Episode 134 - Pupillary Light Reflex

A physical therapist designs a mobility training program for a patient who has a complete C6 spinal cord injury. Which of the following functional outcomes is MOST realistic for this patient to achieve independently?Option 1- Elevating the body during transfers using a press-up with locked elbowsOption 2- Propelling a manual wheelchair equipped with rim projections on level surfacesOption 3- Walking short distances in the community using knee-ankle-foot orthosesOption 4- Clearing a high curb in a manual wheelchair using a wheelie techniqueWatch the video version on our Youtube channel: https://youtu.be/OUqSqQfMnQs

physical therapist reviews the medical record of a patient who sustained a traumatic spinal cord injury. The record notes that the patient has preserved motor function for voluntary anal contraction, as well as motor function below the neurological level. More than half of the key muscles below the neurological level have a muscle grade of 3 or greater. Which American Spinal Injury Association Impairment Scale classification is MOST consistent with this presentation?Option 1- ASIA BOption 2- ASIA COption 3- ASIA DOption 4- ASIA EWatch the video version on our Youtube channel: https://youtu.be/QAg8NIlkNUQ

A physical therapist examines a patient who sustained a right hemisphere stroke. The therapist observes that the patient consistently does not eat the food on the left side of their plate and fails to look toward the left side of the room when called. Which term is MOST descriptive of this behavior?Option 1- SomatognosiaOption 2- Homonymous hemianopsiaOption 3- Unilateral neglectOption 4- Spatial disorientationWatch the video version on our Youtube channel: https://youtu.be/ITmscHb5gnU

A physical therapist performs a cranial nerve assessment on a patient who sustained a brainstem stroke. When testing the pupillary light reflex, the therapist shines a light into the patient's right eye and notes that neither pupil constricts. Shining the light into the left eye results in constriction of both pupils. Which cranial nerve is MOST likely impaired?Option 1- Left cranial nerve IIOption 2- Right cranial nerve IIOption 3- Left cranial nerve IIIOption 4- Right cranial nerve IIIWatch the video version on our Youtube channel: https://youtu.be/faniggMCglE

A physical therapist reviews the medical chart of a patient who has been taking prednisone daily for 20 months to manage an autoimmune condition. The patient presents with central adiposity, hypertension, proximal muscle weakness, and purple abdominal striae. Which of the following BEST describes the physiologic mechanism responsible for this clinical presentation?Option 1- Excess aldosterone secretionOption 2- Excess growth hormone secretionOption 3- Chronic insulin resistanceOption 4- Sustained cortisol elevationWatch the video version on our Youtube channel: https://youtu.be/ITR-vcVDWJc

A physical therapist performs an examination on a patient who sustained a hyperextension injury to the cervical spine. The patient exhibits significant motor weakness in both upper extremities, with relatively intact motor strength and sensation in the lower extremities. Which incomplete spinal cord injury syndrome is MOST consistent with this presentation?Option 1- Brown-Sequard syndromeOption 2- Central cord syndromeOption 3- Anterior cord syndromeOption 4- Cauda equina syndromeWatch the video version on our Youtube channel: https://youtu.be/tUCVXNqwTqE

A physical therapist is selecting an ankle-foot orthosis for a patient status post stroke who exhibits severe knee hyperextension - also known as genu recurvatum - during the midstance phase of gait. Which of the following orthotic modifications is MOST appropriate to address this issue?Option 1- Setting the ankle-foot orthosis in 5 degrees of plantarflexionOption 2- Setting the ankle-foot orthosis in 5 degrees of dorsiflexionOption 3- Allowing free dorsiflexion and free plantarflexionOption 4- Utilizing a posterior leaf spring ankle-foot orthosisWatch the video version on our Youtube channel: https://youtu.be/YO2niKtRjnY

A physical therapist monitors a patient with a T2 spinal cord injury who is participating in a sitting tolerance activity. The patient suddenly becomes restless and the physical therapist notices a marked elevation in blood pressure alongside profuse sweating on the patient's face and neck. Which of the following conditions is the MOST likely explanation for the patient's clinical presentation?Option 1- Autonomic dysreflexia secondary to a blocked urinary drainage systemOption 2- Orthostatic hypotension secondary to prolonged upright positioningOption 3- Pulmonary embolism secondary to deep vein thrombosisOption 4- Spinal shock secondary to an acute inflammatory responseWatch the video version on our Youtube channel: https://youtu.be/JlkKNAnasbk

A physical therapist reviews the medical record of a patient who was recently diagnosed with multiple sclerosis. Which of the following clinical findings is MOST likely to be documented during the initial physical therapy examination?Option 1- Asymmetrical resting tremor that decreases with voluntary movementOption 2- Bilateral visual disturbances accompanied by a delayed pupillary light reflexOption 3- Progressive symmetrical distal muscle weakness and diminished deep tendon reflexesOption 4- Significant cogwheel rigidity during passive upper extremity range of motionWatch the video version on our Youtube channel: https://youtu.be/_QL2qjLhkP0

A physical therapist reviews the medical record of a patient who sustained a cerebrovascular accident. The documentation notes that the patient exhibits Broca's expressive aphasia. Which structural area of the brain is MOST likely affected?Option 1- Left parietal lobeOption 2- Left frontal lobeOption 3- Right parietal lobeOption 4- Right occipital lobeWatch the video version on our Youtube channel: https://youtu.be/rzXUhT1VAg0