Musculoskeletal 1
Which position would least likely contribute to a hip flexor contracture?
Prone
The patient is a 6-year-old male who has diagnosed with CP. He is ambulatory with an assistive device but reports fatigue when walking for longer distances. What type of ambulatory device (e.g. powered mobility, transport by manual wheel chair, hand held mobility aide) do you expect for the patient to use? What GMFCS level do you expect this child to be?
Handheld Assistive Device
Andy which level?
What are the following precautions for? Lifting restriction of 5-10 pounds, avoid UE flexion >90, no pushing/pulling, brace during coughing/sneezing/laughing
Post CABG
This type of wound dressing is semi-permeable and provides moisture while allowing gas exchange but prevents bacteria from entering.
What is a hydrocolloid dressing?
What is the most common medication used for iontophoresis and what polarity does it carry?
Dexamethasone with a negative polarity
Which of the following muscles works in opposition to the deltoid to prevent scapular winging?
rhomboid major
serratus anterior
trapezius
rhomboid minor
serratus anterior
Patients with cervical radiculopathy often places their arm in a certain position to relieve symptoms without instruction. What is this position?
Arm resting on their head (indicative of nerve root tension being alleviated. This is most commonly associated with cervical disc herniation in a posterolateral direction. The arm position reduces the tension on the nerve root, leading to symptom relief. In this context, the cervical extension exacerbates the pain due to the herniated disc's position and displacement, compressing the nerve root and causing radiculopathy.)
A patient with a HCO3 value of 20 and a pH level of 7.33 is experiencing what?
metabolic acidosis
This condition results from adrenal insufficiency, leading to symptoms such as fatigue, weight loss, hypotension, and hyperpigmentation of the skin.
What is Addison’s disease?
What precaution should be followed in the presence of Methicillin-resistant Staphylococcus aureus and what PPE/accommodations should be utilized for this precaution?
Contact precautions requiring gown and gloves as well as a private treatment room
A 65-year-old patient complains of progressive hip pain and stiffness, especially in the morning and after prolonged activity. The physical therapist suspects hip osteoarthritis. Which of the following clinical findings would be MOST consistent with this diagnosis?
A. Pain with hip flexion and internal rotation
B. Positive Ober’s test
C. Increased hip abduction range of motion
D. Pain with resisted knee flexion
A. Pain with hip flexion and internal rotation
You are performing an evaluation on a patient in the hospital and notice that they listen to your instructions well, but have difficulty communicating with you as they stammer over their words. What brocas area do you suspect is impaired?
44, Brocas area. TIPS: W2 (like tax form), so wernickes 22, and brocas is 44 (b4/before)
what heart rate should a physical therapist set as a maximum for a patient in cardiovascular rehabilitation who has been in the hospital for angina?
10 beats below the anginal threshold
A deficiency of vitamin D in adults can lead to this condition, characterized by softening of bones and increased risk of fractures.
What is osteomalacia?
What is the proper fitting for a patient who needs axillary crutches for ambulation? (Crutch height and handgrip height)
Crutch height should be no greater than 3 finger widths from axilla. Handgrip heigh should be level with the ulnar styloid process and allows 20-25 degrees of elbow flexion
thumb, index, and middle fingers. The physical therapist suspects either cervical radiculopathy or carpal tunnel syndrome. Which of the following findings would be MOST indicative of cervical radiculopathy at C6-C7?
A. Hyporeflexia of the brachioradialis reflex
B. Positive Phalen’s test
C. Decreased sensation in the ring and little fingers
D. Weakness in wrist extension and triceps
D. Weakness in wrist extension and triceps
A patient in your neuro-rehab clinic coming in for a spinal cord injury C6 ASIA B has been progressing well over 11 months and managed to progress towards C6 ASIA C. However, from the last 5 visits, they have demonstrated gradual development of weakness, to where their tricep strength is at a 1. What is in your thought process in differential diagnosis, and what would you do next?
Syrinx / Syringomyelia - refer for imaging (MRI)
What lobe is being targeted for percussion therapy if a patient is positioned in left side-lying with 18 inches of Trendelenburg and a pillow under their knees?
R lower lobe
This autoimmune disease causes chronic inflammation of joints and can also lead to systemic symptoms such as fatigue and organ involvement.
What is rheumatoid arthritis?
When performing curb training with a patient who uses axillary crutches due to an impaired RLE with WBAT restrictions, how should the therapist instruct the patient to go up onto and off the curb?
When going up, the crutches should be moved onto the curb first then the LLE follows onto the curb with the RLE stepping onto the curb last. When going down, the crutches should be moved off of the curb first the RLE goes off the curb with the LLE stepping off the curb last.
A 30-year-old soccer player reports knee pain and a sensation of locking and clicking after twisting their knee during a game. The physical therapist performs a McMurray test, which reproduces the patient’s symptoms. What is the MOST likely diagnosis?
A. Anterior cruciate ligament (ACL) tear
B. Medial meniscus tear
C. Patellar tendonitis
D. Medial collateral ligament (MCL) sprain
B. Medial meniscus tear
A patient comes into your orthopedic clinic for patellofemoral syndrome recently had to take a break due to a fever she contracted. When coming back to the clinic, she complains of having new symptoms of the room spinning for 45 minutes. You decide to do a quick screen of her VOR, where her eyes demonstrate the need to catch up to your pointer. What disorder do you suspect is causing her symptoms?
Vestibular neuritis.
These correspond to the max ratings allowed on the Borg dyspnea scale for pulmonary patients in the inpatient and outpatient settings respectively.
3 and 6
This chronic inflammatory bowel disease commonly affects the ileum and colon, causing symptoms such as abdominal pain, diarrhea, and weight loss.
What is Crohn’s disease?
What medical device would be used to remove air, fluid, or pus from the pleural space after surgery?
Chest tube