle spindle signal to the ________

Sensory, spinal cord

Sensory, medulla

Motor, spinal cord

Motor, medulla

Sensory, spinal cord

A ______ neuron that connects the _______ to the muscle tells the muscle to contract.

sensory, spinal cord

sensory, medulla

motor, spinal cord

motor, medulla

motor, spinal cord

What is the normative value for hip flexion?

120°

20°

45°

30°

120°

What is the normative value for hip extension?

45°

30°

120°

20°

20°

What is the normative value for hip abduction?

120°

20°

45°

30°

45°

What is the normative value for hip adduction?

120°

30°

20°

45°

30°

What are the normative values for hip internal and external rotation?

120°

20°

45°

30°

45°

What is the normative value for knee flexion?

110°

120°

135°

145°

135°

A patient going through physical therapy is performing a physical exam of the lower quarter. The therapist uses a goniometer, showing a value of 104° for hip flexion and 17° for hip extension. This patient's performance is ______ the normative value for hip flexion and ________ for hip extension.

above, above

below, below

above, below

below, above

below, below

A patient going through physical therapy is performing a physical exam of the lower quarter. The therapist uses a goniometer, showing a value of 50° for hip abduction and 26° for hip adduction. This patient's performance is ______ the normative value for hip abduction and ________ for hip adduction.

above, above

below, below

above, below

below, above

above, below

A patient going through physical therapy is performing a physical exam of the lower quarter. The therapist uses a goniometer, showing a value of 46° for hip internal rotation and 43° for hip external rotation. This patient's performance is ______ the normative value for hip internal rotation and ________ for hip external rotation.

above, above

below, below

above, below

below, above

above, below

A patient going through physical therapy is performing a physical exam of the lower quarter. The therapist uses a goniometer, showing a value of 140° for knee flexion. This patient's performance is above the normative value for hip flexion.

True

False

True

A patient going through physical therapy is performing a physical exam of the lower quarter. The therapist uses a goniometer, showing a value of 125° for knee flexion This patient's performance is above the normative value for hip flexion.

True

False

False

A patient going through physical therapy is performing a physical exam of the lower quarter. The therapist uses a goniometer, showing a value of

24° for ankle dorsiflexion and 51° for ankle plantar flexion. This patient's performance is ______ the normative value for ankle dorsiflexion and ________ for ankle plantar flexion.

above, above

below, below

above, below

below, above

above, above

What is the normative value of ankle inversion?

20°

50°

35°

15°

35°

What is the normative value of ankle eversion?

20°

50°

35°

15°

15°

A patient going through physical therapy is performing a physical exam of the lower quarter. The therapist uses a goniometer, showing a value of

33° for ankle inversion and 11° for ankle eversion. This patient's performance is ______ the normative value for ankle inversion and ________ for ankle eversion.

above, above

below, below

above, below

below, above

below, below

A patient going through physical therapy is performing a physical exam of the lower quarter. The therapist uses a goniometer, showing a value of

71° for great toe extension and 48° for great toe flexion. This patient's performance is ______ the normative value for great toe extension and ________ for great toe flexion.

above, above

below, below

above, below

below, above

above, above

What kind of end feel is felt when dorsiflexing the ankle?

Soft

Hard

Firm

Empty

Firm

What kind of end feel is felt when plantar flexing the ankle?

Soft

Hard

Firm

Empty

Firm

What kind of end feel sometimes can be felt when everting the subtalar joint if the calcaneus contacts the sinus tarsi?

Soft

Hard

Firm

Empty

Hard

Where should the goniometer fulcrum be placed when measuring hip flexion?

Ischial tuberosity

Greater trochanter

ASIS

PSIS

Greater trochanter

Where should the goniometer stationary arm be placed when measuring hip abduction (or adduction)?

across the medial and lateral malleolus

across the ischial tuberosities

across the ASIS

across the PSIS

across the ASIS

What kind of end feel is felt when flexing the hip with a patient having normal abdominal girth?

Soft

Hard

Firm

Empty

Firm

What kind of end feel is felt when flexing the hip with a patient that has wider abdominal girth?

Soft

Hard

Firm

Empty

Soft

What kind of end feel is felt when flexing the knee?

Soft

Hard

Firm

Empty

Soft

What kind of end feel is felt when abducting the hip?

Soft

Hard

Firm

Empty

Firm

What kind of end feel is felt when internally rotating the hip?

Soft

Hard

Firm

Empty

Firm

What kind of end feel is felt when extending the knee?

Soft

Hard

Firm

Empty

Firm

Your patient presents with diminished sensation over the lateral foot, ankle plantar flexion weakness, and a hyporeflexive gastrocnemius and soleus muscle stretch reflex. Which spinal nerve is most likely affected by a lesion?

L2

L1

S1

S2

S1

Your patient presents with diminished sensation over the medial toe, great toe flexion weakness, and a non-effected muscle stretch reflex. Which spinal nerve is most likely affected by a lesion?

L2

L1

S1

S2

S2

Your patient presents with cutaneous sensory impairments in the lateral distal leg, ankle dorsiflexion weakness, and a hyporeflexive response with muscle stretch reflex testing of the quadriceps. Which structure is most likely affected by a lesion?

L3

L4

L5

S1

L4

Your patient presents with cutaneous sensory impairments over the medial distal thigh, knee extension weakness, and a hyporeflexive response with muscle stretch reflex testing of the quadriceps. Which structure is most likely affected by a lesion?

L3

L4

L5

S1

L3

Your patient presents with cutaneous sensory impairments over the dorsum of the foot, great toe extension weakness, and a hyporeflexive response with muscle stretch reflex testing of the hamstrings. Which structure is most likely affected by a lesion?

L3

L1

L5

S1

L5

Your patient presents with cutaneous sensory impairments over the lateral foot, ankle plantar flexion weakness, and a hyporeflexive response with muscle stretch reflex testing of the gastrocsoleus complex. Which structure is most likely affected by a lesion?

S2

L4

L5

S1

S1

Your patient presents with cutaneous sensory impairments over the medial heel, along with great toe flexion weakness. Which structure is most likely affected by a lesion?

L2

L4

S2

S1

S2

Your patient presents with cutaneous sensory impairments over the anterior proximal thigh and hip flexion weakness. Which structure is most likely affected by a lesion?

L3

L2

L5

S1

L2

Which myotome is best represented with resisted testing of knee extension?

L3

L4

L2

S2

L3

Which myotome is best represented with resisted testing of hip flexion?

L3

L4

L2

S1

L2

Which myotome is best represented with resisted testing of great toe extension?

S2

L4

S1

L5

L5

Which myotome is best represented with resisted testing of ankle dorsiflexion?

S2

L4

L3

S1

L4

Which myotome is best represented with resisted testing of great toe flexion?

L3

S1

L5

S2

S2

Which myotome is best represented with resisted testing of ankle plantar flexion and foot eversion?

S1

L4

S2

L5

S1

True or False: A person's active range of motion is the muscle's contractile ability against gravity, the patient's ability or willingness to move, and the status of inert tissue.

True

False

True

True or False: A person's passive range of motion is the muscle's contractile ability against gravity, the patient's ability or willingness to move, and the status of inert tissue.

True

False

False

True and False: A person's active range of motion is the joint integrity, joint capsule flexibility, and the extensibility of the ligaments and muscles.

True

False

False

True and False: A person's passive range of motion is the joint integrity, joint capsule flexibility, and the extensibility of the ligaments and muscles.

True

False

True

By applying _______ at the end of passive range of motion to assess the resistance of a muscle is called a(n) ________

overpressure, active ROM

overpressure, end-feel

underpressure, active ROM

underpressure, end-feel

overpressure, end-feel

A limitation of motion in a particular pattern caused by restriction of the joint capsule is considered a(n)

end-feel

passive ROM

capsular pattern of restriction

joint lesion

capsular pattern of restriction

True or False: Loss of rotation is always present in joints with 3 degrees of freedom

True

False

True

True or False: Loss of rotation is always present in joints with 2 degrees of freedom

True

False

False

For the hip joint, the loss of _________ is greater than ________ in CPR.

medial rotation, lateral rotation

lateral rotation, medial rotation

extension, flexion

adduction, abduction

medial rotation, lateral rotation

For the hip joint, the loss of _________ is greater than ________ in CPR.

lateral rotation, medial rotation

extension, flexion

abduction, adduction

abduction, flexion

abduction, adduction

For the knee joint, the loss of _________ is greater than ________ in CPR.

extension, flexion

flexion, extension

lateral rotation, medial rotation

medial rotation, lateral rotation

flexion, extension

For the metatarsophalangeal joint at digits 2-5, the loss of _________ is greater than ________ in CPR.

lateral rotation, medial rotation

extension, flexion

abduction, adduction

flexion, extension

flexion, extension

For the metatarsophalangeal joint at digit 1, the loss of _________ is greater than ________ in CPR.

lateral rotation, medial rotation

extension, flexion

abduction, adduction

flexion, extension

extension, flexion

For the interphalangeal joints, the loss of _________ is greater than ________ in CPR.

lateral rotation, medial rotation

extension, flexion

abduction, adduction

flexion, extension

extension, flexion

When should sensation be assessed in a patient?

Only when a patient explicitly complains of numbness or tingling

During the initial patient examination, and when there is a report of sensory disturbance

Only after an injury has been confirmed through imaging

Only if a patient is experiencing severe pain

During the initial patient examination, and when there is a report of sensory disturbance

Which of the following describes an "empty" end feel?

Stiff sensation due to ligament or tendon restriction

Bony restriction preventing further movement

Muscle guarding or pain prevents the full range of motion

Soft tissue approximation limits movement

Muscle guarding or pain prevents the full range of motion

What condition is commonly associated with hyperreflexia?

Lower motor neuron lesion

Peripheral nerve injury

Upper motor neuron lesion

Spinal cord transection at the lumbar level

Upper motor neuron lesion

Which of the following is the best approach when beginning palpation on a patient with an injury?

Apply deep pressure immediately to assess tissue density

Start with broad, light contact and gradually increase pressure

Focus only on the injured area without assessing the surrounding structures

Palpate the most painful area first to determine the exact location of discomfort

Start with broad, light contact and gradually increase pressure

What is the correct grading scale for reflexes?

0 = normal, 1+ = absent, 2+ = hyperreflexive, 3+ = clonus

0 = no response, 1+ = present, but depressed, 2+ = normal, 3+ = increased, brisker than average, 4+ = very brisk, abnormal

0 = absent, 1+ = increased, brisker than average, 2+ = normal, 3+ = present, but depressed, 4+ = exaggerated

0 = normal, 1+ = low normal, 2+ = exaggerated, 3+ = pathological

0 = no response, 1+ = present, but depressed, 2+ = normal, 3+ = increased, brisker than average, 4+ = very brisk, abnormal

Which axis corresponds to motion of a joint in the sagittal plane?

Vertical axis

Medial-lateral axis

Anterior-posterior axis

Longitudinal axis

Medial-lateral axis

Why is it important to test sensation bilaterally, beginning on the uninvolved side first?

It helps the patient understand the test and reduces anxiety

It allows the clinician to establish a baseline for comparison

It prevents over-stimulation of the nervous system

It ensures that the abnormal side is assessed last for the most accurate results

It allows the clinician to establish a baseline for comparison

During a deep tendon reflex test, a clinician cannot elicit a response in a patient's patellar tendon reflex. What is an appropriate next step?

Conclude that the patient has a lower motor neuron lesion

Repeat the test using the Jendrassik maneuver

Perform an MRI to rule out spinal cord pathology

Document the reflex as absent and move on

Repeat the test using the Jendrassik maneuver

A patient has a capsular pattern of restriction. What is true about the expected joint motion loss?

The lost motion will only take place in one plane of movement

The loss of motion will always be a fixed proportion of motion loss in more than one plane of motion

Loss of the rotation motion never occurs in joints with 3 degrees of freedom (movement in 3 planes)

There is equal loss of all motions in all planes of movement

The loss of motion will always be a fixed proportion of motion loss in more than one plane of motion

A patient has a suspected L3 nerve root compression. Which finding would you expect during a segmental neurologic examination?

Absent Achilles reflex

Absent hamstring reflex

Diminished sensation over the medial aspect of the knee

Diminished sensation over the lateral leg

Diminished sensation over the medial aspect of the knee