Free NPTE Flashcards by Content Area

Supraspinatus, infraspinatus, teres minor and subscapularis (SITS).

Subscapularis inserts on the lesser tubercle; the other three insert on the greater tubercle. Together they hold the humeral head centered in the glenoid. Supraspinatus is the tendon most often involved in impingement and tears.

Convex surface moving on a concave surface: glide opposite to the bone's movement. Concave surface moving on a convex surface: glide in the same direction.

Shoulder abduction: the convex humeral head rolls up and glides down, so an inferior glide helps restore abduction. Open-chain knee extension: the concave tibia glides anteriorly, the same direction as the movement.

External rotation is most limited, then abduction, then internal rotation (ER > ABD > IR).

This is Cyriax's capsular pattern. A proportional loss in this order suggests the joint capsule is involved, as in adhesive capsulitis. A painful arc with little capsular restriction points more toward subacromial pain.

Saddle anesthesia, bowel or bladder dysfunction (often urinary retention), and bilateral leg pain, numbness or weakness.

Cauda equina syndrome is a medical emergency. Stop the session and refer for emergency evaluation. The most common cause is a large central lumbar disc herniation.

The radial nerve, most often at the spiral groove of the humerus ("Saturday night palsy") or in the axilla from crutches that bear weight there.

The radial nerve supplies the wrist and finger extensors, so injury leaves the patient unable to extend the wrist. Sensory loss is typically over the back of the hand near the first web space. Teach crutch users to bear weight through the hands, not the axillae.

The common fibular (peroneal) nerve.

It winds around the fibular neck, where leg crossing, tight casts or a fibular fracture can compress it. It supplies the ankle dorsiflexors and evertors. To clear the toes in swing, the patient lifts the hip and knee higher than normal: a steppage gait.

About 60% stance and 40% swing at normal walking speed.

Each cycle has two periods of double-limb support, roughly 10% each. As walking speed increases, double support shortens; in running it disappears and is replaced by a flight phase.

UMN: spasticity, hyperreflexia, positive Babinski, clonus. LMN: flaccidity, hyporeflexia, fasciculations, marked atrophy.

UMN lesions lie above the anterior horn cell, in the brain or the spinal cord's descending tracts. LMN lesions involve the anterior horn cell, nerve root or peripheral nerve.

Spasticity. Rigidity is not velocity-dependent.

Spasticity (a UMN sign) increases with faster passive stretch and may give way suddenly, the clasp-knife response. Rigidity, typical of Parkinson disease, resists movement evenly through the range at any speed: lead-pipe, or cogwheel when tremor is superimposed.

Fine touch, vibration and conscious proprioception. They cross in the medulla.

Because they don't cross until the medulla, a spinal cord lesion causes loss on the same side, below the level of the lesion. The spinothalamic tract (pain and temperature) crosses near where it enters the cord, which is why a hemisection (Brown-Séquard) causes loss of pain and temperature on the opposite side.

Cognitive, associative and autonomous.

Cognitive: the learner is working out what to do, performance is variable and more feedback helps. Associative: movements become more consistent and the learner refines the skill. Autonomous: the skill needs little attention, so it can be done alongside another task, and feedback can be reduced.

Severe 3–8, moderate 9–12, mild 13–15.

The GCS adds eye opening (1–4), verbal response (1–5) and motor response (1–6), so totals range from 3 to 15.

About 1 mm per day, roughly an inch a month.

Expected recovery time depends mainly on the distance from the injury to the muscle. This applies when axons have been lost; a conduction block without axon loss (neurapraxia) can recover much faster.

Heart rate × systolic blood pressure. It's an indirect measure of myocardial oxygen demand.

In a patient with stable angina, symptoms tend to appear at a similar RPP each time, so exercise can be kept below that threshold.

Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, crackles and pulmonary edema.

Think "Left = Lungs": fluid backs up into the pulmonary circulation. Right-sided failure backs fluid into the systemic veins instead, causing peripheral edema, jugular venous distension and weight gain.

A reduced FEV1/FVC ratio (below 0.70 under commonly used criteria) indicates obstruction. In restriction, FEV1 and FVC fall together, so the ratio is normal or high; a reduced total lung capacity confirms it.

Obstructive: COPD, asthma, bronchiectasis, cystic fibrosis. Restrictive: pulmonary fibrosis, chest wall deformity, neuromuscular weakness, obesity. A low FVC alone isn't enough to call restriction, because air trapping in COPD can lower it too.

C3–C5 ("C3, 4, 5 keeps the diaphragm alive"). A complete injury at C3 or above leaves little or no diaphragm function, so long-term ventilatory support is needed.

At C4 some diaphragm function usually remains and many patients can be weaned from the ventilator. From C5 down the diaphragm works, but loss of intercostal and abdominal muscles still weakens the cough and reduces vital capacity.

About 1:2 or longer: breathe in through the nose, then out gently through pursed lips for at least twice as long.

The back-pressure from pursed lips helps keep small airways open during exhalation. That reduces air trapping, slows the breathing rate and can improve oxygen saturation. It's most useful in obstructive disease such as COPD, especially during exertion.

Red = granulation tissue (healthy). Yellow = slough. Black = eschar (necrotic tissue).

In the red-yellow-black system, yellow and black tissue is nonviable and usually needs debridement. The main exception is stable, dry eschar on an ischemic heel, which is generally left intact.

The Lund-Browder chart.

A child's head is a much larger share of body surface than an adult's, and the legs a smaller share, and these proportions change with age. The Lund-Browder chart adjusts for age; the Rule of Nines is built for adults. For small scattered burns, the patient's palm and fingers cover about 1% of body surface.

The ring concentrates pressure around its edge, which can reduce blood flow to the tissue it's meant to protect.

Pressure injury prevention guidelines advise against ring or donut devices. Use pressure-redistributing cushions and support surfaces (foam, gel or air) with regular repositioning instead.

Use a 30-degree lateral tilt, not full 90-degree side-lying.

A 30-degree tilt, supported with pillows or wedges, keeps weight off both the sacrum and the greater trochanter. Keep the head of the bed at 30 degrees or lower when possible to limit sacral shear, and float the heels with a pillow under the calves.

Try to pinch and lift a fold of skin at the base of the second toe (or finger). If you can't, the sign is positive and suggests lymphedema.

A positive sign reflects thickened, fibrotic skin, so it tends to appear once lymphedema is established. It's often negative early on, so a negative result doesn't rule lymphedema out.

Manual lymphatic drainage, compression (bandaging, then garments), exercise and skin care.

CDT has two phases. The intensive phase uses frequent treatment with multilayer short-stretch bandaging. In the maintenance phase, the patient manages the limb with compression garments, exercise, skin care and often self-drainage.

Short-stretch bandages give low pressure at rest and high pressure when muscles contract against them. Long-stretch (elastic) bandages keep pressure high at rest.

The rise in working pressure helps the muscle pump move lymph, and the low resting pressure makes short-stretch bandages tolerable for most of the day and night during the intensive phase of CDT.

If blood glucose is below 70 mg/dL, give 15 g of fast-acting carbohydrate (such as 4 oz of juice or glucose tablets), wait 15 minutes and recheck. Repeat if it's still below 70.

Stop exercise first. Once glucose is back in range, a snack or meal helps prevent another drop. If the patient can't swallow safely or becomes unresponsive, call emergency services and don't give anything by mouth.

6.5% or higher. It reflects average blood glucose over roughly the previous 2–3 months.

Under American Diabetes Association criteria, below 5.7% is normal, 5.7–6.4% is prediabetes and 6.5% or higher is diabetes (usually confirmed with a repeat test). Because it reflects long-term control, not today's level, still check blood glucose before exercise.

A T-score compares bone density with a healthy young adult; a Z-score compares it with people of the same age and sex.

In postmenopausal women and men 50 and over, a T-score of −2.5 or lower indicates osteoporosis, and −1.0 to −2.5 indicates low bone mass (osteopenia). Z-scores are used for premenopausal women, younger men and children; −2.0 or lower is below the expected range for age.

Left side-lying with the head of the bed raised. Lying flat or on the right side tends to worsen reflux.

In left side-lying the stomach sits below the esophagus, which keeps gastric contents away from the lower esophageal sphincter. Chest pain that comes with exertion and eases with rest should be treated as possibly cardiac, not assumed to be reflux.

Urge incontinence (overactive bladder).

Urge incontinence comes from involuntary bladder contractions, often triggered by cues like a key in the door or running water. PT includes bladder training and urge suppression: stop, do several quick pelvic floor contractions, wait for the urge to pass, then walk calmly to the toilet. Leakage with a cough or sneeze is stress incontinence.

Functional incontinence: the bladder works, but mobility or cognitive limits prevent timely toileting.

Management targets the barriers: prompted or scheduled toileting, a bedside commode, a clear path and clothing that's easy to remove. Pelvic floor training isn't the main answer when the bladder itself is working normally.

RA: symmetric, affects MCP, PIP and wrist joints, spares the DIP joints, with morning stiffness of an hour or more and systemic features. OA: often asymmetric, affects DIP, PIP, thumb CMC and weight-bearing joints, with brief morning stiffness.

Heberden's (DIP) and Bouchard's (PIP) nodes point to OA; swan-neck and boutonnière deformities, fatigue and rheumatoid nodules point to RA. In RA, consider upper cervical (C1–C2) instability before cervical manual therapy.

Airborne precautions: a fit-tested N95 respirator (not a surgical mask) and an airborne infection isolation (negative-pressure) room.

CDC's transmission-based precautions: contact (gown and gloves; for example C. difficile, MRSA), droplet (surgical mask; for example influenza, pertussis) and airborne (N95 and isolation room; for example TB, measles, chickenpox).

C. difficile forms spores that alcohol doesn't kill; handwashing physically removes them.

Use contact precautions (gown and gloves), dedicate equipment where possible, and clean surfaces with a disinfectant that kills spores, such as a bleach-based product.

Seat width: widest part of the hips + 2 in. Seat depth: back of buttock to popliteal fossa − 2 in. Seat height: heel to popliteal fossa + 2 in (for footrest clearance). Back height: seat to axilla − 4 in.

A seat that's too wide makes the wheels hard to reach and gives poor lateral support; too narrow puts pressure on the hips. Too deep presses behind the knee and encourages slouching; too shallow puts more weight on the ischial tuberosities.

Use 3 MHz for superficial tissue (roughly 1–2 cm deep) and 1 MHz for deeper tissue (up to about 5 cm).

At the same intensity, 3 MHz heats tissue about three times faster than 1 MHz, so the treatment time needed is roughly a third as long.

Inductive (drum or cable) electrodes heat water-rich tissue such as muscle more. Capacitive (plate) electrodes heat fat and superficial tissue more.

An inductive electrode creates a magnetic field that induces eddy currents, which flow best in tissue with high water content. A capacitive electrode places the patient in an electric field between plates, which heats high-resistance tissue such as fat more.

A ground fault circuit interrupter (GFCI).

A GFCI cuts power within a fraction of a second if current leaks to ground, reducing the risk of electric shock around water. If a whirlpool isn't on a GFCI-protected circuit, don't use it and report it.

No. The minimum necessary standard doesn't apply to disclosures to a health care provider for treatment.

It does generally apply to uses and disclosures for payment and health care operations. Facility policies may still limit what staff can access.

LR+ = sensitivity ÷ (1 − specificity); above 10 strongly rules in. LR− = (1 − sensitivity) ÷ specificity; below 0.1 strongly rules out.

An LR+ of 5–10 or an LR− of 0.1–0.2 gives a moderate shift in probability, and values near 1 barely change it. Unlike predictive values, likelihood ratios don't depend on how common the condition is.