know this also
flexion to decrease tension on the biceps brachii
To measure shoulder hyperextension, the elbow should be in
PREVENT MUSCLE ATROPHY
benefit of passive exercise EXCEPT:
MOVES PARALLEL TO THE FLOOR
A gravity eliminated movement occurs when the moving segment
Left side lying, with the right arm supported on pillows, a pillow behind the back above the sacrum to stabilize the trunk, and with the right hip and knee flexed and supported on pillows.
A hospitalized patient has developed a pressure ulcer on her sacrum and right lateral malleolus. Which of the following is the BEST option for this patient's long term positioning?
3 degrees of extension and 138 degrees of flexion of the R knee 3 - 138 degrees of R knee flexion
A patient remains in 3 degrees of R knee flexion when the ankle is supported on a towel and the calf is off the support surface. Knee flexion is measured at 138 degrees. How would this range accurately be recorded?
The shoulder remains in 5 degrees of external rotation when the therapist attempts to move the shoulder into internal rotation
A therapist recorded R shoulder internal rotation as - 5 degrees of zero. This means:
Lower extremity amputation
A wheelchair in which the rear wheel axle is positioned approximately 2 inches posterior to the normal position is designed to accommodate a patient with:
24 FEET LONG
According to ADA guidelines, a ramp with a two-foot vertical rise should be at least
Increased diuresis resulting in increased plasma production
All of the following are effects of immobilization on the cardiovascular system EXCEPT: -Decreased vessel regulation resulting in decreased blood pressure -Orthostatic Hypotension which could result in syncope -Decrease in venous return to the heart -Increased diuresis resulting in increased plasma production -Thrombus formation which could result in a pulmonary embolus
Posterior pelvic tilt
All of the following can lead to a Kypholordotic Posture Except:
THE MUSCLE LENGTH DOES NOT CHANGE
During an isometric contraction the muscle
Contact Guard Assistance (CGA)
Caregiver is positioned close to the patient with hands on the patient or safety belt
Positions of comfort
Concerning burned or grafted burn areas, what should be avoided?
With the hips and knees flexed and feet flat on the bed
During an upward movement transfer of a supine patient, how should the patient's lower extremities be positioned?
SO THE HAMSTRINGS DO NOT LIMIT ROM
During hip flexion the knee is allowed to flex so:
Increase blood flow
Effects of prolonged immobility DO NOT include:
Hammers, pot handle, soda can
Examples of how to use a cylindrical grip
An adduction pillow to prevent excessive hip adduction
Following a total hip replacement, what device is often used for proper positioning?
Knee extension
Following a total knee replacement, in what position is it important to keep the affected extremity at rest?
HIP ABD
For which motion is it necessary to prevent hip external rotation?
Trace Plus (T+) = 1+
Minimal observable motion (less than 50 %) in gravity eliminated and takes no resistance.
OSTEOKINEMATICS
Goniometry is used to measure which of the following
Forward or Backward
How can a curb be ascended with a wheelchair?
Forward or backward
How can a curb be descended with a wheelchair?
Measure from seat of chair to olecranon process with user's elbow flexed to 90 degrees, add 1 inch
How is the wheelchair armrest height measured?
Measure from posterior butt cheek, along lateral thigh to popliteal fold, subtract 2 inches to avoid pressure from front edge of seat
How is the wheelchair seat depth measured?
From user's heel to the popliteal fold, add additional 2 inches to allow clearance of the footrest
How is the wheelchair seat height measured?
Measure widest aspect of user's butt, hips, or thighs and add 1.5 inches
How is the wheelchair seat width measured?
Measure from seat of chair to the floor of the axilla with shoulder flexed to 90 degrees and subtract 4 inches
How is wheelchair back height measured?
Facing forward, moving in a zigzag fashion
How should a patient using both upper extremities for wheelchair propulsion be taught to navigate up a particularly steep ramp or incline?
In the line of movement, Applied gradually
How should resistance be applied for strength assessment?
Backward
How should stairs be ascended with a wheelchair?
Approximately through the greater trochanter
Ideal plumb alignment from a lateral view includes which of the following (what should the position of the plumb line be in relation to the landmarks)?
The patient may have tremors and extreme hunger
If a diabetic patient has too much insulin:
Above the elbow
If a supine patient has a flaccid upper extremity, how should the hand be positioned?
THE MUSCLE IS CHANGING LENGTH
In an isotonic contraction:
Continue to rub until the hands are dry.
In applying an alcohol-based hand rub, what is the appropriate step to take after rubbing the product briskly over all surfaces of the hands?
At least every 2 hours
In general, how frequently should a dependent patient's positioned be changed?
It increases the base of support of the wheelchair and makes the wheelchair less "tippy."
In preparation for transferring a patient from a wheelchair to the bed, the caster wheels on the wheelchair should be aligned forward. Which of the following is the MOST CORRECT reason?
a. Adduction of the replaced hip beyond midline b. Internal rotation c. Hip flexion beyond 90 degrees Correctd. All of the above
In transferring a patient with a recent total hip replacement from a chair to a bed, which motions should be avoided?
-Decreased muscle mass -Decreased muscle strength -Decreased endurance -Changes in muscle bulk which begins within hours of immobilization
Lack of muscle use from prolonged immobilization may result in which of the following
Normal (N) = 5
Moves through full available motion against gravity and takes maximal resistance
Fair Plus (F+) = 3+
Moves through full available motion against gravity and takes minimal/slight resistance.
Good (G) = 4
Moves through full available motion against gravity and takes moderate resistance.
Good Plus (G+) = 4+
Moves through full available motion against gravity and takes nearly maximal resistance
Good Minus (G-) = 4-
Moves through full available motion against gravity and takes nearly moderate resistance.
Fair (F) = 3
Moves through full available motion against gravity and takes no resistance.
Poor Plus (P+) = 2+
Moves through full available motion in gravity eliminated and takes minimal slight resistance.
Poor (P) = 2
Moves through full available motion in gravity eliminated and takes no resistance.
Fair Minus (F-) = 3-
Moves through less than available motion (at least 50%) against gravity and takes no resistance.
Poor Minus (P-) = 2-
Moves through less than full available motion (at least 50%) in gravity eliminated and takes no resistance
Zero = 0
No observable motion and no contraction tension is palpated
Trace (T) = 1
No observable motion but muscle contraction tension is palpated.
STATE 'CANNOT DETERMINE END FEEL'
On the first rep of shoulder flexion the patient's humerus comes to rest against the surface of the table before finding the end of the available range of motion. The BEST course of action would be to:
THE PATIENT IS CAPABLE OF MOVING ACTIVELY
Passive exercise should be discontinued when
stand by assistance (SBA)
Patient may need verbal or tactile cues, Caregiver is positioned close but not touching the patient
maximum assistance
Patient performs 25-50% of activity
moderate assistance
Patient performs 50-75% of activity
minimum assistance
Patient performs 75% or more of the activity
Prehension
Position of the hand that allows for finger and thumb contact and facilitates manipulation of objects (grasping )
NEUROGENIC
Positioning the patient so that the head is lower than the body is used to treat which form of shock:
To allow alignment with the appropriate landmarks Allows for proper stabilization and prevents deviation So the joint being measured is placed at the starting position To allow full ROM
Proper positioning for ROM measurements is important for which of the following reasons?
LATERAL PREHENSION
The prehension pattern that does NOT require thumb opposition is
FRUITY BREATH
Signs of hypoglycemia
TRUE
T/F In this course we will always use a safety belt (or gait belt) when performing a patient transfer.
TRUE
T/F Patients with an endotracheal tube should avoid cervical spine movement
Take the segment to the end of the available range, apply overpressure, state the end feel based on the response to the overpressure
The correct technique for determining end feel is:
A Deep Squat Lift requires a full squat and a Power Lift requires only a partial squat
The difference between a Deep Squat Lift and a Power Lift is
Widen your stance in a staggered (anterior/posterior) position and Widen your stance in a parallel or lateral stance (feet side by side)
The easiest way(s) to increase your Base of Support when lifting a heavy object from the floor to a shelf at your shoulder level is to:
INTRINSIC
The grasp that is used to hold a flat object such as a book or plate is:
CYLINDRICAL
The most common grasp pattern is
20
The normal value for ankle dorsiflexion is
45
The normal value for hip abduction is:
Sidelying on the left side, with the head supported in midline, left scapula positioned in slight protraction; left arm in reverse T; right arm brought forward and supported on several pillows to prevent shoulder adduction and internal rotation, the elbow in as much extension as possible, wrist in neutral or slight extension and the fingers extended.
The patient is 68 y.o. who had a Left CVA resulting in Right hemiplegia. The Right upper extremity has increased muscle tone and rests in shoulder adduction and internal rotation with the elbow, wrist and hand in flexion. There is a stage II pressure ulcer on the patient's sacrum and on the Right heel. Which of the following would be the BEST position for this patient?
Axillary crutches with a 3-point gait pattern
The patient is a 32 y.o. factory worker with a right femur fracture following a MVA. The patient is NWB on the right and has a long leg cast. His strength is WNL for both UEs and the L LE. Choose the MOST appropriate assistive device and gait pattern.
Prone with the head of the bed flat, with his hips in neutral and his knees in as much extension as possible.
The patient is a 35 y.o. whose left leg was surgically amputated below the knee following a motorcycle accident. He is six weeks post surgery. Upon evaluation you find a 17 degree flexion contracture of the left knee and tightness in the left hip flexors. Which of the following would be the BEST position for this patient?
Reciprocal walker with a 4-point gait pattern
The patient is a 43 y.o. with MS (multiple sclerosis), a long-term neurological disorder. The patient currently has global weakness (her legs are weaker than her arms) and her balance is fair (pretty wobbly). Choose the MOST appropriate assistive device and gait pattern.
ISCHIAL TUBEROSITIES
The patient is a 45 year old with a spinal cord injury. The patient has no volitional movement of the legs. The patient spends 10 hours a day sitting in a wheelchair. Where is the patient at greatest risk for developing pressure ulcers?
Sidelying on the Left (Right side toward the ceiling)
The patient is a 49 year old who is in a medically induced coma and on a ventilator. Pressure ulcers have developed in the following locations: the occiput, the right scapular spine, the right heel, and the right lateral malleolus. How would this patient be BEST positioned in a regular hospital bed?
Hemiwalker with a modified 4-point gait pattern
The patient is a 65 y.o. who had a right CVA one week ago resulting in left hemiplegia. Strength of the right extremities is normal. The L UE is flaccid and the L LE has moderate weakness. Balance is good. The patient can ambulate in the parallel bars and is ready to progress. Choose the MOST appropriate assistive device and gait pattern.
Rolling walker with a modified 3-point gait pattern
The patient is a 72 y.o. female who had a fall at home when getting up in the middle of the night to use the bathroom. She is in the hospital following a R THR 2 days ago. Her doctor has ordered 20% PWB on the R. Her strength is normal for both UEs and the L LE. Choose the MOST appropriate assistive device and gait pattern.
Axillary crutches with a platform attachment on the L with a 3-point gait pattern
The patient is an active 52 y.o. who tripped and fell while hiking, fracturing the R lateral malleolus and the L distal radius. The patient has a short leg cast on the R and is NWB. The L wrist and hand are casted. Strength in the L LE and R UE are WNL. The patient has no other injuries and her balance is good. Choose the MOST appropriate assistive device and gait pattern.
Elbow flexion Shoulder adduction and internal rotation
The patient is status post burn graft to the right anterior shoulder/axilla and elbow. What position(s) should be AVOIDED when positioning this patient for long term?
Corresponds with the distal row of carpal bones
The proximal transverse arch
RECLINING
The wheelchair that would be most appropriate for a patient with orthostatic hypotension is: (Select 1)(1pts)
Could you repeat that to make sure you can follow my instructions?
We will ask our patient to repeat our instructions prior to attempting the transfer. Which of the following statements would NOT be an appropriate way to make this request?
Ankle edema, Color changes in toes, feet, or legs, Decreased sensory response to surface stimuli Loss of hair follicles
What are signs and symptoms of decreased circulation to the lower extremities?
Standing dependent pivot, Standing assisted pivot
What are the 2 types of standing transfers?
False perception of strength
What could testing a joint at end range result in?
The distance from the user's posterior buttock to the popliteal fold, minus 2 inches
What distance is used to determine proper wheelchair seat depth?
Change of direction
What do caster wheels allow?
Increased base of support of wheelchair
What does having the caster wheels forward allow?
Information to allow you to decide which transfer to use
What does strength assessment provide for transfers?
Palm to flatten or cup to accommodate different sized objects
What does the longitudinal arch allow?
Height is below inferior angle of scapulae
What does the subtraction of 4 inches for wheelchair back height allow?
Fine motor coordination
What does the tip prehension require?
Difficulty propelling chair forward, Skin irritation
What if the wheelchair back height is too high?
a. Internal rotation of the femurs b. Difficult lateral sitting transfers c. A tendency for the pelvis to slide forward Correctd. All of the above
What is a potential disadvantage of a sling or hammock seat cushion?
Prevent patient from falling out or sliding forward in chair
What is a wheelchair lap belt used for?
To hold small objects, tying a shoe lace or bow
What is the function of palmar prehension?
Where the head swings, the hips will swing in the opposite direction
What is the heads/hips relationship?
Holding flat objects
What is the intrinsic grasp used for?
cylindrical grip
What is the most common type of grip?
combination of strong thumb flexion and adduction with powerful flexion of the ring and small fingers
What is the power grip?
They should be put into specially designated containers without manipulation.
What is the proper protocol for disposing of sharp instruments?
Extends civil right to persons with disabilities Improves opportunity for employment Access to public transportation Access to public services Access to certain types of telecommunications
What is the purpose/intent of the ADA?
15-30 seconds
What is the recommended length of time for hand washing with ordinary soap and water?
Round objects, balls, apples
What is the spherical grip used for?
Tip prehension
What is the weakest pinch pattern?
Lateral prehension
What ist he strongest pinch pattern?
Standby assistance
What level of assistance is used if a patient requires only verbal cues to perform an activity safely and within an acceptable time frame?
Difficulty changing position, Excessive pressure on greater trochanters, Difficulty wearing bulky garments
What may result from wheelchair seat being too narrow?
Insufficient trunk support Difficulty positioning knees below a table difficulty propelling the wheelchair Poor posture when forearms rest on armrest
What may result if the wheelchair seat height is too high?
Increased pressure on ischial tuberosities, Difficulty getting chair under table/desk, Decreased trunk stability
What may result if wheelchair footplates are too high?
Increased pressure on distal posterior aspect of thigh, Decreased function of upper extremities when propelling chair, unsafe mobility due to lack of clearance
What may result if wheelchair footplates are too low?
Increased pressure in popliteal area, Skin discomfort
What may result if wheelchair seat depth is too long?
Decreased trunk stability - less support under thighs, Increased weight on ischial tuberosities, Poor balance as BOS is reduced
What may result if wheelchair seat depth is too short?
Difficulty propelling when using upper extremity Difficulty perfomring a standing or lateral swing transfer, Difficulty moving through narrow hallways, Postural deviations
What may result if wheelchair seat width is too wide?
Seat height/Leg length Seat Depth Seat width Back height Armrest height
What parts must be accounted for, for wheelchair fitting?
A safety belt
What should a caregiver grasp to guard a patient during transfers?
Sliding board transfer, Lateral swing transfer
What sitting transfers are used when the patient has strength in the arms?
CAPSULE, MUSCLE, LIGAMENT
What structure will contribute to a firm endfeel?
Standing, Lateral swing as COG is lower
What transfers may be difficult if wheelchair seat is too low?
Maximal assistance
What type of transfer assistance is used when the patient performs only 25 to 49 percent of the activity?
MIN ASSIST
When a patient performs 75% or more of an activity but still needs assistance to complete the activity, this would be CORRECTLY noted as:
on the patient's scapula by bringing your hands between the patient's arms and trunk with your forearms near the patient's axillae
When assisting a patient to move up in bed you should place both of your hands:
plan ahead so you are not carrying it for very long
When carrying a heavy item it is best to:
Area to be observed is exposed while protecting patient's modesty Area to be treated can be moved and remained draped Patient asked if gown or clothing can be adjusted or removed
When draping a patient, which of the following must be considered:
Sitting with the forearm and wrist both in neutral and resting on the table
When goniometrically measuring index finger MCP flexion the MOST correct patient position would be:
When patients has one involved leg which is weaker, painful, or injured
When is standing assisted pivot transfer used?
Opening a jar/lid
When is the disc grasp used?
With loss of median and ulnar nerve function
When is the intrinsic grasp unable to be used?
Patient has equal strength in both legs, both legs should be blocked
When is the standing dependent pivot transfer used?
Following certain abdominal or back surgeries
When may a gait belt be contraindicated?
external rotation to keep the greater tubercle of the humerus from hitting the glenoid fossa or acromial process
When measuring shoulder complex abduction, the humerus should be placed in:
Apply resistance to the R plantar flexors
When performing a strength assessment in preparation for transferring a patient who had a R total hip replacement (THR) 3 days ago, it would be MOST appropriate for you to:
Move individual body segments a small amount at a time
When performing dependent or assisted bed mobility with a patient in the clinic or hospital, one should:
Forward
When propelling a wheelchair up an incline, in which direction should the patient lean?
overhead in full shoulder flexion, if the patient has the range
When rolling a pt. from supine to prone, towards the patient's left side, the left UE should be positioned:
Hand washing should be performed after all of the above activities.
When should hand washing be performed?
Increase his activity level Encourage fluid intake
When treating a patient with prolonged immobilization, we can help prevent urinary system problems by having the patient do which of the following:
Acromion processes, forehead, crests of the tibias, and dorsum of the feet
Which areas of a prone patient are at greatest risk for pressure sores?
Occipital tuberosity, spines of the scapula, sacrum, and heels
Which areas of a supine patient are at greatest risk for pressure sores?
Lateral ears, lateral ribs, greater trochanters, and humeral epicondyles
Which areas of the side-lying patient are at greatest risk for pressure sores?
anterior superior iliac spines (ASISs)
Which body areas with bony prominences are at risk of pressure in the prone position?
Wheelchair push-ups and weight shifts
Which exercises would help a patient bound to a wheelchair alleviate pressure on the ischial tuberosities?
Hook grip
Which grip is the thumb not involved in?
Persons with a BKA (below knee amputation) are susceptible to soft tissue contractures in the position of hip flexion, external rotation, abduction, and knee flexion.
Which of the following are TRUE regarding patient positioning?
GREATER TROCHANTER
Which of the following boney prominences is NOT at risk in the prone position?
PROXIMAL DIGITAL CREASE
Which of the following creases is NOT associated with motion?
The size of the goniometer is important and should be selected based on the size of the joint
Which of the following is CORRECT for Goniometry:
INCREASED LOW BACK PAIN
Which of the following is NOT a sign of decreased circulation in the legs?
TO INCREASE ROM
Which of the following is NOT an indication for passive exercise?
Extreme hip and knee flexion can affect ICP
Which of the following is TRUE regarding a patient on an Intracranial Pressure Monitor (ICP)
Caregivers should be instructed to monitor the user for signs of decreased circulation in the legs.
Which of the following is TRUE regarding long term wheelchair use?
A patient may become susceptible to bladder infections, pneumonia, and constipation.
Which of the following is TRUE regarding the effects of immobility?
In the clinic, the therapist must take care to not pull on, dislodge or compress any tubes attached to the patient during the transfer.
Which of the following is TRUE regarding transfers?
The Informed Consent Process includes items such as a description of the proposed treatment and expected benefits from the treatment.
Which of the following is TRUE:
Confirm patient; proposed treatment/benefits; potential negatives; offer alternative treatment; re-emphasize benefits of proposed treatment; request permission.
Which of the following is the MOST CORRECT order for an informed consent
LACK OF SHOCK ABSORPTION IN SPINE
Which of the following is the primary source of pain in Flat Back posture?
Subjects name, age and gender Date and time of the measurement Deviations from the typical position Type of motion being measured
Which of the following should be included with goniometry documentation:
LOOSEN CONSTRICTIVE CLOTHING
Which of the following should you do if your patient has a seizure?
By keeping your COG (Center Of Gravity) close to the COG of the object to be moved, the effect of levers on your body is reduced.
Which of the following statements is TRUE regarding the principles of body mechanics?
POST TRAUMA BED
Which of the following types of bed provides pressure relief by oscillating from side to side?
Pes Planus
Which of the following would MOST likely result in flat feet?
Focus on warming the extremities first to prevent neurological damage
Which of the following would NOT be appropriate when treating a patient with moderate hypothermia:
A MAN WITH A HEARING IMPAIRMENT
Which of the following would be covered by the ADA?
Elongated and weak L hip adductors
Which of the following would you NOT expect to find with a Left Handedness posture?
Prolonged hip flexion
Which position is most detrimental to a patient with a transfemoral amputation?
Prolonged hip flexion and external rotation, and ankle plantar flexion
Which positions of the involved lower extremity are most detrimental to a patient with hemiplegia?
SWAY BACK
Which postural deviation would result in the greatest anterior displacement of the greater trochanter in relation to the plumb line?
Seat width
Which wheelchair dimension should be examined if excessive pressure to the greater trochanters is noted?
INCREASED LUMBAR SPINE FLEXION
With an Anterior Pelvic Tilt you would expect to find all the following EXCEPT:
You should provide a clean contact to help the patient activate the appropriate muscle group.
With regard to the strength assessment, which of the following statements is TRUE?
Left arm across the trunk with the elbow flexed and the left hand near the right shoulder
You are helping your patient (assisted mobility) move from supine into right sidelying. What is the appropriate positioning of the left arm to minimize the risk of the hand getting caught under the trunk during the roll into sidelying? Left arm across the trunk with the elbow flexed and the left hand near the right shoulder -Left arm across the trunk with the elbow extended and the left hand at the midline of the chest -Left arm in a Reverse T position -Left arm by the patients left side -Left arm in complete shoulder flexion, if the patient has the range
-To shorten the lever arm of the legs -To decrease the friction of the legs on the bed -To allow the patient to assist with the movement
You are helping your patient move upward in bed (assisted mobility). Which of the following is/are reason(s) you will ask the patient to flex the hips and knees to place the feet on the bed?
0-145 degrees of L shoulder abduction
You are recoding the PROM for a patient with a left shoulder injury. The patient is able to start at neutral and his left arm abducts to 145 degrees. The proper documentation would be
10 - 125 degrees of R knee flexion
You are recording goniometric measurements for R knee ROM. Your patient is lacking 10 degrees of knee extension and is able to flex the knee to 125 degrees. The appropriate documentation for the patient's ROM would be:
The patient should push his feet down into the bed to help lift the pelvis
You are watching a patient lying in the supine position perform independent bed mobility side to side. Which of the following is/are CORRECT? The patient should move the upper trunk and lower trunk together
YES
You are working with an immobilized patient with a quadriplegic spinal cord injury. You roll the patient from supine to left sidelying and note an area of skin overlying the sacrum that is blanched (lighter in color than surrounding areas). Is this a cause for concern
Lowering the head of the bed to decrease the work of moving for you and the patient
You need to move your patient up in bed. Your patient is watching TV in bed so the head of the bead is elevated approximately 10 degrees with a thin pillow under his head. The MOST appropriate method to move the patient up in bed (assisted mobility) would include which of the following?
TDWB with a small base quad cane
Your patient cannot put full weight on his left foot. Which of the following would NOT be appropriate?
Have him tuck his R ankle behind his L ankle and lie down on his R side
Your patient had a R CVA resulting in L hemiplegia. He is sitting on the edge of the low mat table and you are going to assist him to lie down. Which of the following would be MOST appropriate?
Have both hands over the tops of the patient's shoulders as he uses his arms to push his trunk up into sitting then keep one hand on his trunk and use your other hand to guide his left leg off the left side of the bed.
Your patient had a left TKR (total knee replacement) yesterday and you are assisting the patient with moving from supine to sitting on the edge of the bed. Which of the following statements is the BEST method to assist the patient?
Sliding board transfer
Your patient has recently undergone below knee amputations bilaterally. This is his first time to therapy. The patient's upper extremities are strong. You want to teach the patient to transfer from the wheelchair to the mat table. The type of transfer that would be most appropriate would be:
SEAT TOO WIDE
Your patient is having trouble reaching the handrims on his wheelchair so it is difficult for him to propel the wheelchair independently. This difficulty MOST likely results from which of the following errors in measurement?
prone
Your patient suffered traumatic amputations of the R LE above the knee and the L LE below the knee. He will soon be trained with bilateral prostheses (artificial legs). The BEST position to recommend to this patient to prevent hip contractures would be:
MOD 4
Your patient uses a monopoint cane on the right. Which of the following gait patterns would be APPROPRIATE for this patient?
MOD 2
Your patient uses a unilateral device on the left. The patient moves the left hand/device forward simultaneously with the right foot, then moves the left foot forward. Which gait pattern is the patient using?
PROFUSE SWEATING
symptom of heat stroke EXCEPT
A rib hump is most evident when the patient is standing erect
true about Scoliosis EXCEPT
