Neuromuscular 2 2010

1 All of the following are appropriate treatment interventions for a patient with multiple
sclerosis except for:

a) utilize a distributed practice schedule

b) cool environment
c) exercise time is less than the rest time
d) switch the patient to a pool therapy program

2 A diagnostic EMG was performed with evidence of spontaneous fibrillation potentials.

What does this mean?

a) reinnervation is complete
b) axonotmesis is occurring
c) denervation atrophy has occurred
d) reinnervation is in process

3 Your patient is a complete T10 paraplegia. Which initial gait pattern would you teach
him?

a) swing to
b) swing through
c) 2 point
d) 4 point

4 Your patient was diagnosed with Bell's Palsy. She exhibits facial drooping and
decreased ability to move the face. What are other recognized symptoms ?

a) Sensitivity to sound on affected side of the face

b) Blurred vision
c) Insomnia
d) Problems eating

5 Your patient was stabbed in the leg. He was diagnosed with neurotmesis of the
superficial peroneal nerve. What does this mean?

a) A more severe grade of injury to a peripheral nerve

b) Reversible injury to damaged fibers
c) Irreversible injury; no possibility of regeneration
d) Distal wallerian degeneration can occur
6 Which task developmentally appropriate for an 8-9 month-old?

a) climb the stairs

b) fine pincer grasp
c) transfer objects from one hand to another
d) rolling to left and right

7 Posterior cerebral arteries supplies oxygenated blood to the posterior aspect of the?

a) Occipital lobe
b) Putamen
c) Pallidum
d) Pons

8 Your patient who is a 50-year old female suffers a left cerebral hemisphere stroke.
Which deficits will your patient manifest?

a) loss of motor skill impairment on the left side

b) loss of speech left side
c) loss of motor skill impairment on the right side
d) full immobility on both sides

9 Your patient is states that she feels dull, aching pain. Discriminative fast pain and
discriminative touch are absent. Which pathways are impaired?

a) proprioceptive pathways and lateral spinothalamic tract

b) anterior and lateral spinothalamic tract
c) anterior spinothalamic tract and proprioceptive pathways
d) fasciculus gracilis/cuneatus and medial lemniscus

10 A patient was referred for assessment of the vestibulocular reflex. What action does
this reflex support ?

a) Head and neck balance

b) Gaze stabilization
c) Controlling posture
d) Coordination of the trunk

11 The parent of your pediatric patient states that his son vomited several times, was
irritable and is now lethargic. The patient has an atrio-ventricular shunt for
hydrocephalus. What do you suspect?

a) increased cerebral edema

 b) child abuse
c) drug overdose
d) flu

12 You are practicing balancing in the physical therapy unit with a patient. The name for
this type of balancing is called suspensory strategy. What does it focus on ?

a) To elevate the center of gravity during standing or ambulation in order to better

control the center of gravity
b) To move the centre of gravity forward during standing or ambulation in order to
better control the center of gravity
c) To lower the center of gravity during standing or ambulation in order to better
control the center of gravity
d) To move the center of gravity backward during standing or ambulation in order to
better control the center of gravity

13 Your patient has amyotrophic lateral sclerosis. An important early goal of physical
therapy is to maintain the patient's level of conditioning while preventing what?

a) Myalgia
b) overwork damage
c) radicular pain
d) Ataxia

14 You are treating an 18-month old child with Down Syndrome. What is the best
intervention?

a) rhythmic stabilization
b) proprioceptive exercises
c) weight-bearing activities in antigravity postures
d) verbal cueing

15 Your patient's daughter tells you that her mom suffered from brain attack 2 days ago.
How would you position the upper extremity when in supine?

a) shoulder abducted and externally rotated

b) shoulder adducted and externally rotated
c) shoulder abducted and internally rotated
d) shoulder adducted and internally rotated
16 Your patient was diagnosed with embolic type CVA. This is caused by an embolus
and can originate in any part of the body. Which artery is most commonly occluded by
an embolus?

a) Carotid artery
b) The middle cerebral artery
c) Anterior cerebral artery
d) Posterior artery

17 Your patient sustained a head injury after a fall from the horse. MRI reveals
hemorrhagic stroke. What is the survival rate of patients with this condition in the first 48
hours ?

a) 25%
b) 40%
c) 50%
d) 60%

18 Your patient receives chronic treatment of systemic corticosteroids for her Multiple
Sclerosis. You expect to find:

a) Spontaneous fractures
b) hypoglycemia
c) muscle wasting
d) weight gain

19 Your patient suffers a secondary cerebral vascular accident while at home alone.
What are the risk factors for secondary cerebral vascular accidents ?

a) Poor diet
b) Physical inactivity
c) Insomnia
d) Drug abuse

20 You are treating a patient with a basal ganglia disorder. What is the best strategy?

a) progressive resistive exercises

b) balance platform training
c) task-specific training
d) modalities to decrease pain
21 You suspect your patient has vagus nerve damage. Which findings are consistent
with this?

a) problems with breathing

b) deviation of the uvula to one side when saying "AH"
c) increased gag reflex
d) dryness of the mouth

22 Your patient was referred to physical therapy for movement therapy in relation to
hemiplegia. This technique was developed by Signe Brownstones based on hierarchical
model by Hughlings Jackson. What is the main purpose of using this technique?

a) Reflex inhibiting posture

b) Increased ability for postural adjustment
c) Increased coordination
d) Decreased frustration

23 Kabat, knott, and voss, introduced proprioceptive neuromuscular facilitation (PNF),

the original goal of treatment was to lay down gross motor patterns within the central
nervous system. What is the focus on ?

a) Utilizing stronger parts of the body to stimulate and strengthen weaker parts.
b) The involved lower extremity will abduct and adduct
c) Mobility is restored to the normal expectations
d) Increased awareness and judgement

24 Kabat, Knott, and Voss, introduced proprioceptive neuromuscular facilitation (PNF),

the original goal of treatment was to lay down gross motor patterns within the central
nervous system. Which principle does this technique follow?

a) Utilizing stronger parts of the body to stimulate and strengthen weaker parts.
b) The involved lower extremity will abduct and adduct
c) Mobility is restored to the normal expectations
d) Increased awareness and judgment

25 You are teaching Diagonal patterns -upper extremity responses to your patient. You
want the patient to perform D1 flexion pattern. What are the components of this pattern
for the scapula?

a) Flexion ,adduction, lateral rotation

b) Flexion or extension
c) Elevation , abduction, upward rotation
 d) Supination

26 Your patient with Parkinson's disease developed elbow flexion, shoulder adduction
contractures of the upper extremities along with a flexed, stooped posture. Which PNF
technique will best help this patient?

a) Bilateral symmetrical upper extremity PNF D2 Extension patterns

b) Bilateral symmetrical upper extremity PNF D2 Flexion patterns
c) Bilateral symmetrical upper extremity PNF D1 extension patterns
d) Bilateral symmetrical upper extremity PNF D1 flexion patterns

27 Your patient suffered from CVA affecting the anterior cerebral artery. Which findings
do you expect?

a) decreased pain and temperature to the face and ipsilateral ataxia with
contralateral pain and thermal loss of the body
b) contralateral hemiparesis and hemi sensory deficits with greater involvement of
the arm than the leg
c) contralateral hemiparesis and sensory deficits, leg more involved than the arm
d) contralateral hemiplegia with thalamic sensory syndrome and involuntary
movements

28 Your patient is very ataxic. You decided to use “slow reversal” as one of the
therapeutic exercises. When would you use this technique?

a) Controlled mobility
b) Initiate movement
c) Proximal dynamic stability
d) Increased ROM

29 What type of lesion can result in locked-in syndrome leaving the patient with an
inability to move or speak but with full cognitive function?

a) Pontine lesion
b) Basal ganglia lesion
c) Hypothalamic lesion
d) Frontal Lobe lesion

30 A patient recovering from a stroke is having difficulty with stair climbing. During
ascent, the patient is able to position the more involved foot on the step above but is
unable to transfer the weight up to the next stair level. The BEST intervention to solve
this problem is:

a) hooklying, bridging.
b) standing, partial wall squats.
c) plantigrade, knee flexion with hip extension.
d) standing, side steps.

31 The term ‘Rood” is based on Sherrington and the reflex stimulus model. When would
you utilize this technique?

a) The ability to perform a movement as a result of internal processes

b) The ability to modify or change at the synapse level either temporarily or
permanently in order to perform a particular function
c) Obtain homeostasis in motor output and to activate and perform a task
independently of a stimulus.
d) The ability of the motor and sensory systems to stabilize position and control
movement

32 A 6 year-old boy has a diagnosis of Duchenne muscular dystrophy who is still able to
walk. What is your best course of treatment?

a) wheelchair sports
b) circuit training
c) progressive resistance strength training
d) recreational physical activities

33 Your patient has astereognosis. What will you expect on your assessment?

a) The inability to write due to a lesion within the brain

b) The inability to recognize symbols letters or numbers traced on the skin
c) The inability to interpret information
d) The inability to recognize objects by sense of touch

34 Spasticity is typically strong in antigravity muscles. In the lower extremities, this is

usually the:

a) the hip and knee flexors, adductors, and plantarflexors

b) the hip and knee extensors, adductors, and plantarflexors
c) the hip and knee extensors, abductors, and plantarflexors
d) the hip and knee extensors, adductors, and dorsiflexors
35 The therapist using sensory stimulation techniques for a patient who is very flaccid.
He decides to use facilitation. Which intervention is the therapist using?

a) Deep pressure
b) Joint compression
c) Prolonged stretch
d) Carotid reflex

36 This thrombolytic agent is the most appropriate drug to use for anticoagulation ?

a) Clopidogrel
b) Warfarin
c) Amiodorone
d) Atenolol

37 Your patient exhibits episodic vertigo, nausea, blurred vision, and autonomic
changes that occur with head movement and typically stop within 30 seconds once the
head is static. What does your patient have?

a) Acoustic Neuroma
b) Oscillopsia
c) unilateral vestibular dysfunction
d) benign paroxysmal positional vertigo

38 The gastrocnemius-soleus moves the body backward while the anterior tibialis
moves the body forward. Action of which muscles would result in a backward lean with
the center of motion occurring at the hip (hip strategy)?

a) hip flexors
b) hip extensors
c) hip internal rotators
d) hip external rotators

39 Your patient with Parkinson's disease has constructional apraxia. What will you
expect to find on your assessment?

a) The inability to perform purposeful learned movements, although there is no

sensory or motor impairment
b) The inability to reproduce geometric figures and designs. This person is visually
unable to analyze how to perform a task.
c) The inability to comprehend sentences and form words
d) The inability to understand the meaning of conversations
40 A patient suffered a severe traumatic brain injury and multiple fractures following a
motor vehicle accident. He has positive Kernig's sign with developing nuchal rigidity.
What is the probable cause?

a) cerebral edema
b) brain herniation
c) meningeal irritation
d) CNS infection

41 The ventricular system is designed to protect and nourish the brain. How many
ventricles can be found in the brain?

a) Five
b) Three
c) Four
d) Six

42 Your patient with cerebral palsy is manifesting athetosis. This condition is best
described as:

a) The inability to perceive the direction and extent of movement of a joint or body
part.
b) A condition that presents with involuntary movements combined with instability of
posture.
c) An involuntary an violent movement of a large body part
d) The inability to perform rapidly alternating movements

43 Your patient was involved in motor vehicle accident. He sustained an anterior cord
syndrome, an incomplete lesion that results from compression and damage to the
anterior part of the spinal cord or anterior spinal artery. Which action could have caused
this condition?

a) Cervical extension
b) Thoracic extension
c) Cervical flexion
d) Thoracic flexion

44 Your patient was diagnosed with cauda equina injury. What are the characteristics of
cauda equina injury ?

a) Spasms
b) Rigidity
 c) Flaccidity
d) Involuntary movements

45 Neurapraxia is a mild peripheral nerve injury (conduction block ischemia) that causes
transient loss of function. Nerve dysfunction is rapidly reversed, generally within:

a) 1-2 days
b) 7-10 days
c) 2-3 weeks
d) 1 month

46 Your patient s/p radial head fracture is complaining of pain in the elbow area. You
suspect myossitis ossificans. What other signs will help you confirm your diagnosis?

a) Decreased range of motion

b) Rigidity
c) Deformity
d) Pain

47 Your patient s/p hip fracture has been on bed rest for 3 days. She has been
complaining of pain on the (R) calf area. Which test would you perform to rule out deep
vein thrombosis?

a) Skellinton sign
b) Homan’s sign
c) Moore’s sign
d) Knott sign

48 Your patient who is morbidly obese came to the clinic. She states that it has been
days since she stood up. She is unable to roll and requires maximum assistance to
stand. You suspect that your patient might have developed pressure ulcers. Which
areas are most prone?

a) Buttocks
b) Calf
c) Femur
d) Ulna

49 A physical therapist examines a patient with a C7 spinal cord injury. Which muscle
would NOT be innervated based on the patient's level of injury?

a) triceps
 b) biceps
c) brachioradialis
d) lumbricals

50 The Rinne test is performed by placing the stem of the tuning fork on the mastoid
process. The test is designed to compare bone conduction hearing with:

a) air conduction hearing

b) liquid conduction hearing
c) bone conduction hearing
d) propagating conduction hearing