Musculoskeletal
Match the proper intervention with the degree of angle for idiopathic scoliosis. Surgery is generally perfumed and after we can implement tx of flexibility exercises, trunk and pelvis strength, power, endurance, electrical stimulation for proper muscle performance and educate pt about orthoses. <25 degrees 25- 45 Degrees >45 Degrees
>45 degrees
when you have sprain, what is affected? muscle ligament
ligament think of an ankle sprain
PTA's primary tx plan for TMJ can include: Postural reeducation for normal curves and symmetry of the spine, modalities, biofeedback to decrease effects of stress and anxiety, Inferior glide joint mobs, Flexibility/ strengthening exercises, night splints. It is critical to normalize the cervical spine posture prior to the pt receiving any permanent dental procedure! true or false
true
Pes planus is normal in infant and toddler feet. true or false
true
Sacroiliac Joint (SIJ) intervention involves spinal manipulation like gapping in order to inhibit pain, reduce muscle guarding, and restore motion. Correct muscle imbalance throughout pelvis using strengthening, endurance, coordination, flexibility exercise, and joint mobilization. Sacroiliac belts may be useful in some pts. true or false
true
Talipes Equinovarus (club foot) requires surgical intervention to correct deformity followed by casting or splinting. true or false
true
Your pt presents with reverse scapulothoracic rhythm compensation. what do you suspect is weak.
shoulder abductors
What is the Arthrokinematic of radial head with the humerus articulation surface. Roll Glide Spin
spin
Which of the following is a slow progressive disorder that results in peroneal muscular atrophy that affects motor and sensory nerves, can start as early as childhood, will progresses to hands and forearm after LE, and Neurontin medication helps with neuropathic pain. Equinus Metatarsus Adductus Charcot-Marie-Tooth Disease Plantar fasciitis Forefoot/Rearfoot Deformities.
Charcot-Marie-Tooth Disease The foot will look like Pes Cavus
Which of the following is a result from a sprain/ rupture of ulnar collateral ligament of MCP joint of first digit. Ape Hand Deformity Mallet Finger Gamekeeper's Thumb Boxer's Fracture
Gamekeeper's Thumb results in medial instability of thumb Immobilized for 6 weeks
Pt presents with excessive medial patellar positioning and the pigeon toed orientation of the feet. What is the LE form around the knees? Normal Genu varum Genu Valgum
Genu Varum
Degeneration of a tendon's collagen as a response to chronic overuse and continued overuse without allowing rest and healing time. This is a repetitive strain inquiry which can occurs with even small movements. Which of the following is being described? Tendinitis Tendinosis
Tendinosis
Your pt had a distal repair that is immobilized such that the distal interphalangeal joints are in neutral for 6-8 weeks. What type of hand tendon repair did he have? Flexor tendon repair Extensor tendon repair
extensor tendon repair
What type of ligament will you categorize the MCL? Extra articular ligament intra articular ligament
extraarticular ligaments such as the medial collateral ligament (MCL) act as additional support structures to aid in joint stability
List the three contraindications for Kaltenbom technique
"convex -concave rule" Hypermobility joint effusion inflammation
If you have a few fibers torn what degree of strain and sprain do you have? 1* 2* 3*
1*
If you pt has approximately 1/2 of the fibers torn what type of strain or sprain do they have? 1* 2* 3*
2* 2* sprains for muscles you will have moderate to significate muscle spasms.
If all the fibers are torn what degree of sprain or strain do you have? 1* 2* 3*
3* 3* strain for muscle (rupture) - might have minor spasm, Significant reflex inhibition and pain with loss of function. No pain w/ isometric/ stretch b/c there is no attachment 3* sprain for ligament - moderate to significant joint instability, no pain w/ isometric or stretch, Joint Pay can be normal or excessive.
How many weeks does the trunk need to be immobilized with a bracing after a multilevel vertebral fusion? 6 weeks 10 weeks 1 week 3 weeks
6 weeks
A) This herniation is most commonly observed in the cervical spine but can still be found in L/S. B) This herniation is more commonly observed in the lumbar spine Mach the number with the correct letter: 1) Posterolateral bulge/ herniation 2)Central Posterior bulg/herniation
A = 2 B = 1 Both have the same interventions, outcomes, and goals.
PT intervention immediately following surgery is PROM from 0-70* degrees of knee flexion and Non-WB for 1 week. What type of repair do you suspect the pt had on their knee?
ACL / PCL repair PCL repair pt is often initially in hinged brace at 0degree during ambulation
At what phase is it a contraindication to stretch the involved tissue after an injury? Acute inflammatory phase/ Maximal Protection Subacute Phase/ Moderate Protection Functional Restoration/ Minimal Protection Phase
Acute Inflammatory phase/ Maximal protection
What special test do you use to asses the Glenohumeral joint for Thoracic outlet syndrome? Jerk Test Speeds Roos Test Apprehension O'Brian Yergason's Test Adson's Test
Adson's Test: radial pulse disappears when PTA puts shoulder in Ext, ER, and has pt look over the same shoulder. Roos elevated arm test: 90* shoulder Abd, 90* elbow flex, and open close hand like a ducks mouth for 3min.
Which of the following is a complication of the healing scar tissue formation? Chronic Inflammation Adhesions Fibrosis Dehiscence All of the above
All of the above Adhesions = scar tissue attaches to structures it does not normally attach to. Fibrosis = scar tissue developed in a space that is usually open or hollow Dehiscence = wound that is closed and then is opened up before it is fully healed.
Which condition is observed as thenar muscle wasting with first digit moving dorsally until it is in line with second digit, that results from median nerve dysfunction? Mallet Finger Ape Hand Deformity Gamekeeper's Thumb Boxer's fracture
Ape Hand Deformity
What special tests would you use to asses a meniscal injury? Anterior drawer test Apley's test Posterior drawer test McMurray's test Thessaly Test
Apley's Test: assess for meniscus and ligamentous tears in Prone McMurray's test: assess Medial / lateral meniscal tear in Supine Thessaly Test: assess for meniscus tears in standing
What special test do you use to asses the Glenohumeral joint to anterior instability? Jerk Test Drop Arm Speeds Apprehension O'Brian Hawkins Kennedy Yergason's Test
Apprehension test; 90*abd and ER
Defined biomechanics of the movement between joints surfaces. Arthrokinematics Osteokinematics
Arthrokinematics
The movement of one joint surface to another is seen as roll, glide, and spin. What kinematics best describes these movements. Arthrokinematics Osteokinematics
Arthrokinematics
Which of the following is found in the joint surfaces that is like a matrix at the bottom layer firmly anchored to the end of the bones. It responds well to compressive force because the fibers are in a scaffold- type of arrangement. It also reduces friction between joints and there is a type of hyaline cartilage. This is Avascular and aneural (no nerve) so it's nourishment is from synovial fluid "milking" during joint loading. Dense Irregular Connective tissue Loose, Irregular Connective Tissue Articular Cartilage Dense Regular Connective Tissue Fibrocartilage
Articular Cartilage
What LE hip condition do you suspect the pt has if they present with hip ROM decreased in flexion, IR, and abduction. with Pain in the groin and/or thigh and tenderness with palpation at the hip joint. You notice they have an Coxalgic Gait. Piriformis Syndrome Trochanteric Bursitis Coxa Vara Femoral Anteversion Avascular Necrosis (AVN)
Avascular Necrosis The gait is similar to trandalanburg gait but the hip does not drop and the trunk shifts laterally with same UE further away form the body.
Limitation of movement due to capsular pattern presents as loss of flexion more than extension. Choose answer that applies Glenohumeral Humeroulnar Humeroradial Hip Talocrural
Both Humeroulnar, Humeroradial
Observed deformity is extension of MCP and DIP with flexion of PIP that is caused by rupture of central tendinous slip of extensor hood? In our hand the order is MCP --> PIP --> DIP Boutonniere Deformity Swan Neck Deformity
Boutonniere Deformity
PT interventions: exercise program to promote dynamic stability throughout trunk and pelvis as well as to provide optimal stimulus for regeneration of facet cartilage and or capsule. Biomechanical faults caused by joint restrictions should be corrected with joint mobilization. Spinal manipulation May Be useful for this condition. Which condition best fits with these interventions? DJD Facet extrapment (acute locked back) Posterolateral bulge/herniation Internal Disc disruption
DJD & Facet Extrapment With facet extrapment it is good to do positional facet joint gapping as a tx.
You observe your pt having the following symptoms. There is no pain when they are in a recliner or semi-reclined position, however, with weight bearing activates the pain increases. Their pain description is shooting, burning or stabbing. Pt states they have altered strength with their ADL's. What dysfunction is the pt displaying? Facet joint dysfunction Degenerative Joint Disease / OA Discal With Nerve Root Compromise Vascular Claudication Spinal Stenosis Neoplastic disease
Discal with Nerve Root Compromise
What special test do you use to asses the Glenohumeral joint for Rotator Cuff pathology? Jerk Test Drop Arm Speeds Apprehension O'Brian Hawkins Kennedy Yergason's Test
Drop Arm test: passively abd to 120* and pt can't slowly lower hand down
Which of the following is observed as banding on palm and digit flexion contractures resulting from contracture of palmar facia which adheres to skin? Boutonniere deformity Dupuytran's Swan Neck deformity
Dupuytren's Contracture
What special test asses the wrist and hand for De Quervain's tenosynovitis? (tendonitis of the abductor pollicis longus and extensor pollicis brevis.)
Eichoff's test: make a fist w/ thumb inside of it and do ulner deviation. Finkelstein's test: PTA distracts the wrist with thumb and moves towards the ulner.
What is the special test for Hip Muscle length/ strength involvement for tightness of Rectus Femoris?
Ely's test: prone w/ knee slowly flexed to max but then hip rotates
Pathological end feel: loose, then very hard muscle guarding Rubbery Empty Hypermobiliy
Empty
Mechanism of injury is frequently a weight bearing torsional stress. Presents more frequently in adolescents where an ACL injury would occur in an Adult. Which of the following knee fractures is being described? Medial femoral condyle Tibial Plateau Epiphyseal Plate Patella
Epiphyseal plate
Etiology can be bone deformity, cerebral palsy, contracture of gastrocnemius and/ or soleus muscles with compensation secondary to DF includes subtalar or midtarsal pronation. Talipes Equinovarus Equinus Hallux Valgus Metatarsalgia
Equinus : tx w/ flexibility, joint mobs, strength, orthotic
Pt is on their first 3-4 weeks of distal hand immobilized with a splint from the wrist and the digits flexed. They have a rubber band traction to maintain interphalangeal joints in 30-50 degrees of passive flexion. What type of hand repair did they have? Flexor tendon repair Extensor tendon repair
Extensor tendon repair
What is the special test for Hip Dysfunction, mobility restriction such as labral impingement, musculoskeletal pathologies, lumbar spine, or sacroiliac joint dysfunction?
FABER test "patrick": hip flex, abd, ER, w/ foot other knee & PTA add over pressure. SI joint
You observe your pt having the following symptoms. Stiff upon rising with the pain decreasing with in 1hr. loss of motion w/ some motion causing sharp pain. Stationary positions increase symptoms. However, movement in pain -free range usually reduces symptoms. What dysfunction is the pt displaying? Facet joint dysfunction Degenerative Joint Disease / OA Discal With Nerve Root Compromise Vascular Claudication Spinal Stenosis Neoplastic disease
Facet Joint dysfunction
Which of the following demonstrates significant ability to absorb and disperse multidirectional loads. It is found in intervertebral disc, Labrum, and meniscus. Nourishment is through "milking" in joint loading for the synovial fluid. However, there are portions that are not attached near a blood supply resulting in poor healing ability like the innermost portions of the meniscus. Dense Irregular Connective tissue Loose, Irregular Connective Tissue Articular Cartilage Dense Regular Connective Tissue Fibrocartilage
Fibrocartilage like in the acetabulum labrum (in hip joint)
Pt is using his wrist extensors to flex their fingers. What do you suspect is weak?
Finger flexors are weak ( tenodesis)
Physiological end - feel: capsular and ligamentous stretching Soft Firm Hard
Firm
Concave surface is fixed in one spot and Convex moves. Concave surface is moving as the Convex surface is fixed in one spot. Explain this concept
Fixed Concave + Moving Convex = opposite Moving Concave + Fixed Convex = Same direction Temporomandibular in all duration is a Convex moving on a Concave.
Which of the following can be due to congenital abnormal deviation of head and neck of talus that shows EVERSION of forefoot when subtalar joint is in neutral? Rearfoot Valgus Forefoot Varus Forefoot Valgus
Forefoot Valgus
Which of the following can be due to congenital abnormal deviation of head and neck of talus that shows INVERSION of forefoot when subtalar joint is in neutral? Rearfoot Valgus Forefoot Varus Forefoot Valgus
Forefoot Varus
At what phase is the pt expected to no have any pain, tx can include plyometric activates with WB proprioceptive activates and pt no longer needs modalities. ? Acute inflammatory phase/ Maximal Protection Subacute Phase/ Moderate Protection Functional Restoration/ Minimal Protection Phase
Functional Restoration/ Minimal Protection Phase
If there is an excessive lateral tibial torsion what do you expect to see with the pt's knees? Normal Genu Varum Genu Valgum
Genu Valgum
Limitation of movement due to capsular pattern presents as greater limited ER, followed by abduction and internal rotation. Glenohumeral Humeroulnar Humeroradial Hip Talocrural
Glenohumeral
PTA should restore normal shoulder mechanics via strengthening/ endurance/ coordination exercises that focus on regaining dynamic scapulothoracic and glenohumeral stabilization and muscular reeducation. As well as biomechanical faults caused by joint restriction. This interventions is best implement for what UE condition? Labral Tears Thoracic Outlet Syndrome Glenohumeral Subluxation and Dislocation Rotator Cuff Tendinitis Impingement Syndrome Proximal Humeral Fractures
Glenohumeral Subluxation and Dislocation
What is the Arthrokinematic of the proximal phalanx and metacarpal head articulation surface. Roll Glide Spin
Glide
Pt states they have footwear that is too tight, can also have weak muscles, ligamentous laxity. Pt presents with medial deviation of head of first metatarsal from midline to body, metatarsal and base of proximal first phalanx move medially, distal phalanx then move laterally. Pt does not have the normal metatarsophalangeal angle of 8-20* degrees. Which of the following is being described. Talipes Equinovarus Equinus Hallux Valgus Metatarsalgia
Hallux Valgus
Physiological end - feel: when bone and/or cartilage meet Soft Firm Hard
Hard
Limitation of movement due to capsular pattern presents as limited flexion/internal rotation; some limitation of abduction; no or little limitation of adduction and ER. Glenohumeral Humeroulnar Humeroradial Hip Talocrural
Hip
You pt presents with lateral trunk and tensor fascia latae compensation. What do you suspect is weak.
Hip Abductors.
What is the special test for Hip DJD (degenerative joint disease?
Hip scour test: hip at 90* w/ knee full flex and compressive force to femur.
What special test do you use to asses the Glenohumeral joint to acromioclavicular joint? Jerk Test Horizontal Adduction Speeds Apprehension O'Brian Hawkins Kennedy Yergason's Test
Horizontal Adduction test: flex to 90* then Horez add across body = localized pain at AC joint
Pathological end feel: the end feel is at a later time than on the opposite side Rubbery Empty Hypermobiliy
Hypermobility
List the contraindications for joint mobilization.
Hypermobility joint effusion inflammation
Proximal extension repairs are immobilized with the wrist and digital joints in extension for 4 weeks. Early AROM/PROM in flexion with metacarpophalangeal joints in extension. At 6 weeks, full AROM is initiated into flexion and extension. True or False
I think because the proximal portion is closer to the body with more blood supply so it takes 4 weeks instead of 6-8 weeks like the distal repair.
Your pt is an avid runner who is presenting with an abnormal gait pattern resulting in inflammation of the trochanteric bursa. The PT states they tested positive with Noble compression test. What do you suspect is their Dx and what interventions would you consider for this pt? Piriformis Syndrome Trochanteric Bursitis Coxa Vara Coxa Valga ITB Tightness/ Friction disorder
ITB Tightness/ Friction disorder PTA should reduce pain & inflammation w/ modalities, manual therapy, soft tissue massage and joint oscillations. Then Correct the muscle imbalance w/ strengthening, endurance, coordination, Flexibility to ITB/ Hamstrings/ Quadriceps/ Hip flexors. Joint mobilization. Gait training w/ pt education for running shoes / surfaces, and orthoses.
What type of ligament will you categorize the ACL? Extra articular ligament intra articular ligament
Intra-articular ligaments such as the anterior cruciate ligament (ACL) act as primary stabilizers as well as PCL
What special test do you use to asses the Glenohumeral joint to posterior and inferior instability? Jerk Test Drop Arm Speeds Apprehension O'Brian Hawkins Kennedy Yergason's Test
Jerk test: 90* flex and IR then add a jerk motion and the humeral head subluxes off the back of the glenoid Sulcus sign inferior to the acromian
A superior inquiry is known as a SLAP lesion and is a tear of the rim above the middle of the socket that can also involve the biceps tendon. A tear of the rim below the middle of the glenoid socket is called Bankart lesion and also involves the inferior glenohumeral ligament. This classification is applied to which of the following? Labral Tears Thoracic Outlet Syndrome Glenohumeral Subluxation and Dislocation Rotator Cuff Tendinitis Impingement Syndrome Proximal Humeral Fractures
Labral Tears
Which of the following contains lower density collagen fibers that are multidirectional. This tissue is found in superficial fascial sheaths, muscle and nerve sheaths. It has higher vasculature and water which provides a faster healing time. Dense Irregular Connective tissue Loose, Irregular Connective Tissue Articular Cartilage Dense Regular Connective Tissue Fibrocartilage
Loose, irregular connective tissue
Which of the following is a mobilization technique that provides a joint glide grade I - IV? Maitland Kaltenbom
Maitland
Which of the following is a result of a rupture or avulsion of extensor tendon at its insertion into distal phalanx of digit? Ape Hand Deformity Mallet Finger Gamekeeper's Thumb Boxer's Fracture
Mallet Finger: Observed deformity is flexion of DIP joint
What is the special test for the knee if you are suspecting a Meniscus tear?
McMurray test: finding click or pain at knee joint when applying rotational force w/ knee flex then rotate medially and then extend leg, symptoms will be on the lateral meniscus. For medial meniscus tear you must laterally rotate and then extend the leg.
Pt presents with LE excessive pronation with pain is elicited with palpation of the distal posteromedial border of the tibia. You will be tx with flexibility exercises for anterior compartment muscles as well as the Triceps Surae to gain restoration of normal function. Which of the following is being described? Anterior tibial periostitis Medial Tibial Stress Syndrome
Medial tibial stress syndrome Anterior tibial periostitis is (shin splits) w/ anterior tibialis and extensor hallucis longus
Which nerve dysfunction results in Ape Hand Deformation? Ulnar nerve Median nerve Radial nerve
Median nerve
When you are assessing the strength, power, endurance by the use of MMT, dynamometry what are you exactly assessing? Posture ROM/ Flexibility Motor Function Functional Mobility
Motor Function
You observe your pt having the following symptoms. The pain is gnawing, intense or penetrating. Pain is not resolved by changing position, time of day or activity level. The pain wakes them up. What dysfunction is the pt displaying? Facet joint dysfunction Degenerative Joint Disease / OA Discal With Nerve Root Compromise Vascular Claudication Spinal Stenosis Neoplastic disease
Neoplastic disease
Idiopathic Scoliosis has two types. Which of the following is scoliosis that is reversible lateral curvature of the spine without a rotational component? Structural Scoliosis Nonstructural Scoliosis
Nonstructural Scoliosis
If tibiofemoral shaft angle is 6* degrees of valgum what would you categorize it as? Normal Varum Valgum
Normal
What special test do you use to asses the Glenohumeral joint to SLAP lesion (superior labrum anterior to posterior)? Choose all that apply Jerk Test Drop Arm Speeds Apprehension O'Brian Hawkins Kennedy Yergason's Test
O'Brien test: 90*flex and 15*add and then add downward pressure on arm = pop Yergason test: pathology of long head of biceps and SLAP lesion Biceps load II
Which of the following is described as a separation of articular cartilage from underlying bone that involves medial femoral condyle. PTA should provided, strength, power and flexibility exercises, joint/ bone protection strategies, improve joint mechanics and length of muscles, and use aquatic program for endurance. Osteomyelitis Osteomalacia Osteochondritis Dissecans
Osteochondritis Dissecans
Defined biomechanics of the movement between two bones. Arthrokinematics Osteokinematics
Osteokinematics
What Kinematic describes the convex and concave movement between two bones? Arthrokinematic Osteokinematics
Osteokinematics
Pt presents with malalignment in which patella tracks inferiorly in femoral intercondylar notch. Results in restricted knee extension with abnormal cartilaginous wearing resulting in DJD. What type of Patellofemoral Condition does this pt demonstrate? Patella alta Patella baja Lateral patellar tracking
Patella baja
What part of the bone is a fibrous connective tissue that provided blood supply to the bone as well as an attachment site for tendons and ligaments? Compact bone Cancellous Bone periosteum osteoblast osteoclast
Periosteum dense irregular connective tissue is found in the periosteum
Pt presents with sings of scar tissue at this time, can be easily remodeled with appropriate stresses. Phase 1 proliferative phase Phase 2 fibroblastic phase Phase 3 maturation phase
Phase 3 Remodeling or maturation phase
What special test asses for posterior instability in the Knee for posterior cruciate ligament (PCL)?
Posterior drawer test: hip 90*, knee 45* and PTA pushes Posterior sag sign: bend knee in supine and tibia just slides back
Pt is being treated for a ligament injurie with AROM and light resistance but you are told to still avoid activates that cause pain but focus on exercises endurance and use taping if needed. What healing time frame do you suspect they are in. Day 3-14 (2weeks) Day 5-Week 6 Week 2- week 12 Week 2- week 6
Proliferative stage Week 2- week 6 After Week 6 it is in remodeling stage for up to 1yr
Which of the following generally do not require immobilization or surgical repair because the are of injury is fairly stable. Also, early PROM is important in preventing capsular adhesions. Labral Tears Thoracic Outlet Syndrome Glenohumeral Subluxation and Dislocation Rotator Cuff Tendinitis Impingement Syndrome Proximal Humeral Fractures
Proximal Humeral Fractures
What part of the gait cycle will the pt have difficulty with if they are diagnosed with Pes Planus? Push off swing Initial swing heel strike
Push off due to the the reduction in height of medial longitudinal arch. Can be "due to" (owing to) disease like RA, muscle weakness, ligamentous laxity, paralysis, excessive pronation, trauma.
A pt had a meniscal arthroscopy the includes Non-weight bearing for 3-6 weeks. Rehab of the joint begins with in 7-10 days of procedure. Interventions include message to quadriceps and hamstrings, oscillations, strengthen endurance, coordination, flexibility, joint manipulation. What type of meniscal arthroscopy did they receive base on intervention Partial Meniscectomy Repair Meniscal Arthoroscopy
Repair meniscal arthoroscopy
Which of the following will be the result of a positive Hackings Kennedy special test, Drop arm, and Neer's special test. There can be more than 1 answer. Labral Tears Thoracic Outlet Syndrome Glenohumeral Subluxation and Dislocation Rotator Cuff Tendinitis Impingement Syndrome Proximal Humeral Fractures
Rotator Cuff Tendinitis Impingement Syndrome
If the pt test positive for the drop arm test and they have poor scapulothoracic and glenohumeral rhythm with no reduction of PROM but significant reduction with AROM Abd. Which of the following conditions do they have? Flexor tendon injurie Rotator Cuff Tear SIJ condition Facet joint condition
Rotator cuff tear
Contraindications: Absolute: soft tissue breakdown, infection, cellulitis, inflammation, neoplasm. Relative: hypermobility and sensitivity To what manual technique are they referring to? Soft tissue/ Myofascial Techniques/ massage Joint Articulatory Techniques / oscillation, mobilization.
Soft tissue/ Myofascial Techniques/ massage
You observe your pt having the following symptoms. Pt is flexion biased and their pain is numbness, tightness, or cramping. Walking for any distance initiates symptoms. The pain may persist for hours after pt has found a resting position. What dysfunction is the pt displaying? Facet joint dysfunction Degenerative Joint Disease / OA Discal With Nerve Root Compromise Vascular Claudication Spinal Stenosis Neoplastic disease
Spinal Stenosis
Which of the following can be graded as 1 = 25% slippage up to grade 4 = 100% slippage Spondylolysis Spondylolisthesis
Spondylolisthesis
The actual anterior or posterior slippage of one vertebra on another following bilateral fracture of pars interarticularis. Spondylolysis Spondylolisthesis
Spondylolisthesis you can use the stork test to help identify these conditions. It is a figure 4 SLS and you are observing hip alignment and spine, pt will have lateral localized pain.
Which of the following presents as flexion of MCP and DIP with extension of PIP? (the order on your hand is MCP --> PIP --> DIP Boutonniere Deformity Swan Neck Deformity Ape Hand Deformity
Swan Neck Deformity
Which of the following results from contracture of intrinsic muscles with dorsal subluxation of lateral extensor tendons? Boutonniere Deformity Swan Neck Deformity Ape Hand Deformity
Swan Neck Deformity
which of the following special test would you use to asses a ligament sprain in the ankle? Talar Tilt Test Posterior drawer test Anterior drawer test Thessaly Test
Talar Tilt Test (inversion) to asses CFL Anterior Drawer test to assess for ATFL tear note grade III: is full ATFL and CFL tear and partial PTFL
Limitation of movement due to capsular pattern presents as Loss of plantarflexion greater than dorsiflexion. Glenohumeral Humeroulnar Humeroradial Hip Talocrural
Talocrural
Acute inflammation of a tendon caused by microtears when the musculotendinous unit is overloaded with a tensile force that is too heavy or too sudden. Which of the following is being described? Tendinitis Tendinosis
Tendinitis
The following INTERVENTIONS should be implemented to which Soft tissue condition? Rest, Short-term use of anti-inflammatories, bracing, and protection. Tendinitis Tendinosis
Tendinitis
What is the special test for Hip Muscle length/ strength involvement for Iliacus or iliopsoas?
Thomas test
What is the special test for Hip Muscle length/ strength involvement for weakness of gluteus medius or unstable hip?
Trendelenburg sign: pelvis drops and trunk leans away from the drop.
ITB Friction Disorder can lead to what other LE conditions of the hip? Femoral Anteversion Coxa Vara Coxa Valga Trochanteric Bursitis Piriformis Syndrome
Trochanteric Bursitis In addition to irritation by the ITB, gait abnormalities causing repetitive microtrauma and/ or a direct blow to the area can lead to trochanteric Bursitis.
A Tonic muscles are slow twitch, meaning they can stay "on" for long periods of time. Tonic muscles are closer to the joints, they have great endurance, are oxygen fed, and are well integrated with the brain and vestibular system. True or False
True
A pt who has a multilevel vertebral fusion with Harrington rod placement for idiopathic scoliosis, rehabilitation goals focus on early mobilization in bed and effective coughing. Ambulation can begin between day 4-7 post op. true or false
True
Elastin fibers are in tissues that allows fibers to withstand a stretch and return readily to previous shape. Elastin fibers are found in cartilage and spinal ligaments. True or False
True
Excessive Femoral anteversion of 30 degrees or greater leads to squinting patellae and toeing in. True or False
True
Posterior dislocations frequently cause avulsion fractures of medial epicondyle secondary to traction pull of medial collateral ligament. PTA tx is the reduction of the dislocation "pull it back into place" phase of immobilization then flexibility with limits of stability and strengthening. True or False
True for Elbow Dislocation that is defined by the location of the olecranon relative to the humerus.
What type of collagen fiber is described as rigged, stiff, and located in ligaments, tendons, joint capsule Type 1 Type 2
Type 1
What type of Collagen fiber is found in hyaline cartilage, ear, nose and trachea b/c it provides strength in tissues. Type 1 Type 2
Type 2 it's avascular (lacking blood vessels)
PT Interventions: Spinal manipulation is generally indicated for this Cervical spine condition. Restoration of normal function w/ flexibility, endurance, coordination, strengthening. Joint mobilization for biomechanical faults. Education on harmful positions and best postural. Manual and/or mechanical traction w/ c/s at 15* flexion for optimal intervertebral foraminal opening. Which of the following fits Whiplash hypermobile spinal segments DJD Facet extrapment
Whiplash
You torn transverse humeral ligament, Bicipital tendonitis or tendinosis. What special test would you do? Jerk Test Drop Arm Speeds Apprehension O'Brian Hawkins Kennedy Yergason's Test
Yergason's Test : like ER MMT combined with pronator MMT
Define Wolf's law
bone remodeling and reshaping in response to stresses placed upon it. So weight bearing and loading is good for improving bone strength.
Your approach to tx for early intervention is to manage edema, passive exercises. You initiate AROM at 6 weeks with proximal interphalangeal joints in neutral. Manage soft tissue to provided collagen remodeling which preserves free tendon gliding. Active extension exercises are initiated first then flexion. Resistive and functional exercises are introduced when full AROM is achieved. What type of tendon repair did this pt have? Flexor tendon repair Extensor tendon repair
extensor tendon repair
Pt is over using lower back extensors and adductor magnus, and quadratus lumborum. what do you suspect is weak.
hip extensors
List the three contraindications for Maitland technique
hypermobility joint effusion inflammation
When you have a Strain, what is affected? muscle ligament
muscle
PT w/ knee ligamentous knee repair must be weaned off from brace between 2nd and 4th week? true or false
true for ACL/ PCL knee repair PCL repair pt is often initially in hinged brace at 0 degree during ambulation
By the sixth week of knee repair the PT wants to progress the pt to 0-120* degrees of flexion. What do you suspect the type of repair the pt had?
ACL/ PCL PCL repair pt is often initially in hinged brace at 0degree during ambulation
There is increased pressure within a closed osteofascial compartment, resulting in impaired local circulation / a local ischemic condition due to direct trauma, fracture, overuse, and/or muscle hypertrophy. You observe swelling, paresthesia, and severe pain with PROM. Which of the following is being described and what is your next step as PTA. Anterior Compartment syndrome anterior tibial periostitis (shin splints) Medial tibial stress syndrome Stress fractures
Anterior Compartment syndrome more specifically cute stage. PTA should consider this a medical emergency and requires immediate surgical intervention to prevent tissue death and disability.
A pt with RA is likely to have which deformity? Boutonniere Deformity Swan Neck Deformity
Boutonniere Deformity & Swan Neck Depends on what RA is degenerating. Degeneration of Central extensor tendon Bout Degeneration of Lateral extensor tendon Swan splinting and taping helps
Which of the following is a result from a fracture of neck of fifth metacarpal that results in needing a cast for 2-4 weeks? Ape Hand Deformity Mallet Finger Gamekeeper's Thumb Boxer's Fracture
Boxer's Fracture
A pt with TKR is told they can fully WB or WBAT post surgery and is expected to be 0*-90* with in 2 weeks and 0*-120* degrees with in 4 weeks as well as full WB at week 4 too. Note Resisted exercise begins at week 2-3. What type of TKR did they have? Cemented Non-Cemented (Cementless)
Cemented
Pt had a TKR ROM is 0-90* within 2weeks, 0-120* within 3-4 weeks and must be progressed according to the time frame of fracture healing. WB at 25% - 50% with in 1-7 weeks, 75% WB by week 8, and 100% WB by Week 10. However if the pt is started with WBAT they will be ambulating w/ full WB by week 6. Note resisted exercise begins at week 2-3. What type of TKR did they get? Cemented Cementless (non-cemented)
Cementless (non-cemented)
What Herniation results in loss of strength, radicular pain, paresthesia, inability to perform ADLs, possible compression of the spinal cord with central nervous system symptoms like hyperreflexia and positive babinski's reflex. Internal disc disruption Posterolateral Bulge/Herniation Central Posterior Bulge/ Herniation
Central Posterior Bulge/ Herniation
Which of the following is a Contraindication for Avascular Necrosis of the hip because this medication could be the case of this condition and their dose might need to be decreased. Acetaminophen NSAIDs Corticosteroids
Corticosteroids is a Contraindication so refer pt to MD and implement JOINT/ BONE protection strategies, aqua endurance, gait training, strength, function.
Which of the following angles of the femoral neck with shaft of femur being >135 degrees is listed? Coxa Vara Coxa Valga
Coxa Valga
Which of the following leads to both knees (LE) to have a Genu Varum? Coxa Vara Coxa Valga
Coxa Valga b/c the femoral neck shaft angle is >135 degrees
Which of the following leads to both knees (LE) to have a Genu Valgum? Coxa Vara Coxa Valga
Coxa Vara b/c the <120 digresses will cause the femoral long body to angle inwards
Which of the following angles of the femoral neck with shaft of femur being <120 degrees is listed? Coxa Vara Coxa Valga
Coxa Vara: usually results from a defect in ossification of head of femur.
What special test is best for assessing Femoral Anteversion? FADDIR FABER Craig's Test Ober's test Nobel compression test
Craig's test: you are trying to feel the greater trochanter right on the lateral side and it should take around 8-15 degrease to get there.
Which of the following refers to osteoarthritis where OA is the leading cause of disability in elderly. Notable with diminished joint space, decreased height of articular cartilage, presence of osteophytes. PTA tx is focused on joint protection, flexibility and general strengthening, and endurance in aquatic program. Ankylosing Spondylitis Degenerative Joint Disease (DJD) Gout Psoriatic Arthritis Rheumatoid Arthritis
DJD
You observe your pt having the following symptoms. Pain and stiffness upon rising that eases with in 4-5hrs, pain increase with repetitive bending activates. They are in a constant state of discomfort with episodes of exacerbation, and pain is more soreness and nagging. What dysfunction is the pt displaying? Facet joint dysfunction Degenerative Joint Disease / OA Discal With Nerve Root Compromise Vascular Claudication Spinal Stenosis Neoplastic disease
DJD / OA
TMJ causes clicking, popping, or crepitation and limited flexibility of the jaw. This can be related to the Cervical spine. There is OA and RA in the TMJ. Which of the three types of TMJ diagnostic dose this fall under? Myofascial DJD Internal derangement of joint
DJD TMJ
Pt is being treated due to ligament inflammation with RICE, TENS modality and protect the area. What duration of time frame from injurie do you expect this pt to be in. Day 1-5 Day 3-14 (2weeks) Da 1-14 (2weeks) Week 2-6
Day 3- 14 remember that ligaments take a long time to heal even up to a year to feel 70% normal
Which of the following can be found in the joint capsule, periosteum, aponeurosis, & dermis? Dense Irregular Connective tissue Loose, Irregular Connective Tissue Articular Cartilage Bone Dense Regular Connective Tissue Fibrocartilage
Dense Irregular Connective Tissue the periosteum is part of the bone the aponeurosis is that sheath found in the palm of your head, near the abs, in you back.. ect. dermis is part of the skin.
Which of the following contains type 1 fibers that has multidirectional fiber orientation & withstand multidirectional forces because of it. They are located in joint capsule, periosteum, aponeurosis, dermis. Dense Irregular Connective tissue Loose, Irregular Connective Tissue Articular Cartilage Bone Dense Regular Connective Tissue Fibrocartilage
Dense Irregular Connective tissue
Pt is moving from flexion to extension that leads to abnormal movement of fibroadipose (containing both fibrous and fatty structures) meniscoid (contains connective tissue and adipose tissue) in the facet. Meniscoid does not properly reenter joint cavity and bunches up, becoming a space-occupying lesion, which distends capsule, causing pain. Flexion positions are not comfortable and extension increases the pain. What type of facet joint conditions is this DJD Facet extrapment (acute locked back) Posterolateral bulge/herniation Internal Disc disruption
Facet extrapment (acute locked back) gapping and manipulation is appropriate
The bone is partially bent and partially broken, this occurs in children and not teens or adults. Stress fracture Open Fracture Incomplete fracture Greenstick
Greenstick
What special test do you use to asses the Glenohumeral joint to Subacromial impingement for the supraspinatus? choose all that apply Jerk Test Neer's Speeds Empty Can O'Brian Hawkins Kennedy Yergason's Test
Hawkins- Kennedy test: passive 90* flex and IR Neer's: Passive IR and full abd Empty Can: Shld 90* abd and 30* Horez Abd then IR thumb down add resistance
PT Interventions: Pain reduction w/ modalities, PROM w/ normal range, Passive stabilization w/ corsets/ splints/ casts/tape and collars. Increase strength/ endurance/ coordination especially in multifidus, abdominal, extensors, and gluteals, w/ control posture. Regain muscles balance Educate about posture and limit excessive overloading, limiting sustained activates, and limiting end-rand postures. This intervention is best for what condition? Whiplash hypermobile spinal segments DJD Facet extrapment
Hypermobile Spinal Segments This is an abnormal increase in ROM at a joint due to insuficient soft tissue control like ligamentous, discal, muscle, or a combination of all three.
TMJ causes clicking, popping, or crepitation and limited flexibility of the jaw. This can be related to the Cervical spine. dislocated jaw, displaced articular disc or injury to condyle, these can result in loss of function mobility due to trauma, congenital anatomical anomalies or simply repetitive chewing of ice with forward head posture. Which of the three types of TMJ diagnostic dose this fall under? Myofascial DJD Internal derangement of joint
Internal derangement of joint
This spinal disc condition the disc annulus is affected, however external structures remain normal and condition is most common in lumbar region. Pt will present with constant deep achy pain, increased pain with movement, no objective neurological findings, although pt may have referred pain into LE. Spinal manipulation my be contraindicated. Choose the spinal dic conditions that is being described. Internal disc disruption Posterolateral bulge/herniation
Internal disc disruption PTA will edu on limiting repetitive bending and twisting movements, limiting upper extremity overhead and sitting activates, and carrying heavy loads. Spinal manipulation may be contraindicated for this condition (these are the same contraindications for herniation)
For what PTA intervention is the following list of contraindication applied to. Joint hypermobility, joint effusion, inflammation?
Joint Mobilization Joint effusion is a condition in which excess fluid accumulates in or around a joint, causing a swollen joint.
For what PTA intervention is the following list of contraindication applied to. malignancy, unhealed fracture, bone disease, hypermobility in adjacent joint, RA, blood thinning meds.
Joint mobilization
Which of the following is a mobilization technique that provides a joint distraction grade I - III? Maitland Kaltenbom
Kaltenbom
PTA interventions include Yergason special test, strengthening, endurance, coordination, and flexibility to address muscle imbalance, if needed address shoulder instability, Joint mobilization, and if post surgery the pt will be kept in a sling for 3-4 weeks. After 6 weeks you can do more sport specific training but Full fitness is around 3-4 months. Labral Tears Thoracic Outlet Syndrome Glenohumeral Subluxation and Dislocation Rotator Cuff Tendinitis Impingement Syndrome Proximal Humeral Fractures
Labral Tears
What special test assess for anterior instability of the Knee for the anterior cruciate ligament (ACL)?
Lachman test: supine w/ knee slightly bent PTA adds a anterior pull while stabilizing the femur & lacking firm end feel. Anterior Drawer test: hip at 90, knee at 45* PTA sits on foot and adds anterior pull & lacking firm end feel.
Pt presents with lateral and or medial Knee joint pain effusion, joint popping, knee giving way during walking, limitation in flexibility of knee joint, and joint locking. What LE condition do you expect them to have? Ligament Sprains Meniscal Injurie's Patellofemoral conditions Pes Anserine Bursitis Osgood-Schlatter (jumper's knee)
Meniscal Injuries
Tight triceps surae group or Achilles tendon, callapse transverse arch, short first ray, pronation of forefoot. Pt states "pain at first and second metatarsal heads after long periods of weight bearing" Talipes Equinovarus Equinus Hallux Valgus Metatarsalgia
Metatarsalgia (all on the transverse plane not just the dot seen)
TMJ causes clicking, popping, or crepitation and limited flexibility of the jaw. This can be related to the Cervical spine. Trigger point pain is the most common form of temporomandibular dysfunction pain is in the jaw muscles, neck and shoulders. Which of the three types of TMJ diagnostic dose this fall under? Myofascial DJD Internal derangement of joint
Myofascial TMJ/TMD
What special test will asses the ITB tightness/ friction disorder? Homan's Sign Thessaly Test Nobel Compression test FADDIR Test
Noble Compression test: you add pressure on the lateral femoral condyle when pt is in supine w/ knee bent. Then with continues pressure you will extend the knee and symptoms are replicated. Ober's test is okay Homan's sign is for Deep-Vain-Thrombosis Thessaly Test is for meniscus tears w/ the pt standing & twisting on one leg. FADDIR test: asses anterior - superior impingement syndrome, anterior labral tear, and iliopsoas tendinitis.
What is the special test for Hip Muscle length/ strength involvement for TFL and/ or Iliotibial band?
Ober's Test: sidelying w/ knee bent and dropped behind pt.
Which of the following is a mechanical dysfunction resulting in traction apophysitis (an inflammation or stress injury to the areas on or around growth plates commonly in children or adolescents) of the tibial tubercle at the patellar tendon insertion? Ligament Sprains Meniscal Injurie's Patellofemoral conditions Pes Anserine Bursitis Osgood-Schlatter (jumper's knee)
Osgood-Schlatter (jumper's knee)
PTA interventions are rest with avoidance of throwing or UE loading activates. Once pain free then initiate flexibility and strengthening, endurance, coordination exercises. During late phase initiate slowly the loading increase. After surgery use modalities to address pain and swelling, then flexibility exercises immediately, joint mobility. Which of the following is the condition that a 12-15 year old would have this type of POC. Osteochondrosis of Humeral Capitellum Elbow Dislocations Nerve Entrapment
Osteochondrosis of Humeral Capitellum This loose body in joint is caused by repetitive compressive force between radial head and humeral capitellum.
Which of the following is described as a skeletal condition that is characterized by decalcification of bones as a result of vitamin D deficiency. PTA should provided joint/ bone protection strategies, improve joint mechanics and tissue functions, and use aquatic program for endurance. Osteomyelitis Osteomalacia Osteochondritis Dissecans
Osteomalacia
Which of the following is described as an inflammatory response with bone caused by an infection. This is more common in children or an adult w/ weak immune system. PTA should provided joint/ bone protection strategies and cast care, improve joint mechanics and tissue functions. Osteomyelitis Osteomalacia Osteochondritis Dissecans
Osteomyelitis
A pt had a meniscal arthroscopy the includes partial weight bearing as tolerated when full knee extension is obtained. Intervention is effusion control, AROM postsurgical day 1, isotonic and isokinetic strengthening day 3, decrease loading of the knee joint by jogging on toes. What type of meniscal arthroscopy did they receive base on intervention Partial Meniscectomy Repair Meniscal Arthoroscopy
Partial Meniscectomy
Pt presents with malalignment in which patella tracks superiorly in femoral intercondylar notch. May result in chronic patellar subluxation. Positive camelback sign ( 2 bumps over anterior knee region instead of typical one. b/c bump 1 is the patella riding with in femoral condyles and 2nd bump is tibial tuberosity. What type of Patellofemoral Condition does this pt demonstrate? Patella alta Patella baja Lateral patellar tracking
Patella alta: tx is to regain functional strength particularly VMO, normal flexibility of ITB and hamstring, patellar bracing/tape.
Pt presents with increased height of longitudinal arches, dropping of anterior arch, metatarsal heads lower than hindfoot, plantar flexion, and splaying of forefoot, and claw toes. PT educate on limiting of high impact sports like long distance running and ballet. Which of the following is being described? Flexor Hallucis Tendonopathy Pes Cavus Pes Planus Talipes Equinovarus (clubfoot)
Pes Cavus (hollow foot)
You have a pt who is presenting with weakness of thaner muscles and lateral two lumbricals. What special test would you implement? Phalen's test Neers' test O'Brian Apprehensive test
Phalen's test but also Tinel's for Carpal Tunnel median nerve problem.
What special test assesses neurological dysfunction carpal tunnel of median nerve in the wrist and hand?
Phalen's test: inverse prayer position hold for 1min Tinel's test: tapping over palmer side where the carpal tunnel has the median nerve pass Two point discrimination test: less than 6mm the pt is unable to distinguish between two points then they test positive.
Your pt presents with sings and symptoms of edema, erythema, heat and pain. What phase of scar tissue healing do expect them to be in. Phase 1 Inflammation/ proliferative phase Phase 2 Granulation/ fibroblastic phase Phase 3 Remodeling or maturation phase
Phase 1
Pt is with in 24-36hours from tissue formation and there are macrophages migrating to the damage site. What phase do you expect them to be in? Phase 1 Inflammation/ proliferative phase Phase 2 Granulation/ fibroblastic phase Phase 3 Remodeling or maturation phase
Phase 1 Inflammation/ proliferative phase
Pt is between 48hours - 6 weeks from tissue injurie. This is what they call the fibroblastic phase. What scar tissue phase are they in? Phase 1 Inflammation Phase 2 Granulation Phase 3 Remodeling
Phase 2 Granulation/ fibroblastic phase
Which of the following can be observed to show EVERSIONof calcaneus w/ a neutral subtalar joint due to the abnormal mechanical alignment of the knee (genu valgum or tibial valgus? Rearfoot Valgus Forefoot Varus Forefoot Valgus
Rearfoot Valgus
Which of the following refers to an autoimmune disorder that produces antibodies to their own immunoglobulins. Systemic symptoms include weight loss, fever and extreme fatigue. This disorder can be in juveniles prior to age 16 and about 75% of them are in remission. PTA tx is focused on joint protection, improve joint mechanics and connective tissue functions, and and endurance in aquatic program. Ankylosing Spondylitis Degenerative Joint Disease (DJD) Gout Psoriatic Arthritis Rheumatoid Arthritis
Rheumatoid Arthritis (RA)
Congenital ((of a disease or physical abnormality) present from birth) narrow spinal canal or intervertebral foramen coupled with hypertrophy of the spinal lamina and ligamentous flavum or facets as the result of age related degenerative processes or disease. Which of the following is defined by this? Muscle Strain Spondylolysis Spondylolisthesis Spinal/ intervertebral stenosis
Spinal or intervertebral stenosis
Contraindications: Avoid extension and other positions that narow the spinal canal or intervertebral foramen like ipsilateral side bending, and ipsilateral rotation. For Manual/mechanical traction include joint hypermobility, pregnancy, RA, down syndrome, any other systemic disease that affects ligamentous integrity. Muscle Strain Spondylolysis Spondylolisthesis Spinal/ intervertebral stenosis
Spinal/ intervertebral stenosis
Entrapment of the posterior tibial nerve that is due to overpronation, tendinitis of long flexor & posterior tibialis tendon. Pt presents with pain numbness and paresthesias along the medial ankle to the plantar surface of the foot. Which of the following condition is described? Ligament Sprain Achilles tendinitis/ tendonosis Tarsal Tunnel Syndrome
Tarsal Tunnel Syndrome Taniel's test will be a good test to perform b/c you just tap in the are to recreate the symptoms, just like you would for carpal tunnel syndrome. Neurontin for Neuropathic pain is good for this pt recommend orthoses
Your pt presents with visible compensatory scapular stabilizers to initiate shoulder motion in abduction. The pt is displaying weakened abductors and is there for reverse scapulothoracic rhythm. True / False
True
Pt presents with compression of neurovascular bundle that is composed of brachial plexus, subclavian artery and vein, vagus and phrenic nerves, and the sympathetic trunk. Which of the following is most likely the problem? Labral Tears Thoracic Outlet Syndrome Glenohumeral Subluxation and Dislocation Rotator Cuff Tendinitis Impingement Syndrome Proximal Humeral Fractures
Thoracic Outlet Syndrome
Which of the following condition are located in the scalene triangle, between clavicle and first rib, and between pectoralis minor and thoracic wall? Labral Tears Thoracic Outlet Syndrome Glenohumeral Subluxation and Dislocation Rotator Cuff Tendinitis Impingement Syndrome Proximal Humeral Fractures
Thoracic Outlet Syndrome (superior thoracic outlet is another area)
Your pt has been immobilized with a protective splint on their hand for 3-4 weeks due to a tendon repair. Your tx starts with resisted extension and passive flexion within constraints of splint with AROM to tolerance imitated at the 4 week mark. Early intervention consists of wound management, edema control, and passive exercises. You will manage all soft tissue by providing collagen remodeling which preserves free tendon gliding. Then resistive and functional exercises are introduced when full AROM is achieved. These Interventions are best for what type of repair? Flexor tendon repair Extensor Tendon repair
flexor tendon repair
Pt presents with over worked lower abdominal, lower obliques, hip adductors and latissimus dorsi due to all of the compensation. What do you suspect is weak.
hip flexors.
Your pt presents with compensatory bicep long head, coracobrachialis, and anterior deltoid. What do you suspect is weak.
pectoralis major
What is the Arthrokinematic of the femoral and tibial articulation surface. Roll Glide Spin
roll
High incidence of avascular necrosis of the proximal fragment of the scaphoid secondary to poor vascular supply and Carpals are immobilized between 4-8 weeks. These complications best fit what condition? Colles; fracture Smith's fracture Scaphoid fracture
scaphoid fracture
Which of the following refers to progressive inflammatory disorder affecting Axial Skeleton, which can be miss diagnosed as spinal stenosis. Symptoms: Mid-low back pain with morning stiffness and sacroiliitis. This will result in kyphotic deformity of C/s & T/s with a decrease in L/S lordosis. PTA tx is focused on flexibility on the trunk to improve joint motion and length of muscles in all direction, with emphasis in extension. Show relaxation activates, respirator function with breathing strategies and endurance in aquatic program. Ankylosing Spondylitis Degenerative Joint Disease (DJD) Gout Psoriatic Arthritis Rheumatoid Arthritis
Ankylosing Spondylitis
For the pt with the lateral retinacula release The PT wants you to normalize the flexibility of the hamstrings, triceps surae, ITB, perform mobilization of patella. What type of kinetic chain exercises would you do if you need to strengthen the quadriceps and dynamic balance of all structures? Open kinetic chain Close kinetic chain
Close kinetic chain
Idiopathic Scoliosis has two types. Which of the following is scoliosis that is irreversible lateral curvature of the spine with a rotational component? Structural Scoliosis Nonstructural Scoliosis
Structural Scoliosis
Pt presents with pain at anatomical snuffbox, swelling, decreased grip and pinch strength, positive Finkelstein's test. What do you suspect his diagnosis is? Colles' Fracture Smith's Fracture De Quervain's Carpal Tunnel Syndrome
De Quervain's Tenosynovitis
What special test do you use to asses Elbow's neurological dysfunction, cubital tunnel syndrome?
Elbow flexion test: Ulnar nerve symptoms w/ shoulder fully ER and max elbow flex and wrist ext for 1min.
Contraindications: Absolute: joint ankylosis, malignancy involving bone, diseases that affects integrity of ligaments like RA / Down syndrome, arterial insufficiency and active inflammatory / infective process. Relative: DJD arthrosis, metabolic bone diseases like osteoporosis, Paget's disease and tuberculosis, hypermobility, total joint replacement, pregnancy's, spondylolisthesis, steroids, radicular symptoms. To what manual technique are they referring to? Soft tissue/ Myofascial Techniques/ massage Joint Articulatory Techniques / oscillation, mobilization.
Joint Articulatory Techniques / oscillation, mobilization.
Pt presents with the following signs and symptoms: General shoulder pain that they can not localize, pain increases with over head activity or moving arm behind back. Pt has weakness, instability in the shoulder, pain with resisted elbow flexion and tenderness over the front of the shoulder. Labral Tears Thoracic Outlet Syndrome Glenohumeral Subluxation and Dislocation Rotator Cuff Tendinitis Impingement Syndrome Proximal Humeral Fractures
Labral Tears based on these you can try to do O'Brian or Yergason test
What type of the following conditions is a result of patellofemoral pain syndrome (PFPS). This procedure is to restore normal tracking of the patella. Lateral Retinacular Release Meniscal Arthroscopy Ligamentous Repair of knee
Lateral Retinacular Release
Can result if there is an increase in Q angle with a tendency for lateral subluxation or dislocation. What type of Patellofemoral Condition does this pt demonstrate? Patella alta Patella baja Lateral patellar tracking
Lateral patellar tracking: pt w/ patellofemoral pain syndrome will benefit from PFPS McConnell taping to inhibit pain during rehabilitation. Also be mindful in what direction you are providing patella glides.
Overall Metatarsus Adductus is a congenital muscle imbalance or neuromuscular disease such as polio. Out of the two types which one is observed as adduction of all five metatarsals at the tarsometatarsal joints.. Metatarsus Adductus Rigid Deformity Metatarsus Adductus Flexible Deformity
Metatarsus Adductus Flexible Deformity
Overall Metatarsus Adductus is a congenital muscle imbalance or neuromuscular disease such as polio. Out of the two types which one results in a medial subluxation of tarsometatarsal joints. Hindfoot is slightly in valgus with navicular lateral to head of talus. Metatarsus Adductus Rigid Deformity Metatarsus Adductus Flexible Deformity
Metatarsus Adductus Rigid Deformity
Pt presents with sings and symptoms of granulation tissue formation. what phase of scar tissue formation do you expect them to be in? Phase 1 proliferative phase Phase 2 fibroblastic phase Phase 3 maturation phase
Phase 2 Granulation/ fibroblastic phase
Pt is 3weeks - 6 months post tissue damage, there is an increase of fibroblasts and collagen production. What phase of scar tissue formation is the pt in. Phase 1 Inflammation/ proliferative phase Phase 2 Granulation/ fibroblastic phase Phase 3 Remodeling or maturation phase
Phase 3 Remodeling or maturation phase
PTA should rule out involvement of lumbar spine and sacroiliac joint. Provided reduction of pain w/ modalities, manual therapy and oscillations to hip or pelvis to inhibit pain. Correct muscle imbalance. Protection of the sacroiliac joint by providing instruction not to step off a curb onto the dysfunctional LE. Educate on orthoses, orthotic devices for feet. Which of these conditions will benefit from this tx. Piriformis Syndrome Trochanteric Bursitis Coxa Vara Femoral Anteversion Avascular Necrosis (AVN)
Piriformis Syndrome
Pt presents with restriction in IR, pain w/ palpation of piriformis muscle, referral of pain to posterior thigh, weakness in ER, positive piriformis test, uneven sacral base. Which of the following condition are being described? Piriformis Syndrome Trochanteric Bursitis Coxa Vara Femoral Anteversion Avascular Necrosis (AVN)
Piriformis Syndrome
Which of the following is due to overworked with excessive pronation of foot, which causes abnormal femoral IR. Piriformis Syndrome Trochanteric Bursitis Coxa Vara Femoral Anteversion Avascular Necrosis (AVN)
Piriformis Syndrome: Considered a tonic muscle which is active with motion of sacroiliac joint, particularly sacrum.
Pathological end feel: muscle spasm Rubbery Empty Hypermobiliy
Rubbery
At what phase is it the most effected to stretch the involved tissue after an injury and this stage lasts 2-3 days up to 8-10 weeks depending on tissue damage or surgery? Acute inflammatory phase/ Maximal Protection Subacute Phase/ Moderate Protection Functional Restoration/ Minimal Protection Phase
Subacute Phase/ Moderate Protection
Bone inflammatory phase is form day 1 - 14 (2weeks), then from week 2- week 12 it's the proliferative phase, and then week 12 - 1yr it's in remodeling phase. True or false
True Day 1- 14 you are NWB or limited WB Proliferative you are now WBAT
For muscle injury you are dealing with loose irregular connective tissue. So the healing phase is Day 1-5 inflammatory, Day 5- Week 6 proliferative, Week 6 - Month 6 Remodeling. True or False
True Inflammatory stage you can do isometric
What type of collagen fibers are found in ligaments, tendons, and joint capsule? Type 1 Type 2
Type 1
What special test do you use to asses Elbow's ligamentous instability?
Varus/Valgus stress test: elbow in 20* flex and add force biceps rupture "popeye" sign: rupture of proximal long head of bicep notable bump
What type of collagen fibers are found in hyaline cartilage, nose, ears, and trachea? Type 1 Type 2
Type 2
Thompson test examines the integrity of the Achilles tendon. The pt might need Acetaminophen for pain, NSAIDs for pain and inflammation, and Corticosteroid injection or by mouth for this Achilles injury. True or false
true
Match the proper intervention with the degree of angle for idiopathic scoliosis. Use of spinal orthoses is the best approach with flexibility exercises, trunk and pelvis strength, power, endurance, electrical stimulation for proper muscle performance and educate pt about orthoses. <25 degrees 25- 45 Degrees >45 Degrees
25-45 Degrees
Match the proper intervention with the degree of angle for idiopathic scoliosis. Conservative PT tx is the best approach with flexibility exercises, trunk and pelvis strength, power, endurance, electrical stimulation for proper muscle performance and educate pt about orthoses. <25 degrees 25- 45 Degrees >45 Degrees
<25 degrees
Which of the following contains the most tensile strength and is the least extensible. It can withstand unidirectional forces, and is found in ligaments and tendons. Dense Irregular Connective tissue Loose, Irregular Connective Tissue Articular Cartilage Dense Regular Connective Tissue Fibrocartilage
Dense Regular Connective Tissue. think about how it said unidirectional for ligaments and tendons.. it makes it "regular" vs. the "irregular" connective tissue that is multidirectional.
Subtalar is varus, calcaneal is varus, abnormal mechanical alignment of tibia results in rigid inversion of calcaneus when subtalar joint is in neutral position. Metatarsus Adductus Plantar Fasciitis Charcot-Marie-Tooth Disease Forefoot/ rearfoot Deformities
Forefoot/ rearfoot Deformities
A painful condition of abnormal calcification within a muscle belly following a direct trauma that results in hematoma. This calcification can also be induced by early aggressive PT following trauma. Tx is flexibility exercises, manual therapy with soft tissue however, note that you should avoid being aggressive with these tx. Joint mobilization and endurance with aquatic program. Torticollis TMJ Conditions Idiopathic Scoliosis Myositis Ossificans
Myositis Ossificans
Document states this condition is more commonly see in the lumbar spine due to the following: Posterior disc is narrower in height than anterior disc, posterior longitudinal ligament is not as strong and only centrally located in lumbar spine, and posterior lamellae of annulus are thinner. Overstretching and tearing of annular ring, vertebral endplate, and ligamentous structures from high compressive forces or repetitive microtrauma. Pt presents wit loss of strength, radicular pain, paresthesia, and inability to perform activities of daily living. Choose the spinal dic conditions that is being described. Internal disc disruption Posterolateral Bulge/Herniation Central Posterior Bulge/ Herniation
Posterolateral bulge/ herniation PTA: promote dynamic stability throughout trunk and pelvis as well as to provided optimal stimulus for regeneration of disc. Positional gapping for 10min to increase space within region of space occupying lesion If left posterolateral lumbar herniation present = pt lying on R side w/ pillow under R trunk causing trunk side bending R then flex both hips and knees, then rotate trunk to L (or pelvis to R) pt can be taught to perform this at home.
Your pt states they fell with their wrist flexed and the distal fragments of radius dislocates in a volar direction. Which of the following fracture is being described? Colles' Fracture Smith's Fracture Scaphoid Fracture
Smith's Fracture
Pt presents with bilateral pain and perasthesia in back, buttocks, thighs, claves, and feet. The pain is decreased in spinal flexion & increased with extension. Pain is increased with walking and relived with prolonged rest. Muscle Strain Spondylolysis Spondylolisthesis Spinal/ intervertebral stenosis
Spinal or Intervertebral stenosis
Which of the following is a fracture of the pars interarticularis with positive "scotty dog" sing on oblique radiographic view of spine. Spondylolysis Spondylolisthesis
Spondylolysis note that there is no slip disk
Contraindications: spinal manipulation, traction, trunk extension, ipsilateral side-bending, contralateral rotation. Which of the following is the conditions that best align to these contraindications? Muscle Strain Spondylolysis Spondylolisthesis Spinal/ intervertebral stenosis
Spondylolysis & Spondylolisthesis PTA: joint mobolization for biomechanical faults caused by injurie, dynamic stabilization of trunk with particular emphasis on abdominals and trunk extension with multifidus muscle working from flexion bias up to neutral position & posture education.
The following INTERVENTIONS should be implemented to which Soft tissue condition? Stretch tendon, soft tissue work, strengthen surrounding muscles, medical intervention my include injection (platelet rich plasma). Tendinitis Tendinosis
Tendinosis
Pt injury was a combination of valgum and compression forces to the knee when it was in a flexed position. Often occurs in conjunction with medial collateral ligamentous injury. Which of the following knee fractures is being described? Medial femoral condyle Tibial Plateau Epiphyseal Plate Patella
Tibial Plateau: different angle of fractures on tibia Medial femoral condyle is involved due to its anatomical design and due to trauma, shearing, impacting, and avulsion forces.
Your pt tested positive for Adson's and Roos' test. What would be your interventions?
Thoracic Outlet Syndrome PTA intervention will vary depending on the exact cause. Postural reeducation, functional training, restoration of muscle imbalance, strength, endurance, coordination, flexibility, Biomechanical faults are addressed by joint mobs, and Manipulation of first rib articulation to diminution pain and muscle guarding.
Acetaminophen for pain, NSAIDs for pain and inflammation or Corticosteroid Injections. or orally are possible medications to address Patellar Tendinitis and Pes Anserine Bursitis. True or falce
True
Colles' Fracture complications are median nerve compression due to edema, loss of motion, decreased grip strength, CRPS "pain syndrome", carpal tunnel syndrome. PTA early normalizing flexibility is key, joint mobs, soft tissue, .. True or false
True
Medication to tx TMJ can be acetaminophen for pain, NSAID's for pain and inflam, Muscle relaxants, trigger point injections, corticosteroid injection or by mouth. True or false
True
PT tx should be to return to function without pain. Early flexibility is important in preventing capsular adhesion after a Fracture involving the knee joint. True or False
True
Torticollis is a spasm or tightness of sternocleidomastoid muscle. Pt will present with side bending toward muscle and rotating away from SCM. Muscle relaxers and NSAID might be prescribed. True or False
True
With Spine Fusion the intervention should include massage to paraspinal muscles, oscillation, restore multifidus function, develop dynamic stabilization of trunk and pelvis during functional actives. True or False
True
What type of collagen fiber is slightly more flexible in order to help maintain shape and provide internal strength in tissues. This type is found in hyaline cartilage. Type 1 Type 2
Type 1
What special test asses the medial - lateral instability of the Knee for MCL and LCL?
Varus stress test: you will stress the LCL and see a lot of movement Valgus stress test: stress the MCL in knee at 0* if seen a lot of movement then it's positive. If not sure then place knee at 30* and add stress and that will confirm findings.
You observe your pt having the following symptoms. Pain is consistent in all spinal positions but pain is relieved promptly with rest (1-5min). Pain is brought on by physical exertion that is described as numbness. The pt usually has decreased or absent pulses. What dysfunction is the pt displaying? Facet joint dysfunction Degenerative Joint Disease / OA Discal With Nerve Root Compromise Vascular Claudication Spinal Stenosis Neoplastic disease
Vascular claudication