Final Frontier - The Final Deck
_____: tachycardia, increased sweating, heat intolerance, increased appetite, dyspnea, weight loss, inability to gain weight
Hyperthyroidism
_____: low calcium and high phosphorus
Hypoparathyroidism
_____: responsible for regulation of the ANS (body temperature, appetite, sweating, thirst, sexual behavior, rage, fear, blood pressure, sleep_
Hypothalamus
What should you associate Hashimoto's disease with?
Hypothyroidism
_____: cold intolerance, excessive fatigue, headaches, weight gain, dry skin, peripheral edema, peripheral neuropathy, proximal weakness
Hypothyroidism
_____: pregnancy induced acute hypertension after the 20th week (5th month) of gestation
Preeclampsia
Anterior Apprehension Test AKA Crank Test
Pt lies supine, PT abducts arm to 90 and ER shoulder slowly (+) pt is apprehensive in this position and feels like dislocation is possible, indicates previous anterior dislocation of shoulder/anterior shoulder instability
COPD: _____ and _____ are increased
Residual volume Functional residual capcity
Maudsley's test
Resist extension of the 3rd digit (+) pain, indicates lateral epicondylitis (tennis elbow)
PaCO2 >45 pH <7.3
Respiratory acidosis
PaCO2 <35 pH >7.45
Respiratory alkalosis
PaCO2 <35 pH <7.35
Respiratory compensation for metabolic acidosis
PaCO2 >45 pH >7.45
Respiratory compensation for metabolic alkalosis
_____: difficulty expanding the lungs and a reduction of lung volumes
Restrictive lung disease
_____: the eyes lag behind which causes blurred vision with head or eye movement
Retinal slip
What are the downward rotators of the scapula (force coupe)?
Rhomboids, levator scap, pec minor (shortened with upper crossed syndrome = rounded shoulders)
In the cspine, what happens to the facets with RIGHT rotation?
Right facets close Left facets open
In the lspine, what happens to the facets with RIGHT rotation?
Right facets open Left facets close
Which foot? Cannot be used on uneven terrain
SACH foot
Which foot? Contains energy absorbing cushion heel
SACH foot
Which foot? Limited transverse and mediolateral motion
SACH foot
Which foot? Permits PF in early stance
SACH foot
Which foot? Can be used on uneven terrain
SAFE foot
Which foot? Greater mediolateral motion on rear foot
SAFE foot
Which foot? Heavier but less durable
SAFE foot
Describe active insufficiency
SAME motion as muscle action Example: Rectus femoris is extending the knee and flexing the hip at the same time
In a typical clinical setting, exercise should be terminated if SBP> _____ and/or DBP >_____
SBP> 210 DBP> 110
What is the mneumonic for CN IV?
SO4 Superior Oblique, Cranial Nerve IV
Which foot? Heavier
Seattle foot
Which foot? Keel stores energy and recoils it in late stance for springy motion
Seattle foot
Which foot? Slightly flexible plastic keel bends at heal contact
Seattle foot
TP/(TP + FN) =
Sensitivity
Speed's test
Shoulder flexed to 90, forearm supinated; pt resists extension (+) pain in bicipital grover indicates bicipital tendonosis
What is the significance of a retinal slip even if by a few degrees?
Significant decreases in vision and postural control
What sign would you expect with a vagus nerve lesion?
Soft palet on same side as lesion fails to rise; uvula will deviate to the opposite side
TN/(TN + FP) =
Specificity
What is the prognosis for walking of a child with myelomeningocele at T12 level?
Standing using a parapodium; walking will not be possible
Galant reflex (trunk incurvation) Stimulus and response
Stimulus: Sharp stroke on paravertebral line from scapula to iliac crest Response: lateral trunk flexion towards stimulus
Crossed extension reflex Stimulus and Response
Stimulus: Sharp, quick pressure to side of foot Response: Withdrawl of LE and extension of opposite LE
Tonic Labyrinth Reflex Stimulus and Response
Stimulus: plae child prone or supine Response: Placing child prone will promote flexion tone; supine will promote extension tone
Neonatal nintegration eck righting reflex Stimulus and Response
Stimulus: turn head with head in supine position Response: Body log roll toward same side
Stress incontinence treatment
Strengthen pelvic floor
Closed chain interventions, think _____
Strengthening
What is the treatment for irritable bowel syndrome?
Stress reduction, dietary modification, exercise
What position must be avoided in the 3rd trimester of pregnancy?
Supine lying
What muscles are responsible for closing the mandible?
TIM: Temporalis, Internal (Medial) Pterygoid, Masseter
Pain Pattern: LUQ
Tail of pancreas, spleen pathology
_____ lobe: Language comprehension
Temporal
_____ lobe: Primary auditory cortex
Temporal
_____ lobe: Wernicke's area
Temporal
Lateral rotation lag sign
Tests the integrity of the teres minor and infraspinatus
A t-test compares...
The mean scores from two groups on the same variable
Describe ideomotor apraxia
The pt cannot do a task on command but can do it spontaneously
Describe ideational apraxia
The pt cannot do the task at all; they have "no idea" how to perform it
Describe concurrent validity
The test performed is compared to the gold standard test and the results are compared
What does standard deviation measure?
The variability of the data
_____: produces hormones that act to control the rate at which cells burn the fuel from food
Thyroid gland
Describe negative babinski
Toes flex
Urge incontinence treatment
Treat infections
What is the mneumonic for remembering CN V?
TrigeMinal = "M" for muscles of mastication
_____: corneal (blink) reflex
Trigeminal nerve, CN V
_____: motor innervation to the muscles of mastication (medial pterygoid, lateral pterygoid, masseter, temporalis)
Trigeminal nerve, CN V
_____: sensation to the mucous membranes and sinuses of the face
Trigeminal nerve, CN V
_____: sensation to the skin of the face
Trigeminal nerve, CN V
What is the best assistive device for a pt with Parkinson's disease?
U-shaped walker
Traction or pull to sit Stimulus and Response
UE flexion and head lag
UMN or LMN? (+) Babinski
UMN
UMN or LMN? CNS lesion
UMN
UMN or LMN? Clonus
UMN
UMN or LMN? Hypertonia
UMN
UMN or LMN? Increased reflexes
UMN
UMN or LMN? Increased tone
UMN
UMN or LMN? Involuntary muscle movements
UMN
UMN or LMN? Movement in synergies
UMN
UMN or LMN? Muscle spasms
UMN
UMN or LMN? Weakness, paresis, or paralysis
UMN
UVH or BVH Blurred vision, especially when turning the head quickly
UVH
UVH or BVH Disequilibrium
UVH
UVH or BVH Dizziness or vertigo
UVH
UVH or BVH Nausea
UVH
UVH or BVH Poor balance, espcially with head turns
UVH
UVH or BVH Trauma
UVH
UVH or BVH Trouble walking, especially outdoors, in dark rooms, or in crowded places
UVH
UVH or BVH Vascular events
UVH
UVH or BVH Viral insults
UVH
_____: spontaneous nystagmus that can be suppressed with visual fixation
UVH
Bloody diarrhea indicates...
Ulcerative colitis
_____: continuous lesions; rectal pain, bleeding, LBP, fecal urgency, bloody diarrhea with mucus/pus, weight loss
Ulcerative colitis
_____: occurs in large intestine and rectum
Ulcerative colitis
An _____ hernia causes pain around the ______ ring in the mid to lower abdomen
Umbilical
What supplies blood to Broca's area?
Upper division of the Middle Cerebral Artery
What are the upward rotators of the scapula (force couple)?
Upper trap, serratus anterior, lower trap
What cranial nerve is responsible for the gag reflex?
Vagus and glossopharyngeal nerves
_____: Rolls supine to prone
6-7 months
_____: sits alone without support (hands free)
6-7 months
_____: sitting equilibrium: protective extension forward
6-7 months
_____: transitions quadruped to-from sitting
6-7 months
-1SD to +1SD =
68% 34% (1SD) X 2 = 68%
_____: maintains quadruped and assumes sitting from quadruped
7 months
_____: trunk rotation in sitting
7 months
If the APGAR score is above _____, there is no need to reasses AGPAR
7/10
Normal anteversion angle of hip
8-15 degrees
_____: can stand alone
8-9 months
_____: cruises sideways
8-9 months
_____: quadruped creeping
8-9 months
0-9 months reflex mneumonic
9 Plants
_____: child can move object from hand to hand
9 months
-2SD to +2SD =
95%
-3SD to 3SD =
99%
When is exercise contraindicated as it is related to ABI?
<0.8
If hematocrit is _____ all forms of exercise are contraindicated
<27%
If WBC is _____ all forms of exercise are contraindicated
<500
If platelets are _____ all forms of exercise are contraindicated
<50k
What FEV1/FVC ratio indicates obstructive lung disease?
<70%
If hemoglobin is _____ all forms of exercise are contraindicated
<8
Retroversion of the hip
<8 degrees (retro = past or less)
What is considered a high fasting blood glucose?
> 100 mg/dL
What is the ABI scale?
>1.3 = Rigid Arteries; need US 1-1.3 = Normal 0.8 - 0.99 = Mild PAD 0.4-0.79 = Moderate PAD <0.4 = Severe PAD
Abnormal anteversion of hip
>15 degrees
How is preeclampsia diagnosed?
A BP >140/90; a second abnormal BP four hours after the first confirms the diagnosis
Spinal mobs Gapping, upglide used for...
A flexion or opening restriction
What does a high score on the BODE indicate?
A greater mortality risk
On the Oswestry Disability Questionnaire, a _____ score is better
A lower score is better because it indicates a percentage of disability
Describe construct validity
Does the test measure what it is supposed to measure?
Melena tarry (dark, tarry) stools indicates...
Duodenal ulcer
What are the signs and symptoms of idiopathic pulmonary fibrosis?
Dyspnea with activity and non-productive cough
Pronation mneumonic
EDAB = Eversion, Dorsiflexion, Abduction
What is the gait deviation? Dorsiflexion stop too soft, Late stance
Early knee flexion
What is the gait deviation? Socket too anterior, late stance
Early knee flexion
Functional ROM of mouth opening
40mm
2SD =
47.5% 95% (or -2SD to 2SD) divided by 2 = 47.5%
When can you begin exercise after infarct? What mode of exercise?
48 hrs begin UE and LE AROM
0-4 months reflexes mneumonic
4PM
What are the correlation intervals?
High = 0.76-1 Moderate = 0.51-0.75 Fair = 0.26-0.5 Low = 0-0.25
Coxa vara
Hip varus
_____: can demineralize bones (bone weakness and decreased density)
Hyperparathyroidism
_____: elevated calcium and decreased serum phosphate
Hyperparathyroidism
How is spinabifida diagnosed prenatally?
-Maternal Serum Alpha-Feto-Protein (MSAFP) Test -Triple Screen Blood Test
What are the signs for appendicitis?
-McBurney's point -Rovsing's sign -Blumberg's sign
What is the gait deviation? Soft heel cushion, initial contact
Insufficient knee flexion
Halstead maneuver
"T" for traction PT finds radial pulse and applies downward traction on the test extremity while the pt's neck is hyperextended and the head is rotated to the opposite side (+) pulse disappears, indicates thoracic outlet syndrome
Pack years =
# of packs/day X # of years smoked
O'Bien Test
(+) Pain in IR > pain in ER Indicates SLAP lesion
What are the potential causes of a positive Kehr's sign?
(+) indicates air or blood in the abdominal cavity -Recent laparoscopy -Stomach ulcer -Rupture of the spleen
Empty can test
(+) pain or weakness, indicates tear/impingement of supraspinus tendon or suprascapular nerve neuropathy
Hawkins-Kennedy Test
(+) pain, indicates impingement of supraspinatus
What are the non-parametric tests?
-Chi square test -Mann Whitney u -Kruskal Wallis test
What does the patient complain of with a retinal slip?
-Decreased visual acuity -Blurred vision (horizontal) -Jumpy vision (vertical)
Right plagiocephaly is characterizd by: - _____ occipito-parietal flattening - ______ occipital bossing - anterior displacement of _____ ear - _____ frontal bossing
-ipsilateral (RIGHT) occipito-parietal flattening -contralateral (LEFT) occipital bossing -anterior displacement of (RIGHT) ipsilateral ear -ipsilateral (RIGHT) frontal bossing
Continue with special tests
.
Draw heart auscultation diagram
.
Draw the ankle bones diagram
.
Draw the eye muscles diagram
.
Draw the lung capacities diagram
.
Draw the sensitivity/specificity chart
.
Write out the spinal nerves
.
Babinski reflex integration age
0-12 months
Crossed extension reflex integration age
0-2 months
Galant reflex (trunk incurvation) integration age
0-2 months
Positive support/primary standing reflex integration age
0-2 months
Primary walking reflex integration age
0-2 months
Rooting reflex integration age
0-3 months
Moro reflex integration age
0-4 months
Palmar grasp reflex integration age
0-4 months
Asymmetrical Tonic Neck Reflex integration age
0-5 months
Traction or pull to sit integration age
0-5 months
Neonatal neck righting reflex integration age
0-6 months
Tonic Labyrinth Reflex integration age
0-6 months
Plantar grasp reflex integration age
0-9 months
INR
0.9-1.1 (or 2-3 if on anticoagulation therapy)
HR APGAR score
0: Absent 1: <100 BPM 2: 100-140 BPM
Respiratory effect APGAR score
0: Absent 1: Slow, shallow 2: Good, crying, irregular
Color APGAR score
0: Blue 1: Body pink, extremities blue 2: All pink
Muscle tone APGAR score
0: Flaccid 1: Some flexion 2: Active motion of extremities
Reflex irritability APGAR score
0: No reponse 1: Grimace 2: Cough or sneeze
When is APGAR scored?
1 minute after birth
What are the steps for spinal mobilizations?
1) Decide whether it is a central or unilateral glide (Spinous process ir transverse process) 2) What segment needs to be stabilized? 3) What segment needs to be mobilized? 4)What are the arthrokinematics of the motion?
What is Tetrology of Fallot (TOF)?
1) Ventricular septal defect 2) Ventricular hypertrophy 3) Pulmonary artery stenosis 4) Overriding aorta
What is virchow's triad?
1. Venous stasis 2. Hypercoagulability 3. Trauma to a vessel
When do you use parametric data? Non-parametric data?
10 nurses : 10 PTs = Parametric statistics because there's an equal ratio 100 nurse : 10 PTs = Non-parametric data because it is an unequal ratio
_____: begins to walk unassisted
10-15 months
_____: floor to stand
10-15 months
_____: pincer grasp
10-15 months
_____: tower of two cubes
10-15 months
_____: transitions in and out of squatting
10-15 months
What is a perfect APGAR score?
10/10
Prothrombin time
11-15 seconds
_____: start imitating others
18 months
_____: Assumes prone on elbows when placed in prone
2-3 months
The TM ligament allows up to ______ of manibular opening to occur before it becomes tight; after that the condyle _______ to allow further opening ______
20-25mm; the condyle translates anteriorly; 15mm
When can you begin exercise after bypass? What mode of exercise?
24 hrs begin UE and LE AROM
What percentage of oxygen is flowing at a rate of 1L/min by nasal cannula?
24%
Partial Thromboplastin Time (PTT) Normal
26.3 - 39.4 seconds
_____: ride a tricycle
3 years
_____: rolls supine to side lying
3-4 months
1SD =
34%
Oxygen percentage increases at a rate of _____ per 1L/min by nasal canula
4% from 1L/min to 6L/min
_____: Feet to mouth
4-5 months
_____: Pulls to sit without head lag
4-5 months
_____: Self-supported sitting propped forward on arms
4-5 months
_____: rolls prone to supine
4-5 months
Describe the ASIA Scale
A: Complete (Motor and Sensory Impaired) B: Sensory Incomplete (Motor impaired, Sensory Spared) C: Motor incomplete, major muscles <3/5 MMT D: Motor incomplete, major muscles >3/5 MMT E: Normal, motor and sensory spared
0-5 month reflexes mneumonic
AT (Asymmetrical Tonic Neck Reflex) Track (Traction or pull to sit) 5
What tendons are effected in DeQevain's tenosynovitis?
Abductor pollicis longus Extensor pollicis brevis
Lumbar spine Nerve root exits... Disc herniation occurs... Stenosis affects...
Above, below, below Example: L3-L4 level Nerve root exiting this space is L3 nerve root Disc hernation at this level affects L4 nerve root Stenosis at this level affects L4 nerve root
HCO3- <22 =
Acidosis
PaCO2 > 45=
Acidosis
_____: Hearing loss and tinnitus in affected ear
Acoustic neuroma
_____: Tumor on vestibular nerve leading from inner ear to brain
Acoustic neuroma
_____: Unsteadiness, loss of balance, dizziness, facial numbness
Acoustic neuroma
UVH intervention
Adaptation
ATCH stimulates the...
Adrenal gland
_____: produces corticosteroids that will regulate water and sodium balance, the body's reponse to stress, the immune system and metabolism
Adrenal gland
Describe the NPTE rule of 6
After major surgeries (think RTC repair) First 6 weeks post-op= Acute/Protection phase Next weeks (weeks 6-12) post-op= Assistive, Active training 6 months post-op = ADL, PLOF, return to work/sport activities
What is the treatment of torticollis on a pt 6 months old or less?
Aggressive stretching is not advised; focus on positioning, call baby's name or use bright colored toys to attract her attention to the opposite side
HCO3- >26 =
Alkalosis
PaCO2 <35 =
Alkalosis
_____:when there is an actual difference between the variables
Alternate hypothesis "The drug has an effect"
Describe face validity
An assessment or test appears to do what it claims to do (this is a weak form of validity)
What does ANOVA stand for?
Anaylsis of variance - it is a parametric test Example: Tall and short subjects are tested for gait using ADs; here, height is the covariant that must be controlled during statistical analysis
Spinal nerves Anterior root =
Anterior root = Ventral Root = Motor = Efferent
Pain pattern: RLQ
Appendix, Crohn's disease
_____: s/s include weakness, fatigue, drowsiness, myalgias, depression, sensory loss in glove/stocking distribution, osteopenia, confusion, and gout
Hyperparathyroidism
What should you associate Grave's disease with?
Hyperthyroidism
What is the mneumonic for Broca's aphasia?
BEN Broca's, Expressive, Non-fluent
An increase in cortisol will result in an increase in...
BP
UVH or BVH Autoimmune disorder
BVH
UVH or BVH Gait ataxia
BVH
UVH or BVH Head trauma
BVH
UVH or BVH Meningitis
BVH
UVH or BVH No nausea
BVH
UVH or BVH Oscillopsia (visual blurring with head movements
BVH
UVH or BVH Tumor on the 8th cranial nerve
BVH
UVH or BVH Ototoxicity
BVH Expecially antibiotics such as gentamicin, streptomycin
Where is kidney pain referred to?
Back or upper abdominal
Retrolysthesis
Backward displacement of one vertebrae on another
Describe positive babinski
Big toe extension with fanning of the other toes
Red blood in stool indicates...
Bleeding in lower GI tract
Mneumonic for spinal mobs
Bottoms up will close the gap To open a space, mobilize the top segment To close a space, mobilize the bottom segment
_____: slow, hesitant speech
Broca's aphasia
Age 0-2 reflexes mneumonic
C (Crossed extension) GF (Galant and Flexor Withdrawl) PP (Positive support and Primary walking)
What are the criteria of APGAR score?
HR, Respiratory effect, Reflex irritability, Muscle Tone, Color
What structures can refer pain to the left shoulder?
Heart, tail of the pancreas
Where will a Pancoast Tumor refer pain?
C8-T2 nerve distribution
What is the mneumonic for the origins of the cranial nerves?
CE 1-2 (Cerebrum) MI 3-4 (Midbrain) PONS 5-8 (Pons) MEDU 9-12 (Medulla)
The therapist moves the pen from the center aligned with the nose, to the pt's right. Which CN is being tested?
CN VI, Lateral Rectus of the right eye ball
BP = _____ x _____
Cardiac output (CO) x Total Peripheral Resistance
What is Phalen's test used to diagnose?
Carpal tunnel syndrome
What is the weakest form of evidence?
Case report
Central or Peripheral Vestibular Pathology Abnormal smooth pursuit and saccadic eye movement tests
Central
Central or Peripheral Vestibular Pathology Acute vertigo not usually suppressed by visual fixation
Central
Central or Peripheral Vestibular Pathology Altered consciousness
Central
Central or Peripheral Vestibular Pathology Diplopia
Central
Central or Peripheral Vestibular Pathology Pure vertical nystagmus
Central
Central or Peripheral Vestibular Pathology Usually no hearing loss
Central
Central or Peripheral Vestibular Pathology? Ataxia often severe
Central
_____: brainstem vascular disease; arteriovenous melformation; acoustic neuroma; tumor of the brainstem and cerebellum; multiple sclerosis; vertebrobasilar migraine
Central Vestibular Pathology
_____: use of nominal data to find the difference between groups (boy vs. girl running speed)
Chi square test
______: inflammation of the bile duct
Cholangitis
_____: blockage or impaction of gallstones in the cystic duct resulting in inflammation of the gallbladder
Cholecystitis
Functional incontinence treatment
Clear clutter and prompted voiding
TMJ Disc displacement with reduction
Clicking
Spinal mobs Closing, downglide used for...
Closing or extension restriction
What structures can refer pain to the pelvis/low back/sacrum?
Colon, appendix, pelvic viscera
What causes global aphasia?
Compromise to the stem of the Middle Cerebral Artery
_____: lack of fiber/fluids, HYPOthyroidism, splinting/mm guarding
Constipation
What factors influence static and dynamic lung measurements?
Height, gender, and race
Sidebending is a function of the _____ facets
Contralateral
_____: occurs anywhere in the GI tract
Crohn's Disease
_____: skip lesions present; pain relieved by passing gas, joint arthritis, abdominal pain, weight loss
Crohn's disease
Excessive facial hair
Cushing disease/syndrome
Fat deposition (cervical ft pad/buffalo hump), truncal obesity
Cushing disease/syndrome
Round "moon" face
Cushing disease/syndrome
Weight gain (children show poor growth in height)
Cushing disease/syndrome
easy bruising, poor wound healing
Cushing disease/syndrome
______: Tumor on adrenal gland
Cushing syndrome
______: Pituitary Ademona
Cushing's Disease
Pain pattern: LLQ
Diverticulitis, Ulcerative colitis, IBS
Describe content validity
Does the test measure the specific problem?
What is Virchow's triad used to diagnose?
DVT
Describe Ordinal type data
Data measured in ranks Example: MMT
Describe Interval type data
Data with no true zero Example: Temperature
Describe ratio type data
Data with true zero Example: ROM, Distance walked, Time traveled R for ROM and Ratio
What is Finkelstein's test used to diagnose?
DeQervain's tenosynovitis (AKA Radial Styloid tenosynovitis)
What should you associate Addison's disease with?
Decreased cortisol
TMJ capsulitis
Decreased opening with deviation
TMJ synovitis
Decreased opening, no deviation
Spinal mobs Closing =
Decreased space = downglide = extension
Spondylosis
Degeneration of the intervertebral disc
What is the gait deviation? Dorsiflexion stop too hard
Delayed knee flexion
What is the gait deviation? Socket too posterior, Late stance
Delayed knee flexion
_____: caused by infection such as diverticulitis, IBS, and HYPERthyroidism
Diarrhea
Erb's or Klumpke's Palsy Deformity: Waiter's tip
Erb's
Erb's or Klumpke's Palsy Loss of abduction and lateral rotation of the shoulder
Erb's
Erb's or Klumpke's Palsy MOI: Stretched downward
Erb's
What structures can refer pain to the mid-back?
Esophagus, gall bladder, stomach, pancreas
What is the gait deviation? Flexion contracture, Initial contact
Excessive knee flexion
What is the gait deviation? High prosthetic heel, Initial contact
Excessive knee flexion
What is the gait deviation? Insufficient plantarflexion, Initial contact
Excessive knee flexion
What is the gait deviation? Socket too far anterior, Initial contact
Excessive knee flexion
What is the gait deviation? Stiff heel, Initial contact
Excessive knee flexion
What is the gait deviation? Weak quadriceps, Initial contact
Excessive knee flexion
What is the gait deviation? Excessive foot inset, mid stance
Excessive lateral thrust
What is the gait deviation? Excessive foot outset
Excessive medial thrust
If a child exhibits RIGHT torticollis, how would you stretch the SCM?
Extension, LEFT side-bending, RIGHT rotation
What is the mneumonic for remembering CN VII?
Facial nerve = "F" for muscles of Facial expression
_____: innervates lacrimal glands (Tears)
Facial nerve, CN VII
_____: innervates submandibular and sublingual salivary glands
Facial nerve, CN VII
_____: sensation around the concha of the auricle
Facial nerve, CN VII
_____: sensation to the anterior 2/3 of the tongue
Facial nerve, CN VII
______: Innervates nasal, pharyngeal, and palatine mucous glands
Facial nerve, CN VII
______: innervates muscles of facial expression
Facial nerve, CN VII
Type 2 error =
False negative Dr. tells clearly pregnant pt "You're not pregnant"
Type 1 error =
False positive Dr. tells male pt "You're pregnant"
What muscles of eyeball movement are required to walk downstairs?
First look for CN IV (superior oblique, down and in) Next look for CN VI (lateral rectus, peripheral)
Describe STNR
Flexion of neck will result in flexion of UEs and extension of LEs
Spondylolisthesis
Forward displacement of one vertebrae on another
_____ lobe: Primary motor cortex
Fronal
_____ lobe: Broca's area
Frontal
_____ lobe: Emotion and behavior control
Frontal
_____ lobe: Olfaction
Frontal
_____ lobe: Voluntary movement
Frontal
______: reflux of gastric contents of the gastroduodenal content into the esophagus
GERD (gastro esophageal reflux disease)
What structures can refer pain to the right shoulder?
Gall bladder, liver, head of pancreas, peptic ulcers
Respiration =
Gas exchange
What can cause GI bleeding?
Gastritis, peptic ulcers, ulcerative colitis
_____: target is stable; head movements with eyes focused on stable target
Gaze stabilization VOR x1
_____: target and eyes move in opposite directions
Gaze stabilization VOR x2
_____: coordinate eye and head movements to maintain gaze stability (reset gain of VOR to 1)
Gaze stabilization exercises
What treatment technique can be used for pts with Wernicke's aphasia?
Gestures and/or demonstration
Froment's sign
Grasp paper with thumb and index finger pad-to-pad (+) flexion of DIP of thumb indicating weakness of adductor pollicis, possible ulnar nerve involvement
Describe nominal type data
Groups Example: Blood type, gender
What are the ranges for a lipid profile?
HDL = "Good" cholesterol LDL = "Bad" cholesterol Total <200 = Desireable LDL <100 = Optimal HDL <40 = Low HDL > or = 60 = Desireable Triglycerides <150 = Optimal
Supination mneumonic
IPAD = Inversion, Plantar Flexion, Adduction
Cranial remodeling with helmet has the best outcomes used age ______; no longer useful after _____
Ideal: 4-6 months No longer useful: after 18 months
What is the most common restrictive lung disease?
Idiopathic pulmonary fibrosis
What are the s/s of preeclampsia?
Increase in protein in urine, hyperreflexia, edema, visual disturbances, headache, sudden weight gain
What should you associate Cushing's disease with?
Increased cortisol
Spinal mobs Gapping =
Increasing space = upglide = flexion
An _____ hernia causes groin pain
Inguinal
What is the gait deviation? Low prosthetic heel, Initial contact
Insufficient knee flexion
What is the gait deviation? Socket too far posterior, initial contact
Insufficient knee flexion
_____: nausea, vomitting, foul breath, diarrhea, symptoms disappear while sleeping
Irritable bowel syndrome
_____: spastic, nervous, or irritable colon
Irritable bowel syndrome
______: causes include emotional stress, anxiety, high fat and lactose diet
Irritable bowel syndrome
______: pain is relieved by defecation, sharp cramps in the morning or after eating
Irritable bowel syndrome
_____: the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated
Kehr's sign
Erb's or Klumpke's Palsy Deformity: Claw hand
Klumpke's
Erb's or Klumpke's Palsy Stretching of arm overhead
Klumpke's
Erb's or Klumpke's Palsy aralysis of the instrinsic muscles of the hand
Klumpke's
______: Non-parametric ANOVA
Kruskal Wallis test
A CVA to what hemisphere can result in ideational or ideomotor apraxia?
LEFT CVA
Where is pain with irritable bowel syndrome?
LLQ
Ulcerative Colitis versus Crohn's Disease: where is the pain?
LLQ = Ulcerative Colitis RLQ = Crohn's Disease (same as appendix)
UMN or LMN? Cranial nerve lesion
LMN
UMN or LMN? Decreased or absent reflexes
LMN
UMN or LMN? Decreased tone
LMN
UMN or LMN? Fasciculations
LMN
UMN or LMN? Flaccidity
LMN
UMN or LMN? Lesion of anterior horn of spinal cord
LMN
UMN or LMN? Neurogenic atrophy
LMN
UMN or LMN? Peripheral nerve lesion
LMN
UMN or LMN? Spinal nerve root lesion
LMN
UMN or LMN? Weak or absent voluntary movement
LMN
What is the mneumonic for CN VI?
LR6 Lateral Rectus, Cranial Nerve VI
______: Involved the ipsilateral TMJ spinning in place with the contralateral TMJ sliding anteriorly
Lateral excursion
TMJ Hypomobility s/s
Less ROM, no pain
What sign would you expect with a hypoglossal nerve lession?
Lick my lesions Tongue will deviate toward side of lesion, same side as atrophy
What structures can refer pain to the shoulder?
Liver, diaphragm, pericardium
White/clay/gray stools indicate...
Liver, pancreas or colon disorder
Where can pain from constipation be referred to?
Lower abdomen, anterior hip, groin/thigh
What supplies blood to Wernicke's area?
Lower division of the Middle Cerebral Artery
What interventions should be the focused with a patient with osteoporosis?
Lumbar extension and core stabilization (avoid flexion and rotation)
_____: Nonparametric test designed to test the null hypothesis with two independent samples from the same population (Amateur versus professional running speed...it's a spectrum)
Mann Whitney u
What is the SF-36?
Medical outcomes study 36-iten short form; contains 8 domains which focus on quality of life
Overflow incontinence treatment
Medication and catheterization
_____: Recurrent and usually progressive vestibular disease
Meniere's disease
_____: Tinnitus, deafness, sensation of fullness in ear, vertigo
Meniere's disease
Which foot? Improves ability to ambulate on incline, stairs, and uneven surfaces
Microprocessor foot
Which foot? Microcomputer controls DF and PF
Microprocessor foot
Which foot? Not widely used due to maintenance and cost
Microprocessor foot
Where do the gallbladder, stomach, pancreas, and small intestines refer pain?
Mid-back and scapula
Limitation of passive and active ROM that is pain-free, what intervention?
Mobilization
Ventilation =
Movement of air (a ventilator moves the air for you but doesn't act on the cellular level)
0-6 months reflex mneumonic
NS PTS or Neck Sucks Physical Therapy Labyrinth Starts Neonatal neck righting, Sucking reflex, Placing reaction,Tonic Labyrinth Reflex, Startle
_____: occurs from irritation of the GI tract
Nausea/Vomitting
TN/(FN+TN) =
Negative predictive value
_______ or ______ causes selective damage to autonomic afferent nerves, impairing the sensation of bladder fullness
Neurogenic bladder dysfunction or cystopathy
Which of the data types are qualitative?
Nominal and ordinal
Articulated or non-articulated? Microprocessor foot
Non-articulated
Articulated or non-articulated? SACH foot
Non-articulated
Articulated or non-articulated? SAFE foot
Non-articulated
Articulated or non-articulated? Seattle foot
Non-articulated
What lung capacities indicate restrictive lung disease?
Normal or >80% FEV1/FVC ratio FVC is NOT reduced
What are the abnormal results of a ventilation-perfusion (VQ) scan which would lead you to suspect a pulmonary embolism?
Normal ventilation, abnormal perfusion
_____: there will be no statistical difference between the variables; if there is a difference it will be by chance of a 5% error
Null hypothesis "The drug has no effect"
Describe passive insufficiency
OPPOSITE motion as muscle action Example: Rectus femoris is stretched over the flexed knee and extended hip at the same time
_____ lobe: Lesion can cause hemianopia/hemianopsia
Occipital
_____ lobe: Primary visual cortex
Occipital
_____ lobe: lession can cause inability to recognize previously known objects
Occipital
_____: infection of the middle ear causing fever and ear pain
Otititis media
What is the p value?
P = Probability Probability that the result obtained was due to chance or the probability of making an error
S/S of cholecystitis
Pain in RUQ that radiates to the right scapula, nausea, vomitting, low grade fever
Describe Murphy sign
Palpate near right subcostal margin, as the pt to take a deep breath (+) pain and tenderness on inspiration, indicates Cholecystitis
_____: regulate calcium and phosphate metabolism
Parathyroid gland
_____ lobe: Primary sensory cortex
Parietal
_____ lobe: Sensation
Parietal
_____ lobe: Somatosensory
Parietal
_____ lobe: Taste
Parietal
Coffee ground emesis indicates...
Peptic ulcer
Pain pattern: RUQ
Peptic ulcers, gall bladder pathology, head of pancreas
Central or Peripheral Vestibular Pathology Ataxia mild
Peripheral
Central or Peripheral Vestibular Pathology Feeling of fullness in ears
Peripheral
Central or Peripheral Vestibular Pathology Hearing loss
Peripheral
Central or Peripheral Vestibular Pathology Horizontal nystagmus
Peripheral
Central or Peripheral Vestibular Pathology Normal smooth pursuit and saccadic eye movement tests
Peripheral
Central or Peripheral Vestibular Pathology Symptoms of vertigo are usually suppressed by visual fixation
Peripheral
Central or Peripheral Vestibular Pathology Tinnitus
Peripheral
Central or Peripheral Vestibular Pathology Torsional nystagmus
Peripheral
_____: BPPV, Meniere disease; vestibular neuritis; labryinthiris; perilymphatic fistula; acoustic neuroma
Peripheral Vestibular Pathology
_____: controls ovulation and works as a catalyst for the testes and ovaries to create sex hormones
Pituitary gland
_____: secretes endorphins and reduced a person's sensitivity to pain
Pituitary gland
TP/(TP+FP) =
Positive predictive value
Spinal nerves Posterior root =
Posterior root = Dorsal root = Sensory = Afferent
Posterior Apprehension Sign
Pt lies supine, PT elevates shoulder in scaption to 90 and applies a posterior force through the elbow while adducting and IR arm (+) pt is apprehensive about test position and feels like it will dislocate; previous posterior shoulder dislocation/posterior shoulder instability
Posterior Internal Impingement Test
Pt lies supine, PT passively AB 90-110 with 15-20 extension and max ER (+) pain, indicates impingement between rotator cuff and greater tuberosity or posterior glenoid and labrum
Fulcrum test
Pt lies supine, PT provides posterior to anterior force with one hand and abducts the shoulder to 90 while slowly ER with the other (+) pt is apprehensive about test position and feels like dislocation is possible, indicates previous anterior dislocation/anterior instability
Yocum test
Pt places hand on opposite shoulder, PT elevates elbow (+) pain, indicates sub-acromial impingement
Abdominal compression test
Pt pushes into PT's hand which rests on pt's stomach as hard as possible while moving elbow forward (+) pt in unable to maintain pressure on PT's hand, indicates tear of subscapularis
Biceps load test
Pt seated or supine, shoulder AB to 120, elbow flexed to 90, forearm supinated; PT performs an apprehension test by ER shoulder, if apprehension appears, the examiner stops ER and holds that position, the pt is then asked to flex elbow against resistance at the wrist (+) apprehension remains the same or shoulder becomes painful, SLAP lesion indicated
Yergason's test
Pt sits with elbow flexed to 90 and forearm pronated; pt resists supination of the forearm and ER of the shoulder (+) tendon of long head of biceps pops out of the groove indicates lack of integrity of the transverse ligament; tenderness in bicipital groove without dislocation indicates bicipital tendonitis/tendonosis
Clunk test
Pt supine, shoulder AB, PT pushes humeral head anteriorly while ER (+) clunk, indicates labrum tear
Neer's Impingement Test
Pt's arm is passively and forcibly elevated in scapular plane with the arm medially rotated (+) pain, indicates supraspinatus and biceps tendon impingement
How is scoliosis named?
RIGHT scoliosis = RIGHT convexity
What does the pinch-an-inch test, test for?
RIGHT side = appendicitis LEFT side = Diverticulitis
Describe the positioning of RIGHT torticollis
RIGHT side bend, LEFT rotation
Open chain interventions, think _____
ROM
Colle's fracture
Radius dislocates in a dorsal direction (Colle sounds like Collie which is a Dog - "d" for dorsal)
Smith's fracture
Radius dislocates in a ventral direction
Which of the data types are quantitative?
Ratio and interval
______: for maintaining stable gaze while we move or the world moves around us
Vestibular Ocular Reflex (VOR)
Asthma: _____ and _____ are reduced
Vital capacity and Inspiratory Reserve Volume
What are the blood count lab values?
WBC: 5-11k HgB Male: 13-18 HgB Female: 12-16 Hct Male: 37-39% Hct Female: 36-46% Platelet: 150-400k
What is the prognosis for walking of a child with myelomeningocele at L4-L5 level?
Walk with AFO at home and school
Lower cross syndrome
Weak: Abdominals, glutes, back extensors Tight: Rectus femoris, iliopsoas
Upper crossed syndrome
Weak: deep neck flexors, scapula stabilizers, scapula retractors, scapula depressors Tight: Upper trap, levator scap, pecs, and SCMs
What is the mneumonic to remember the blood supply to Wernicke's area?
WernIcke = "I" for inferior division of middle cerebral artery
_____: pt cannot comprehend speech
Wernicke's aphasia
When is postural drainage contraindicated?
With a pt who is dehydrated
What treatment technique can be used for a pt with Broca's aphasia?
Yes/No questions
Explain a 1-tailed paired t-test
You expect the results Alterntive hypothesis = The drug has a decreasing effect
Explain a 2-tailed paired t-test
You have no expectation of the results Alternative hypothesis = The drug has an effect (either decreases or increases)
What is the heart rate resevere/Karvonen's formula for the low target range?
[(HRmax - HRrest) x0.4] +HRrest
What is the heart rate resevere/Karvonen's formula for the upper target range?
[(HRmax - HRrest) x0.85] +HRrest
Blood pressure is _____ in the first and second trimester and may _____ in the last trimester
_____ side lying is considered best during pregnancy as it decreases compression of the IVC, maximizes CO, decreases GERD
A drop in peak flow rates indicates...
airway narrowing
If the fibers of the diaphragm are aligned horizontally (such as the case with severe COPD), it will result in...
an inward motion of the lower ribs during a diaphragm muscle contraction of inhalation
Cspine Nerve root exits... Disc herniation occurs... Stenosis affects...
below, below, below Example: C3-C4 level Nerve root exiting this space is C4 nerve root Disc herniation at this level impacts C4 nerve root Stenosis at this level effects C4 nerve root
After a repair of a SLAP lesion where the biceps tendon was detatched... Avoid tension on the _____
biceps (avoid elbow extension with shoulder extension)
After a repair of a SLAP lesion where the biceps tendon was detatched... Avoid active ______ for 6 weeks
biceps contraction
In the cspine, to allow rotation the ipsilateral facet must _____
close
Describe Legg-Calve-Perthes Disease
condition in which the femoral head undergoes necrosis. usually seen in children btwn ages 5-10 years.
The TMJ is formed by the ______ mandibular condyle articulating with the TM disc and _____ glenoid fossa of the temporal bone
convex mandibular condyle concave gloid fossa of temporal bone
If the adrenal gland is stimulated, more _____ is released
cortisol
Spondylolysis
defect in pars interarticularis (arc of the vertebrae)
_____ cerebral palsy: tonic hold of muscles and contributes to passive joint stiffness
dystonic
Medial glide of the talus will promote...
eversion/pes planus/pronation
A _____ hernia causes lateral pelvic wall pain
femoral
When choosing an assistve device for a child with spastic diplegia, you want to avoid _____ posture
flexed
A _____ hernia causes shoulder pain
hiatal
Coxa valga
hip valgum
In severe COPD, the diaphragm fiber aligment becomes more _____ than _____
horizontal than vertical
In the lumbar spine, rotation and sidebending occur...
in the opposite direction
In the cspine, rotation and sidebending occur...
in the same direction
Rotation is a function of the _____ facet
ipsilateral
Scheuermann's Disease AKA
juvenile kyphosis
Schmorl nodes
may be referred to as intervertebral disc herniations; refer to protrusions of the cartilage of the IV disc through the vertebral body end plate and into the adjacent vertebra
A pituitary adenoma will result in...
more ATCH secreted by the pituitary gland
The bigger the standard deviation the _____ the scores
more variable
In the lspine, to allow rotation the ipsilateral facet must _____
open
To allow sidebending in the cspine, tspine, or lspine, the contralateral facet must ______
open
Write out ABG values
pH = 7.35-7.45 PaCO2 = 35-45 PaO2 = 80-100 SaO2 = 95-100 HcO3= 22-26
After a repair of a SLAP lesion where the biceps tendon was detatched... Only perform _____ humeral rotation with the shoulder in the scapular plane for the first 2 weeks
passive
What is the BODE index?
prognostic indicator for mortality risk in pt's with COPD
Pain provocation (Mimori) test
pt seated, arm 90/90, PT ER arm at the wrist, forearm is max supinated then max proanted (+) pain provoked or worse in pronation, indicates SLAP
Jerk test
pt sits with arm medially rotated and forward flexed to 90, PT grasps elbow and provides axial load to the humerus towards pt's shoulder. While maintaining axial load, PT horizontally adducts arm (+) sudden jerk or clunk as the humeral head subluxes, indicated recurrent posterior instability of the shoulder
Blood in the abdominal cavity secondary to liver trauma will refer pain to the...
right shoulder
Referred pain from pancreatic cancer in the head of the pancreas will be...
right shoulder
An adrenal gland tumor will result in...
secretion of more cortisol
Scheuermann's Disease
self-limiting skeletal disorder of childhood; describes a condition where the vertebrae grow unevenly with respect to the sagittal plane (the posterior angle is greater than the anterior angle)
Anteversion =
the ball of the hip is subluxed ANTERIORLY
During mandibular depression, the condyle _________ on the TM disc; the disc also ______ to maintain a congruent surface within the fossa
the condyle rolls and slides anteriorly The disc also slides anteriorly
