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IRENE GOLD PT BOARDS FINAL EXAM NEWEST
ACTUAL EXAM COMPLETE 20 0 + QUESTIONS AND
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When evaluating a shoulder, the ratio of the glenohumeral movement to scapular movement should be: - answer 2: How do you determine the max HR for aerobic activity in a pt - answer Resting HR Which type of exercises is best to use when rehabbing a disc - answer McKenzie Which muscle exercise will stimulate the multifidus, strengthen the obliques & strengthen rectus abdominals - answer Core exercises 55 yo male leaned over & had immediate pain in his low back extending into his right lateral foot. Bechterew's was positive. What is the initial treatment: - answer 1. Cryotherapy
- Traction
- McKenzie exercises 55 yo male leaned over & had immediate pain in his low back extending into his right lateral foot. Bechterew's was positive. What is the best exercise program in the subacute phase: - answer 1. Water resistance
- Walking
- Extension exercises 55 yo male leaned over & had immediate pain in his low back extending into his right lateral foot. Bechterew's was positive. What is the best exercises for rehab - answer 1. Stretch abdominals
- Stretch psoas
- Stretch glutes A 15 yo boy has pain below the knee & it is worse w/walking up & down stairs. THe physical exam revealed a problem at the tibial tuberosity. All orthos were negative on the knee. What is the case management - answer 1. Chopat strap
- Cryotherapy
- Limit activity A 15 yo boy has pain below the knee & it is worse w/walking up & down stairs. THe physical exam revealed a problem at the tibial tuberosity. All orthos were negative on the knee. What is the proper way to handle this in the subacute phase - answer 1. Stationary bike
- Swim exercises
- Stretch quads A 15 yo boy has pain below the knee & it is worse w/walking up & down stairs. THe physical exam revealed a problem at the tibial tuberosity. All orthos were negative on the knee. Once the pt is out of pain, which muscles should be rehabbed - answer 1. Stretch hamstrings
- Strengthen rectus femoris
- Stretch rectus femoris The pt presents w/post pelvic tilt, which of th efollowing should be facilitated - answer Quads Which of the following muscles should be exercised in a mother following the birth of her baby - answer Pelvic floor Which of the following muscles should be stretched to rehab pts w/TOS - answer Pec minor Pt is in the standing position w/hands over head & palms to sky. Which muscles are being stretched - answer Lat dorsi Which of the following muscles should be strengthening to correct anterior head carriage - answer Deep neck flexors Which is a closed chain exercise - answer Push ups Which is the best exercise to correct upper cross syndrome - answer Seated rows Which type of exercise is weight lifting A. Isometric B. Isotonic C. Isokinetic - answer B. Isotonic (eccentric & concentric together)
When using TENS to relieve pain, which of the following opiates is released - answer Enorphins Which of the following is a benefit of using premod interferential current - answer You can only use 2 pads What is the benefit of using continuous passive movement after surgery - answer Increase flexibility When using galvanic, what goes on the site of an acute injury - answer Anode (positive) Special needs are to be taken when using galvanic to prevent - answer Bursa What is the best level of pain control when utilizing TENS - answer 0- 15 How does electrical stim stimulate a muscle contraction - answer Stimulates motor end plate Side bridge exercises are utilized to strengthen which of the following muscles: - answer QL Deep heat modalities are contraindicated for: A. Scar tissue B. Chronic inflammation C. Infection D. Bone fractures - answer C. Infection Paraffin provides which type of heat A. Dry superficial B. Moist superficial C. Dry deep D. Moist deep - answer B. Moist superficial What is an appropriate safety precaution for application of MWD A. Applicator should be 12-18 in from skin B. Perspiration should be promoted to enhance treatment C. Remove contact lenses during treatment around head D. Intensity settings should be based on the pt's tolerance - answer A. Applicator should be 12-18 inches from skin What form of cryotherapy doesn't use conduction A. Cold pack B. Ice massage C. Cold baths D. Vapocoolant spray - answer C. Cold baths
Cryotherapy reduces muscle spasm by inhibiting A. Scar tissue formation B. Muscle spindle activity C. Cellular metab D. Ach production - answer B. Muscle spindle activity Which of these is typically the last sensation felt w/cryotherapy application A. Intense cold B. Burning C. Aching D. Numbness - answer D. Numbness Modulation of electrical current helps prevent ____ of muscle tissue A. Adaptation B. Fatigue C. Recruitment D. Excitation - answer A. Adaptation Which type of electrotherapy is most likely to slow atrophy of a denervated muscle A. TENS B. Microcurrent C. Interferential D. Low voltage Galvanic - answer D. Low voltage galvanic In general, the smaller the electrode, the _____ A. Stronger the motor response B. Weaker the current C. Stronger the stimulus D. Weaker the nociceptive response - answer C. Stronger the stimulus Which of these is most appropriately treated w/high voltage pulsed stimulation A. UMNL B. Edema C. Fungal infection D. Thrombophlebitis - answer B. Edema Which type of massage is used for the treatment of adhesive capsulitis A. Effleurage B. Tapotement C. Transverse friction D. Petrissage - answer C. Transverse friction A contraindication for continuous traction is A. IVF encroachment B. Osteoporosis C. Scoliosis
D. Weak lat dorsi - answer A. Weak serratus ant Which muscles are hypertonic when the pt is placed in the modified Thomas position & the hip remains in 15 deg of flex w/the knee only 70 deg A. Glut max and rectus femoris B. Glut max & biceps femoris C. Iliopsoas & rectus femoris D. Iliopsoas & biceps femoris - answer C. Iliopsoas & rectus femoris An exercise program designed to increase muscle endurance includes _____ repitition w/ _______ resistance A. Low; low to moderate B. Low; high C. High; low to moderate D. High; high - answer C. High; low to moderate The phosphagen system provides ATP for _______ activities: A. Short term low intensity B. Short term high intensity C. Long term low intensity D. Long term high intensity - answer B. Short term high intensity A major catabolic effect of cortisol is converting amino acids to: A. Lipids B. Carbs C. Fat D. Protein - answer A. Lipids What is the primary source of energy utilized during aerobic endurance exercise A. Protein B. Glucose C. Lipid D. Glycogen - answer C. Lipid Endurance training & performance is improved when following a diet high in: A. Omega 3s B. Carbs C. Calories D. Proteins - answer B. Carbs Which of these factors contributes to improvements in athletic performance & aerobic power from overload training specific muscle groups A. Decrease in overall mito concentration B. Increased microcirculation C. Accumulation of blood lactate
D. Using a generalized, sub-maximal training regimen - answer B. Increased microcirculation Eccentric muscle contractions require the muscle to: A. Contract w/o resitance B. Lengthen against resistance C. Shorten against resistance D. Contract w/resistance - answer B. Lengthen against resistance In which circumstance would plyometric training be the most benefit A. Training a pro football player B. Increasing balance of a geriatric pt C. Following hip replacement surgery D. Increasing proprioceptive input to an unstable joint - answer A. Training a pro football player Which commonly used strength program relies on multi-set exercises targeting a variety of muscle groups w/minimal resistance A. Progressive resistance exercises B. Circuit training C. Isometric resistive training D. Compound training - answer B. Circuit training Which of these is the neurophysiological principle of the contract-relax principle technique for muscle stretching A. Crossed extensor reflex B. Reciprocal inhibition C. Monosynaptic stretch reflex D. Polysynaptic innervations - answer B. Reciprocral inhibition Neuromuscular coordination is primarily programmed in the ______ tract of the nervous system A. Sympathetic B. Extrapyramidal C. Spinothalamic D. Parasympathetic - answer B. Extrapyramidal In order to maintain proprioceptive input & prevent adhesion formation, the pt should begin ______ exercises during the subacute phase of a grade II ankle sprain A. Isometric high-weight B. Passive ROM C. Wt bearing wobble board D. Plyometric high-impact - answer B. Passive ROM A biomechanical ankle platform system is designed to elicit which of these effects A limited ROM
D. Variable resistance - answer A. Isometric Which of these is the most appropriate rehab of diastasis recti A. Anchored full sit ups B. Modified squats C. Bilateral straight leg raises D. Head lift w/pelvic tilt - answer D. Head lift w/pelvic tilt 40 yo man w/lat elbow pain; 4/10 while playing tennis & using screw driver. What passive modalities are most appropriate during the initial tx. (Choose 3) A. Cryotherapy B. High voltage pulsed stim C. Interferential current D. MWD E. Hydrocollator packs F. Continuous US G. IR lamp H. UV lamp - answer A. Cryotherapy B. High voltage pulsed stim C. Interferential current 40 yo man w/lat elbow pain; 4/10 while playing tennis & using screw driver. Which of these are the most appropriate recs during the acute phase A. Stretching wrist into flexion B. Stretching wrist into extension C. Eliminating pronation - supination activities D. Eliminiating supination - pronation activities E. Using cock-up splint F. Using counter-force brace during rest G. Beginning plyometric exercises H. Using a sling for two weeks - answer A. Stretching the wrist into flexion F. Using counter-force brace during rest H. Using a sling for two weeks 40 yo man w/lat elbow pain; 4/10 while playing tennis & using screw driver. Following resolution of the symptoms, which of these activities are most likely to benefit this patient A. Wrist curls w/palms down B. Wrist curls w/palms up C. Push up w/plus D. Splint elbow in max flex E. Biceps curls w/supination F. High-velocity exercises G. Codman exercises H. Resisted seated rowing - answer A. Wrist curls w/palms down C. Push up w/plus
E. Biceps curls w/supination Knee extension against resistance on a seated pulley machine is an example of what type of exercise A. Isometric B. Isokinetic C. Closed-chain kinetic D. Open-chain kinetic - answer D. Open-chain kinetic Which of these is not an appropriate exercise for lumbar facet syndrome A. Ab curls B. Knees to chest C. Ball superman D. Supine planks - answer C. Ball superman Which of these is an absolute contraindication to cervical traction A. Chronic myofascitis B. Vertebral artery syndrome C. Acute muscle spasm D. Ankylosing spondylitis - answer B. Vertebral artery syndrome What modality can produce therapeutic thermal, chemical & mechanical actions A. MWD B. Galvanism C. US D. Fluidotherapy - answer C. US Which of these is safe to use over a joint w/a metallic implant A. High voltage therapy B. Continuous US C. MWD D. SWD - answer A. High-voltage therapy Denervated muscle is most effectively stimulated by which of these currents A. Square wave alternating B. Low-voltage direct C. Indirect biphasic pulsed D. Interferential - answer B. Low-voltage direct Which exercise should be avoided during rehab of the supraspinatus in order to prevent impingement of suprahumeral tissues A. Full can B. Empty can C. Ball squeezing D. Forward punching - answer B. Empty can
What is the NT for a short preganglionic nerve of sympathetics? - ANSWERAcetylcholine What are the NT for long postganglionic of SNS? - ANSWEREpinephrine Norepinephrine What type of catecholamines does epinephrine use? - ANSWERAlpha and beta What type of catecholamines does nor-epinephrine use? - ANSWERAlpha only What makes up the parasympathetic NS? - ANSWERCN 3,7,9, What spinal levels control the PNS? - ANSWERS2-S What is the NT for pre and post ganglionic fibers in the PNS? - ANSWERAcetylcholine Main thing to know about the Enteric system? - ANSWERActs Autonomously (by itself) In times of great stress, what can override the enteric system and decrease GI function?
- ANSWERSympatheticotonia What did Selye do for chiropractic? - ANSWERDeveloped general adaptation syndrome What are Selyes 3 stages of chronic stress? - ANSWERAlarm Resistance Exhaustion What is the most important thing that is increased in the alarm stage of GAS? - ANSWERIncreased cortisol Chronic stress causes Neuroendocrine response that suppresses thymicolymphatic system which has what negative affect? - ANSWERReduces resistance of the body Does acute stress increase or decrease immunity? - ANSWERIncrease Does chronic stress increase or decrease immunity? - ANSWERDecrease Where are most cervical headache subluxations present? - ANSWERC0-C Signs and symptoms of most Cervicogenic headaches? - ANSWERHypomobility Trigger points
Decreased ROM What is cervicogenic dorsalgia? - ANSWERNeck problem that can cause pain between shoulder blades What can be a major symptom of Horner's syndrome? - ANSWERBlurring vision 3 major causes of vertigo? - ANSWERNeuro Vascular Physical What is brain hibernation? - ANSWERDecreased blood flow = decreased function Cells alive but function has ceased How can adjustments help brain hibernation? - ANSWERCan increase CSF flow MC age range of disc derangement? - ANSWER30-50 y/o How to treat disc derangements? - ANSWERAdjust for first 2 weeks Traction, ice, massage, and electrical therapy Flexion/extension What is the autism theory? - ANSWERBrain growth disturbance What is Alzheimer's disease? - ANSWERNeurotangles consisting on microtubule tau proteins What is known to cause seizures? - ANSWERDecrease in GABA What causes Myasthenia Gravis? - ANSWERAutoantibodies to Ach receptors at the NMJ How does the Herpes Virus manifest? - ANSWERUse retrograde channels to get to the neurosoma and hide How do local anesthetics work? - ANSWERThey prevent sodium channels from opening, thus blocking action potentials True or False: Potassium and sodium are electrolytes; so dehydration can effect neural transmission - ANSWERTrue
What does the upper alar ligament do? - ANSWERRestricts contralateral bending @ occiput-C What does the lower alar ligament do? - ANSWERRestricts ipsilateral rotation Why is the apical ligament important? - ANSWERSuspensatory ligament at top of the dens What does the transverse ligament do? - ANSWERLimits flexion and extension Where is transverse ligament located? - ANSWERGroove posterior to the dens What is the ligamentum flavum? - ANSWERMost important ligament in absorbing flexion forces When is ALL damaged? - ANSWERHyperextension Where is the PLL thinnest? - ANSWERL When are interspinous and nuchal ligaments damaged? - ANSWERHyperflexion Where does rectus capitis posterior major attach? - ANSWERMeninges between c1 and c Where does rectus capitis posterior minor attach? - ANSWEROccipit and C What segments have the most flexion/extension? - ANSWERC5-c What cervical region has the most lateral bending? - ANSWERMid cervical What is the angle of upper cervical facets? - ANSWER35 degrees What is the angle of lower cervical facets? - ANSWER60 degrees What spinal region has the most rotation? - ANSWERUpper thoracics What thoracic region has most F/E and lateral bending? - ANSWERLower thoracic (MC T11-T12) Which lumbar segment has the most flexion/extension? - ANSWERL5-S What motion is limited in lumbars? - ANSWERRotation What does aberrant mean? - ANSWERReverse motion around an axis What is Buckling syndrome? - ANSWERLong standing creep with hysteresis event
What is hysteresis? - ANSWEREnergy loss from loading and unloading disc What is Hooke's law? - ANSWERDeformation increases in proportion to load applied What is elasticity? - ANSWERability of muscle to recoil to original resting length after stretched What is plasticity? - ANSWERProperty of a material to permanently deform when its loaded beyond its elastic range What is viscosity? - ANSWERProperty of materials to resist loads that produce shear Strain delay What is Wolff's Law? - ANSWERbone grows or remodels in response to the demands placed on it What is the Heuter-Volkmann principle? - ANSWERIncreased epiphyseal plate pressure= decreased growth What is algometry? - ANSWERPain threshold Pain measurement What is double crush? - ANSWERproximal neurological irritation causing distal neurological pathology Most acute pain is the result of what? - ANSWERPhysiological nerve irrritation What is chronic pain? - ANSWERTypically pathological pain due to nerve compression What are the pain amplifiers? - ANSWERInflammation Traumatic neuroma Wide dynamic receiver Norepinephrine Depression In inflammation, what is released due to trauma? - ANSWERSubstance P Bradykinin
Venous insufficiency Blood nerve barrier What does hypoxia lead to? - ANSWERAnoxia—> ischemia—-> necrosis How does edema affect action potential? - ANSWERLowers threshold to increase action potential Causes of chronic nerve compression? - ANSWERAxoplasmic transport aberration Local tissue death What is Wallerian degeneration? - ANSWERaxon distal to injury degenerates What is hiltons law? - ANSWERany nerve that innervates a muscle producing movement at a joint also innervates the joint itself (and the skin over it) What is the static fixation model? - ANSWERBone out of place What is the fixation by adhesion model? - ANSWERCaused by trauma/inflammation What is fixation by meniscoid entrapment? - ANSWERLeaf like synovial folds that increase in flexion/extension What is fixation by nuclear fragmentation? - ANSWERCentral aspect of annular fibers weakened by rotational injuries What is mechanical joint locking? - ANSWERCoronal facets do not resist torsion causing saggital facets to lock up What is aberrant axoplasmic transport? - ANSWERMechanical stress—> increased intracellular protein metabolism What is neuropraxia? - ANSWERMnimal injury (myelin) but not axon or nerve sheath. Temporary nerve conduction block; loss of motor and sensory function, but not autonomic. Full recovery expected hours to months What is Macrocirculation ischemia? - ANSWERVBAI Crossed legs (numbness) What is nerve compression? - ANSWERSubluxation results in altered nerve transmission of nerve energy
What can cause nerve impingement? - ANSWERPressure Traction Torsion Stretch Angulations What is an axoplasmic aberration? - ANSWERNerve or plexus with decreased nerve supply in microtubular network What is the neurodystrophic hypothesis? - ANSWERStress causes alteration in Neuroendocrine function—-> decreases immunity —> multiple fixations What is Korrs model? - ANSWERExplain neurological effects of segmental dysfunction resulting in a sustained hyperactivity of a segment caused by a muscle spindle activity What does Korr model cause? - ANSWERHypersympatheticotonia Key components of fixation theory? - ANSWERLessened mobility Aberrant reflexes Segmental facilitation Soft tissue aberrations What is the reflex theory? - ANSWERSomatic bombardment of the dorsal horn There is an input imbalance (^ pain decreased mechanoreceptors input) What is dysautonomia? - ANSWERdysfunction of the autonomic nervous system How do acute issues affect dysautonomia? - ANSWERIncrease dysfunction Irritation Facilitation Excitation How do chronic issues affect dysautonomia? - ANSWERDecreased dysfunction
