Vestibular/Cerebellar
These are the vestibular structures responsible for the sensation felt while moving up or down in an elevator.
The Otolith Organs: detect linear motions
(Saccule: vertical motions
Utricle: Horizontal motions)
A patient presents with spasticity in his BLEs, weakness in his BUEs, and complete impairment of CN 3,4, 6, 11, 12. No other findings are noted. Which of the degenerative diseases is most consistent with this finding?
ALS
Damage to which tract MOST likely to result in integumentary damage?
DC-ML
A patient with a supracondylar fracture of the humerus has radial nerve damage. What are some problems that the physical therapist assistant expect this patient to demonstrate?
impaired sensation of the dorsum of the hand (digits 1, 2, 3,.5 of 4)
weakness of the wrist/finger extensors
A patient post stroke is having trouble with identifying an object by touch with eyes closed. What is this name of this deficits, and what lobe was most likely affected by the CVA?
Parietal lobe- Astereognosis
This vestibular condition is caused by displaced otoconia in the semicircular canals, leading to brief episodes of vertigo triggered by changes in head position
BPPV
Benign Paroxysmal Positional Vertigo
A patient with multiple sclerosis has been on prednisolone for the past 4 weeks and this is the third time that the patient has received this medication for an MS exacerbation. What are the possible adverse effects of this medication?
Muscle wasting and osteoporosis
What would you expect to see in a patient with an anterior spinal cord injury?
Loss of motor function, loss of pain and temperature sense with preservation of proprioception/light touch/vibration
This lower motor neuron disease disrupts function of the acetylcholine receptors at the neuromuscular junction.
Myasthenia Gravis
This is a disease in which there is degeneration of the myelin-producing glial cell in the peripheral nervous system?
GBS, CMT1 -
This is the term for generalized muscle weakness due to cerebellar pathology
Asthenia
A physical therapist assistant treats a patient for lumbar pain after a motor vehicle accident. The patient reports a new onset of burning pain, and a linear blistery rash is observed. What should the PTA do NEXT?
Refer back to the physician to be evaluated for possible shingles ( Herpes Zoster)
The varicella-zoster virus ( chicken pox), remains dormant in the _____ and is reactivated causing shingles along a specific dermatome.
A patient presents with 5/5 in their bilateral biceps, and triceps, 1/5 in their finger flexors, 0/5 in all trunk and LE muscles. They have intact anal sensation, no anal contraction, and a hyperreflexic bladder. They also have intact sensation at their thumb, but absent sensation at their 3rd and 5th digits. How would you best classify their injury?
C6 SCI, ASIA B ( sensory incomplete)
What is the most common moderately invasive medical intervention for pain relief for patients with Carpal Tunnel Syndrome?
injection of corticosteroids
Out of the common tests to assess thoracic outlet syndrome, this test is known to be the most reliable diagnostic test for TOS.
Adson's Test (Neurogenic or vascular)
Allen's test ( vascular TOS): primarily evaluates the patency of the radial and ulnar arteries at the wrist
Roos test (Elevated Arm stress test)
What is the term for the inability to associate multiple muscles firing at the correct time, during a complex movement due to a cerebellar pathology?
Asynergia
A patient 3 months status post brachial plexus injury is having difficulty with completing a pull-up/chin up during exercise. All other exercises are completed without issue. What nerve was most likely affected?
Thoracodorsal N.
A physical therapist assistant attempts to assess the integrity of the C6 spinal level. Which deep tendon reflex would provide the assistant with the MOST useful information?
Brachioradialis Tendon
A patient with an UE peripheral nerve compression injury is assessed to check their shoulder abduction AROM. The patient demonstrates extreme difficulty during the first 15 degrees of ABD. Which nerve was most likely affected?
Suprascapular N. (due to innervation of the Supraspinatus muscle)
A patient diagnosed with a right anterior cerebral artery stroke would MOST likely present with a functional impairment in what location?
Left lower extremity > upper extremity
A patient with vestibular deficits presents with abnormal saccades and double vision. This is consistent with what type of vestibular dysfunction, and where could the lesion be?
Central signs/ Central system dysfunction:
Vestibular nuclei, brainstem
What is the name of the foot deformity seen in patients with Charcot-Marie-Tooth disease
Pes Cavus
During sensory testing, a patient with an incomplete T7 SCI is unable to differentiate between sharp object and dull objects at T7, but is able to detect light touch. Which of the following spinal cord tracts is MOST likely damaged and where is the lesion located in the SC?
Spinothalamic Tracts (B sides)
Central cord lesion affected the anterior white commissure (where the spinothalamic tracts decussate)
A patient with a 10mm herniated disc is being treated by a PTA in prone. The patient is unable to flex their R knee, which nerve root is most likely affected?
The R S2 Nerve Root
Damage to the neurons found within the anterior horn of the SCI will lead to what type of presentation, and is one of the common sites of degeneration for which disease(s)?
LMN symptoms
ALS (disease)
Post -Polio ( disease)
Anterior cord syndromes ( trauma/stroke induced)