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?

Accepted Answer

Working with the patient in a closed, quiet environment can help minimize distractions and improve their ability to focus and remember important information during the examination and interventions. Providing clear and concise instructions may also be helpful in optimizing their cognitive function. Treating the patient with another patient may pose more distractions and may not necessarily improve their cognitive function, and working in the physical therapy gym may also be distracting and overwhelming for the patient with impaired memory and attention.

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?

Accepted Answer

The positive Babinski sign is characterized by dorsiflexion of the big toe and fanning of the other four toes in response to a stroking stimulus on the sole of the foot, indicating a dysfunction of the corticospinal tract.

Question 3

What does the Modified Ashworth Scale measure?

Accepted Answer

The Modified Ashworth Scale measures spasticity, which is a resistance to passive movement of a joint due to increased muscle tone. The scale rates the severity of spasticity in a muscle by assessing the resistance felt when the muscle is passively stretched. Clonus, reflexes, and strength are not directly measured by the Modified Ashworth Scale.

Question 4

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

Accepted Answer

If a patient has normal tone, their limb will feel responsive and light during passive motion testing. This means that when the limb is moved, it will move easily and without resistance or stiffness. It will also feel relatively light in the examiner's hands. Heavy and unresponsive (B) or tight and firm (D) are characteristics of hypertonia or increased muscle tone, while stiff and rigid (A) are characteristics of spasticity.

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?

Accepted Answer

The therapist is assessing sustained attention, which is the ability to maintain focus and attention over a prolonged period of time.

Question 6

What statement best characterizes spasticity?

Accepted Answer

Spasticity is characterized by increased muscle tone, which leads to resistance to passive elongation (stretch). The resistance to stretch is velocity-dependent, meaning that the faster the stretch, the greater the resistance. Choice A is incorrect because spasticity does not typically result in large involuntary movements. Choice B is incorrect because stretch reflexes are actually hyperactive in spasticity. Choice D is incorrect because the resistance to movement in spasticity is not always uniform, and can vary depending on the muscle and joint involved.

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?

Accepted Answer

The patient is exhibiting the characteristics of a persistent vegetative state, which is a prolonged state of disordered consciousness following a severe brain injury. In this state, the patient may be awake and exhibit some basic reflexes, but they do not show any signs of awareness or purposeful behavior.

Question 8

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

Accepted Answer

Measuring performance on a retention test is an appropriate method of examining if motor learning has occurred as it involves assessing the patient's ability to retain and recall the learned motor skills over time. This would demonstrate that true learning has taken place, rather than just a temporary improvement in performance due to other factors such as fatigue, motivation, or medication effects. Options A and B are measures of strength and range of motion, respectively, and do not necessarily indicate motor learning. Option D is a measure of spasticity, which may be relevant in certain cases but does not necessarily reflect learning or improvement in functional ability.

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?

Accepted Answer

The description given in the question is indicative of clonus, which is a rhythmic, involuntary contraction and relaxation of a muscle. This is specifically seen in the plantar flexors after a quick stretch, and is often associated with upper motor neuron lesions. Therefore, the best choice for documenting this finding would be D), stating that 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

Accepted Answer

Deep tendon reflexes are typically increased in patients with upper motor neuron lesions due to the loss of inhibitory signals from the brain or spinal cord, leading to hyperreflexia.

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?

Accepted Answer

The amount of spasticity and abnormal synergy present is important to consider first because it may affect the accuracy and safety of manual muscle testing. In patients with significant spasticity or abnormal synergy, manual muscle testing may not accurately reflect true muscle strength and may also induce involuntary movements or spasms. Therefore, the therapist should assess spasticity and abnormal synergy before deciding if manual muscle testing is appropriate.

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?

Accepted Answer

The therapist is assessing alternating attention, as the task requires the patient to switch between adding and subtracting pairs of numbers. Selective attention involves focusing on one stimuli while filtering out distractions, sustained attention involves maintaining focus on a task, and divided attention involves simultaneously attending to multiple tasks or stimuli.

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

Accepted Answer

Feedback control involves the monitoring of movement and correction through sensory information sent to the central nervous system. Feedforward control involves anticipating movement and preparing the body for the task, while synergistic units and coordinative structures refer to specific motor patterns and muscle activation sequences.

Question 14

Which statement best describes dynamical systems theory?

Accepted Answer

Dynamical systems theory proposes that motor control emerges from the interaction between the individual's biomechanical properties, the environment, and the specific task demands. Units of the CNS are therefore organized around these task demands, rather than in a hierarchical manner as described in option A. Option C describes the reflex model of motor control, which is not a part of the dynamical systems theory. Option D is also not accurate as there is no specific weighting of input from higher levels in determining motor response in dynamical systems theory.

Question 15

A motor program is best defined as

Accepted Answer

A motor program is a prestructured set of movement commands that define and shape the movement sequence. It is initiated by a central nervous system command and results in a specific movement or action.

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?

Accepted Answer

The patient is unable to form new memories (such as the names of the nurse and therapist or the reason for being in the hospital) but can recall past information (like the names of best friends and high school), which is characteristic of 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

Accepted Answer

Divided attention refers to the ability to process two or more responses or react to two or more different demands simultaneously. In this scenario, the patient is walking (a physical task) and talking (a cognitive task) at the same time, which exemplifies divided attention.

Question 18

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

Accepted Answer

Self-assessment questionnaires are preferred when examining a patient's fatigability because they allow the patient to report their own experiences of fatigue, which can be more accurate than relying on observations or tests.

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?

Accepted Answer

The lack of resistance to passive movement and hyperextension of the elbow are indicative of flaccidity in the right upper extremity.

Question 20

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

Accepted Answer

Increased resistance to passive stretch is indicative of hypertonia (increased muscle tone), which should be documented to accurately reflect the patient's condition. Option B (hypotonia) is incorrect because it refers to decreased muscle tone, which is not indicated by the patient's increased resistance to passive stretch. Option C (dystonia) is also incorrect because it refers to a neurological condition characterized by involuntary muscle contractions and abnormal posture, which is not indicated by this specific finding. Option D (normal tone) is incorrect because it does not reflect the patient's increased resistance to passive stretch.

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