PTH 226 FINAL
A PTA educates a patient s/p transfemoral amputation on the importance of frequent skin checks. What is the MOST appropriate resource for the patient to utilize when inspecting the posterior aspect of the residual limb?
Hand mirror
All of the following would be appropriate orthopedic questionnaires for a patient with a diagnosis of right knee OA except:
HOOS
Which of the following activities should be used initially to correct a diastasis recti postpartum?
Have the patient lie supine, arms across the abdomen, and perform head lifts.
You are treating a patient with weak hip abductors (muscle grade is 2/5). Which of the following ROM exercises is most appropriate to prevent tightness of the hip adductors and maintain the current level of strength of the hip abductors?
Have the patient perform active hip abduction through the available ROM while positioned in the supine position as you support the weight of the leg
Your goal is to improve lower extremity proprioception, balance, and strength. Which of the following closed-chain exercises is the most challenging?
Have the patient stand on one foot on a piece of foam and maintain his balance
Which of the following statements about stretching is true?
To stretch the posterior tibialis, you dorsiflex and evert the foot and ankle.
Your instructions to a patient who has been fit with an elastic shrinker for the residual limb is to wear it
23 hours a day, except when bathing
When a person is standing in chest-deep water, the percentage of weight bearing is approximately what percentage of body weight?
33%
Which of the following is true regarding appropriate HEP's?
A HEP is an important component for success of a PT program and should be provided early in the treatment, updating as appropriate
Each of the following is an indication that muscle fatigue is occurring when a patient is exercising against resistance except:
A gradual increase in temperature (sensation of warmth) in the exercising muscles
Which of the following is a true statement about the use of autografts and allografts for repair of tissue lesions?
A risk associated with an autograft is potential weakening of a patient's otherwise healthy tissue at the donor site.
Which of the following is a correct statement about surgical repair of a torn or ruptured muscle or tendon?
A surgically repaired muscle or tendon is immobilized in a shortened position for a period of time after surgery.
In order to maintain the web space of the hand, it is important to maintain which of the following motions of the carpometacarpal joint of the thumb?
Abduction and extension
What balance strategy is activated with small external pertubations?
Ankle strategy
The center of gravity in most adult humans is located slightly:
Anterior to the S2 vertebra
The special test that is performed to test for meniscal injury where the patient lies prone with 90 degrees of knee flexion and the therapist stabilizes the femur while pushing down on the heel medially and laterally rotating the tibia is called the
Apley's Compression Test
To strengthen the posterior tibialis using manual resistance, have the patient assume a long sitting position on a table or mat. Support and hold the lower leg with one hand and:
Apply resistance to the plantar and medial surfaces of the foot at the first metatarsal as the patient plantar flexes and inverts the ankle and foot
John is a 25-year-old active athlete and outdoorsman who suffered a severe lateral ankle injury 5 years ago, resulting in progressive subtalar arthritis, pain, and instability of the ankle and hindfoot. His quality of life and ability to work are now restricted owing to the pain and instability despite repeated sessions in therapy. The surgical procedure of choice for John is most likely:
Arthrodesis (fusion)
Which of the following is a true statement about a muscle's response to immobilization?
As the immobilized muscle atrophies, an increase in fibrous and fatty tissue in the muscle occurs.
You are educating your patient about returning to functional activities following a radial head resection with an implant. What should you tell her about returning to high-demand, high-impact activities?
Avoid these activities on a permanent basis
To prevent falls and maximize safety while lifting heavy objects from the floor, an elderly patient is instructed to:
Bend at the knees partially while keeping the back straight and pick up the load slowly.
Which of the following functional assessments does not include a gait component?
Berg
Decreasing the amount of weight bearing by immersing more of a person's body in water is a result of what property of water?
Buoyancy
All of the following are signs and symptoms your patient may exhibit that would alert you to a possible pulmonary embolism except:
Chest pain alleviated with deep breathing and rib compression
Which of the following stages of soft tissue healing is characterized by remodeling and maturation of collagen in the scar?
Chronic stage
The Functional Independence Measure is an example of a multidimensional functional assessment instrument because it includes some measure of which of the following? A. Physical function B. Social function C. Activities of daily living function D. All of the above
D. all of the above
Common postural changes/deviations that develop or become exaggerated during pregnancy include each of the following except:
Decreased thoracic kyphosis
Rhythmic stabilization exercises are important in a spinal rehabilitation program because they:
Develop postural muscle response to external disturbances
Which of the following PROM exercises provides the most flexion of the lumbar spine?
Double knees to chest
The special test that is performed to test for RTC tear where the arm is placed at 90 degrees abduction and then the patient slowly lowers to their side is called the
Drop Arm Test
Individuals with symptoms from an intervertebral disk lesion and individuals with osteoporosis should not do:
Dynamic trunk flexion exercises
A PTA observes a patient complete a test that requires the patient to perform quick alternating pronation and supination of the forearm. What can this test be used to identify?
Dysdiadochokinesia
Mr. J underwent a repair of a torn biceps brachii 2 days ago. During PROM exercises, which combination of motions should you avoid at end range to protect (not disrupt) the healing tissue?
Elbow extension, shoulder extension, forearm pronation
When designing an exercise program to return a patient to his/her prior functional level, each of the following guidelines is true except:
Exercises for strength and power should precede balance and stability exercises
Which of the following tests can be performed with only a stopwatch and four canes?
Four Square Step Test
A properly applied and progressed therapeutic exercise program should:
Grade the exercise to the stage of recovery to stress the tissues safely
The most effective and safe way to perform passive pronation and supination of the forearm is to:
Grasp the patient's forearm just proximal of the wrist and perform ROM while maintaining the elbow in flexion
An orthosis that includes a pelvic band that wraps around the hips, a thigh strap, hinge component at the knee, and goes to the shoe is called a:
HKAFO
According to the International Classification of Functioning, Disability and Health (ICF) endorsed by the American Physical Therapy Association (APTA), a rotator cuff tear is considered a(n):
Health condition
What balance strategy is activated with larger rapid external pertubations or from movements that occur near the limits of stability?
Hip strategy
If a patient has lower extremity edema, which of the following principles associated with hydrotherapy (an aquatic environment) will assist with decreasing the edema?
Hydrostatic pressure
Which of the following is a true statement about surgical repair of the rotator cuff and postoperative management?
If the size and severity of the tears are similar, rehabilitation after repair of an acute, traumatic cuff tear typically progresses more rapidly than after repair of an atraumatic tear associated with chronic impingement
Contraindications to the use of plyometrics include all of the following except:
Individuals under 10 years or over 70 years
Following recovery of a posterolateral disk protrusion, your patient will be returning to a job that requires prolonged forward bending and stooping. Your instructions to the patient must include:
Interruption of the flexed postures at frequent intervals by standing upright and bending backward
The anterior pillar of the spine:
Is the weight-bearing portion of the spinal column
All of the following are generally true of the nucleus pulposus except:
It is centrally aligned within the annulus fibrosis at all levels of the spine to provide uniform shock absorption
Your patient, a 19-year-old college student, sustained a nondisplaced fracture of the distal humerus, which was managed by closed reduction and 6 weeks of immobilization in a cast. Yesterday the cast was removed and the patient is to begin exercises to improve range of motion (ROM) and strength of the elbow. Your examination reveals significant limitation of elbow flexion/extension and forearm pronation/supination as well as reduced joint play at the elbow. The patient describes her elbow as feeling "very stiff," but pain occurs only when overpressure is applied at the end of the available ranges. One of the goals in this patient's treatment plan is to increase elbow ROM. With which of the following techniques should you begin to increase ROM?
Joint-mobilization techniques to stretch the restricted joints (grade III sustained glide or grade IV oscillation techniques) after evaluating the reactivity of the elbow joints with grade II sustained glides
Fundamental techniques that every patient with spinal impairments should learn before progressing to basic and advanced training exercises include:
Kinesthetic awareness of safe spinal positions and movement, activation of deep segmental muscles, and global muscle control of spinal posture when moving the extremities or moving from one position to another.
Extreme caution should be used when manipulating the spine of patients with rheumatoid arthritis. There is high potential for subluxation of the vertebrae and damage to the spinal cord secondary to:
Ligamentous necrosis
Which of the following types of active exercises are the most appropriate to use first during the acute phase of healing after a muscle injury?
Low-intensity muscle setting
Which of the following is the primary function of the cerebellum?
Maintenance of upright posture
Your patient has osteoarthritis of the left hip and states he experiences hip and thigh pain after walking for more than 20 to 30 minutes. As a therapist, which of the following is the most appropriate intervention for you to recommend?
Measures to decrease the mechanical stresses on the hip joint, such as use of a cane when walking over an extended period of time
A PTA is performing an assessment of proprioception and has the patient close their eyes then lifts their finger by the side asking the patient to determine if it was moved up or down. This test is called:
Movement test
A patient has mild joint swelling and pain during active ROM, but resisted tests of the muscles that cross the swollen joints do not cause pain. Your goal is to maintain or possibly increase strength through the available ROM. The most appropriate choice of exercise is:
Multiple-angle isometric exercise against resistance
A lesion in the cerebellum will most likely cause which of the following impairments?
Nystagmus
According to the definition of therapeutic exercise and the goal of designing an individualized program of therapeutic exercise, the physical therapist might develop a therapeutic exercise program in order to:
Optimize overall health status, fitness, or sense of well-being
Which of the following signs and symptoms in the hip region and/or lower extremity is most consistent with the finding associated with trochanteric bursitis?
Pain along the lateral aspect of the hip joint and possibly along the lateral thigh and knee to the insertion of the iliotibial band; pain typically worsens during long periods of asymmetrical standing with more weight shifted to the involved side
A PTA is treating a patient two weeks post rotator cuff repair. Which of the following interventions in the MOST appropriate?
Passive range of motion up to 10 degrees of external rotation
As you develop progressions of exercise programs for varied patients, which of the following describes the appropriate use of plyometric drills?
Patients in advanced phases of rehabilitation should be trained to return to high-demand functional activities and sports
Which of the following statements is true regarding the temperature range of water 26°C-35°C (78.8°F-95°F) recommended for aquatic exercise?
Patients should perform cardiovascular exercise at the low end of this range.
Of the following choices, which is the most appropriate application of the hold-relax (contract-relax) method of muscle inhibition and elongation of the gastrocnemius muscle? Extend the patient's knee, stabilize the lower leg, and:
Place the patient's ankle in as much dorsiflexion as is comfortable; have the patient isometrically contract the plantar flexors against resistance for 3 to 5 seconds. Then have the patient relax as you passively dorsiflex the ankle.
A 55-year old man with stable congestive heart failure is unable to tolerate land-based exercises for strengthening his back because of chronic low back pain. He has expressed concern with attempting pool therapy because of his inability to swim and his use of pain medications. Which of the following statements is true about his ability to participate in aquatic therapy?
Pool therapy can be used to decrease pain, improve mobility, and strengthen muscles.
A PTA considers an AFO for a 62 y/o female who has difficulty with toe clearance during ambulation due to dorsiflexor weakness. Which objective finding would make a posterior leaf spring orthosis an INAPPROPRIATE orthotic selection?
Poor plantarflexor strength
During the subacute stage of soft tissue healing after injury and repair of the flexor tendons of the hand or forearm, each of the following is an important intervention except:
Progressive resistance exercise
A patient reports to PT one week s/p transtibial amputation. Which sleeping position would be the MOST appropriate to prevent a knee and hip contracture?
Prone lying without the use of a pillow
Which of the following braces for scoliosis would you instruct your client to wear only at night?
Providence brace
Ergonomics is defined as all of the following EXCEPT
Provides the design for the ramp to assist the worker to get into a job or establishment
In the above picture, the patient is performing an exercise to primarily work which muscle group?
Quadriceps
Which of the following orthopedic questionnaires would be most appropriate for a patient with a diagnosis of frozen shoulder/ adhesive capsulitis?
QuickDASH
A patient rehabilitating from a lower extremity injury is instructed in a stretching exercise. Based on the depicted image what does this stretch MOST appropriately target:
Rectus femoris
Ambulation should begin in the early postoperative phase in order to:
Reduce the risk of a DVT after surgery
The image on the right is an example of what type of surgical procedure?
Reverse Total Shoulder Replacement/ Arthroplasty
Synovectomy, when used, typically is indicated for:
Rheumatoid arthritis
You have a patient assume a prone-lying position and prop symmetrically on his forearms. You apply manual resistance in several directions at the shoulder girdles as you ask the patient to hold (maintain) the symmetrical position. This technique is known as:
Rhythmic stabilization
During the last trimester of pregnancy, pain in the groin area is often caused by overstretching of the:
Round ligament
Which of the following two upper extremity muscle groups are the MOST important to strengthen to assist with body lifting during ambulation?
Scapular depressors and elbow extensors
What would the patient in the picture need to change in order to increase hip flexor stretch?
Scoot more toward the end of the table
You are observing your patient with a transfemoral prosthesis ambulate and note that she has increased lateral trunk bend in stance phase. Which of the following is the MOST likely explanation of the problem?
Short prosthesis
Each of the following is a relative or absolute contraindication for use of total joint replacement arthroplasty except:
Significant joint deformity
You are observing your patient with a transtibial prosthesis ambulate and note that she has insufficient knee flexion in early stance phase. Which of the following is a likely explanation of the problem?
Soft heel cushion
A PTA observes a patient complete a standing squat as shown in the image. During the squat the assistant notes that the patient is unable to maintain their heels in contact with the ground. Based on this finding, which muscle is MOST likely shortened?
Soleus
A PTA is performing an assessment of proprioception and has the patient close their eyes while the PTA moves a body part to a position and asks the patient to match with the opposite side. This test is called:
Space test
What balance strategy is activated when a large force displaces the center of mass beyond the limits of stability?
Stepping strategy
All of the following are recommendations of the National Osteoporosis Foundation for ways to prevent osteoporosis except:
Strengthen the core and protect the spine with flexion exercises (curls and sit-ups)
During pregnancy, in which direction does the center of gravity of the body move?
Superior and anterior
Your patient describes posterior cervical pain and headaches that get progressively worse throughout each workday. She is a computer programmer, plays tennis on the weekends, and is an aerobic walker in the evenings. Your evaluation reveals a person who is physically fit with well-balanced flexibility and strength. Your treatment emphasis will be:
Teaching tension-reducing postures and modification of chair, desk, and computer heights
An 82-year-old woman is referred to physical therapy with a history of two falls in the past month. She shows inadequate anticipatory control on the Functional Reach Test and is now expressing fear of falling. The patient lives alone and relies on her daughter for transportation. The best exercise program for this person is:
The Otego Home Exercise Program
Disc lesions are more common in the 30 year to 45 year age span because:
The annulus begins degenerating, loses tensile strength, and begins to tear with excessive forces
Which of the following is true about testing for a diastasis recti?
The fingertips are placed horizontally at the midline of the abdomen (perpendicular to the linea alba) at the level of the umbilicus to assess the size of the separation.
Your patient has only 50° of passive and active knee flexion (but full passive extension) 2 weeks after removal of a cast for a fracture of the tibia. The bone is now radiologically healed. Each of the following techniques will be of value to increase the range of knee flexion except:
The hold-relax technique, with isometric contraction of the hamstrings with the knee at 45°, followed by relaxation, then passive movement into more flexion
If a patient, who is in a prone-lying position with a cuff weight around his ankle, flexes his knee from a fully extended (0°) position to a fully flexed (135°) position, what type(s) of contraction will occur in which muscle group(s)?
The knee flexors contract concentrically from 0° to 90°, and the knee extensors contract eccentrically from 90° to 135° of flexion
Which of the following is true about physical therapy intervention for pelvic floor dysfunction?
The primary contributing factor for pelvic floor dysfunction in men is prostate enlargement or prostate cancer treatment.
Each of the following is true about flexor tendon-gliding exercises except:
To perform these exercises, the therapist passively moves the patient's fingers into five different positions in a particular sequence
After a musculoskeletal injury of the lower extremity, you develop an aquatic exercise program for your patient. An aquatic exercise program is the least effective for:
Transfer of training to land-based functional activities
The spinal muscles that are activated first with rapid arm movements are the:
Transversus abdominis and multifidus
True or False? Older adults may report a fear of falling, with or without a history of a previous fall, that may result in them avoiding or restricting activities.
True
A PTA is performing balance exercises with a patient in the parallel bars on a firm surface with one hand hold assist on the bars. Which of the following would NOT be a progression?
Two hand hold on the bars on a firm surface
Which of the following sacroiliac impairments will probably not respond to muscle energy techniques?
Up-slipped innominate
To maintain gains in ROM achieved as the result of a stretching program, it is recommended to:
Use the stretch-induced gains in ROM during functional activities as soon as able on a regular basis
At what point with prosthetic socks do you request a reevaluation by the PT of socket fit?
Using more than 15-ply of socks
