APK 1998 Flashcards by Mind Med

Continuous standing, particularly on a hard surface, can cause fatigue and stress on the back, legs and feet. Improvements in workstation design include the following, EXCEPT:

A. Opportunities to change positions, move around, or alternate between sitting or standing
B. Feet must remain flat on the floor
C. Provide cushioned in soles
D. Provide anti-fatigue mats or other floor materials which provides cushioning
E. Provide stools or sit-lean stands

Feet must remain flat on the floor

Need Foot Stools, Need Change in Position

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This is the most common method for lifting and allows full use of good body mechanics principles. To perform the lift, the individual should establish a wide base of support and straddle the object with one foot slightly ahead of the other

A. Golfer’s Lift
B. Diagonal Lift
C. Tripod Lift
D. Power Lift
E. Deep Squat Lift

Diagonal lift

Small objects you can straddle. just one foot ahead for better momentum

Golfer’s Lift - For small light objects; Raise one leg to counterbalance your torso. Recommended for people with knee problems or decreased leg strength.

Power Lift - For objects too large for stradling. Similar to Diagonal lift; pushes buttocks outwards to compensate the shift of COG

Tripod Lift - For objects with uneven weight distribution. Recommended for people with decreased arm strength

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Which hip-repair surgical procedure is indicated for pain in early stages of degenerative joint disease before motion has been lost?

a. Double-cup arthroplasty
b. Femoral Prosthesis
c. Muscle Release
d. Arthrodesis
e. Displacement Osteotomy

Displacement Osteotomy

Cut wedge on bone to equalize WB on extremity

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The following statements describe true leg length discrepancy, EXCEPT:

a. To determine true leg length discrepancy, measure the distance from the anterior superior iliac spines to the medial
malleolus of the ankles
b. With the subjects in supine with knees flexed to 90 degrees and feet flat on the table, if one knee appears higher than
other, the femur of that extremity is longer
c. With the subject in supine with knees flexed to 90 degrees and feet flat on the table, if one knee projects further
anteriorly than the other, the femur of that extremity is longer
d. A fracture that crossed the epiphyseal plate during childhood may result in true leg length discrepancy
e. Measurement begins at the slight concavity must below the anterior superior iliac spine

B. With the subjects in supine with knees flexed to 90 degrees and feet flat on the table, if one knee appears higher than other, the femur of that extremity is longer

Higher = Tibia, Anterior = Femur

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The following statements apply to alveolar dead space, EXCEPT

a. All of these
b. A condition that occurs when blood flow is blocked by a pulmonary embolus
c. Selected alveoli are replaced with scar tissue, decreasing ventilation to areas with normal perfusion
d. A result of vascular abnormalities
e. The volume of gas in alveoli that is ventilated but poorly perfused or underperfused.

C. Selected alveoli are replaced with scar tissue, decreasing ventilation to areas with normal perfusion

Alveolar dead space - well ventilated but poor perfusion

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The following statements apply to halo skeletal traction, EXCEPT:

a. This is applied to reduce or immobilize stable cervical fractures of dislocations
b. The halo is a metal ring that is secured around the patient’s head by four pins, two anterior and two posterior
c. None of these
d. Permitting mobility is an advantage of halo traction over other forms, reducing respiratory and circulatory problems
and muscle atrophy
e. Because the pins penetrate the skull only about 1/8+, skin incisions and drill holes are not necessary, reducing the risk
of infection

None of these

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The following statements are true in supracondylar and condylar fracture, EXCEPT:

a. Traction is treatment of choice
b. Traction is not indicated in this type of fracture
c. For transverse or oblique fractures, and other fractures that aren’t complex, internal fixation may be used
d. Rod, nail, plate or screws may be used as internal fixation device
e. Internal fixation carries risk of damage to the sciatic or popliteal artery

B. Traction is not indicated in this type of fracture

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The following statements apply to mononeuropathy, EXCEPT:

a. Multiple single-nerve pareses are often due to disseminated vasculitis and infarction of nerve trunks
b. Refers to a dysfunction of a single nerve, not several nerves that are separately involved without general affliction of
the peripheral nervous system
c. May be caused by primary “neuritis” related to viral infection
d. Examples include paralysis of the facial nerve and of the ninth-tenth cranial nerve complex
e. Etiology is usually vascular occlusive disease or vasculitis, trauma of some kind, of impingement

Refers to a dysfunction of a single nerve, not several nerves that are separately involved without general affliction of the peripheral nervous system

can be multiple nerves

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Waddell’s nonorganic signs assess a patient’s pain behavior in response to certain maneuvers. Which of the following signs indicate a positive simulation test?

a. Cogwheeling of many muscle groups that cannot be explained on a neurological basis
b. Marked improvement of straight leg raising of distraction as compared with formal testing
c. Back pain is reported with the first 30 degrees when the pelvis and shoulders are passively rotated in the same plane
as the patient stands
d. Deep tenderness left over a wide area, not localized to one structure
e. Disproportionate verbalization, facial expression, muscle tension and tremor

Back pain is reported with the first 30 degrees when the pelvis and shoulders are passively rotated in the same plane
as the patient stands

Tenderness: Deep, not Local
Simulation: Pelvis & shoulder rot on same plane passively = pain
Distraction: SLR
Regional: Cogwheel
Overreaction: Disproportionate verbalization, facial expressions, tremor, sweating

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The following statements apply to Percussion and Vibration, EXCEPT:

a. Recommended for patients with impaired cognition or poor coughing ability
b. Recommended for the patient who is intubated and mechanically ventilated
c. Used to enhance mucociliary clearance from both central and peripheral airways
d. The exact mechanism of action of chest percussion is unknown, but there is some evidence that physical stimulation
alters airflow and is associated with the release of pulmonary chemical mediators
e. Alterations in airway diameter and airflow may increase the viscosity of mucus, making percussion more effective in mobilizing secretions that are adherent to the bronchial walls

E. Alterations in airway diameter and airflow may increase the viscosity of mucus, making percussion more effective in mobilizing secretions that are adherent to the bronchial walls

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Arterial blood pressure increases with:
a. Decreased angiotensin
b. Increased bradykinin
c. Decreased Aldosterone
d. Increased carbon dioxide

Increased carbon dioxide

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This lifting technique allows the individual to conveniently bring the item close to the body before completing the lift. One
foot is placed behind the front portion of the object, and drop slowly to the other knee. This lift should be avoided by those
with knee problems:

a. Power lift
b. Diagonal lift
c. Deep squat lift
d. Tripod lift
e. Partial Squat Lift

Tripod Sign

Partial Squat Lift - Used for lifting objects th handles close to knee height

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Tumor located at the premotor cortex will give rise to:
a. Incoordination of the contralateral side
b. Paralysis of the contralateral side
c. Tremors of the ipsilateral side
d. spasticity of the ipsilateral side
e. Paralysis of the ipsilateral side

Incoordination of the contralateral side

Basal Ganglia or Cerebellum for coordination

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The following statements characterize flexion in the lumbar spine, EXCEPT:
a. Flexion in the low back produces kyphosis
b. Involves relaxation of the anterior longitudinal ligament and stretching of the supraspinal and interspinal ligaments the ligamentum flavum and the posterior longitudinal
c. To test, the subject bends as far forward as he can with knees straight, and try to touch the toes
d. There is no reversal of the normal lordosis during flexion, the low back merely flattens out
e. Limited by the size of the vertebral bodies

Flexion in the low back produces kyphosis

Only in cervical spine

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Subjects who have menisectiomies follow the following program, EXCEPT:

a. Flexion-to-extension exercises are used when there is a partial ROM with very little swelling or discomfort in or about the knee
b. Resistance is kept low but is raised as the subject becomes able to handle the resistance with good exercise technique
c. Subjects with arthroscopic menisectomies are started on a much more vigorous exercise program much earlier
d. Hamstring stretching exercises and flexion exercises are begun about 10 days after surgery
e. Subjects are allowed to begin straight-leg-raise exercises at day one and progress to about eight sets of 10 repetitions in a very short period of time

Flexion-to-extension exercises are used when there is a partial ROM with very little swelling or discomfort in or about
the knee

Full ROM

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This test makes it possible to determine whether or not the radial and ulnar arteries are supplying the hand to their full capacities:

a. Bunnel-Littler Test
b. Tinel Test
c. None of these
d. Allen test
e. Retinacular test

Allen test

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Inhibitive ankle-foot orthosis are used in children with spastic cerebral palsy for the following reasons, EXCEPT:
a. Inhibit or decrease abnormal reflexes in the lower extremity by protecting the foot from tactile-induced reflexes
b. Normalize movement of trunk, pelvis and lower extremity in standing and during gait
c. Decrease spasticity by prolonged stretch and pressure on the tendons of the triceps surae muscle and too flexors
d. Change in bony alignment of the foot and ankle
e. Prevent excessive ankle plantar flexion and improve lower extremity muscle timing

Change in bony alignment of the foot and ankle

Muscle only

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The following statements describe electrical stimulation (ES) in the treatment of chronic wounds, EXCEPT:
a. ES involves the application of low-level, therapeutic dose of electricity directly into the wound
b. Eliminates many microorganism that might otherwise inhibit or prevent healing
c. ES is not an alternative treatment for a wound that has shown only slow or minimal improvement
d. ES is the first alternative treatment for a wound that has not responded to traditional care
e. Promotes healing by enhancing tissue proliferation and repair

ES is not an alternative treatment for a wound that has shown only slow or minimal improvement

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In lateral epicondylitis, repetitive stress may result in injury to the following muscles:
a. All of these
b. Proximal attachments of the extensor radialis brevis
c. Extensor Carpi Radialis Longus
d. Extensor Digitorum

Proximal attachments of the extensor radialis brevis

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In cardiac transplantation, postoperative cardiovascular physiology is dramatically affected by the following, EXCEPT:
a. None of these
b. Immunosuppression
c. Donor-recipient size mismatch
d. Denervation
e. Rejection

None of these

A. Immunosuppression
B. Donor recipient size match
C. enervation
D. Rejection

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The only two muscles inserted into the back part of the sclera:
a. Superior Oblique and Inferior Oblique
b. Superior Rectus and Medial Rectus
c. None of these
d. Lateral Rectus and Inferior Rectus

Superior Oblique and Inferior Oblique

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The following statements apply to the ulnar nerve, EXCEPT:

a. Innervates the hypothenar, all interossei, two medial lumbricals, the adductor pollicis and part of the flexor pollicis
brevis via its deep palmar branch in the hand
b. Innervates the flexor carpi ulnaris and the flexor digitorum profundus to the 4th and 5th digits in the forearm
c. Carries fibers from the C8 and T1 roots.
d. In early or minimal lesions of the ulnar nerve, there is atrophy of the first dorsal interosseus and sensory loss distally
in the fifth digit
e. Paralysis causes the grip to be fairly weak but finger abduction and adduction will be nearly lost

Paralysis causes the grip to be fairly weak but finger abduction and adduction will be nearly lost

Grip will still be fairly strong

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In a workplace, an issue closely related to heights is difficulty with reaches. Following are some recommendation to improve
on material handling ergonomics problem, EXCEPT:

a. Increase dimensions of the work surface
b. Smaller lot sizes
c. Tilt the work surface
d. Provide containers with removable sides
e. Provide cut-outs in the work surface

Increase dimensions of the work surface

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There is a greater frequency of tears of the medial semilunar cartilage, a common athletic injury. This is due to:

a. The medial meniscus which is fixed to the tibia front and back by its two horns as well as around its periphery
b. The posterior cruciate ligament which is attached to the tibia so far back as to allow some of its fibers to arise from the
back of the bone below the upper surface.
c. Tightness of the medial coronary ligament of the knee that prevents back-and-forth movements of the medial cartilage
d. None of the above

Tightness of the medial coronary ligament of the knee that prevents back-and-forth movements of the medial cartilage

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The nerve most likely to be injured in wrist slashing is: a. Median nerve b. Ulnar nerve c. Radio-ulnar nerve d. Musculocutaneous nerve e. radial nerve

Median Nerve

The major modifiable risk factors for the development and progression of coronary artery disease include the following, EXCEPT: a. Habitual smoking b. Hypertension c. Physical activity d. Habitual smoking e. Hypercholesterolemia

Physical activity | Not okay for CAD

The following statements describe Osteochondritis Dissecans, EXCEPT: a. Usually a history of intermittent nonspecific knee pain, usually related to some form of exertion b. Symptoms include acute episodes of locking, giving way, or joint effusion when a fragment becomes detached and falls into the jt c. Treatment may include debridement with femoral condyle drilling to increase the vascularity in the subchrondral bone to help form a new articular surface d. Commonly has a lesion of the articular surface of the femoral condyles e. Most common location of separation is the medial aspect of the anterior margin of the medial femoral condyle

Most common location of separation is the medial aspect of the anterior margin of the medial femoral condyle | Lateral aspect of posterior margin of the femoral condyle

The neurological basis for sexual dysfunction in men with spinal cord injury (SCI) are as follows: EXCEPT: a. The parasympathetic spinal outflow originating from the S-2 to S-4 spinal segments is primarily responsible for mediating reflexogenic erection S2- S4 b. The T-10 to S-2 spinal segments contain the reflex arc that receives sensory afferents from the genitals c. The neural output from the hypothalamus to the sexual organs courses in the anterolateral columns to terminate in the intermediolateral cell columns of T-10 to L-3 d. In men, the sympathetic output is primarily responsible for regulating ejaculation and psychogenic component of penile erection e. Supraspinal component of the motor pathways descends with the corticospinal tracts to the S-2 to S-4 segments of the sacral cord

The T-10 to S-2 spinal segments contain the reflex arc that receives sensory afferents from the genitals | S2-4

Due to the difference in length of the moment arms used by the hip abductor (HA) muscles and body weight, the HA muscles must produce this force to that of body weight to ensure frontal-plane equilibrium: a. About twice b. Five times c. About four time d. three times e. equal

About Twice

The following muscles arise from the medial epicondyle of the humerus and bounds the medial side of the antecubital fossa: a. Flexor Carpi Radialis, Palmaris Longus and Flexor Carpi Ulnaris b. Flexor Digitorum Sublimis, Flexor Digitorum Profundus and Flexor Pollicis Longus c. None of these d. Pronator Teres, Palmaris Longus, and Flexor Digitorum Superficialis

Flexor Carpi Radialis, Palmaris Longus and Flexor Carpi Ulnaris

Persistent asymmetry of the Moro reflex suggest the following, EXCEPT: a. Hemiparesis b. Fracture of the clavicle c. Injury to the brachial plexus d. Hemiplegia e. Fracture of the humerus

Hemiplegia

The following statements described the Hassis Infant Neuromotor Test (HINT), EXCEPT: a. Asks the infant’s parent or caregiver to assess how the infant moves and plays b. Aimed at identifying early motor deficits and early signs of cognitive delay in infants at risk c. Spans an age range of 3 to 12 months d. Designed to examine differences in motor behavior, specifically posture and antigravity control e. Was developed to provide a reliable and valid neuromotor screening tool for early identification of neurodevelopment handicaps in high-risk infants

Designed to examine differences in motor behavior, specifically posture and antigravity control | Describes Alberta Infant Motor Scale to test infant motor performance

All of the following statements are true, EXCEPT a. Nerve impulses are propagated by the continuous progression of the action potential along the length of the fiber in myelinated fibers b. Nerves with larger axons have lower stimulus thresholds for development of an action potential than do nerves with smaller axons c. Nerves with large-diameter axons have greater conduction velocities than do nerves with smaller diameter axons d. Conduction velocity is also substantially greater in myelinated axons than in unmyelinated axons

Nerve impulses are propagated by the continuous progression of the action potential along the length of the fiber in myelinated fibers | Jumps/Interrupted d/t myelin sheath

Depending on patient size and transfer method, condition and mobility potential, the following are preferred features in wheelchair selection for a hemiplegic, EXCEPT: a. Fixed armrests and foot-and-leg rests are swing-detachable with heel loops b. Motorized type with reclining back c. Back with head extension and foot-and-leg rests are elevating d. Standard type with standard handrims e. Extension brakes and fixed back

Motorized type with reclining back | For SCI

Stimulation of the anterior hypothalamus causes all of the following, EXCEPT: a. Sweating b. Cutaneous vasodilatation c. Increased respiration d. Shivering

Shivering | Posterior hypothalamus

Home exercise program following open reduction internal fixation include the following, EXCEPT: a. Basic ROM and strengthening exercises to prevent contracture and reduce atrophy while non ambulatory b. Subject’s full weight bearing status may be achieved at 3 months post surgery c. Subjects perform isometric exercises, ROM exercises, and upper extremity exercise until fatigued d. Even as pain increases or weakness develops, full active ROM must be performed e. Resistive exercises are encouraged with the lower extremities because of the subject’s non-weight bearing status

Resistive exercises are encouraged with the lower extremities because of the subject’s non-weight bearing status

Decreases vascular resistance by decreasing catecholamine mediated vasoconstriction of peripheral vasculature: a. Alpha-adrenergic blockers b. Diuretics c. Angiotensin- converting (ACE) enzyme inhibitors d. Calcium channel blockers e. Beta-adrenergic blockers

Alpha-adrenergic blockers

The following statements are true of the primary dorsiflexor of the foot, EXCEPT: a. The extensor digitorum longus tendon is perceptible on the dorsum of the foot, crossing in front of the ankle mortise and fanning out to insert, by slips into the dorsal surfaces of the middle and distal phalanges of the four lateral toes b. The tendon of the extensor hallucis longus is perceptible to its insertion at the proximal end of the distal phalanx of the great toe c. The primary dorsiflexor of the foot lie in the anterior tibial compartment and share a common innervations, the deep peroneal nerve d. The muscle belly of the extensor digitorum brevis can be palpated where it bulges out from the sinus tarsi and therefore can be isolated for muscle testing e. The tendon of the tibialis anterior can be seen where it crosses the anteromedial portion of the ankle joint

The muscle belly of the extensor digitorum brevis can be palpated where it bulges out from the sinus tarsi and therefore can be isolated for muscle testing | Not a Dorsiflexor

When applied, second class levers can be: a. Levers that operate at a mechanical disadvantage but one of speed b. Levers that work at a mechanical advantage c. Levers of stability and speed d. All of these

Levers that work at a mechanical advantage | F-W-E

An area routinely addressed in fitness test is flexibility, and the sit-and-reach test 9SRT) is typically used. The following statements characterize SRT, EXCEPT: a.It evaluated flexibility of the low back and hamstring muscles b. The subject being tested leans forward in a long-sitting position c. Passing scores are given when subjects can reach at least 4 cm beyond their toes d. A score given is based on the most distant point reached by both hands on a standardized box e. It is an important test because decreased flexibility is thought to contribute to the development of low back pain

Passing scores are given when subjects can reach at least 4 cm beyond their toes | at least 2 cm

This tendon can be isolated by holding the subject’s fingers in extension and flexing the finger in question at the IP joint. If the finger can be flexed at the specified joint, the tendon is intact: a. Interossei b. Flexor digitorum profundus c. Lumbricals d. Flexor digitorum superficialis e. None of these

Flexor digitorum superficialis

When the patient is able to make two breaths in order to complete counting aloud to 15, the Ventilatory Index Scale is: a. 0 b. 1 c. 2 d. 3 e. 4

2 | 1:1, 2:2, 3:3, 4: >4

Knees with ligamentous repair following the following program, EXCEPT: a. Excessive quadriceps femoris muscle activity can cause the tibia to become subluxed anteriorly and stretch the repaired tissues b. Immobilized for at least six weeks c. Gait is partial weight bearing with crutches d. The very complicated anteromedial, anterolateral and posterolateral surgeries requires an especially slow progression e. Quadriceps femoris setting and ankle ROM is initiated at day one

Gait is partial weight bearing with crutches | SUpposed to be NWB

As part of an overall ergonomics program, a variety of administrative practices can be used effectively, but must not be used instead of considering engineering improvements. Following are some accepted recommendations, EXCEPT: a. Subdivision of labor b. Exercise c. Workload reduction d. Job rotation e. Work/Rest Schedule

Exercise

A frame of reference for balance and head control that gives information about body position with respect to the environment: a. Geosynchronous b. Egocentric c. Ecocentric d. Exocentric e. Proprioceptive

Exocentric ## Footnote Egocentric - Reference frame provides spatial coordinates for limb & body positions Geocentric - Reference system maintains posture with respect to gravity

Any bodily movement produced by skeletal muscles that results in increased energy expenditure: a. Physical activity b. Training c. exercise d. performance e. physical fitness

Physical activity

The stability and integrity of the transverse arch is maintained by: a. Hypothenar and thenar muscles b. Extrinsic muscles of the hands c. Interossei and lumbricals d. tendons e. ligaments

Hypothenar and thenar muscles

During isovolumentric contraction phase: a. The aortic and tricuspid valves are closed b. The aortic valve is open while the pulmonic valve is closed c. The mitral valve is open but the tricuspid valve is closed d. The mitral valve is open while the aortic valve is closed e. The mitral and aortic valves are closed

The mitral and aortic valves are closed

The following steps describe increased cardiopulmonary activity in response to various levels of physical activity, EXCEPT: a. During exercise, CO is increase because of increase in both stroke volume and heart rate, with stroke volume reaching its maximal level at approximately 40% of maximal oxygen consumption. b. When ventilation occurs, the muscles contract creating a negative pressure within the thorax allowing air to move inward from the mouth to various lung parts. c. Because of regional differences in the distribution of both ventilation and perfusion, the possibility exists to have areas of the lungs that are well ventilated but underperfused, but not vice versa. d. In myocardial ischemia, the ability to adequately fill the left ventricle may be impaired and patients may experience dyspnea or signs and symptoms of decreased CO. e. At rest, the primary muscles of respiration are the diaphragm, scalene and parasternal intercostals.

Because of regional differences in the distribution of both ventilation and perfusion, the possibility exists to have areas of the lungs that are well ventilated but underperfused, but not vice versa.

The following statements are true of laminectomy, EXCEPT: a. Involved a surgical removal of a portion of the lamina b. Spinal fusion may be performed along with laminectomy for additional vertebral stability. c. The protruding disc fragments are removed to relieve pressure on the nerve root. d. Spinal fusion can only be performed in laminectomy. e. In laminectomy with spinal fusion, the spine is reinforced by using bone chips or inserting a metallic rod, screw or plate.

Spinal fusion can only be performed in laminectomy.

The following statements are true of the Swing Phase of gait, EXCEPT: a. The ankle dorsiflexor are active during the entire swing phase to clear the ground by holding the ankle neutral b. The knee reaches its maximum degree of flexion approximately 65 degrees between toe-off and midswing c. Steppage gait occurs when the ankle dorsiflexor do not work properly d. If the subject has poor quadriceps strength, he may rotate the pelvis posteriorly in an exaggerated motion to provide forward thrust for the leg e. If the hamstrings are weak, heel strike may be excessively harsh and the knee may hyperextend

If the subject has poor quadriceps strength, he may rotate the pelvis posteriorly in an exaggerated motion to provide forward thrust for the leg | Anteriorly

The following statements are true of erythrocytes, EXCEPT a. They are produced in red bone marrow and in the spleen and other lymphoid tissues b. A mature red cell is completely filled with hemoglobin, a high specialized compound of protein and iron c. These are formed in bone marrow where they pass through several stages before reaching maturity d. The life of an erythrocyte is about four months, and four million new cells every second of every minute must be produced.

They are produced in red bone marrow and in the spleen and other lymphoid tissues | Refers to Leukocytes ## Footnote Erythocytes graveyard: Spleen

The following statements apply to the common peroneal nerve, EXCEPT: a. Subject is able to walk on his toes and Achilles reflex is preserved b. Interruption of the nerve results in loss of dorsiflexion of ankle and toes and in loss of eversion of the foot c. There is foot drop with hypotonia and atrophy of muscle but not sensory loss d. Received fibers from the L4, L5, S2, and S2 roots e. There is varying sensory loss along the lateral aspect of the dorsum of the foot

There is foot drop with hypotonia and atrophy of muscle but not sensory loss

Thrombus formation in the legs, particularly in patients following surgery may be prevented in the following manner, EXCEPT: a. Gentle mobilization and modified exercises after thrombi have resolved b. Increase movement and activity to negate sequelae of restricted mobility and recumbency on oxygen transport c. Specially designed stockings in conjunction with pneumatic compression devices to stimulate the normal action of the muscle pump in the leg d. Stockings that are applied with uniform pressure along the leg, and removed frequently for 10 minute periods and reapplied. e. Compression stockings to prevent peripheral blood pooling and augment venous return

Increase movement and activity to negate sequelae of restricted mobility and recumbency on oxygen transport | consider risk

Transcutaneous electrical nerve stimulation has been used for pain management over the years. Conventional TENS has the following properties, EXCEPT: a. Uses intensities below the motor threshold b. Uses relatively low pulse frequencies (50-100 pulses per second) c. Used relatively short pulse durations (2-50 microseconds) d. Stimulates large-diameter fibers e. Stimulates superficial cutaneous nerve fibers

Uses relatively low pulse frequencies (50-100 pulses per second) | High pulse freq

A dome shaped bump that lies in the occipital region on the midline and marks the center of the superior nuchal line: a. Lanula b. None of these c. Cricoid tubercle d. Cricoid ring e. Inion

Inion

In this lifting technique, the individual squats in front of the object with feet and knee approximately shoulder width apart. This should only be used when lifting small, light items or when insufficient space is provided. This lift should be avoided by those with knee problems: a. Power lift b. Tripod lift c. Deep squat lift d. Diagonal lift e. Golfer’s lift

Deep squat lift

Which of the following statements is true in forefoot adduction correction test? a. If forefoot can be fully corrected to less than neutral, foot will probably not correct itself, and cast correction is necessary b. If forefoot can only be partially corrected to neutral or less, foot will still correct itself and cast correction is not necessary c. If you can manually correct adduction and abduct forefoot greater than the neutral position, no treatment is necessary as foot will partially correct itself. d.If forefoot can be fully corrected to neutral or greater, foot will probably not correct itself, and cast correction is not necessary e. If you can manually correct adduction and abduct forefoot beyond neutral position, no treatment is necessary as foot will partially correct itself.

If forefoot can be fully corrected to less than neutral, foot will probably not correct itself, and cast correction is necessary | ALL was Wrong answer but this was the first wrong

Characteristic of patellofemoral pain syndrome include the following, EXCEPT a. Can be used by malalignment of the lower extremity b. Most frequently recommended treatment is exercise c. Surgical treatment is rarely indicated d. Pain results in decreased force by knee extensors e. Consists of anterior knee pain excluding intra-articular pathology, peripatellar tendinitis and bursitis.

Can be used by malalignment of the lower extremity

The following statements characterize extension in the lumbar spine, EXCEPT: a. To test, the subject is instructed to bend backward as far as he can, using the examiner’s hand on the posterior superior iliac spine as fulcrum b. Increase in lumbar lordosis is resisted by the rectus abdominis muscles c. Stretches the anterior longitudinal ligament and relaxes the posterior ligaments d. When testing extension, the examiner must not assist the subject manually by pushing gently on his chest e. Motored by the intrinsic muscles of the back

When testing extension, the examiner must not assist the subject manually by pushing gently on his chest

This test was developed to assist in diagnosing posterior meniscal tear by causing a palpable or audible “click” within the joint: a. McMurray test b. “Bounce Home” Test c. Apley’s Compression Test d. Distraction Test e. Reduction Test

McMurray test

The following statements describe the patellar reflex, EXCEPT: a. While the reflex may be significantly diminished, it is rarely totally absent b. A deep tendon reflex mediated through nerves emanating from L2, L3 and L4 neurologic levels c. To test, the subject sits on a chair with one leg crossed over his knee d. Even if the L4 nerve root is pathologically involved, the reflex may still be present e. For clinical application, the patellar reflex is to be considered an L4 reflex

To test, the subject sits on a chair with one leg crossed over his knee | Is alternative method

Some of the eight basic techniques which can be used to safety perform most lifting tasks include the following, EXCEPT: a. Golfer’s lift b. Diagonal lift c. Tripod lift d. Full squat lift e. Deep squat lift

Full Squat Lift

The following are effects of cardiac transplantation on cardiovascular and pulmonary variables, EXCEPT: a. The peak heart rate achieved during maximal exercise is markedly lower in cardiac transplant patients than in age- matched subjects thereby limiting the usefulness of exercise prescriptions based on target heart rate b. Peak systolic blood pressure of cardiac transplant recipient is less than that of individuals without, but diastolic blood pressure is not much different c. Resting stroke volume of patients following cardiac transplantation is less than that of individuals without, but diastolic blood pressure is not much different d. At rest, cardiac recipients exhibit lower heart rates than do individuals without cardiac transplants due to the loss of vagal tone associated with the surgical procedure e. Oxygen consumption at anaerobic threshold is markedly lower than that of individuals without cardiac transplants, partially due to skeletal muscle weakness

At rest, cardiac recipients exhibit lower heart rates than do individuals without cardiac transplants due to the loss of vagal tone associated with the surgical procedure | No Vagal Tone = Inceased HR

Epidemiological studies have established some risk factors for work-related low back pain and include the following, EXCEPT: a. Vibration b. Movements into inner ranges of motion such as stretching or reaching heavy-materials handling c. Prolonged posture of sitting or standing d. Requirements of lifting, pushing, pulling, bending and twisting e. Repetitious work, poor management employee relations and new employment status

Movements into inner ranges of motion such as stretching or reaching heavy-materials handling

The following are true of the types of breathing exercises, EXCEPT: a. Use of a flutter valve, the forced-expiration technique and autogenic drainage are beneficial in patients with cystic fibrosis, although efficacy has not been determined. b. Following coronary artery bypass of gall-bladder surgery, breathing exercises offer no advantage over early patient mobilization c. Incentive spirometry is no more advantageous or cost-effective than instruction in deep breathing and coughing d. Diaphragmatic breathing and lateral costal and segmental costal and segmental costal expansion exercises are used most often post-operatively e. Inspiratory muscle training and resistive diaphragmatic breathing exercises are not beneficial in weaning the patient with chronic obstructive pulmonary disease

Inspiratory muscle training and resistive diaphragmatic breathing exercises are not beneficial in weaning the patient with chronic obstructive pulmonary disease

A patient requires skin traction using a cervical head halter. The following applies to proper head halter application, EXCEPT: a. The patient’s head may be elevated 20 deg for patient comfort b. If any adjustment to the straps is necessary, the anterior straps must be adjusted first, then the posterior c. The back of the halter is positioned beneath the head, aligning the sides in order not to cover the patient’s ears d. A head halter is contraindicated for extended use for it can cause skin irritation e. To avoid zygomatic nerve damage, the straps leading to the sidepiece should be loose over the patient’s check

If any adjustment to the straps is necessary, the anterior straps must be adjusted first, then the posterior | Posterior before anterior

The perpendicular distance from the pivot point to the line of action of the weight is called the: a. Lever Arm b. Mechanical Advantage c. Force Arm d. Weight Arm

Weight Arm

The following conditions can result from excessive and repetitive end-range motions, excessive force, and stretching leading to chronic soft tissue inflammation, muscle spasm and postural imbalance, EXCEPT: a. Repetitive sprain injuries b. None of these c. Cumulative trauma disorders d. Repetitive strain injuries e. Repetitive motion injuries

Repetitive sprain injuries

The following are characteristics of “fasciculations”, EXCEPT: a. Refers to low-voltage potentials which results from independent contractions of single, denervated muscle b. Especially prominent in and characteristics of chronic, progressive, motor neuron disease c. When infrequent and not accompanied by atrophy, are not necessarily evidence of progressive disease d. A result of almost any disorder of a motor neuron resulting in spontaneous, irregular, recurrent contraction e. Occasionally occurs in otherwise normal subjects

Refers to low-voltage potentials which results from independent contractions of single, denervated muscle | Describes Fibrilation

Stroke volume is expected to increase if: a. After load increases b. Myocardial contractility decreases c. Myocardial elasticity decreases d. pre-load increases e. none of these

pre-load increases | pre-load is end diastolic volume ; stretch of the heart

If the blood pressure reading is 150/90 the mean blood pressure is: a. 100 mm Hg b. 135 mm Hg c. 120 mm Hg d. 110 mm Hg e. 115 mm Hg

110 mm Hg | DBP + ((SBP-DBP)/3)

In anterolateral rotator instability of the knee, healing requires: a. Six to eight weeks of cast immobilization with the knee flexed 90 degrees and leg maximally externally rotated b. Four to five weeks of cylinder cast immobilization of the knee at about 60 degrees of flexion c. None of these d. A long leg cast over a bulky compressive dressing with the knee positioned 60-70 degrees of flexion and the tibia is internally rotated on the femur for five to eight weeks e. Cast immobilization with the knee flexed at 60-70 degrees and the tibia internally rotated to prevent the postero-lateral subluxation of the tibia for six to eight weeks.

Six to eight weeks of cast immobilization with the knee flexed 90 degrees and leg maximally externally rotated

Rapid, upredictable jerks of a muscle or a part: a. Chorea b. Myoclonus c. Hyperkinesia d. Tremor e. Athetosis

Chorea

Management following open reduction internal fixation of the pelvis include the following, EXCEPT: a. Time frame for meeting these goals varied from four to eight weeks depending on the subject’s medical status b. Physical therapy is initiated to begin transfer and exercise training with the subjects c. Subjects are expected to be able to perform a home exercise program prior to hospital discharge d. Subjects are maintained on bed rest for 1 to 2 days e. Short-term goals include independence with transfer and wheelchair mobility

Time frame for meeting these goals varied from four to eight weeks depending on the subject’s medical status | 2-6 weeks

The following assumptions on mechanical pain threshold (MPTh) are true, EXCEPT: a. MPThs are perceived differently by male subjects than female subjects b. Women have lower MPThs than do men c. MPThs do not differ in different body regions d. There is no gender difference in MPTh with pressure applied at the top of the index finger proximal to the nail e. There is positive correlation between age and MPTh

MPThs do not differ in different body regions

Which eye muscles are contracting when the subject is looking downward and to the left: a. Left superior rectus and right inferior oblique b. Right inferior rectus and left superior oblique c. Right superior rectus and left inferior oblique d. Left inferior rectus and right superior oblique

Left inferior rectus and right superior oblique

The angle formed by the tendons of the quadriceps and ligamentum catella with the center of the patella: a. Q- Angle b. None of these c. Genu Varum d. Genu Valgum

Q-Angle

The following statements characterize percussion in chest PT, EXCEPT: a. For patients with rib and sterna fracture, controlled mechanical ventilation may even stabilize the fracture site by minimizing negative intrathoracic pressure b. Used during both the inspiratory and expiratory phases or respiration c. Pneumathorax and hemothorax that develop as a result of the initial injury is considered a contraindicated to percussion d. Not indicated for the spontaneously breathing with rib fractures who is responding to breathing exercises and assistive coughing techniques e. Fast percussion (240 cycles/min) demonstrated the greatest sputum production, although slow percussion (6-12 cycles/min) was more effective than no percussion f. None of the above

Pneumathorax and hemothorax that develop as a result of the initial injury is considered a contraindicated to percussion | If it's a secondary development it's okay to perform percussion

Postoperative complications in cardiac transplantation include the following, EXCEPT: a. Weight loss b. Transplant Vasculopathy c. Cyclosporine related hypertension d. Rejection e. Infection

Weight loss

The following statements allow soft tissue palpation of certain structures, EXCEPT a. The flexor carpi radialis may be palpated radial to the Palmaris longus proximally toward its origin at the medial epicondyle when making a tight fist and then to radially deviate and flex the wrist b. The wrist flexors may be palpated as a unit and individually as you move from their origin at the medial epicondyle and supracondylar line down the forearm and toward the wrist c. The ulnar nerve may be palpated as it is rolled gently under the index and middle fingers in the sulcus between the medial epicondyle and the olecranon process d. The medial collateral ligament, a basic stabilizer of the humeroulnar articulation, rises from the medial epicondyle and extends to the medial margin of the ulna’s trochlear notch may be palpated directly e. To facilitate palpation of the triceps, the subject may lean on the table where it will stand out on the posterior aspect of the arm

The medial collateral ligament, a basic stabilizer of the humeroulnar articulation, rises from the medial epicondyle and extends to the medial margin of the ulna’s trochlear notch may be palpated directly | Cannot

Following spinal cord injury (SCI), myths as to whether men can biologically father children abound. The following statements are true of male fertility following SCI, EXCEPT: a. High immotile sperm count is caused by lifestyle factors (such as elevated scrotal temperature, or ejaculation frequency) b. Immotile sperm count may be due to factors within the seminal plasma c. Semen can be obtained from almost all men with SCI through the use of vibratory or electrical stimulation d. Most men with SCI experience impairments in erectile and ejaculatory functions e. While their ejaculated often have normal sperm counts, more immotile sperm are found than men

High immotile sperm count is caused by lifestyle factors (such as elevated scrotal temperature, or ejaculation frequency)

The following are causes of cardiac muscle dysfunction, EXCEPT: a. Pulmonary embolus b. Hypotension c. Renal insufficiency d. Spinal cord injury e. Cardiomyopathy

Hypotension | Supposed to be hypertension

The following statements are true of the hips, EXCEPT: a. The combination of an observed shortened extremity, external hip rotation, and pain movement strongly suggests a fractured hip b. The ischial tuberosity is easily palpable if the hip is flexed as the gluteus maximus moves laterally c. A line drawn across the top of the iliac crest crosses the spine between the spinous processes of L4 and L5 d. Due to the overhang of the ilium and the obstruction of supporting ligaments, the sacroiliac joint is not palpable e. The center of the sacroiliac joint, at S2, is crossed by an imaginary line drawn between the posterior superior iliac spines

The ischial tuberosity is easily palpable if the hip is flexed as the gluteus maximus moves laterally | moves upward

A patient with long thoracic nerve injury will have the most difficulty in: a. Folding blanket b. Reaching at shoulder level c. Combing his hair d. washing his face e. eating

Combing his hair | Will have difficulty in overhead activities

The following statements apply to the radial nerve, EXCEPT: a. Extension of the distal phalanges, which appears to be absent in wrist drop, will be found to be possible if ulnar and median nerves are intact b. Classically paralyzed by ischemia from pressure in the drunken and comatose and also in lead poisoning c. Abduction and adduction of fingers are not weakened d. Partly mediates flexion and supination at the elbow through innervations of the bronchioradialis muscle e. A “finger drop” may result when a penetrating injury of the dorsal forearm spares branches that mediate dorsiflexion of the wrist but sever the posterior interosseus branch that mediates extension of the thumb and fingers

Abduction and adduction of fingers are not weakened

Lesion of the seventh cranial nerve at the stylomastoid foramen results in the following conditions, EXCEPT: a. Can still close the eye on the side of the paralysis b. Bell’s palsy c. The buccinators is paralyzed, and the cheek puff out during expiration d. Total paralysis of facial expression muscles on that side

Can still close the eye on the side of the paralysis

“Motor neuron disease” is a rather broad term applied to disorders characterized by the following, EXCEPT: a. Fasciculation are common and are often found generally before diffuse atrophy is evident. b. These are painless disorders except for muscle cramping, and there are no sensory deficits. c. Onset is often symmetric, with wasting of a hand, arm of shoulder girdle. d. Bulbar involvement may occur early or later and leads to fatal respiratory complications. e. Signs of progressive motor neuron loss with or without the paresis and spasticity of corticospinal tract degeneration.

Onset is often symmetric, with wasting of a hand, arm of shoulder girdle. | "motor neuron disease" - ALS, which is asymmetric

The following statements are true of the collateral ligaments, EXCEPT: a.Lateral collateral ligament connects the femur and the fibula b. These ligaments may be easily injured when force is applied to the knee while a person’s leg is extended with his foot firmly planted on the ground. c. Medial collateral ligament connects the femur to the tibia. d. Prevent side-to-side movement by tightening during leg extension e. The collateral ligaments can tear when the femur is externally rotated on the tibia

The collateral ligaments can tear when the femur is externally rotated on the tibia ## Footnote ER of tibia, IR of femur = Taut collaterals IR of tiba, ER of femur = Taut Cruciates

Nonunion may occur with internal fixation. When this happens, the bone fragments may be stimulated with electrical current. Which of the following statements does not apply? a. The electrodes may be implanted either by open incision or percutaneously, using a hand drill b. The electricity applied either through magnetic coils placed on the skin at the fracture site, or through implanted electrodes c. Electrical bone stimulation substitutes for normal piezoelectric effect, in which mechanical stress on a solid object induces electrical activity d. A weak current of 20 microamperes is transmitted, because higher level would cause tissue necrosis and a lower level could fail to stimulate osteogenesis e. In alternating current stimulation of the bone, electronegativity appear to have the same osteoblastic simulating effect

In alternating current stimulation of the bone, electronegativity appear to have the same osteoblastic simulating effect | Has to be direct current ## Footnote Direct current = Increase pH and Decrease O2 = Increase osteoblast proliferation

The following statements are true of the quadriceps, EXCEPT: a. Small amount of quadriceps activity if the center of gravity line passes behind the knees axis b. There is no quadriceps activity in bilateral standing in most cases c. Standing erect is still possible even with bilateral quadriceps paralysis even without braces d. Keeping the knees slightly flexed minimizes knee collapse during postural sway

Keeping the knees slightly flexed minimizes knee collapse during postural sway | Has to be maximally extended to lock the knee

The rapid exchange of positive and negative ions due to cell’s increase in permeability is termed: a. Action Potential b. Membrane Potential c. Depolarization d. Repolarization

Depolarization

Action of the External Abdominal Oblique: a. Unilateral contraction causes side bending and trunk rotation with the opposite shoulder b. Both of these c. Unilateral contraction causes trunk rotation to the opposite side and side bending to the same side d. None of these

Unilateral contraction causes trunk rotation to the opposite side and side bending to the same side | Ex Ob - I/L lat flex & C/L Trunk Rot ## Footnote In Ob - I/L lat flex & I/l Trunk Rot

The following statements apply to the posterior tibial nerve lesions, EXCEPT: a. Sensory loss involves much of the sole and dorsum of the foot b. If high, may result in paralysis of the hamstrings c. Tropic changes may be prominent d. May result in paralysis of the gastrocnemius and soleus muscles, the long flexor of the toes and the intrinsic foot muscles e. Causalgia may appear

Sensory loss involves much of the sole and dorsum of the foot | Dorsum of foot = Common Peroneal Nerve

This neurologic level outlines a strip down the midline of the posterior thigh and the popliteal fossa, and it is supplied by the posterior femoral cutaneous nerve of the thigh: a. L3 b. L4 c. S1 d. L2 e. S2

The following are true of the femoral artery, EXCEPT: a. If the common iliac or external iliac artery is partially occluded, the femoral artery pulse may be diminished b. The femoral nerve lies lateral to the femoral artery c. The femoral vein lies medial to the femoral artery and is a clinical site for venous puncture d. Palpable just superior to the inguinal ligament, at a point halfway between the anterior superior iliac spine and the pubic tubercle e. Passes under the inguinal ligament at about its midpoint

Palpable just superior to the inguinal ligament, at a point halfway between the anterior superior iliac spine and the pubic tubercle | Femoral V.A.N. (M-L)

C5, C6 and the lateral cord receive contributions from the: a. Lower trunk b. Middle trunk c. Anterior cord d. Upper trunk e. Medial cord

Middle trunk | Middle trunk - contributes, Upper trunk - connects

Hemiplegia or hemiparesis is perhaps the most common physical manifestation of the disease of the brain. The following conditions describe hemiplegia, EXCEPT: a. Subjects may suffer severe hemisensory losses and hemianopsia b. Bilateral mild hemiparesis may pass unnoticed unless Babinski sign is present on both side c. Due in largest part to the vulnerability of the cortex and its radiations the lesions of vascular disease d. Ipsilateral weakness can result even when there is no immediate impingement of the motor cortex and its descending radiations e. Babinski sign is commonly present but the tendon reflexes may be absent, equal to those of the other side or exaggerated

Ipsilateral weakness can result even when there is no immediate impingement of the motor cortex and its descending radiations

The following statements describe the metatarsal heads, EXCEPT: a.The transverse arch of the forefoot is located immediately behind the metatarsal heads b. An antalgic gait may be created secondary to aseptic neurosis of the second, third, or fourth metatarsal heads c. The second metatarsals head is the most common site of disproportionate prominence d. The lateral aspect of the first metatarsal head is also a common site for gout e. The head of the first metatarsal bone and the first metatarsophalangeal joint is the site of hallux valgus.

The lateral aspect of the first metatarsal head is also a common site for gout

The following statements apply in combined anterolateral and anteromedial rotator instability, EXCEPT: a. Result of anterior drawer test is positive with the tibia in the neutral position b. Result of the abduction and abduction and adduction stress tests are positive with the knee in 30 degrees of flexion c. Result of anterior drawer test is positive with the tibia internally rotated d. Posterior cruciate ligament remains intact e. Occurs with tears of the middle third of the medial and lateral capsular ligaments

Result of anterior drawer test is positive with the tibia internally rotated

The following statements describe the lateral compartment of the knee, EXCEPT: a. Although the anterior cruciate ligament is an important stabilizer of the knee, whether to repair it after injury is controversial b. Muscular support is provided by the ilio-tibial band and iliotibial tract c. The tension on the bundles of the anterior cruciate ligament is altered as the knee moves from extension to flexion d. The anterior third of the lateral capsule provides little static support e. The insertion of the popliteus muscle reinforces the posterior third of the lateral capsular ligament

The tension on the bundles of the anterior cruciate ligament is altered as the knee moves from extension to flexion | As knee moves from flexion - extension

Which of the following examples therapeutically decreases the pressure on a given area? a. Use of orthotics to increase the force arm length b. All of these c. Prescribing a wearing schedule for a prosthesis d. Use of closed-cell foam shoe inserts for walking

All of these | Pressure = Force / Area

Postoperative care of acute knee instability repair after hospital discharge include the following, EXCEPT: a. Immobilization is continued for six weeks, during which time the subject is non weight- bearing b. Muscle strength is gained through such techniques as leg raising, terminal knee extension with leg raises or progressive resistance exercises c. When using free weight in progressive resistance exercises, it is extremely important that his foot and weight rest on a surface and not allowed to dangle free with muscles relaxed when the subjects returns to the 90 degrees flexed position. d. ROM should be regained passively because passive techniques tend to stretch excessively the healing ligaments and allow residual laxity e. It is important that the subject not externally rotate the involved leg during early weight bearing in order not to pull apart the repaired ligaments

ROM should be regained passively because passive techniques tend to stretch excessively the healing ligaments and allow residual laxity | regained actively

If the central slip of the extensor digitorum communis tendon is avulsed from its insertion into the base of the middle phalanx, the proximal interphalangeal joint becomes markedly flexed and the distal interphalangeal joint extended. This deformity is called: a. Heberden’s b. Mallet finger c. Boutonniere d. Swan-neck e. Trigger finger

Boutonniere

These tendons work only in unison. By limiting the three, the fourth is also limited. This is demonstrated by flexing the finger at any given distal IP joint – the subject is then unable to accomplish such individual flexion. a. None of these b. Flexor digitorum superficialis c. Flexor digitorum profundus d. Interossei e. Lumbricals

Flexor digitorum profundus

In-hospital postoperative care in acute knee instability repair include the following, EXCEPT: a. Cast change usually on the 5th postoperative day b. Cast immobilization of the knee at about 60 degrees of flexion c. Toe-touch weight bearing crutch walking as tolerated d. Non-weight bearing crutch walking e. Ankle ROM, quadriceps, femoris muscle setting exercises progressing to straight-leg raising exercises

Toe-touch weight bearing crutch walking as tolerated | Performed after 10 weeks

In the knee, excessive normal forces resulting in overuse syndrome can be caused by the following, EXCEPT: a. High repetition, high load b. Low repetition, high load c. Activity level is greater than the possible physiological repair d. Poor conditioning e. Small biomechanical dysfunction that become magnified with high-performance activities

High repetition, high load | High reps with low load

The following statements are true of the knee joint, EXCEPT: a. Limitation by the two-joint rectus femoris muscle decreases knee flexion ROM when the hip is in flexion b. End-feel for extension or hyperextension is firm c. End-feel for passive knee flexion is soft. d. It possesses two degrees of freedom and range of flexion is from 120 to 150 degrees

Limitation by the two-joint rectus femoris muscle decreases knee flexion ROM when the hip is in flexion | Knee extension & Hip flexion

Depending on patient size and transfer method, condition and mobility potential, the following are preferred features in wheelchair selection for arthritis patients, EXCEPT: a. Foot-and-legrests are swing-detachable with heel loops b. Standard type and standard handrims c. Toggle brakes and fixed back d. Special type with lever brakes e. Fixed or removable armrests

Special type with lever brakes

The axilla is a quadrilateral pyramidal structure through which vessels and nerves pass to the upper extremity. The following statements apply to the axilla, EXCEPT: a. The apex permit the entry of the brachial plexus and axillary artery b. The medial wall is bound by ribs two to six and the overlaying serratus anterior c. The anterior and posterior wall can be palpated when the arm is abducted and extended d. The anterior wall is formed by the pectoralis major and the posterior by the latissimus dorsi e. The lateral wall is defined by the bicipital groove of the humerus

The anterior and posterior wall can be palpated when the arm is abducted and extended | Not extended

The following statements characterize Moro reflex, EXCEPT: a. Absence of the response in the neonate definitely indicates brain disease b. It is normally present from birth until age 3-4 months c. Loss of the reflex previously present is one of the early signs Kernicterus d. Is indicative of a significant cerebral disorder if present beyond six months

Absence of the response in the neonate definitely indicates brain disease | Not definitive

The following are true of the sciatic nerve, EXCEPT: a. Tenderness of the nerve may be due to a herniated disc in lumbar spine, a piriformis muscle spasm or direct trauma to the nerve itself. b. Located midway between the greater trochanter and the ischial tuberosity c. Tenderness elicited during palpation of the tuberosity may possibly result from ischial bursitis d. It is covered by the gluteus maximus when the hip is flexed

It is covered by the gluteus maximus when the hip is flexed | Covered when the hip is extended

Characteristics of myotonic dystrophy are as follows: EXCEPT: a. General loss of strength and energy are regularly present and slowness of grip release may be evident b. A quick tap on the thenar eminence results in contraction that is abnormally short, and the thumb abducts for several seconds c. Symptoms commonly appear in adulthood, usually in the third and fourth decades d. No sensory or specific reflex changes are seen e. There is prolonged contraction with posture of the hand

A quick tap on the thenar eminence results in contraction that is abnormally short, and the thumb abducts for several seconds | Contraction is abnormally long and the thumb adducts

In the venous system: a. Blood vessels have smaller diameters than their corresponding arteries b. Mean pressures are higher than in the arterial system c. Blood vessels have greater compliance d. All of these are true e. None of these are true

Blood vessels have greater compliance | 20x more than artery

Injury to the tibial collateral, middle one-third medial capsular, and posterior oblique ligaments may be determined by the following test: a. Adduction stress test at 45 degrees of flexion and the internal rotation posterior drawer sign b. Abduction stress test at 15 degrees of flexion and the external rotation anterior drawer sign c. Abduction stress test at 30 degrees of flexion and the external rotation anterior drawer sign d. Abduction stress test at 30 degrees of flexion and the internal rotation anterior drawer sign e. Adduction stress test at 45 degrees of flexion and the external rotation anterior drawer sign

Abduction stress test at 30 degrees of flexion and the external rotation anterior drawer sign

In the cranial cavity, this structures act as the outermost covering for the brain, but also as the lining membrane on the inner surfaces of the bones. It also gives valuable support to the brain, the partitions preventing shifting thereby safeguarding the brain against injury. a. Pia Mater b. Arachnoid Mater c. None of these d. Dura Mater

Dura Mater

Characteristics of Fascioscapulohumeral dystrophy of Landouzy and Dejerine are as follows, EXCEPT: a. Lordosis is exaggerated b. It progress quickly, resulting in disability years after onset c. Atrophy of the face become severe d. Atrophy and weakness of the shoulder-girdle muscles are prominent e. Usually appears in the second decade of life and in either sex

It progress quickly, resulting in disability years after onset | Progresses slowly

In apparent leg length discrepancy, the following are true, EXCEPT: a. Poliomyelitis may result in apparent leg length discrepancy b. Apparent shortening may stem from pelvic obliquity or from adduction or flexion deformity in the hip joint c. Measurement is taken from the umbilicus to the medial malleoli of the ankle d. Pelvic obliquity manifests itself as uneven anterior or posterior iliac spines while the patient is standing

Poliomyelitis may result in apparent leg length discrepancy

The shoe is a showcase for certain disorders of the foot. The following are examples, EXCEPT: a. Creases of the forepart of the shoe that are markedly transverse, indicate possible hallux rigidus b. Absence of creases on the forepart of the shoe indicate no toe off c. Shoes of an individual with a drop foot display scuffed toes from scrapping the floor in swing phase d. Shoes of subjects of who toe-in show excessive wear on the lateral border of the sole e. Shoes of individuals with flat feet usually have broken lateral borders due to the prominence of the talar head

Creases of the forepart of the shoe that are markedly transverse, indicate possible hallux rigidus | Creases makedly oblique & big toe rigid = less toe extension = no crease

Which statement does not apply to the posterolateral drawer sign? a. When the tibia is in external rotation, the sign is positive b. The test is performed in the usual drawer fashion with the knee in 70 to 80 degrees of flexion c. The tibia is internally or externally rotated as well as being positive in neutral position d. Confirms a posterolateral rotator instability of the knee e. The sign is negative if the tibia is in internal rotation because of the intact posterior cruciate ligament

The tibia is internally or externally rotated as well as being positive in neutral position | Done for posterior drawer only

The following may be observed upon examination of the patient’s lumbar spine, EXCEPT: a. Soft, doughy lipomata appearing as lumps in the area of the low back may be a sign of spina bifida b. Any reddened dislocation may indicate infection, and skin markings may denote underlying neurologic or bone pathology. c. Pedunculated tumors indicate the presence of neurofibromatosis and are often accompanied by café-u-lait spots which may impinge upon the spinal cord and nerve roots d. An unusual patch of hair on the back may be evidence of some body defect in the spine such as a congenital bony bar e. Gibbus deformity may bone present secondary to a herniated disc

Gibbus deformity may bone present secondary to a herniated disc | Gibbus deformity is thoracic

If patient develops gas gangrene, or persistent osteomyelitis, hyperbaric oxygen therapy may be ordered. The following statements apply to hyperbaric oxygen therapy, EXCEPT: a. Administering 100% oxygen at pressures higher than three times of sea level can cause central nervous system toxicity b. Repeated treatment in a multiple chamber may result in complications, i. e, pneumothorax, air embolism, CNS and pulmonary in toxicity c. Provides an oxygen-rich environment to help destroy the anaerobic organisms that cause gas gangrene d. Increasing the barometric pressure inside the chamber result in ½ or 1/3 the concentration e. The patient receives 100% oxygen concentration in a specially designed chamber at greater than normal atmospheric pressure

Increasing the barometric pressure inside the chamber result in ½ or 1/3 the concentration | Direct relationship - increases the concentration

Dysphagia, dysphonia and regurgitation of food into the nose on swallowing is a result of bilateral lesion to this nerve: a. Glossopharyngeal nerve b. Hypoglossal nerve c. Accessory nerve d. Vagus nerve

Vagus nerve

The following statements apply to micro trauma, EXCEPT: a. May be caused by abnormal forces that occur about the knee, i.e., unaccustomed walking on particularly uneven terrain. b. May be caused by abnormal biomechanics of the lower extremity kinetic chain, i.e., when excessive compensatory pronation causes excessive medial transverse plane rotations at the knee c. A series of inflammatory reactions to submaximal loading that eventually produces clinical signs and symptoms d. May be caused by excessive normal forces (overuse syndrome) about the knee, i.e., the different biomechanical forces that occur during walking, jogging, and running

May be caused by abnormal forces that occur about the knee, i.e., unaccustomed walking on particularly uneven terrain.

Central nervous system toxicities usually precede pulmonary toxicities, and are indicated by apprehension, visual changes, muscular twitches and convulsions. a. Both statements are true b. Both statements are false c. First statement is false, second statement is true d. First statement is true, second statement is false

Both statements are true

Following denervation atrophy, how long before loss of functional return becomes no longer possible: a. None of these b. 1-2 years c. Up to three months d. 2-3 years

1-2 years ## Footnote Up to 3 mos could still have full recovery

Which crutch-walking technique would you choose for patients with spina bifida, paraplegia or myelomeningocele? a. Two-point gait b. Four-point gait c. Swing-through three-point gait d. Three-point-gait (non-weight-bearing) e. Three-point-and-one-gait (partial-weight-bearing)

Swing-through three-point gait

The following statements apply to condylar fractures of the knee, EXCEPT: a. Usually, there is anterior displacement of the distal fragment caused by the muscular action of the gastrocnemius muscles as well as a reduction of the femoral length by the action of the hamstring and the quadriceps femoris muscle b. Single condylar fracture often occur from severe varus or valgus forces and the fracture line may be vertical and in the sagittal plane or it may be vertical and in the coronal plane c. Prolonged, rigid immobilization is usually unnecessary, but full weight bearing is usually restricted during the three months following the injury d. Supracondylar fractures may be caused by direct trauma or by a torsion stress placed upon the lower extremity e. Femoral condyles are rarely injured, and fractures of the femur may be of the “Y” or “T” type and usually include soft tissue damage

Usually, there is anterior displacement of the distal fragment caused by the muscular action of the gastrocnemius muscles as well as a reduction of the femoral length by the action of the hamstring and the quadriceps femoris muscle | Posterior displacement

In this maneuver, with the patient in supine, the legs are raised straight two inches from the table and held as long as he can; if he can hold the position for 30 seconds within pain, intrathecal pathology may be ruled out. a. Gaenslen’s Sign b. Milgram Test c. Hoover’s Test d. Patrick Test e. Naffziger Test

Milgram Test

The following signs and symptoms generally accompany a fracture, EXCEPT: a. Deformity but no shortening in the injured area b. Decreases of complete loss of muscle power in the injured area c. Localized discoloration and edema d. Presence of grafting sound when testing for ROM during assessment e. Presence of crepitation during skin palpation

Deformity but no shortening in the injured area

A fracture with cord transaction at the C6 level will produce the following, EXCEPT: a. The subject is parasympathetic, ileus appears and the urinary bladder distends b. Breathing is diaphragmatic c. There is complete sensory loss below the C6 or C7 dermatome d. An immediate flaccid paralysis of the trunk and extremities sparing some shoulder movement and flexion at the elbows e. At a later stage, reflexes in this zone will be reduced or absent, whereas those mediated through intact cord segment below will be hyperreflexic

The subject is parasympathetic, ileus appears and the urinary bladder distends | Spinal shock : Sympathomimetic (Inc SNS & Dec Para)

An abnormal contraction occurring in denervated muscle fibers after motor neurons have been destroyed, in which individual muscle fibers contract in an unsynchronized manner, producing muscle flutter but no effective movement. a. Tetanic contraction b. Convulsion c. Fasciculation d. Fibrillation e. Twitch

Fibrillation

A patient has been admitted to your hospital with severe lower back pain. The patient will be placed in a pelvic belt for intermittent traction. The following applies to proper pelvic belt application, EXCEPT: a. Although pelvic traction may be applied directly on the skin, it may also be applied over clothing made of cotton (for better traction) and wrinkle-free (to avoid excessive pressure on the skin) b. The patient may be placed in Williams position with hips flexed 30º and knees flexed 30º as part of daily care c. The straps must be parallel to each other and to the patient’s thighs when attached to the traction cords d. The free ends of the belt are wrapped around the hip bone so the iliac crests are covered

The patient may be placed in Williams position with hips flexed 30º and knees flexed 30º as part of daily care | Not daily

This crease lies at the base of the fingers and marks the location of the proximal pulley. a. Distal palmar crease d. Thenar crease b. Hypothenar crease e. Proximal palmar crease c. Proximal interphalangeal crease

Proximal palmar crease

Which of the following statements is true when testing for rigid or supple flat feet? a. While standing on feet and seated, if medial longitudinal arch absent in some positions, subject has flat feet. If present and absent only when he stands, flat feet are supple and correctable with longitudinal arch supports. b. While standing on toes and seated, if medial longitudinal arch is absent in all positions, subject has flat feet. If arch is absent and present only when he stands, flat feet are supple and correctable with longitudinal arch supports. c. While standing on toes, if medial longitudinal arch is absent in all positions, subject has flat feet. If present and absent only when he stands, his flat feet are supple and correctable with longitudinal arch supports. d. While standing on toes and seated, if the medial longitudinal arch is absent in all positions, subject has flat feet. If present and absent only when he stands, his flat feet are supple and correctable with longitudinal arch supports e. While standing on toes and seated, if medial longitudinal arch is absent in all positions, subject has flat feet. If arch is present and absent only when he stands, flat feet are supple and correctable with longitudinal arch supports

While standing on toes and seated, if medial longitudinal arch is absent in all positions, subject has flat feet. If arch is present and absent only when he stands, flat feet are supple and correctable with longitudinal arch supports

The following statements are true of balanced suspension traction, EXCEPT: a. A hammock or splint, such as a Thomas splint with Pearson attachment is an example of this type of Traction b. The weight that suspends the affected extremity is greater than the weight of the counter traction being applied c. This assembly allows more range of motion than other forms of traction without affecting the line of traction pull d. Most commonly used to support leg injuries such as femoral fractures with displacement, and nonaligned bone fragments e. This assembly promotes neurovascular integrity by decreasing prolonged pressure on the back of the patient’s leg.

The weight that suspends the affected extremity is greater than the weight of the counter traction being applied | Has to be equal force

The following are true of muscle contraction efficiency, EXCEPT: a. Less than 20-25 % of input energy to the muscle can be converted into muscle work b. Minimal efficiency is achieved when velocity contraction is about 30% of maximum c. Large amount of maintenance heat are released even though the muscle performed little or not work d. Low efficiency is because about half of nutrient is lost in the formation of ATP

Minimal efficiency is achieved when velocity contraction is about 30% of maximum | Max efficiency

Upon inspection of the lumbar spine from the side, which of the following observations is not TRUE? a. If the spine exhibits an exaggerated curve, the anterior abdominal muscles may be weaken b. Increased lumbar lordosis may also be caused by a fixed flexion deformity of the hip c. An absence of the normal lordosis may suggest paravertebral muscle spasms d. Pelvis obliquity is evident when the two dimples overlying the posterior iliac spine directly above the buttocks lie along the same horizontal plane e. Excessive lordosis occasionally substitutes for true hip extension

Pelvis obliquity is evident when the two dimples overlying the posterior iliac spine directly above the buttocks lie along the same horizontal plane

The height of a specific vertebrae may be used to determine the following landmarks, EXCEPT: a. C3-level with hyoid bone b. T4-height of the manubrium and body of sternum c. C4 and C5-level with thyroid cartilage d. All of these

T4-height of the manubrium and body of sternum | T4- height of junction of manubrium & body of sternum

The following statements are true of the ulnar styloid process, EXCEPT: a. It articulates with the proximal carpal row to take part in wrist articulation b. It does not extend as far distally and it is more prominent and thicker than its radial counterpart c. The external carpi ulnaris tendon runs through its groove d. In the anatomic position, it is both medially and posteriorly located in the wrist e. It is most easily palpated when the hand is radially deviated and the tendon is contracted

It articulates with the proximal carpal row to take part in wrist articulation | No articulation

At the atlanto-occipital joint, the head is balanced by the pull of neck extensor muscles. This is an example of: a. First Class Lever b. Second Class Lever c. Third Class Lever d. Fourth Class Lever

First Class Lever

The following statements apply to the median nerve, EXCEPT: a. Sensory loss involves the palmar surface of the hand and fingers b. These is conspicuous atrophy of the thenar eminence with flattening of the pal c. Partial injuries are often painful and paresthetic and causalgia may occur d. Interrupt at the elbow produces weakness of wrist flexion with median deviation e. Carries fibers from the C6, C7, C8 & T1 roots

Interrupt at the elbow produces weakness of wrist flexion with median deviation | with ulnar deviation

The following characterizes straight anterior knee instability, EXCEPT: a. Injury is sustained while twisting, decelerating of changing direction b. May involve external rotation of the tibia with knee flexed c. May involve forward rotation of the tibia with knee extended or slightly flexed d. Subject usually hears a pop at the time of injury but still able to continue the activity e. Gross swelling develops within 12 hours

Gross swelling develops within 12 hours

The following statements describe the medial tubercle of the foot, EXCEPT: a. Gives attachment to the abductor hallucis muscle medially and to the flexor digitorum brevis muscle and the plantar aponeurosis anteriorly b. It lies on the medial plantar surface of the calcaneus c. Heel strike may altogether be avoided during gait when there is pain of the os calcis d. Unlike the lateral tubercle which is weight bearing the medial tubercle of the calcaneus is not e. A heel spur can cause it to become tender to palpation

Unlike the lateral tubercle which is weight bearing the medial tubercle of the calcaneus is not

The following statements apply to the 7th cranial nerve, EXCEPT: a. Innervates the musculature of the face and the platysma b. The platysma is tested by pulling down the corners of the subject’s mouth c. Minor degrees of unilateral weakness are often best seen at rest or during expressional changes during conversation and in blinking d. This nerves via its division called the chords tympani conveys the taste from the posterior tongue

This nerves via its division called the chords tympani conveys the taste from the posterior tongue | anterior 2/3 of tongue supplied

The following positions describe the examination the reflexes, EXCEPT: a. With the subject standing, the hands are placed on hips with arms akimbo, tests for the triceps reflex b. With the subject kneeling, the triceps surae stretch reflex is tested with one hand positioned on the ball of the foot stretching the muscle slightly and tapping quickly and gently c. With the subject’s feet flat on the floor, hold one hand on the distal thigh and strike the tendon just below patella to test for quadriceps stretch reflex d. In the ankle joint, clonus is elicited by briskly but gently dorsiflexing the ankle increasing pressure against the sole e. Striking the examiner’s thumb on the biceps tendon with the elbow flexed at varied degrees for best response is assumed for biceps stretch reflex

In the ankle joint, clonus is elicited by briskly but gently dorsiflexing the ankle increasing pressure against the sole | maintained pressure against the sole

This test is used to detect pathology in the hip and sacro-iliac joint. Inguinal pain is a general indication that there is pathology in the hip joint or surrounding muscles. a. Hoover Test b. Beevor’s Sign c. Fabere Test d. Gaeslan’s Sign e. Naffziger Test

Fabere Test | Fabere = Patrick's

The following statements are true when functional deficits are exclusively below a horizontal line at right angle to the spinal neuraxis, EXCEPT: a. Diffuse tract disease may give no clear level b. Suspicion of spinal cord dysfunction is appropriate c. Multiple focal lesions of the cord may give multiple levels d. Diffuse cerebral disease of midline cerebellar (vermis) lesions may produce predominantly sensory dysfunction and ataxia in the lower extremities e. Signs of neuropathy or motor neuron disease can be limited largely to the legs

Diffuse cerebral disease of midline cerebellar (vermis) lesions may produce predominantly sensory dysfunction and ataxia in the lower extremities | produce predominantly motor dysfunction

The following describes the medial meniscus, EXCEPT: a. Situated on top of the tibia on the medial plateau b. Its anterior end attaches to the nonarticular portion of the top of the tibia, in feat of the anterior cruciate ligament c. Normally there is no specific sulcus between the margin of the meniscus and the joint capsule anywhere along the medial joint line d. e. Has a firm attachment to the top of the tibia and a less firm one to the femur through the coronary ligament e. The anterior attachment seems to slip under the anterior cruciate ligament, attaching to the bone beneath.

The anterior attachment seems to slip under the anterior cruciate ligament, attaching to the bone beneath.

APK 1998 Flashcards

(150 cards)