Download Physical Therapy Exam Notes: Plantar Fascia, Achilles Tendon, Cerebellar Problems and more Exams Advanced Education in PDF only on Docsity!
NEW Notes From 2nd PEAT Exam
Factors that may lead to a greater delay in recovery for plantar fasica: - ANSWER 1) increased BMI (>25= poorer prognosis)
- decreased hallux extension (helps support medial arch?)
How do you test the integrity of an achille's tenon? - ANSWER squeeze the calf with the ankle in neutral dorsiflexion
What does an anterior drawer at the ankle with the ankle in neutral dorsiflexion test? - ANSWER This stress test is for evaluating the anterior talofibular ligament
How do you test the calcaneofibular ligament? - ANSWER Talar tilt with the ankle in neutral dorsiflexion
What is horizontal nystagmus caused by? - ANSWER a symptom of a cerebellar problem such as a lesion of the anterior inferior cerebellar artery
What is ataxia a symptom of? - ANSWER a cerebellar problem such as injury to the basilar artery
What is apraxia due to? - ANSWER a lesion to the middle cerebral artery
What do the rhomboids do? - ANSWER elevate, retract, and downwardly rotate the scapula
Plantar fascia Intervention goals should focus on: - ANSWER 1) midfoot stability
- functional foot and ankle range of motion (ROM)
Normal (5/5) foot and ankle strength
minimal pain
return to functional status for activities of daily living and vocational activities
How do you test the anterior talofibular ligament? - ANSWER Anterior drawer at the ankle with the ankle in neutral dorsiflexion
When do you use paraffin? - ANSWER used as thermotherapy when there is no swelling. Used to decrease pain and increase motion
do not place on a site with an incision
ACL rehab: when would you perform partial mini squats? - ANSWER sub-acute phase: closed chain
avoid open chain that places more stress on the ACL
ACL rehab: When would you perform a SLR? - ANSWER acute phase: places no added stress on the ACL
used to strengthen the quad
Oswestry Disability Questionnaire what does it measure? - ANSWER patient's current level of self-reported level of disability used for low back pain
higher score is worse, you want a low score
Why would athletes have a lower HR? -ANSWER they have a greater SV and SV x HR =CO
A patient complains of fatigue, weakness of the proximal upper extremities, and double vision that worsens throughout the day. Examination reveals bilateral ptosis of the eyelids, difficulty chewing and swallowing, and an inability to raise the eyebrows. Which of the following is the MOST likely condition present? -ANSWER myasthenia gravis
Is a productive cough a symptom of heart failure? - yes
Would you order leather soles for pt w/ diabetes? - no--> more likely to cause pressure sores
crepe soles reduce walking stress
Why is a snug fit around the heel important for those with diabetes? - snug fit around the heel prevents friction forces
Why should leather material uppers be made of?- ANSWER Shoes for the insensitive foot should be soft leather that will mold to abnormalities on the dorsal surface
What is meralgia paresthetica? - ANSWER an entrapment or injury to the lateral femoral cutaneous nerve, a purely sensory nerve
injury affects sensation to the lateral thigh so sensory testing to the lateral thigh would be performed to test for this
What would sensory testing to the superior medial aspect of the thigh assess? - ANSWER the ilioinguinal nerve
What is massed practice? - ANSWER a sequence of practice and rest times in which rest time is much less than the practice time.
What is distributed practice? - ANSWER practice intervals in which the practice time is equal to or less than the rest time.
What is blocked practice? -ANSWER a practice sequence organized around one task performed repeatedly, uninterrupted by practice of any other tasks.
This type of practice is not related therefore to the amount of time being spent on performing a task.
What is random practice? -ANSWER a practice sequence in which several various tasks are ordered randomly across trials.
Should you treat confused-nonagitated TBI pts in gym with other patient's? - ANSWER No--> they are not easily agitated by get overstimulated due to confusion.
Treat in a quiet, calm, environment with limited distractions
How should you communicate with a confused-nonagitated TBI patient? - ANSWER with simple commands in a calm voice:
The gross attention to the environment for the patient is brief, and selective attention may be non-existent. Instructions given should be simple without complex commands. The patient may also be hypersensitive to stimulation. Hence, a calm voice may be soothing to the patient.
How would you schedule the pt? - ANSWER Confused-nonagitated The pt should see the same person at the same time with a similar routine and structure. Consistency and routine is calming and reassuring to the patient.
How do you examine/test for posterior capusle tightness? - ANSWER pt in sidelying: one hand on scapula and one hand moving the shoulder into horizontal adduction
-you retract the scap to take out compensatory scapular protraction and isolate the GH joint
What is a condition you might check for posterior caspule tightness? - ANSWER adhesive capsulitis- DM pts
How is functional horizontal adduction tested? - ANSWER -Functional horizontal
Should a non-sterile ruler touch a wound bed? ANSWER no- should not touch and should be discarded after
(still correct even if you dress the wound)
at what range does the maximum torque of the quads occur? - ANSWER 60 degrees of knee flexion--> therefore stepping up onto a curb would be the most difficult activity to perform
A patient has been taking warfarin (Coumadin) following total hip arthroplasty. Based on the patient's history from a first postoperative visit, which of the following over-the-counter medications would be of GREATEST concern to a physical therapist? - ANSWER Aspirin
Why would aspirin be the greatest concern of a PT on warfarin? - ANSWER Aspirin and warfarin are both anticoagulants --> this could cause a serious interaction with warfarin by increasing the anticoagulant effect and increase the risk of bleeding
What is Diphenhydramine (Benadryl)? - ANSWER antihistamnine antagonist
What is Cetirizine (Zyrtec)? - ANSWER antihistamine antagonist
What is Omeprazole (Prilosec)? - ANSWER proton pump inhibitor
What does the AIN supply? - ANSWER FPL and FDP
A patient complains of numbness and tingling of the upper extremity originating from the neck extending to the thumb and index finger (1st and 2nd digits). Which of the following positions of the shoulder would MOST likely increase the symptoms in this patient? - ANSWER 1. Lateral (external) rotation with abduction
Which nerve is involved in this description? - ANSWER median nerve= thumb/index finger
Shoulder ER/ABD= median nerve (ULTT 2a)
-shoulder ER to 90 degrees, abducted and depressed shoulder
What would eliminate tension on the median nerved? - ANSWER shoulder adduction
Where does shoulder internal rotation get used? - ANSWER for radial nerve symptoms ULTT 2b
Which of the following positions are not used in testing upper limb tension? - ANSWER adduction and internal rotation because they don't cause enough tension on nerves
What position are you in when you are performing latissimus dorsi strength? ANSWER Prone with arms extended and palms facing upward
What is substituting if arms are not upward-facing (move into ER)? ANSWER Long head of the triceps substituting for the lat
A patient's electrocardiogram reveals a junctional rhythm. The patient's heart rate is 60 bpm and regular. Which of the following waves will MOST likely be absent from the rhythm strip? - ANSWER P
Where does a junctional rhythm originate from? - ANSWER AV junction (atrioventricular) INSTEAD of the SA node which normally causes the P wave
- that is why the P wave will be missing
Where are the R, S, and T waves originated from? - ANS the ventricles after stimulation from the AV junction--> they will be unaffected in a junctional rhythm
the involved joints, prevent excessive movement, and reduce mechanical stresses, all desired outcomes in the acute phase of rheumatoid arthritis.
Should passive stretching, strengthening, and AROM be done in the acute phase of RA? -ANSWER rest and protection in the acute phase, stretching is not appropriate
Should unilateral crutches be used to with restricted WBing gait? -ANSWER no- only bilateral is appropriate for this
Should canes be sued with restricted WBing gait? -ANSWER no- bilateral crutches or walker
Initial examination of a patient reveals paresthesia over the hypothenar eminence. The MOST probable cause of this condition is: - ANSWER C8 nerve root involvement
C8 nerve root innervates the hypothenar eminence, Injury to the C8 nerve root will cause paresthesia in the hypothenar eminence
What do carpal tunnel and pronator teres syndrome affect? - ANSWER the median nerve thenar eminence
De Quervain's tenosynovitis- involves the first dorsal compartment of the arm.
A person with spina bifida utilizes a knee-ankle-foot orthosis to replace a missing muscle activity.
A knee-ankle-foot orthosis is utilized for an individual with spina bifida when there is weakness or absence of motor function or when instability of the knee is present. These appliances are not as universally applied in the incoordination of muscles.
Patients with advanced emphysema cannot exercise properly because they have a
problem with breathing due to the: - ANSWER alveolar dilation
Emphysema is a condition wherein there is an abnormal and permanent enlargement of the air spaces distal to the terminal nonrespiratory bronchioles accompanied by destructive changes of the alveolar walls.
Do people with emphysema typically have hypercapnia or hypocapnia? ANSWER Emphysema patients typically present with a normal to somewhat elevated PaCO2, not low CO2 (hypocapnia).
A therapist is treating a patient who recently had a myocardial infarction. At the beginning of treatment blood pressure was 120/80 mm Hg and heart rate was 90 beats/min. Midway through treatment, blood pressure was 130/84 mm Hg and heart rate was 105 beats/min. The BEST action for the therapist to take is to: - ANSWER continue with treatment.
Why do you continue with treatment? - ANSWER Systolic blood pressure should increase directly proportional to the level of exertion applied. A hypertensive response to low level exercise (above 160/90 mmHg) in the patient who is at least 3 days post myocardial infarction is suggestive of cardiac ischemia. Heart rate should increase between 12-24 bpm above the resting heart rate. This means the patient is within normal limits with his exercise response and therefore should be continued with treatment.
What is a neuroma? - ANSWER A neuroma is a collection of axons and fibrous tissue that presents with sharp, shooting, and localized pain. It is a part of the natural repair process following an amputation.
When values obtained in an upper extremity exercise test are compared to maximal oxygen uptake values obtained in a lower extremity exercise test, they are typically: - ANSWER 30% to 40% lower
Arm exercise typically results in 30% to 40% lower maximal oxygen uptake compared to leg exercise.
Which of the following breathing exercises are helpful for a ventilated client? ANSWER
diaphragmatic breathing
deep breathing
lateral costal breathing
What is osteochondritis dissecans? ANSWER a necrotic bone lesion of unknown cause.
The knee, talus, and elbow may be affected
What is slipped capital femoral epiphysis? ANSWER when the capital femoral epiphysis becomes displaced.
-the patient is typically an adolescent male with reduced hip ROM and hip/thigh pain.
-t is known as an acute or gradual femoral neck lateral dislocation relative to the capital femoral epiphysis, while the head remains within the acetabulum
What sinks when an infant is dehydrated? - ANSWER the fontanelle
When would a massed practice schedule be prescribed? - ANSWER in those clients with fatigue problems
Although learning does occur with this sort of practice schedule, the level of cognitive processing required is not usually as deep as would be foreseen upon changes in tasks and environments.
How do patients with a unilateral vestibular lesion present? - ANSWER Patients with a unilateral vestibular lesion will present with vertigo, postural instability, oscillopsia, and disequilibrium. The wide-based gait is an attempt to minimize trunk rotation and movement of the head, which can increase sensory conflict and vertigo in the patient with a unilateral vestibular lesion.
A physical therapist is treating a patient with a lower extremity ulcer. After 1 week of
treatment, the patient reports intermittent burning pain and pruritus around the ulcer. What is the MOST likely cause of the reported symptoms? - ANSWER contact dermatitis
What is pruritus? - ANSWER Pruritus is severe itching often associated with an allergic response.
Wound care product used in treatment can cause pruritus and mild to severe burning pain
Cellulitis-what are symptoms of cellulitis? - ANSWER expect the leg to be red, hot swollen and tender and for the patient to have a fever
When would you expect decreased FEV1? - ANSWER obstructive lung disease, either due to secretions or bronchospasm
In which situation would you expect to see an increased functional residual capacity? -ANSWER seen in obstructive lung disease and not in restrictive lung disease
In which situation would you expect to see an increased residual volume? -ANSWER seen in obstructive lung disease and not in restrictive lung disease
In which situation might you find a decreased inspiratory reserve volume? -ANSWER in RLD
Which of the following interventions is MOST appropriate to assist with maintaining bone density for a patient with a history of osteoporosis and previous vertebral fractures? - ANSWER walking on a treadmill
Which of the following features are MOST characteristic of a room designed for airborne infection isolation? - ANSWER Negative air pressure, with the direction of the airflow into the room from the adjacent space outside the room
Is quadruped appropriate for elderly patients? - ANSWER The quadruped position may be difficult for an elderly patient to tolerate and does not involve weight-bearing through the entire lower extremity.
