Lower
A physical therapist is examining a patient with foot pain. During the gait assessment, the therapist observes that the patient excessively pronates. Excessive pronation is documented in the anterior view of the posture assessment as which of the following?
(A) Knee valgus
(B) "Too many toes sign"
(C) Tibial rotation
(D) Femoral rotation
(B) "Too many toes sign"
Rationale: The anterior view of the posture assessment includes observation for "Too many toes sign," which is indicative of a pronated foot1 .... Excessive pronation allows the forefoot to abduct relative to the rearfoot, making it appear that more lateral toes are visible from behind
A 45-year-old patient presents with unilateral neck pain that worsens with right rotation and side bending. On examination, the physical therapist notes limited right cervical rotation, negative Spurling's test, Palpation reveals tenderness over the C6-C7 facet joint on the right. Based on these findings, which of the following is the MOST likely physical therapy diagnosis?
(A) Neck pain with radiating pain
(B) Neck pain with movement coordination deficits
(C) Neck pain with mobility deficits
(D) Neck pain with headache
(C) Neck pain with mobility deficits.
Rationale: unilateral stiffness and decreased ROM or movement in certain directions (closing movements: rotation, extension) are examination findings consistent with facet syndrome/neck stiffness/spondylosis.
Which of the following is characteristic of disc displacement with reduction (DDWR) in the temporomandibular joint (TMJ)?
a) The disc displaces anteriorly and does not relocate when the mouth opens.
b) Clicking and popping are heard and palpated during jaw movements, but there is no restriction in range of motion.
c) Limited jaw opening occurs due to the disc not reducing.
d) There is a constant limitation in jaw range of motion less than 40mm.
b) Clicking and popping are heard and palpated during jaw movements, but there is no restriction in range of motion.
A patient with Parkinson's disease presents with bradykinesia and freezing gait. Which of the following interventions is most effective in addressing the patient's freezing gait?
a) Pivoting
b) Visual or auditory cueing
c) Taking smaller steps
d) Changing the environment frequently
b) Visual or auditory cueing
A 72-year-old female is admitted to the acute care unit with altered mental status. As the physical therapist, you are developing a plan of care. What is the initial focus of your physical therapy intervention?
a) Ambulation of 100 feet
b) Bed therex, bed mobility, transfer training
c) Discharge planning
d) Strength training
b) Bed therex, bed mobility, transfer training
A physical therapist is performing a straight leg raise test on a patient with suspected lumbar radiculopathy. The therapist notes reproduction of the patient's leg pain between 35 and 70 degrees of hip flexion. To further assess for nerve root involvement versus peripheral nerve involvement, which component of the lower quarter neurological exam should the therapist MOST likely perform next?
(A) Deep tendon reflexes of the patella and Achilles
(B) Sensory testing of the lower extremity dermatomes
(C) Palpation of the sciatic nerve along its course
(D) Assessment of hip accessory mobility
(B) Sensory testing of the lower extremity dermatomes
Rationale: Since the patient presents with radiating pain, a full lower quarter neurological exam is indicated. After a positive straight leg raise between 35 and 70 degrees (a range indicative of potential nerve root involvement), assessing dermatomes will help determine if the sensory changes follow a specific nerve root pattern. This would further support the hypothesis of lumbar radiculopathy (nerve root involvement) versus a peripheral nerve issue affecting multiple dermatome
A physical therapist is developing a rehabilitation plan for a patient 4 weeks following a carpal tunnel release. According to the typical phases of postoperative rehabilitation for this condition, which of the following interventions would be MOST appropriate for the moderate protection phase?
(A) Initiation of heavy resistance exercises for grip strengthening
(B) Application of modalities to control edema and pain, followed by immobilization in a wrist splint.
(C) Implementation of tendon gliding exercises and gentle nerve mobilization techniques.
(D) Return to all prior work activities, including those with repetitive wrist flexion and extension
(C) Implementation of tendon gliding exercises and gentle nerve mobilization techniques.
Rationale: The moderate protection phase (3-6 weeks) following wrist and hand surgery, which would include a carpal tunnel release, focuses on continuing edema control and increasing tissue mobility (tendon gliding, nerve mobility, etc.)
What additional symptom differentiates disc displacement with reduction with intermittent locking (DDWR with intermittent locking) from disc displacement with reduction (DDWR)?
a) The presence of constant TMJ pain
b) Limited jaw range of motion less than 40mm
c) Intermittent limited jaw opening when the disc does not reduce
d) Absence of clicking and popping during jaw movements
c) Intermittent limited jaw opening when the disc does not reduce
A patient presents with spasticity and hypertonia following a recent stroke. What is the primary goal of interventions aimed at managing the patient's spasticity?
a) To eliminate spasticity completely
b) To facilitate functional activity
c) To reduce muscle weakness
d) To increase muscle tone
b) To facilitate functional activity
A 56-year-old female patient, status post coronary artery bypass graft (CABG), develops confusion and dysarthria during a physical therapy session. What is the priority action for the physical therapist?
a) Continue the physical therapy session
b) Call a stroke code and transfer to Neurovascular ICU
c) Provide education
d) Re-evaluate after 24 hours
b) Call a stroke code and transfer to Neurovascular ICU
A patient reports to a physical therapist with posterior ankle stiffness and pain. The therapist wants to differentiate between joint impingement and a muscle length deficit of the soleus. Which of the following movement analysis techniques described in the sources would be MOST appropriate for the therapist to utilize?
(A) Have the patient perform a squat while maintaining heel contact, noting when they feel a stretch or discomfort
(B) Have the patient perform a single-leg heel raise and observe weight distribution
(C) Perform a functional dorsiflexion measurement by having the patient lunge towards a wall
(D) Palpate the Achilles tendon for areas of swelling and have the patient actively dorsiflex and plantar flex their ankle
(A) Have the patient perform a squat while maintaining heel contact, noting when they feel a stretch or discomfort
Rationale: The "Soleus vs Joint Differential Diagnosis" section in the Movement Analysis describes having the patient perform a squat while maintaining heel contact and stopping when they feel a stretch or discomfort to differentiate between soleus muscle length deficit and joint issues
During the examination of a patient with suspected thoracic outlet syndrome, which of the following special tests, would be MOST supportive of this diagnosis if positive?
(A) Spurling's Test
(B) Cervical Distraction Test
(C) Roos Test
(D) Upper Cervical Flexion Rotation Test
(C) Roos Test.
◦
Rationale: The ROOS Test is an assessment for thoracic outlet syndrome. A positive Roos Test, indicated by an increase in the patient's symptoms, increased sensation of heaviness, or tingling with repetitive fist clenching in an abducted and externally rotated arm position, suggests a challenge to the integrity of vessels and nerves in the thoracic outlet
Which of the following AROM measurements is indicative of a potential TMJ subluxation?
a) Mouth opening greater than 40mm
b) Protrusion less than 5mm
c) Lateral excursion greater than 8mm to each side
d) Retrusion greater than 1mm
b) Protrusion less than 5mm
Protrusive Movement: Normal protrusive (forward) movement is also 8 to 12 millimeters.
A 65-year-old male patient presents to the emergency department with sudden-onset right-sided weakness and speech difficulties. A CT scan confirms the presence of a left middle cerebral artery (MCA) infarct. The patient's right arm and face exhibit hemiparesis, and he demonstrates difficulty with word-finding and comprehension. Which of the following is the most likely outcome for this patient?
a) Severe memory loss and gait instability
b) Contralateral upper extremity and face hemiparesis with aphasia
c) Contralateral leg hemiparesis and dysphagia
d) Homonymous hemianopia and apathy
b) Contralateral upper extremity and face hemiparesis with aphasia
When performing a stand pivot transfer with a patient, where should the clinician position themselves?
a) Behind the patient
b) In front of the patient, with hips and knees flexed and a wide staggered stance
c) On the side of the patient
d) Above the patient
b) In front of the patient, with hips and knees flexed and a wide staggered stance
A patient with anterior knee pain exacerbated by prolonged sitting and stair climbing is being evaluated by a physical therapist. Palpation reveals tenderness at the inferior pole of the patella. Which of the following special tests would be MOST appropriate to further assess this patient's condition?
(A) McMurray Test
(B) Lachman Test
(C) Patellar Compression Test
(D) Valgus Stress Test
(C) Patellar Compression Test
Rationale: The patient's anterior knee pain exacerbated by activities like prolonged sitting and stair climbing, along with tenderness at the inferior pole of the patella, is suggestive of patellar tendinopathy. The Patellar Compression Test is a specific assessment to reproduce pain by compressing the patella against the femur, which would be indicated in this scenario. Clarke's sign is often performed in conjunction with patellar compression
Which of the following special tests is NOT used to assess for lateral epicondylalgia (tennis elbow)?
a) Cozen’s Test
b) Mill’s Test
c) Maudsley’s Test
d) Resisted Wrist Flexion
d) Resisted Wrist Flexion
A patient presents with a restricted mouth opening of 22mm. Which of the following conditions is most likely associated with this finding?
a) TMJ subluxation or other dysfunctions
b) Maximal protrusion of 6mm
c) Normal lateral excursion of 10mm
d) Retrusion within the normal range of 1mm
a) TMJ subluxation or other dysfunctions
A 72-year-old woman presents with a complaint of sudden onset double vision, difficulty swallowing, and left-sided weakness. Upon examination, she exhibits a left-sided hemiparesis, dysphagia, and impaired gaze to the right. An MRI reveals a lesion in the brainstem affecting the medial inferior pontine area. Based on this presentation, which of the following impairments is most likely associated with the lesion?
a) Ipsilateral facial paralysis
b) Paralysis of conjugate gaze
c) Memory loss
d) Contralateral loss of pain and temperature sensation
b) Paralysis of conjugate gaze
What is the most common device used to treat mild hypoxemia?
a) Venturi Mask
b) Simple Nasal Cannula
c) Non-Rebreather Face Mask
d) Rectal Tube
b) Simple Nasal Cannula
A physical therapist is examining a patient with lateral hip pain. The patient reports increased pain with sidelying on the affected side. Palpation over the greater trochanter elicits significant tenderness. Which of the following special tests is MOST directly indicated to assess this patient's potential condition?
(A) FABER Test
(B) FADIR Test
(C) Trendelenburg Test
(D) Trochanteric Bursae Assessment
(D) Trochanteric Bursae Assessment
Rationale: Lateral hip pain that is worse with sidelying on the affected side, along with tenderness over the greater trochanter, strongly suggests greater trochanteric pain syndrome, often involving trochanteric bursitis. The Trochanteric Bursae Assessment involves direct palpation over the greater trochanter to assess for reproduction of symptoms
What is the main goal of transverse friction massage?
a) To increase blood flow to the area
b) To soften and desensitize tissue before stretching or manipulation
c) To increase tension in a muscle
d) To increase joint mobility
b) To soften and desensitize tissue before stretching or manipulation
What is the normal range for mouth opening in the temporomandibular joint (TMJ)?
a) 10-30mm
b) 30-50mm
c) 40-60mm
d) 60-80mm
c) 40-60mm
A 67-year-old male presents with sudden onset of weakness and numbness in the right arm and leg, along with difficulty speaking. On examination, you observe hyperreflexia and spasticity in the right side of the body, and the patient demonstrates difficulty with coordinated movement. Given these findings, which area of the brain is most likely affected by the lesion?
a) Cerebellum
b) Basal ganglia
c) Cortex
d) Brainstem
c) Cortex
What is a key feature of a Venturi mask?
a) It is a low flow system
b) It does not use a flow meter
c) It uses a flow meter to deliver precise measurements of O2
d) It delivers up to 25 Lpm
c) It uses a flow meter to deliver precise measurements of O2