Deck 8: Examination of Motor Function: Motor Control and Motor Learning

Question 1

If a patient has impaired memory and attention,what might be an effective strategy for the therapist when performing the examination and subsequent interventions?

A)Work with the patient in a closed,quiet environment to minimize distractions.
B)Treat the patient with another patient so they can assist each other.
C)Provide the patient with detailed instructions and directions to assist his memory.
D)Work with the patient in the physical therapy gym.

Answer 1

A

Question 2

A patient who presents with a positive Babinski sign would demonstrate what type of response to a stroking stimulus on the sole of the foot along the lateral border?

A)Dorsiflexion of the foot and great toe
B)Plantar flexion of the foot and great toe
C)Dorsiflexion of the big toe and fanning of the other four toes
D)Extension of the big toe and the other four toes of the foot

Answer 2

C

Question 3

What does the Modified Ashworth Scale measure?

A)Clonus
B)Spasticity
C)Reflexes
D)Strength

Answer 3

B

Question 4

If a patient has normal tone,how would the limb feel during passive motion testing?

A)Stiff and rigid
B)Heavy and unresponsive
C)Responsive and light
D)Tight and firm

Question 5

The therapist asks the patient to perform a group of exercises and then monitors how long the patient is able to follow through with the task.What type of attention is the therapist assessing?

A)Selective attention
B)Sustained attention
C)Alternating attention
D)Divided attention

Question 6

What statement best characterizes spasticity?

A)Clinical presentation includes large involuntary movements.
B)Stretch reflexes are dampened or absent.
C)Resistance to passive stretch is velocity-dependent.
D)Clinical presentation includes uniform resistance to movement.

Question 7

The patient sustained a traumatic brain injury approximately 15 months ago.He exhibits normal respiration,digestion,and blood pressure.He is able to be aroused,but he is not aware of his environment and does not have any purposeful responses to the environment.What is this patient's level of consciousness?

A)Vegetative state
B)Coma
C)Persistent vegetative state
D)Obtunded

Question 8

What is an appropriate method of examining if motor learning has occurred in a patient with motor deficits?

A)Manual muscle testing of the impaired extremity
B)Active-assisted ROM of the impaired extremity
C)Measuring performance on a retention test
D)Using the Modified Ashworth Scale

Question 9

The patient presents with cyclical,spasmodic,alternating contraction and relaxation of the left plantar flexors following a quick stretch.How could the therapist document this finding?

A)The patient presents with rigidity of the left plantar flexors.
B)The patient presents with flaccidity of the left plantar flexors.
C)The patient presents with a Babinski sign of the left plantar flexors.
D)The patient presents with clonus of the left plantar flexors.

Question 10

Deep tendon reflexes in a patient with an upper motor neuron lesion are

A)increased.
B)decreased.
C)not changed.
D)dependent on location of the lesion.

Question 11

When deciding if manual muscle testing is appropriate in a patient with an upper motor neuron lesion,what should the therapist consider first?

A)Amount of spasticity and abnormal synergy present
B)The severity of the upper motor neuron lesion
C)Previous strength as reported by the patient
D)The patient's ability to move the extremity

Question 12

During the examination the therapist asks the patient to add one pair of numbers and then subtract a pair numbers.What type of attention is the therapist assessing?

A)Selective attention
B)Sustained attention
C)Alternating attention
D)Divided attention

Question 13

During a movement sequence the sensory system sends information to the central nervous system to monitor the task and provide for correction of movement.This type of control is

A)feedforward control.
B)synergistic units.
C)feedback control.
D)coordinative structures.

Question 14

Which statement best describes dynamical systems theory?

A)Control occurs in a hierarchical manner with higher levels of the CNS controlling lower levels.
B)Units of the CNS are organized around demands of specific tasks.
C)Motor elements are activated in response to specific sensory stimulation.
D)The input from higher levels are given more weight when determining the motor response.

Question 15

A motor program is best defined as

A)a representation of a motor task that when initiated results in a movement sequence.
B)information about how a movement felt and the outcome of the movement sequence.
C)a plan for a movement sequence that includes multiple components of movement.
D)movement that occurs as a result of practice and feedback.

Question 16

A patient demonstrates difficulty recalling the nurse and therapist's names and is unsure why she is in the hospital.She does remember the names of her best friends and the high school she attends.What is the best description of this patient's deficits?

A)Dementia
B)Acute confusional state
C)Retrograde amnesia
D)Anterograde amnesia

Question 17

The patient is able to walk independently from his room to the physical therapy gym while talking to the therapist.This is an example of

A)selective attention.
B)sustained attention.
C)alternating attention.
D)divided attention.

Question 18

What type of assessment is preferred when examining a patient's fatigability?

A)Performance-based tests
B)Manual muscle testing
C)Self-assessment questionnaire
D)Observational assessment

Question 19

The patient presents with no resistance to passive movement of the right upper extremity and notable hyperextension of the right elbow.How should the therapist document this finding?

A)The patient presents with rigidity of the right upper extremity.
B)The patient presents with flaccidity of the right upper extremity.
C)The patient presents with a Babinski sign of the right upper extremity.
D)The patient presents with clonus of the right upper extremity.

Question 20

The patient demonstrates increased resistance to passive stretch of the right biceps.How should this be documented?

A)The patient demonstrates hypertonia of the right biceps.
B)The patient demonstrates hypotonia of the right biceps.
C)The patient demonstrates dystonia of the right biceps.
D)The patient demonstrates normal tone of the right biceps.

Question 21

On Tuesday afternoon the patient practiced transfers from the wheelchair to the mat with assistance from the therapist and progressed from minimal assist to stand-by assist.On Wednesday morning the therapist asks the patient to perform the same transfer.What type of assessment of motor learning is the therapist using?

A)A performance test
B)A transfer test
C)A retention test
D)A reliability test

Question 22

What is included in examination of sensory organization of postural control and balance?

A)Vision,lower extremity somatosensation,and vestibular function
B)Vision,lower extremity range of motion,and vestibular function
C)Hearing,lower extremity somatosensation,and vestibular function
D)Vision,lower extremity somatosensation,and reflex integration

Question 23

After gently pushing on a patient's sternum in standing,the therapist observes the patient shifting her center of mass forward at the ankles.How would the therapist document this finding?

A)The patient demonstrates normal postural sway with gentle perturbations in standing.
B)The patient has good standing balance after perturbations.
C)The patient demonstrates an ankle strategy with gentle perturbations in standing.
D)The patient is able to maintain balance in standing with gentle perturbations.

Question 24

The therapist observes the patient walking in the grass at a hospital picnic with many people in the area.What type of skill is the patient demonstrating?

A)Open skill
B)Closed skill
C)Dynamic task control
D)Specificity skill

Question 25

The therapist observes the patient maintaining her center of mass over the base of support in a sitting position while reaching.What type of motor task is this patient demonstrating?

A)Mobility
B)Static postural control
C)Dynamic postural control
D)Skill

Question 26

Which of the following could a therapist use to document changes in motor performance?

A)The patient's perceptions
B)The number and type of errors
C)Changes in strength
D)Respiratory and heart rate

Question 27

When performing the Clinical Test for Sensory Interaction in Balance,how long must the patient maintain standing in Condition 4 with eyes open and a moving surface?

A)2 minutes
B)10 seconds
C)4 minutes
D)30 seconds

Question 28

What score on the Berg Balance test has been shown to be useful in evaluating risk of falling in older adults?

A)56
B)24
C)45
D)60

Question 29

The patient demonstrates the ability to move from supine to sitting while maintaining postural control.What type of motor task is this patient demonstrating?

A)Mobility
B)Static postural control
C)Dynamic postural control
D)Skill

Question 30

How should the therapist examine a patient's limits of stability in a standing position?

A)Ask the patient to reach as far as he can until he begins to fall.
B)Gently push on the patient's sternum and observe the reaction.
C)Observe postural sway with the patient standing against a grid.
D)Watch the patient attempt to reach with feet in a tandem position.

Question 31

The therapist observes the patient walking on a stable surface in a quiet hallway.What type of skill is the patient demonstrating?

A)Open skill
B)Closed skill
C)Dynamic task control
D)Specificity skill

Question 32

A patient who presents with significant deficits in lower extremity somatosensation will have to depend on what systems to maintain balance?

A)Auditory and proprioception
B)Visual and auditory
C)Auditory and vestibular
D)Visual and vestibular

Question 33

In addition to exhibiting a stepping strategy with large,fast postural perturbations,what else will many individuals demonstrate?

A)Grasping movements with their upper extremities
B)Shifting of the limits of stability
C)Shifting of the center of mass
D)Unequal weightbearing on one extremity

Question 34

What would be a positive finding on the Romberg Test?

A)The patient is unable to maintain balance on an unstable surface.
B)The patient is unable to maintain balance on one foot.
C)The patient is unable to maintain balance with eyes closed.
D)The patient is unable to maintain balance while turning the head from side to side.

Question 35

How should the therapist examine for abnormal synergies in individuals with upper motor neuron disease?

A)Move the patient through passive range of motion and note any changes in resistance.
B)Ask the patient to perform a specific movement and observe how the movement is carried out.
C)Resist a specific movement and observe the strength of the muscle being tested.
D)Encourage the patient to move within normal synergies and observe the muscles closely.

Question 36

How should ambient vision be examined?

A)Instruct the patient while in a sitting position to visually track from right to left with increasing speed.
B)Instruct the patient to read a Snellen eye chart from a distance of 20 feet.
C)Instruct the patient to move across the busy gym area while observing ability to navigate safely,avoiding obstacles.
D)Instruct the patient to look at the therapist's nose while the therapist slowly brings a pencil into the patient's field of view from the right or left.

Question 37

The therapist observes that the patient is able to maintain his center of mass over the base of support in a standing position without upper extremity support.What type of motor task is this patient demonstrating?

A)Mobility
B)Static postural control
C)Dynamic postural control
D)Skill

Question 38

When might the therapist expect the patient to demonstrate a hip strategy for balance while in a standing position?

A)With very large perturbations to stop from falling
B)With very small perturbations
C)With large perturbations while standing with a wide base of support
D)With large perturbations while standing with a narrow base of support

Question 39

What is the best use of the Timed Up and Go Test?

A)A comprehensive examination of balance and postural sway
B)A comprehensive examination of balance in gait
C)A reliable,quick screening of balance and postural sway
D)A reliable,quick screening of balance in functional mobility tasks

Question 40

How should peripheral vision be examined?

A)Instruct the patient while in a sitting position to visually track an object from right to left with increasing speed.
B)Instruct the patient to read a Snellen eye chart from a distance of 20 feet.
C)Instruct the patient to move across the busy gym area while observing ability to navigate safely,avoiding obstacles.
D)Instruct the patient to look at the therapist's nose while the therapist slowly brings a pencil into the patient's field of view from the right or left.

Question 41

On Tuesday afternoon the patient practiced transfers from the wheelchair to the mat with assistance from the therapist and progressed from minimal assist to stand-by assist.On Wednesday morning the therapist asks the patient to perform a transfer from the wheelchair to the toilet.What type of assessment of motor learning is the therapist using?

A)A performance test
B)A transfer test
C)A retention test
D)A reliability test