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‫بسم اهلل الرحمن الرحيم‬
‫اللهم إغفر لمن جمع هذه المعلومات و أعان إخوانه و جميع المسلمين‬
‫أضع بين يديك أخي هذا العمل و هو عبارة عن ملخص مركز جداُ و أنصحك أن تراجعه قبل إمتحانك بفترة كافية‬
‫و فقنا اهلل و إياكم‬
‫وصلى اهلل و سلم على رسوله الكريم‬

Grading of stretch reflexes upon tapping muscle tendon
Grade

Response

Significance

0

no response

always abnormal

1+

slight but definitely present response

may or may not be normal

2+

brisk response

normal

3+

very brisk response

may or may not be normal

4+

clonus

always abnormal

Stretch reflexes


Biceps reflex C5/C6

Triceps reflex C7/C8



Brachioradialis reflex C6

Extensor digitorum reflex C6/C7



Patellar reflex L4-L2 (knee-jerk)

Hamstrings reflex L5-S1



Ankle jerk reflex-Achilles S1/S2

Plantar reflex L5-S2





Abdominal reflex
upper T8-T10
lower T10- T12

Dermatome and myotome

Level of lesions and movement

1
...
The
current test assesses the strength of the long toe extensors
...
L2
B
...
L4
D
...


When using TENS to help modulate pain, one electrode is placed on the posteromedial
thigh and another on the posterolateral calf
...
L2
B
...
S2
D
...


progressive neurodegenerative disease that affects nerve
cells in the brain and the spinal cord
...
"A" means no
...
"

You have assessed the deep tendon reflexes of a patient recently diagnosed with
amyotrophic lateral sclerosis
...
Your interpretation is
that the reflexes are:
A
...
normal on the left and exaggerated on the right
C
...
exaggerated on both sides

A patient with a transverse spinal cord injury has total lack of hip flexion, abduction and knee
extension
...
T12/L1
F
...
L3/L4
H
...

And lateral rotation
a- Frozen shoulder ( adhesive capsulitis)
b- Supra spinatus tendenitis
c- Rotator cuff tears

d- Acromioclavicular dysfunction
In radiating energy when we use it 30 inch from the patient then change it to 15 inch so there
will be Radiating energy will become 4 times
Which gland regulate the growth of bones




thyroid gland
Anterior pituitary gland
Adrenal Glands

Anterior pituitary gland – increases the rate of mitosis of chondrocytes and osteoblasts, and
increases the rate of protein synthesis (collagen, cartilage matrix, and enzymes for cartilage and
bone formation)
**At the beginning of the muscle activity which make increase of blood supply to the muscles
Sympathetic adrenergic
Fracture dislocation L4-L5 will result in Flaccid Paraplegia
Which of the following muscles can perform shoulder extension, internal rotation and
adduction? Latissimus Dorsi ----- ms for swimming

Gait cycle and Gait Analysis
60% stance phase (40% single leg support -20% double leg support)
40% swing phase

Muscles activities and action during Gait cycle

With age the gait Cycle is distributed
Stance phase increased above 60% ---double support increased more than 20% to improve
balance and prevent fall down
Swing phase decreased below 40%
The question may come in different ways like
Elderly person 65 year of age during his gait, the therapist will note:
Swing phase is less than 40%

Common Abnormal and pathological gait pattern
Antalgic :- A protective gait pattern where the involved step lenth is decreased in order to avoit
weight bearing on the involved side usually secondary to pain
...
There is usually a wide
base of support and movements are exaggerated
...

Double Step :-A gait pattern in which alternate steps of a different length or at a different rate
...

Festinating :-A gait pattern where a patient walks on toes as though pushed
...

Hemiplegic :-A gait pattern in which patient abduct the paralyzed limb, swing it around, and
bring it forward so the foot comes to the ground in front of them
...

Scissor :-A gain pattern in which the legs cross mid-line upon advancement
...
Commonly seen in spastic paraplegia
...
The foot will slap at initial contact
with the ground secondary to decreased control
...

Trendelenburg :-A gait pattern that denotes gluteus medius weakness; excessive lateral trunk
flexion and weight shifting over the stance leg
...

Common questions about gait are
1-patient with long below knee prosthesis his gait ------------- vaulting
Patient with above knee prosthesis his gait --- circumduction
...
It targets strength building and muscular endurance
...
Spinal cord
c
...
Brainstem
d
...
The therapist estimates that T2 is the involved vertebra because he or
she notes that it is at the approximate level of the
E
...
superior angle of the scapula
G
...
xiphoid process of the sternum

During a voluntary movement, the Golgi tendon organ provides the central nervous system with
information about
a
...
The velocity of the movement
c
...
The tension developed by the muscle being moved
e
...

Golgi tendon organs slowly adapting Changes in muscle tension
Muscle spindles rapidly adapting Changes in muscle length

Repetitive stimulation of a skeletal muscle fiber will cause an increase in contractile strength
because repetitive stimulation causes an increase in
a
...
The concentration of calcium in the myoplasm
c
...
The number of muscle myofibrils generating tension
e
...
Large muscle fibers are recruited before small muscle fibers
b
...
Weak muscle fibers are recruited before strong muscle fibers
d
...
Anaerobic fibers are recruited before aerobic fibers
Tapping the patella tendon elicits a reflex contraction of the quadriceps
muscle
...
The Ib afferents from the Golgi tendon organ increase their rate of firing
b
...
The alpha motoneurons innervating the extrafusal muscle fibers decrease their
rate of firing
d
...
The alpha motoneurons to the antagonistic muscles increase their rate of firing
You are treating a 54 year-old woman for degenerative arthritis of the left knee
...
In this case, you should consider
that this patient might be more susceptible to:
A
...
osteoporosis

C
...
weight gain

Levers work to create movement in the human body
A first-class lever has the axis (fulcrum) located between the weight (resistance) and the force
(figure 1
...
An example of a first-class lever is a pair of pliers or scissors
...
One example is the joint between the head and the first vertebra (the
atlantooccipital joint) (figure 1
...
The weight (resistance) is the head; the axis is the joint, and
the muscular action (force) come from any of the posterior muscles attaching to the skull, such as
the trapezius
...
22a)
...
In the human body, an example of a second-class lever is found in the lower leg when
someone stands on tiptoes (figure 1
...
The axis is formed by the metatarsophalangeal joints,
the resistance is the weight of the body, and the force is applied to the calcaneus bone (heel) by
the gastrocnemius and soleus muscles through the Achilles tendon
...
23a)
...
The axis is the end of the handle where the person grips with one
hand
...
At
the other end of the shovel (the bed), a resistance (weight) is present
...
23b)
...
The resistance (weight) is the forearm,
wrist, and hand
...


The answer is C

The answer is D

The answer is C

The answer is B

The answer is D

The answer is C

The answer is D

2
...
To administer this treatment using the acetate ion, the current
characteristics and polarity should be:
A
...
monophasic twin peaked pulses using the negative pole
C
...
continuous monophasic using the negative pole

Sometimes the answer used the name of pole so Remember Anode is a positive pole and
Cathode is a negative pole
Acetate, Dexamethasone, Iodine, Salicylate -- Negative Charged Ions
Calcium/Magnesium, Copper, Hydrocortisone, Lidocaine -- Positive Charged Ions
acetic acid-ve diposition of cacified calceim
dexamethazone -ve anti inflammatory uses
hydrocortizone+ve anti inflammatory uses
magnesium sulphate+ve decrease spasticity

1
...
To increase elbow range of motion, joint mobilization
in the maximum loose-packed position should be performed at:
A
...
90 degrees of flexion
C
...
30 degrees of flexion

3
...
She currently jogs four days a week for
30 minutes at 70% of her age-predicted maximum heart rate
...
increasing the distance covered in the same 30 minutes
B
...
changing to interval training with maximum burst of running for 15 seconds,
followed by a 30 second rest
...

D
...


A patient with degenerative joint disease of the right hip complains of pain in the
anterior hip and groin, which is aggravated by weightbearing
...
Right gluteus medius weakness is evident during
ambulation and there is decreased tolerance of functional activities including transfers
and lower extremity dressing
...
flexion, abduction and internal rotation
B
...
extension, abduction and external rotation
D
...


When using ultrasound in treating chronic bursitis of the hip, the most benefit might
occur if the ultrasound frequency and dosage were:
A
...
5 Watts/cm2
B
...
5 Watts/cm2
C
...
5 Watts/cm2
D
...
5 Watts/cm2

5
...
The tell-tale finding is:
A
...
bamboo appearance of the spine
C
...
bilateral pars interarticularis defects

1
...
This form of aphasia is
usually characterized by:
A
...
very slow speech
C
...
impaired articulation

Other name Receptive aphasia- sensory aphasia
Fluent Aphasia: People with fluent aphasia have problems understanding spoken and written
language
...

Non-fluent Aphasia: People with non-fluent aphasia have difficulty communicating orally and
with written words
...


TO assess impact of impairments on function and to help predict patient performance within
their environment, the tool that would not be of much help is the





Get up and Go test
Romberg test
Berg balance scale
Dynamic GAIT INDEX



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