Question | Answer |
cervical flexion ROM | 45 |
cervical extension ROM | 45 |
cervical lateral flexion ROM | 45 |
cervical rotation ROM | 70 |
shoulder flexion ROM | 180 |
shoulder extension ROM | 60 |
shoulder internal rotion ROM | 70 |
elbow flexion ROM | 150 |
elbow extension ROM | 0 |
supination ROM | 80 |
pronation ROM | 80 |
wrist flexion ROM | 80 |
wrist extension ROM | 70 |
radial deviation ROM | 20 |
ulnar deviation ROM | 30 |
thumb flexion ROM | 50 |
thumb extension ROM | 0 |
finger flexion ROM | 90 |
finger extension ROM | 45 |
IP thumb flexion ROM | 80 |
PIP finger flexion ROM | 100 |
DIP finger flexion ROM | 90 |
IP thumb extension ROM | 20 |
PIP finger extension ROM | 0 |
DIP finger extension ROM | 0 |
lumbar flexion ROM | 90 |
lumbar lateral flexion ROM | 35 |
lumbar extension ROM | 30 |
hip flexion ROM | 120 |
hip extension ROM | 30 |
hip abduction ROM | 45 |
hip adduction ROM | 30 |
hip external rotation (knee flexed) ROM | 45 |
hip internal rotation (knee flexed) ROM | 45 |
knee extension ROM | 10 |
knee flexion ROM | 135 |
plantar flexion ROM (point toes) | 50 |
dorsiflexion ROM | 20 |
inversion ROM | 35 |
eversion ROM | 15 |
big toe (MTP) flexion ROM | 30 |
big toe (MTP) extension ROM | 70 |
When testing coordination the therapist is observing all of the following for quality of the movement by the patient, except? | Understanding of movement |
patient is presenting with diplopia, head tilt to the right, weakness in depression of left adducted eye, which cranial nerve would most likely be involved? | right trochlear |
pathologic reflex? | babinski's reflex |
When measuring range of motion using a goniometer, the reliability of the observed score is a function of which of the two following components? | True score and error component |
Which area of the body would be most sensitive in distinguishing two points close together? | finger tips |
In order to test cranial nerve XII the therapist would ask the patient to _______________ | stick out their tongue |
Which of the following types of reliability is important for determining the consistency of the measurement tool? | test-retest reliability |
If you see the following documented in a chart, A and O X 2 (time), which of the following would be true? | The patient is oriented to person and place |
Before proceeding with a neurological examination, which of the following should the physical therapist measure first in order to determine whether the exam would be valid? | orientation |
Which of the following is involved in self-protective reaction as a response to potentially harmful stimuli and contains slow-conducting fibers of small diameter, some of which are unmyelinated? | antereolateral spinothalmic pathway |
This patient is presenting with upper motor neuron signs and symptoms. To test for clonus which of the following techniques would be used? | Quick stretch stimulus then maintain stretch |
This patient is presenting with obtunded arousal and consciousness. Which of the following would define the patient’s level of arousal and consciousness? | Difficult to arouse, constant stimulation needed, confused |
When the physical therapist is testing the abdominal reflex which type of reflex is being tested? | superficial |
Achilles reflex, the integrity of which of the following nerve roots is being tested? | S1 |
A measurement of reflexes using a scale of present or absent, would be what level of measurement? | nominal |
Which of the following is impacted by amplitude and velocity of stretch? | spasticity |
If a patient’s arousal state is drowsy and he consistently falls asleep when no stimulation is occurring and has trouble focusing and maintaining attention to the therapist, which of the following would define the patient’s state? | lethargic |
Proprioceptors are responsible for deep sensation and receive stimuli from all of the following except? | viscera |
therapist will take a measurement, using a goniometer then will compare the score to a standard. This patient’s score is compared to which of the following standards? | norm referenced standards |
Which of the following would be the most disruptive to collecting sensory information from an older patient? | short term memory deficits |
Validity is the extent to which an instrument measures what it is intended to measure and is the degree of truthfulness of a test score. Validity is a measure of _______________________?
Question 21 answers | systematic error |
When testing sensation, which of the following should the physical therapist test first? | superficial |
difficulty performing the following coordination tests: finger to nose, alternating nose to finger, pronation/supination. Movement is jerky, and becomes irregular with a rapid loss of range and rhythm as speed is increased. What is this? | Dysdiadochokinesia |
Which of the following scales can any mathematical procedures and statistics be used and is the highest level of measurement? | ratio scale |
Which of the following cranial nerves is considered to be mixed, having both sensory and motor functions? | facial |
Which of the following cranial nerves can cause syncope (drop attack)? | vagus |
The “0-10” scale to evaluate pain is an example of which type of scale? | ordinal scale |
Which of the following would be the best way to test dysmetria? | pointing and past pointing |
an outcome measurement tool could be modified to determining an older patient’s ability to perform activities of daily living. It was developed for the use with peds - what must she determine as far as the modifications to the tool? | validity of a tool |
What temperature range for cold and warm is suggested for use when testing sensation for temperature?
Question 32 answers | Cold 41º F to 50º F; warm 104º F to 113º F |
Which of the following best defines the term rigidity? | Resistance to passive movement involving both agonist and antagonist muscles |
Which of the following most closely defines the meaning of deep sensation of proprioception? | Joint position sense and awareness of joints at rest |
When testing tone which of the following is speed dependent or will result in an increase in resistance with increased speed of movement of the limb by the tester? | spasticity |
Which of the following responds to change in posture, position, proprioception, muscle tone, speed, and direction of movement? | deep sensory receptors |
All of the following represent nonequilibrium coordination tests EXCEPT? | single limb stance |
When testing for dysdiadochokinesia, dyssynergia, and intention tremor, which of the following tests could the physical therapist use to test for all three at the same time? | finger to nose |
Which of the following statements is true when testing a patient’s reflexes? | pt can be conscious or unconscious |
All of the following should be screened prior to testing coordination, EXCEPT? | equilibrium |
When the patient sticks out her tongue, it deviates to the right. Which of the following cranial nerves is most likely involved? | cranial nerve 12 palsy (right) |
Which of the following statements is true in regards to reliability and validity of a measure? | A valid test is always reliable |
For standardized testing, it has been determined that a turning fork at which frequency is best to use in the clinical setting when testing vibration sense in patients? | 128 Hz |
In order to determine if the treatment done by the physical therapist truly caused the patient to get better it is important that the therapist know whether the measurement tool has which of the following characteristics? | responsiveness |
All of the following can significantly influence the results of tonal testing except? | visual and acuity of hearing of pt |
A lesion of the ______________ cranial nerve will result in difficulty speaking and swallowing, and hoarseness? | vagus |
The ______________ is testing C5 and C6 segmental level and nerve? | biceps reflex |
When testing cranial nerve IX the therapist is testing _________________. | swallow and gag |
When testing kinesthesia, all of the following statements is true, except? | The patient should respond once the movement is stopped |
When positioning a patient for testing deep tendon reflexes the physical therapist should always ___________ | place the muscle at mid range position |
coronal view / sagittal view | side view / straight on |
disablement | various impacts of chronic and acute conditions on the functioning of specific body systems |
impairement | usually a consequence of a disease or pathology, some change that affects your anatomy, and keeps you from being able to participate in life at your normal ability -can be permanent, such as the effects of polio or temporary like a broken ankle. |
functional limitations | usually a result of an impairment, limitations limit your ability to perform tasks and activities efficiently - you can't get up your steps and into your house after breaking your foot. |
system level of disablement model | physiological and tissue level - identifies the disease |
body level of disablement model | loss or abnormality at tissue or organ level |
task level of disablement model | skills that a person must have appropriate ROM, strength, endurance, balance, etc (home vs hospital - the chairs) |
context level of disablement model | environment in which a skill is performed |
social level of disablement model | roles people play in their societal lives |
reflex | is a motor response to a sensory stimulus and is used to assess the integrity of the motor system in the conscious or unconscious patient |
Types of Reflexes | 1. Superficial (corneal, gag/swallow,
Perianal, Babinski Sign)
2. Deep tendon (myotatic) reflexes
3. Visceral (organic) reflexes
4. Pathologic (abnormal) reflexes |
muscle spindles | provide info about length and rate of change in muscle |
alpha motor neurons | elicit muscle contraction |
gamma motor neurons | detect the gain on the muscle spindle |
renshaw cells | feedback loop to prevent overactivity |
golgi tendon organs | within muscle tendon - activated by stretching or contracting muscles |
polysynaptic reflexes | not limited to 1 muscle, usually many |
activity | performance of a task or action |
context | situations, in which activity can be assessed |
disease | a pathological condition or abnormal entitiy |
function | activities identified by an individual as essential to support physical, social and psychological well-being and to create personal sense of a meaningful life |
quality of life | what people feel about their health condition or it's consequences |
signs | objective evidence of physical abnormality |
symptoms | subjective evidence of physical abnormality |
alert | patient is awake, attentive |
lethargic | appears drowsy and may fall asleep if not stimulated |
obtunded | difficult to arouse, somnolent state |
stupor | responds only to strong noxious stimuli |
coma | can't be aroused by any stimulation |
cognition | awareness and judgment - fund of knowledge, calculation ability & proverb interpretation |
rigidity | passive movement, observed during functional activities |
Cranial nerve 1 lesion | cerebral cortex - inability to smell |
cranial nerve 2 lesion | thalamus - ipsilateral blindness, loss of reflex |
CN 3 lesion | midbrain - ptosis, ipsilateral, diplopia, loss of reflex, loss of constriction |
CN 4 lesion | midbrain - double vision |
CN 5 lesion | pons - blink reflex, jaw deviates to side |
CN 6 lesion | pons - can't abduct eye, double vision, eye looks inward |
CN 7 lesion | pons - paralysis of facial expression, one side face droop, bells palsy |
CN 9 lesion | medulla - gag reflux, salvation decreased |
CN 10 lesion | medulla - difficulty speaking, asymmetrical palate elevation, hoarseness |
CN 8 lesion | medulla - deafness |
CN 11 lesion | medulla - SCM, trap weakness (same side) |
CN 12 lesion | medulla - atrophy of tongue - deviate to same side |
cerebellum | funct: voluntary movement, control equillibrium, postural control, muscle tone
Disorder: hypotonia, ataxia |
basal ganglia | fucnt: movement, posture control, gross movements, chose motor response while inhibiting others, automatic movements, postural adjustments, muscle tone
Disorder: tremor, akinesia, chorea, athetosis, dystonia |
dorsal columns (posterior) | Funct: coordinated movements, posture, input from muscles and joint receptors
Disorders: lack proprioceptive feedback, disturbances of gait, dysmetria |
4 basic motor task requirements | 1. mobility
2. stability
3. controlled mobility
4. skill |
superficial tests of sensation | pain, temp, light touch, pressure |
deep sensation tests | kinesthesia (movement), proprioception (at rest), vibration, recognition of weight (barognosis), traced figure (graphesthesia), recognition of texture |
combined cortical sensation tests | tactile object recognition (stereognosis), tactile location, 2 pt discrimination, double stimulation |
isotonic | constant external force - constant muscle tension **1 rep max, test with free weights |
isokenetic | pt provides resistance thru range of motion at constant velocity |
isometric | against an immovable resistance, so muscle length remains the same - MMT, HHD (hand held dynamometry |
anterolateral spinothalmic pathway | self protective, harmful stimuli, slow-conducting fibers, small in diameter, thermal and pain, touch (tickle, itch and sexual) |
when to sensory test? | edema, impaired: gait, mobility, motor function, muscle performance, reflexes, posture, respiration and pain |
hypertonia | muscles feel taut and harder then normal, caused by: clasp knife, clonus, babinksi sign - lesion: UMN or CNS |
clasp knife | high resistance, followed by sudden inhibition or letting go |
clonus | spasmodic alteration of muscle contraction |
hypotonia | (flaccidity) decreased or absence of muscle tone, soft and flabby - lesion: LMN |
dystonia | hyperkinetic movement disorder, twisting and writhing movements - lesion: CNS(basal ganglia) |
decorticate rigidity | LE in extension, UE flexed
diencephalon |
decerebrate rigidity | All extremities extended
brainstem |
opisthotonus | contraction of extensor muscles of neck
tetanus |
cogwheel rigidity | rachetlike fell to passive movement |
leadpipe rigidity | constant rigidity, independent to velocity |
Tone Scale | 0: none (flaccid)
1+: decreased (hypotonia)
2+: normal
3+: exaggerated (hypertonia)
4+: sustained response (severe hypertonia) |
osteokinematics | gross angular motions of the shafts of the bone, the WHOLE bone (lever arm) - usually what you are measuring when you take a goni measurement - anatomical position = start
ex: shoulder flex -> lever arm is the humerus |
sagittal plane | flexion and extension |
frontal plane | abduction and adduction |
transverse plane | medial and lateral rotation |
arthrokinematics | actual joint movements in relation to each other - (roll, glide, slide or spin)
ex: shoulder flex -> humerus rolls and glides on glenoid fossa |
3 components of an exam | history, systems review & tests and measures
(formal observation - analysis of posture) |
posture | relative positions of different joints at any given moment OR ideal skeletal alignment involves minimal stress and strain and maximum efficiency of body |
factors influencing posture: | heredity, environment, disease, habit, muscle length and dysfunction |
outcomes assessment | screen, assess, monitor, description, prediciton |
3 level of ADLs | 1. BADL: basic (eat, bathe, groom, dress etc)
2. IADL: instrumental activities (cook, shop, wash)
3. AADL: advanced (work, reaching, walking, lifting #, recreation - dance etc) |