Integrative Therapeutic Applications Chapter 1 Test Review
Applying ice, compression, and elevation to an acute injury decreases injury to the A) Zone of secondary injury B) Soft tissue C) Associated bone D) Zone of primary injury
A) Zone of secondary injury
Which, if any, of the following is NOT a sign of inflammation? A) all of the answers are signs of inflammation B) loss of function C) redness D) swelling E) heat
A) all of the answers are signs of inflammation
Of the following, which is NOT a component of informed consent? A) an assurance that the recommended treatment will be effective B) an explanation of the risks and benefits of recommended treatment C) an agreement between the clinician and patient before moving forward with a treatment D) an explanation of the diagnosis or findings of a physical examination
A) an assurance that the recommended treatment will be effective
The prominent phagocyte at the end of acute inflammation is the A) neutrophil B) macrophage C) basophil D) T lymphocyte
B) macrophage
The _______________________ dimension of pain refers to the emotional or autonomic response to noxious stimulation.
Affective
The quality of pain that involves conscious thought processes is the ____________________ dimension of pain.
Evaluative
Stages of healing occur in a coordinated fashion with distinct stages and timelines. True False
False
The term chemotaxis refers to the process in which cells stimulate chemicals that repel specific cells in a particular area. True False
False
Found in all types of connective tissue, collagen is a fibrous protein that is produced by __________________.
Fibroblasts
____________________, a lack of blood flow to tissue, can result in the three physiological challenges associated with secondary metabolic injury: hypoxia, inadequate fuel delivery, and inadequate waste removal.
Ischemia
The problem-solving approach to developing an intervention strategy is a logic-based technique that uses what components? (Select all that apply.) A) cost of the interventions B) patient's long-term goals C) clinical examination findings D) best available evidence E) supplies of the facility
B) patient's long-term goals C) clinical examination findings D) best available evidence
What best defines negligent behavior when a person acts on a situation by performing an act that is not theirs to perform or commits an act that is their duty but does so at a level different than a reasonable and prudent person would? A) Fraud B) Act of omission C) Act of Commission D) Tort
C) Act of Commision
Macrophages are responsible for A) Release of growth factors B) Recruitment of other macrophages C) All of the above D) Debridement
C) All of the above
The proliferative phase of healing includes A) Development of new blood cells B) Formation of fibrous tissue C) All of the above D) Wound contraction
C) All of the above
The codes that were established by the AMA for health care providers to receive third-party reimbursement are CPT codes. What does CPT mean? A) Current Procedural Treatments B) Current Provider Terminology C) Current Procedural Terminology
C) Current Procedural Terminology
From which horn do efferent nerves exit the spinal column? A) Either dorsal or posterior B) Lateral C) Either ventral or anterior
C) Either ventral or anterior
Following primary injury, which, if any, of the following is/are NOT caused by pain? A) Neural inhibition of strength B) Neural inhibition of range of motion C) Hematoma formation D) Spasm
C) Hematoma formation
As a general rule, treatment tables should be _______ high and _______ apart. A) 30 in.; 30in. B) 2ft; 30 in. C) 2 ft; 4ft D) 30in.; 4ft
A) 30in.; 30in.
The placebo effect is summarized by all of the following descriptions, except A) A measured relief of pain due to therapeutic modality application B) A felt improvement in the patient's condition due to altered activity in the pain-sensitive regions of the brain C) A felt improvement in health not attributable to treatment D) An observed enhancement of the patient's condition attributable to mock intervention
A) A measured relief of pain due to therapeutic modality application
Pain threshold is often based on the recruitment of _______________ fibers. A) A-delta B) A- beta C) C
A) A-delta
Of the following, which would be considered a component of the nociceptive pathway to the brain? A) A-delta fibers B) Golgi tendon organs C) A-beta fibers D) Muscle spindles
A) A-delta fibers
Failure to receive informed consent from an athlete could result in? A) Battery B) Gross negligence C) Malpractice D) Misfeasance
A) Battery
The substance that increases vessel permeability and stimulates nerve endings to cause pain is A) Bradykinin B) Prostaglandins C) Histamine D) Serotonin
A) Bradykinin
_____________ nerves are most responsible for slower pain sensation and are smallest in diameter. A) C fiber afferent B) A- alpha afferent C) A-beta afferent D) A-delta afferent
A) C fiber afferent
Planning a treatment and rehabilitation program requires the integration of what complex skills? (Select all that apply.) A) Clinical examination skills B) Identification of the patient's participation restrictions C) Identification of the patient's level of function D) Knowledge of pathology E) Knowledge of the current costs associated with common modalities
A) Clinical examination skills B) Identification of the patient's participation restrictions C) Identification of the patient's level of function D) Knowledge of pathology
Ice, compression, and elevation are indicated for immediate care of acute injury. What does elevation do that is most beneficial in swelling control? A) Decrease capillary hydrostatic pressure B)Decrease tissue hydrostatic pressure C) Decrease capillary oncotic pressure D) Decrease tissue oncotic pressure
A) Decrease capillary hydrostatic pressure
Which of the following in NOT a stage during blood clotting? A) Formation of leukocytes B) Release of Thromboplastin C) Conversion of fibrinogen to fibrin D) Formation of thrombin
A) Formation of leukocytes
Whirlpools and other electrical devices used in the presence of water must be connected to a? A) Ground fault interrupter circuits B) Hospital grade plug C) Three-pronged outlet
A) Ground fault interrupter circuits
Which of the following chemical mediators is a powerful vasodilator found in mast cells? A) Histamine B) Prostaglandin C) Necrosin D) Leukotaxin
A) Histamine
Which of the following describes the inverse relationship between energy absorption and penetration? A) Law of Grotthus-Draper B) Arndt-Schultz Principle C) Inverse-square law D) Cosine law
A) Law of Grotthus-Draper
An athletic trainer suspects that a football player was burned due to the inappropriate application of a hotpack during a thermotherapy treatment. What type of legal liability could result from the athletic trainer's actions? A) Misfeasance B) Nonfeasance C) Malfeasance
A) Misfeasance
Which is an accurate statement regarding the effect of modalities and the healing process? A) Modalities attempt to provide the optimal environment for healing to occur B) The stage of the healing process does not influence which modality is used C) Modality devices are primarily used to alter the body's psychological status to provide a good healing environment D) Most modalities can speed up the healing of an injury
A) Modalities attempt to provide the optimal environment for healing to occur
Which statements are true regarding the definition of pain? (Select all that apply.) A) Pain is an unpleasant sensory and emotional experience. B) Pain is always an emotional experience. C) Pain is just a simple sensation and not a process. D) Pain is associated only with actual tissue damage and not potential damage. E) Acute pain has an identifiable cause and extended duration.
A) Pain is an unpleasant sensory and emotional experience. B) Pain is always an emotional experience.
Which of the following signs is not present during the inflammatory response phase? A) Pallor B) Pain C) Swelling D) Loss of function
A) Pallor
A failure to maintain accurate, legible medical records may result in what charge? A) Professional Negligence B) Ordinary Negligence C) Ordinary and Professional Negligence D) Neither Ordinary nor Professional Negligence
A) Professional Negligence
What can you be charged with if you provide care without consent in a nonemergent situation? (Select all that apply.) A) Professional Negligence B) Mischief C) Battery D) Slander E) Tort
A) Professional Negligence C) Battery
There are three potential outcomes of the injury process. What best describes the regeneration outcome? (select all that apply) A) The damaged tissue is replaced by cells of the same type B) The structure's original structure and function is lost C) The structure retains some or all of its original structure and function D) Dead cells and cellular debris are removed by phagocytosis
A) The damaged tissue is replaced by cells of the same type C) The structure retains some or all of its original structure and function
There are three potential outcomes of the injury process. What best describes the repair outcome? (select all that apply) A) The original tissue is replaced with scar tissue B) The structure retains some or all of its original structure and function C) Dead cells and cellular debris are removed by phagocytosis D) The structure's original structure and function is lost
A) The original tissue is replaced with scar tissue D) The structure's original structure and function is lost
How long might the process of collagen restructuring during the maturation phase last? A) Up to one year or more B) Up to one month C) Up to one week D) Up to two years
A) Up to one year or more
All therapeutic equipment must be inspected and calibrated by a qualified technician at least _____________. A) yearly B) twice a year C) weekly D) montly
A) Yearly
All of the following apply to endorphins: (Select all that apply) A) endogenous B) inhibited by exercise C) produced in several locations in the body
A) endogenous C) produced in several locations in the body
What pain-decreasing medication temporarily blocks nerve conduction, thus resulting in the loss of sensation? A) lidocaine B) propoxyphene C) Aspirin D) endorphin
A) lidocaine
Secondary hypoxic injury results from an imbalance in A) metabolism and oxygen delivery B) inflammation and oxygen delivery C) metabolism and inflammation D) conditioning and force
A) metabolism and oxygen delivery
In order to decrease the potential growth of fungi, bacteria, and viruses, what should the humidity of the hydrotherapy area be? A) 60 to 70 percent B) 40 to 50 percent C) 70 to 80 percent D) 50 to 60 percent
B) 40 to 50 percent
Edema is defined as the: A) Conversion of aerobic to anaerobic metabolism in a cell. B) Accumulation of the fluid portion of blood in tissue. C) Compression of tissue by blunt force. D) Increase in tissue mass caused by excess cellular material.
B) Accumulation of the fluid portion of blood in tissue
When assessing for the possibility of professional negligence, what forms the benchmark for determining if care provided was standard or substandard? (Select all that apply.) A) Patient opinion B) Best Practice Standards C) Facility policies and procedures manual D) State practice acts E) Professional standards of practice
B) Best Practice Standards C) Facility policies and procedures manual D) State practice acts E) Professional standards of practice
Edema may contribute to secondary injury by: A) Dilating blood vessels, thus increasing circulation. B) Compressing blood vessels, thus reducing circulation. C) Compressing blood vessels, thus decreasing diffusion of nutrients out of injured tissue. D) Dilating blood vessels, thus increasing diffusion of nutrients into injured tissue.
B) Compressing blood vessels, thus reducing circulation.
Which of the following are characteristics of scar tissue? I. Elastic II. Fibrous III. Inelastic IV. Vascular V. Nonvascular A) I, II, and IV B) II, III, and V C) II and IV D) II, III, and IV
B) II, III, and V
Rubor, calor, tumor, dolor, and loss of function are symptoms of A) Fractures B) Inflammation C) Abrasions D) Concussions
B) Inflammation
What two factors determine whether an injury occurs when a force is sustained by tissues in the human body? A) Size of force and girth of tissues B) Magnitude of forces and tissue's material properties C) Tensile forces and girth of tissues D) Compression of force and yield point of tissues
B) Magnitude of forces and tissue's material properties
In assessing a potentially serious neck injury, an athletic trainer removed the helmet of the injured athlete. What type of legal liability could result from the athletic trainer's actions? A) Nonfeasance B) Malfeasance C) Misfeasance
B) Malfeasance
When leukocytes line up along the wall of the blood vessel it is called: A) Lukotaxin B) Margination C) Diapedesis D) Phagocytosis
B) Margination
Which of the following is NOT one of the changes of the inflammatory reaction? A) Permeability changes B) Neutrophilic changes C) Metabolic changes D) Hemodynamic changes
B) Neutrophilic changes
According to the gate control theory of pain: A) Noxious stimuli travel along small diameter nerve fibers only. B) Only one sensation at a time is allowed to pass through to the brain. C) The stimulus cell determines which impulses continue up or down the spinal cord. D) The brain is unable to collect and integrate sensory input from multiple sources.
B) Only one sensation at a time is allowed to pass through to the brain
The constant ongoing remodeling of bone is caused by the: A) Fibroblasts and osteoblasts B) Osteoblasts and osteoclasts C) Osteocytes and fibroblasts D) Monocytes and fibroblasts
B) Osteoblasts and osteoclasts
The process of ingesting microorganisms, other cells, or foreign particles commonly performed by monocytes is called: A) Permeability B) Phagocytosis C) Margination D) Synthesis
B) Phagocytosis
Which of the following statements does not apply to chemical mediators involved in the inflammatory response? A) They signal the rest of the body that an injury has occurred B) They decrease the permeability of blood vessels C) They are activated by ultrastructural changes D) They regulate the inflammatory response
B) They decrease the permeability of blood vessels
What best defines a civil wrong done to an individual whereby the injury party seeks a remedy for damages suffered? A) Fraud B) Tort C) Act of Omission D) Act of Commission
B) Tort
Employers or clinical instructors can be held liable for negligent acts of their employees or students through the doctrine of? A) Contributory Negligence B) Vicarious Liability
B) Vicarious Liability
__________ explains that bones remodel and adapt to forces placed upon them. A) Hunting response B) Wolff law C) Grotthus-Draper law D) Theory of specificity
B) Wolff law
Nociceptive impulses from traumatized tissue: A) Facilitate motor functions and tissue repair B) inhibit motor functions and tissue repair C) Stimulate motor functions and tissue repair D) propagate motor functions and tissue repair
B) inhibit motor functions and tissue repair
Of the following, which is true regarding collagen? A) It is the principal component of ground substance. B) It is synthesized by fibroblasts. C) It is formed by the conversion of fibrin to fibrinogen. D) ROS-activated proteases synthesize collagen and extracellular matrix.
B) it is synthesized by fibroblasts
Which inflammatory events work to break down a hematoma resulting from a torn muscle? A) Primary injury, ultrastructural changes, chemical mediation and phagocytosis B) Ultrastructural changes, chemical mediation, hemodynamic changes, and metabolic changes C) Hemodynamic changes, permeability changes, leukocyte migration, and phagocytosis D) Primary injury, chemical mediation, metabolic changes, and permeability changes
C) Hemodynamic changes, permeability changes, leukocyte migration, and phagocytosis
_________________ is the first chemical mediator to appear during the inflammatory stage of tissue healing. A) Bradykinin B) Serotonin C) Histamine D) Heparin
C) Histamine
The heating effect quadruples if a heat lamp is lowered half the distance between the device and body part. This is based on the A) Cosine law B) Arndt-Schultz principle C) Inverse-square law D) Law of Grotthus-Draper
C) Inverse-square law
What is the strictest form of state regulation? A) Exemption B) Certification C) Licensure D) Registration
C) Licensure
Which statement best describes nociception? A) Nociception describes an unpleasant sensation. B) Nociception must be interpreted as pain by higher brain centers. C) Nociception is the neural process of encoding and processing noxious stimuli. D) Nociception is a neuropsychological process that must be interpreted as pain.
C) Nociception is the neural process of encoding and processing noxious stimuli.
What term best describes the negligent tort when there is a duty to act but a failure to perform the act? A) Malfeasance B) Misfeasance C) Nonfeasance
C) Nonfeasance
Which develops safety standards and regulations to prevent work-related injuries and illnesses? A) Health Insurance Portability and Accountability Act (HIPAA) B) American Hospital Association (AHA) C) Occupational Safety & Health Administration (OSHA) D) Food and Drug Administration (FDA)
C) Occupational Safety & Health Administration (OSHA)
Which of the following are examples of mechanical stimuli that can trigger peripheral nociceptors? (Select all that apply.) A) Release of prostaglandins from trauma B) Thermal changes associated with the inflammatory response C) Pressure from swelling D) Direct-force trauma
C) Pressure from swelling D) Direct-force trauma
Precautions are sometimes called A) Partial contraindications B) Absolute contraindications C) Relative contraindications D) Relative indications
C) Relative contraindications
In pain control theory, which is considered a secondary pain control approach? A) Decrease chemical irritation B) Resolve physiological pain triggers C) Target the perception of pain D) Decrease mechanical irritation
C) Target the perception of pain
A civil legal action brought by a person injured while being treated by a certified athletic trainer would be a A) Misdemeanor B) Negligent act C) Tort D) Case of malpractice
C) Tort
During the inflammatory response phase there is a period of ___________ followed by _____________ . A) Vessel permeability, vasoconstriction B) Vasoconstriction, phagocytosis C) Vasoconstriction, vasodilation D) Vasodilation, vasoconstriction
C) Vasoconstriction, vasodilation
What does the verbal rating scale use to represent the current pain intensity of a patient? A) 10-cm line B) different faces C) descriptive terms D) numbers 1 through 10
C) descriptive terms
A substance similar in shape to morphine that was named because it was found in the head (along with the spinal cord and gut) is A) saloxone B) endorphin C) enkephalin D) morphelin
C) enkephalin
What substance is released by the body and reduces the perception of pain by bonding to pain receptor sites? A) mast cells B) serotonin C) enkephalin D) tract cells
C) enkephalin
The temporary pain relief that results from counterstimulation techniques is based on A) rhythmical pain modulation B) endogenous opiate release C) gate control theory D) central biasing theory
C) gate control theory
Which inflammatory pain mediator is released by mast cells to directly stimulate nociceptors? A) substance P B) prostaglandin C) histamine D) bradykinins
C) histamine
Memories of past experiences are a component that creates one's "pain filter." Where do these memories come from? A) cerebral cortex B) thalamus C) limbic system D) somatosensory system
C) limbic system
In which of the following circumstances would treatment with therapeutic modalities be most appropriate? A) when pain results from a rest-reinjury cycle B) when biomechanical flaws are overstressing tissues C) when pain results in muscle guarding and a loss of range of motion D) when pain is caused by underlying structural lesions that remain unidentified
C) when pain results in muscle guarding and a loss of range of motion
What is the inflammatory response? A) A delayed response of the body to an injury or irritant. B) A permanent response of the body to an injury or irritant. C) A systemic response of the body to an injury or irritant. D) A local response of the body to an injury or irritant.
D) A local response of the body to an injury or irritant.
What is pain? A) An event-specific neurological reflex. B) A purely physical response to inhibition of neural input. C) An emotional stimulus-response mechanism. D) A subjective sensory and emotional experience associated with actual or potential tissue damage.
D) A subjective sensory and emotional experience associated with actual or potential tissue damage.
_____________ nerves are most responsible for fast pain sensation and are myelinated and larger in diameter. A) C fiber afferent B) A- alpha afferent C) A-beta afferent D) A-delta afferent
D) A-delta afferent
What best defines negligent behavior when a person fails to perform a legal duty? A) Tort B) Fraud C) Act of Commission D) Act of Omission
D) Act of Omission
Current Procedural Terminology (CPT) codes were established by what organization? A) American Hospital Association (AHA) B) National Center for Health Statistics C) Health Care Finance Administration (HCFA) D) American Medical Association (AMA)
D) American Medical Association (AMA)
Chemotaxic factors A) Assist with the formation of bradykinin B) Help to promote lymphatic drainage C) Promote vasodilation D) Attract leukocytes
D) Attract leukocytes
Which statements are true regarding the afferents responsible for transmitting pain? (Select all that apply.) A) The fibers that transmit pain are A-beta and C fibers. B) Pain originating from C fibers is referred to as "fast" pain. C) The fibers are heavily myelinated. D) Both types of fibers respond to mechanical pressure and temperature extremes. E) A-delta fibers give ability to localize pain to a specific spot.
D) Both types of fibers respond to mechanical pressure and temperature extremes. E) A-delta fibers give ability to localize pain to a specific spot.
What type of tissue is the most abundant in the body? A) Epithelial B) Adipose C) Muscle D) Connective
D) Connective
What part of the FDA's minimal requirements for device labeling describes conditions where the risk of use outweighs the anticipated benefits? A) Precautions B) Warnings C) Boxed warning D) Contraindications
D) Contraindications
If an ultrasound wave strikes a surface at a 30° angle, less energy is transferred than if it had been perpendicular to the surface. This is based on the A) Inverse-square law B) Law of Grotthus-Draper C) Arndt-Schultz principle D) Cosine law
D) Cosine Law
Phagocytosis describes the: A) Movement of leukocytes out of blood vessels during the inflammatory response. B) Creation of ATP from aerobic metabolism. C) Accumulation of fluid at an injury site. D) Engulfment and digestion of foreign material or organisms by leukocytes.
D) Engulfment and digestion of foreign material or organisms by leukocytes.
Which of the following cleans up most of the tissue debris during the inflammatory reaction? A) Neutrophils B) Fibrin C) Fibroblasts D) Macrophage
D) Macrophage
Which of the following statements regarding macrophages is true? A) Macrophages are smaller and more numerous than neutrophils. B) Macrophages mature from undifferentiated satellite cells. C) Macrophages attract neutrophils into an area of tissue damage. D) Macrophages release growth factors, which in turn stimulate fibroblast activity.
D) Macrophages release growth factors, which in turn stimulate fibroblast activity.
An often neglected part of modality application is: A) Positioning the patient in a manner that will be comfortable, yet allow accessibility to the modality B) Setting up the equipment and checking equipment operation C) Removing bandages and braces during therapy D) Properly recording the specifics of treatment, including patient responses and instructions to the patient
D) Properly recording the specifics of treatment, including patient responses and instructions to the patient
Which of the following dimensions of pain perception localize the source and type of pain? A) Cognitive-evaluative B) Effective-terminal C) Affective-motivational D) Sensory-discriminative
D) Sensory-discriminative
Prostaglandins are formed when enzymes such as cyclooxygenase act on which of the following? A) bradykinin B) dopamine C) phospholipase D) arachidonic acid
D) arachidonic acid
Trauma to the body A) indirectly results in secondary injury B) directly causes secondary injury C) directly causes primary and secondary injury D) directly causes primary injury and indirectly results in secondary injury E) directly causes primary injury
D) directly causes primary injury and indirectly results in secondary injury
A clot is formed by __________ and platelets. A) fibroblasts B) collagen C) protocollagen D) fibrin
D) fibrin
All of the following are accurate statements about documenting patient progress EXCEPT A) it can facilitate communication between the patient and clinician B) it can be used as evidence in defense against a charge of negligence C) it may inform which interventions are most beneficial for patients D) it is mainly needed for clinicians who do not remember treatments provided to patients
D) it is mainly needed for clinicians who do not remember treatments provided to patients
All of the following pertain to C fibers EXCEPT A) unmyelinated B) require greater stimulation to elicit a response C) slowest sensory nerve fibers D) smallest efferent pain fibers
D) smallest efferent pain fibers
What is the purpose or objective(s) of immediate vasoconstriction following soft tissue damage? A) to promote the invasion of neutrophils into the damaged tissue B) to increase the permeability of involved capillary membrane C) to increase hemophilia D) to minimize the loss of red blood cells
D) to minimize the loss of red blood cells
Hypoxia occurs when a cell is deprived of ____________________.
Oxygen
The cardinal signs of inflammation are redness, heat, swelling, ________________, and loss of function.
Pain
At the time an injury occurs, there is a brief period of vasoconstriction followed by vasodilation. True False
True
During the fibroplastic repair phase there is a growth of endothelial capillary buds in response to a lack of oxygen. True False
True
Healing characteristics differ based on the severity of injury, type of tissue involved, and the amount of tissue affected. True False
True
Persistent pain can lead to withdrawal and depression, which relate to the affective-motivational aspect of pain. True False
True
Regulation of who can apply a modality and the setting in which the treatment can be rendered is NOT identical in all state practice acts. True False
True
The period of fibrous scar formation is known as fibroplasia. True False
True
When selecting and administering a treatment, the patient should be provided with reasonable alternatives to the proposed treatment and rehabilitation plan. True False
True
