PEAT 1.2
patient prone, knee flexed, pointing the toes to the ceiling = toes slightly invert
What is the reason for this?
ANS: Tibialis posterior substitution
Anterior pelvic tilt = Which muscles are weak?
• ANS: Rectus abdominis and Gluteus max are lengthened and weak
What can help with orthostatic hypotension
ANS: ankle pumps before standing
Knee flexion contracture of the right side will cause what gait issue on the left side?
ANS: hip hiking to clear the swinging leg
Management of heterotrophic ossification
ANS: Gentle stretching of the affected tissue
preforming submaximal cycle ergometer will result in constant values in:
• oxygen consumption
• systolic pressure
• diastolic pressure
• heart rate
ANS: Diastolic pressure
Numbness, tingling, paresthesia in both feet. Stock-and-glove symptoms, diminished ankle reflexes, loss of pain and temperature,
Decreased strength in both feet
> Knee-jerk reflexes are not affected
•
•
•
•
Neuropathy
Nerve root compression L4-L5
PVD
Claudication
ANS: Neuropathy
wound with: red granulation tissue, no eschar, no order, minimal serosanguinous drainage
what type of wound care?
• thin occlusive film, change as needed
• hydrocolloid film, change as needed
• wet to dry on normal gauze
• pulsed lavage with sharp debridement
ANS: hydrocolloid film is uses for wounds with mild - moderate drainage with no infection
What hip glide is this: what movement does it help with?
ANS: Hip inferior glide, and this helps improve hip flexion
Localized pain in the lower back and hip region, tingling radiating to the posterior thigh, pain increases with hip medial rotation is a
symptoms of what?
ANS: Piriformis syndrome
patient who cant walk and talk at the same time has a problem with what?
ANS: This finding suggests the individual is struggling with the introduction of a secondary task (conversation), which may
interfere with performance of a primary task (walking). Individuals who must devote extra attention to walking are unable to perform
the two tasks simultaneously
Best self-assessment tool for a patient with coronary artery disease.
ANS: rating of perceived exertion
Myelomeningocele of L2 (L1-L2) - what will their walking ability be?
expected levels of mobility at:
• L4 - L5
• L3 - L4
•
Thoracic level
ANS: A child who has L1–L2 level myelomeningocele would be expected to walk short distances in the home.
• Walking in the home and community using only ankle-foot orthoses would be possible for a child who has a L4–L5
myelomeningocele, not a L2 lesion.
• A child who has a L3–L4 myelomeningocele would be expected to achieve community ambulation using knee-ankle-foot
orthoses.
• Standing in a parapodium would be an appropriate prognosis for a child who has a thoracic-level myelomeningocele.
Electromyographic biofeedback (EMG) measures what?
ANS: Muscle activity
correcting thoracic kyphosis elongates with muscles?
ANS: Sternocleidomastoid
Insidious onset of pelvic and hip pain that is relieved with passing Gas?
ANS: Crohn's disease
Non-specific neck pain risk factors/differential diagnosis?
ANS: MI - myocardial infarction
C5 radiculopathy would have weakness in what?
ANS: Shoulder abduction
Rotator cuff repair progress (goal) 4 months post-surgery
ANS: be able to lift 5lbs, 20 times above shoulder level
Which modality of the biofeedback should be used in order to prevent overactivity of recruiting muscles?
ANS: Increase the sensitivity (gain)
inappropriate Anti-diuretic hormone secretions effects which system?
ANS: Anti-diuretic hormone helps to control blood pressure by acting on the kidneys and the blood vessels
So it effects the Cardiovascular system.
Syndrome of inappropriate antidiuretic hormone results in fluid volume excess, so it may cause hypertension and arrhythmias,
which require monitoring as activity levels change. Also the physical therapist may observe distended neck veins or a visible
jugular pulse
Calcaneus, forefoot, and subtalar joint positions in a "collapsed arch" or pes planus foot pronation
ANS: Valgum, Abduction, Eversion
The subtalar joint's main components with this are eversion and abduction. The midtarsal joint (the transverse tarsal joints) also
everts. In stance, the calcaneus is excessively everted from midline, which is a valgus position. With pronation there is also
associated abduction of the forefoot.
Dysdiadochokinesia
ANS: The inability to perform rapid alternating muscle movements
Interrater reliability vs. Interrater reliability vs. criterion-related validity
Intrarater reliability consistency of measurements made by the same examiner on different occasions
Interrater reliability consistency of measurements between two different examiners
criterion-related validity justifies the validity of an instrument by comparing it to a gold standard of measurement
What modification on a stationary bike would help with hamstring strengthening?
ANS: Toe clips can limit ankle motion, thereby allowing for increased knee flexion force to facilitate hamstring strengthening
What does an ST segment displacement indicate?
ANS: Myocardial infarction (MI)
Shoulder abduction strength of 4/5, but difficulty with abduction means what?
ANS: when there is no pain, but weakness, it is a nerve injury
Pediatric anterior groin pain radiating down the anterior thigh and knee
:NO ANS
Dermatome and myotome symptoms of L4-L5 disc bulge
ANS: pain in the dorsal of the foot with weakness in great toe extension
Ideomotor disorder
ANS: Ideomotor apraxia is the inability to perform purposeful movements when there is no loss of sensation, strength,
coordination, or comprehension. Frequently, patients who have ideomotor apraxia will be unable to perform a motor task on
command but will be able to perform the task when they are left on their own
What happens immediately to the blood PH as a response to vigorous exercise
ANS: > Respiration rate to raise blood pH levels <
Vigorous exercise produces lactic acid, which would lower the pH of blood unless compensatory mechanisms are in place.
Increasing RR reduces the alveolar partial pressure of arterial carbon dioxide (PaCO2), resulting in more alkalinity in the blood to
prevent an imbalance
Hip is flexed, slightly adducted, and laterally rotated. No abduction ability, and painful internal rotation.
ANS: Dislocated hip
High ESR and low RBC
ANS: High ESR is indication of high inflammatory state in the body = RA
Pain in the distal, posterior, medial aspect of leg. worse in the morning, eases, then worsens throughout the day.
ANS: posterior tibialis tendonitis
Spondelysthesis is defect in what?
ANS: pars interarticularis
Bigeminy
Couplets
Multifocal PVC's
Ventricular tachycardia
ANS: PVC (premature ventricular contraction) every other heart beat
insidious onset of pain in the lateral forearm and hand, worsens with neck extension
ANS: C6 radiculopathy
Which nerve extends the wrist and long extensor of digits?
ANS: Radial nerve
Q
Which mobilization helps with
wrist extension?
A
: dorsally to promote wrist flexion or
palmar (volar) to promote wrist extension
factors to measure myocardial
oxygen demand
Reflexes in response to high
blood pressure
What test is this? what is it
used for?
blood pressure + heart rate
N/A
Phalen's test
used to diagnose carpel tunnels syndrome
(reverse prayer sign)
gaze evoked nystagmus in
MS, what is the best test to
determine the cause of this?
Proprioception, 2 point
discriminations, and vibration which part of the spinal cord
has a lesion?
Atlantooccipital joint ROM
Which ankle glide is used to
improve dorsiflexion ROM?
anterior shoulder dislocation
(horizontal abduction, lateral
rotation).
falling on extended wrist, with
pain between flexor and
extensor of the first digit
Symptoms of a right CVA
------------
Posterior/Dorsal column
Flexion/Extension of the head on the neck
Posterior talar glide
anterior capsule, subscapularis, anterior glenoid labrum
Scaphoid fracture
•
•
•
•
•
•
judgement
impulsiveness
short attention span
spetial awareness issues
visual field deficits
impaired time concept
testing the compression of the
right lumbar facet would be
with movementes?
postural drainage for a
posterior lower lobes of the
lungs
Which cardiopulmonary values
change with COPD and
emphysema?
posture for desk jobs
Gait deviation with sciatic
nerve problems
Nerve root and lymph node
involvement for patients with
cancer
Diminished elbow reflexes is
due to
VO2 Blood test indication of
prostate cancer max for MS
patients
Blood test indication of
prostate cancer
Facial nerve functions (CNVII)
Cranial nerve V is responsible
for what?
anticipatory postural control
Stages of the motor learning
process
Dix Hallpike maneuver
Vestibular ocular assessment
Drugs:
•
•
•
gold sodium thiomalate
(Myochrysine)
Flurbiprofen (Ansaid)
Etodolac (Lodine)
•
extension and right sided flexion
•
laying prone with the pillows under the pelivs
….
;;;;;;
Decreased ankle dorsi flexion
•
Cryotherapy or moist heat pack? ****
C7 compression
…..
LOW PSA
facial expressions and movement
Cranial nerve 5 is the trigeminal nerve, responsible
for sensation on the whole face, and muscles
of mastication
responding to an unexpected perturbation while standing
…..
a bedside test/maneuver that is used to diagnose BPPV
(benign paroxysmal positional vertigo)
used to diagnose symptoms of concussion
1- Gold sodium thiomalate is categorized as a diseasemodifying antirheumatic drug
2- Flurbiprofen is not a disease-modifying, but is a
nonsteroidal anti-inflammatory drug
•
Aspirin
3- Etodolac is a nonsteroidal anti-inflammatory drug
4- Aspirin is a nonsteroidal anti-inflammatory drug
Unifocal pvc during PT
session
one of the main symptoms of
brain stem injury
types of exudates:
•
•
•
•
•
serous
sanguineous
serosanguineous
purulent
Proteinaceous
What is the most important
thing/first thing to assess on a
patient who has had a
mastectomy? post op
2 main areas at risk of
Neuropraxia as a result of ice
massage
Unifocal PVC is not dangerous and pt session can
continue lightly with monitoring the electrocardiogram
Decreased level of arousal and alertness will cause
slow progress of a patient with brain stem injury
• Serous – a clear, thin and watery plasma. It’s
normal during the inflammatory stage of wound
healing, and smaller amounts are considered
normal. However, a moderate to heavy amount
may indicate a high bioburden.
• Sanguineous – a fresh bleeding, seen in deep
partial- and full-thickness wounds. A small amount
is normal during the inflammatory stage.
• Serosanguineous – thin, watery and pale red to
pink in color.
• Seropurulent – thin, watery, cloudy and yellow to
tan in color.
• Purulent – a thick and opaque exudate that is tan,
yellow, green or brown in color. It’s never normal in
a wound bed, and is often associated with infection
or high bacteria levels.
• Proteinaceous exudate is exudate composed of a
high proportion of protein. It is not typically green in
color or foul-odored
Pain is most important to assess, because pain limiting
range of motion can lead to a frozen shoulder and
more pain
1- Applying cold directly over the superficial main branch
of a nerve, such as the fibular (peroneal) nerve at the
lateral knee, may cause a nerve conduction block
2- When applying ice to the posterolateral elbow (not
medial elbow), the physical therapist should monitor for
signs of radial nerve conduction block
Normal LDL levels
Symptoms of metabolic
acidosis
signs and symptoms of
metabolic syndrome
below 100
Headache, fatigue, and muscular twitching are signs and
symptoms of metabolic acidosis
Metabolic syndrome consists of signs and symptoms that
are actually risk factors and are strongly linked to type 2
diabetes, cardiovascular disease, and stroke. Metabolic
syndrome is characterized by abdominal obesity (waist
size > 40 in (101.6 cm), high triglycerides levels, high lowdensity lipids and low high-density lipids cholesterol
values, and elevated blood pressure (> 130/85 mm Hg)
Symptoms of metabolic
Confused mental state, weakness, and nausea are signs
alkalosis
and symptoms of metabolic alkalosis
What do each of these means: 1. Induration is due to local edema in the tissue, causing
firmness of the skin
1. Induration
2. Ecchymosis is a darkish discoloring of the skin
2. Ecchymosis
3. maceration, which is characterized by a white wrinkled
3. Maceration
appearance of the skin
4. Hyperkeratosis
4. Hyperkeratosis involves thickening of the skin.
When positioning the patient
on the hemiplegic side, what
should be considered?
Which muscles are shortened
when the pelvis is in an
anterior tilt?
which ones are lengthened?
The scapula should be in a protracted position
shortened
iliopsoas
erector spinae
sartorius
latissimus dorsi
Lengthened
rectus abdominis
gluteus maximus
Weakness of the bicep
femoris would manifest in
what motions of the leg
motions of hip extension, knee flexion, and lateral
(external) rotation of the tibia
Heterotopic ossification
Heterotopic ossification (HO) is the presence of bone in
soft tissue where bone normally does not exist.
> gentle stretching is indicated, maintaining optimal
wheelchair positioning
avoid vigorous stretching
maximal elbow isometric
exercises are indicated at
what week post shoulder
repair surgery
week 4
what is this ECG showing?
V-fib, and its a medical emergency
Knee tests
•
•
•
•
Varus test
McMurray test
patellar compression
test
Lachman's test
Pivoting on a planted foot with
an extended knee is
mechanism of injury to which
knee structure?
Nail issues and indications:
1- Varus = lateral collateral ligament
2- McMurray = Meniscus injuries
3- Patella femoral compression = patella femoral joint
4- Lachman = Anterior cruciate ligament integrity
Anterior cruciate ligament
1- Lung cancer - chronic hypoxia
2- Liver dysfunction
•
•
Extreme clubbing
Transverse
depressions (Beau
lines), or a nail bed that
is white and extends
3- Renal failure
•
2/3s of the length of
the nail
Short transverse lines
across the nail (Mees
lines) or a brownish
distal one-third end of
the nail (half-and-half
nails)
Murphy's test
Percussion over the costovertebral space causes pain
=> kidney disorder
Important info prior to patient
home visit
1- Cervical radiculopathy
2- Cervical myelopathy
Patients present level of function according to the
patient themselves and all involved disciplines
1. Cervical radiculopathy (injury to the nerve root)
presents with unilateral motor and sensory symptoms into
the upper limb, with muscle weakness in the myotome,
sensory alteration in the dermatome, and reflex
hypoactivity.
2. Cervical myelopathy (injury to the spinal cord itself)
presents with spastic weakness, paresthesia, and
possible incoordination in one or both lower limbs, and
well as sphincter dysfunction.
Brachial plexus lesions
Peripheral nerve root lesions
Apgar score for newborns
Brachial plexus symptoms are more localized to the
shoulder and neck. Cervical positions do not change
brachial plexus symptoms. Weakness in the myotome
and sensory alteration in the dermatome are common.
Peripheral nerve lesions typically do not present with
pain. Weakness and sensory symptoms are specific to
the nerve involved.
• Heart rate
• Color
• Respiration
• Muscle tone
• Reflex irritability
How to get a patient with
gradually decrease the number of verbal cues
limited recall to do 3 exercises
independently?
Latissimus dorsi is responsible
• Latissimus dorsi is responsible for Extension and
for what shoulder movement?
Medial rotation
•
To stretch it = Flexion and (lateral) external rotation
What motion of the GH joint
applies maximal stretch?
Quality assurance
Productivity analysis
Utilization review
Accreditation review
Which muscles do not need
strengthening,
but lengthening post-partum
What do PT's work on with
complete vestibular
loss/recovery?
What stationary bike
modifications challenge the
core, trunk, and balance
Peer review of patient care notes is a measure of
quality
A measure of financial efficiency of labor costs;
Utilization review is an external review of the necessity
of patient care
The accreditation process is a voluntary process of
quality measurement against an external set of
standards
Hip flexors are often short due to the lordotic posture of
pregnant mothers.
Improving gaze stability is a well-studied mechanism for
recovery from loss of vestibular function
Raising the handlebars of a bike brings the patient more
upright for increased trunk control and balance challenge
Tilting the seat forward on a bike extends the hips and,
therefore, places increased load on the trunk
In order to unlock the knee
from full extension in stance,
what needs to occur (femur,
tibia, patella)?
What is important before
preforming biofeedback
lateral (external) rotation of the femur on the tibia
Determination that the patient is mentally alert and has
intact thought processes regarding treatment should
precede other treatment procedures
appropriate patient guarding
when teaching how to use
crutches?
Symptoms of a tethered cord
Symptoms of UTI
Symptoms of Arnold-Chiari
malformation
Flaccid arm/Shoulder
subluxation may cause what
type of dislocation
ipsilateral Left posterior
innominate, what isometric hip
contraction would help?
ACE inhibitors cause what
change in BP
excessive fatigue and sitting
with elbows resting on knees,
are indicative of what?
intolerance with passive SLR
is due to pain, reason?
Tx for a patient with complex
regional pain syndrome with a
TBI
Swimming exercise
contraindication
Placing one hand on the gait belt and one hand on the
patient's shoulder is the correct technique to best facilitate
ambulation activity with crutches and provide appropriate
guarding
Changes in bowel and bladder function, increased
spasticity, back pain.
Urinary frequency, dysuria, and pyuria.
Weakness, pain, sensory changes, vertigo, diplopia, and
ataxia.
The most common type of subluxation is an inferior
subluxation. Weakness and the weight of a heavy arm
result in downward rotation of the scapula
Left hip flexion contraction would help assist pelvic
correction
drop in systolic and dyastolic BP
Fatigue, which was evident during warm-up, may have
worsened after the activity. The patient's preferred
position after the activity increases the effectiveness of
the pectoralis and serratus anterior muscles to act as
accessory muscles of inspiration by fixing their insertions,
thereby improving breathing and minimizing fatigue
With the straight leg raise, the hamstrings are stretched
across both joints at the same time. Because no limitation
is noted in the hip or knee joints, the limitation would be
due to the hamstrings
Active range of motion, functional training, and
transcutaneous electrical nerve stimulation
•
•
patient with an open wound (that are unable to
dress with a waterproof dressing)
Severe kidney disease
> MS patients, epilepsy patients, may still participate with
medication and close monitoring
What measure is used for
fitness and conditioning after
exercise
Stress incontinence
symptoms of a hip dislocation
Symptoms of avascular
necrosis of the femoral head
Symptoms of a slipped capital
femoral epiphysis
Babinski reflex indicating an
upper motor neuron lesion
What methods is the MOST
effective way to encourage a
patient who is learning a new
movement pattern
Nerve conduction velocity test
indications
Amount of time until the heart rate returns to
baseline after exercise
Stress incontinence is essentially due to insufficient
strength of the pelvic floor musculature. Pelvic floor
dysfunction is most often caused by a weakening of the
pelvic floor structures as a result of childbirth or
overstretching of the muscles
severe groin and lateral hip pain and the hip held in
abduction
The clinical indicators avascular necrosis of the femoral
head include pain in the groin, proximal thigh, or buttock
area that is usually exacerbated by weight-bearing
recent onset of knee pain, hip is in slight flexion,
adduction, and lateral (external) rotation. Examination
shows no medial (internal) hip rotation and abduction,
with increasing pain on abduction
the great toe extends while the other toes plantar flex and
splay
Provide frequent feedback during the initial trials of the
movement
Nerve conduction velocity testing is most useful in the
evaluation of peripheral nerve or lower motor neuron
status.
i.e. Carpal tunnel syndrome
MOST appropriate exercise to
help resolve an acute lumbar
disc posterior derangement
Deltoid ligament sprain
indication
Tarsal tunnel syndrome
active lumbar extension in prone
Location of the deltoid ligament is the medial ankle.
Tenderness with palpation of the medial ankle is more
suggestive of an eversion ankle sprain.
Tarsal tunnel syndrome presents with pain/numbness in
the medial ankle radiating into the plantar aspect of the
foot only
Plantar fasciitis
Movement contraindication for
a post 1-week anterior
shoulder dislocation
Which structure is a restraint
to the anteroinferior translation
of the humeral head in
overhead activities
What kind of issues with the
prosthesis can cause a lumbar
lordosis during push off
Which of the following
muscles should be
strengthened to reduce
scapular winging?
MS patient has motor and
sensory impairments with
gaze-evoked nystagmus and
vertigo. What test is best to
use to determine the cause?
Plantar fasciitis presents with pain and tenderness
located on the medial calcaneal tubercle. Pain that is
worse in the morning and decreases with activity is
suggestive of plantar fasciitis. Periods of inactivity are
followed by increased pain as activity is recommenced.
Lateral (external) rotation to 50° with the shoulder
abducted to 80°
The inferior glenohumeral ligament is the primary restraint
against anterior and posterior dislocations and is the most
important stabilizing structure in the overhead movement
Insufficient socket flexion can cause lordosis of the
lumbar spine
Serratus anterior
The therapist should determine which sensory system is
contributing to the patient's postural dyscontrol.
Assessing sensory conditions of vision, vestibular
function, and somatosensation in a systematic fashion,
such as by conducting the Clinical Test for Sensory
Interaction in Balance (CTSIB), will help determine which
system is contributing to the balance dysfunction
Patient was taught how to go
Measuring retention at the beginning of a treatment
up and down the stairs using a session or after a rest period can minimize variables
cane, how can the PT
associated with temporary improvement of performance,
determine if they have
so that the physical therapist can determine if learning
retained this skill or not, when has been retained
should they be tested?
Ulcers on the planter part of
The ulcer is located on the plantar surface of the foot. It
the foot due to reduced
has a thick callus border. The patient has decreased
sensation cause what type of
protective sensation, which is associated with peripheral
ulcers?
neuropathies. Based on these findings, the wound is
a neuropathic ulcer
How to monitor patients heart
rate when on beta blockers
Signs of dermatitis
Alternatives to heart rate monitoring, such as the rating of
perceived exertion scale, should be used due to the
blunted heart rate response to exercise while taking betablockers
Generally, dermatitis includes the presence of papules,
vesicles, blisters, or ulcerations
> No fever, malaise, chills
Cellulitis
Cellulitis signs/symptoms include pain, redness,
tenderness, edema, and, at times, fever, chills,
tachycardia, headache, and hypotension