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Jaime Lynne is a 12 y/o female who you are treating for scoliosis; her Cobb angle is 28 degrees which is 5 degrees worse than last year. The best course of treatment for Jaime would be
Localized avascular necrosis of the capitellum is also known as
Slipped Capital femoral epiphysis can present
with c/o vague pain in thigh and knee
What type of curve is this and what is the name of the test used in the image to assess said curve?
Right thoracic/left lumbar curve: Adamಬs forward bend
True or false Vertebral bodies rotate toward the convex side of a curve in scoliosis and the spinous process rotates toward the concave side.
Amy Smith is a 12 year old female gymnast who arrives at your clinic with c/o low back pain that has gradually worsened over the past few weeks after practicing on the parallel bars. She denies neurological symptoms at this time and is eager to return to gymnastics. Upon examination, you note a "step-off" deformity at the L4-5 level of her lumbar spine and note that she is hypermobile in all joints. You suspect
Spondylolisthesis grade 1
A young hypermoble female patient arrives in the clinic and you want to perform the prone instability test on her: the point of the test is to:
Assess for Spondylolisthesis
Relative Energy deficiency or ( RED-S) ( Formerly the female athlete Triad) is thought to now have
Multi system involvement
According to the CPG's released in 2019 on Patella Femoral Pain Syndrome (PFPS), what is/are the finding/ findings that would NOT support the Diagnosis of PFPS:
You are examining a young female pitcher after she arrives at your clinic due to c/o shoulder pain. This image shows you the findings in which you see when performing test and measures on her
this finding could represents MDI
What are some external factors that could contribute to a young athletes overuse injury?
The Hypothalmus will stimulate the anterior pituitary gland to produce what hormones during puberty and what are the target organs ?
FSH testes and ovaries
Weight training for adolescents should focus on which of the following parameters:
Frequency 2-3x/wk (per muscle group)
Mandy R is a 15 year old female who tore her ACL while playing volleyball and has been prescribed "Pre-hab" prior to her ACL reconstruction scheduled in 3 weeks: Current finding: + edema of .5 cm, knee PROM : 25-105 supine, Ankle PROM : 14 degrees DF and 40 degrees PF; MMT quads at 45 degrees: 2+ , Balance: unable to assess SLS due to pain. What is the primary focus of treatment for Mandy in order to prepare her for surgery for a successful outcome?
restore full knee extension actively and passively
FAI (Femoroacetabular impingement) is seen in young female athletes, especially dancers: what type of impingement is most common in this population and how is it diagnosed?
Pincer impingement FADDIR test
According to the Tanner Staging system: what stage is a transphyseal reconstruction using hamstrings graft most commonly performed .
Stage 2 will have breast bud forming
Michael Murphy is a 15 year old male who arrives at PT s/p Medial patella femoral ligament repair: what is the most important piece of information to provide to him on his first visit with you post operatively?
pt education of post op precautions donning/doffing his brace
This patient arrives in your clinic and you decide to perform a functional assessment on her, ( see image below) What muscle group would be important to also assess via standardized MMT after you view this activity?
hip abductors in side-lying MMT
According to the Ottawa Ankle rules imaging is indicated when
The patient is unable to WB immediately after injury and 4 steps in the waiting room
Internal impingement in young overhead throwing athletes can be attibrituted to:
general laxity of the anterior capsule
You are treating a 14.5 year-old girl with a skeletal age of 14.5 years. She has a right cervicothoracic S - curve that measures 32°. Appropriate treatment would include:
A high profile brace, such as a Milwaukee Brace
The primary advantage of a rotationplasty is:
improved prosthetic functioning
what type of terminal device would you suggest for a child who has upper extremity limb loss when they are 5 years old?
voluntary closing device
A complication of surgical amputation that occurs in children but not in adults is:
A 6-year-old boy presents with a history of no specific trauma, pain during ambulation, and no history of fever. Assessment reveals that his pain is located in his groin and thigh and he has decreased hip range (especially IR) on the painful limb side. The most appropriate differential diagnosis is?
You have been seeing a 9 month old child for the past three weeks now. This child has a transhumeral congenital right upper extremity and a transfemoral congenital left lower extremity. You have noticed that they are having difficulties progressing from rolling to crawling and have started to scoot backwards while sitting to get around. At what age would you start to introduce an upper extremity prosthesis?
An appropriate time to introduce a non-hydraulic functional knee joint (such as a polycentric knee) for a child with a transfemoral congenital limb loss would be when the patient:
is a preschooler
A child with Slipped Capital Femoral Epiphysis may present with:
external rotation gait
George Smith is a 12 year old arrives at your clinic under direct access after playing soccer with his club team: he blocked a goal, but got kicked in the process along his left shoulder and stomach; his examination findings are: pain in left AC joint and left shoulder rated 9/10 on NPRS at rest and with movement: no significant change in end-range pain into elevations or IR/ER. Rest does not change his pain, nor does changing positions. Based on these findings you:
Inform his parents that he needs to go to the ER due to possible + Kerr's sign
A grade 2 Spondylolithesis is measured by ------- % of slippage of the superior body over the inferior body
25-50% of slippage
A physical therapist exams a 17 year old female who is complaining of shoulder pain. The patient is an avid swimmer. Tests and measures reveal the following: 5/5 MMT for bilateral shoulders throughout; ROM WNL except for ER 0-95, IR 0-95, and Flexion 0-190 bilaterally. GH joint play 4.0 for anterior, posterior and inferior glides bilaterally. Scapula joint play 3.0 for rotations, inferior, superior glides and distraction. No tenderness noted on palpation. Based upon these findings the therapist should perform:
Rhythmic stabilization exercise to both UEs
Which is NOT a component of the Clinical Prediction Rule for Spinal Hyper-mobility
Age > 40 years old
Mindy C is a 16 year old female long distance runner: you are concerned that she may be exhibiting signs of compartment syndrome : which of the symptoms below is NOT a sign of compartment syndrome
A young male basketball player has had 3 patella dislocations in the past 2 months: he has poor motor control of the quad and inability to descend stairs reciprocally. He is being scheduled for surgery, the most likely procedure that the surgeon will perform on him is
With the arm positioned in 45° of abduction, which of the glenohumeral ligaments are the primary restraint to external rotation?
Middle GH ligament
Why is it important to assess extensor lag in a post-operative ACL reconstruction of a young female soccer player who is WBAT.
it is important to assess motor control of the quad for safe ambulation w/o an AD
Patient Bobby Jones is recovering well from a lateral ankle sprain , but he continues to have pain along the mortise with dorsiflexion. What would be important to assess with Bobby?
Talar glide, specifically dorsal glide
Janet James is a 14 year old with a chronic illness that requires frequent MD appointments and now Physical therapy. Her mother brings her to her appointment. What might be the best interview technique to use with this particular patient?
Communication with the parent occurs after the interview/assessment of Janet, then the parent is included in a discussion they had about goals
Misty Copeland is a 15 year old ballet dancer who just had an ACL reconstruction ( without a MM repair) using a quad tendon allograft; her ROM is now -2/0 in extension and 90/100 supine knee flexion. She is 2 weeks post - op and you want to progress her quad strengthening program. What is the best method of working her quads at this stage of her rehab program?
Closed-chain Terminal knee extension with a ball or T-band behind the knee
At what phase of LCP disease does the Ligamentum Teres cause a compromised femoral head blood supply?
Andrew has Duchenne Muscular dystrophy and has recently been diagnosed with nocturnal hypoxia, but has adequate oxygenation during waking hours. Andrew would most likely benefit from
intermittent positive pressure ventilation via a facial mask while sleeping
Andrew has weakness of his trunk and lower extremities. When transitioning from the floor up into standing, he needs to use his hands supporting against his legs in order to rise up into standing. This finding is known as a positive
Three characteristics commonly noted during a gait analysis of a client with Duchenne MD includes:
lumbar lordosis, wide BOS and toe walking
Duchenne muscular dystrophy and _______________ muscular dystrophy are both x-linked recessive diseases resulting from a mutation in the gene coding for dystrophin
Becker muscular dystrophy
Psuedohypertrophy is the result of
fatty and connective tissue infiltration
What causes the progressive loss of muscle contractility in clients diagnosed with Duchenne Muscular dystrophy?
destruction of the myofibrils
The following is true about individuals presenting with TAR except:
the hypothenar eminence can be absent or lack of musculature
The Ottawa Knee Rules were developed in order to determine the need for radiographs after acute knee injury secondary to the risk of fracture: they include all but the following:
+ Lachman's test
The three structures that are the static stabilizers of the Posterior Lateral Corner that can cause knee instability during pivoting activities are :
Lateral Collateral Ligament, Popliteofibular Ligament, popliteus tendon
You have a patient that arrives in the clinic with the attached x-rays from an injury he sustained 2 months ago: this image represents a ____________________ that can occur from ______________
Lis Franc Fracture: loaded Plantar flexion
Bobby Jones is a 14 y/o soccer player who arrives at your clinic via direct access for c/o left AC shoulder pain. His mom reports that he tripped on the soccer field and fell on his left shoulder and wants you to examine the shoulder so he can play in next week's game. Upon questioning during the interview you discover that nothing relives his pain and movement does not make it worse. When he takes off his shirt you discover bruising along his left ribcage. He reports while he was down someone kicked me there. Based on this information you:
Inform his parents that he needs to be taken to the ER for further evaluation, even though the mother feels you are over reacting when you explain to her about Kerr's sign
A 12 y/o female gymnast arrives at your clinic with c/o low back pain during back handsprings on her floor routine. Upon examination she displays the following: aberrant motion with forward flexion testing, an SLR of 110 degrees and pain with lumbar extension while lying prone. What test would you perform?
Prone instability test for segmental instability
A young 15 female arrives at your clinic with c/o knee pain with sitting and descending stairs and you haver her perform the "stepdown test" and you witness her hips fall into IR and a knee "valgus collapse" what potential problems are you assessing her for?
PFPS due to weak glut med during suspensory strategies
You are treating a 14.5 y/o girl with a skeletal age of 14.5 years. She has a right cervicothoarcic S curve that measure 32" Appropriate treatment would include
A high profile brace such as a Milwaukee brace
Picture of Craig's test: The ROM in this image was performed using the test on a 15 y/o female and was determined to be 35 degrees. This ROM finding demonstrates
Susie Q arrives at your clinic and demonstrates significant laxity in her joints and you suspect Ehlers Danlo's syndrome. She has bilateral elbow hyperextension of 15 degrees, bilateral knee hyperextension of 20 degrees, can touch (palm) the floor with legs straight, but both thumbs and 5th digits remain normal w/o the ability to hyper-extend them past neutral Her score on the Beighton-Horan index is;
This image represents what type of fracture? Goes diagonally through Physis and epiphysis
Salter Harris type IV fracture
Jimmy Smith arrives in your clinic via direct access after twisting his knee while playing soccer. You notice that he has difficulty walking and reports it feels like it will give out. Lack of end range knee extension and edema in the joint. You have accessed his ROM and edema and are trying to determine what structure he has damaged in his knee. What tests and measures would help you determine what is causing his swelling and difficulty waling to assist in developing your plan of care
Perform a lachmann's test
Contact between the greater tuberosity of the humerus and the posterior superior glenoid rim leading to impingement of the posterosuperior labrum and articular side of the rotator cuff best describes
When a 6 y/o boy is referred to clinic and presents with the following history, no specific trauma, pain during ambulation, and no history of a fever. Upon further questioning you find his pain to be located in his groin and thigh, his gait pattern has decreased stance on the painful limb and decreased hip flexion noted on the painful side he also has decreased hip range of motion, and decreased gluteal muscle strength. With the above information which of the following diagnosis might you suspect?
Legg calve perthes disease
The term subdural hematoma refers to a hematoma located
between the dura and the pia matter
You are treating an older individual with severe spinal stenosis who sustained a cervical hyperextension injury resulting in Central Cord syndrome. This individual would have difficultly with ADLS such as
Difficulty buttoning his shirt
When teaching an individual with a T4 ASIA B SCI how to perform a wheelie you note they are having difficultly getting the front wheels to pop. one reason for this may be
the axle is too far backward on the frame of the WC
You have a cervical injury patient who has UMN symptoms after an accident involving lower cervical spine. you would expect to see the following findings
Hypereflexia and spasticity below the level of the lesion: flaccidity at the level of the lesion
You ask your patient to perform rapid alternating movements of his UE by quickly alternating supination and pronation of his hands in his lap. He performs the task well with his right hand but he has significant trouble coordinating the task with his left hand. what are you testing for and what area of his brain is most likely damaged
dysdiadochokinesia, left cerebellum
A pt exhibits right arm weakness, an ataxic gait and decreased memory. which of the following scenarios would cause this
left frontal lobe, cerebellum and temporal lobe damage
Which is the highest level at which the expected outcome for independent transfer with a sliding board would be feasible for and individual post SCI?
a pt s/p spinal cord injury at the C3 level was referred to PT. As part of the patient care program the PT makes recommendations on positioning to the nursing staff. How often should turning/repositioning occur
every 2 hours
you are treating a pt who sustained a mid-cervical cord lesion, classified as ASIA A who suddenly c/o severe HA, blurred vision and is diophoretic with severe facial sweating and nasal congestion. your best course of action should be
sit him upright immediately to reduce BP
This is the fifth day of treatment for a pt with a T4 level spinal cord injury. the right lower extremity is swollen, there is no redness however the leg feels a little warmer than the left. your treatment plan for this session should be
discuss the finding with the nurse and hold treatment
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