Physical Therapy Assessment Quiz
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Questions and Answers

What is one of the primary purposes of collecting a patient's history during an initial observation?

  • To establish a direct diagnosis immediately
  • To prescribe medications based on symptoms
  • To identify any relevant underlying conditions (correct)
  • To determine a standard treatment protocol

Which of the following functional outcome measures is specifically designed for lower extremity function?

  • LEFS (correct)
  • KOS
  • FAAM
  • BPI

When is a screening exam deemed necessary?

  • When the patient displays acute symptoms
  • When coming from the spine (correct)
  • When observing full joint motion
  • When the patient is in chronic pain

What is the primary focus of the movement analysis during the examination?

<p>Assessing patient pain during specific movements (B)</p> Signup and view all the answers

In the context of range of motion assessment, what does 'end-feel' refer to?

<p>The quality of the resistance at the end of the passive range (C)</p> Signup and view all the answers

What does a Positive Likelihood Ratio (LR) greater than 10 indicate in probability assessment?

<p>Generates large and often important shifts in probability (D)</p> Signup and view all the answers

In the context of sensitivity and specificity, what does a high sensitivity indicate?

<p>It is likely to rule out the condition (A)</p> Signup and view all the answers

Which condition is associated with an increased risk in breech births and has a genetic component?

<p>Developmental hip dysplasia (A)</p> Signup and view all the answers

What is indicated by a Negative Likelihood Ratio (LR) between 0.1 and 0.2?

<p>Generates moderate shifts in probability (A)</p> Signup and view all the answers

Which of the following findings during a structural inspection suggests a potential issue with lymph nodes or internal organs?

<p>Swelling in the groin (B)</p> Signup and view all the answers

What might you observe in a patient with right gluteal weakness?

<p>Valgus collapse of the pelvis (D)</p> Signup and view all the answers

What does the presence of atrophy of the gluteals indicate during a musculoskeletal examination?

<p>Chronic nerve dysfunction (A)</p> Signup and view all the answers

What is one of the key features of severe cases of developmental hip dysplasia identified at birth?

<p>Congenital subluxation or dislocation (B)</p> Signup and view all the answers

What is the capsular pattern for the hip joint?

<p>Flexion more limited than Abduction, more limited than Internal Rotation (A)</p> Signup and view all the answers

Which position corresponds with the loose-packed position of the tibiofemoral joint?

<p>30° knee flexion (A)</p> Signup and view all the answers

What is the primary end-feel for flexion at the tibiofemoral joint?

<p>Soft tissue (C)</p> Signup and view all the answers

In the evaluation of the patellofemoral joint, what position is noted for full extension?

<p>Full extension to 5° of flexion (B)</p> Signup and view all the answers

Which joint demonstrates flexion greater than extension in its capsular pattern?

<p>Tibiofemoral joint (C)</p> Signup and view all the answers

What is the capsular pattern for the subtalar joint?

<p>Inversion more restricted than eversion (C)</p> Signup and view all the answers

For the metatarsophalangeal joint, what is the expected end-feel for extension?

<p>Firm (D)</p> Signup and view all the answers

What defines the loose-packed position for the talocrural joint?

<p>10° plantar flexion (D)</p> Signup and view all the answers

What is the limitation observed in the capsular pattern for the tarsometatarsal joint?

<p>Equal limitation in all directions (A)</p> Signup and view all the answers

What is the most limited movement in the capsular pattern of the hip joint?

<p>Internal Rotation (B)</p> Signup and view all the answers

Flashcards

LEFS (Lower Extremity Functional Scale)

A standardized tool that helps assess and measure the functional limitations in people with lower extremity conditions impacting their ability to perform daily activities.

KOS (Knee Outcome Score)

A tool that evaluates the overall health and well-being of the knee joint, taking into account pain, function, and quality of life.

Structural Inspection

A structured examination used to identify and evaluate potential sources of pain or dysfunction by carefully observing body structures, movements, and other signs.

Active Range of Motion (AROM)

A systematic evaluation of a patient's active range of motion (AROM), usually measured in degrees.

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Passive Range of Motion (PROM)

Examining the joint's movement through passive motion, evaluating the end-feel for restrictions or limitations.

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Loose-Packed Position

The position of a joint where it experiences minimal stress and maximum freedom of motion.

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Closed-Packed Position

The position of a joint where the ligaments are taut and there is minimal motion potential.

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Sensitivity

The ability of a test to correctly identify individuals who have a specific condition.

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Capsular Pattern

A specific pattern of joint restriction, where movement in some directions is more limited than in others.

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End-Feel

The feeling at the end of a joint's range of motion.

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Specificity

The ability of a test to correctly identify individuals who do NOT have a specific condition.

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Positive Likelihood Ratio (LR+)

A measure of how much a test result changes the probability of having a condition. A high positive LR indicates a strong likelihood of the condition being present.

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Ligamentous End-Feel

A type of end-feel where the motion is stopped by the joint's ligaments.

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Negative Likelihood Ratio (LR-)

A measure of how much a test result changes the probability of NOT having a condition. A low negative LR indicates a strong likelihood of the condition being absent.

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Bony End-Feel

A type of end-feel where the motion is stopped by bone contacting bone.

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Developmental Hip Dysplasia (DHD)

A condition that affects the hip joint, often present at birth or early childhood, and can lead to subluxation or dislocation of the femoral head. It can be due to abnormal development of the hip socket or the femur.

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Soft Tissue End-Feel

A type of end-feel where the motion is stopped by soft tissues like muscles or tendons.

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Palpation

An examination technique that involves applying gentle pressure to specific areas of the body to assess tenderness or pain.

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Ecchymosis

The appearance of bruising or discoloration under the skin.

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Muscle Length

The ability of a muscle to lengthen or stretch.

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Anteversion

A condition where the hip joint is rotated inward, causing the toes to point inward.

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Retroversion

A condition where the hip joint is rotated outward, causing the toes to point outward.

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Special Tests

Tests designed to assess specific joint motions or ligaments.

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Study Notes

Musculoskeletal Physical Therapy II - Lower Extremity Pathologies

  • Course information: PT 892, Fall 2024, LIU Brooklyn School of Health Professions, Doctor of Physical Therapy Program.
  • Course instructors include: Michael Masaracchio, PT, DPT, PhD, OCS, FAAOMPT, Associate Professor and Chair, and others.
  • Faculty members also include: Clinical Director Masefield and Cavallaro Physical Therapy, President of CM OrthoSports Inc., Vice-President of APTA New York, Vice Chair of ACAPT, and APTA Education Leadership Fellowship, class of 2022.

Bony Anatomy of the Hip

  • Hip (coxal) bone is structured from the ilium, ischium, and pubis.
  • Ilium has key landmarks: ASIS, AIIS, PSIS, PIIS, ischial spine, tuberosity.
  • Pubis includes superior/inferior pubic ramus, pubic tubercle
  • Acetabulum comprises cartilage and labrum for congruence and proprioception.
  • Femur includes head, neck, greater and lesser trochanters, intertrochanteric line, crest, linea aspera, pectineal line.

Ligamentous Anatomy of the Hip

  • Iliofemoral ligament restricts hyperextension/abduction and supports upright posture
  • Ischiofemoral ligament restricts excessive hip ER
  • Pubofemoral ligament restricts hip hyperextension/abduction and excessive ER
  • Ligamentum teres restricts excessive ER during hip flexion (MRI).

Muscles of the Anterior Thigh

  • Iliopsoas: hip flexion
  • Rectus femoris: hip flexion
  • Vastus lateralis
  • Vastus intermedialis
  • Vastus medialis
  • Sartorius

Muscles of the Medial Thigh

  • Adductor longus
  • Adductor brevis
  • Adductor magnus
  • Gracilis
  • Obturator externus

Muscles of the Posterior Hip

  • Gluteus maximus: hip extension and external rotation
  • Gluteus medius: hip abduction and internal rotation
  • Gluteus minimus: hip abduction and internal rotation stabilizer
  • Piriformis:
  • Superior gemellus: ER and abduction in 90° flexion
  • Obturator internus: ER and abduction in 90° flexion
  • Inferior gemellus: ER
  • Quadratus femoris: ER, possible adduction

Neurovascular Anatomy

  • Lumbar plexus (L1-L4): ventral rami, major nerve roots, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerves.
  • Sacrococcygeal plexus (L4-S4): cluneal nerves, superior gluteal nerve, inferior gluteal nerve, nerve to the obturator internus, nerve to the quadratus femoris, sciatic nerve, and pudendal nerve.

Examination

  • Includes review of patient history, radiographic/other information, functional outcome measures (LEFS, KOS, FAAM);
  • Screening exam (when coming from spine): movement analysis (squat, step down, lateral step down, gait), bridge with leg extension test, pelvic tilt test, Active Range of Motion (AROM), Passive Range of Motion (PROM), and resistive tests (MMT).

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Description

Test your knowledge on key concepts in physical therapy assessments, including patient history, functional measures, screening exams, and movement analysis. This quiz is essential for those studying or practicing in the field of rehabilitation and physical therapy.

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