Question 1

To effectively treat CRPS, a physical therapist:

Accepted Answer

A) Performs a sympathetic block prior to any manual or exercise interventions. 
B) Utilizes an approach that manages the physical symptoms of pain, edema, stiffness, and muscle changes. 
C) Bombards the autonomic nervous system with stimuli using desensitization techniques. 
D) Avoids the "no pain, no gain" philosophy and encourages the patient to minimize activity if it causes discomfort. 
A) Performs a sympathetic block prior to any manual or exercise interventions. 
B) Utilizes an approach that manages the physical symptoms of pain, edema, stiffness, and muscle changes. 
C) Bombards the autonomic nervous system with stimuli using desensitization techniques. 
D) Avoids the "no pain, no gain" philosophy and encourages the patient to minimize activity if it causes discomfort. B

Question 2

You have been treating a patient with a diagnosis of TOS for 1 week; she describes increased burning pain over the past week.She also has ischemic symptoms in the upper extremity whenever she exercises or while engaging in simple functional activities.This means:

Accepted Answer

A) There could be progressive axonal disruption and compromise of the vascular supply; the physician should be notified. 
B) The patient has not been compliant with instructions for posture and safe exercises. 
C) The exercises have been too vigorous and should be decreased in intensity. 
D) This is a typical reaction to exercises for TOS. 
A) There could be progressive axonal disruption and compromise of the vascular supply; the physician should be notified. 
B) The patient has not been compliant with instructions for posture and safe exercises. 
C) The exercises have been too vigorous and should be decreased in intensity. 
D) This is a typical reaction to exercises for TOS. A

Question 3

Your patient experiences a tingling sensation in the upper extremity while in the following position: shoulder girdle depression; slight abduction of the shoulder; elbow extension; medial rotation of the arm; pronation of the forearm, wrist, and finger; thumb flexion; and ulnar deviation of the wrist.Which peripheral nerve is being placed on a stretch?

Accepted Answer

A) Median 
B) Radial 
C) Ulnar 
D) Musculocutaneous 
A) Median 
B) Radial 
C) Ulnar 
D) Musculocutaneous B

Question 4

Your patient describes total numbness in the tips of the index and middle fingers that has been there for 2 months.Four months ago, he sustained a Colles' fracture.While immobilized in a cast, he had experienced periods of intermittent numbness and pain.You observe atrophy in the thenar eminence and ape hand deformity.This patient most likely sustained:

Accepted Answer

A) Mild compression of the median nerve and has excellent prognosis for full recovery. 
B) Laceration of the median nerve with complete interruption; there is no chance of neurological recovery. 
C) Chronic compression of the median nerve; there is a guarded prognosis; may require surgical intervention. 
D) A stretch injury to the median nerve with adhesions preventing normal mobility; gentle nerve mobilization should alleviate the symptoms. 
A) Mild compression of the median nerve and has excellent prognosis for full recovery. 
B) Laceration of the median nerve with complete interruption; there is no chance of neurological recovery. 
C) Chronic compression of the median nerve; there is a guarded prognosis; may require surgical intervention. 
D) A stretch injury to the median nerve with adhesions preventing normal mobility; gentle nerve mobilization should alleviate the symptoms.

Question 5

Your patient sustained a traumatic injury to his shoulder 3 weeks ago.You have been treating him because of decreased shoulder ROM and strength and general lack of functional reaching and overhead use of the upper extremity.Today he reports that he has been experiencing increased pain, swelling, and stiffness of his hand.What can you conclude?

Accepted Answer

A) These signs are the result of a thoracic outlet syndrome (TOS); begin treating this region as well. 
B) The patient is possibly developing complex regional pain syndrome (CRPS); treatment should be initiated to reduce swelling, maintain range, and increase use of the hand. 
C) These signs are a normal reaction to trauma; it is important to tell the patient he is engaging in too much activity. 
D) These are signs of a possible clot; immediately send him to the emergency room. 
A) These signs are the result of a thoracic outlet syndrome (TOS); begin treating this region as well. 
B) The patient is possibly developing complex regional pain syndrome (CRPS); treatment should be initiated to reduce swelling, maintain range, and increase use of the hand. 
C) These signs are a normal reaction to trauma; it is important to tell the patient he is engaging in too much activity. 
D) These are signs of a possible clot; immediately send him to the emergency room.

Question 6

Your patient complains of numbness in the hand and forearm whenever working for prolonged periods at the computer; the hand also develops a puffy sensation and occasionally turns blue.Adson's maneuver reproduces these symptoms.All of the following should directly help your patient with this problem and will be part of your treatment approach for TOS except:

Accepted Answer

A) Stretch the scalene muscles. 
B) Teach posture correction. 
C) Teach relaxed diaphragmatic breathing. 
D) Apply mechanical traction at 20 lb for 20 minutes. 
A) Stretch the scalene muscles. 
B) Teach posture correction. 
C) Teach relaxed diaphragmatic breathing. 
D) Apply mechanical traction at 20 lb for 20 minutes.

Question 7

Following nerve injury, motor retraining exercises:

Accepted Answer

A) Begin as soon as signs of voluntary muscle action are detected. 
B) Begin as soon as the patient tolerates electrical stimulation. 
C) Are used to desensitize the areas of hypersensitivity. 
D) Cannot be used until the chronic phase of healing in order to avoid further trauma to the nerve. 
A) Begin as soon as signs of voluntary muscle action are detected. 
B) Begin as soon as the patient tolerates electrical stimulation. 
C) Are used to desensitize the areas of hypersensitivity. 
D) Cannot be used until the chronic phase of healing in order to avoid further trauma to the nerve.

Question 8

The pain associated with CRPS characteristically is:

Accepted Answer

A) Entirely psychogenic and responsive to antidepressants. 
B) Intermittent and related to body and head position. 
C) Out of proportion to the report of history of injury or precipitating event. 
D) Always responsive to modalities, primarily cold and electrical stimulation. 
A) Entirely psychogenic and responsive to antidepressants. 
B) Intermittent and related to body and head position. 
C) Out of proportion to the report of history of injury or precipitating event. 
D) Always responsive to modalities, primarily cold and electrical stimulation.

Question 9

CRPS is defined as an extremely painful multisymptom syndrome involving many systems that is:

Accepted Answer

A) Responsive and easily treated with modalities. 
B) Primarily psychomotor, resulting in weight changes and depression. 
C) Easily diagnosed with universal signs and symptoms. 
D) Accompanied by dystrophic and vascular changes and hyperesthesia. 
A) Responsive and easily treated with modalities. 
B) Primarily psychomotor, resulting in weight changes and depression. 
C) Easily diagnosed with universal signs and symptoms. 
D) Accompanied by dystrophic and vascular changes and hyperesthesia.

Question 10

The chronic phase of recovery following nerve injury occurs when:

Accepted Answer

A) The patient has significant residual effects from lack of regeneration and must learn to compensate for lost function. 
B) The nerve is regenerating, and strength and sensory recovery are emphasized in the rehabilitation program. 
C) Innervation is complete and emphasis is placed on retraining and re-education. 
D) The surrounding connective tissue can withstand normal tensile stresses, and the patient can return to all functional activities. 
A) The patient has significant residual effects from lack of regeneration and must learn to compensate for lost function. 
B) The nerve is regenerating, and strength and sensory recovery are emphasized in the rehabilitation program. 
C) Innervation is complete and emphasis is placed on retraining and re-education. 
D) The surrounding connective tissue can withstand normal tensile stresses, and the patient can return to all functional activities.

Question 11

Your patient injured her ulnar nerve falling up some steps and catching herself on the medial side of her hand 2 days ago.She currently has constant tingling and decreased sensation to pressure and touch in the little finger and ulnar half of the ring finger.Your intervention during the first week of treatment will be all of the following except:

Accepted Answer

A) Protect the nerve by immobilizing the wrist in a splint. 
B) Teach active ROM to wrist and fingers. 
C) Emphasize the importance of resistive exercises to prevent muscle atrophy. 
D) Inform the patient about ways to protect the hand from further injury. 
A) Protect the nerve by immobilizing the wrist in a splint. 
B) Teach active ROM to wrist and fingers. 
C) Emphasize the importance of resistive exercises to prevent muscle atrophy. 
D) Inform the patient about ways to protect the hand from further injury.

Question 12

Nonoperative management of carpal tunnel syndrome emphasizes:

Accepted Answer

A) Vigorous stretching to gain mobility of the structures in the carpal tunnel. 
B) Activity modification and joint, nerve, and tendon mobilization. 
C) Strengthening exercises, especially to the muscles of the thenar eminence. 
D) Immobilization. 
A) Vigorous stretching to gain mobility of the structures in the carpal tunnel. 
B) Activity modification and joint, nerve, and tendon mobilization. 
C) Strengthening exercises, especially to the muscles of the thenar eminence. 
D) Immobilization.

Question 13

Dominant signs of CRPS that should alert you to the potential of this condition developing are:

Accepted Answer

A) Pain, osteoporosis, swelling, and paresthesias. 
B) Pain, swelling, stiffness, and discoloration of the hand. 
C) Pain, muscle atrophy, stiffness, and brittle nails. 
D) Recent injury, pain, and red, hot, swollen tissue. 
A) Pain, osteoporosis, swelling, and paresthesias. 
B) Pain, swelling, stiffness, and discoloration of the hand. 
C) Pain, muscle atrophy, stiffness, and brittle nails. 
D) Recent injury, pain, and red, hot, swollen tissue.

Question 14

Following transverse carpal ligament surgery to release impingement of the median nerve in the carpal tunnel, your patient has increased sensation of tingling when the wrist is extended.The impairment and its intervention should be:

Accepted Answer

A) Joint adhesions: use joint-mobilization techniques. 
B) Median nerve adhesions: use nerve-mobilization techniques. 
C) Ligamentous stress from the surgery: use cross-friction massage. 
D) Scar adhesions: mobilize the skin around the surgical site followed by range of motion (ROM) exercises. 
A) Joint adhesions: use joint-mobilization techniques. 
B) Median nerve adhesions: use nerve-mobilization techniques. 
C) Ligamentous stress from the surgery: use cross-friction massage. 
D) Scar adhesions: mobilize the skin around the surgical site followed by range of motion (ROM) exercises.

Question 15

On examination, your patient reports that he is an avid cyclist and over the past 2 months has been experiencing numbness of the little finger and the ulnar side of his ring finger that has become painful over the past week with an inability to effectively grasp the handlebars.One area of possible nerve compression producing these signs and symptoms is:

Accepted Answer

A) Carpal tunnel. 
B) Tunnel of Guyon. 
C) Thoracic outlet. 
D) Tarsal tunnel. 
A) Carpal tunnel. 
B) Tunnel of Guyon. 
C) Thoracic outlet. 
D) Tarsal tunnel.

To effectively treat CRPS, a physical therapist:

You have been treating a patient with a diagnosis of TOS for 1 week; she describes increased burning pain over the past week.She also has ischemic symptoms in the upper extremity whenever she exercises or while engaging in simple functional activities.This means:

Following nerve injury, motor retraining exercises:

The pain associated with CRPS characteristically is:

CRPS is defined as an extremely painful multisymptom syndrome involving many systems that is:

The chronic phase of recovery following nerve injury occurs when:

Nonoperative management of carpal tunnel syndrome emphasizes:

Dominant signs of CRPS that should alert you to the potential of this condition developing are:

Following transverse carpal ligament surgery to release impingement of the median nerve in the carpal tunnel, your patient has increased sensation of tingling when the wrist is extended.The impairment and its intervention should be:

Therapeutic Exercise: Foundational Concepts

Prevention, Health, and Wellness

Range of Motion

Stretching for Improved Mobility

Peripheral Joint Mobilizationmanipulation

Resistance Exercise for Impaired Muscle Performance

Principles of Aerobic Exercise

Exercise for Impaired Balance

Aquatic Exercise

Soft Tissue Injury, Repair, and Management

Joint, Connective Tissue, and Bone Disorders and Management

Surgical Interventions and Postoperative Management

The Spine: Structure, Function, and Posture

The Spine: Management Guidelines

The Spine: Exercise and Manipulation Interventions

The Shoulder and Shoulder Girdle

The Elbow and Forearm Complex

The Wrist and Hand

The Hip

The Knee

The Ankle and Foot

Advanced Functional Training

Exercise in the Older Adult

Womens Health: Obstetrics and Pelvic Floor

Management of Lymphatic Disorders

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Exam 13: Peripheral Nerve Disorders and Management

To effectively treat CRPS, a physical therapist:

You have been treating a patient with a diagnosis of TOS for 1 week; she describes increased burning pain over the past week.She also has ischemic symptoms in the upper extremity whenever she exercises or while engaging in simple functional activities.This means:

Following nerve injury, motor retraining exercises:

The pain associated with CRPS characteristically is:

CRPS is defined as an extremely painful multisymptom syndrome involving many systems that is:

The chronic phase of recovery following nerve injury occurs when:

Nonoperative management of carpal tunnel syndrome emphasizes:

Dominant signs of CRPS that should alert you to the potential of this condition developing are:

Following transverse carpal ligament surgery to release impingement of the median nerve in the carpal tunnel, your patient has increased sensation of tingling when the wrist is extended.The impairment and its intervention should be:

Therapeutic Exercise: Foundational Concepts

Prevention, Health, and Wellness

Range of Motion

Stretching for Improved Mobility

Peripheral Joint Mobilizationmanipulation

Resistance Exercise for Impaired Muscle Performance

Principles of Aerobic Exercise

Exercise for Impaired Balance

Aquatic Exercise

Soft Tissue Injury, Repair, and Management

Joint, Connective Tissue, and Bone Disorders and Management

Surgical Interventions and Postoperative Management

The Spine: Structure, Function, and Posture

The Spine: Management Guidelines

The Spine: Exercise and Manipulation Interventions

The Shoulder and Shoulder Girdle

The Elbow and Forearm Complex

The Wrist and Hand

The Hip

The Knee

The Ankle and Foot

Advanced Functional Training

Exercise in the Older Adult

Womens Health: Obstetrics and Pelvic Floor

Management of Lymphatic Disorders

Filters