220 Quiz Questions

PROM for your patient's entire (R) arm is WNL. In the sitting position with your patient's arm supported entirely on the table, the patient is only able to actively extend her (R) elbow 150-45 degrees. What muscle are you testing and what would be the most accurate MMT grade to record?

(R) triceps brachii 2-/5. Patient needs AAROM exercise program to improve elbow strength

Cervical Flexion

0 inches from start to end of motion 0-45

Which of the following would be the most accurate MMT grade to assign to a muscle that cannot move through any ROM cannot produce a muscle contraction, nothing felt on palpation nor visual inspection

0/5

If an MMT is repeated by several PT/PTA's and the same grades are obtained, then the MMT is said to be reliable. What is generally accepted as inter tester reliability?

1/2 grade

What position is the ankle in at mid-stance

10 degrees dorsiflexion

Spinal extension

2 inches from start to end of motion 0-20/30

In inches, what is the normal base of support during walking?

2-4

Spinal Flexion

4 inches from start to end of motion 0-80

Cervical sidebending

5 inches from start to end of motion 0-45

Cervical roation

5 inches from start to end of motion 0-45 up to 75

An efficient Gross Muscle Test of the entire body by a skilled clinician to determine areas of functional weakness should only take ____ minutes to perform

5 minutes

Cervical extension/hyper extension

7-10 inches from start to end of motion 0-45

Which of the following pathologies would be MOST likely to cause instability in stance and be considered a safety risk for ambulation?

Acutely torn lateral ligament of the ankle.

The grading systems used by PT'PTA's to assess muscle strength is based on the following four factors:

Amount of resistance given manually ability of the muscle to move a part through complete test ROM is a measure of muscle strength evidence of the presence or absence of palpable muscle contraction is critical to strength evaluations Grades are obtained based on the effects of gravity (parallel or w/ gravity= minimized) against gravity = AG

Which of the following represents the most normal ankle/foot goniometric measurement?

Ankle eversion 0-15

Patient has a +1 biceps reflex but lacks sensation along the lateral shoulder, down the radial forearm down into the thumb and index finger. Which of the following statements is most true?

Appears to have LMNL, with irritation along the C5-C6 nerve root

Patient has a +3 patella reflex, + plantar reflex and is very hypersensitive to pain, light touch, graphesthesia along the knee and medial aspect of distal leg. Which of the following would be most accurate to document in the patient's SOAP note?

Appears to have UMNL, with irritation along the L3-S1 nerve root

Your supervising therapist has asked you to administer either the Berg or the POMA (Tinoetti) test on your patient and document results. You should recognize that these are assessments of your patient's _______. Components of these tests are _____.

Balance. Components are having the patient stand up, walk, reach, turn around, and sit down

List four primary reasons why a PT/PTA should perform patient assessments

Develop a database plan treatment evaluate results of treatment modify/terminate treatment

At normal walking speeds, during what phase of gait is weight bearing being transferred from the other leg onto the reference leg?

During foot flat

If your patient's elbow PROM is 5-0-75, all of the following would be true EXCEPT:

Elbow flexion is hyper mobile and the triceps brachia muscle needs to be strengthened

A muscle that has a Fair grade is one that has 20% muscle force. Patient is only able to move through full ROM, gravity minimized.

False

During heel strike or initial contact component of gait, the knee is at 0 degrees of extension, the ankle is at 20 degrees of dorsiflexion and the hip is at 30 degrees of flexion

False

During terminal stance or heel off the foot is plantar flexing concentrically to propel the limb into swing phase

False

Foot slap gait is most often caused by paralysis of the gastroc soleus muscle group

False

If a patient demonstrates weakness on a specific muscle test, then a therapist or assistant should follow up this test with a gross muscle test.

False

Reliability is the extent to which a particular assessment tool accurately measures what it is supposed to measure.

False

Single support occurs at toe off and heel strike of opposite legs

False

Stance phase comprises 8% of the gait cycle

False

T/F Axis for measuring wrist joint ulnar deviation should be the pisiform

False

Which of the following occur normally during mid stance?

Gastric and soles muscles working eccentrically to control excessive forward movement of the tibia on a flat foot

Your patient is 17 years old who just underwent major reconstructive surgery to the (L) knee to correct genu valgus and torn ACL. The patient was NWB for 6 weeks and has been cleared by the physician to begin WBAT. Initially had poor balance when attempting to walk w/o crutches. After a week of therapy, you are asked to document the status of this patient's balance. The patient is able to walk independently on level terrain, but tends to be unstable on stairs, ramps, and gravel without assistive devices requiring only verbal cues to shift weight onto the involved limb and to maintain upright posture. Which ion the following would be most appropriate to document in the patient's SOAP note?

Good ambulatory balance, SBA on uneven terrain

Which of the following PROM measurements has the most limited motion in the direction measured and would need stretching exercises to improve function?

HIP IR is 5-15

Mrs. White has a plantar flexion contracture of her (R) ankle (10-60 degrees PF). You might expect to see all of the following gait deviations EXCEPT:

Hiking of the (L) hip during stance phase on the (R) leg

Gait analysis of Mr. Green's gait shows that he is spending 60% of the gait cycle in double support (double stance phase). This indicates:

His gait is slower than normal

Your patient has normal PROM in her (R) hip, but sonly able to actively flex her right hip 0-100 degrees w/ her spine stabilized in the sitting position. What muscle are you testing and which grade would be most accurate?

Iliopsoas = 3-/5

During normal gait, at which phase of the gait cycle is the knee bent to its maximum amount? How many degrees?

Initial swing, 60 degrees

All of the following should be working in normal gait pattern for pre-swing (toe off)

Knee is moving from 60 degrees of flexion to 30 degrees of flexion

Specific muscle palpation should be performed during ___ muscle strength assessments, but is NOT necessary when a PTA is performing a quick, symmetrical strength assessment as in _____.

MMT Gross muscle test

What phase follows foot flat during the stance phase?

Midstance

In which position is the contralateral limb if the right lower extremity is in mid stance?

Midswing

The gluteus medium on the reference limb contracts isometrically to keep the pelvis level during all of the following phases EXCEPT:

Midswing

What phase of gait has maximum knee flexion?

Midswing

What is the most logical reason why a person might exhibit a foot slap gait deviation?

Moderate weakness (3/5) in the tibias anterior

Your patient is able to maintain unsupported static and dynamic standing balance postural orientation with the eyes open. When the patient closes his eyes, 100% of the time he needs mod-max assist to prevent him from falling backwards and to the left. Which of the following is the most accurate regarding this patient?

Patient has a + Romberg sign.

What are the most common substitution movements a patient will make during measurement of hip medial rotation?

Pelvic hiking with ischial tuberosities off sitting surface, side bending contralateral, hip abduction

At normal walking speeds, the rectus femurs has to perform a complex function at the ________ phase of gait when it must contract and shorten at the hip and lengthen at the knee

Preswing

During which phase of the gait cycle does the ankle reach its maximal plantar flexion range, and what is this range?

Preswing 20 degrees

Tommy injured his (L) knee playing soccer yesterday. He is wearing a knee immobilizer that prevents any knee movement. What phase(s) of the gait cycle will be most affected by this orthosis?

Preswing, initial swing, and midswing

In what ways does a walker interfere with or prevent a normal gait pattern?

Prevents arm swing and trunk rotation thus decreasing momentum, slowing the person down, and increasing energy expenditure

A PTA should expect that damage to the anterolateral spinothalamic track will lead to which sensory impairment?

Problems discriminating pain ,temperature, and deep pressure

What characterizes a right positive Trendelenburg

Right side of pelvis drops when weight bearing on the left

Mrs. Jones has bilateral osteoarthritis in her hips with decreased internal rotation (lacks 10 degrees or -10 hip IR), and decreased hip hyperextension (0 degrees). How might these impairments affect her gait?

She will exhibit an increased foot angle and will go directly from midstance to preswing

Select the most appropriate technique that a PTA should perform to get the most valid reading for wrist flexion and extension

Stabilize the forearm to prevent pronation/supination, elbow flexion/extension

The distance from heel strike of one foot to heel strike of the opposite foot is:

Step length

Which of the following statements are true about running?

Step width decreases, there is a period of non-support, and there is no period of double support

Which of the following abnormal gait patterns is characterized by excessive knee and hip flexion during swing phase?

Steppage gait

At normal speeds, when the reference limb is in initial contact, what phase of gait is the opposite limb usually in?

Terminal stance

Which of the following should occur normally during mid stance?

The gastric and soles muscles are working eccentrically to control excessive forward movement of the tibia on a flat foot.

What muscle is responsible for controlling the ankle as it moves from plantar flexion in foot flat to dorsiflexion in mid stance?

The gastrocsoleus contracting eccentrically

During normal terminal stance:

The hip is hyperextended 10 degrees, the knee is at neutral, and the ankle is dorsiflexed

If your patient's shoulder flexion PROM is 20-100, a PTA should recognize ALL of the following are correct except:

The patient has a shoulder flexion contracture of 80 degrees and these shoulder flexors need to be stretched into flexion

a PTA assesses kinesthesia in a 61 year old male patient with Parkinson's disease. Which of the following patient responses should a PTA recognize as most appropriate for a normal kinesthesia rating when the therapist moves the (R) UE into abduction elbow flexion, supination, wrist extension 3x fast

The patient responds by moving his (l) UE into abduction, elbow flexion, supination, wrist extension 3X as fast as he is able

The function of the hip extensors and hamstrings at terminal swing includes all of the following EXCEPT:

To flex the knee for shock absorption during stance phase

What is the primary function of the quadriceps at loading response?

To lessen the impact on the knee joint as the weight is shifted onto the reference limb by contracting eccentrically to allow the knee to bend slightly for shock absorption

After initial evaluation, and prior to the first treatment with a patient, a PTA should perform a quick ROM screening test for indicated body segments to determine the need for a follow up goniometric measure.

True

Each single support period accounts for approximately 40% of the gait cycle

True

Gene recurvatum gait deviation is commonly caused by weakness of both quadriceps and hamstrings and excessive tightness of achilles tendon during mid stance phase of gait

True

MMT reliability studies indicate that 90% of the time, MMT is considered a reliable strength assessment tool within one full MMT grade +/-

True

Muscles that cross more than one joint are generally more efficient than those that span only one joint.

True

Patient assessment results are the basis of all therapy treatments.

True

Patient's with plantar flexion contracture of 10-50 degrees will have difficulty with all phases of gait except initial swing

True

Physiologically, muscles are capable of generating their greatest tension during an eccentric contraction, less when contracting isometrically and the least when contracting concentrically.

True

T/F A patient with partial damage to the spinal cord may be expected to have 3+ to 4+ DTR?

True

The purpose of performing a muscle length assessment is to determine whether or not a joint LOM is due to muscle tightness across the joint

True

A person with a 2+/5 gluteus medium weakness on the (R) will exhibit all of the following EXCEPT:

Unable to raise the (R) leg at all against gravity while sidling on the (L) side

Information about changes in head position that can affect muscle tone, posture, movement and equilibrium are conveyed to the brain via which type of sensory receptor?

Vestibuloreceptors

PTA's should be aware of 3 variables that affect grading muscle strength.

Weight of the limb or distal segment being moved against the horizontal effect of gravity weight of the limb, plus effect of gravity on the limb when the motion occurs perpendicular to the effect of gravity. weight of the limb, plus the effect of gravity plus manual resistance

What gait deviations would you see in a person's gait that would indicate that they had poor balance?

Wide step width, arms held out to side, slow speed at cadence.

All of the following would characterize an antalgic or "sore foot gait" except:

a prolonged stance phase on the involved limb

5 uses for MMT

establish basis for muscle re-education and strengthening exercises determine how functional a pt. may be determine if a pt. may need an AD and justify ordering assist PT in determining and modifying diagnoses determine a patient's prognosis

The dorsiflexors contract eccentrically at______, and if they are too weak to do their job, the patient will exhibit a _________ gait deviation.

foot flat, foot slap

What muscle is responsible for controlling the ankle as it moves from plantar flexion in foot flat to dorsiflexion in mid stance

gastrocsoleus contracting eccentrically

The term that means the patient has maintained their ability to recognize numbers, letters, or objects traced on the palm during sensory testing

graphesthesia

During swing phase, a person with weak dorsiflexors may do all of the following EXCEPT:

hike the hip on the uninvolved side

The combination of excessive elongated muscle length, looseness of joint capsule structures and laxity of supportive ligaments can cause ___ around a joint

hypermobility

Another term used for the deep sensory cells that detect pain

nociceptors

When determining whether muscle flexibility might be the cause of a LOM, muscles that are elongated or stretched over two or more joints may develop __________.

passive insufficiency

When performing sensory or sensation testing, a PTA should know that all of the following are important to gathering accurate, valid data EXCEPT:

performing the tests with variable speeds...fast or slow...to make sure the patient pays attention

Patients with poor balance lack _______, which is defined as the ability to maintain all forces acting on the body to keep the center of gravity within the base of support.

postural equilibrium

A muscle must be _____ enough to provide stability to a joint and _____ enough to allow normal mobility.

short long

Equinus gait is an abnormal gait deviation characterized by

the person walking on the balls of their feet