Final Frontier - The Final Deck

_____: tachycardia, increased sweating, heat intolerance, increased appetite, dyspnea, weight loss, inability to gain weight

Hyperthyroidism

_____: low calcium and high phosphorus

Hypoparathyroidism

_____: responsible for regulation of the ANS (body temperature, appetite, sweating, thirst, sexual behavior, rage, fear, blood pressure, sleep_

Hypothalamus

What should you associate Hashimoto's disease with?

Hypothyroidism

_____: cold intolerance, excessive fatigue, headaches, weight gain, dry skin, peripheral edema, peripheral neuropathy, proximal weakness

Hypothyroidism

_____: pregnancy induced acute hypertension after the 20th week (5th month) of gestation

Preeclampsia

Anterior Apprehension Test AKA Crank Test

Pt lies supine, PT abducts arm to 90 and ER shoulder slowly (+) pt is apprehensive in this position and feels like dislocation is possible, indicates previous anterior dislocation of shoulder/anterior shoulder instability

COPD: _____ and _____ are increased

Residual volume Functional residual capcity

Maudsley's test

Resist extension of the 3rd digit (+) pain, indicates lateral epicondylitis (tennis elbow)

PaCO2 >45 pH <7.3

Respiratory acidosis

PaCO2 <35 pH >7.45

Respiratory alkalosis

PaCO2 <35 pH <7.35

Respiratory compensation for metabolic acidosis

PaCO2 >45 pH >7.45

Respiratory compensation for metabolic alkalosis

_____: difficulty expanding the lungs and a reduction of lung volumes

Restrictive lung disease

_____: the eyes lag behind which causes blurred vision with head or eye movement

Retinal slip

What are the downward rotators of the scapula (force coupe)?

Rhomboids, levator scap, pec minor (shortened with upper crossed syndrome = rounded shoulders)

In the cspine, what happens to the facets with RIGHT rotation?

Right facets close Left facets open

In the lspine, what happens to the facets with RIGHT rotation?

Right facets open Left facets close

Which foot? Cannot be used on uneven terrain

SACH foot

Which foot? Contains energy absorbing cushion heel

SACH foot

Which foot? Limited transverse and mediolateral motion

SACH foot

Which foot? Permits PF in early stance

SACH foot

Which foot? Can be used on uneven terrain

SAFE foot

Which foot? Greater mediolateral motion on rear foot

SAFE foot

Which foot? Heavier but less durable

SAFE foot

Describe active insufficiency

SAME motion as muscle action Example: Rectus femoris is extending the knee and flexing the hip at the same time

In a typical clinical setting, exercise should be terminated if SBP> _____ and/or DBP >_____

SBP> 210 DBP> 110

What is the mneumonic for CN IV?

SO4 Superior Oblique, Cranial Nerve IV

Which foot? Heavier

Seattle foot

Which foot? Keel stores energy and recoils it in late stance for springy motion

Seattle foot

Which foot? Slightly flexible plastic keel bends at heal contact

Seattle foot

TP/(TP + FN) =

Sensitivity

Speed's test

Shoulder flexed to 90, forearm supinated; pt resists extension (+) pain in bicipital grover indicates bicipital tendonosis

What is the significance of a retinal slip even if by a few degrees?

Significant decreases in vision and postural control

What sign would you expect with a vagus nerve lesion?

Soft palet on same side as lesion fails to rise; uvula will deviate to the opposite side

TN/(TN + FP) =

Specificity

What is the prognosis for walking of a child with myelomeningocele at T12 level?

Standing using a parapodium; walking will not be possible

Galant reflex (trunk incurvation) Stimulus and response

Stimulus: Sharp stroke on paravertebral line from scapula to iliac crest Response: lateral trunk flexion towards stimulus

Crossed extension reflex Stimulus and Response

Stimulus: Sharp, quick pressure to side of foot Response: Withdrawl of LE and extension of opposite LE

Tonic Labyrinth Reflex Stimulus and Response

Stimulus: plae child prone or supine Response: Placing child prone will promote flexion tone; supine will promote extension tone

Neonatal nintegration eck righting reflex Stimulus and Response

Stimulus: turn head with head in supine position Response: Body log roll toward same side

Stress incontinence treatment

Strengthen pelvic floor

Closed chain interventions, think _____

Strengthening

What is the treatment for irritable bowel syndrome?

Stress reduction, dietary modification, exercise

What position must be avoided in the 3rd trimester of pregnancy?

Supine lying

What muscles are responsible for closing the mandible?

TIM: Temporalis, Internal (Medial) Pterygoid, Masseter

Pain Pattern: LUQ

Tail of pancreas, spleen pathology

_____ lobe: Language comprehension

Temporal

_____ lobe: Primary auditory cortex

Temporal

_____ lobe: Wernicke's area

Temporal

Lateral rotation lag sign

Tests the integrity of the teres minor and infraspinatus

A t-test compares...

The mean scores from two groups on the same variable

Describe ideomotor apraxia

The pt cannot do a task on command but can do it spontaneously

Describe ideational apraxia

The pt cannot do the task at all; they have "no idea" how to perform it

Describe concurrent validity

The test performed is compared to the gold standard test and the results are compared

What does standard deviation measure?

The variability of the data

_____: produces hormones that act to control the rate at which cells burn the fuel from food

Thyroid gland

Describe negative babinski

Toes flex

Urge incontinence treatment

Treat infections

What is the mneumonic for remembering CN V?

TrigeMinal = "M" for muscles of mastication

_____: corneal (blink) reflex

Trigeminal nerve, CN V

_____: motor innervation to the muscles of mastication (medial pterygoid, lateral pterygoid, masseter, temporalis)

Trigeminal nerve, CN V

_____: sensation to the mucous membranes and sinuses of the face

Trigeminal nerve, CN V

_____: sensation to the skin of the face

Trigeminal nerve, CN V

What is the best assistive device for a pt with Parkinson's disease?

U-shaped walker

Traction or pull to sit Stimulus and Response

UE flexion and head lag

UMN or LMN? (+) Babinski

UMN

UMN or LMN? CNS lesion

UMN

UMN or LMN? Clonus

UMN

UMN or LMN? Hypertonia

UMN

UMN or LMN? Increased reflexes

UMN

UMN or LMN? Increased tone

UMN

UMN or LMN? Involuntary muscle movements

UMN

UMN or LMN? Movement in synergies

UMN

UMN or LMN? Muscle spasms

UMN

UMN or LMN? Weakness, paresis, or paralysis

UMN

UVH or BVH Blurred vision, especially when turning the head quickly

UVH

UVH or BVH Disequilibrium

UVH

UVH or BVH Dizziness or vertigo

UVH

UVH or BVH Nausea

UVH

UVH or BVH Poor balance, espcially with head turns

UVH

UVH or BVH Trauma

UVH

UVH or BVH Trouble walking, especially outdoors, in dark rooms, or in crowded places

UVH

UVH or BVH Vascular events

UVH

UVH or BVH Viral insults

UVH

_____: spontaneous nystagmus that can be suppressed with visual fixation

UVH

Bloody diarrhea indicates...

Ulcerative colitis

_____: continuous lesions; rectal pain, bleeding, LBP, fecal urgency, bloody diarrhea with mucus/pus, weight loss

Ulcerative colitis

_____: occurs in large intestine and rectum

Ulcerative colitis

An _____ hernia causes pain around the ______ ring in the mid to lower abdomen

Umbilical

What supplies blood to Broca's area?

Upper division of the Middle Cerebral Artery

What are the upward rotators of the scapula (force couple)?

Upper trap, serratus anterior, lower trap

What cranial nerve is responsible for the gag reflex?

Vagus and glossopharyngeal nerves

_____: Rolls supine to prone

6-7 months

_____: sits alone without support (hands free)

6-7 months

_____: sitting equilibrium: protective extension forward

6-7 months

_____: transitions quadruped to-from sitting

6-7 months

-1SD to +1SD =

68% 34% (1SD) X 2 = 68%

_____: maintains quadruped and assumes sitting from quadruped

7 months

_____: trunk rotation in sitting

7 months

If the APGAR score is above _____, there is no need to reasses AGPAR

7/10

Normal anteversion angle of hip

8-15 degrees

_____: can stand alone

8-9 months

_____: cruises sideways

8-9 months

_____: quadruped creeping

8-9 months

0-9 months reflex mneumonic

9 Plants

_____: child can move object from hand to hand

9 months

-2SD to +2SD =

95%

-3SD to 3SD =

99%

When is exercise contraindicated as it is related to ABI?

<0.8

If hematocrit is _____ all forms of exercise are contraindicated

<27%

If WBC is _____ all forms of exercise are contraindicated

<500

If platelets are _____ all forms of exercise are contraindicated

<50k

What FEV1/FVC ratio indicates obstructive lung disease?

<70%

If hemoglobin is _____ all forms of exercise are contraindicated

<8

Retroversion of the hip

<8 degrees (retro = past or less)

What is considered a high fasting blood glucose?

> 100 mg/dL

What is the ABI scale?

>1.3 = Rigid Arteries; need US 1-1.3 = Normal 0.8 - 0.99 = Mild PAD 0.4-0.79 = Moderate PAD <0.4 = Severe PAD

Abnormal anteversion of hip

>15 degrees

How is preeclampsia diagnosed?

A BP >140/90; a second abnormal BP four hours after the first confirms the diagnosis

Spinal mobs Gapping, upglide used for...

A flexion or opening restriction

What does a high score on the BODE indicate?

A greater mortality risk

On the Oswestry Disability Questionnaire, a _____ score is better

A lower score is better because it indicates a percentage of disability

Describe construct validity

Does the test measure what it is supposed to measure?

Melena tarry (dark, tarry) stools indicates...

Duodenal ulcer

What are the signs and symptoms of idiopathic pulmonary fibrosis?

Dyspnea with activity and non-productive cough

Pronation mneumonic

EDAB = Eversion, Dorsiflexion, Abduction

What is the gait deviation? Dorsiflexion stop too soft, Late stance

Early knee flexion

What is the gait deviation? Socket too anterior, late stance

Early knee flexion

Functional ROM of mouth opening

40mm

2SD =

47.5% 95% (or -2SD to 2SD) divided by 2 = 47.5%

When can you begin exercise after infarct? What mode of exercise?

48 hrs begin UE and LE AROM

0-4 months reflexes mneumonic

4PM

What are the correlation intervals?

High = 0.76-1 Moderate = 0.51-0.75 Fair = 0.26-0.5 Low = 0-0.25

Coxa vara

Hip varus

_____: can demineralize bones (bone weakness and decreased density)

Hyperparathyroidism

_____: elevated calcium and decreased serum phosphate

Hyperparathyroidism

How is spinabifida diagnosed prenatally?

-Maternal Serum Alpha-Feto-Protein (MSAFP) Test -Triple Screen Blood Test

What are the signs for appendicitis?

-McBurney's point -Rovsing's sign -Blumberg's sign

What is the gait deviation? Soft heel cushion, initial contact

Insufficient knee flexion

Halstead maneuver

"T" for traction PT finds radial pulse and applies downward traction on the test extremity while the pt's neck is hyperextended and the head is rotated to the opposite side (+) pulse disappears, indicates thoracic outlet syndrome

Pack years =

# of packs/day X # of years smoked

O'Bien Test

(+) Pain in IR > pain in ER Indicates SLAP lesion

What are the potential causes of a positive Kehr's sign?

(+) indicates air or blood in the abdominal cavity -Recent laparoscopy -Stomach ulcer -Rupture of the spleen

Empty can test

(+) pain or weakness, indicates tear/impingement of supraspinus tendon or suprascapular nerve neuropathy

Hawkins-Kennedy Test

(+) pain, indicates impingement of supraspinatus

What are the non-parametric tests?

-Chi square test -Mann Whitney u -Kruskal Wallis test

What does the patient complain of with a retinal slip?

-Decreased visual acuity -Blurred vision (horizontal) -Jumpy vision (vertical)

Right plagiocephaly is characterizd by: - _____ occipito-parietal flattening - ______ occipital bossing - anterior displacement of _____ ear - _____ frontal bossing

-ipsilateral (RIGHT) occipito-parietal flattening -contralateral (LEFT) occipital bossing -anterior displacement of (RIGHT) ipsilateral ear -ipsilateral (RIGHT) frontal bossing

Continue with special tests

.

Draw heart auscultation diagram

.

Draw the ankle bones diagram

.

Draw the eye muscles diagram

.

Draw the lung capacities diagram

.

Draw the sensitivity/specificity chart

.

Write out the spinal nerves

.

Babinski reflex integration age

0-12 months

Crossed extension reflex integration age

0-2 months

Galant reflex (trunk incurvation) integration age

0-2 months

Positive support/primary standing reflex integration age

0-2 months

Primary walking reflex integration age

0-2 months

Rooting reflex integration age

0-3 months

Moro reflex integration age

0-4 months

Palmar grasp reflex integration age

0-4 months

Asymmetrical Tonic Neck Reflex integration age

0-5 months

Traction or pull to sit integration age

0-5 months

Neonatal neck righting reflex integration age

0-6 months

Tonic Labyrinth Reflex integration age

0-6 months

Plantar grasp reflex integration age

0-9 months

INR

0.9-1.1 (or 2-3 if on anticoagulation therapy)

HR APGAR score

0: Absent 1: <100 BPM 2: 100-140 BPM

Respiratory effect APGAR score

0: Absent 1: Slow, shallow 2: Good, crying, irregular

Color APGAR score

0: Blue 1: Body pink, extremities blue 2: All pink

Muscle tone APGAR score

0: Flaccid 1: Some flexion 2: Active motion of extremities

Reflex irritability APGAR score

0: No reponse 1: Grimace 2: Cough or sneeze

When is APGAR scored?

1 minute after birth

What are the steps for spinal mobilizations?

1) Decide whether it is a central or unilateral glide (Spinous process ir transverse process) 2) What segment needs to be stabilized? 3) What segment needs to be mobilized? 4)What are the arthrokinematics of the motion?

What is Tetrology of Fallot (TOF)?

1) Ventricular septal defect 2) Ventricular hypertrophy 3) Pulmonary artery stenosis 4) Overriding aorta

What is virchow's triad?

1. Venous stasis 2. Hypercoagulability 3. Trauma to a vessel

When do you use parametric data? Non-parametric data?

10 nurses : 10 PTs = Parametric statistics because there's an equal ratio 100 nurse : 10 PTs = Non-parametric data because it is an unequal ratio

_____: begins to walk unassisted

10-15 months

_____: floor to stand

10-15 months

_____: pincer grasp

10-15 months

_____: tower of two cubes

10-15 months

_____: transitions in and out of squatting

10-15 months

What is a perfect APGAR score?

10/10

Prothrombin time

11-15 seconds

_____: start imitating others

18 months

_____: Assumes prone on elbows when placed in prone

2-3 months

The TM ligament allows up to ______ of manibular opening to occur before it becomes tight; after that the condyle _______ to allow further opening ______

20-25mm; the condyle translates anteriorly; 15mm

When can you begin exercise after bypass? What mode of exercise?

24 hrs begin UE and LE AROM

What percentage of oxygen is flowing at a rate of 1L/min by nasal cannula?

24%

Partial Thromboplastin Time (PTT) Normal

26.3 - 39.4 seconds

_____: ride a tricycle

3 years

_____: rolls supine to side lying

3-4 months

1SD =

34%

Oxygen percentage increases at a rate of _____ per 1L/min by nasal canula

4% from 1L/min to 6L/min

_____: Feet to mouth

4-5 months

_____: Pulls to sit without head lag

4-5 months

_____: Self-supported sitting propped forward on arms

4-5 months

_____: rolls prone to supine

4-5 months

Describe the ASIA Scale

A: Complete (Motor and Sensory Impaired) B: Sensory Incomplete (Motor impaired, Sensory Spared) C: Motor incomplete, major muscles <3/5 MMT D: Motor incomplete, major muscles >3/5 MMT E: Normal, motor and sensory spared

0-5 month reflexes mneumonic

AT (Asymmetrical Tonic Neck Reflex) Track (Traction or pull to sit) 5

What tendons are effected in DeQevain's tenosynovitis?

Abductor pollicis longus Extensor pollicis brevis

Lumbar spine Nerve root exits... Disc herniation occurs... Stenosis affects...

Above, below, below Example: L3-L4 level Nerve root exiting this space is L3 nerve root Disc hernation at this level affects L4 nerve root Stenosis at this level affects L4 nerve root

HCO3- <22 =

Acidosis

PaCO2 > 45=

Acidosis

_____: Hearing loss and tinnitus in affected ear

Acoustic neuroma

_____: Tumor on vestibular nerve leading from inner ear to brain

Acoustic neuroma

_____: Unsteadiness, loss of balance, dizziness, facial numbness

Acoustic neuroma

UVH intervention

Adaptation

ATCH stimulates the...

Adrenal gland

_____: produces corticosteroids that will regulate water and sodium balance, the body's reponse to stress, the immune system and metabolism

Adrenal gland

Describe the NPTE rule of 6

After major surgeries (think RTC repair) First 6 weeks post-op= Acute/Protection phase Next weeks (weeks 6-12) post-op= Assistive, Active training 6 months post-op = ADL, PLOF, return to work/sport activities

What is the treatment of torticollis on a pt 6 months old or less?

Aggressive stretching is not advised; focus on positioning, call baby's name or use bright colored toys to attract her attention to the opposite side

HCO3- >26 =

Alkalosis

PaCO2 <35 =

Alkalosis

_____:when there is an actual difference between the variables

Alternate hypothesis "The drug has an effect"

Describe face validity

An assessment or test appears to do what it claims to do (this is a weak form of validity)

What does ANOVA stand for?

Anaylsis of variance - it is a parametric test Example: Tall and short subjects are tested for gait using ADs; here, height is the covariant that must be controlled during statistical analysis

Spinal nerves Anterior root =

Anterior root = Ventral Root = Motor = Efferent

Pain pattern: RLQ

Appendix, Crohn's disease

_____: s/s include weakness, fatigue, drowsiness, myalgias, depression, sensory loss in glove/stocking distribution, osteopenia, confusion, and gout

Hyperparathyroidism

What should you associate Grave's disease with?

Hyperthyroidism

What is the mneumonic for Broca's aphasia?

BEN Broca's, Expressive, Non-fluent

An increase in cortisol will result in an increase in...

BP

UVH or BVH Autoimmune disorder

BVH

UVH or BVH Gait ataxia

BVH

UVH or BVH Head trauma

BVH

UVH or BVH Meningitis

BVH

UVH or BVH No nausea

BVH

UVH or BVH Oscillopsia (visual blurring with head movements

BVH

UVH or BVH Tumor on the 8th cranial nerve

BVH

UVH or BVH Ototoxicity

BVH Expecially antibiotics such as gentamicin, streptomycin

Where is kidney pain referred to?

Back or upper abdominal

Retrolysthesis

Backward displacement of one vertebrae on another

Describe positive babinski

Big toe extension with fanning of the other toes

Red blood in stool indicates...

Bleeding in lower GI tract

Mneumonic for spinal mobs

Bottoms up will close the gap To open a space, mobilize the top segment To close a space, mobilize the bottom segment

_____: slow, hesitant speech

Broca's aphasia

Age 0-2 reflexes mneumonic

C (Crossed extension) GF (Galant and Flexor Withdrawl) PP (Positive support and Primary walking)

What are the criteria of APGAR score?

HR, Respiratory effect, Reflex irritability, Muscle Tone, Color

What structures can refer pain to the left shoulder?

Heart, tail of the pancreas

Where will a Pancoast Tumor refer pain?

C8-T2 nerve distribution

What is the mneumonic for the origins of the cranial nerves?

CE 1-2 (Cerebrum) MI 3-4 (Midbrain) PONS 5-8 (Pons) MEDU 9-12 (Medulla)

The therapist moves the pen from the center aligned with the nose, to the pt's right. Which CN is being tested?

CN VI, Lateral Rectus of the right eye ball

BP = _____ x _____

Cardiac output (CO) x Total Peripheral Resistance

What is Phalen's test used to diagnose?

Carpal tunnel syndrome

What is the weakest form of evidence?

Case report

Central or Peripheral Vestibular Pathology Abnormal smooth pursuit and saccadic eye movement tests

Central

Central or Peripheral Vestibular Pathology Acute vertigo not usually suppressed by visual fixation

Central

Central or Peripheral Vestibular Pathology Altered consciousness

Central

Central or Peripheral Vestibular Pathology Diplopia

Central

Central or Peripheral Vestibular Pathology Pure vertical nystagmus

Central

Central or Peripheral Vestibular Pathology Usually no hearing loss

Central

Central or Peripheral Vestibular Pathology? Ataxia often severe

Central

_____: brainstem vascular disease; arteriovenous melformation; acoustic neuroma; tumor of the brainstem and cerebellum; multiple sclerosis; vertebrobasilar migraine

Central Vestibular Pathology

_____: use of nominal data to find the difference between groups (boy vs. girl running speed)

Chi square test

______: inflammation of the bile duct

Cholangitis

_____: blockage or impaction of gallstones in the cystic duct resulting in inflammation of the gallbladder

Cholecystitis

Functional incontinence treatment

Clear clutter and prompted voiding

TMJ Disc displacement with reduction

Clicking

Spinal mobs Closing, downglide used for...

Closing or extension restriction

What structures can refer pain to the pelvis/low back/sacrum?

Colon, appendix, pelvic viscera

What causes global aphasia?

Compromise to the stem of the Middle Cerebral Artery

_____: lack of fiber/fluids, HYPOthyroidism, splinting/mm guarding

Constipation

What factors influence static and dynamic lung measurements?

Height, gender, and race

Sidebending is a function of the _____ facets

Contralateral

_____: occurs anywhere in the GI tract

Crohn's Disease

_____: skip lesions present; pain relieved by passing gas, joint arthritis, abdominal pain, weight loss

Crohn's disease

Excessive facial hair

Cushing disease/syndrome

Fat deposition (cervical ft pad/buffalo hump), truncal obesity

Cushing disease/syndrome

Round "moon" face

Cushing disease/syndrome

Weight gain (children show poor growth in height)

Cushing disease/syndrome

easy bruising, poor wound healing

Cushing disease/syndrome

______: Tumor on adrenal gland

Cushing syndrome

______: Pituitary Ademona

Cushing's Disease

Pain pattern: LLQ

Diverticulitis, Ulcerative colitis, IBS

Describe content validity

Does the test measure the specific problem?

What is Virchow's triad used to diagnose?

DVT

Describe Ordinal type data

Data measured in ranks Example: MMT

Describe Interval type data

Data with no true zero Example: Temperature

Describe ratio type data

Data with true zero Example: ROM, Distance walked, Time traveled R for ROM and Ratio

What is Finkelstein's test used to diagnose?

DeQervain's tenosynovitis (AKA Radial Styloid tenosynovitis)

What should you associate Addison's disease with?

Decreased cortisol

TMJ capsulitis

Decreased opening with deviation

TMJ synovitis

Decreased opening, no deviation

Spinal mobs Closing =

Decreased space = downglide = extension

Spondylosis

Degeneration of the intervertebral disc

What is the gait deviation? Dorsiflexion stop too hard

Delayed knee flexion

What is the gait deviation? Socket too posterior, Late stance

Delayed knee flexion

_____: caused by infection such as diverticulitis, IBS, and HYPERthyroidism

Diarrhea

Erb's or Klumpke's Palsy Deformity: Waiter's tip

Erb's

Erb's or Klumpke's Palsy Loss of abduction and lateral rotation of the shoulder

Erb's

Erb's or Klumpke's Palsy MOI: Stretched downward

Erb's

What structures can refer pain to the mid-back?

Esophagus, gall bladder, stomach, pancreas

What is the gait deviation? Flexion contracture, Initial contact

Excessive knee flexion

What is the gait deviation? High prosthetic heel, Initial contact

Excessive knee flexion

What is the gait deviation? Insufficient plantarflexion, Initial contact

Excessive knee flexion

What is the gait deviation? Socket too far anterior, Initial contact

Excessive knee flexion

What is the gait deviation? Stiff heel, Initial contact

Excessive knee flexion

What is the gait deviation? Weak quadriceps, Initial contact

Excessive knee flexion

What is the gait deviation? Excessive foot inset, mid stance

Excessive lateral thrust

What is the gait deviation? Excessive foot outset

Excessive medial thrust

If a child exhibits RIGHT torticollis, how would you stretch the SCM?

Extension, LEFT side-bending, RIGHT rotation

What is the mneumonic for remembering CN VII?

Facial nerve = "F" for muscles of Facial expression

_____: innervates lacrimal glands (Tears)

Facial nerve, CN VII

_____: innervates submandibular and sublingual salivary glands

Facial nerve, CN VII

_____: sensation around the concha of the auricle

Facial nerve, CN VII

_____: sensation to the anterior 2/3 of the tongue

Facial nerve, CN VII

______: Innervates nasal, pharyngeal, and palatine mucous glands

Facial nerve, CN VII

______: innervates muscles of facial expression

Facial nerve, CN VII

Type 2 error =

False negative Dr. tells clearly pregnant pt "You're not pregnant"

Type 1 error =

False positive Dr. tells male pt "You're pregnant"

What muscles of eyeball movement are required to walk downstairs?

First look for CN IV (superior oblique, down and in) Next look for CN VI (lateral rectus, peripheral)

Describe STNR

Flexion of neck will result in flexion of UEs and extension of LEs

Spondylolisthesis

Forward displacement of one vertebrae on another

_____ lobe: Primary motor cortex

Fronal

_____ lobe: Broca's area

Frontal

_____ lobe: Emotion and behavior control

Frontal

_____ lobe: Olfaction

Frontal

_____ lobe: Voluntary movement

Frontal

______: reflux of gastric contents of the gastroduodenal content into the esophagus

GERD (gastro esophageal reflux disease)

What structures can refer pain to the right shoulder?

Gall bladder, liver, head of pancreas, peptic ulcers

Respiration =

Gas exchange

What can cause GI bleeding?

Gastritis, peptic ulcers, ulcerative colitis

_____: target is stable; head movements with eyes focused on stable target

Gaze stabilization VOR x1

_____: target and eyes move in opposite directions

Gaze stabilization VOR x2

_____: coordinate eye and head movements to maintain gaze stability (reset gain of VOR to 1)

Gaze stabilization exercises

What treatment technique can be used for pts with Wernicke's aphasia?

Gestures and/or demonstration

Froment's sign

Grasp paper with thumb and index finger pad-to-pad (+) flexion of DIP of thumb indicating weakness of adductor pollicis, possible ulnar nerve involvement

Describe nominal type data

Groups Example: Blood type, gender

What are the ranges for a lipid profile?

HDL = "Good" cholesterol LDL = "Bad" cholesterol Total <200 = Desireable LDL <100 = Optimal HDL <40 = Low HDL > or = 60 = Desireable Triglycerides <150 = Optimal

Supination mneumonic

IPAD = Inversion, Plantar Flexion, Adduction

Cranial remodeling with helmet has the best outcomes used age ______; no longer useful after _____

Ideal: 4-6 months No longer useful: after 18 months

What is the most common restrictive lung disease?

Idiopathic pulmonary fibrosis

What are the s/s of preeclampsia?

Increase in protein in urine, hyperreflexia, edema, visual disturbances, headache, sudden weight gain

What should you associate Cushing's disease with?

Increased cortisol

Spinal mobs Gapping =

Increasing space = upglide = flexion

An _____ hernia causes groin pain

Inguinal

What is the gait deviation? Low prosthetic heel, Initial contact

Insufficient knee flexion

What is the gait deviation? Socket too far posterior, initial contact

Insufficient knee flexion

_____: nausea, vomitting, foul breath, diarrhea, symptoms disappear while sleeping

Irritable bowel syndrome

_____: spastic, nervous, or irritable colon

Irritable bowel syndrome

______: causes include emotional stress, anxiety, high fat and lactose diet

Irritable bowel syndrome

______: pain is relieved by defecation, sharp cramps in the morning or after eating

Irritable bowel syndrome

_____: the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated

Kehr's sign

Erb's or Klumpke's Palsy Deformity: Claw hand

Klumpke's

Erb's or Klumpke's Palsy Stretching of arm overhead

Klumpke's

Erb's or Klumpke's Palsy aralysis of the instrinsic muscles of the hand

Klumpke's

______: Non-parametric ANOVA

Kruskal Wallis test

A CVA to what hemisphere can result in ideational or ideomotor apraxia?

LEFT CVA

Where is pain with irritable bowel syndrome?

LLQ

Ulcerative Colitis versus Crohn's Disease: where is the pain?

LLQ = Ulcerative Colitis RLQ = Crohn's Disease (same as appendix)

UMN or LMN? Cranial nerve lesion

LMN

UMN or LMN? Decreased or absent reflexes

LMN

UMN or LMN? Decreased tone

LMN

UMN or LMN? Fasciculations

LMN

UMN or LMN? Flaccidity

LMN

UMN or LMN? Lesion of anterior horn of spinal cord

LMN

UMN or LMN? Neurogenic atrophy

LMN

UMN or LMN? Peripheral nerve lesion

LMN

UMN or LMN? Spinal nerve root lesion

LMN

UMN or LMN? Weak or absent voluntary movement

LMN

What is the mneumonic for CN VI?

LR6 Lateral Rectus, Cranial Nerve VI

______: Involved the ipsilateral TMJ spinning in place with the contralateral TMJ sliding anteriorly

Lateral excursion

TMJ Hypomobility s/s

Less ROM, no pain

What sign would you expect with a hypoglossal nerve lession?

Lick my lesions Tongue will deviate toward side of lesion, same side as atrophy

What structures can refer pain to the shoulder?

Liver, diaphragm, pericardium

White/clay/gray stools indicate...

Liver, pancreas or colon disorder

Where can pain from constipation be referred to?

Lower abdomen, anterior hip, groin/thigh

What supplies blood to Wernicke's area?

Lower division of the Middle Cerebral Artery

What interventions should be the focused with a patient with osteoporosis?

Lumbar extension and core stabilization (avoid flexion and rotation)

_____: Nonparametric test designed to test the null hypothesis with two independent samples from the same population (Amateur versus professional running speed...it's a spectrum)

Mann Whitney u

What is the SF-36?

Medical outcomes study 36-iten short form; contains 8 domains which focus on quality of life

Overflow incontinence treatment

Medication and catheterization

_____: Recurrent and usually progressive vestibular disease

Meniere's disease

_____: Tinnitus, deafness, sensation of fullness in ear, vertigo

Meniere's disease

Which foot? Improves ability to ambulate on incline, stairs, and uneven surfaces

Microprocessor foot

Which foot? Microcomputer controls DF and PF

Microprocessor foot

Which foot? Not widely used due to maintenance and cost

Microprocessor foot

Where do the gallbladder, stomach, pancreas, and small intestines refer pain?

Mid-back and scapula

Limitation of passive and active ROM that is pain-free, what intervention?

Mobilization

Ventilation =

Movement of air (a ventilator moves the air for you but doesn't act on the cellular level)

0-6 months reflex mneumonic

NS PTS or Neck Sucks Physical Therapy Labyrinth Starts Neonatal neck righting, Sucking reflex, Placing reaction,Tonic Labyrinth Reflex, Startle

_____: occurs from irritation of the GI tract

Nausea/Vomitting

TN/(FN+TN) =

Negative predictive value

_______ or ______ causes selective damage to autonomic afferent nerves, impairing the sensation of bladder fullness

Neurogenic bladder dysfunction or cystopathy

Which of the data types are qualitative?

Nominal and ordinal

Articulated or non-articulated? Microprocessor foot

Non-articulated

Articulated or non-articulated? SACH foot

Non-articulated

Articulated or non-articulated? SAFE foot

Non-articulated

Articulated or non-articulated? Seattle foot

Non-articulated

What lung capacities indicate restrictive lung disease?

Normal or >80% FEV1/FVC ratio FVC is NOT reduced

What are the abnormal results of a ventilation-perfusion (VQ) scan which would lead you to suspect a pulmonary embolism?

Normal ventilation, abnormal perfusion

_____: there will be no statistical difference between the variables; if there is a difference it will be by chance of a 5% error

Null hypothesis "The drug has no effect"

Describe passive insufficiency

OPPOSITE motion as muscle action Example: Rectus femoris is stretched over the flexed knee and extended hip at the same time

_____ lobe: Lesion can cause hemianopia/hemianopsia

Occipital

_____ lobe: Primary visual cortex

Occipital

_____ lobe: lession can cause inability to recognize previously known objects

Occipital

_____: infection of the middle ear causing fever and ear pain

Otititis media

What is the p value?

P = Probability Probability that the result obtained was due to chance or the probability of making an error

S/S of cholecystitis

Pain in RUQ that radiates to the right scapula, nausea, vomitting, low grade fever

Describe Murphy sign

Palpate near right subcostal margin, as the pt to take a deep breath (+) pain and tenderness on inspiration, indicates Cholecystitis

_____: regulate calcium and phosphate metabolism

Parathyroid gland

_____ lobe: Primary sensory cortex

Parietal

_____ lobe: Sensation

Parietal

_____ lobe: Somatosensory

Parietal

_____ lobe: Taste

Parietal

Coffee ground emesis indicates...

Peptic ulcer

Pain pattern: RUQ

Peptic ulcers, gall bladder pathology, head of pancreas

Central or Peripheral Vestibular Pathology Ataxia mild

Peripheral

Central or Peripheral Vestibular Pathology Feeling of fullness in ears

Peripheral

Central or Peripheral Vestibular Pathology Hearing loss

Peripheral

Central or Peripheral Vestibular Pathology Horizontal nystagmus

Peripheral

Central or Peripheral Vestibular Pathology Normal smooth pursuit and saccadic eye movement tests

Peripheral

Central or Peripheral Vestibular Pathology Symptoms of vertigo are usually suppressed by visual fixation

Peripheral

Central or Peripheral Vestibular Pathology Tinnitus

Peripheral

Central or Peripheral Vestibular Pathology Torsional nystagmus

Peripheral

_____: BPPV, Meniere disease; vestibular neuritis; labryinthiris; perilymphatic fistula; acoustic neuroma

Peripheral Vestibular Pathology

_____: controls ovulation and works as a catalyst for the testes and ovaries to create sex hormones

Pituitary gland

_____: secretes endorphins and reduced a person's sensitivity to pain

Pituitary gland

TP/(TP+FP) =

Positive predictive value

Spinal nerves Posterior root =

Posterior root = Dorsal root = Sensory = Afferent

Posterior Apprehension Sign

Pt lies supine, PT elevates shoulder in scaption to 90 and applies a posterior force through the elbow while adducting and IR arm (+) pt is apprehensive about test position and feels like it will dislocate; previous posterior shoulder dislocation/posterior shoulder instability

Posterior Internal Impingement Test

Pt lies supine, PT passively AB 90-110 with 15-20 extension and max ER (+) pain, indicates impingement between rotator cuff and greater tuberosity or posterior glenoid and labrum

Fulcrum test

Pt lies supine, PT provides posterior to anterior force with one hand and abducts the shoulder to 90 while slowly ER with the other (+) pt is apprehensive about test position and feels like dislocation is possible, indicates previous anterior dislocation/anterior instability

Yocum test

Pt places hand on opposite shoulder, PT elevates elbow (+) pain, indicates sub-acromial impingement

Abdominal compression test

Pt pushes into PT's hand which rests on pt's stomach as hard as possible while moving elbow forward (+) pt in unable to maintain pressure on PT's hand, indicates tear of subscapularis

Biceps load test

Pt seated or supine, shoulder AB to 120, elbow flexed to 90, forearm supinated; PT performs an apprehension test by ER shoulder, if apprehension appears, the examiner stops ER and holds that position, the pt is then asked to flex elbow against resistance at the wrist (+) apprehension remains the same or shoulder becomes painful, SLAP lesion indicated

Yergason's test

Pt sits with elbow flexed to 90 and forearm pronated; pt resists supination of the forearm and ER of the shoulder (+) tendon of long head of biceps pops out of the groove indicates lack of integrity of the transverse ligament; tenderness in bicipital groove without dislocation indicates bicipital tendonitis/tendonosis

Clunk test

Pt supine, shoulder AB, PT pushes humeral head anteriorly while ER (+) clunk, indicates labrum tear

Neer's Impingement Test

Pt's arm is passively and forcibly elevated in scapular plane with the arm medially rotated (+) pain, indicates supraspinatus and biceps tendon impingement

How is scoliosis named?

RIGHT scoliosis = RIGHT convexity

What does the pinch-an-inch test, test for?

RIGHT side = appendicitis LEFT side = Diverticulitis

Describe the positioning of RIGHT torticollis

RIGHT side bend, LEFT rotation

Open chain interventions, think _____

ROM

Colle's fracture

Radius dislocates in a dorsal direction (Colle sounds like Collie which is a Dog - "d" for dorsal)

Smith's fracture

Radius dislocates in a ventral direction

Which of the data types are quantitative?

Ratio and interval

______: for maintaining stable gaze while we move or the world moves around us

Vestibular Ocular Reflex (VOR)

Asthma: _____ and _____ are reduced

Vital capacity and Inspiratory Reserve Volume

What are the blood count lab values?

WBC: 5-11k HgB Male: 13-18 HgB Female: 12-16 Hct Male: 37-39% Hct Female: 36-46% Platelet: 150-400k

What is the prognosis for walking of a child with myelomeningocele at L4-L5 level?

Walk with AFO at home and school

Lower cross syndrome

Weak: Abdominals, glutes, back extensors Tight: Rectus femoris, iliopsoas

Upper crossed syndrome

Weak: deep neck flexors, scapula stabilizers, scapula retractors, scapula depressors Tight: Upper trap, levator scap, pecs, and SCMs

What is the mneumonic to remember the blood supply to Wernicke's area?

WernIcke = "I" for inferior division of middle cerebral artery

_____: pt cannot comprehend speech

Wernicke's aphasia

When is postural drainage contraindicated?

With a pt who is dehydrated

What treatment technique can be used for a pt with Broca's aphasia?

Yes/No questions

Explain a 1-tailed paired t-test

You expect the results Alterntive hypothesis = The drug has a decreasing effect

Explain a 2-tailed paired t-test

You have no expectation of the results Alternative hypothesis = The drug has an effect (either decreases or increases)

What is the heart rate resevere/Karvonen's formula for the low target range?

[(HRmax - HRrest) x0.4] +HRrest

What is the heart rate resevere/Karvonen's formula for the upper target range?

[(HRmax - HRrest) x0.85] +HRrest

Blood pressure is _____ in the first and second trimester and may _____ in the last trimester

_____ side lying is considered best during pregnancy as it decreases compression of the IVC, maximizes CO, decreases GERD

A drop in peak flow rates indicates...

airway narrowing

If the fibers of the diaphragm are aligned horizontally (such as the case with severe COPD), it will result in...

an inward motion of the lower ribs during a diaphragm muscle contraction of inhalation

Cspine Nerve root exits... Disc herniation occurs... Stenosis affects...

below, below, below Example: C3-C4 level Nerve root exiting this space is C4 nerve root Disc herniation at this level impacts C4 nerve root Stenosis at this level effects C4 nerve root

After a repair of a SLAP lesion where the biceps tendon was detatched... Avoid tension on the _____

biceps (avoid elbow extension with shoulder extension)

After a repair of a SLAP lesion where the biceps tendon was detatched... Avoid active ______ for 6 weeks

biceps contraction

In the cspine, to allow rotation the ipsilateral facet must _____

close

Describe Legg-Calve-Perthes Disease

condition in which the femoral head undergoes necrosis. usually seen in children btwn ages 5-10 years.

The TMJ is formed by the ______ mandibular condyle articulating with the TM disc and _____ glenoid fossa of the temporal bone

convex mandibular condyle concave gloid fossa of temporal bone

If the adrenal gland is stimulated, more _____ is released

cortisol

Spondylolysis

defect in pars interarticularis (arc of the vertebrae)

_____ cerebral palsy: tonic hold of muscles and contributes to passive joint stiffness

dystonic

Medial glide of the talus will promote...

eversion/pes planus/pronation

A _____ hernia causes lateral pelvic wall pain

femoral

When choosing an assistve device for a child with spastic diplegia, you want to avoid _____ posture

flexed

A _____ hernia causes shoulder pain

hiatal

Coxa valga

hip valgum

In severe COPD, the diaphragm fiber aligment becomes more _____ than _____

horizontal than vertical

In the lumbar spine, rotation and sidebending occur...

in the opposite direction

In the cspine, rotation and sidebending occur...

in the same direction

Rotation is a function of the _____ facet

ipsilateral

Scheuermann's Disease AKA

juvenile kyphosis

Schmorl nodes

may be referred to as intervertebral disc herniations; refer to protrusions of the cartilage of the IV disc through the vertebral body end plate and into the adjacent vertebra

A pituitary adenoma will result in...

more ATCH secreted by the pituitary gland

The bigger the standard deviation the _____ the scores

more variable

In the lspine, to allow rotation the ipsilateral facet must _____

open

To allow sidebending in the cspine, tspine, or lspine, the contralateral facet must ______

open

Write out ABG values

pH = 7.35-7.45 PaCO2 = 35-45 PaO2 = 80-100 SaO2 = 95-100 HcO3= 22-26

After a repair of a SLAP lesion where the biceps tendon was detatched... Only perform _____ humeral rotation with the shoulder in the scapular plane for the first 2 weeks

passive

What is the BODE index?

prognostic indicator for mortality risk in pt's with COPD

Pain provocation (Mimori) test

pt seated, arm 90/90, PT ER arm at the wrist, forearm is max supinated then max proanted (+) pain provoked or worse in pronation, indicates SLAP

Jerk test

pt sits with arm medially rotated and forward flexed to 90, PT grasps elbow and provides axial load to the humerus towards pt's shoulder. While maintaining axial load, PT horizontally adducts arm (+) sudden jerk or clunk as the humeral head subluxes, indicated recurrent posterior instability of the shoulder

Blood in the abdominal cavity secondary to liver trauma will refer pain to the...

right shoulder

Referred pain from pancreatic cancer in the head of the pancreas will be...

right shoulder

An adrenal gland tumor will result in...

secretion of more cortisol

Scheuermann's Disease

self-limiting skeletal disorder of childhood; describes a condition where the vertebrae grow unevenly with respect to the sagittal plane (the posterior angle is greater than the anterior angle)

Anteversion =

the ball of the hip is subluxed ANTERIORLY

During mandibular depression, the condyle _________ on the TM disc; the disc also ______ to maintain a congruent surface within the fossa

the condyle rolls and slides anteriorly The disc also slides anteriorly