] y THERAPYED'S ee National Physical Therapy Examination Review & Study Guide SUSAN Ee O’SULLIVAN, PT, EDD Professor sr of Physical ‘Therapy ‘School of Health and Environment University of Massachusetts Lowell Lowell, Massachusetts, RAYMOND P. SIEGELMAN, PT, DPT, MS. President eed ‘TherapyEd Evanston, Ulinois Therapyéd Evanston, linc United states et Americaofthe final hurdles for physica therapist to become lensed o practice United San socesful completion of the National Phyicl Therapy Examination (NPTE). This exam often reques candidates to combine base physical therapy Snowledge wit clinical experiene inorder to interpret, ‘autor sole problems that may ecurin linia ‘ations. In ordero prot the pul, Heesing boards use [NPTE esl asthe main resource to determine wheter & candi as demonic minimal standans ces for tae and ffesive practice ‘ace 1988, TherspyEd bas offered Examination Preparsory Courses for physical therapists, physical ‘therapist assistants, ocapational heaps and occupa tional therapy assistants. The physical therapist ed ysl heaps assis’ cous Help exam candidates ses their trengths and weaknesses vis dsvis NPTE BS soiroducion Purpose of This ook nd Softwar, sl Wat the Procedure for Obtaining a License, x How isthe NPTE Developed, 2 PTE Security Agreement,» What Areas Does the NPTECover, xc What the Procedure for Taking the Exam, 2a! Test Dates “Test aking strategies xa Reperted?, xi Panning Your Exam Reviews ‘Analysis of Strengths ad Weaknesses, xxv Level of Quentin Difficult, xx ethos of Reading Mute Choice Questions, Strategies for Answering Multiple Chlce Questions 0 Final Review, x ‘he Day Before the Ex, il ‘he Role of CricalReasonng in Your Performance, xsi subst of erial Ressonng, vel Summary of Reasoning Skis! Improving Your CrticalResoning Skil, Reasoning References, x Retakng the xara) Useful Web Links and E-Mal Addresses, x cee avi cHarreR 1 SS MSs ryt Therapy ....... Anatomy and lomechanc of te Masala system. Gener PicesfBonachan, Finer! arsoyané Boreas, 3 Pra Therapy amination, 18 ol Patel Hon (or tee, Sts Reve, 3d Tess and Messe, 18 Speci Tess ofthe Upper remy 23 Speci Ts fhe Lower Exrer 26 Spi Tess ofthe Spine, Pi, an “eprom nt, 23 sessment of Normal Gait Fatt, 31 sculoskeletal Conditions, 29 “Arle Coons, 33 Skeletal ard Sot Tsu Condos, 37 Upper Berit Dsodes, 41 Lower bxvemiy Condon. 51 Spina Condon, 60 ‘ntopsedc Sura Repas, 6 Interventions fe Palentslens with Musculoskeletal Conditions, 70 Intrenton for Pabens/herts with Acute Conditions, 70 Intention for Fenton with Chole Condon, 70 Speci erentns, 70 Manu Therapy proaches a Rehab, 73 Felerant Parmacloy 74 Frjchesocil Corsierations, 74 Radiology, 75 etesonals 75 Dagnosic Exams and Procedures, 75 ‘Append A: Cini Pratice Guidelines: Grades of Evidence, 76 ‘Append 8: Cnc! Practice Guidelines: Mena! 3nd Artiular Cartage Lesions, 77 ‘Appendix C: inal Pracce Guidelines Hip Pain and Mobility Dein. Osteoarthritis 76 Appendix D: Clinical Practie Gui Neck ain, 73-Appandic€: Clinical Practice Guidelines: Hes inlortar Fast ‘Appendix: Clinical Practice Guidelines: Knee Ugument Sprains -AppandicG Selected Medical Images for Physical Fagor: Head and Neck, 83 Fagor: Thora ard Spine, 65 Regor: Upper remy, 85 Fagor: Lower remy, 88 Advonledgmens 2 CHAPTER 2 Neuromuscular Physical ‘Therapy ....... i “Anatomy and Physiology of the Nervous Sytem, 53 rai 93 Spiral ors, 95. he Suppor Structures 96 Newons 97 Feshara Nanous Sem, $7 Spiral Lee tees, 99 Nevrotogial Examination: Hitny, Systems Review, "Tess, and Measures, 100 Fert inteew, 100, Fann evel of Consciousness, 100, ine Cognit Functen, 100 fain Speech and Communcaton, 101 amine Canal Nene, 10 rain Vil Sigs, 104 brine or CNS nection or Meningel tation 102 amin or eresedinacail resse Secondny "Cereal rand ran Heritin, 102 framing Autonomic Newous Sat Function, 102 Bain Sensory Fncton, 103 amine Perceptual Funct, 103 famine Motor uncon, 108 even Medial Record fo Diagnostic Procedures este, 312 Neurologial Dysfunction 113 Cenbeovscle Acie (tke), 114 ona, 177 egeerative Died, 123 Epo, 126 Cntr Dior, 127 rani and Petgherl Nene Doers, 129 fan 135 \ncerention for Patients wth Neurological Dyrunction, 135 Reredion FocitationItereton, 135. Mot Conteiotr Leaving Svateges, 138 ‘asespecte Wang Svateges, 141 ConpensatayTraning Aspoach, 143 93 CHAPTER 3 Cardiovascular Physical ‘Therapy .. seeees 145 ‘Anatomy and Phisiology ofthe Cardiovascular ‘system, 145 The Hear and Creation, 45 Perper Cresson, 147 Neurchumera sence, 147 erdiovalor tamination: History, Systems Review, Tests, and Mesures, 18 Physea xarniten-—Carsorasue Sete, 128 Pryce raminaton—sher! Vasc Sten, 152 Diagnose et 154| Laborato Testsand values, 158 coronary Artery Disease (CAD, 156 teres, 156 Main Cina! tees of CAD, 156 Medial and Sugcl Managenent of Candonasculr ‘iene, 157 Peripheral Vaca Disese (PVD), 158, arte Dee 158 Venove Die, 159 lymphaicDsene, 160 ordiae Rehabiltation 16¢ rare Trace eng, 160 arse esoison, 162 hase I: ngatet Cadac Rehaltation (Rete), 165 se 2 Outpatent Cardiac Reba (Gubacte, 165 hase 3 Commany ure Progra (Post cute, PostOiharge fom Paso 2 Poston), 166 fesronce GuerteTiing, 106. terse Peston for Patents Regurng Special Consceratins, 165 Basic Life Supper and Caropuimonay essctaton(CP), 168 Fest Ad, 168 Peripheral Vascular Diease Management, 17° ehabitaton Guidelines or rer Osea, 170 Aetaitaton Gees for Vious Oss, 170 eration Gadeines fr impo Disease, 171 CHAPTER 4 Pulmonary Physical Therapy . .173 Pulmonary Anatomy and Physio, 173 ony Thorn 17 Inert Stes, 173 rcs of Veriton, 174 ‘Mechanic of ating, 174 ena 174 essa, 175 ‘elon aa Ferien oad Flo 175 Conol of Veriton, 178Physical Therapy Buaminaion, 175 "ests an Measures, 178 Physical Dytunctonimgatments 179 "cite Dosa, 179 ‘Cron Otatucive Dea, 181 ‘von Restrctive Die, 182 Bronchogeni Crcroma, 183 the umonay Condens, 188 Physical Therapy intervention, 165 ‘Manual Sect Removal Technigus, 185 Independent Secretion Renova Techniques, 187 Sresthing rcs, 188 Postural Cre. 169, Actes for nomsing Fanconi, 189 Medical and Suga Menagerent of Pulmonary Disease 190 Surgal Management, 190 Medal Management. 190 Interie Care nit Managerent 191 CHAPTER 5 oa integumentary Physical Therapy... ---. ss Integumentary System, 193 Stn or ntegurent, 193, reunion 193 Cconmnen skin orders, 194 Dermat cera, 198 xctna infects. 194 Vil inections, 198 Fungal, 195 Paras tectins, 195 Inenane Dire of he Ski, 195 Sin Caner 196 ‘tin Far, 196 Examination of integumentary Integy, 197 PentvChent etry 197 ‘amination o Stn 187 ter Syste, 198 Pryscal Therapy Intervention for Impaled Integumentary integrity, 198 lteventons, 198 Burr, 198 Fethophysolony 199 Calton of un uy, 99 fun Heaieg, 200 fm Management, 200 Physical Thrapy Goal, Outcome, ad neeetons, 201 skinUleers 202 ‘Venus tle, 202 ‘aerial ew, 202 abet eee 202 “able of content +b Pressure ker (Decbis Uke, 203, jariration of Wounds, 203 Wound Care, 208 chapter 6 Other Systems: Immune, Hematological, Gastrointestinal, Genital/Reproductive, Renal and Urological, Endocrine and Metabolic... Immune Stem, 209, ‘vers, 208 ‘Acute rmunedefcienc Syeome (ADS) 270 ‘onic Fague yom 9,211 Faryaga Sone MS) 215 Inecou Dears 25 Stapfooce con 218 Seto econ, 218 eps, 216 Twtewaa Te). 216 ents fr Disease Control and Prevetion COO Stondrd Precautions 217, Standard Peas 217 Fel Teopy-eatestfeten Col 217 Hermologil Stem. 217 Oneview. 217 soem 28 Side Cel Dees, 219 fenopii 219 cance 220 ‘rei, 20 Pcl Thr Enon, 222 Pcl top Goat, Outer itererrs, 222 asvontestinal tm 223 Oren, 23 Eophons 225 Stomocn 225 inrines 225 fecum 227 entameprodctie Sytem, 227 Onl Fre Repradtie Sten, 227 Frenne Normal 227 Fearn festa Ptologes 228 Dido fe Feral epee Stem, 229 ‘Over Tele Repredutie tem, 229 Disorders ofthe Male epeducte ster, 230 eral end Urological tems 2° vee 230 iy eatin of i nde, 231 Endocine sed Metaboli Syste 235 rene of he Endocine Syst, 235 Cree fh ate Ste, 235 Dae lis 295Obesity, 238 ‘Thyroid, 239, ‘dtl Dieses, 280 Prychate Condos, 240 cat tatetvechansns, 240 Patios, 261 Get Process, 242 Death ane bing, 242 CHAPTER 7 Dediatric Physical ‘Therapy . . ..245 ‘Theo'es of Development, Motor Cont, ‘nd Motor Learning. 265 Devopment 245 | Metoe contol 285 ExiyMotr tearing, 265 Fer Sensonmoter Deeopment, 245 Pectre Examination 23%, Pert neve, 228 Prete infant Examination, 248 uke Newborn, nd Chi Eaination, 248 Cvenien of Pediatric Physical Therapyinteretion, 250 Gea, outcomes an irterenton, 250 este erapies, 250 Pedic Condition ad interventions ?51 Prematrty Phys Thetoy race, 251 rb Faby (Ch, 252 Myodplasiaspina si, 253, Brena leu ny, 258 Down Sjarame sony 2, 285, ‘weamate Brain jy, 256 Duchenne’ Muscular ystophy Peuibhypevophic Muscular Oystophy), 257 Pest Adept Eaupment, 258 Far Eo nent, andthe Eduction Seng, 258 CHAPTER @ Geriatric Physical therapy . . Foundations of Geriatric Physical Theropy, 261 {Geraal Conepts a Detntions of ging, 21 Demearaphic, Moai and Morb 261 Tears of ing, 262 Pysologcal Changes and Adapttionin the ‘der Adult, 262 Mau, 263 Stole Sst, 24 Neurol! Stem, 264 ‘sso Sse, 265, Cognition, 267 Corns System, 268 Pumonary System, 268 Ireguentay Systm, 268 “sasvoltstnal system, 269 Renal stem, 270 Pathologial Conditions Asecated with he Eider, 279 Masclseleta sores and seas, 270 Neurological Dorset and Diseases, 272 ‘Coqitve Diodes, 273 {ardiopuevonary rtegumertary Disorders nd iene, 275 etaboicPatologes, 276 Patent Care Concepts 275 ‘General rnc of Ge Rehabiliaton, 276 Fembursersent ses, 27 Esha ond tepals, 277 ‘Common Problem Areas for Geri Cents, 778 rei Osby, 278 Fat ane aii, 278 eden Eos, 279 Naor Drie, 260, CHAPTER ‘Therapeutic Exercise Foundations -...... ‘rang Programs 283, ‘tengthTaiing 283 Endurance Toning, 297 Mobiy and ext Ting, 290 stra Staining, 292 Cardnaon and Balance Taiing, 294 esation traning, 296 Aquatic execs, 297 CHAPTER 10 ‘Therapeutic Modalities .. Pica Agents, 29 ‘Supra Themosheroy, 299 Croterpy, 903 ‘Acoust Padan: Utsasound (9,305 Mechanical Agents and Massage 38 Mecha Sina action tent Tato) 308 Item Mechanical Conpresion 303 Continous Psive Won CP, 310 ‘ial, 310 Nassoge, 311 teal Agents 312 ase Concpt of Nan nd Mac Pysclogy 312 tera tution, 314 lemtophre 316 “Tansetaneots Becca Nee Simulation TENS), 317 ih tage Pe Gahan tintin 313 Concept of Meu Feuer ier in 5,319 futon Cre, 320 inerrental Curent OF), 320 Foncional eS), 321 Eecromrapic Bseecback EMG Bofeebac) 322 299CHAPTER 11 Functional raining, Equipment, and Devices ..... 325 att 225 Phases ofthe Gat Cc, 325 emeron Gal Deion: Stance Phase, 327 men Gat Devos: Sng Phase, 328 Ambolatory Ais 278 ‘cones 328 riots, 28 Wales, 329 Barat Equipment, 329, Gat Paver Un of eve Desc, 329 Guang, 330 Loconator alg, 30 ortho 390 ‘General Concepts, 330 Lower Otoses Componentserminsiogy 330 Spinal runt) Ontos: ComporentsTemialogy 335, Uppertinb Onoses Companentyeminalogy 336 Physica Therapy Iteventn, 334 Adhesive Taping, 35 General Concepts 335 Prosthetics, 335 “General Concepts, 26 Lowering eshet: Deves Us), 337 Uppertin Preset Dvces (UNS, 338 Pryscal Therapy ntevetin, 339 wheelchairs 382 ‘Components 342 \eeioe Mesures, 344 Weeks Taning 345 “ansteraining, 146 Dependent Taste, 345 Dsssted ares, 346 ‘ing, 346 Environmental Considerations 347 Envnmentl Modfcaton, 387 Append 8 Ergonomics, 248, fale ofthe Phys Terapia Oeaupatonal Hes, 389 funcional Capacty Balution FE), 349 irk Conditoning and Work Hardening Progam, 350, ‘Manual Matra Handing a fing nts, 350, Gaidetnes or Seated Wer, 351 Upper Exrerity Work elt Musculoskeletal Osa ‘vis, 351 CHAPTER 12 Professional Roles & Management . Instone! Types 353 act Enuronment, 353 ‘ta Unites States HeattrCare System, 255, ‘rganaaton, 355 1Wble of Contents xt emus Tia Payers for Heat Care ‘serves, 356 Detesble ocunentaten, 358 Element of Paterlet Management 2 Management & Legal isues, 362, Huron Resources 362 Fiscal Managenent 367 Quality Asurance ad Quay Improvement, 367 Profesional Standart, 268 aregie Dettns ana oles, 366. Patent Right, Safety and Mabpoctce, 372 Arpondix& Code of Ethie 375 ‘Agpendi< 8: Guide for Professional Cond, 27E ‘Azpendix Guide for Conduct ofthe Physical “Therapist Asstant, 385 ‘Aspendh D: Standards of Practice for Pha ‘Therapy, 285 ‘spend: Outcome Mestures Orgarized by ‘the international Clarifiston of Funcioning, Disability, and Health (CF) Categorie, 18 CHAPTER 13 ‘Teaching & Learning ...... ..395 Pryscal Merapst Roles and Responibitiy, 395 Patera elated rstucion, 395 aucatoal Pogians, 395 Cnet acaton of tents, 395 dxationa Theory, 396 Learn Stes, 396 Learing Testis, 396 Behavioral jects tem the Eaucatonl Domai, 397 ston Proce, 398 ‘evertons Me, 400 Meter arming, 201 ase of Mt esning, 40 Motor tearing ttn, 401 Motor earning Strategies, 401 CHAPTER 14 Research & Evidence Based Practice ........ 403 Physical Therapist Roles and Responses, 403 hycal Tarps Ue dence Bed Pratce (een aos Pye Terapits Conduct Research ny Clea and ‘adem etn 403 Physi Therap incorporate Rew Ewdene into Precis, 4 Research Design, 405, thos, 405 arises, 406 hypothe, 406 aa oes. 405 er atlInked Consent, 407 Probes Rete to Mesisement 407 aluating the Evidence: Levels of Evidence and “Grades of Recommendation, $08 Detntns 09 Levels of Evidence, 409 Data Araysis and interpretation, 410 Desciptve statis, 10 a Compute Siulted Examinations 415 (Guetone wy Teaching Pots, 472 Eraminiton 38 rmination 8,526 Examination Ce oferences, 763 Inde, 757Contributors “Thomas Bianco, PT, MSPT President ‘Sensi Ergonomic Slutons ‘Wilbraham, Mastachaets Suzanne Kobben Brown, PT, MPH “Associate Profesor an Director School of Physical Therapy ‘Touro University Nevado Henersa, Neva John Carlos, PT, PRD Professor ‘Deparment of Physical Therapy and Asocate Ditto Behavioral Sciences Coordinator Andrews Unversity Benin Springs, Michigan Sean Collins. PT, ScD. CCS ‘Associate Profesor and Chair Deparment of Paysical Therapy School of Health and Exon Univensiy of Massachosets, Lavell Lowel Massacsews Gerard J. Dybel, PT, ScD, GCS Associ Professor Department of Physical Thecapy ‘School of Health nd Boiron Univesity of Massachsens, Lovell Lowell, Masachasets William Farina, PT, DPT, MBA, FACHE Vice President for Rehabilttioe Services Radius Management Services ‘Framingham, Massachusets Rita P.Feming-Castaldy, PhD, OTL, FAOTA “Asociat Profestor ‘Occupational Therapy Program Univesity of Seratoe ‘Sern, Penny Kari Inda, OTR, PAD Profesioal Entry Program Dirtor Professor (Occupational Therapy Deparment Mount Mary College Miwaukee, Wisconsin Department of Physical Therapy ‘School of Health nd Eavironment Universy of Massachusetts, Lovell Lowel, Massachorete LL Vincent Lepak I, PT, DPT, MPH, CWS Assistant Profesor Division of Rehabilitation Sciences Universi of Oklahoma Heald Sciences Center Tulse, Okthome Eizabeth Oakley, PY, DHSc, MSPT sone Profesor Department of Physical Teri ‘Anitews Univesity Berrien Springs, Michigan Rohert Rowe, PT, DMT, MHS, FAAOMPT Residency Fellowship Progam Manager Brooks Healh Systems Jacksonville, ide Julie Ann Start, DPT, MS, CCS (linia Associate Professor Pysial Therapy Program Deparment of Rehabilitation Sciences ‘Sargat College of Health and Rehabilitation Sciences Beton Universy Bouton, MassachusettsAcknowledgements = | : Al Beringer Publishing Services (Chery Hil. New Jersey Harjeet singh ead: US Operations Spearhead Gro Bear, Delaware Surinder Sharma ‘Accounts Manager Speaead Groop Beat Delaware Kathleen McCullough Copyeite Philadelphia, Pennsylvania ‘Ruth Ann Cassidy President nd Creative Distr Zowrahis. Ine Roseville, California Laura Girardeau Copyeitor Pullmae, Washington Shannon Gleason Copyeitoe Polina, Wasiagtnof This Book and S he National Physical Pherapy Examination Revie Sy Guide designed elp phy therapst anda prepare forthe Nao] Pal Ther "Examination (NPTE). Each chapter is resented in am cay-o-ead outline Fost Specific chaps focus on musculoskeletal, neuromusula, cudiovascla, pul- monary nteumentary, psychological, and ote aspects of Phical therapy practice. Relevant anatomy, inesilogy, nd pathopbysology of different agnostic cegores ae ‘willy reviewed. Isporant medical pharmacooical, and sgl interventions are also etifed. Each chapter vis he element of physica therapy practice iactuling: ‘examination, evaluation of data, determination ofan ap ropa dignoss, prognosis, plan of er, inerventons, Sd recaluton of merventions selected, Aaliona hap ‘es foes on the profesional roles sumed bythe phys cal therapist consultant, admiiseator, edsaton, and ‘escarcher, Chaps on pediatrics, gules, herpetic erste research and evidence-based practic, physics] gets, and fonctions devices are ao include is ital for andes o master the element of phys teal therapy pace inorder to apply the lfceration © Clinical situations This ook was developed to ep you ot. tanize and focus you review eficealy ad fective Homever, you may let o pare a mor indepth review ‘of topics, tems, or proedes by selesng Wo recor mnended referents “The paccevexam software wil help you sess your ‘understanding of parcular content reas and our ability to “pp thi owe to real-world sitions. The practice ‘ram format simulates the atal NPTE fora, with {ueton counter and ranning clock onthe top ofthe een {Seip you Keep tack of your progress. Te solar ls allows you © go back o questions you would ket ‘Niew, When you ae iio, the computer program wil Introduction RAYMOND P. SIEGELMAN snalyze yours and provide eedback oly you oss ‘om area for ado sy ‘AT the bick of the text are the question explanations long with ital reasoning rationales o Bp You under. stand how the answers were derived. Reading and intr rein hese pace questions wl aso help prepare you forthe varios forms of muliple-hoie questions you may ‘encounter onthe tual NPTE Wis important to aot that although he practice wet are designed to help you dagrose the rtengths and weake ‘nesses of your teademic and clinical preparation, they ‘should not bused to measure minimal en-leve compe: tency preit your Sore onthe NPTE. Licensure of heakticare practioner protects the public ‘rom unsafe practices Inthe U.S. ait eres, all physical thers requ aTicense to practice. Lsesure Teafncton tito terterilgovermeat pte fed cal goverment. Isboul be noted that pial Heaps mpoyees of he federal goverment are exempt fe state regulation. However, vai licens inset on ate oF oristicion susualy require by federal employes, such ‘the mia or Pubic Health Service Al jrsdesons require candidates to compte the [PTE succesilly o obtain a license, but becase he USS. inmade yp of oumeous sae and goveming ents, ach state may have dfferet requirements for ou to become eligibiew ake the NPTE.Difleent sts ay also he ferent practice estctions after you have passed the NPTE, The eiremens can even die win the same sat, sxrdag to wheter you graduate fom apo ram accredied by the Commision on Accedittion in Physical Thtapy Education (CAPTE. The CAPTE no longer accreds baccalaureate degree programs. a the act del ntroduction United Sates, all candies must have grade fom an ety lee masters or dotral program oan equivalent in ‘ematonal propa Each as tas sovereign over pb feathery ces and regulation, Conta he nid ‘easing Board in your jursaiction wo obtain applications infomation about requirements and prcedies, Jurisprudence Examination Some sts requis caidas to pas separate examine tion conering the rls, regulations, nd Tavs governing pyscal therapy practice in ht sate, Licensed tops ‘sho wie tobi note icense when moving another Ste may have to pasa jarsrdence examination i quid by that sate. The Federation of State Boards of Physical Therapy (FSBPT) amines some, bt not al, Jurspuience exams. Fees Al tates require a fe to apply for and renew iene. ‘Thece se separate fees oi forthe NPTE. Fees vary widely nd can change yearly, Special Accommodation 1, Candidates with documented curent disbiiis can ‘spp to tei jriadicton fr epecil accommodation arog the NPTE. 2. Medial or belt condtons that ay ceuieasnack, water mediation, visual ads, a reader, extra ime, Whelcair placement and 30 on tay be considered. Pregnancy without complications sot consiered ads abit by he ADA. 4. English as second language isnot considered dis sli. No dicsonaries or eta time wil be pant 4. Test anxiety and tcbnophobia are not considered de stiles 5. Allacommodations must be approved atest 15 days before the exam dat 6. I spedilacemmodatio s dened he json may have an appeal proces. Other Requirements and Issues Tess of English Language Proficeney. Various tests of spon, wien, or comprehended Ens ay be equied 1 gli isnot your fist language. Standards and ‘irements ifr from state toate, Personal inerviews ‘may alsobe required AIDS Avareness Trening. Some sates reopre AIDS arenes waning fo cease Fingerprinting, FBI Check, Vaccination, Malpractice In- surance. One oe mote of ese may be rquted by some jst CCredenits Evaluation. Curenty, most stats requie physical therapist edocated otside ofthe United States who graduated rom progam nc acredied by CAPTE to Subuit twanseits and ter cede to approved agen ‘es for evluation. Credential ofe ince course con: tent cedit hous, grades cared, and degres granted. This rocesis required 1 establish eligi oak the NPTE ‘Supersed Practice Peri Some states may requ ther anit edested oud othe United Stats to undergo 4 sod of supervised pracice fer sucesflly completing ‘he NPTE. Permanent isms ist granted unl his persed pacice period is successfuly completed. Temporary License. Some sts rant temporary license ‘tw candies lige wo tke the NPTE This epoca I= cease allows the indivi to practice under the supe ‘om of icensed therapist before aking and psig the [NPTE, In some states, this temporary eens may bere oked if candidate fs the NPTE. As of 201, on ve Sates extend this tempor Horas ithe candidate applies ‘oretke the examination, In seme sates, if temporary cue nt offered, pica teapst may no pace in ‘hat state ut all regiements for censure have been st ‘sid In ote state witha temporary Hens pons, ‘Spplicane who have filed keto exam maybe slowed (o ratio under supevisi of icemsed heaps. There fort is prodet fr youto Keep caret on the rues and regulations ofthe sae()ia whic you wish o pace ‘ranser of Scores o Other Jurstictions. Al jurisdictions se the eniterion referenced grading method, which stan luis exam scoring andallows nse of passing coe. ‘The Federation of State Boards of Physical Theapy (FSBPT) is eesponsible for sco uanser (hp ‘spar For fee you may waster your Scores oo tin or waloed te Soot Tranter Request Form and al ‘he completed form othe SBP. Ifyou maintain cease, you shoul not have to eke the NPTE if you move to 2 ieteat state However, you ae nicense, let your Ie ese lape, or never tok he exainatio, you wil ave 0 take the NPTE when seckagalicnse in that jurisdiction, etaking the Ecemination. Cannes may take the NPTE exam upto thee times per I-meonth period, which isthe limi stby the FSBPT. cane never takes the same form of an exam be ors had peviouly taken. Some states allow only three opporunites to ake the NPTE in teva you fil the tate ay poe tpi that you ‘ow’ erdeace of remedil work or sty before retaking the NPTE, The state lcesire board hasan obligation to protect the public fiom pacttoners who donot demon- rate competency. “License Removal. Str | 2,03 yeas, iense must be reoeed fora pial heaps oconinve practicing. Re eval notes eset ouby he tte a etry in Which the therapist is pratcing Sometimes, renewal ply i= volves paying the fee and etuning te form. However, Some sates requiteverifction of continuing evcaionunis If yu fal to nti the tt of change of aes and do nt receive renewal otc, fl to espond to w= ‘eval in a timely manner, of do not meet eke requ ‘meas, your cease could lps. 1 lal 9 practice thot a ald eense. Te state mayrequie a number onions be met reinstate ape ins, One cond ti might inclde retaking the NPTE even if you ba pe ‘ously passed the exam Inform the boa of any change tsar Do note your license lapse! Continuing Education or Active Practice. Many sates = gui the physica therapist to acquis murber of oni education units (CEUs) renew alicese. Do ‘umeataon, approval. and reporting af CEU vary fom sate o sate. Some states require evidence of coming ‘sive practice to renew. The FSBPT and the Americin Physial Therap Association (APTA) ar exploring alr ive meat 0 sce continsed competeney Endorsement With aid icensein oe sate o ja ‘ion, 2 plea! teeapst may apply wo another ste fora “Ions by endorsement” All rei established by Re now tte mast be met. This an ince taking jai eace exam fr tat sate, atending interviews, proving leer of recommendation, taking Eaglsh competency cxams,atending AIDS awarenes iin, and eering (CEU Contact the icensie bond in the tte where lea se by endorsement is sought oe information and a= plications Start the proces cry; an tke oaths ped! The PSR is the organization that develop and wee (he NPTE. The exam i based on 8 srvey of pace conducted periodically by the FSBPT, fom which the “lucy forth exam s developed Nomerous lin, educators, and eters conibte questions tothe NPTE ‘Questions are designed to test knowledge and poblen= Solving skis that reflect curent cial practice and nt level competency (defined athe fist 6 months cf acice).Vaou content exper nd ciniians review he {uestons(temevewer) Pinal. th FSBPT commits {nd pyebomerican fine une the question and const the final exam blueprint The APTA oe the individ te censing boards do ot develop, oversee o di ter the NPTE ‘Each examination adheres closely tothe bogpia 9 funy and comprehensively asses candidate's compe: tea to pace. Te luerint imparts 2 degree of stat iy constenc, and contity between ferent forms cf ‘he exam. However, cach eam is unig document wis is own mix of questions. Question ar referened phys ‘cal therapy textbook common use (ist of textboks salable on fitptor), and are not eived from spells ‘eutbook or point of view. Teminoogy is content with Introduction «xb that used in the Geto Physical Therapist Pace and ‘ter commonly used et Son Security gener In part this agroumen ses that itis ‘legal an unethical 6 recall (emerize and sare NPTE ‘westons or soit questions frm candidates who have ‘ken the exam. The FSBPT wil continue to osu i viduals who violate he security agreement Sneek ‘The exam places great emphasis on ealtio, pin of ae, and interventions fo a variety of patience problems. ‘The exam aio covers opie hat are peripheral o diet po ‘ent care fen including profesional ls in seach, Sdence-hted practice, edeaton, ethical deison- aking, tivities The exam s ery comprebensive. Ease that oat reparation reflects the composition ofthe caent exam, [Natural pot every item o subtest here i covered {in each examination, The NPTE cirenty conse of 250, questions, bu only 200 questions cout fer you score. The ‘dion 0 questions ae sed by the FSBFT to check hee valid for fue use. The content oui ised on the 200 questions that are scored ‘The following lformaton hasbeen adapted from the [NPTE Content Oatline Federation of State Boards of ‘Physical Merapy (tect March 2008, Copyiht 207), "The use of eaegory und domain designations specie the practice exams andi used forthe porposes of ep ing your resus. Category A. Clinical Applications of Foundational Sciences (Pediatric and Adult: 20 Total Questions, or 4.5% of the NPTE + Anatomy and Physiology of Systems “+ Pharmacology as Related o Specie Systems 4 Bet of Activity and Exerite + Physiological Response to Eavrcamental Factors and ‘Aquat Therapy + Motor Leaming and Control + Cognition, fet, Arousal. and Memory (nexomuscolar ‘uttions oly) + Joint Strotre and Function (muscloseletd questions oo) + Normal Inerlatonships among Mulipe Sens l= tiple stem involvement questions ely) a le attn\\ a Category A: Number of Questions by System Domai ‘Cadac, Vascular, Lymphatic, and Pulmonary Saquestions Domain Mcoloskeetat questions Domain I Neuromaescola 6 qventions Domai IV. Integumentary Sqventons omsin MetbolicEndocrne 2aguestins Gassoitetial 1 gustion Genitourinary 1 question Maliple System Inclement, Saquenions Category B Examination of the Patent/Clent (Pediatric and ‘Adult: 26 Total Questions, oF 13%¢of the NPTE + Tot and Mesures and Toi Applieion + Information Called Daring Systems Review and History + Kinesiology/Kinematics (musculoskeltal and neuro: smoscuar oly) + Movemeat Analjsis (cui gai deviations, pros fhetclorbtis git deviations, thonic excursion {pulmonary only), ftom, pressure, shear, and scar ategumenary ony) + Physiological Response to Tes and Measures Category B: Number of Questions by System Domain (Casa Vascular, Lymphatic, and 4 guesions 9 questions 9 questions Suestons MetaoliEndoctine 1 uestion Gastrointestinal Dguetins Genitourinary oguestions ‘Mall System Involvement Oo qeestions Category C Foundations for Evaluation, Differential Diag- nosis, and Prognosis (Pediatric and Adult): 47 Total Questions, or 23.5% of the NPTE + Interpretation of Knowledge (egaring condition, ds ‘eases, and pathologies to ensure sae, appropriate, and ‘eetve pasealient management decisions) + iter! Digoosis + Diagostic Imaging + Medical’! Management 1 Impact of Comorbidties o Coexiing Conditions Af feaing Musple Systems + PryeharicorPyetoogial Conditions (multiple system lnvolvemect on) + Conditions or Patbologies Affecting Connective Tissue (sculoseltl ely) Category C: Number of Questions by System Domain Cath, Vol, Lymph, ad Pulmonsy 7 gestions Demin ‘Musas ro gueons Demin Neurasaar Squeions Doman, Tnegumenary Sesion Domain ‘MeabolEadocrine 3 gestions Gscinesia 2 guess Gentoaeary 2 gusions Male Sem nokemert, 1 questions Category D Interventions (Pediatric and Adult): 37 Total Questions, oF 18.58% of the NPTE + Seeton, “yes, Seeing, nd Arlcton of Appr + Pasiopal Reaponse wo nenentons + Compo or ecntay lt laevetons {Morr coal and Motor Leming (eraser ‘yam on) + Wound Management Teshigues Gaclading ‘pial eens, dnidencn, and eingsUntepientry saiy + Goorin erento Going eds, der props, sn pave or ering) Category D: Number of Questions by System Doms (Candia, Visca, Lymphatic, and Pulmonary Tqvestions Doms Moscsosklet 1H questions Dona I Newrombscule 1 questions Tetegumentry Saventions Dons, MetbolicEndccrine 2avestions Gastontesinal 1 questionesitouinary Malipi System Involvement 1 gestion Oguestions Category F Equipment, Devices, and Modalities (Pediatric ‘and Adult): 22 Total Questions, or 11% of the NPTE + Seletion and Application of Devices and Bqipment for Prsicot Management + Assistive, Suppoive, Protective, ané Adaptive Devices + Pronthesics + Ontotics + Barat Equipment and Devices * Gravy Assisted Devices (body weight super lo ‘comotoe using) + Prins of nd iftion for Therapeutic Modis * Indiestios, Preeatons, and Contindcsions for Moslity Use + Physical Ages including sound ight, hydoterapy, ‘hermodersp,coteapy, and ahermal gens) + Mechanical Motes (such as compression, tation, ‘ud mtion devices (CPM) + Becta Stimulation (including TENS, NMES, HVPC, snd FES) Category E: Number of Questions by Category Bauipment and Devices 10 questions Modalies 12 questions Category F Teaching and Learning; Research and Evidence-Based Practice; Safety, Protection, and Emergencies; Healthcare Roles: 39 Ques- tions, or 19.5% of the NPTE + Teaching and Learning Theories, Strategies, and Tesh- gues (including moat ering and opti mode of duction, fr patenetient management) + EtfectiveCommuaiaion wih PatensClents * Heal Behavior Change Modes (uch as postive ea forcement) + Quaiive and Quantitative Intrpreain of Research Design + Como Statistical Methods of Measurement (nlaing reliably and waly) + Outcome Mestces + Types Data Clleton sch as surveys and observation) + Evidence Hlerchy Gacloding randomized contol std Jes cohr sti and ase studies) + InjryPreveation an PatienlChent Sefey including fais, covironmental facto, stains and equipment related sss) Introduction + + Infection Control Gelding standadhniveral preeay- tions) Use of Proper Body Mechanics Emergency Fist Aidand CPR Response to Emergeney Situations ind Disses ‘PusenuCliet Rights Gaclding HIPAA. IDEA. ADA. DNR, and advance deecives) + Reporting Neplect or Abe + Legal Isuestlating o OSHA, sexual hres, of ‘ter human resource problems) + Standards of Documentation * Risk Guidelines (including aciden! reporting an po ‘ies and procedares) + Roles and Responibiies (of support tf stents, and er eather practioner) Category F: Number of Questions by Category ‘Teaching, Leamiag nd Communication: 11 questions Research and Evidence-Based practice 13 guetons Safe, Proction, Emergencies, ‘and Healibeare Roles 1s questions ern ‘To stat the proces of preparing forthe exam, contact the sensing agency in the ste o jurisdiction in which you with 16 apply fora licence, Retun the completed appliation othe appropiate agency If you ae eligible, ‘he FSBPT will send you an “Authorzatn 1o Test” eter (Once you are eligible, you should receive information ‘houtow to conic Prot a establish your est ce tio. You may contac the FSBPT Examination Services by plane at (23) 739-940 o check onthe sas oF your application or inguie about cher general information Nowe ‘har ouare nc equied take the exam inthe state where you sek aliens, You may tak the NPTE in any Promet ‘le Caner inthe United States. (See Box fran uli of theses) ‘aermine the exam site for your exam, itis ecssry ‘orn th day before and sek edging, make aman ‘in avance, Pln to ive a the exam ite eal. You mast ive atleast 30 mines before your scheduled exami Ite. Bring a map or use GPS (Jou ean also get Aizectons at wi 2estoom), know the wae paterns Gelding rash our tines), and bring money to coer pestle parking fees. Prioeo 2011, a sytem of open-ended, continuous om puter dased esting existed fo taking the NPTE. Security teaches and tem sharing mong canldates compromised exam questions, possibly endangecing the public and i ltay ‘igo oo armen peace ns 3, Hoe ea ath ie tests at son ayo an. The eration dedi 30 cys prt pam ae jaw Trp «Fe Gttdet pres rege te mu rely he Fett ror han 15 ae ic the shed a te aoa er wera Weeds ntoe ou atta hatter est” ry ae you ele ene [agen Carne Rene a Fpemeche Arle ot eer yw ace tconat Moret sed Ow she whee You ws ake Fe ot have take he amin tector wn yu sdk aks You myst any Roma Cente nant, I tan peste ring te et Save es may Bp Ge SOM Ree toa Maroc ats bat ee Enet eo 9s song confidence inthe esting procedure Therefore the Federation of State Bours of Pyscal Therapy (FSBPT) Fup nde sing for lender The mam ter of fxd dts i imited, and ll questions wil be new ‘omach frm of the exam Fixed NPTE dates for 2012 “anwry 30° (Mondsy) March 29" (Thun) daly (Monday) July 30" Tuesday) Cnmkor 2 Cues) ‘Candidates with documented sais may reeive spe= ‘al accordion during the exam. Special seating, extra ‘peval accommodation wst be approved in aance bythe eering bod ‘Prom personel wil orient you regarding exam po cedures. A tral befre the exam shold fansiize You sit keyboard commands and other feneons. We urge You {otake the moi nd ak or lacan of any detail b= fore the sat ofthe exam. Kyou are dase With the lighting, seating by to read the compute sren, noise level cr ote ctor, request change tanker computer 1. Check in at ast 30 minutes prior othe era, Wen you ave at th exam st st he som before you check. ‘The whole xarsnation procedie can sup i 6 hours. You ay se the resoom duing bess. 2, Romero ng prope Mecano our "Autortion tet let, nes you wi ot be alowed tte the eam without eof them. wo fame of Senbatanaerequred, One must be a govementssed hot 1D Such esa passport and versiens, nate an bean Oprepite wth our are andi, such cet ‘a Sook Sey case not sceped Os wl be Seared. You st and lst rare onthe Ds must be te sae ithe nmescon he “avthoraaton tester there sary prablem withthe Ds you il ot be alowed take ‘he xam Al fs willbe fofted nd you vil have tesceauie or he ner aed dete Protocols of deticaton erat acceptable +3 Yount be fnguptintd and photographed. Al esting sessions ae videotaped you eae the tesing rom for any reason 2.9, vt he estoom), you wi be ngerpinted aga. «4 Youmoy request ad eree boro make notes. You may not bringin your own cath pape. The boas alle Caled wen you leave the testing cate. 5, Persone ts sucha yeesecontacs nd macicatos ate alowed. Some afore such 5 sus or mits ‘maybe allowed. 6. Crug are not peed ret wil uply ound dampening headphones upon request espn ind that ‘background nose maybe dstactng 7. loser wil be provid for personal tems. The lcer anne be accessed during the ear, 1 ear multe ting to sty comfortable varous room tempatuesJadets wth peckets, “hood” snes, fase” seanes ano permite you ewe a sweater or ott si, you must wraparound your wast. These ems cannot be puedo the back ofa har or eae inthe tes oor you mus wea a ead coving or Feather elgtus ese, you mst eve approval eo te testing date Prometric personel anna ret approval No electronic devices of any kind ch cl phones, M3 players, digtl watchs) are allowed in the testing room. They must be putin he ok 10, Eat god el before aking the ean, Food or ik fy ot alowed athe compute cubic ding the txemiation at soe centers water may be avelable he recpton rea, oF YU ay kee Your ov ink ee +1, Nourmay not ak errs alo rte am,bic Before the exam sas. Contac rometc personel immediely if there is any computer malfunction, ‘The exams divided no sections of 0 gueton each, The secon ar balaca in terms ofthe content covered on the ‘ram vein Once you hve colt eon and you {ake abeeak, you may not go back to any question in hat section. Howeve, before You complete any section, YOU ‘may review marke questions and change answers, You {sh The computer sree sows a running lok of your remaining time to complete the exam. There wl be a Seheduled beak of 18 minutes when the clack estopped During other breaks, the clock will an. You may Iso choose nt 1 take a break yo complete the exam be fore the located tie, you may leave aly. ‘Dring th esa, you may eleconicaly mark question you have sipped ar wish o review at inter time, We do to recommend skipping questions. Answer each question tothe best of your ably. Use erated ese you mst ‘Goessing isnot penalized tine pets, we he computer review commands tretunopreviosl marked ema A ‘ers may be changed if cesar. dab, sick with ‘our erginal choice, Retin ote marked gueson before yoweriteath section. Once you ext section ofthe exam, you canoe et to that Seton, "Te management ria There are 250 items to a serine Shout period noe counting breaks. Thin amounts ‘atime allotment of ust over oe minut pe queso. You ‘mas complete an average of S0quetons per hour fish alf the examination questions. When you have completed the iat 30 qusions, check the rnnng cock onthe com- ter seen, Have you completed them in an hour oes? fot, you rst increase yor peo ou may nx Bt a swell qursim. Check gaa sins #100 4150, Some peope prefer to check the compute clock at the end ofeach hour and nas the umber of gieston an ‘ered ithe way, pace yourself propery ‘Also keep ini that ding he hind hour of te ex amnion, reading sil ead wo deteriorate and tay ake Tanger o proces each question If English is your second language. you should think ia English when answering ‘uestons. Otherwise, t maybe very dius he ‘amination on ns, and this oul lo caase iterpret- "war shoud you do if there are only two minutes left and you have not answered all ofthe questions? Do not Teave anything blank. Quickly shoose answers for cach ‘gurtion, veo if you have ot had chance 1o rea them SIL Since here no penalty for enrng incor answer, you may be lcky aod get few comet! Over the year, ‘ny candidates have been unsooefl on the NPE be ‘case of fille to budget thei time proper. ‘Once te exam hs begun, communicate cay with Pro ‘merc personnel. Am innocent remark 0 nearby tsar Introdvetion + or lacing at another computer sen might e mistaken focaratempe to chest Candies utenping cheat can face rious comespences. Trying obnin a physical er apy lense by fraudulent meant i ime. Don't even nkabou doing i eer reece port ‘The FSBPT employs criterion referenced performance standards. Using this system, a et sear is terpretd in termsof a indidua’s mastery of specified omen do main. passing criterion o standard is exalted by the FFSBPT for each examination. A candidate mst reach of ‘exceed the designated cut scare of competency pass the ‘eam The ct coe represents the minimal acceptable ve fof exam peefommance consistent wit safe ant effective ‘practise expected of physical therapists A pad py al therapy content experts extaliakes the pasing scone iter srening gestions for perfomance characteris ld bias The examines performance isnot conpared with the performance of ote who wok the same test. Each form f the NPTE bas its own citron eferened pasting grade and these may vary from exam to exam. Grating on ‘cur, using a fined percentage, and using teaumber of {quests answered corel are methods that ae not used "to determie posing sores ‘Reporting of grades to candidates can be confusing. Sealed scores, rather than the absolute number of gues tions answered correctly (Caw score), are eported to ‘candidates. The sealed scoring range is from 200-800, wit 0 always reflecting the eat core. For example, the passing va score is determined oe 149 out of 200, ‘questions fran exam, this would eels sealed score of 600. Ia candidate achieved score of 600 orbete, the state Lceasing board Would notify th eadidae of his oF her sucess apd rte a licenre provided ta ll ober conditions were ised ‘Some sates sil convert the pasig cled Soret an ‘other stem based onthe ber 70075, Yor score ca be rete as being above ot below the number 10 or 75 75% er comely o incorrectly answered 70 75 ques tions. eis merely an arbitrary numbering system used 16 eno passa ine. re on Alter you have completed your entry-level physical esp ‘tucation, ou bring all 0f your weademnc and lineal experiences to the ale in preparation fer the NPTE. For to's weeks of sructred independent review sould be deguse. More time might be necesery for candies ‘whore not native English speakers or or andes who ere not edoated through an APTA accredited program,2 + tntroduction ‘Candidates with learning siabilites might require more preparion tive because te processing of information ay Ee stower Most andes probably do aot nent tke 8 lengthy refesheremedil couse. However, «Licensure Examination Preparatory couse, such ashe type offered Since 1988 by Therapy ca be gute bef. Extensive Stee feedback ha inst that tis eof preparation ourse, when used in combination with this text, ane fecdie tool o provide information about cateat exam ex Dretatins and trends. The course maual and additonal trea of slf-asesament provide ven more focus an ie ‘esto for exam preparation, Please show respect forthe examination process Procsination, py review and lek of understanding out the nate ofthe NPTE could lead to disapointing fens, The expenses lacared to reake the exami hatin, along with te potential loss of income because ‘of fallure to obtain a beense, ae significant. IF you fre unsoccesail, your selfesteem may take 9 mighty how Discipline. About a month oro before your scheduled ‘exam, exablish a routine and spend 6 day pe week “lowing materi Setup realise and pteatally achievable Shorten goals a o what you Wish accomplish each ‘Tae one day off per mek o pre iatests ote than phil teapy Give youl a beak! When you sree eing, ower, allt 203 Ror of uniacruped sod Time each day. Study in quiet and well-lit space. Do ot tly when you aed ri Tf you wook during the Steck. weekends may give you more Neb aod time forrsien, If yom bre your une, ad compensatory tne. An oer the computer bed sample questions 363 means of ‘Esgosig stents and weakness. Tying to memeice hundreds of sample questions and raioales isnot sts- factory meane of preparation. Practice question seve 08 temples for a multe of em possiblities and prima fly serve as dlagnowti wos. You most review base py Fealtherapy knowledge abe able to ppl that owed for varity of problems, segs, lrcumstances, and it ‘tions, Some individuals may benefit fom small group sy sessions. “Alhoush the review i for the purpose of pusing the [NPTE, we have ceive fedhack though the yar tha this tevenpectve overview of ne’ physical therapy ed {ation helped to sharpen an focus many aspect of lin fea pectin aswel | “shotgun approach to exam preparation is tthe best thay to ve your te, Try to form composite pictare of our physical therapy edation and experiences Academie Program. en scree phy cl erat eo- frame can vzy widely in terms ofthe quantity ad quality {the content Covers. Many program are sper, Ottes nay have problems with carculfalty- There cou Be {lack of emphasis on catent that might Be import fo the NPTE. Be su to request copy of your sehoo's re ot on performance of peevious clases onthe exam a= ordng 10 the exam blueprint. Some informations ‘Srila atthe FSBPT website ‘Consider which conten areas were presented in a com rbenve manner and which aes let somthing tobe de ‘red. Were there any gape in your basi preparation st nay be enphasinod on the NPTE? Wil hs equ Yout© Spend more time gathering or reviewing information in These areax? Were academe standards poorly enfored ‘tere grades ifinte, or were some marginal ston piven ‘cial promotions 0 elp enhance their selfestem oF te "tus of te progr’? Your study plan should eompensite for weaknesses in your academic program since the NPTE, ‘fon oa standard tide th acadome seins. Casson Performance. Genel, songclascom per fonmre with good English skis should fae well on he [NPT ar ong they tae the tino prepare properly. St ens who performed marginals i hl progam, whose basic phys therapy education program licked rigor, trhose English sla not wel developed ae often is {Ippon when they reseive NPTE resus. Clinical EsperiencedAffiations. the range of clscal, expences was ited io ens of etigs, patient pop Jaton, ypes of teaments, or dere of responsibly, nam candidates may have dict answering questions ‘hat equi the application of iia! Knowledge or jue- ‘neat For example, an exam candidate with no clinical ex osc in such aes x ponte crn reablitation, or trou or bur care may have ily in reaching eon ‘sions requiring sytem eew, evaluation, outcome peo- jection, or interventions in these areas Mary NPTE {ueston require an amalgam af clinical experienc anda Ademic edge to solve problems Selected se of the Guide to Physiol Therap Practice may prove bp in ‘teas of deficient lisa preparation, Specie pace pt tems examinatos, ols, iterventns and otcomes ay be deliesed Analysis of Sample Question Results. A appropri ines {you bool tempt answer te practice questions athe ‘Sled exam othe socompanying software. The con puter scoring wl iit you in idemi¥ing content rss, ‘Somains, and eral rearoning estore ia wich your performance was good and tose areas that need more trork This analyst can serve a bai for suc ther si and review Aer taking te exams, be sure © read the rand and eal reasoning satenas fre practice exam question inthe Review & Stay GudeBased on your pesoral analysis, write down areas of weakness pty to rank ede ths in tof wich ess might requ he most ened work Set rors based ‘othe Content Outline, Gude 1o Physical Pherapiat Prac tee 2 editor, and expetatons ofthe examination. Keep ‘nmid thatthe NPTE emp i pimarily on ety level oiled and judgment ‘The NPTE auempt to ateain ow a cant dels with «vary of diferent stuns to determine ow the app ‘le would uneon inthe oe of physi therapist a linia sting: Mos of the questions require problem sa ‘ng at the wppe levels of cognitive furconing (8 Box C: {Levels of NPTE Exam Questions) Methods of Reading Multiple-Choice Careful read teste ofeach question, Wht the focus of the question? Think aout tbe information using Your knowlege aswel as your judgment. Then ed each choice ‘uly. Begin the proses by eliminating one option a ‘ime. Everytime you ae she to amaze eliminating an Iacoect option, the odds of answering the question cor. real increase dramatically Be crf sometimes options hve some corect infomation that doesnot spy 0 the question asked. If the stem ofthe question i long o a= ‘oved you might wish tread the options fst This may lp yoo focus beter on he relevance f the Infrton prescted. A the exam progresses your aig kl ytd to . Appsicaton ereFntomaton and applton of es proces er thers to new stations For example how t ppl ‘gona pins to modify 2 work stan fo someone wth lateral carpal nel syrcore Aelance athe NTE Fee dtr one integrate trowadge and comprhersion as wel x compstences developed ding nical creme hordes bet rovers pace serra, Many NPE questions shouldbe at thse sce aman oa ot Shera co ses the canoes ly respond competent fo fret stains NeTE rom Prepxation Suey Hoey conprenenson ae sid nal major domalns ofthe xan as put fort nhs Review & tty (QUEL tke coe tne computer bused practice was at acorpary hs text. The changing questions fol the ete Ue NPTE Use you feu Getemne aes of academic crcl and reasoning stengths and weekesss, 4. nab Mean of interaonshios betwee princes nd iterpretation or evaluation of data presented For example the rascal fos for dichrge loin sean fr parent and an alsa wth cured tata ban uy. Ackance she NETE Fee Pte at stakes have mastay and comprchensn of ene rowed ad can apy it Tenpeteny nr dkee stuns heefore pet oan and respond to ambigucis tutors, Dect “tebook are ny nt app wen caespoiams fr some concrete hres. Many ems are ats level since the min aoe he ea ot atemin competency corp race ec stuns. moter word, procter out ‘Bt ne “cutie ofthe box to save robles in reaboré ust, TE fam reparation ates Ha pe pce east reflect on your reonng ard judgment Cita even the explanation or ‘ach giesion hat you stugged wih Use pero study tous fo he determine gps in aahits of exam quesions ‘Sec ep sce" cs neg aoa me Be es he nee Modied and adapted with permis rom the Naonl Oupational Teeny Certiaion Examination Ravew 8S ‘tie, Seaton by Rita emig-CastlyIT ntoaution + + Rea he arnt careful but gully before selecting a response. {Read the oa tem for key word tht et int * Use owen of mecca terminlogy to decipher unknown word sng pei eff ad oot weds. + Employ relevant cna experience Oo otal on til apa case * Apo ical reasoning silo sete the reevance of the feat inthe question (agnosting,ntereton, ‘theoreti prope). Check the ans fo eis theoretical dagnostaly and developmental constant wth the hem sen * Choose paterelen centered acors haf onthe emeionalwelng othe pen i Sey ae vert othe ‘quesion «Elmina tices hat cotanconsalnicatons (uns sik fo a containdstion and use otis, {Use bth your acadeic knowledge and crcl judgment to supper you arse, + were rp but acct, Te management an portant creren forces 1 TheNPTE so tenor xm ght atiue ond eye stam. * sam boredom an be a fat, espera ater you hae answered 200 questo, wth SO mare to go, Losing interstn ‘eadng and answering questions Can cx you pons, fale choice would be he comes answer if you cite oized everyting arora, These ypes of eae tive quetions are Boooming leet common on the NerE. Don't look fora particular patra of answers tht would case yout alerachole you believe tbe cor ‘et For instance dont eliminate a coer coice be ‘mae you chose these leur or umber choice response inthe item immeditely preceding the ove youare curently ansvering Question ae selected and ‘andomly placed in th exam. Don lok fo think ‘shout answer pater, 9, Don't overanayze a question Reale question at fice ‘ale: Don't go ote ofthe it of te infomation in the stem ofthe question to reach a conto, Sut ‘entnfomnation should be avale ding your own hypoheclcondons othe station preset ould lead you inte wrong ection 40, Some questions may present graphic or vu repee- Scoltons wih a accompanying goeston, These may Inclnde rays; Wounds; ECO readouts: therapist per loming various ess, measures, cr imervetons of 3- Pistons of patients with inpainments sucha close ‘or amputations. A useful suategy for these ype of ‘guests sto ok tthe ect With he choices ining ok at the graphic representation next, an nally lok atthe question Looking atthe choices frst may hep you focus en the aspect ofthe graphic representation ha may be most relevant anshetthe ‘question ere ‘Areviw consisting of jus answering or memsrizng sa ple questions soften unsrsctory, ince he sample oee- ions inthe accompanying compiter softwar ate ot actual [PTE questions These questions ae meant to be wed for agnosie or lean purposes, Although sme questions ‘on the NPTE may ser sna to the practice questions, {he NPTE goertions may baveeatily diferent answers sci NPTE that havea diferent fan than he pace ‘cam questions "You final review should refocus on te ares that are ‘emphasized onthe NPTE ad tht you have ented teas of personal weakness. You my wish ost the Pracioe exams, if ie permis, + lent the queso heme. Whats the queston ray asking? «Avoid eading“into' the question. Dont makeup ato. Rad the question and nothing butte queton + Identify choles hatare quay pause to hoes yaaa the same thang. rant ter th + Carey consider poses you cannot linate both fata} one maybe the comet arse. ¢ Mote than one chose may corey arowe he question. Chace the oe thats MST cet {inmost sas, sale paste, ace hols ther than pave negate oes * ten changing an sve; make sue you have od reason to imate your ginal coke, and navn beter reason {to makea nen chote Oo let seind-guesng ak you ou of the com arseool nroduction “The dy before the examination, make re you ave guth- redall neenary documents, material, medications, JOINT LOOSE PACKED POSITIONS Table 1-3 > JOINT CLOSE-PA Mayet so an ton Jaws teeny 8) ‘ames ye ‘mre ie 55:70" aca 5" hota iin ten 7 fan a1" suphasten abesrcenanéainon 1 esi 23 ten eval dla ddan ttt aie rare Miya eaten mid Stans” Ketendratemecce ‘opedonetans! Midna bee erosion ant ‘ete soconnesanon eucxpepege SIM ort ghee one HCP 25: eon wt ar Son replace) Posi its 1° fen Dealer 30 Basen % Hien a mae ewe 2 fen "ane! imate 10 plata rmdir cree Terametins! —_tid Beton ten rd Metsunptagel Nata enon) Imepaonged Slt feibe Tess esos Py hep apkswn cas $e isso, pre, 196 wh pemson (6 Use oflover abdominal, mer obliques, hip ad- cor an tins dort when ip less ae weak Ser ers 1. Shoulder region. 2 Osteology humerus, spl, clavicle) () Hunens. (@) Proxima end of humeras ie approximately a spheroi (@) Anicule surface i covered by yan xt (6) Head is eovered 207-0 ected ia ecaen Spocmandbuar Nanna ain ut can ts teehee min wt as SBineu wera eel sumodedair henry ate Soomcnisir ——Amabasen Thmewunar ——fdletin ad aton tmeceds 90" Reten and spnaton nd doug span etn Dealer Saphaton fsa Fulatesen leon ts skp atosesen Capanetoaral —Fulopaion Tapesrstcps Fu option Mewampagunged Fe che lesen Nerf 25 een Fearon wdnenaonten Ben 9 toon ert con sd So ena oe lesson nd een Piro "Moon! aldrteson sar Fulimersen Maat hulsprtn TSremestas’ Farin utente Irene Foleceacn "eet Gant: yea Tha Fcge nats Sea, Pop Leen, 186 ah perma (© Logitdoal axis of head ie 135° rom ais of neck. ©) seapul. (@) Large, a wiangula bone that sit over nd (@) Cont sae and a dora sure. (e) Thre angle superiog sl ner (Lateral ingle bears gleaoid Toss, which faces anterior, ately and superiny. + Pearsape of foes lows fo er ge ‘of moon (ROM) in abduction apd exon + Concave shape receives convex humeral ea, + Orienaton ofthe glenoid fossa planes true abduction a 30 anteroe wo frontal plans~ ‘ten lowed chan tra ot irene Uemotfeion> aceon Fearn Fay eid pons Tika sn se Snel eco Une o> een (nye once er cal iis wae Eat ween ser iain Saka sea We nt ‘Breiman star ‘Fee rnean cot ‘evar Fon re ENT toeoleareon rr Panwtenohteeat “Bela ————Tast ror> dation Tea Seal Aan) era ig Messie=: a a Seton» FIESTA ‘Scie pat iron. ‘Epon an et ion FRETS Wario oes — Sign tetacnct ten _aRTERTE VW ee ‘hain a eR EE Fro Here, Kes Mangano Connon ‘lacus ore Pcl Pane ‘etd 3c hisadpha Ups 386 pemasion ree Oy Penne ent ponesty Sigh hemo Sight typsmaty ‘eran parcbky From Gre, Mebleten fhe srs: A frm rardbosk “Seine ano: chac eine 8 th (8) Clave (@) Extends laterally and links manubrum to (b) Connects sboaler complex to ail seen 1 Aaology(plenobumeral, semoclvicla, a0 ‘moclaviul, and scapuletorai). (1) Glenotumer joe. (a) Convex humeral head aicuates with con- ‘eave dened fos (¢) Geno fossa very sallow, (2) Stemoctaiclar ort (@) Conver upeioinferin) and concave (eaerceposterin ariculates wih recipeo- cal shape of serum. (b) Both aiculations covered with fibvocat lage. (3) Acromoctavialr joi (@)A plane oi with reaivey at sures, (4) Seapulotora joe. (@) A “elinica” aicuation Muscles (depresson, elevators, pouactrs, rea toes internal tats external obtors, exors, ab dtc, cts, ad extensors) (Table 1-8 Noncontetilestactures eromicavieua,ape> oid, copold, and stepociaviculrligamest sb ‘cromial bursa, shoulder capsule, geno abram nd asocaed eves and vessel) (1) Caps (@) Aches medal to glo margin, lenoid Ishrom, cameo! poses () Atabes laterally tuner anatomical ‘neck and descends spprosimately em on the stat (6) Sepported by tendons of spraspinats, n= fraspinaos, tres minor, sbeapularis nd Tong head of cep below (Inferior ape least sported ad most ® Ligaments, (@) Coracohumerl ligament. + Base of corcoid proces to greater and Jeger bere of humens,Sep eon, donor ah Wea Sapien aion ceo, Rea Sonata Siders ond Fon eal rasta Sodio nas “exter ii foie ren Osis ~s ow fn foram sphaion Bens wact Spake oe, Cancale bow ten el ‘BRS da aes Fer om Ea ‘thre Fare ee =a —— “Rabin tt p86 7 rr —— Shaptazer ae aH a —— Sean ages r rar “wage ein reer aac cic NE Ree fond ae sam cor Fecamperion ae er ‘5 —— to Waa S Fas a Wistar aie od Tha Phan Foros eas sea aor Toor doom Fe ad par Tanta seat plc ba Ta nin —————— Tr poles rs ——— ar oppo pons reise a eae Sa a (Conon owing)rear eRT Fomamsipaton Sei Thunb Mer abn so PR os Tragieso a om CG. Condave Neostyle ange Mi Paton, tot A 97; an eral Mec soe, Mace sing an en + Primary fection to reinforce biceps ten don, enforce sper cape, and pre ‘ets ea dislocation of bumer. Tat with extemal oan. () Corcoacromialtgament + Strong tangulrigameot runs from coe ‘oid acromion + Nott "re Higament, connects (Wo Point of sane bone (6) Geoohumeral games, 1 Thre ads (supe, mos, and ine tot) Toeted ‘on anterior lenobumerl join, + Reinforce anterior glenohumeral capsule (@ Transverse hamealipament + "Broadband passing over top of bcp ‘Boor. + ets ar artinacotom fron biceps tn- en, (8) Labram, (@) Gleooid labrum sa fibrocarilaginous ing that deepens gles foea (© Attached to capsule superior and inferiorly well as tothe long ead ofthe biceps ten ‘hom sup (ey Imeral surface covered with anicular ear lage which is thicker peripherally and thin es cently, (@ Ads in aviation le meiseus of knee and serves to poet the bone Burs. (4) Malle ure fond within this region (@) Primary trea svoved with poy b> seroma bra between deed and capel [Aion unter sromion adcorcacromi ligament and betwee the sprepinats ten in Shoulder biomechanics (@) Gezohumeral joint artvokisemassloseskine (4) Occurs in opposite reins With elevation fuer ead of ures moves in an it~ fesordirstion esas of convex moving (© Rolling aiding ocours during elevation of the mers, 2 tha the istntaeous cen teeof rotation aris considers uring the ‘complete range (@ Atapproximaely 75 of elevation, exert roaton (onjunt ottion) oars, pevent- tng compression o greater tubercle against the seromion, (2) Sexpulotharacie. and. glesohumeral #hythm (seapuloumeralchythm) isthe rato of move- Inet ofthe glenobueral with he seapuotho cio. (a) With 180” of abduction, theres 221 rato ‘of movemeat esween he two ois (@) Fit 30-60" of elevation oceay msl in the glenohumer joi. (6) 120 of moverent occurs glenohamerat (@) of movement occurs a seaplthorcic (2) Reguirements of fll elevation, (a) Scapular sabia (6) Inter glide of hameres (e)Exteral rotation of umes (@) Rotation of the claile a sternclviclar join. (e Scapular abduction and lateral rotton of ssromiotavicla int (0 Suaighteing of cae kyphosis 2 Ehbow region. 4 Oncology and artology (elaobumeral, rior ‘humeral, superior and infor aol). (A) Hmeoulnar eit (@) Distal end humers (rochlea) aicultes i proximal end af in,(0) Tochla and woehlear nach face aneiry 45" angle, allowing space between ulna ed hamers during xen (2) theerordia join, (@) Distal end humerus (aptlum) aiulates with concave oval facet of proximal radios (2) Primal radioular joint (a) Radial bea ie ovid and cone shaped (b) Meal ads arcalates wit ada notch (of una (4) Disa adouna join. (a) Conver ui stilts with concave rai {oppose to proximal aiculaion ofthese two bone). 1. Muscles (eters, extensors, spinators, apd roma os) (2 Tale 1). &. Noncontactie sractues (ned colt game, ‘ial olatral ligament, sola igumen, elbow Capsule assoined bree nerves, and ves) (0) Capt (@)Encloses ene elbow joint comples. tt {is thin, both ari and postrcly Continous medly with vlna collateral ligament, an tray with radial eolseal © Ligaments (@)Uinar colle + Ligaments wiangularsbaped consisting ol thee pat + Reinforces humerouaar joint meal (©) Rati eolter + Ligaments fan shaped, and rns fom a= cralepicondsleof humerus arcu ig + Reifores bumeroradil jot laterally ands stronger histologically thn lar colter!iguet. (© Annular {A csteofibous sag attached 0 modi ‘ans nd ences racial ea, + Coneshaped, and ane surface is lned ‘wth roca + Protet al ead, especially in semi Alexion, where itis ery wstable- Tain exremet of ration and supination (Quadra, 1+ Exleds rom rail noth (ln) tothe neck of rai. + Reiners inferior jin spa, ain tains radia Read in opposition tole, Fits amount of spin supination sd pronation, (@ Distal radouis, + Amerie radioulnar ligamest:pimasly trengens caps + Ponterie radioulnar ligament: pimasly swengthens capsule 6) Bossa (0) Oleranon brs ote on porter spect ‘of elbow over olecranon process. (4) Blood spy. (9) Elbow joint receives blood supply from Dacha atery, anterior ule reureat a ter, poten unarrecuren artery, rain) ‘eeureatatery, and mile clara branch ofthe doc brachial anes (6) Eton join stabi (@) Elbow joit complex possesses sigaifiant {abort ibii. (©) Main contort bony stability is acu ation between the trchles (hues) and troche oss (ls), (© Meal collateral iment provides stong ressane to valgus forces. (@ Resistance of lateral contra igament to ‘sas fees minima, de ois etait ‘oaboter sft sive stsctue (anal Higa men). (© Functionally, this relationship i bene since functional aces place ten forces really and compressive forces lateral ‘Therefore, the lateral ligament does ot ave to be as song as themed igament 4. Etbow biomechanie. () Conjunertaions. (@ Uinapronates slighty with extension, Una splashy with exion. (Proximal ulna plies meslydrngexten- sion and ately dung flexion (© Fexionfestension of elbow i ccompanied by screw home mechanism with count rotton of una: Un externally oats (or ‘pies dri elbow Nexon a itera rotates or rents) dig elbow extension. ‘3. Wrist ana nana repon. 2 ‘Osteciogy (raisins, carpal, metacarpal, nd pales (0) Rats ie iconcave relative to carpal (2) Unais comer ait dita end relative tothe ti (peu (©) Proximal aspect of proximal row is bicones, sta apet of proximal row is concave a fo efeaptne nd tiquerumfarat arculsins. ‘Scaphoid i conver snterinposerir and con ‘eve mediaViateral eave uapeciumfeape- oid, Capi is comes, and ateuats wih “aocvites of capo, haat and pezoi. (4) Netcapal heads are bicoavex, and bases are ‘eer flat lave wo distal row of caps (6) Pualangs' proximal ends are most biconenve, ida ge running dowa the cee, iin ‘it wo surfaces. Distal end pulley-saped, sud mostly Biconvex, with a groove mining ‘trough the comer,1 Arto (atoapa. ipa xponetu + Dans ioc ints fein pos smoucarpbalngel MCP, an inerpsnges on nd ory hl ein im «Rain: bie and for ey impact (1 adie ji throgh trees (0) Comes apd an nat arcu wit) @) ator oad onve ni. (0 Frou esha on he dorsum of ach (2 madcap ger ava far expan of ee {0 area ewe proximal nour tse: ton don {la cue Done os vier (ovtupuyoas ow ait vith extension of he re ian bin (0) Fansionl eer hen aoc in. poe {0} Game die init par man ane ‘oc icp and bated CR nd DI jin ve eos spl tn is Spur sng ut lavas resam os (Capen CMO joie conser tane {Fim MC tant) fase scton eee et gece ‘rth pena fing comer indi! (enh thier platy a oral) Tater rection and concave in stein! posterrdvcton (by First metacarpal is opposite in shape ot ee eee Peo 0 Nh (©) Ind-Sth CMC are essently Oa baween (0) Present on paar aspect ofthe MCP, PUP aa sn sna Hat baween srt kein ope Foe (4) Metaapalteageal (MEP joer of ‘is oineresse acu uae during ex coax etacarpa wit coocaeproial pe terion and protec jon vou. Volar plite be ‘noe motile a MCP tha Ps (5) Proxima imespalangeal PIP) jit consi of (5) News, Pcp reget il rei eiegebi (@) Uae innervates hypothenar region (pal- wth midearal joint. but usualy has ts Concave primal arpet of middle ps anges. ‘arly and dorsally) th digit, and medal Same orientation exis a isl ieterphalngcal hor ah dit (MP) ois. () Median nerve ingevates reminder of palmer Mules (sis ers, wrist extensors, adil devi- ‘urs notnnervate bya ere ad or tors ulnar deviotors, extrinsic finger exes x ‘spoon of 2nd, rn ala of th tein finger extensors anda ng mses) ‘ip fom DIP joint oti of figs. (see Tale 15), (6) Rata ere ineraes einer éoesum 4. Nonconacle strate (volar cap riicarpl of hand not enervated by ular oe mein Collateral, and palma igen extensor hes ves. Socited Caples; volar plate eves and vessels). (6) Blool supply from ulna and radial anere. (0) Ligamens. Mero form palmar rch sn then send itl (a) Figs. wanes that tan Up medal nd lateral aspects + Colmer rn from aera conde. dis feat dit fal pala aod Literal volar pla, All &, Mand and west biomechanics, Ser tighten with leon and vole fibers (0) Hana. hte with extension (@) Ps and DI «+ ecerory: fun fom condae rad 9 + Daring lesion digs tate adily te. soap ago pasp and opposition. + Transverse: present at MCP joints. Pro- oMcrs vie aii tnking MCP joints peo + During lesion digi rotate radially we. ‘iin enforcement to aneior ep, ance aasp and opposition. coy wis. (e) Ft CMC. + Radial collar ints lar devition, + "Due to position of wapecum (amriey Ulnar cole: iis rata deviion, and medially routed relative to ther 1 Palmar uinearpal lit extension and pals) plane of flexionfestenson sper supination pendula to ote dis. + Palma radocarpal: Knits extension + During lexionfestension it is concave suplaaon. ‘moving on conven+ During abdueonAdduction, it is convex moving on concave. + Daring lesion and abdvein, the fist ‘metacarpal routes lay. + Daring extension sd addecton, he ist metacagpal utes radial. 0) Weis. (@) lexion, + Proximal sipest of scahoidunate glide desl slave toads. (tension. + Proximal aspect of seapboidanate glide veal elas ads. (6) Radial deviation + "Proximal sow glides ulna. Proximal surface of capi rotates palmar. (Vina deviation, + Proximal row ges radially @ unit 4. Hip regon, 1 ‘Osteoiogy (femur and aeabulum of pti) () Fem (@) Headis two thirds ofa sphere wit a depres sion a ss center eae the Tove capitis femoris. (©) Head is ovented superior, anton, and ‘medial (e) Ariculrcriage covers etree xcept for foves capitis. (@) Ange of ntnaon normaly 115% 125% + Goxa vaigaisangle > 125 + Coxa vara is ange < 15% (e) Femoral neck angles neinly 10-15 fom ftomal plane to form atrior setocsion angle opateversion:couidred excessive if a ‘elo anetorsion angle > 25-80" + Rexoverion: considered excessive if terior anetosion angle < UP (2) Aces (a) Acetablum faces Interaly, infil, and nero (b) Made of union betwesn cium, iam, and pubis ones. (©) Acetabular fossa: center of aetabatum, Which is nonariculting end filed wih a ‘id for shock absorption, (@) Acebulum isnot completely cover with ‘rile, Lined with ahorseshoe shaped a= ‘eal eariage with imemuptin infeiay Torming aceablar noth Anthology (oxofemor. (2) Synovial joine (2) Cone femoral ead antclates wih concave scetaulu, (3) Very sable eto bony anatomy as well as sent of ligaments an capsule Muscle (Mexors,etnsos, actor, sbdvtrs,n- ‘eral rotators IRS}, and extra rotors (ERS) (ible 1-7. Noxcontacilesroctures (cps, Itrum,barsae, ‘ifemoval ligament, schiofemoralgameat, pb ‘ofenorl ligament, and astocited nerves and ve. set. (1 Capsule i strong, dense, and encoves the entire seine 2) Labram, (@) angular shaped, made up ofa boca Iapinous rin, hicks superior () Ataches to Bony rim of teeta, big ing acetabular noth (e) Serves to depen acetabulum. (@)Imererace ined with acl caniage, and outer surface connects to int capsule (6) Ligament. @)liofemora igament CY" or ligament of Bigeiow). + Two bands, both sting rom anterior in- fer lac pine (AIS). Media runing 0 ‘il intense le. Litera inning tp proximal spect iereoan ie + Nery strong. Both bands taut wth extension and exer ‘al rotation. Lateral band tut with ah ‘duction, (by Pabotemoral ligament, + Runs fom lepectieal emience, supe ior ram of pu, obuaor ext and 0 {urstoe membrane ltaly Bending with Sipe sae oats ed + Tautwithestersion, external tation, and shan (e)chiotemora ligament + Runs fromiscium and poser acetbo- ty soperoly tnd lateral, blending with zona arcu, abd attaching 10 ester chante. + Taut with medial ration, ebiution, and (@ Zona obicaaris + Rans in a eal pater rand femoel neck + Has no bony atachmens, bt elps to ‘old hed of femur in acetabulum, (©) Inguinal gamer. "12-14. long rnning from ASS med ally and inferiorly, tacking to pubic berle ‘+ Forms tumel fr muscles, nes, eins, and eres, (2) Bare (4) Subiendioous ie, leated betwen hip and xpiFofeson tess 2 ue Feet 1 fen sb, Seo o Ga foro free oneran Qosiepsemois “ eu Fanond asian en = psa eR Gu one pation rns au Constr roskiin a aes ne = sr Sop ga “Fi fon ion Tewari So aes edareen ipl ioe Ti Br Ta gat poner tot Geass as et ted pled ion karan sore iss Seasons Ho neal ton Gert gas us Sales Seeace 4 ‘rote aaa Fae Ge eal ee BESO aG ae Fc on a Taare Coo Fear irae Sie ea Daa ae ap a eat sa "Sed cory td mn Ne Made Woy nde sre oetae tons Whe 13. (©) lopectinel between erdons of proas “May cause pu wit ip eon and intern majo iicus and capsule. Les else to rotation de to compression of gluteus femora nerve maxims (6) lehofemoral between sci bers and (e) Superficial wochanei loeated over greater tens maximus muscle May case pn mocha, fetaue aseouson (9) Innervation of lp join comes rom femora, (@) Deep rocharei between ates maxims ‘uate sea, nd superior putea nerves and! posterior Intra greater wochastor (6) Blood supply.(9) Media and ara femoral cecum sup les proximal fem. (Remora head is supplied bya mal branch off obtrtorarery {) Acstabalum is supplied by branches om su: ‘eo and inferior lta! ate. (0) Hip biowectanis, (@) Conofemoraljolat_arvokinematisos: teokinematics coca in oposite ditions {ue to lationship of convex femora bead ‘moving within coneste sebum, Kee eon, 2 Ostelogy (femur, i, Shula, and pare). () Femur, (4) Femoral condyles ae convex in axeio! posterior and mediaateral plane Both Temoral condyles are spiral, bt Intra one Iva longer sface are ad medial oe de- scons ater nero 2) Tih () Medial bil condyle i biconcave, has 2 Taegr surface area ands more sable, od therfore les mobile (ty Lateral bil condyle iscomex atiapos- terior and coneave meister Smaller Surface ate, moe cult, and less stable, therfore more mobile. (o) Both tibial rrfces are raised where they ‘border intercon aes 6) Paella (0) A verical ie divides plain «ager and slr medal part Paola can further be divided by two faint horizontal ridges whieh divide eit i fact by Antrology(ibifemoral, pstellfemora, td prox imal iodbul (0) Proximal ibibo. (4) Oval ial facet i ito sity ones Flr he an a by coms fst site (2) Tiber jon. (@) Synovial hinge join With two degrees of freedom, Minimal bony sbiy th eis ‘on caps, ligaments, and muscles (9) Paslltenora jun, (6) Pei arial arcs ape to pte surface fara Ancbiqn rove ring in fehl and tel ithe ging ean, ‘on fom for seit tacking, Pal face ‘of femur is conaveeaneverey and cone ‘itl creating Hs sade lk se ce, Muscles errs, bial rtaters, and exten) (se ‘able 1). 4. Noncontactle stractres (media collate ia ‘mea, lateral clit igamet, antic ati tere pte roca ligament, enc apse, burs tnd asocited ners snd ves, () Capsule {@)Tibiofemorat capsule i a fibrous sleeve stacked to distal fear and proxi tia Inner walls covered by asynoviom, Shaped ass einer with x postrioc invagination, ‘hich posteriny divides cavity into edi td lateral bales, Aatrioe surface has 8 window ut at for patel (0) Proxima tibia joint has a ibeons cap ule, whichis continuous with kaee Joint Capsule 10% of time ©) Ligaments (@)Tibioferora and patellofemom jon (knee join prope. + Meal collateral igament (MCL runs from mail aspect of medial femoral condyle wo upper end of tia. Posesior fters bead with eapsle, Runs clique aturiody and infer. Tat ia exension {nd shckened in exon, Prevents exter. tal rotation and provides tablyogalst "algo Fores. Runs in same direction as ack. + Laver collateral igament (LCL runs {rom Intra femoral condyle ead of ‘ula. Free of any capsular attachment ns big infers and poster in same drecion as PCL, Tat in extension tnd sickened in flexion, Prevents exter ‘al tation and provies stability gains van force, + Amerior cruciate ligament (ACL at- {ached fo anterior inercondar fsa of tin and ferred spec I ‘eal cone Runs oblique sper ah Intel. Extacapslr, but more coecty fs ickeing ofthe capele, Check for ‘rad aldng of ta on fer ad Tims [ata rotation of tia during Neon ‘wins amind posterior cricale ent + Posterior eruite ligament (PCL) a {aches to potrioe ntecondyar fsa of tibin and on steal surface of femal ne fal condyle Runs obligue medal and aneiorly-superiony, Checks posterior tispacemento ia on fe + Meniscfemoral ligament rs wit PCL Altches below posterior bon of ler ‘menses, Has common insertion ito at: tral spect of medial condyle. Octson tly asia igument exists edly Obliga popliteal ligament: nse io expansion from tendon of semimembrs boss. It partly bleads with capsule Forms floor of popliteal fossa an in oatact with popliteal anterior anery. Srenthens posteromedil capsuleArcus popliteal gament shaped ind commonly esribed as having two baxds (edi ao ater). Stem attaches fi larbead, Medial band etacheso poster border of inereondyar area of i Lat ral band extends olateal picondyle af femur Suengbens posterolateral eps Transverse igament connect tral ind ‘medial meniscus anteriorly. Meniscopselar ligament rans from in- ferlatral edges of patel to trl tr dere of cach meniscus. Pall meni forward with extension, ‘Alar fold: rns from lnterat borders of Patella to medial an lateral aspects of Femoral condyles. Keeps patel incontct wi fe (©) Infapatllr fold: formed by stachmentsof pull fat pad and tendons via Secale band Tying in intercondylar notch. Acts as sop gap as its compressed by patel te ‘on in fl flexion (@ Proxima biol joie igamens, ‘Aner softer Fignment Iocatedon terior aspect of join. Reinforces ep ‘eatery. Posurir fibula ligament loatston poser aspect of jit. Reiners cp Sule posto 0) Meni (@) Medial mises ‘Medial meniscus i lrg, Cshaped snd iy sabe Lately sly sched {0 MCL and fibrous capsule. Or sine ‘res hat tach othe meal meniscus rtemimembranoun mae and me ‘meniscopalaTigament (Lateral menisus ‘Sale than medial meniscus and more circular Seuctres at asch ole ‘menses incade poplitus msc, aa ‘menicopallar Uzamet, and eas- femoral ligament Lateral meniscus is ‘panel fom LCL and lea eapea by popliteus muscle teadon. (6) Peton af menise ‘Deepens fossa of tibia Increase congreney of tibia and fem Proves stability oibofemeral jt. Provides shock absorption and Ibrication tones Redes fition daring movement. + Improves weight dibaton (@) Movement of menisci. “Menise elow bia with Nesionfxte + Medal meniscus moves a tot of 6mm ‘wilelateral mover 12 mam. With slated ‘bial eatin, the meni move opposite; 2g. th bial IR, the medial meniscus moves anterior andthe lateral meniscus moves poster. ‘+ Mensa motion lb intuenced by sot issue seuctus. Medial meniscs is pallet postericely(Bexion) by seinen rane mescle and ACL, Plled ater nl (eesion) by medial meniscoptlr igament. Hed im by atachmeno MCL and vous capsule. + Later meniscus ples posterior (Nex- ton) by poplious muscle and antsoly (cxtesion by aera menseoptlarig ten’ and menisofemoral gunn. (4) Barsae (@) Propel, between skin and antrio ist pal (© Supertica infapateia, nese games ‘um pata, (e) Deep intapatellar, between posterior liga ‘rentumputlla and anterior ial tera (@)Sopeaprela, Between patella and iba femoral int (@ Popes, posterior nee often connected synovileaviy (© Semimenbranosus, becween muscle and femoral ondyle. (@) Gastocaemius, one foreach head Medial ua seally communists with seinem: trance burs (2) Pes ans bursa, between pes anein tnd cL. (8) Blood sipply comes trom descending branch from eral crcomflex femoral branch ofthe deep femal artery. Geniular ranches of popliteal ary and recent branches of ane- riba rey. (6) Aricalarimervation is provided by obturator, {femoral sb and common Ruler nerves © Biomechanics kee joint proper (0) Ardrekinenatcclsteakinemais, (@) Movements femoral condyles during flex {om and extension, (only way that posterior dislocation af feonl conve can be sve) nity, ‘movement sporeroling andes impure dig, Fr endl condyle pe roling ‘cco during ist 1013" of exon. For Ter conde, rolling continues et 20" offeron. + Daring io, femoral onde al pos teroy; ACL becomes tot easing eon ses lide amin.