Meeting The Physical Therapy Needs of Children 1st Edition by Susan K. Effgen - Test Bank

Meeting The Physical Therapy Needs of Children 1st Edition by Susan K. Effgen – Test Bank

 

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Sample Questions Are Posted Below

 

Chapter 5. Musculoskeletal System: Structure Function and Evaluation

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____       1.   You are doing an orthopedic evaluation on a 13-month-old child. The parents are concerned that the child isn’t walking. Select the finding that is atypical in a 13-month-old child.

A.	The child has no visible longitudinal arch in standing (flat feet).
B.	The child has a 3-degree hip flexion contracture.
C.	The child has genu valgum.
D.	The child has a straight lateral border of the foot.

 

 

____       2.   Select the factor(s) that contributes to neonatal hip instability.

A.	Synovial viscosity
B.	High neck shaft angle of inclination
C.	30 degrees of retrotorsion
D.	Spherical femoral head

 

 

____       3.   When performing the hip prone extension test, you should

A.	stabilize the pelvis prior to measuring.
B.	allow the “non-testing” foot to rest gently on the floor.
C.	position the child with one hip on the edge of the plinth and the other securely on the plinth.
D.	test both sides at the same time.

 

 

____       4.   A full-term, typically developing neonate will have which following range of motion?

A.	Limitations in hip flexion and elbow flexion and excessive plantar flexion
B.	Limitations in hip extension and elbow extension and excessive plantar flexion
C.	Limitations in plantar flexion and excessive hip flexion and elbow extension
D.	Limitations in hip extension and elbow extension and excessive dorsiflexion

 

 

____       5.   Select the correct definition(s):

A.	Antetorsion is a posterior rotation through the long axis of the femur.
B.	Retrotorsion results in a posterior rotation of the neck of the femur in relation to the acetabulum.
C.	Anteversion refers to the position of the head of the femur relative to its position in the acetabulum.
D.	Retroversion places the leg into external rotation.

 

 

____       6.   Measuring a child’s thigh-foot angle gives you an indication of the amount of

A.	twisting of the long axis of the tibia (version).
B.	hamstring limitation.
C.	genu valgum.
D.	metatarsus adductus.

 

 

____       7.   It is common to see the most significant genu valgum posture (knock-kneed) in children around __________ year(s) of age.

A.	1
B.	19
C.	4
D.	12

 

 

____       8.   After initial development, bone shape can be changed through a process called

A.	metaphysis.
B.	calcification.
C.	ossification.
D.	modeling.

 

 

____       9.   Variability in joint angle or kinematic patterns during gait is most common in

A.	young independent walkers.
B.	toddlers.
C.	adolescents.
D.	running.

 

 

____     10.   Cadence is

A.	highest in adolescence.
B.	very high in 1-year-old walkers.
C.	highest in toddlers.
D.	stable during maturation of gait.

 

 

____     11.   The clavicle, mandible, and facial and cranial flat bones develop directly in vascularized mesenchyme through a process called

A.	endochondral ossification.
B.	mesodermal outgrowth.
C.	differentiating chondroblasts.
D.	intramembranous ossification.

 

 

____     12.   The spine of a newborn infant is initially in a

A.	scolotic position.
B.	kyphotic position.
C.	straight position.
D.	lordotic position.

 

 

____     13.   The kinematics of a child’s gait are generally mature by which age?

A.	2 years
B.	4 years
C.	7 years
D.	9 years

 

 

____     14.   Reciprocal arm swing

A.	starts to emerge at age 4 years.
B.	is correlated with decreased base of support.
C.	is common with hand high guard.
D.	is common in early walkers.

 

 

True/False

Indicate whether the statement is true or false.

 

____       1.   A flexible flat foot in a typically developing 3 -year-old is a concerning finding and should be referred to an orthopedic physician for further evaluation.

 

____       2.   To estimate the amount of metatarsus adductus present, you should draw a line that bisects the child’s metatarsals and then draw a second line that is perpendicular to this line and bisects the calcaneus.

 

____       3.   A tape measure is a more accurate method to measure an actual leg length discrepancy than the block method.

 

____       4.   Cartilage provides the initial prenatal structure for the development of bone.

 

____       5.   It is typical for a 24-month old to have a hip flexion contracture of about 10 degrees.

 

 

Chapter 5. Musculoskeletal System: Structure Function and Evaluation

Answer Section

 

MULTIPLE CHOICE

 

1. ANS:   C

Rationale: Children at this age have genu valgum.

 

PTS:    1

 

2. ANS:   B

Rationale: Neonates have a high neck shaft angle of inclination. This angle reduces over time, putting the head of the femur deeper and more securely in the acetabulum.

 

PTS:    1

 

3. ANS:   A

Rationale: Stabilizing the pelvis is essential to ensure that the pelvis doesn’t rotate and give you additional false range of motion.

 

PTS:    1

 

4. ANS:   D

Rationale: Babies are born with physiological flexion, which limits hip and elbow extension. Babies are also born with more than normal dorsiflexion range and less than normal plantar flexion. These situations occur due to the compression of the fetus in the uterus.

 

PTS:    1

 

5. ANS:   C

Rationale: Version refers to the position of the head of femur relative to the acetabulum; torsion refers to a twisting of the long axis of the femur. Anteversion and retrotorsion both place the leg in external rotation. Retroversion and antetorsion place the leg in internal rotation.

 

PTS:    1

 

6. ANS:   A

Rationale: Thigh-foot angle measures the difference between the thigh and foot axis. This is an indication of tibial version.

 

PTS:    1

 

7. ANS:   C

Rationale: Knee posture starts in genu varum at birth, moves into genu valgum around age 4, and then moves into a more neutral alignment.

 

PTS:    1

 

8. ANS:   D

Rationale: After initial development, bone shape can be changed through a process called modeling, which includes bone formation and resorption.

 

PTS:    1

 

9. ANS:   A

Rationale: Variability in joint angle or kinematic patterns is the highest in the youngest independent walkers and decreases rapidly with gait maturation (Ivanenko, Dominici,&  Lacquaniti, 2007).

 

PTS:    1

 

10. ANS:   B

Rationale: Cadence is the number of steps per min. Cadence is very high in 1-year-old walkers and decreases with age; the most rapid decrease is between 1 and 2 years. It continues to decrease over time into adulthood (Sutherland et al., 1988).

 

PTS:    1

 

11. ANS:   D

Rationale: The clavicle, mandible, and facial and cranial flat bones develop directly in vascularized mesenchyme through a process called intramembranous ossification. Intramembranous ossification begins near the end of the second month of gestation. The remaining bones of the body develop through endochondral ossification, or the deposition of bone on a cartilaginous model.

 

PTS:    1

 

12. ANS:   B

Rationale: The infant’s spine is initially in a kyphotic position, but as the infant begins to hold his head up and prop on his forearms in prone position, cervical and lumbar lordosis begin to develop.

 

PTS:    1

 

13. ANS:   C

Rationale: The kinematics, or joint angles, of children mature and change over time. These changes generally mature by age 7 years (Sutherland et al., 1988).

 

PTS:    1

 

14. ANS:   B

Rationale: Sutherland (1988) indicated that by age 1 years, the arms begin to come down and reciprocal arm swing begins to emerge. By age 3 to 4 years, it is seen in all children. It has been suggested that the high guard pattern assists the child with balance and stability during upright forward locomotion. Additionally, the emergence of a reciprocal arm swing though walking experience is correlated with the decrease in the base of support, indicating improvement in balance (Ledebt, 2000).

 

PTS:    1

 

TRUE/FALSE

 

1. ANS:   F

Rationale: Children typically do not develop a visible longitudinal arch until after age 4 years.

 

PTS:    1

 

2. ANS:   F

Rationale: To estimate metatarsus adductus, you draw a line that bisects the heel and then follows the long axis of the foot.

 

PTS:    1

 

3. ANS:   T

Rationale: Studies have compared tape measure measurements to x-rays to confirm its accuracy. A study of the block method showed that accuracy was very poor.

 

PTS:    1

 

4. ANS:   T

Rationale: Cartilage provides the initial prenatal structure for bone development. Cartilage is a gel-like substance with fine collagen fibrils distributed in the gel to add tensile strength.

 

PTS:    1

 

5. ANS:   F

Rationale: In a study of 86 typical healthy infants, the hip flexion contracture diminished from a mean of 10 degrees (SD = 2.6 degrees) at 9 months to 9 degrees (SD = 4.8 degrees) at 12 months, 4 degrees (SD = 3.2 degrees) at 18 months, and 3 degrees (SD = 3.0 degrees) at 24 months (Phelps, Smith, & Hallum, 1985).

 

PTS:    1