Final NPTE spinal

Which cranial nerve's efferent fibers influence an individual's ability to swallow and say "ahh"? a. vagus b. hypoglossal c. facial d. trigeminal

a. vagus

An active normal response to deep tendon reflex testing would be documented as: a. 1+ b. 2+ c. 3+ d. 4+

b. 2+

The spinal defect shown in the diagram should be managed with avoidance of lumbar spinal: (picture shows a fracture of the L5 pars) a. Flexion b. Rotation c. Extension d. Lateral flexion

c. Extension

2. A pt complains of pain w/ mouth opening that makes it difficult to eat foods that require chewing. Examination revealed active mouth opening to be WNL of: a. 15-24 mm b. 35-44 mm c. 50-64 mm d. 65-74 mm

b. 35-44 mm

A159: Upon examine a patient with vague hip pain that radiates to the lateral knee, the PT finds a negative FABERE test. A negative grind test and positive Noble's compression test. The dysfunction is MOST likely due to: a. DJD of the hip b. An IT band friction disorder c. SI joint dysfunction d. Irritation of the L5 spinal nerve root

b. An IT band friction disorder A (+) Noble's compression test is an indication of an IT band friction disorder

Which dermatome level would be assessed by lightly touching the occiput? a. C1 b. C2 c. C3 d. C4

b. C2

During a finger-to-nose test, a patient demonstrates hesitancy in getting started and is then unable to control the movement. The moving finger slams into the side of the face and misses the nose completely. The therapist documents these findings as moderate impairment in: (A-82) a. Dysmetria b. Response orientation c. Dysdiadochokinesia d. Dyssynergia

A. dysmetria Dysmetria refers to impaired ability to judge the distance or range of movement

3. A PT reviews a physicians examination which indicates diminished sensation in the L3 dermatome. The MOST appropriate location to confirm the physicians findings is a. Dorsum of the foot b. Anterior thigh c. Groin d. Lateral calf

B. anterior thigh

6. A PT performs an evaluation on a 46-year old male patient diagnosed with piriformis syndrome. the pt indicates he has experienced pain in his low back and buttock region for the last 3 weeks. Which motions would you expect to be weak and painful during muscle testing based on this diagnosis? a. Abduction and lateral rotation of the thigh b. Abduction and medial rotation of the thigh c. Adduction and lateral rotation of the thigh d. Adduction and medial rotation of the thigh

a. Abduction and lateral rotation of the thigh

An elderly adult patient presents with a history of and subjective complaints consistent with lumbar central spinal stenosis. The most appropriate clinical test used to differentiate spinal stenosis from intermittent vascular claudication would be: a. Bicycle (van Gelderen's) test b. Lumbar quadrant test c. Femoral nerve traction test d. Valsalva's maneuver

a. Bicycle (van Gelderen's) test The bicycle (van Gelderen's) test is designed to differentiate between spinal stenosis and intermittent vascular claudication. Van Gelderen's bicycle test is designed to stress the LE vascular system without causing any central canal or foraminal stenosis that could be misinterpreted as intermittent neurogenic claudication.

Weakness of the sternocleidomastoid would be associated with which myotome? a. C2 b. C3 c. C4 d. C5

a. C2

20. A patient presents with insidious onset of pain in the jaw that is referred to the head and neck regions. As best as the patient can recall, it may be related to biting into something hard. Cervical ROM is limited in flexion by 20 degrees, cervical lateral flexion limited to the left by 10 degrees. Mandibular depression is 10 mm with deviation to the left, protrusion is 4 mm, and lateral deviation is 15 mm to the right and 6 mm to the left. Based on these findings, the diagnosis for this patient would be: (C-85) a. Capsule-ligamentous pattern of TMJ on the left b. Weak lateral pterygoids on the left c. Weak lateral pterygoids on the right d. Cervical spine and TMJ capsular restrictions on the left

a. Capsule-ligamentous pattern of TMJ on the left The capsule-ligamentous pattern of the TMJ is limitation on opening, lateral deviation greater to the uninvolved side and deviation on opening to the involved side. Normal parameters for TMJ measures are 25-35 mm functional and 35-50 mm normal, normal protrusion is 3-6 mm and normal lateral deviation is 10-15 mm.

35. A manual therapy technique appropriate to correct a closing restriction of T5 on T6 is a. Central posterioanterior (PA) pressure at a 60° angle on the spinous process of T6 while stabilizing T5 b. Central posterioanterior (PA) pressure at a 45° angle on the spinous process of T5 while stabilizing T6 c. Unilateral posterioanterior (PA) pressure at a 45° angle on the right transverse process of T6 while stabilizing T5 d. Unilateral posterioanterior (PA) pressure at a 60° angle on the left transverse process of T6 while stabilizing T5

a. Central posterioanterior (PA) pressure at a 60° angle on the spinous process of T6 while stabilizing T5 In a closing restriction, inferior facets of the superior vertebrae will not inferiorly glide on the superior facets of the inferior vertebra. Therefore, T5 inferior facts will not caudally glide on the superior facets of T6. Stabilizing T5 and application of pressure to T6 localizes the cephalad movement of the superior facets T6 on T5 bilaterally. The angle of the thoracic facets is 60-degreees; therefore, the application of force should be at the same plane.

31. A pt was dx with a bulging disc at the right L5-S1 spinal level without nerve root compression. The impairment MOST LIKELY to be documented is a. Centralized gnawing pain with loss of postural control during lifting activities b. Radicular pain to the right great toe with a compensated gluteus medius gait c. Centralized gnawing pain with uncompensated gluteus medius gait d. Radicular pain to the right great toe with difficulty sitting for long periods

a. Centralized gnawing pain with loss of postural control during lifting activities Discal degeneration without nerve root compression would likely be exhibited as a centralized gnawing pain with loss of proprioception

28. A PT examines a pt with limited cervical ROM. As part of the examination, the PT attempts to screen the patient for possible vertebral artery involvement, but is unable to position the pt's head and neck in the recommended test position. The MOST appropriate action is? a. Complete the vertebral artery test with the head and neck positioned in approximately 50 percent of the available cervical ROM b. Complete the vertebral artery test as far into the available cervical ROM as tolerated c. Avoid completing the vertebral artery test until the patient has full cervical ROM d. Avoid all direct cervical treatment techniques until the vertebral artery test can be assessed at the limits of normal cervical ROM

b. Complete the vertebral artery test as far into the available cervical ROM as tolerated

14. A patient is being examined for impairments after stroke. When tested for 2-pt discrimination on the right hand, the patient is unable to tell whether the therapist is touching with one or two points. The therapist determines that there is impaired function in the: (B-131) a. DCML pathways and somatosensory cortex b. Anterior spinothalamic tract and thalamus c. Lateral spinothalamic tract and somatosensory cortex d. Spinorectal tract and somatosensory cortex

a. DCML pathways and somatosensory cortex Discriminative touch, proprioceptive sensibility and vibration sense are carried in the posterior white columns. The long ascending tracts cross the medulla and form the medial lemniscus, which then travels to the thalamus and finally to the cortex. Loss of 2-pt discrimination could result from an insult affecting any of these component parts. Parietal lobe or internal capsule lesions are the most common sites

21. During a PT session, an elderly woman with low back pain tells the PT that she has had urinary incontinence for the last year. It is particularly problematic when she has a cold and coughs a lot. She has not told her physician about this problem because she is too embarrassed. The therapists BEST course of action is to a. Examine the pt, document impairments, and discuss findings with the physician b. Refer the pt back to the physician c. Examine the pt, document impairments, and refer her back to her physician d. Examine the pt and proceed with tx for low back pain

a. Examine the pt, document impairments, and discuss findings with the physician

4. A client with RA presents at the PT clinic with severe whiplash from a motor vehicle accident 1 week ago. Initial cervical radiograph results revealed osseous structures appeared intact. The client's chief complaints are of cervical pain and sudden falls with loss of consciousness. Examination reveals a (+) Romberg sign and hyperreflexia. The PT's INITIAL action is to: (A-173) a. Fit this client with a hard cervical collar and contact the referring physician recommending a CT scan b. Immediately inform the referring physician and recommend a MRI scan c. Immediately inform the referring physician and recommend another series of radiographs d. Perform a test for transverse ligamental laxity

a. Fit this client with a hard cervical collar and contact the referring physician recommending a CT scan This patient is exhibiting signs and symptoms of spinal cord compression with UMN signs (hyperreflexia), a (+) Romberg sign, and sudden falls with loss of consciousness. This requires immediate immobilization and contact with the physician for further imaging. Some cervical lesions (non-displaced dens fracture, rupture of the transverse ligament) require greater imaging detail than radiographs provide. This individual also has RA, which often accompanied by erosion of the dens and facets and ligamental laxity (transverse). Immediately informing the physician is important, and if the client is exhibiting spinal cord compression, immediate stabilization is required.

2. A client with RA presents at the PT clinic with severe whiplash from a MVA 1 week ago. Initial cervical radiograph revealed osseous structures appeared intact. The clients chief complaints are of cervical pain and sudden falls with loss of consciousness. Examination reveals a positive Romberg sign and hyperreflexia. The PTs INITIAL action is to a. Fit this client with a hard cervical collar and contact the referring physician recommending a computed tomography (CT) scan b. Immediately inform the referring physician and recommend an MRI scan c. Immediately inform the referring physician and recommend another series of radiographs d. Perform a test for transverse ligament laxity

a. Fit this client with a hard cervical collar and contact the referring physician recommending a computed tomography (CT) scan

34. A patient in a motor vehicle accident sustains an injury to the posterior cord of the brachial plexus. Which muscle would NOT be affected by the injury? a. Infraspinatus b. Subscapularis c. Latissimus dorsi d. Teres major

a. Infraspinatus- trunk that becomes lateral cord

14. A pt w/ a confirmed L C6 n root compression due to foraminal encroachment complains of pain the L thumb and index finger. The MOST effective cervical position to alleviate this radicular pain in weight-bearing is: a. Lower cervical flexion b. L side bending c. Lower cervical extension d. R rotation

a. Lower cervical flexion

11. A patient with a confirmed left C6 nerve root compression due to foraminal encroachment complains of pain in the left thumb and index finger. The MOST effective cervical position to alleviate this radicular pain in WB is: (C-103) a. Lower cervical flexion b. Left side-bending c. Lower cervical rotation d. Right rotation

a. Lower cervical flexion Flexion increases the space at the intervertebral foramen, allowing the C6 nerve root to decompress and reduce or alleviate radicular pain

15. A patient with long-term postural changes exhibits an excessive forward head, and complains of pain and dizziness when looking upward. The MOST effect PT intervention is: (B-175) a. Manual therapy techniques to provide pain relief and postural reeducation b. Anterior cervical muscle stretching and postural reeducation to relieve vertebral artery compression c. Strengthening exercises to the posterior cervical musculature d. Postural reeducation to reduce compression of the cervical sympathetic ganglia

a. Manual therapy techniques to provide pain relief and postural reeducation Long-term postural changes with forward head posture include shortening of the posterior muscles, potential joint restrictions with possible vertebral artery compromise at the occiput. Restoration of normal movement throughout the cervical region and postural reeducation is the best choice for this condition

10. A patient with long-term postural changes exhibits an excessive forward head, and complains of pain and dizziness when looking upward. The MOST effective physical therapy intervention is: (B-175) a. Manual therapy techniques to provide pain relief and postural reeducation b. Anterior cervical muscle stretching and postural reeducation to relieve vertebral artery compression c. Strengthening exercise to the posterior cervical musculature d. Postural reeducation to reduce compression of the cervical sympathetic ganglia

a. Manual therapy techniques to provide pain relief and postural reeducation Long-term postural changes with forward head posture include shortening of the posterior muscles, potential joint restrictions, with possible vertebral artery compromise at the occiput. Restoration of normal movement throughout the cervical region and postural reeducation is the best choice for this condition

Ataxia is best described as: a. the inability to perform coordinated movements b. the inability to initiate movements c. the inability to interpret information d. the inability to perform purposeful learned movements

a. the inability to perform coordinated movements

5. A PT is performing the maximal cervical quadrant test to the right with a patient with right C5-6 facet syndrome. The patient would most likely complain of: (A-181) a. Pain in the right cervical region b. Tightness in the right upper trapezius c. Radicular pain in the right upper limb d. Referred pain to the left midscapular region

a. Pain in the right cervical region The test position would consist of right cervical side bending with extension. This shortens the upper trapezius and stresses the right cervical facets. When a pathological cervical facet is provoked, the result will cause pain in the ipsilateral cervical region, with referred pain to the ipsilateral scapular region. The test might also compress the nerve root, creating radicular signs, but only on the right side.

A newborn with Erb-Klumpke palsy is referred for PT. INITIALLY, the POC should include: a. Partial immobilization of the limb across the abdomen, followed by gentle ROM after immobilization b. Passive mobilization of the shoulder in overhead motions c. Age-appropriate task training of the upper extremity d. Splinting the shoulder in abduction and internal rotation

a. Partial immobilization of the limb across the abdomen, followed by gentle ROM after immobilization

A pt recovering from TBI demonstrates difficulties in feeding resulting from an unstable posture while sitting. The PT determines that modification is necessary to ensure optimal function. The FIRST body segment or segments that the PT would align is/are the: a. Pelvis b. Head c. LEs d. Trunk

a. Pelvis

18. A pt complains of right buttock pain after slipping. The right hip had been forced into internal rotation. Lumbar active motion testing is full and pain free. Neurological findings are unremarkable. S1 provocation testing is unremarkable. Passive hip internal rotation is limited with pain and pulling noted in the right buttock region. Resisted external rotation produces pain in the same region. Based on these findings, the MOST LIKELY dx would be a. Piriformis strain b. Sacroiliac sprain/strain c. Lumbar disc herniation at L5/S1 d. Quadratus lumborum strain

a. Piriformis strain Forceful hip internal rotation would overstretch and potentially strain the piriformis muscle. Limited passive hip internal rotation would reproduce symptoms from a tight or tense piriformis. Pain with resisted external rotation and would suggest a contractile problem with the piriformis

1. During a cervical spine examination, the PT observes restricted left rotation of the C7-T1 spinal level. After stabilizing the thoracic spine, the therapist's hand placement for mobilization to improve left rotation should be at the: (A-10) a. Posterior right C7 articular pillar b. Posterior left C7 articular pillar c. Tip of T1 spinous process d. Posterior left C6 articular pillar

a. Posterior right C7 articular pillar The most effective hand placement for mobilization into greater left rotation is at the posterior aspect of the right C7 articular pillar because it rotates the C7 vertebra to the left

24. The problems associated with ankylosing spondylitis in its early stages can BEST ne managed by the PT with a. Postural education b. Pain management c. Joint mobilization d. Stretching of scapular stabilizers

a. Postural education Postural reeducation will help to prevent further increases in thoracic kyphosis and costal expansion exercise will improve breathing efficiency.

26. Pts dx with Paget's disease typically have symptomatology similar to that of spinal stenosis. The MOST important aspect if PT intervention is a. Postural reeducation to prevent positions that increase symptoms b. Strengthening exercises for abdominals and back muscles c. Modalities to decrease pain d. Lumbar extension exercises

a. Postural reeducation to prevent positions that increase symptoms Patients should be educated to minimize certain positions for long periods. Symptoms resulting from Paget's disease are aggravated by positions in which the lumbar spine is in extension

8. A group of PTs conduct a scoliosis screening on adolescents as part of physical therapy week . The MOST appropriate action after identifying an adolescent with a moderate scoliotic curve is to a. Refer the adolescent for further orthopedic assessment b. Educate the adolescent as to the cause of scoliosis c. Devise an exercise program for the adolescent d. Instruct the adolescent in the importance of proper posture

a. Refer the adolescent for further orthopedic assessment

9. A patient presents with complaint of neck pain on the right. During the AROM examination, the PT observes the following osteokinematic neck motions-full side bending left, full rotation to the left, full forward flexion, limited and painful extension, limited and painful right side bending and limited and painful right rotation. Based on this pattern, what is the arthrokinematic restriction? (B-173) a. Restriction with downglide of a facet on the right b. Restriction with upglide of a facet on the right c. Restriction with downglide of a facet on the left d. Restriction with upglide of a facet on the left

a. Restriction with downglide of a facet on the right If the facet on the right was restricted with downgliding (arthokinematic restriction), then the osteokinematic motions that would be limited would be rotation and side bending to the right with limited extension. The fact that there is pain on the right supports that the restriction is on the right.

13. The therapist tests a patient's hearing by holding a vibrating tuning fork on the mastoid process and then in front of the ear. Comparison is made by asking the patient which is louder - bone conduction or air conduction. This is known as: (B-105) a. Rinne's test b. Weber's test c. Caloric test d. Hallpike-Dix test

a. Rinne's test Rinne's test is used to compare bone conduction (BC) with air conduction (AC). If BC is greater than AC the patient is experiencing conductive deafness. If AC is greater than BC the patient is experiencing sensorineural deafness

SI Question 1. B133: A patient presents with signs and symptoms consistent with sacroiliac dysfunction. The cluster of special tests/findings that has the highest diagnostic accuracy for SI dysfunction would be: a. SI gapping, sacroiliac compression, thigh thrust test (P4), sacral thrust and Gaenslen's test b. Thigh thrust test, Gillet's test, stork test and Patrick's test c. Fortin finger test, torsion test, supine-to-sit test and Gaenslen's test d. ASIS asymmetry, PSIS asymmetry, pubic symphysis pain with palpation and sacral inferior lateral angle asymmetry

a. SI gapping, sacroiliac compression, thigh thrust test (P4), sacral thrust and Gaenslen's test

Touch and pain sensations on the skin of the face are associated with which cranial nerve? a. trigeminal b. facial c. trochlear d. glossopharyngeal

a. trigeminal

A therapist performs sharp and dull sensory testing to assess the: a. trigeminal nerve b. facial nerve c. abducens nerve d. accessory nerve

a. trigeminal nerve

4. In neural tension testing, what position will BEST bias the tibial n? a. SLR w/ DF and eversion b. SLR w/ DF and inversion c. SLR w/ PF and eversion d. SLR w/ PF and inversion

a. SLR w/ DF and eversion A SLR with DF and eversion will best bias the tibial nerve. This is the optimal position for neural tissue provocation of the tibial nerve. Neural tension techniques are used to decrease adverse mechanical tension on the nerves. Peripheral nerves can often become trapped within the tissues, where there can be a pull on the nerve with movement. This technique frees up the nerve so that it can slide in its sheath.

22. An elderly pt is referred to PT following a recent compression fracture at T8. The medical hx includes OP and GERD. The pt is currently taking antacids. Which of the following is MOST important for the therapist to consider in the POC a. Schedule therapy sessions at least 90 min after eating b. Ensure that the pt eats a small snack before starting exercise c. Include sit-ups in supine to strengthen abdominals d. Recommend an over-the-counter proton pump inhibitor (PPI) medication

a. Schedule therapy sessions at least 90 min after eating

22. If the subject's vision is blocked, either by having the subject close the eyes or by placing a barrier between the part being tested and the subject's eyes, the therapist can effectively examine: (C-125) a. Somatosensory integrity b. Vestibular/visual/somatosensory integration c. Discriminative touch and fast pain, but not proprioception d. Conscious proprioception, but not discriminative touch

a. Somatosensory integrity The term "somatosensation" refers to conscious relay pathways for discriminative touch, conscious proprioception, fast pain and discriminative temperature. Sensory examination must rule out vision in order to establish the reliability of sensory testing.

: A PT is reviewing a medical record prior to examining the patient for the first time. The suspected diagnosis is multiple sclerosis. On the neurologist's note, the therapist finds the following: deep tendon reflex (DTR); Right quadriceps is 2+, Left quadriceps is 4+. The therapist concludes that: a. The right DTR is normal, the left is abnormal b. Both DTRs are abnormal and indicative of UMN syndrome c. The right DTR is exaggerated, the left is clearly abnormal d. Both DTRS are abnormal and indicative of hyporeflexia

a. The right DTR is normal, the left is abnormal DTRS are graded on scale of 1-4. 0=no response, 1+=present but depressed, 2+=normal, 3+=increased but brisker than average, not necessarily abnormal, 4+=very brisk, hyperactive, with clonus, abnormal.

42. Therapist hand/finger placements for posteroanterior mobilization techniques to improve down-gliding/closure of the T7-8 facet jt should be located at the a. Transverse process of T8 b. Spinous process of T8 c. Transverse process of T7 d. Spinous process of T6

a. Transverse process of T8 The axis of motion for the mid-thoracic vertebrae is above the spinous processes and below the transverse processes. Therefore, if down-gliding/closure of T7-8 vertebral segment is required, the therapist's hand placement should be at the transverse process of T8 or the spinous process of T7

36. A pt with osteoporosis and no fractures complains of increased middle and lower back pain during breathing and other functional activities. The MOST beneficial interventions for this pt include pt education and a. Trunk extension and abdominal stabilization exercises b. Trunk rotation and abdominal stabilization exercises c. Trunk flexion and extension exercises d. Trunk flexion and rotation exercises

a. Trunk extension and abdominal stabilization exercises Avoid excess twisting (rotation) and bending and high impact exercises and flexion

8. A patient presents with problems with swallowing. When the PT tests for phonation by having the patient say "Ah" with mouth open, there is deviation of the uvula to one side. The therapist then tests for function of the gag reflex and notices decreased response to stimulation. These findings suggest involvement of the: (A-161) a. Vagus nerve b. Trigeminal nerve c. Facial nerve d. Hypoglossal nerve

a. Vagus nerve These are the tests to examine Vagus nerve (CN X) function.

A physical therapist prepares to assess the blink reflex in a patient with suspected neurological involvement. Which cranial nerve components are assessed with this reflex? a. afferent cranial nerve V; efferent cranial nerve VII b. afferent cranial nerve VII; efferent cranial nerve V c. afferent cranial nerve IX; efferent cranial nerve X d. afferent cranial nerve X; efferent cranial nerve IX

a. afferent cranial nerve V; efferent cranial nerve VII

A PT employed in a work hardening program performs an examination on a pt diagnosed with fibromyalgia. During the exam the PT identifies an inconsistency between the measured lumbar ROM and the amount of lumbar ROM observed while lifting a milk crate from the floor to a table. The MOST appropriate PT action is: a. avoid discussing the identified inconsistency with the pt b. confront the pt with the identified inconsistency c. discuss the identified inconsistency with the referring physician d. discharge the pt from PT

a. avoid discussing the identified inconsistency with the pt Symptom magnification is best identified by inconsistencies in the presentation of function. PT should be extremely cautions to avoid labeling pts as "symptom magnifiers" or "malingerers" without adequate evidence to support their hypothesis. There is not enough info presented to form a definitive conclusion and therefore the PT would not address the observation with the pt. The PT would be better served by continuing the exam and gathering additional info during future tx sessions.

The efferent fibers of which cranial nerve can be assessed by stimulating the gag reflex? a. glossopharyngeal b. trochlear c. trigeminal d. hypoglossal

a. glossopharyngeal

A patient is asked to close their eyes and identify a letter drawn on their skin by the therapist. This technique is used to assess: a. graphesthesia b. kinesthesia c. light touch d. sterognosis

a. graphesthesia

What cranial nerve is responsible for voluntary movement of the tongue? a. hypoglossal b. glosspharyngeal c. facial d. trigeminal

a. hypoglossal

A lesion of the C4 nerve root would most likely be associated with weakness of the: a. levator scapulae b. sternocleidomastoid c. infraspinatus d. splenius capitis

a. levator scapulae

A physical therapist examines several pathological reflexes on a patient with a suspected upper motor neuron disease. Which stimulus would be the MOST appropriate when assessing Hoffman's reflex? a. tapping the nail of the middle finger b. stroking the inner thigh c. stroking the plantar aspect of the foot d. rapidly dorsiflexing the foot

a. tapping the nail of the middle finger

A pt was referred to a PT with a Dx of Bell's palsy. Which cluster of examination findings below would the PT expect to find? a. Ptosis, weakness in the temporalis and masseter muscles, and deviation of the tongue to one side b. Decreased closure of one eye, drooping of the mouth, and inability to raise the eyebrow c. Decrease sensation to the forehead, cheek, and jaw; absence of a gag reflex; and deviation of the tongue to one side d. Ptosis, decreased abduction of the eye, and excessive tearing

b. Decreased closure of one eye, drooping of the mouth, and inability to raise the eyebrow

4. A patient is referred to a physical therapist with a diagnosis of Bell's palsy. Which cluster of examination findings below would the PT expect to find? (A-111) a. Ptosis, weakness in the temporalis and masseter muscles and deviation of the tongue to one side. b. Decreased closure of one eye, drooping of the mouth, and inability to raise the eyebrow c. Decreased sensation to the forehead, cheek and jaw; absence of a gag reflex, and deviation of the tongue to one side d. Ptosis, decreased abduction of the eye and excessive tearing

b. Decreased closure of one eye, drooping of the mouth, and inability to raise the eyebrow Decreased function of the facial nerve (CN VII) is associated with motor weakness of the muscles of facial expression, which could result in a decreased ability to close the eye tightly, raise the eyebrow and raise the corner of the mouth as in a smile. Other functions of the facial nerve include taste to the anterior tongue, tearing, salivation, and dampening sound.

10. A patient with pain in the left lateral face and head is found to have limited active and passive mouth opening ROM. However, passive lateral deviation is full to both sides. The likely reason for the limitation in mouth opening ROM is: a. Capsular restriction of the left TMJ b. Decreased flexibility in the muscles of mastication on the left c. An anteriorly displaced disc without reduction in the left TMJ d. An anteriorly displaced disc with reduction in the left TMJ

b. Decreased flexibility in the muscles of mastication on the left Mouth opening requires lengthening of the muscles of mastication as the body of the mandible moves away from the upper palate. Lateral deviation does not require a significant lengthening in the muscles of mastication, as the primary motion of the mandible is a light anterior translation of the mandibular condyle without increasing the distance between the body of the mandible and the upper palate (B-30)

A pt with pain in the left lateral face and head is found to have limited active and passive mouth opening ROM. However, passive lateral deviation is full to both sides. The likely reason for the limitation in mouth opening ROM is: a. Capsular restriction of the left TMJ b. Decreased flexibility in the muscles of mastication on the left c. An anteriorly displaced disc without reduction in the left TMJ d. An anteriorly displaced disc with reduction in the left TMJ

b. Decreased flexibility in the muscles of mastication on the left Mouth opening requires lengthening of the muscles of mastication as the body of the mandible moves away from the upper palate. Lateral deviation does not require a significant lengthening in the muscles of mastication, as the primary motion of the mandible is a light anterior translation of the mandibular condyle without increasing the distance between the body of the mandible and the upper palate (B-30)

17. A patient is referred for PT with jaw pain and dysfunction. The patient has experienced three episodes of jaw locking in an open position in the past week. The MOST LIKELY cause of this problem is: (B-195) a. Impingement of the temporomandibular ligament b. Disc displacement c. Lateral pterygoid muscle spasm d. Entrapment of the retrodiscal lamina

b. Disc displacement This patient is experiencing TMJ dysfunction. The jaw becomes locked in an open position when the disc is displaced. The muscles influence lateral deviation of the jaw when opening

8. A patient presents with neck pain, which is a result of a motor vehicle accident (hit from behind while the car was at rest). To determine the function of the deep cervical flexors, the PT decides to perform a muscle function test utilizing the cranio-cervical flexion test. Findings of a normal test would be: (B-136) a. During active chin tuck, the patient is able to hold the head 1 inch above the table for 30 seconds b. During active chin tuck, the pressure in the stabilizer cuff increases to 22 and the patient can hold this position for 10 seconds c. When palpating the anterior cervical musculature during the active chin tuck, the SCM activates prior to the longus colli muscle d. During active chin tuck, the patient is able to maintain the normal cervical lordosis for 10 seconds

b. During active chin tuck, the pressure in the stabilizer cuff increases to 22 and the patient can hold this position for 10 seconds During an active chin tuck, the pressure in the stabilizer cuff increases to 22 and the patient can hold this position for 10 seconds.

16. While driving a ball during a golf match, a pt felt an immediate sharp pain in the right lower back. The following morning the pt reported stiffness, with easing of pain after taking a shower. Based on this information, the source if the pain is MOST LIKELY a. Nerve root compression b. Facet jt impingement c. A stress fracture d. Diminished blood supply to the spinal cord

b. Facet jt impingement Facet joint dysfunction is exacerbated with sustained positions, and eases with movement. Progressive increase in activity intensifies the pain.

14. A patient presents with a complaint of severe neck and shoulder pain of 2 days duration. The patient reports falling asleep on the couch watching TV, has been stiff, and sore since. There is tenderness of the cervical muscles on the right, with increased pain upon palpation. Passive ROM is most limited in flexion, then side bending left, and then rotation left and active extension. Side bending right and rotation right are also painful. Based on these examination findings, the patient's diagnosis is: (C-190) a. Cervical radiculopathy b. Facet syndrome c. Cervical strain d. Herniated disc

b. Facet syndrome A facet syndrome presents with localized pain

9. A 29 yo male with ankylosing spondylitis reports progressive stiffening of the spine and associated pain for more than 5 years. The patients MOST typical standing posture demonstrates: a. Anterior thoracic rib hump b. Flattened lumbar cure, exaggerated thoracic curve c. Excessive lumbar curve, flattened thoracic curve d. Lateral curvature of the spine with fixed rotation of the vertebrae.

b. Flattened lumbar cure, exaggerated thoracic curve Ankylosing spondylitis: forward protrusion of head, flattening of anterior chest wall, thoracic kyphosis, protrusion of abdomen, and flattening of lumbar lordosis.

1. With respect to a worker's sitting posture, the greatest reduction in lumbar spine compression forces would be achieved by: a. Using a 2 inch gel seat cushion b. Increasing the chair backrest-seat angle to between 90-110 c. Eliminating armrests on the chair d. Decreasing the chair backrest-seat angle to 85

b. Increasing the chair backrest-seat angle to between 90-110

6. A pt exhibits pain and sensory loss in the posterior thigh, lateral calf, and dorsal foot. Extension of the Hallux is poor, however the Achilles reflex is normal. What spinal level would you expect to be involved? a. L4 b. L5 c. S1 d. S2

b. L5 S1 and S2: achilles reflex

9. A PT teaches a pt positioned in supine to posteriorly rotate her pelvis. The pt has full AROM and PROM of the UE, but is unable to achieve full shoulder flexion while maintaining a posterior pelvic tilt. Which of the following could BEST explain these findings a. Capsular tightness b. Latissimus dorsi tightness c. Pectoralis minor tightness d. Quadratus lumborum tightness

b. Latissimus dorsi tightness

A PT examination reveals posterior superior iliac spine (PSIS) is low on the left; ASIS is high on the left; standing flexion test shows that the left PSIS moves first and farthest superiorly; Gillet's test demonstrates that the left PSIS moves inferiorly and laterally less than right; long sitting test shows that the left malleolus moves short to long; and the sitting flexion test is negative. In light of these finding, the therapist's diagnosis is: a. Left anterior rotated innominate b. Left posterior rotated innominate c. Left upslip d. Iliac inflare on the left

b. Left posterior rotated innominate A posterior rotated innominate is unilateral iliosacral dysfunction. The question outlines positive physical findings, both static and dynamic, found with this dysfunction. One of these positive findings alone does not confirm the diagnosis of left rotated posterior innominate.

25. A PT dx with lumbar spondylosis without discal herniation or bulging has a left L5 neural compression. The most likely structure compressing the nerve root is the a. Supraspinous ligament b. Ligamentum flavum c. Anterior longitudinal ligament d. Posterior longitudinal ligament

b. Ligamentum flavum The ligamentum flavum becomes hypertrophied with lumbar spondylosis and may include the intervertebral foramen, compressing the left L5 spinal nerve root

14. A male pt is referred to outpatient PT for LBP. During the pt interview, he describes a recent increased difficulty w/ urinating that doesn't affect his LBP sxs. Neurological screening exam is normal and Murphy's sign is negative. Based on this clinical scenario, the pt's LBP may be associated w/ the: a. Kidney b. Lower urinary tract c. SI joint d. First lumbar n root

b. Lower urinary tract Murphy's sign: gallbladder

7. A PT treats a 9yr old child dx with CF. As part of the tx session the therapist attempts to improve the efficiency of the pts breathing. The MOST appropriate technique to encourage full expansion at the base of the lungs is a. Manual percussion over the posterior portion of the ribs with the pt in prone b. Manual contacts with pressure over the lateral boarders of the ribs with the pt in supine c. Manual vibration over the lateral portion of the ribs with the pt in sidelying d. Manual cues over the epigastric area with the pt in supine

b. Manual contacts with pressure over the lateral boarders of the ribs with the pt in supine

19. A PT shines a light into a patient's eye and observes the pupil of the eye. Constriction of the pupil results. This is a test of the function of the: (C-73) a. Optic nerve b. Oculomotor nerve c. Trochlear nerve d. Abducens nerve

b. Oculomotor nerve The pupillary reflex (constriction of the pupil) is a function of the efferent portion of the oculomotor nerve (CN III)

4. A PT instructs a pt rehabilitating from a low back injury in a series of five pelvic stabilization exercises. The pt indicates he understands the exercises, however, frequently becomes confused and is unable to perform them correctly. The MOST appropriate therapist action is a. Repeat the exercise instructions b. Reduce the number of exercises in the series c. Select a different treatment option d. Conclude the patient is not a candidate for physical therapy

b. Reduce the number of exercises in the series

16. An individual presents with chronic TMJ dysfunction. Which of the following muscles should be addressed with inhibitory or soft tissue lengthening techniques to help restore limited lateral movement of the mandible to the RIGHT as a result of muscular tightness? (B-187) a. Right digastric muscles b. Right medial pterygoid muscle c. Right temporalis muscle d. Right geniohyoid muscle

b. Right medial pterygoid muscle Lateral excursion of the mandible is produced by the contralateral medial and lateral pterygoids and ipsilateral temporalis muscles. Tightness of the ipsilateral pterygoids or contralateral temporalis muscles may need lengthening in order to allow full lateral mandibular excursion. The right medial pterygoid would be one of the muscles targeted for interventions restoring sufficient length

During an examination of a pt who complains of back pain, the PT notes pain with end-range AROM into left hip flexion, abduction, and external rotation. The origin of the pain is MOST LIKELY the a. Sartorius muscle b. Sacroiliac (SI) jt c. Left kidney d. Capsule of the hip jt

b. Sacroiliac (SI) jt

43. A female pt complains of right lumbosacral pain after giving natural childbirth to her first child 2 months ago. Pain has subsided somewhat, but remains high enough that she has to sit after walking more than 2 blocks. Pain is noted in right lumbosacral region, buttock, and groin and is aggravated with weight bearing on the right. Active flexion, extension, and side bending reproduce the pts symptoms. Hamstrings are slightly tight on the right, but no neutral tension is noted. Neurological findings (reflexes, sensation, and motor) are unremarkable. S1 provocation tests are positive. The MOST likely diagnosis for this pt would be a. Piriformis syndrome b. Sacroiliac sprain c. Lumbar disc protrusion at L5/S1 d. Quadratus lumborum strain

b. Sacroiliac sprain Child bearing can place considerable stress on the SI joint, causing an overstretch of the ligaments. Pain is reproduced with active movement testing, which is characteristic of a musculoskeletal condition. Sacroiliac provocation tests are fairly valid as well, thus implicating the SI joint. The groin and buttock are common referral regions for the SI joint.

2. Which of the following GI sources of pain can refer to the shoulder? a. Esophageal pain b. Spleen or diaphragmatic pain c. Colon or appendix pain d. Gallbladder pain

b. Spleen or diaphragmatic pain

A pt complains of increased pain and tingling in both hands after sitting at a desk for longer than 1 hr. The dx is TOS. Which tx would be the MOST effective PT intervention? a. Strengthening program for the scalenes and SCM b. Stretching program for the pectoralis minor and scalenes c. Cardiovascular training using cycle ergometry to reduce symptoms of TOS d. Desensitization by maintaining the shoulder in abduction, extension, and external rotation with the head turned towards the ipsilateral shoulder

b. Stretching program for the pectoralis minor and scalenes

18. A patient has limited right rotation caused by left thoracic facet joint capsular tightness at T6-7. The artthrokinematic glide that would MOST effectively improve right rotation in sitting is: (C-46) a. Superior and anterior glide on the right T6 transverse process b. Superior and anterior glide on the left T6 transverse process c. Superior and anterior glide on the right T& transverse process d. Superior and anterior glide on the left T7 transverse process

b. Superior and anterior glide on the left T6 transverse process Because the left thoracic facet joint capsule is restricting movement, motion that would stretch the capsule would facilitate improved right rotation. With right rotation, the left superior facets move upward (opening the joint and stretching the capsule) and the right facets move downward (closing the joint and putting the capsule on relative slack).

34. A pt has limited right rotation caused by left thoracic facet jt capsular tightness at T6-7. The arthrokinematic glide that would MOST effectively improve right rotation in sitting is a. Superior and anterior glide on the right T6 transverse process b. Superior and anterior glide on the left T6 transverse process c. Superior and anterior glide on the right T7 transverse process d. Superior and anterior glide on the left T7 transverse process

b. Superior and anterior glide on the left T6 transverse process Because the left thoracic facet joint capsule is restricting movement, motion that would stretch the capsule would facilitate improved right rotation. With right rotation, the left superior facets move upward (opening the joint and stretching the capsule) and the right facets move downward (closing the joint and putting the capsule on relative slack).

6. A PT palpates medially along the spine of the scapula. Which Spinous process is at the same level as the vertebral end of the spine? a. T2 b. T3 c. T4 d. T5

b. T3 T7: inferior angle L4: iliac crest sacral apex: greater trochanter

11. A patient currently being seen for low back pain awoke one morning with drooping left facial muscles and excessive drooling. The patient was recovering from a cold and had experienced an earache in the left ear during the previous 2 days. The therapist suspects Bell's palsy, which can be confirmed by examining: (B-41) a. Trigger pts for pain, especially over the TMJ b. Taste over the anterior tongue and having the patient raise the eyebrows and puff the cheeks c. Taste over the posterior tongue and having the patient protrude the tongues d. Corneal reflex and stretch reflexes of facial muscles

b. Taste over the anterior tongue and having the patient raise the eyebrows and puff the cheeks Bell's palsy is LMN lesion affecting the branches of the CN VII. Examination of the motor function of muscles of facial expression (i.e., raise eyebrows, show teeth, smile, close eyes tightly, puff cheeks) and taste over the anterior tongue will reveal deficits of CNVII function

The major concentrations of proprioceptive receptors providing information about position of the TMJ are located in: a. The capsule and ligaments of the TMJ and the medial pterygoid muscle. (mechanoreceptors GTO, closing: passive) b. The capsule and ligaments of the TMJ and the lateral pterygoid muscle. (mechanoreceptors GTO, opening: active) c. The articular disc of the TMJ and the medial pterygoid muscle. (avascular, aneural) d. The articular disc of the TMJ and the lateral pterygoid muscle. (avascular, aneural)

b. The capsule and ligaments of the TMJ and the lateral pterygoid muscle. (mechanoreceptors GTO, opening: active)

A 2 month-old child w/ bilateral hip dislocations is being discharged from an acute pediatric facility. The PT has developed a home exercise program and now needs to instruct the parents. The MOST important item for the PT to assess before instructing the parents is: a. The financial reimbursement plan b. Their degree of anxiety and attention c. Their level of formal education d. The home environment

b. Their degree of anxiety and attention

13. A patient is referred for physical therapy with a diagnosis of DJD affecting C2 and C3. The patient complains of pain and stiffness in the cervical region and transient dizziness with some cervical motions. The BEST initial examination procedure is: (C-152) a. Lhermitte's test b. Vertebral artery test c. Oppenheim's test d. Adson's maneuver

b. Vertebral artery test The vertebral artery test checks the integrity of the blood flow through the artery in the cervical region. Because the patient is experiencing symptoms of circulatory disturbance and a unilateral pull could compress the left cervical structures, the vertebral artery test is an appropriate screening test. The test consists of passively placing the patient's head in extension and side flexion in supine position. Then the head and neck are slowly rotated to the laterally flexed side and held for 30 sec. Some of the (+) signs may be syncope, lightheadedness, nystagmus or visual disturbances. Though there are some doubts about the sensitivity/specificity of this test, the patient's initial complain of dizziness with come cervical movements would indicate that it be applied in this case.

24. A therapist suspects lower brain stem involvement in a patient with amyotrophic lateral sclerosis (ALS). Examination findings reveal motor impairments of the tongue with ipsilateral wasting and deviation on protrusion. These findings confirm involvement of CN: (C-156) a. IX b. XII c. XI d. X

b. XII The hypoglossal (CN XII) controls movements of the tongue. Ipsilateral wasting and the deviation to the ipsilateral side on protrusion are indicative of damage.

A patient who has undergone a radical neck dissection is unable to initiate a shoulder shrug. Which nerve was most likely damaged during surgery? a. vagus b. accessory c. long thoracic d. musculocutaneous

b. accessory

Which of the following structures is not a part of the vestibular system? a. semicircular canals b. cochlea c. labyrinth d. otoliths

b. cochlea

A patient with a neurological disorder expresses that she is no longer able to differentiate between the tastes of many foods on the front portion of her tongue. Which cranial nerve would potentially contribute to this reported findings? a. cranial nerve I b. cranial nerve VII c. cranial nerve IX d. cranial XII

b. cranial nerve VII

A patient sustains a corticospinal tract lesion at the level of the brainstem that produces extension of the trunk and extremities. This would be termed: a. decorticate rigidity b. decerebrate rigidity c. ideomotor apraxia d. constructional apraxia

b. decerebrate rigidity

Which finding is typically associated with the presence of a lower motor neuron disorder, however, would not be associated with an upper motor neuron disorder? a. hypertonicity b. fasciculations c. weakness d. atrophy

b. fasciculations

A pt returns to an outpt PT clinic 2 hours after a PT session complaining of increased back pain. The pt has been in PT for 3 previous visits and has had little difficultly with a program consisting of palliative modalities and pelvic stabilization exercises. the pt was referred to PT after injuring his back 2 weeks ago. The MOST appropriate PT action is: a. contact the referring physician to discuss pt's care plan b. instruct the pt to discontinue the pelvic stabilization exercises and re-examine the pt at his next visit c. refer the pt to the ER of a local hospital d. instruct the pt to cancel existing PT visits and schedule an appt with the physician.

b. instruct the pt to discontinue the pelvic stabilization exercises and re-examine the pt at his next visit Discontinue activities that increase their pain. re-exam to determine appropriate course of action based on the findings

A score of 10 on the Glasgow Coma Scale is indicative of: a. coma b. moderate brain injury c. mild brain injury d. absence of a brain injury

b. moderate brain injury

A pt fails to attain established PT goals within the # of visits approved by the pt's 3rd party payer. The pt has made progress in therapy, however, has been slowed somewhat by an adverse reaction to medications. The MOST appropriate PT action is: a. request additional visits from referring physician b. request additional visits from 3rd party payer c. inform the pt that PT services may not be fully covered by the 3rd party payer d. discharge the pt from PT with a HEP

b. request additional visits from 3rd party payer According to the Criteria for Standards of Practice for PT published by the APTA, "the PT discharges the pt/client from PT when the anticipated goals or expected outcomes for the pt/client has been achieved. The PT discontinues intervention when the pt/client is unable to continue to progress toward goals or when the PT determines the pt/client will no longer benefit from PT. A PT should attempt to secure approval for additional PT visits when there is ample evidence that the pt is progressing towards the established goals

During an examination of a pt who complains of back pain, the PT notes pain with end-range AROM into left hip flexion, abduction, and external rotation. The origin of the pain is MOST LIKELY the a. Sartorius muscle b. Sacroiliac (SI) jt c. Left kidney d. Capsule of the hip jt

b. sacroiliac jt Pain at end-range of flexion, abduction, external rotation and extension (FABRE) is diagnostic for SI joint dysfunction because it both gaps and compresses the joint

2. An elderly pt w/ back pain is referred to PT. The pt has pancreatic cancer and moderate senile dementia and is unaware of the dx or prognosis, at the family's request. The pt asks the PT's BEST response is: a. "I will tell the doctor to answer all of your questions" b. "Ask the nurse practitioner for this information" c. "I'll treat the sxs and see how well you do" d. "To discuss the dx and prognosis w/ the pt"

c. "I'll treat the sxs and see how well you do"

41. The pt has a fifth rib that is "stuck" in the position of maximal inspiration. Which technique is BEST to improve the rib mobility and assist it in returning to its resting position a. Grade IV mobilization of the head of the rib at the costovertebral jt in the inferior direction b. Grade II mobilization of the head of the rib at the costovertebral jt in the superior direction c. Grade IV mobilization of the head of the rib at the costovertebral jt in the superior direction d. Grade II mobilization of the head of the rib at the costovertebral jt in the inferior direction

c. (Maitland) Grade IV mobilization of the head of the rib at the costovertebral jt in the superior direction Grade: I: small amp at beginning ROM, gate control theory, increase fibroblast activity II: Large amp within range (midrange). Start at beginning. pain and start motion III: large amp. to point of limitation. increase ROM IV: small amp at end range. increase ROM V: high velocity thrust of small amp at end range. increase ROM

A physical therapist reviews the medical record of a patient with a suspected head injury. During testing using the Glasgow Coma Scale, the patient exhibited spontaneous eye opening, was able to follow selected motor commands, and was considered to be "oriented" based on verbal responses. the MOST likely score assigned to the patient would be: a. 6 b. 12 c. 15 d. 18

c. 15

25. An examination of a patient reveals drooping of the shoulder, rotary winging of the scapula, an inability to shrug the shoulder and complaints of aching in the shoulder. Based on these findings, the cause of these symptoms would MOST LIKELY be due to: (C-165) a. Muscle imbalance b. A lesion of the long thoracic nerve c. A lesion of the spinal accessory nerve d. Strain of the serratus anterior

c. A lesion of the spinal accessory nerve Rotary winging occurs when the inferior angle of one scapula is rotated farther from the spine that the inferior angle of the other scapula. The shoulder drooping and inability to shrug the shoulder are secondary to lesion of the spinal accessory nerve (CN XI) which innervates the trapezius muscle

9. An elderly person has lost significant functional vision over the past 4 years, and complains of blurred vision and difficulty reading. The patient frequently mistakes images directly in front of her, especially in bright light. When walking across a room the patient is able to locate items in the environment using peripheral vision when items are located to both sides. Based on these findings, the therapist suspects: (B-18) a. Glaucoma b. Homonymous hemianopsia c. Cataracts d. Bitemporal hemianopsia

c. Cataracts Glaucoma produces reverse symptoms: loss of peripheral vision occurs first, then central vision, progressing to total blindness. Hemianopsia is a field defect in both eyes that often occurs following stroke. There was no mention of CVA in the question.

A patient is receiving mobilizations to regain normal mid thoracic extension. After three sessions, the patient complains of localized pain that persists for greater than 24 hours. The therapist's treatment should: a. Continue with current mobilizations, followed by cold pack to the thoracic spine b. Place the physical therapy on hold and resume in 1 week c. Change mobilizations to gentle, low-amplitude oscillations to reduce the joint and soft tissue irritation d. Change to self-=stretching activities, because the patient does not tolerate mobilizations

c. Change mobilizations to gentle, low-amplitude oscillations to reduce the joint and soft tissue irritation Changing to low-amplitude oscillations will promote a decrease in the pain and tissue irritation. If pain persists for more than 24 hours, the soft tissue and joint irritation may progress.

Which Rancho Los Amigos Level of Cognitive Functioning presents with heightened activity levels, confabulation, inability to follow directions, and non-purposeful behaviors? a. Generalized Response b. Localized Response c. Confused-Agitated d. Confused-Inappropriate

c. Confused-Agitated

40. An adult pt is diagnosed with TOS. The pt presents with guarding in the upper trapezius and scalene muscles. Given this situation, which technique would be the MOST EFFECTIVE way to decrease the muscle guarding and provide pain relief a. Grade II mobilization of the atlanto-axial jt b. Grade III mobilization of the C6-7 jt c. Grade V manipulation of the first rib d. Grade V manipulation of the C6-7 jt

c. Grade V manipulation of the first rib

A patient has been diagnosed with acute synovitis of the temporomandibular joint. Early intervention should focus on: (A-9) a. Application of an intraoral appliance and phonophoresis b. Joint mobilization and postural awareness c. Instruction to eat a soft food diet and phonophoresis d. Temporalis stretching and joint mobilization

c. Instruction to eat a soft food diet and phonophoresis Reasoning: Phonophoresis and education regarding consumption of only soft food should help resolve the acute inflammatory process in the temporomandibular joint

After treating a pt for trochanteric bursitis for 1 week, the pt has no resolution of pain and is complaining of problems with gait. After reexamination, the PT finds weakness of the quadriceps femoris and altered sensation at the greater trochanter. This is MOST likely due to a. Degenerative jt disease (DJD) of the hip b. Sacroiliac (SI) dysfunction c. L4 nerve root compression d. L5 nerve root compression

c. L4 nerve root compression

25. A PT is examining a pt newly dx w/ MS. The pt experiences an intense shock-like pain throughout the body when the neck is passively flexed. The PT recognizes these findings as: a. Paresthesias b. Dysesthesias c. Lhermitte's sign d. Uthoff's sign

c. Lhermitte's sign

28. A pt presents to PT with a primary complaint of low back pain and right lower extremity radicular symptoms extending distally to the calf of 2 weeks duration. Current pain intensity is rated as 2/10 with rest and 5/10 during lumbar extension movements. What us the strongest prognostic indicator that would affect the clinical outcome? a. 2/10 pain intensity with rest b. 5/10 pain intensity during lumbar extension c. Lower extremity radicular symptoms d. Current symptoms duration (2weeks)

c. Lower extremity radicular symptoms The presence of lower extremity radicular symptoms in patients experiencing low back pain is strong negative prognostic indicator for achieving good clinical outcomes.

9. An adult pt is dx w/ TOS. The pt presents w/ guarding in the upper trap and scalene mm. Given this situation, which technique would be the MOST EFFECTIVE way to decrease the m guarding and provide pain relief? a. Maitland grade I mobilization of the atlanto-axial joint b. Maitland grade I mobilization of the C6-7 joint c. Maitland grade V manipulation of the 1st rib d. Maitland grade V manipulation of the C6-C7 joint

c. Maitland grade V manipulation of the 1st rib

17. While reviewing a pts imiaging films, the most appropriate imaging view to identify abnormal anatomy of the pars interarticularis in the lumbar region is a. Anteroposterior view b. Lateral view c. Oblique view d. Lumbosacral view

c. Oblique view For the lumbar region, the oblique view will clearly demonstrate the pars interarticularis

A PT performs the slump test on a pt with a dx of lumbar disc herniation whose complaint is pain in the posterior thigh. Which of the following findings would indicate a positive test result a. Pain in the lumbar spine region that is increased with cervical flexion b. Pain in the buttocks that is unchanged with head or ankle movement c. Pain in the posterior thigh that is relieved with cervical extension d. Pain in the posterior knee and calf that is relieved with ankle plantar flexion

c. Pain in the posterior thigh that is relieved with cervical extension

14. A PT performs the slump test on a pt with a dx of lumbar disc herniation whose complaint is pain in the posterior thigh. Which of the following findings would indicate a positive test result a. Pain in the lumbar spine region that is increased with cervical flexion b. Pain in the buttocks that is unchanged with head or ankle movement c. Pain in the posterior thigh that is relieved with cervical extension d. Pain in the posterior knee and calf that is relieved with ankle plantar flexion

c. Pain in the posterior thigh that is relieved with cervical extension (+) slump test is indicated by a reproduction of the patient's symptoms in the test position that is reduced or relieved by reducing tension on the nervous systems through movement of a body segment not directly affecting the joints or muscles in the location of the symptoms

23. A patient with trigeminal nerve neuralgia (CN V) is referred to the physical therapist. Upon examination the MOST LIKELY findings are: (C-128) a. Bilateral sensory loss of CN V in all three divisions b. Sudden severe pains in the ophthalmic division of CN V c. Paroxysmal and severe pain originating from the mandibular or maxillary divisions of CN V d. Unilateral sensory loss of the ophthalmic division of CN V

c. Paroxysmal and severe pain originating from the mandibular or maxillary divisions of CN V Trigeminal neuralgia (tic douloureux) is condition characterized by sudden severe pain occurring in the distribution of the trigeminal nerve (CN V). It typically occurs in the maxillary or mandibular division on one side of the face.

10. A PT attempts to assess the integrity of the L4 spinal level. Which deep tendon reflex would provide the therapist with the MOST useful information a. Lateral hamstrings b. Medial hamstrings c. Patellar reflex d. Achilles reflex

c. Patellar reflex

8. A Physical therapist assess the deep tendon reflexed as part of a lower quarter screen. The therapis determine that the right and left patellar tendon reflex and the left Achilles tendon reflex are 2+, while the R Achilles reflex is absent. The clinical condition that coule BEST explain this finding is: a. Cerebral palsy b. Multiple sclerosis c. Peripheral neuropathy d. Intermittent claudication

c. Peripheral neuropathy

A PT obtains a gross measurement of hamstrings length by passively extending the lower extremity of a patient in short sitting. The MOST common substitution to exaggerate the hamstrings length is a. Weight shift to the contralateral side b. Anterior rotation of the pelvis c. Posterior rotation of the pelvis d. Hiking of the contralateral hip

c. Posterior rotation of the pelvis

A 42-year-old female is admitted to a rehabilitation hospital after sustaining a stroke. During the examination the physical therapist identifies significant sensory deficits in the anterolateral spinothalamic system. Which sensation would be MOST affected? a. barognosis b. kinesthesia c. graphesthesia d. temperature

d. temperature

27. A retired bus driver has experienced increasing frequency of low back pain over the past 10 years. The pt states that NSAIDS help to relieve the symptoms, but there is always a nagging-type pain. The pt reports significant stiffness in the morning that dissipates by noon after exercising and walking. Pain exacerbated with frequent lifting and bending activities, as well as sitting for long periods. PT intervention should emphasize a. Modalities to reduce pain, jt mobilization, and lumbar extension exercises b. Jt mobilization, soft tissue mobilization, and flexion exercises c. Postural reeducation, soft tissue mobilization, and dynamic stabilization d. Modalities to reduce pain, postural reeducation, and dynamic stabilization

c. Postural reeducation, soft tissue mobilization, and dynamic stabilization This long-term degenerative and postural dysfunction is manageable with medication and proper physical activity. Therefore, the most effective use of treatment time should emphasize regaining normal postural alignment and functional ADLs

4. A pt presents w/ pain radiating down the posterior hip and thigh as a result of a herniated disc in the lumbar spine. The PT decides to apply mechanical traction. If the pt can tolerate it, the PREFERRED pt position is: a. Supine w/ 1 knee flexed b. Supine w/ both knees flexed c. Prone w/ no pillow d. Prone w/ pillow under the abdomen

c. Prone w/ no pillow placing the pt in prone position would better align the spine so that the pull of the traction would be along the axis of the vertebral bodies for traction of herniated disc

12. To reduce an elderly individual's chronic forward head posturing in standing and sitting the therapist should consider stretching exercises to: (B-73) a. Middle trapezius and rhomboids b. Longus capitiis and longus colli muscles c. Rectus capitis posterior minor and rectus capitis posterior major muscles d. Rectus capitis anterior muscles

c. Rectus capitis posterior minor and rectus capitis posterior major muscles Forward head posturing or forward translation of the occiput in relation to the neck and trunk is associated with extension of the occipital and axial joint flexion of the lower and mid cervical spines. Chronic extension of the occipital axial joint will lead to shortening of the suboccipital extensor muscles (rectus capitis posterior major and minor) and localized stretching of these muscles would be indicated as part of the therapeutic intervention to reduce forward head posturing

6. To reduce an elderly individual's chronic forward head posturing in standing and sitting the therapist should consider stretching exercises to: (B-73) a. Middle trapezius and rhomboids b. Longus capitiis and longus colli muscles c. Rectus capitis posterior minor and rectus capitis posterior major muscles d. Rectus capitis anterior muscles

c. Rectus capitis posterior minor and rectus capitis posterior major muscles Forward head posturing or forward translation of the occiput in relation to the neck and trunk is associated with extension of the occipital and axial joint flexion of the lower and mid cervical spines. Chronic extension of the occipital axial joint will lead to shortening of the suboccipital extensor muscles (rectus capitis posterior major and minor) and localized stretching of these muscles would be indicated as part of the therapeutic intervention to reduce forward head posturing

6. A PT discusses the importance of proper posture with a pt rehabilitating from a back surgery at the L3-L4 level. Which body position would place the most pressure on the lumbar spine? a. Standing in the anatomical position b. Standing with 45 degrees of hip flexion c. Sitting in a chair slouching forward d. Sitting in a chair with reduced lumbar lordosis

c. Sitting in a chair slouching forward Nachemson study examined intradiskal pressure in the lumbar spine: from lowest load to greatest load goes from lying supine, sidelying, standing in anatomical position, standing with 45 deg hip flexion, sitting with reduced lumbar lordosis, to sitting in chair slouched forward ref: Nachemson A, Morris JM. In vivo measurements of intradiscal pressure.J Bone Joint Surg [Am] 1964;46:1077-92.

3. A patient demonstrates weakness when rotating the head to one side as well as weakness flexing the head laterally and forward to the same side. The therapist recognizes these symptoms of the lesion of the: (A-98) a. Spinal nerve root of the accessory nerve of the same side b. Motor portion of the facial nerve c. Spinal nerve root of the accessory nerve on the contralateral side d. Motor portion of the hypoglossal nerve

c. Spinal nerve root of the accessory nerve on the contralateral side The spinal nerve root of the accessory nerve (CN XI) innervates the SCM. This allows for head rotation and flexion of the head laterally and forward, both to the contralateral side.

A patient demonstrates weakness when rotating the head to one side as well as weakness flexing the head laterally and forward to the same side. The therapist recognizes these symptoms of the lesion of the: (A-98) a. Spinal nerve root of the accessory nerve of the same side b. Motor portion of the facial nerve c. Spinal nerve root of the accessory nerve on the contralateral side d. Motor portion of the hypoglossal nerve

c. Spinal nerve root of the accessory nerve on the contralateral side The spinal nerve root of the accessory nerve (CN XI) innervates the SCM. This allows for head rotation and flexion of the head laterally and forward, both to the contralateral side.

6. A PT obtains an x-ray of a 14yr old female recently referred to PT after experiencing an increase in back pain following activity. The pt previously participated in competitive gymnastics, however, states that her back was unable to tolerate the intensity of training. Based on the presented xray, the therapist would expect the pts medical dx to be a. Sponsylitis b. Spondylolysis c. Spondylolisthesis d. Spondyloptosis

c. Spondylolisthesis Increased pain in ext degenerative: failure of facets (L4-5) Isthmic: failure of pars (anterior porition of lamina at L5) congenitally: defective pars interarticularis: slipping of one vertebra after a bilateral pars interarticularis tested with stork test palpation: step off (deformity) at L4-L5 seen in gymnastics, weight lifting, and football

With a traction injury to the anterior division of the brachial plexus, the PT would expect to see weakness of the elbow flexors, wrist flexors, and forearm pronators. The therapist would also expect to find additional weakness in: a. Wrist extension b. Forearm supination c. Thumb abduction d. Lateral rotation of the shoulder

c. Thumb abduction

19. A pt with a hx of low back pain has been receiving PT for 12 weeks. The pt is employed as a loading dockworker. He performs repetitive lifting and carrying of boxes weighing between 15 and 30 lbs. An appropriate engineering control to reduce the stresses of lifting and carrying would be to a. Use job rotation b. Issue the employee a back support belt c. Require the worker to attend a class using correct body mechanics while performing the job d. Provide a two-wheel handcart for use in moving the boxes

d. Provide a two-wheel handcart for use in moving the boxes

7. A patient with traumatic onset (Motor vehicle accident) of neck pain presents with subjective complaints of frank upper cervical spine instability. One test that would safely assist in identifying the integrity of the C1-C2 articulation would be: (B-121) a. Vertebral artery test b. Maximum cervical compression test c. Transverse ligament stress test d. Hautant's test

c. Transverse ligament stress test The transverse ligament stress test is specifically designed to assess the integrity of the transverse ligament, which maintains the position of the dens of C2 with the anterior arch of C1

The majority of cranial nerves originate from which structure in the brain? a. cerebrum b. cerebellum c. brainstem d. diencephalon

c. brainstem

An example of an upper motor neuron disease is: a. poliomyelitis b. muscular dystrophy c. cerebral palsy d. C2 spinal cord injury

c. cerebral palsy

Which sense is assessed by asking a patient to close their eyes and identify the direction in which a joint is moving? a. sterognosis b. proprioception c. kinesthesia d. two-point discrimination

c. kinesthesia

A PT asks a PTA to complete a LE isokinetic test on a pt. The PTA is willing to complete the test, however, indicates it has been quite some time since they have set up the isokinetic device. The MOST appropriate PT action is: A. provide verbal cueing for the PTA prior to beginning the set up b. instruct the PTA to refer to the owner's manual c. observe the PTA complete the set up d. ask another PTA to complete the set up

c. observe the PTA complete the set up observing the PTA complete the set allows the PT to assist the PTA as needed and at the same time ensures the device is set up correctly. Direct involvement of the PT is collaborative and may assist the PTA to complete the set up independently in the future

Which of the following is responsible for providing proprioceptive information to the central nervous system regarding balance? a. auditory input b. vestibular system c. somatosensory receptors d. visual receptors

c. somatosensory receptors

A pt informs PT how frustrated she feels after being examined by her physician. The pt explains that she becomes so nervous, she can't ask any questions during scheduled office visits. The therapist's MOST appropriate response is to a. offer to go with the pt to her next physician visit b. offer to call the physician and ask any relevant questions. c. suggest that the pt write down questions for the physician and bring them with her to the next scheduled visit d. tell the patient it is a very normal response to be nervous in the presence of a physician

c. suggest that the pt write down questions for the physician and bring them with her to the next scheduled visit PT should attempt to identify a strategy that the pt can use to take a more active role. Writing down questions allows the pt to reflect on the information she would like to gather in advance and provides the structure necessary to reduce the influence of the pt's anxiety during office visit

A physical therapist conducts a sensory assessment on numerous areas of a patient's face. The cranial nerve MOST likely assessed using this type of testing procedure is: a. facial nerve b. oculomotor nerve c. trigeminal nerve d. trochlear nerve

c. trigeminal nerve

The superior oblique muscle of the eyeball is innervated by which cranial nerve? a. oculomotor b. abducens c. trochlear d. optic

c. trochlear

A tuning fork may be used to assess which cranial nerve? a. trochlear b. trigeminal c. vestibulocochlear d. vagus

c. vestibulocochlear

The medical record indicates that a patient was classified as having a mild brain injury based on the results obtained from the Glasgow Coma Scale. The patient's most likely score was a/an: a. 3 b. 7 c. 10 d. 14

d. 14

37. When performing scoliosis screening in a school setting, the optimal age for girls to be screened is a. 6-8 b. 12-14 c. 15-17 d. 9-11

d. 9-11 The most effective age to screen girls for scoliosis is just before the pubescent growth spurt between 9-11 years, when the scoliotic curve can increase dramatically. Boys should be screened between 11-13 years of age because of the differences in the age of onset of puberty between girls and boys.

6. A patient is referred to PT for vestibular rehabilitation. The patient presents with spontaneous nystagmus that can be suppressed with visual fixation, oscillopsia, and loss of gaze stabilization. Additional postural findings include intense disequilibrium, and an ataxic wide-based gait with consistent veering to the left. Based on these findings, the PT determines that the patient is MOST LIKELY exhibiting signs and symptoms of: (A-142) a. Benign paroxysmal positional vertigo (BBPV) b. Acoustic neuroma c. Meniere's disease d. Acute unilateral vestibular dysfunction

d. Acute unilateral vestibular dysfunction This patient is presenting with classic signs and symptoms of unilateral vestibular dysfunction. An abnormal vestibular ocular reflex (VOR) produces nystagmus, loss of gaze stabilization during head movements and oscillopsia. Abnormal vestibulospinal function produces impairments in balance and gait. Veering to one side is indicative of unilateral vestibular dysfunction.

5. A pt referred to PT with chronic low back pain has failed to make any progress toward meeting estabilished goals in over 3 weeks of treatment. The PT has employed a variety of treatment techniques but has yet to observe any sign of subjective or objective improvement in the pt condition. The MOST appropriate action would be to a. Transfer the pt to another therapists schedule b. Re-examine the pt and establish new goals c. Continue to modify the pt treatment plan d. Alert the referring physician to the patients status

d. Alert the referring physician to the patients status PT must be willing to consult with a referring physician when there is ample evidence suggesting that the pt is not benefiting from PT services. Formal communication should occur with the referring physician when a pt fails to make progress in PT. This is particularly relevant in the described scenario since the PT has employed a variety of tx techniques and has not observed any sign of subjective or objective improvement.

Which of the following is an example of a lower motor neuron disease? a. hydrocephalus b. multiple sclerosis c. cerebral palsy d. muscular dystrophy

d. muscular dystrophy

Asking a patient to identify an object placed in their hand without looking at it is used to assess: a. light touch b. kinesthesia c. graphesthesia d. sterognosis

d. sterognosis

38. A young adult pt is referred to outpatient PT for an insidious onset of thoracic spine stiffness and mild pain. The pt reports a great deal of difficulty moving in the mid-back region in the morning and states that this has become progressively worse over the past 6 months. The neurological exam is negative. Based on this clinical scenario, the pt is exhibiting symptoms of a. Lyme disease b. Pneumothorax c. Thoracic compression fracture d. Ankylosing spondylitis

d. Ankylosing spondylitis Ankylosing spondylitis is associated with traumatic, insidious onset of thoracic pain and/or pain with an increased duration of morning stiffness being the primary symptom

5. During a sensory examination, a patient complains of a dull, aching pain and is not able to discriminate a stimulus as sharp or dull. Two-pt. discrimination is absent. Based on these findings, the pathway that is intact is the: (A-132) a. Lateral spinothalamic tract b. Dorsal columns/neospinothalamic systems c. Fasciculus gracilis/medial lemniscus d. Anterior spinothalamic tract

d. Anterior spinothalamic tract Sensations interpreted as dull, aching pain travel in the anterior (paleo) spinothalamic tract.

11. A middle-aged pt complains of "throbbing pain" in the lumbar region w/ activities upon exertion, such as walking up a flight of steps or playing tennis. The pt expresses no complaints of pain w/ bending, twisting, sitting, standing, or walking any distance. Active movements of the lumbar spine are full and pain-free. Provocation testing is negative. Neurological signs are unremarkable. There is no significant tenderness to palpation. The MOST likely dx for this pt would be: a. Quadratus lumborum m strain b. Lumbar disc herniation c. SI joint sprain d. Aortic aneurysm

d. Aortic aneurysm Throbbing low back pain that occurs only with activities that increase the HR is a red flag for aortic aneurysm. Medical referral is indicated.

39. An adolescent felt a "clunk" in the lumbar spine 2 weeks ago while lifting weights. There was immediate right lumbar pain and spasm. Posteroanterior and bilateral radiograph views of the lumbar spine were normal except L4 was shifted approximately 1mm anterior to L5 on the lateral views. Which of the following imaging techniques would give the PT the best information regarding a diagnosis and formulating a POC for this pt a. Posteroanterior T1 MRI b. Posteroanterior CT scan c. Right oblique radiograph d. Bilateral oblique radiographs

d. Bilateral oblique radiographs The clinician should suspect SPONDYLOLISTHESIS. Spondylolisthesis is a forward slippage of a vertebra due to bilateral defect in the pars interarticularis. Causes include congenital, acute fracture or degenerative conditions. The degree of forward slippage is graded on 1-4 scale from the lateral view. It is unclear from the description whether there is an actual spondylolisthesis. Bilateral oblique views with the radiograph are needed to see whether there is a fracture at the pars interarticularis bilaterally.

A patient demonstrates goal-directed behaviors in treatment with cues from the therapist, but gives incorrect verbal responses in conversation. This behavior corresponds with which Rancho Los Amigos Level of Cognitive Functioning? a. Generalized Response b. Localized Response c. Confused-Inappropriate d. Confused-Appropriate

d. Confused-Appropriate

7. A patient is admitted to rehab with a 3-week history of Guillain-Barre syndrome. The therapist examines the patient for function of CN IX/X. The BEST test for motor function of these nerves is to: (A-143) a. Have the patient swallow different consistencies of food b. Ask the patient to protrude the tongue and note any deviation c. Ask the patient to swallow, observing the rise and fall of the larynx d. Elicit the gag reflex by swiping a tongue depressor at the back of the throat

d. Elicit the gag reflex by swiping a tongue depressor at the back of the throat Because CN IX/X mediates similar functions, they are tested simultaneously. The gag reflex is correct and is tested by swiping a tongue depressor at the back of the throat

A 6 month old child was referred to PT for right torticollis. The MOST effective method to stretch the muscle is by positioning the head and neck into: a. Flexion, left side-bending, and left rotation b. Extension, right side-bending, and left rotation c. Flexion, right side-bending, and left rotation d. Extension, left side-bending, and right rotation

d. Extension, left side-bending, and right rotation

27. A PT treats an infant with torticollis with marked lateral flexion of the neck to the right. As part of the infants plan of care the therapist performs passive stretching activities to improve the patients ROM. The most appropriate stretch for the patient is: a. Lateral flexion to the right and rotation to the right b. Lateral flexion to the left and rotation to the left c. Lateral flexion to the right and rotation to the left d. Lateral flexion to the left and rotation to the right

d. Lateral flexion to the left and rotation to the right

Pt presents with low back pain of insidious onset. Based on the hx and subjective complaints pts has dysfunction of a lumbar facet jt (most pressure during extension). What clinical test should be used to confirm this dx a. Slump test b. Stork standing test c. McKenzie's slide glide test d. Lumbar quadrant test

d. Lumbar quadrant test (extend-sidebend, extend-rotate) The motion of the lumbar quadrant test places the lumbar facet joint in its maximally closed and therefore most provocative position, so if positive it is typically indicative of a lumbar facet dysfunction.

33. A pt with unilateral spondylolysis at L4 is referred for PT. The pt complains of generalized lower back pain when standing longer than 1 hour. Interventions for the subacute phase should include strengthening exercise for the a. Abdominals working from neutral to full flexion b. Multifidi working from neutral to full extension c. Abdominals working from full extension to full flexion d. Multifidi working from full flexion back to neutral

d. Multifidi working from full flexion back to neutral Performing strengthening exercises to the multifidi from flexion to neutral will not stress the pars defect.

A female patient complains of intermittent pain in the right SI region. There was insidious onset approx. 4 months ago. Pain has gradually worsened and is now fairly constant and does not vary much with activity or movement. Active motion assessment of the lumbar spine reveals no change in symptoms with movement. SI provocation tests are negative. The patient is mildly tender over the right SI region. The MOST likely diagnosis for the patient would be: a. SI joint sprain b. Multifidus muscle strain c. Right L5/S1 facet joint arthrosis d. Ovarian cyst

d. Ovarian cyst An ovarian cyst can refer pain to the SI region and is more likely to cause constant pain that does not vary much with activity. Symptoms are not likely to be reproduced with musculoskeletal examination.

21. A patient presents with decreased motion at the occipitoatlantal joint (OA). The PT wants to use the principles of coupled motions that occur in that area of the spine during manual therapy techniques. In order to improve OA mobility, when the occiput is side bent to the right, the therapist should mobilize C1 into: (C-116) a. Flexion b. Extension c. Rotation to the right d. Rotation to the left

d. Rotation to the left Given the rules of coupled movement in the upper cervical spine, when the occiput is side bent into one direction, C1 rotates into the opposite direction. Side bending and rotation occur in the same direction from C2-7 regardless if the spine is in flexion or extension

12. A patient presents with decrease motion at the occiptoatlantal joint (OA). The PT wants to use the principles of coupled motions that occur in that area of the spine during manual therapy techniques. In order to improve OA mobility, when the occiput is side-bent to the right, the therapist should mobilize C1 into: (C-116) a. Flexion b. Extension c. Rotation to the right d. Rotation to the left

d. Rotation to the left Given the rules of coupled movement in the upper cervical spine, when the occiput is side-bent into one direction, C1 rotates into the opposite direction. Side bending and rotation occur in the same direction from C2-C7 regardless if the spine is in flexion or extension.

2. A patient was referred to physical therapy complaining of loss of cervical AROM. X-rays showed degenerative joint disease (DJD) at the uncinated processes in the cervical spine. The motion that would be MOST restricted? (A-88) a. Flexion b. Extension c. Rotation d. Side-bending

d. Side-bending The uncinated processes (joints of Luschka) are located at the inferolateral aspect of the lower cervical vertebrae. Side bending is lost with degenerative changes at the joint that the uncinated process makes with the vertebra below.

2. A PT performs gait training activities with an 8yr old child who utilizes a reciprocating gait orthosis. Which medical diagnosis is MOST often associated with the use of this type f prthotic device? a. CP b. Down Syndrome c. Legg-Calve-Perthes disease d. Spina Bifida

d. Spina Bifida

3. During surgery to remove an apical lung tumor, the long thoracic n was injured. Muscle testing of the serratus anterior demonstrates its strength to be 3+/5. The BEST initial exercises are: a. Standing arm overhead lifts using hand weights b. Supine arm overhead lifts using weights c. Sitting arm overhead lifts using a pulley d. Standing wall push-ups

d. Standing wall push-ups

20. A pt has a lumbar spinal stenosis encroaching on the spinal cord. The PT should educate the pt to avoid a. Bicycling using a recumbent cycle ergometer b. Use of rowing machine c. Tai chi activities d. Swimming using a crawl stroke

d. Swimming using a crawl stroke Continuous positioning in spinal extension increases symptoms in patients with spinal stenosis. Activities such as swimming using a crawl stroke place the spine in this position

A PT examines a 36yr old female referred to PT after experiencing back pain 2 weeks ago. The pt identifies the majority of pain in the buttock and lateral thigh and denies any referred pain down the posterior leg. Presently she rates the pain a "3" on a 0-10 scale, however, indicates that the pain is a "6", or a "7" during activity or at night. This description MOST closely resembles a. Sacroilitis b. Iliolumbar syndrome c. Piriformis syndrome d. Trochanteric bursitis

d. Trochanteric bursitis

3. A pt presents w/ sxs of uncoordinated eye movements, profound gait and trunk ataxia, and difficulty w/ postural orientation to vertical. Balance deficits are pronounced in standing w/ EO and EC. Examination of the extremities reveals little change in tone or coordination. The PT suspects involvement of the: a. Spinocerebellum b. Basal ganglia c. Premotor cortex d. Vestibulocerebellum

d. Vestibulocerebellum

A pt diagnosed with piriformis syndrome is referred to PT for one visit for instruction in a HEP. After examining th pt, the PT feels the pt's rehab potential is excellent, but is concerned that one visit will not be sufficient to meet the pt's needs. The MOST appropriate action is to: a. schedule the pt for tx sessions as warranted by the results of the exam b. explain to the pt that recent health care reforms have drastically reduced the frequency of PT visits covered by 3rd party payers c. explain to the pt that she can continue with PT beyond the initial session, but will be liable for all expenses not covered by her insurance d. contact the referring physician and request approval for additional PT visits

d. contact the referring physician and request approval for additional PT visits The PT will need to seek physician approval for additional visits in order to be working under a physician's referral. Although this does not guarantee that the visits will be approved by the physician or that the visits will be covered by the 3rd party payer, it provides the PT with the opportunity to act in the pt's best interest.

A 46 y.o. male rehabilitating from a radial head fx misses his 3rd consecutive PT tx session. The therapist called the pt after the 2nd missed appt, but didn't receive a return phone call. The MOST appropriate PT action is: a. contact the pt's insurance provider b. design a HEP from the pt c. schedule the pt with another PT d. discharge the pt from PT

d. discharge the pt from PT Multiple missed appt without a response to a phone call warrents discharging the pt from PT. Failure to act in this manner limites the availability to PT services for other pts.

16. Which cranial nerve contains both sensory and motor fibers? a. optic b. trochlear c. abducens d. facial

d. facial

A patient is asked to distinguish between sweet and salty substances placed on the anterior aspect of their tongue. This task assesses the sensory aspect of which cranial nerve? a. glossopharyngeal b. hypoglossal c. olfactory d. facial

d. facial

Efferent and afferent components are found in which cranial nerve? a. optic b. oculomotor c. hypoglossal d. glossopharyngeal

d. glossopharyngeal

Which of the following is most characteristic of an upper motor neuron disease? a. hypotonic muscle tone b. fasciculations c. lesion of ascending tracts d. hyperactive reflexes

d. hyperactive reflexes

A physical therapist attempts to assess the integrity of the vestibulocochlear nerve by administering the Rinne test on a patient with a suspected upper motor neuron lesion. After striking the tine of the tuning fork to begin vibration, which bony prominence should the therapist utilize to position the stem of the tuning fork? a. midline of the skull b. occipital protuberance c. inion d. mastoid process

d. mastoid process

In reference to a stoop lift vs a deep squat lift, when a constant load using either, the MOST significant contributing factor for increasing lumbar spine compression forces in addition to the weight of the load is: a. performing the lift with the lumbar spine in a kyphotic posture b. performing the lift with the lumbar spine in a neutral position rather than in a lordotic posture c. the height of the load from the ground d. the distance of the load from the base of the spine

d. the distance of the load from the base of the spine

A physical therapist attempts to assess the integrity of the first cranial nerve. Which test would provide the therapist with the desired information? a. the patient protrudes the tongue while an examiner checks lateral deviation b. the patient completes a vision examination c. the patient performs a shoulder shrug against resistance d. the patient is asked to identify familiar odors with the eyes closed

d. the patient is asked to identify familiar odors with the eyes closed

IMPORTANT NOTE ABOUT SPONDYLOLITHESIS

there is typically an anterior slippage of one vertebra on the vertebra below. Because of the anterior shearing forces acting at the vertebra caused by the wedge shape of the vertebra and gravity, SPINAL EXTENSION POSITIONS SHOULD BE AVOIDED!!