240 FINAL EXAM

T/F In the blood supply to the brain, the Circle of Willis connects the anterior and posterior systems at the base of the brain to assure adequate circulation

True

t/f Both MS and GB are diseases of neuronal demyelination. However, there is better progress with MS ebcause it is occurring int he peripheral nervous system neurons.

false. GB is better recovery

T/F Shoulder subluxation can occur in patients diagnosed with CVA with hypertonia

false. Hypotonia

T/F With a child with osteogenesis imperfecta it is important to perform passive rotation exercises

false. Perform active rotation

T/F The difference between hold relax and contract-relax is the contract-relax you do not allow the rotational component

false. You do allow rotation

T/F Vision is lost only one eye with the condition of homonymous hemianopsia

false. both eyes

T/F A score of 4 on the modified Ashworth scale for spasticity would mean no excess tone noted

false. it means excess rigidity is present

T/F When working with a patient with increased tone, the PTA tries some PNF techniques to try to decrease the tone and increase the ROM. The best technique for the PTA to use would be rhythmic stabilization

false. it would be rhythmic rotation

T/F A child with arthrogryposis multiplex congenita has progressive joint contractions

false. non progressive

A PNF technique that you could use to give Bubba stability in long-sitting is a. Rhythmic Rotation b. Contract Relax c. Timing for Emphasis d. Rhythmic Stabilization

d. Rhythmic Stabilization

Assuming the ATNR is present, what position would you place a patient's head to elicit weight-bearing through the left upper extremity when sitting? a. Cervical flexion b. Midline neutral c. Rotation to Right d. Rotation to Left

d. Rotation to the left

a spinal cord lesion a or below ___ can classify a person as a paraplegic a. C5 b. C6 c. C7 d. T1

d. T1

Examples of approximation incorporated into developmental activities include all of the following except a. Rocking on hands and knees b. Bouncing while sitting on a ball c. Manual compression at the shoulder through the extended weight-bearing arm d. Throwing and catching a balloon

d. Throwing and catching a balloon

A transfemoral amputee is circumducting the prosthetic leg during gait. what might be the problem? a. prosthesis too long b. lateral wall too high c. patient is afraid to bend the knee d. a and c

d. a and c

T/F A child with Prader-Willi syndrome is obsessed with food

true

sitting, no support

6-8 months

T/F A symes amputaiton usually makes it easier for a prosthetist to fabricate a prosthesis

F. more difficult

t/f the most common complatin of patients with MS is severe thrist

False it is headache

At this point, Charles still has great difficulty producing muscle contractions necessary to perform rolling to his right from a supine position. Describe the Brunnstrom Rolling technique that will help teach Charles to gain independence for him in rolling to the right.

PNF patterns Associated reaction RI UE clasped and LE in hooklying

For strengthening the above muscle group, describe how to perform one (1) PTA 230 exercise (isotonic exercise) and how to perform one (1) PTA 240 technique (PNF) that could be used to best benefit for this patient.

PTA 230-Isotonic, elbow extensions with Theraband /AAROM tricep dips PTA 240-slow reversal hold in D1-D2 patterns to increase elbow extensor strength.

"Pusher" syndrome

R CVA with L hemiplegia, increase weight bearing on L with sitting

Transmetatarsal

middle metatarsal shafts

T/F Athetosis seen in CP clients is notably caused by lack of coordination fo agonist and antagonists

true

T/F Cerebellar functions are monitored and modified by the basal ganglia

true

T/F the FUnctional Reach Test is designed to test a patient's LOS

true

T/F the Tinetti Balance Test with a socre fo >24 out of 28 would indicate a low rist of falls

true

T/f Variation in timing and random application fo sensory stimuli prevents guessing by patient

true

List 5 Facilitation techniques

1. Vibration 2. Quick tapping 3. Quick icing 4. Stroking 5. Limb approximation (co-contraction)

List 3 main components of a neuron

1. cell body 2. dendrites 3. axon

cruising

10-12 months

rolling prone to supine

3-4 months

creeping reciprocally 4 pt.

6-8 months

Residual limb wrapping must be smooth, wrinkle free, emphasize angular turns, and provide pressure __ and prevent __. a. distal to proximal, "dog ears" b. proximally, infection c. distally, infection d. proximal to distal, "dog ears"

A. Distal to proximal, Dog ears

If a right transfemoral amputee patient displays a Trendelenburg gait by swinging the left LE in circumduction and lateral side bending to the right, what might be wrong. A. weak glute med and min and med on right b. medial bring of the prosthesis too high c. lateral brim of the prosthesis too high d. prosthesis is too short

A. weak glute med and min and med on right

a patient with a right transfemoral amputation has just been fitted with his final prosthesis. It is observed that he demonstrates a significant lateral bending to the right on stance. Choose the selection with the 2 prosthetic causes for the gait difficulty. A. Low medial wall, improper lateral wall B. High medial wall, improper lateral wall C. Low medial wall, socket set in abduction D. Improper lateral wall, socket set in adduction.

B. High medial wall, improper lateral wall

Transtibial

BKA (below knee amputee)

3 components of prosthetic endoskeleton are: Pylon, residual limb shrinker, SACH/flex foot b. cushioned skin colored padding, SACH.flex foot, pylon C. SACH or flex foot, pylon, suspension socket D. cushioned skin colored padding, suspension socket, pylon

C. SACH or flex foot, pylon, suspension socket

at the ___ spinal cord level, a quadriplegic patient should be independent in manual W/C locomotion with rim pegs for level surfaces and moderate distances. a. C3 b. C4 c. C5 d. C6

D. C6

Why are individuals who sustain a brain stem injury likely to be ventilator dependent?

The brain stem consists of the medulla/pons that have control in respiration and motor respiration. If it is injured they will not be able to breathe independently.

A patient with a recent right transfemoral has just been fitted with his final prosthesis. It is observed that he demonstrates a significant lateral bending to the right on stance. You have completed manual muscle testing for this patient for all hip motions and notice that there is significant loss in strength in the muscle group that results in this gait pattern. The muscle group is a. hip extensors B. hip flexors C. hip adductors D. Hip abductors

D. Hip abductors

a patient with a diagnosis of CVA presents with significant balance and coordination deficits. The patient has good upper and lower extremity strength, however ambulates with an ataxic gait pattern. The area of brain affected bu the CVA is the: a. cerebellum b, Cerebrum - left hemisphere c. frontal lobe d. Broca's Area

a. cerebellum

Shrinkers are used to a. control edema, shape limb, provide proprioceptive feedback b. Control phantom pain, prevent skin abrasions c. prevent dog ears and stop infection Decrease swelling ad control phantom pain

a. control edema, shape limb, provide proprioceptive feedback

Which of the following measures is identified as a contraindication in working with a paitent with MS? a. exercising to fatigue b. lowering the body temp before exercise c. aerobic exercise d. resistance training

a. exercising to fatigue

The Gower maneuver is a technique used to a. get up from the floor b. sit down c. roll prone to supine and back d. get into hands and knees position

a. get up from the floor

which of the following examples indicate that you have a child with developemtal delays? a. special positional seating b. difficulty with suck and swallow c. reflex dominance d. all of the ablvoe

d. all of the ablove

Primitive reflexes are integrated as a child develops. Integration of these reflexes mean a. The reflexes are absent for the remaining life span of the child b. The reflexes are absent until adolescence c. The reflexes are less dominating in response and become voluntary movement d. The reflexes are more dominating in response and become voluntary movement

c. The reflexes are less dominating in response and become voluntary movement

Two muscle groups and their respective actions that are involved during rolling to the right from the supine position are a. Trunk flexors, neck extensors b. UE flexors, Trunk extensors c. Trunk flexors, upper extremity flexors d. Neck extensors, Trunk extensors

c. Trunk flexors, upper extremity flexors

rigid, limited movement patterns

spastic

A PTA treats a patient s/p R CVA which resultant left hemi. A note left by the primary therapist indicates that the pt exhibits "pusher syndrome." When examining the pt's sitting posture which of the following findings would be most likely? a. increased lean to the left with increased weight bearing on the left buttock b. increased lean to the right with increased weight bearing on the right buttock c. increased forward lean with increased weight bearing on the right buttock d. increased forward lean with increased weight bearing on the left buttock

a. increased lean to the left with increased weight bearing on the left buttock

children with decreased balance or postural control will compensate by a. not walking b. Leaning to the weak side when walking c. Use a wide based gait d. Use a narrow based gait

c. Use a wide based gait

You are working on LAQ exercises and notice that you patient can not extend his knee fully actively or passively, what does this mean? a. his knee extensors (quads) are weak b. his knee flexors (hamstrings) are tight c. His knee extensors (quads) are tight d. His knee flexors (hamstrings) are weak

b. his knee flexors (hamstrings) are tight

The term used most frequently for the posture shown in this figure is: a. sit back from kneeling b. short sitting c. W sitting d. side sitting

c. W sitting

Orthostatic hypostension can be managed with ___ during upright positioning for patients with an acute SCI. a. max assist of 1 b. diuretic medications c. abdominal wraps d. diaphragmatic breathing

c. abdominal wraps

Define and Describe what a VOR is.

Vestibular Ocular Reflex. The eye's ability to remain on an object even when the body is moving.

In the cross section of the spinal cord the anterior/ventral regions contain a. Motor information b. Sensory information c. Spinal Muscles d. Cranial nerves

a. Motor Information

jerky

ataxia

wormlike

athetosis

Chopart

cuboid, cuneiform level

A diagnosis appropriate for the use of Rhythmic Rotation would be a. Flaccidity b. Sprain c. Osteoporosis d. spasticity

d. spasticity

prone head control

0-3 months

List one gross motor development skill for the following ages: 0-3/3-6/6-8/9-12

0-3: head control: prone 3 months 3-6: sitting with support, logrolling 6-8: segmental rolling 9-12: cruising

Transfemoral

AKA (above knee amputee)

Thalamic pain syndrome

Burning pain and sensory perseveration

tPA

Drug given to minimize damage of CVA

Vertebrobasilar artery

Infarct is usually fatal, if not severe causes double vision, vertigo

Hypothalamic function

Light stimulus on palm of hand elicits hyperextension of fingers

T/F Infants develop cephalon to caudal and flexion first

True

T/F Learned skills are integrated in the cortex region

True

T/F The two types of CVAs that account for approximately 90% of all CVAs are ischemic CVAs and hemorrhagic CVAs

True

a patient with a spinal cord injury works on self range of motion activities in sitting. Suddenly, the patient begins to demonstrate signs and symtoms of autonomic dysreflexia. The most appropriate PTA action is to: a. keep the patient sitting, check for kink in the catheter, take blood pressure b. lie the patient flat, monitor blood pressure, check bowel and bladder or impairment c. lie the patient flat, monitor BP, and give the patient fluids d. keep the patient sitting, check BP, and give the patient fluids

a. keep the patient sitting, check for kink in the catheter, take blood pressure

you have a 58 yo female transtibial patient with a new prosthesis. she is observed to have excessive knee flexion in early stance. Choose the selection that could be an amputee cause. a. knee flexion contracture b. strong knee extensors c. prosthetic foot placed in plantar flexion d. socket set in flexion

a. knee flexion contracture

You have used each of these sitting postures with your student in the classroom today. What do you call each posture when writing your progress note?

a. long sitting b. ring sitting c. tailor sitting

the fragile x syndrome is characterized by: a. mental retardation, unusual faces, poor coordination and low muscle tone b. normal intelligence, unusual faces, poor coordination and increased muscle tone c. brittle bones with frequent fractures d. none of the above

a. mental retardation, unusual faces, poor coordination and low muscle tone

What should be done immediately if a patient lying in bed with a SCI displays the abnormal reflex in question 23? a. lay the patient down immediately and check for decubiti, kinked catheter b. lay the patient down immediately, call for assistance, take vital signs c. check for kinked catheter or other noxious stimulus, sit patient up immediately, call for asistance, take vital signs d. check for kinked catheter, decubiti, and bowel impaction

c. check for kinked catheter or other noxious stimulus, sit patient up immediately, call for asistance, take vital signs

The main cause for amputations is: a. congenital deformities b. trauma/accidents c. diabetes/PVD d. Cancer

c. diabetes/PVD

for a child with atheotoid or ataxic CP, which of the following iterventions will most effectively addresst he goal fo maintaininig a stable posture against gravity? a. sitting ona stool and beding the trunk from side to side b. practicin sit to stand transfers from a child-size wooden chair c. ascending and descending a set of stairs using the handrails d. maintaining tall kneeling while tossing bean bags into a basket

d. maintaining tall kneeling while tossing bean bags into a basket

Caution should be used during mobility, gait and strengthening excercises with a patient diagnosed wiht acute GB because: a. the patient may experience severe vertigo symptoms b. nstagmus may become so severe,t he patient my fall c. the patient may experience severe hypertension d. neural pathways may fatigue and breakdown

d. neural pathways may fatigue and breakdown

A PTA is working with a patient who has parkinson's Disease/ THe assistant should expect the patient to be taking L-Dopa ro Sinemet, which affect: a. alpha motor neuron excitability b. transmission fo impulses within the spinal cord c. synaptic transmission at the neuromuscular synapse d. neurochemical imbalances in the basal ganglia

d. neurochemical imbalances in the basal ganglia

Dysarthria

difficult articulating words

t.f the 3 hallmarks of guillain-barre are ascending weakness, areflexia, and spasticity

false it is MS

t/f a higher sore on teh Berg Balance Scale indicates a higher risk for falls

false lower risk for falls

You have a new Home Health patient who has just come home from the sub acute unit at the local hospital. He is 78 years old, status post MVA on Nov. 7th. He is now in a Halo jacket for a C7 incomplete SCI injury. He is ten days post trauma and was limited in his hospital rehab experience due to pulmonary atelectasis (lung collapse) from rib fractures suffered in the MVA. His frail spouse also sustained a lumbar sprain in the MVA. Identify the KIND of wheelchair transfer the therapist most likely instruct his spouse and explain the rationale for this transfer.

slide board transfer.

Identify 2 muscle groups that a T1 paraplegia patient would have that a C8 SCI patient would not have as a result of the SCI

1. Abdominals T9-T11 2. Finger intrinsics-flexion and abduction, pec major sternal portion

Your patient, Tina, post-CVA, falls to the left and looks to the right when placed in sitting. List and describe three (3) interventions that can be done during PT to increase Tina's sitting skills while on the edge of the bed.

1. Approximation 2. Weight bearing on L UE 3. AI, RS

List three (3) contractors that are often seen with (transfemoral) amputations. Be joint specific.

1. Hip flexion 2. Hip ER 3. Hip Abduction

List 5 Inhibition techniques

1. Rhythmic Rotation 2. WB 3. Prolonged warmth/ice 4. Prolonged stretching static 5. Put pillows under knees 6. Pressure on insertion of tendon of a spastic muscle

List the 5 characteristics that identify a development theory as being life span approach.

1. lifelong 2. multidimensional 3. plastic & flexible 4. contextual 5. embedded in history

Name the two greatest risk factors for cerebral palsy

1. low birth weight under 3.3 lbs 2. Pre-mature, early births, hemorrhage/damage/virus

A 22 year old female with GB is a patient assigned for an afternoon PT treatment in her room. The patient was diagnosed 5 weeks ago and her respiratory and autonomic functions have stabilized. The STG for the patient is "increase tolerance in upright position". Describe your technique(s) to work on this goal.

1. slowly raise head of the bed 2. transfer to w/c or chair with reclined/elevated legs 3. slowly lower the legs on the chair 4. transfer to P.T. department to start on tilt table in supine. Slowly increase the angle into standing.

walking with or without support

12-15 months

primitive rolling supine to prone

4-6 months

sitting immature C curve

5-6 months

Long term ventilator assist is necessary with ___ SCI patients a. C1-C4 b. C5-C6 C. C7-T1 d. T2-T4

A. C1-C4

List the three (3) Motor Learning Phases and describe each phase Cognitive Associative Autonomous

Cognitive-task is evaluated and thought through before executing-conditions need to be considered Associative-task is understood and individual is determining how it will be done. Autonomous-

List the three (3) Motor Learning Phases and describe each phase

Cognitive: The ability to understand and comprehend. Understand verbal cues, The initial start of a treatment/teaching a task Associative: The learning phase. Motor action is responded with failure or success, and ability to change or improve. Sensory feedback. Closed loop Autonomous: Automatic phase, the ability is learned and there is no time for feedback until after the task. It is difficult to correct errors. This phase is open looped.

Parkinson's patients have symptoms that include which of the following: a. Bradykinesia b. rigidity c. tremor d. all of the above

D. all of the above

Describe the Functional Reach Test and what it assesses.

Dynamic balance test to assess patient's limits of stability. (BOS) Reach forward without losing balance.

t.f orientation x3 means orientation to name, gender, and place.

False it is name, date and place

t/f When you are performing sensory assessments, you want the patient's eyes open sot he patient can trust you

False you want them closed, and so they can perform the assessment correctly

T/F Human motor development matures caudal to cephalon, proximal to distal, flexion to extension and stability to mobility

False.

T/F the higer up the CNS, the more primitive the reflexes

False. The less primitive the reflexes

T/F All children develop motor milestones at the same age

False

Identify 2 contractors that are common in transtibial amputation and DESCRIBE how to perform a PNF stretching technique to decrease ONE of the contractures.

Hip flexion-Quadriceps: Hold-relax (fatigue the muscle then stretch) Knee flexion-Hamstrings: Reciprocal Inhibition

Dysphagia

Not able to swallow

Using Brunnstrom's Associated Reaction Technique of the LEs, describe the application of this technique to increase Charles' left hip flexion.

Resist or have Charles activate R hip extension

Describe the flexor synergy of the UE and the extensor synergy of the LE with the joint motion (flex, ext, abd, etc) that is affected at the listed joints. UE flexor synergy Scapula Shoulder Elbow Forearm LE extensor synergy Hip Knee Ankle Toes

Scapula: depressed/retracted Shoulder: adducted & IR Elbow: flexed Forearm: pronation/midline Hip: adducted & IR Knee: extended Ankle: inverted/plantar flexed Toes: flexed

Charles had a Right CVA with Left hemiparesis. He has progressed through Brunnstrom's Stage I and is currently at Stage II in the left upper extremity and Stage III in the left lower extremity. Describe Stage I, Stage II and Stage III as classified by Brunnstrom.

Stage I: Flaccidity-no voluntary movement Stage II: Spasticity starts-synergy begins Stage III: Spasticity peaks-limb is in full synergy/movement of spasticity

t/f Schwann cells proliferate to cause re-myelination of nerve fibers thus improving nerve impulses in the Guillain-Barre' paitient

T

t/fWith MS, plaques form on demyelinated areas fo nerve fibers thus interfering with normal nerve impulses

T

TIA

Temporary interruption of blood flow, signs disappear within 24 hours

A 2 year old child has a tonic labyrinthine reflex still present. The parents want their child to roll from supine to prone and ask for your help. Explain why the child cannot roll from this position.

The child can not roll because when the child is supine the body's (TLR) reflex is fixed in extension when the child is on his back. Because the child is fixed in extension, the child cannot flex his trunk/neck to help facilitate the roll. Place child in sidelying to break up the reflex.

To assist in his transfer ability, name a specific muscle group that should be strengthened for this patient and why?

Triceps (elbow extenders) in order to push off his wheelchair for improved safe transfers.

T/F According to the text, many individuals who survive a CVA have permanent neurological disabilities that prevent the return to previous functional levels. The most significant neurological recovery occurs within the first 3 months after the CVA.

True

T/F Bridging with a neuro patient is used to increase hip stabilizers and promote weight bearing through the feet and ankles.

True

Amy is treating a patient with a lower motor neuron condition and Cindy is treating an upper motor neuron patient. Describe the difference between upper motor neuron and lower motor neuron, including location, tonal differences and reflexes.

Upper Motor Neuron-patients are likely to be high tone, spastic and have a positive Babinski reflex when lesions are present located in brain and spinal cord.? Lower Motor Neuron-

Amy is treating a patient with a lower motor neuron condition and Cindy is treating an upper motor neuron patient. Describe the difference between upper motor neuron and lower motor neuron, including location, tonal differences and reflexes.

Upper Motor Neuron: Brain & Spinal Cord, increase DTR, cortex to Anterior horn cell Lower Motor Neuron: Peripheral, Anterior horn cell to PNS, decreased reflexes

A patient with a diagnosis of CVA presents with significant balance and coordination deficits. The patient has good upper and lower extremity strength, however ambulates with an ataxic gait pattern. The area fo the brain affected is the a. Cerebellum b. Cerebrum-left hemisphere c. Frontal lobe d. Broca's area

a. Cerebellum

Choose the factor that does not affect or exacerbate Multiple Sclerosis: a. Dosing with VItamin E b. Stress c. Temperature Extremes d. Sleep Deprivation

a. Dosing with Vitamin E

Which type or types of muscle tone may be present in a child with Myelomeningocele? a. Flaccidity, spasticity, or a combination of flaccidity and spasticity b. Spasticity c. Flaccidity d. Combination of flaccidity and spasticity

a. Flaccidity, spasticity, or a combination of flaccidity and spasticity

Patients with Parkinson's Disorder have a decrease in rotation and extension. Describe one exercise to increase trunk rotation and one developmental position to increase cervical extension a. Exercise to increase trunk rotation b. Developmental position to increase cervical extension

a. Lower trunk rotation-hooklying with trunk rotation side to side/rhythmic rotation of trunk with therapy ball b. prone lying on elbows

White matter in the brain consists of a. Myelinated axons from many neurons b. Cell bodies and dendrites and/or unmyelinated axons c. A and B

a. Myelinated axons from many neurons

When a LE amputation is performed, the nerves are stretched out, cut, and allowed to retract back into the tissue and it creates a bundle or ganglion this is referred to as: a. Neuroma b. Myoplasty c. phantom pain d. proximal to distal

a. Neuroma

Information transmitted in the dorsal columns of the afferent nervous system includes a. Proprioception, vibration, two-point discrimination, light touch b. Proprioception, pain, two-point discrimination, temperature c. Proprioception, vibration, skilled motor movement, light touch d. Proprioception, muscle tone, two-point discrimination, light touch

a. Proprioception, vibration, two-point discrimination, light touch

The physical therapist has completed the initial evaluation of a neurologically involved patient nad developed the plan of care. The therapist has assigned the patient to the physical therapist assistant to care to the plan of care. The role of the assistant in the rehab of this neurologically involved patient is a. Provide therapeutic interventions and provide family education b. Create the discharge plan c Reexamine the patient for revision of the plan of care d. Interpret the referral

a. Provide therapeutic interventions and provide family education

The two (2) most functional positions to move from are a. Sitting and standing b. Supine and sitting c. Prone and standing d. Supine and prone

a. Sitting and standing

A Babinski reflex is present if there is a lesion to the a. UMN b. LMN c. Vertebral artery d. Cranial nerve

a. UMN

A child with Cri-du-Chat syndrome has: a. a cat-like cry, microcephaly and mental retardation b. a cat-like cry, hydrocephaly and mental retardation c. a cat-like cry, low muscle tone and normal intelligence d. a cat-like cry, hypertonia and normal intelligence

a. a cat-like cry, microcephaly and mental retardation

A PTA prepares to instruct a patient rehabing form a CVA in bed mobility activities. The most important initial step when designing an instructional program is to a. assess the patient's cognitive status b utilize a variety of teaching methods. c. avoid using medical jargon d. speak loudly and directly to the patient

a. assess the patient's cognifitve status

A patient with MS presents with increased lower extremity extensor tone, strength loss in lower extremities (all motions 3/5 MMT) and postural instability in sitting. List/describe one PTA 240 exercise or intervention that can be done for each of the impairments.

a. increased LE extensor tone: PNF D1 & D2, AROM/AAROM Rhythmic Rotation of LEs, Put pillow under legs/knees. If she uses pillows after cued, knee flexion contracture b. Postural instability in sitting: (AI) Alternating Isometrics

The results of surgical lengthening of the heel cord are a. increased ankle dorsiflexion and weaker plantar flexors b. inceased ankle dorsiflexion and stronger plantar flexors c. increased ankle plantar flexion and weaker dorsiflexors d. increased ankle plantar flexion and stronger dorsiflexors

a. increased ankle dorsiflexion and weaker plantar flexors

Two patients have been admitted to the hospital and are scheduled for PT. Patient A's evaluation states the patient is showing poor judgment, unrealistic expectations, denial fo disability or deficits, disturbances in body image and irritability. He is emotionally labile. Patient B's eval states that the patient has difficulty to plan motor tasks (apraxia), difficulty in initiating, sequencing and processing tasks. He has difficulty producing speech and he is anxious. Based on these clinical deficits it can be determined that patient A has a ___ injury and patient B has a ____ injury. a. Right CVA, left CVA b. Right CVA, basal nuclei c. Basal Nuclei, left CVA d. Left CVA, right CVA

a. right CVA, left CVA

____ Testing is an assessment to determine if spinal shock is resolving and a good prognosis for decubitus prevention a. Sacral sparing b. gag reflex c. VOR d. Dysphagia

a. sacral sparing

The 2 most functional postitions to move from are a. sitting and standing b. supine and sitting c. prone and standing d. supine and prone

a. sitting and standing

Which one of the following correctly describes the PNF techniques and what they are used for? a. slow reversal and slow reversal hold for strengthening and coordination; alternating isometrics and rhythmic stabilization for core stability; contract relax and hold relax for stretching; rhythmic rotation and rhythmic initiation for initiating movement b. slow reversal and slow reversal hold for initiation movement; alternation isometrics and rhythmic stabilization for strengthening and coordination; contract relax and hold relax for core stability; rhythmic rotation and rhythmic initiation for stretching c. slow reversal and slow reversal hold for strength and coordination; alternating isometrics and rhythmic stabilization of core stability; contract relax and hold relax for initiating movement; rhythmic rotation and rhythmic initiation for stretching slow reversal and slow reversal hold for strengthening and coordination

a. slow reversal and slow reversal hold for strengthening and coordination; alternating isometrics and rhythmic stabilization for core stability; contract relax and hold relax for stretching; rhythmic rotation and rhythmic initiation for initiating movement

The plan of care for a patient recently returned home with right hemi indicates the patient demonstrates good recovery. Spasticity is in decline, there is no indication fo synergistic movement and the patient is ambulatory with a small based quad cane. The MOST appropriate activity for a patient at this stage of recovery is a. standing, marching with one hand on a surface for balance b. supine, heel slides c. sitting, marching d. standing weight shifting

a. standing, marching with one hand on a surface for balance

A PTA preparing to treat a patient who was recetly admitted to the hospital with a diagnosis of Guillain-Barre' Syndrome should expect the patient to present wiht: a. symmetrical distribution fo extremity weakness and hyporeflexia b. asymmetrical weakness with hyperreflexia c. unilateral facial paralysis d. sensory loss with minor loss of motor function.

a. symmetrical distribution fo extremity weakness and hyporeflexia

A patient is seen in physical therapy with a referral for an initial exam and intervention two days after having a left CVA with right hemi. The IE reveals flaccidity fo the right UE and decreased tone with min movement of the right LE. Which of the following would be appropriate initially for this patient? a. attempts to elicit functional movement of the right extremities b. putting a splint/sling on the right UE to prevent shoulder subluxation c. gait training with a rolling walker d. fitting the patient with an AFO

b. putting a splint/sling on the right UE to prevent shoulder subluxation

Upper motor neurons are located in a. Peripheral Nerves b. Brain and spinal cord c. A and B

b. Brain and spinal cord

A patient is positioned in prone on elbows to work on weight shifting activities, what stage of control is being demonstrated? a. Skill b. controlled Mobility c. Stability d. Mobility

b. Controlled Mobility

An adult with a present Babinski reflex is characterized by: a. Flexion of the great toe b. Extension of the great toe c. Abduction of the great toe d. Adduction of the great toe

b. Extension of the great toe

A patient with a lack of ability to produce speech with motor control may be due to an injury to the a. Parietal lobe b. Frontal lobe c. Temporal lobe d. Occipital lobe

b. Frontal lobe

Hydromyelia can cause rapid progression of scoliosis. If this occurs, the physical therapist assistant should a. Discuss the situation with the parents b. Inform the supervising physical therapist c. contact the nursing staff d. Inform the physician immediately

b. Inform the supervising physical therapist

The spinal cord ends at the ___ segment and becomes the Cauda Equina. a. T9-T12 b. L1-L2 c. L3-L4 d. L5-S1

b. L1-L2

The American Spincal Injury Association's standard for normal muscle function is defined as the lowest key muscle with a manual muscle testing grade of: a. MMT 2/5 b. MMT 3/5 c. MMT 4/5 d. MMT 5/5

b. MMT 3/5

Majority of cerebral bleeds occur in the a. Anterior cerebral artery b. Middle cerebral artery c. Posterior cerebral artery d. Coronary artery

b. Middle cerebral artery

A relatively permanent change in behavior that is the result of practice or experience is called a. Motor Skill b. Motor Learning c. Motor Behavior d. Feedback Loop

b. Motor Learning

Injury to the corticospinal tracts affects: a. Posture and tone b. Motor movements c. cranial nerves d. Fine sensation

b. Motor movements

The sympathetic division of the nervous system regulates a. Your body response to relaxation b. Raises heart rate and blood pressure in response to stress c. Dilates peripheral blood vessels and redistributes blood to organs d. Bradychardia

b. Raises heart rate and blood pressure in response to stress

Children with low muscle tone and joint hyper mobility need _________ while children with high muscle tone and decreased joint range of motion need _____________. a. Stability, skill b. Stability, mobility c. Mobility, stability d. Mobility, skill

b. Stability, mobility

Side sitting is a difficult posture because a. Weight bearing is not equal b. Trunk rotation is required c. Center of gravity is outside the base of support d. The head is hard to hold in this position

b. Trunk rotation is required

The above signs and symptoms listed in question 33 above are a result of a lesion ro damage to a. LMN b. UMN c. Spinothalamic tracts d. Protopathic tracts

b. UMN

Parkinson's patients have gait difficulties which may result in them freezing as they walk which is called: a. bradykinesia b. akinesia c. hypokinesia d. microphagia

b. akinesia

What two PNF techniques are mostly applied to increase core stability? a. contract relax and hold relax b. alternating isometrics and rhythmic stabilization c. rhythmic rotation and rhythmic initiation d. slow reversal and slow reversal hold

b. alternating isometrics and rhythmic stabilization

Pseudohypertrophy is an increase in muscle size caused by a. increased muscle mass b. decreased muscle mass and increased fat and connective tissue in the muscle c. edema in the muscles d. hypertonicity in the muscles

b. decreased muscle mass and increased fat and connective tissue in the muscle

Since decubiti formation can delay rehabilitation, how often should a weight shift be performed in a wheelchair by a patient with a SCI? a. every 5-10 mins b. every 15-30 mins c. every 1-2 hours d. every 2-3 hours

b. every 15-30 mins

In the above question, regarding the reflex, what will the patient complain to you as the PTA? a. extreme thirst b. extreme headache c. erector pilae d. Extreme HBP

b. extreme headache

A patient presents with a flexion synergy pattern and spastic hemiparesis on the let. the PTA has worked through the initial spasticity by performing rhythmic rotation and rhythmic initiation. What would be a good functional activity to work on? a. continue with passive ROM on the left until all traces of spasticity are gone. b. have the patient perform right UE exercises with the left UE placed in a weight bearing position with the shoulder ER and the wrist extended c. Perform functional activities and right UE exercises with he left UE in a sling d. Apply a slow stretch to the left shoulder extensors elbow extensors and wrist extensors

b. have the patient perform right UE excercises with the left UE placed in a weight bearing posititon with the shoulder ER and the wrist extended

A tonic labrythine reflex that persists or is exaggerated may interfere with developmental progression. In a 10 month old child which of the following problems would most likely be associated with a persistent tonic labrythine reflex in supine? a. inability to prop on extended arms in sitting b. inability to reach for objects suspended above the child who is lying on her back c. inability to roll from the stomach to back d. inability to pull to stand in the crib

b. inability to reach for objects suspended above the child who is lying on her back

A PTA notices in the patient chart thata patient had initial signs and symptoms of complete loss fo sensory and motor function below the level of the spinal cord lesion. Approximately 72 hours after the initial injury, the patient begins to report return of sensation and function in some areas below the level of the lesion. The PTA acknowledges that these signs and symptoms are the result of: a. autonomic dysreflexia b. incomplete spinal cord injury c. thethered spinal cord d. complete spinal cord injury

b. incomplete spinal cord injury

The PT intervention for children with CF is focused on reducing symptoms. what is the main PT intervention? a. avoid or aggressively treat respiratory infection b. instruct caregivers in postural drainage c. increase white blood cell count d. maintain adequate hydration

b. instruct caregivers in postural drainage

Proprioceptive neuromuscular facilitation uses diagonal patterns to restore functional movement. which of the following si the reason for the use of diagonal patterns? a. proprioceptive neuromuscular facilitation facilitates mobility from distal to proximal b. most functional movements do not occur in cardinal planes c. diagonal patterns allow the patient to see the movement d. diagonal movements stimulate the joint receptors

b. most functional movements do not occur in cardinal planes

The PT evaluation identifies that a patient has scored low on the Berg Balance Test. the PTA understands tat this assessment best identifies the patient's ability to: a. hold a single-limb standing position without losing balance b. perform multiple daily activiites including turning, stepping up or down, and reaching c. reach forward without losing balance d. raise from a chair, walk and return to the chair and sit back down

b. perform multiple daily activities including turning, stepping up or down, and reaching

Rett syndrome is characterized by a. seen in girls only, mental retardation, low muscle tone and hypermobility b. seen in girls only, mental retardation, ataxia and growth retardation c. seen in boys only, mental retardation, spasticity and growth retardation d. seen in boys only, mental retardation increased appetite, low muscle tone

b. seen in girls only, mental retardation, ataxia and growth retardation

MS is a demyelinating progressive UMN disease that starts with visual deficits. Other clinical symptoms that are present with this disease are: a. falcidity, decreased DTRs b. spasticity, clonus, babinski c. falccidity, clonus, babinski d. spasticity, decreased DTRs

b. spasticity, clonus, babinski

What genetic disorder produces muscle weakness without cognitive impairment a. down syndrome b. spinal muscular atrophy c. muscular dystrophy d. fragile x syndrome

b. spinal muscular atrophy

Sensations from the dorsal column-medial leminiscal pathway include discrimination fo objects which is a. graphesthesia b. steriognosis c. bareognosis d. two point discrimination

b. steriognosis

A PTA is treating a transfemoral amputee. What 2 muscle groups will most liekly need to be stretched and what muscle groups with need to be strengthented? a. stretch hip extensors and adductors; strengthen flexors and abductors b. stretch hip flexors and abductors; stregthen extensors, adductors, and abductors c. stretch hip extensors and abductors; strengthen hip flexors and adductors d. stretch hip flexors and adductors; strengthen hip flexors and abductors

b. stretch hip flexors and abductors; stregthen extensors, adductors, and abductors

During the first 3 weeks fo gestation, oxygen is briefly iterrupted. After delivery, the infant is diagnosed with CP and the physical therapy staff is notified. The PTA is concerned because a. the PT should not be concerned with this infant b. the earlier the damage, the more severe the CP c. the infant will have difficulty with speech d. the infant will not be able to walk

b. the earlier the damage, the more severe the CP

The PTA reviews the patient chard and the PT's evaluation before working with the patient who has had a spinal cord injury. From the chart, the PTA learns that the patient has a C7 spinal cord injury. Which of the following statements is correct? a. this patient will require mechnical ventilation b. the patient will have the use of this triceps c. this patient will not be able to extend his elbows d. this patient will have complete use of this upper extremities

b. the patient will have the use of this triceps

a person has been diagnosed with central cord syndrome. Which one of the following would be expected to be true? a. This person would not have sensory on same half of body of motor movement on the other half. b. this person would not be able to use his hands, but might be able to walk c. this person would only have position sense and vibration sense D. this person would have both sensory and motor losses on the same side

b. this person would not be able to use his hands, but might be able to walk

Following a CVA, a patient with right hemiplegia is beginning ambulation using a large base quad cane after having trained in the parallel bars. the patient is having difficulty advancing the right lower extremity. The initial feedback the PTA should provide to the patient is: a. verbal cue to shift the weight to the left b. to physically assist the patient to shift the weight to the left c. to verbally instruct the patient to lift the right lower extremity d. to physically assist the patient to advance the right LE

b. to physically assist the patient to shift the weight to the left

A toy shopping cart is a good tool to use to encourage a. better balance b. walking c. play activities d. creative play

b. walking

A person must have an IQ of less than _____ in order to be diagnosed with mental retardation a. 55-60 b. 60-65 c. 70-75 d. 80-85

c. 70-75

You place a child who has a residual STNR in the quadruped position. When the child looks up to the ceiling the arms and legs will respond to cervical extension with a. Arms will flex and adduct, legs will extend and adduct b. Arms will extend and adduct, legs will flex and adduct c. Arms will extend and legs will flex d. Arms will flex and legs will extend

c. Arms will extend and legs will flex

a patient diagnosed with Guillain Barre Syndrome fifteen months ago continues to have complaints of paresthesia of both feet and "drop" feet during extended gait activities. The BEST intervention for this patient is: a. pulsed ultrasound at the L5-S1 dermatome b. NMES at the S1-S2 dermatome c. Bilateral AFOs d. NMES at the L4-S1 dermatome

c. Bilateral AFOs

The central nervous system (CNS) consists of a. Brain, spinal cord, peripheral nerves b. Brain, spinal cord, peripheral nerves c. Brain, cerebellum, brain stem d. Brain, cerebellum, cranial nerves

c. Brain, cerebellum, brain stem

Parkinson's patients have excessive tremors which is a result of damage to the a. Diencephalon b. Thalamus c. Substantia Nigra/Basal Ganglia d. Cerebellum

c. Substantia Nigra/Basal Ganglia

Dystonia, disordered tone, dysfunction of multi-joint movement patterns and ataxia are present in a. Anterior Spinothalamic Pain Syndrome b. Reticulospinal Tract Lesion c. Cerebellar Dysfunction d. Basal Ganglia Dysfunction

c. Cerebellar Dysfunction

The Gower maneuver is a technique seen in which genetic disorder a. Fragile X b. Rett syndrome c. Duchenne Muscular Dystrophy d. Down syndrome

c. Duchenne Muscular Dystrophy

Because family members of children with developmental delays tend to lead busy lifestyles, a physical therapist assistant should a. Limit the therapy sessions to once daily b. Ignore positioning and handling in the home therapy session c. Incorporate positioning and handling into the daily routine d. Realize that parents will do whatever is necessary to help the child

c. Incorporate positioning and handling into the daily routine

In the peripheral nervous system, the afferent system conveys a. Sensory and motor impulses to the CNS b. Sensory and Motor information from the CNS to a muscle c. Information from sensory receptors to the CNS d. Information from motor receptors to the CNS

c. Information from sensory receptors to the CNS

Progression of Motor control is: a. Skill, Mobility, Stability, Controlled Mobility b. Stability, Controlled Mobility, Skill, Mobility c. Mobility, Stability, Controlled Mobility, Skill d. Mobility, Stability, Skill, Controlled Mobility

c. Mobility, Stability, Controlled Mobility, Skill

An injury to the frontal lobe of the brain will affect a. Motor, mood, and auditory b. Motor, mood, and short term memory c. Motor, mood, and judgment

c. Motor, mood, and judgment

A PTA is positioning a patient in bed following treatment. The patient has spastic left hemiparesis. The PTA should position the left UE with the: a. scapula retracted, shoulder adducted, IR, and elbow flexed b. Scap retracted, shoulder abducted, ER and elbow flexed c. Scap protracted, shoulder adducted, ER and elbow extended d. Scap protracted, shoulder adducted, IR and elbow extended

c. Scap protracted, shoulder adducted, ER and elbow extended

Parkinson's patients exhibit bradykinesia with rigidity. What does bradykinesia mean? a. difficulty initiating movement b. an increase in tone in the extremities c. Slowly initiates movement d. A decrease in muscle tone in the upper extremities only

c. Slowly initiates movement

A 55-year-old patient's family has noticed that their mother has not been able to remember tasks, has difficulty understanding any verbal instructions that they give her in her daily care. This sudden onset maybe due to a brain trauma when she fell and hit her head on the bathroom floor. The lobe that is responsible for these activities is: a. Parietal lobe b. Frontal lobe c. Temporal lobe d. Occipital lobe

c. Temporal lobe

In the above question, which of the following techniques would work best to increase the ROM of the knee into extension a. contract-relax b. rhythmic rotation c. hold relax d. slow reversal

c. hold relax

patient with right transtibial continues to complain of pain in the right great toe with is referred to a. neuroma b. myoplasty c. phantom pain d. phantom sensation

c. phantom pain

Ms. Jones, an individual with Parkinson's has been described as exhibiting bradykinesia with rigidity and maintains a flexed posture. Bradykinesia means: a. Difficulty initiating movement b. increase in tone in all extremities c. slowness of movement d. decrease in UE muscle tone only

c. slowness of movement

Parkinson's patients have excessive tremors which is a result of damage to the a. diencephalon b. thalamus c. substantia nigra/ basal ganglia d. pons

c. substantia nigra/ basal ganglia

The primary emphasis of PT intervention for childerent with CP is a. to identify the child's functional abilityeis and motor development b. to ensure that the child is able to perform activities of daily living and walk independently c. to foster motor development and to learn functional motor skills d. to develop and program the parents can incorporate into the daily routine

c. to foster motor development​ and to learn functional motor skills

Briefly explain the role of a neurotransmitter

chemicals that transmit information across the synapse

PNF technique that focuses on increasing strength, ROM, coordination, and smooth transitions and uses resistance through the movement is: a. Timing for emphasis b. rhythmic stabilization c. rhythmic initiation d. slow reversal

d slow reversal

Using rhythmic initiation to teach rolling from supine to prone, the initial command should be: a. "slowly roll over by yourself" b. "help me roll you over" c. "stop me from rolling you over" d. "don't help me, let me do it"

d. "don't help me, let me do it"

Musculoskeletal impairments often seen in Myelomeningocele or MMC are a. Club foot b. Spinal deformities c. Osteoporosis d. All of the above

d. All of the above

Neurological defects often seen in MMC are: a. Hydrocephalus b. CNS deterioration c. Arnold-Chiari Malformation d. All of the above

d. All of the above

An abnormal reflex with SCI resulting from any painful stimuli in the nervous system causing life threatening severe high blood pressure is called: a heterotropic ossificacans b. Autogenic inhibition c. Osteogenesis Imperfecta d. Autonomic dysreflexia

d. Autonomic dysreflexia

A patient diagnosed with an incomplete spinal cord lesion that presents with loss of motor function on the same side of the lesion and a loss of pain, temperature, and sensitivity on the opposite side of the lesion describes: a. Steinert's disease b. Central cord syndrome c. Anterior spinal artery syndrome d. Brown-Sequard's Syndrome

d. Brown-Sequard's Syndrome

A mother reports to the pediatrician that when she kisses her baby, she gets a salty taste. The pediatrician informs the mother that the child has a condition resulting from a defect on chromosome 7 involving the pancreas. The PTA recognizes this condition as: a. Duchenne Muscular dystrophy b. Rett Syndrome c. Osteogenesis imperfecta d. Cystic fibrosis

d. Cystic fibrosis

The text discusses 10 components fo PNF used to enhance motor learning. which of the following components stimulates pressure receptors and provides information to the patient about the desired direction of movement? a. Voice commands b. Resistance c. Joint facilitation d. Manual Contacts

d. Manual Contacts

Infants with Myelomeningocele demonstrate a. Sensory impairments b. Motor impairments c. Autonomic impairments d. Motor and sensory impairments

d. Motor and sensory impairments

Visual disturbances, bowel and baldder incontinency, ataxic gait, and scanning speech depict signs and symptoms of: a. Guillain-Barre Syndrome b. Parkinson's Disease c. Parkinson's Plus Syndrome d. Multiple Sclerosis

d. Multiple Sclerosis

Prone progression developmental sequence includes a. Sitting, prone on elbows, standing b. Crawling, cruising, walking c. Prone on elbows, cruising d. Pivot prone, prone on extended elbows

d. Pivot prone, prone on extended elbows

A 60 year old man gets up in the night to go to the bathroom and falls striking his chin on the bathtub. The force from this fall ruptures the anterior longitudinal ligament and compresses and ruptures the intervertebral disc. This patient is diagnosed with a spinal cord injury. Which of the following indicates the type of SCI this patient sustained? a. compression fracture injury b. cervical hyperflexion injury c. cervical flexion/rotatoin injury d. cervical hyperexteionsion injury

d. cervical hyperextension injury

The therapist has just started working with Bubba Smith, who is a C6 quadriplegic patient newly admitted in an acute rehab facility. He previously was a brick layer and concrete finisher. CHOOSE a functional mat activity that might be impaired because of the limitations found in the shoulders of the patient in the scenario a. short sitting at edge of bed b. long sitting supported c. combing hair or brushing teeth d. performing prone push ups

d. performing prone push ups

a patient with Parkinson's disease demonstrates the highly stereotypical gait pattern called the festinating gait pattern. which activity could present a danger if used by the PTA? a. standing, using a tilt table b. sidestepping and crossovers with minimal assistance c. gait training with a rolling walker and minimal asssitance d. slow, rhythmical walking on a treadmill

d. slow, rhythmical walking on a treadmill

When a transtibial amputee comes into the clinic, you notice that he has a knee flexion contracture, which means he ahs difficulty ____ his knee. You ask the PT if you can do some moist heat before stretching the patient. You will apply the hot pack to the ___ area. a. Bending; hamstrings/posterior knee b. bending; quads/anterior knee c. straigtening; quads/anterior knee d. straightening; hamstrings/posterior knee

d. straightening; hamstrings/posterior knee

You are performing some PNF techniques to a post-stroke patient who is starting to get stronger proximally. You have the patient performing D1 diagonals against resistance on his R UE and during one of the reps you have the patient resist an isometric contraction at the shoulder while you let the rest of the lower arm continue to move through the movement. The contraction of the shoulder flows over into the lower arm and you see more elbow flexion and wrist flexion than before. This is an example of: a. slow reversal b. alternating isometrics c. contract-relax d. timing for emphasis (irradiation)

d. timing for emphasis

In a child with spinal muscular atrophy, it is important to teach diaphragmatic breathing in a. supine b. sitting and standing c. standing and walking d. walking, standing, sitting, supine

d. walking, standing, sitting, supine

The patient has a diagnosis of a left CVA with right side hemiparesis. The patient cannot write his name and has a job as an artist for a large corporation. Using the disablement model identify the following (use arrows to connect the columns correctly). a. disease 1. CVA b. Impairment 2. Left side paralysis c. Functional limitation 3. unable to write or use left arm to paint d. disability 4. decreased strength and range of motion

disease-CVA impairment-left side paralysis functional limitation-decreased strength and range of motion disability-unable to write or use left arm to paint

In a spinal monosynaptic or stretch reflex, the stimulus is ______.

stretch

t/fGB develops from distal to proximal and then as a patient recovers they progress from proximal to distal

t

t/fMS tends to be more fo an UMN disease while GB tends to be more of a LMN disease ude to their typical signs and symptoms

t

Symes

talocrural disarticulation

Single transmission between one cell axon and another cell dendrite is located at ______ ______________ .

the synapse

T/F Timing for emphasis allows isometric hold at the strongest component of a movement to facilitate overflow to the weaker components

true

T/F an advantage of a rigid post ampuation dressing is to allow the patient to be immeiately weight bearing

true

T/F pathological reflexes can be seen as an evaluative or diagnostic sign

true

t/f LOS is the furthest distance in any direction a person can lean without altering the original base of support

true

t/f Loss of ability to have reciprocal arm swing while walking can be an early sign of rigidity in a person with Parkinson's Disease

true

t/f Visual distrubances seen in MS, such as diploplia, are due to plaque formations ont he optic tracts

true

t/fthe symptoms that are most frequently first signs fo MS are paresthesias and visual distrubances

true