A patient is being evaluated to determine their Ranchos Level of Function. They can respond to simple commands, however their memory is impaired and when they speak, they are often incoherent and make comments that are improper and out of place. What should the level be?
III: localized response
IV: confused/agitated
V: confused-inappropriate
VI: confused- appropriate
V: confused-inappropriate
A patient has motor function intact below the neurological level, though the key muscle groups below have a muscle grade of less than three. What ASIA level is this?
A
B
C
D
C
Which is not a risk factor for strokes?
Metabolic Syndrome
Lower LDL levels
Atherosclerosis
Previous cardiac surgery
Lower LDL levels
When does nociceptive pain occur?
In response to an immediate noxious stimulus
After damage to the somatosensory nervous system
After 3-6 months of chronic pain
Only after first experiencing nociplastic pain
In response to an immediate noxious stimulus
Tonic Labrinthine reflex integrates at what age?
8 months
2 months
6 months
10 months
6 months
A patient is noted to be level VII, automatic-appropriate. What may still be limited in terms of cognitive or mental behaviors?
Judgment
No memory recollection present
No response to physical stimuli
Performance of simple, innate tasks
Judgment
What is NOT true about spasticity in patients with SCI?
More prevalent with higher and incomplete lesions
Quick stretching will elicit this response
It is only detrimental to a patient’s function
Nociceptive stimuli can increase tone
It is only detrimental to a patient’s function
Which of the following is NOT a common issue with a RIGHT sided stroke?
Apraxia
Irritability
Poor hand-eye coordination
Left-sided neglect
Apraxia
Which of the following is NOT true of nociplastic pain?
Nociplastic pain includes hyperalgesia or allodynia
Symptoms are localized with a relatively short healing time
Pain is associated with central sensitization
Both nociceptive pain and neuropathic pain can lead to peripheral and central sensitization
Symptoms are localized with a relatively short healing time
You want to test to see if the traction reflex is still integrated. You set the child up for the test, then grasp their forearm and pull them from supine to sitting. What is the expected response?
Grasp of upper extremity and head in line with spine
Baby cries
Head lags behind as well as grasp and total flexion of upper extremity
Total extension of upper extremity and head lags behind
Head lags behind as well as grasp and total flexion of upper extremity
What is NOT a category that the Glasgow Coma Scale quantifies?
Eye opening
Motor response to commands
Verbal response
Emotions related to stimuli (graded agitated, aggression, calm, etc.)
Emotions related to stimuli (graded agitated, aggression, calm, etc.)
To prevent pressure ulcers, a therapist is to encourage position changes ____ for patients in bed and ____ for patients in wheelchairs.
4 hours, 30 minutes
2 hours, 15-20 minutes
3 hours, 1 hour
1 hours, 10 minutes
2 hours, 15-20 minutes
Which of the following CVAs would most likely result in “locked-in” syndrome?
Middle Cerebral
Anterior Cerebral
Posterior Cerebral
Vertebral-Basilar
Vertebral-Basilar
Where is right subscapular pain referred from?
Gallbladder
Kidney
Spleen
Liver
Gallbladder
Place the following developmental milestones in order from earliest reached to latest reached: sits unsupported, rolls supine to prone, holds head up in prone, creeps on hands and knees up stairs
Holds head up in prone, rolls supine to prone, sits unsupported, creeps on hands and knees upstairs
Sits unsupported, creeps on hands and knees upstairs, holds head up in prone, rolls supine to prone
Rolls supine to prone, holds head up in prone, sits unsupported, creeps on hands and knees up stairs
Holds head up in prone, rolls supine to prone, creeps on hands and knees up stairs, sits unsupported
Holds head up in prone, rolls supine to prone, sits unsupported, creeps on hands and knees upstairs
Name this level of alertness/arousal: the patient responds to strong and noxious stimuli only, returning to an unconscious state when stimuli is stopped
Lethargic
Obtunded
Stupor
Coma
Stupor
After a SCI, the most common cause of death is related to respiratory dysfunction. What is NOT true about the effects an injury has on respiration?
Tidal volume and capacity are reduced
Though inspiration is weakened, forced expiration remains the same
Atelectasis, pneumonia, and insufficiency are most common complications
Percussion or vibration techniques can be used to clear secretions
Though inspiration is weakened, forced expiration remains the same
Which of the following is NOT a common characteristic of PCA syndrome?
Choreoathetosis
Homonymous hemianopsia
Thalamic pain
Ataxia
Ataxia
You have performed sensory testing for neuropathic pain. Your findings might show which of the following distributions?
Dermatomal pattern
Cutaneous nerve pattern
Central nervous system pattern
All of the above
All of the above
You are evaluating a child with Erb’s Palsy, a brachial plexus injury to C5 and C6. Which of the following would you NOT expect to see from this population?
Waiter’s tip
Weakness in scapular stabilizers
Claw hand
Weakness in elbow flexion
Claw hand
You are working with a patient with a TBI who is experiencing increased agitation and overall confusion when trying to teach them rolling techniques. What is the BEST course of action for continuing the session?
Begin to “dumb down” the language and tasks so that it would make more sense for their mental capacity
Orient the patient to the situation, personnel and themselves while remaining calm and “in control”
Elongate and continue the session until the patient can complete the requested tasks
Keep the patient in their room and continue to work one on one without aides or other PTs nearby
Orient the patient to the situation, personnel and themselves while remaining calm and “in control”
A C7 SCI patient is experiencing a decrease in blood pressure and an increase in heart rate upon transferring from supine to sit. They are experiencing diaphoresis and dizziness. What is the most likely cause and what should be done?
Autonomic dysreflexia, lie patient back down and seek cause
Orthostatic hypotension, continue to monitor vitals and provide stocking or binder as necessary
Pulmonary embolism, consult the medical team ASAP
BPPV, begin asking vestibular-based questions to see if performing Dix-Hallpike is warranted for further evaluation
Orthostatic hypotension, continue to monitor vitals and provide stocking or binder as necessary
A patient presents to the clinic following a recent stroke. They demonstrate greater motor deficits in their lower extremities than upper and are suffering from urinary incontinence. Where did the stroke most likely occur?
Middle Cerebral
Anterior Cerebral
Posterior Cerebral
Vertebral-Basilar
Anterior Cerebral
A patient complaining of widespread pain with fatigue, disrupted sleep, and difficulty concentrating may have what condition associated with nociplastic pain?
Osteoarthritis
Polyneuropathy
Fibromyalgia
Fibromyalgia
There are four main syndromes related to Cerebral palsy. Which of the following is NOT one of the four syndromes?
Spastic
Gestational
Athetoid
Mixed forms
Gestational