Mary is a 55-year-old female with CC of 3-month history of left sided neck and central – left upper back/scapula pain. SH: married with twin 10 year old children; she is trained as a research lab. technician but is currently a homemaker. CLOF: Mary reports she’s having a hard time keeping up with her husband and children and increasing difficulty managing her home. Even minor activities such as reaching to upper cabinets/closets, lifting and carrying groceries or laundry result in significant pain. As a result she has been very sedentary lately and feels that she fatigues easily. PMH:  hypercholestemia (210mg/dL) SH: 1 pack per day smoker x 35 years MEDS: takes Tylenol for current pain; started taking over the counter allergy medicine, Zyrtec, by mouth 3 weeks ago because of recent nasal congestion and cough. She is self referred to PT with goals to decrease pain, return to regular activities and exercise, and to feel good enough to be able to start part-time work. PHYSICAL EXAMINATION: Posture and Observation: Posterior pelvic tilt, increased thoracic kyphosis, Mod forward head, C – spine in L side bend.   Height:  1.75 meters  (69 in)    Weight: 55 kg  (121 lbs)       BMI: 18.28 VSs at rest: HR 84 bpm, reg ;  RR 22,  upper chest breathing pattern  BP  120/75 Active Range of Motion: Cervical spine: flexion 0 to 30 degrees; extension 0 to 25 degrees; rotation (R) 0 to 40 degrees, (L) 0 to 15 degrees; sidebending (R) 0 to 30 degrees, (L) 0 to 20 degrees MMT Strength Testing: Upper trapezius (B) 5/5; middle trapezius (R) 3/5, (L) 2/5; lower trapezius (B) 2/5; sternocleidomastoid (B) 2/5; trunk curl 3/5; bilat leg lowering (abdominals)  2/5; Palpation: Tender to light pressure in suboccipital region, medial upper and mid trapezius, SCM origin & insertion L > R Function: sitting tol. 20 mins, standing tol. 15 mins, can lift 5lbs from knee to waist and waist to shoulder level with mild increase in discomfort; unable to lift heavier loads due to significant increase in pain, unable to lift loads from floor level, unable to reach/lift overhead due to pain.  Amb. independently indoor and outdoors w/o assistive device, up to ½ mile on level surfaces with reports of fatigue and increased discomfort/pain; Amb. elevations independently w/o AD but uses 1 rail on stairs for stability. Question 44: Explain how the results from the aerobic capacity test you selected /described above combined with the other information you have on this client eg age and HR, can be used to establish appropriate exercise parameters for aerobic activity including intensity and target HR. (1.5pts).

An elderly patient has been hospitalized for the past 3 days with pneumonia. The MD and patient are hoping for a home discharge tomorrow. The patient lives with his sister in a first floor apartment.  The PT has determined that ambulation status is independent with rolling walker up to 15ft. which is not enough to allow the patient to get from the bed to the bathroom (30 feet). Which of the following is the most appropriate PT recommendation?

Mary is a 55-year-old female with CC of 3-month history of left sided neck and central – left upper back/scapula pain. SH: married with twin 10 year old children; she is trained as a research lab. technician but is currently a homemaker. CLOF: Mary reports she’s having a hard time keeping up with her husband and children and increasing difficulty managing her home. Even minor activities such as reaching to upper cabinets/closets, lifting and carrying groceries or laundry result in significant pain. As a result she has been very sedentary lately and feels that she fatigues easily. PMH:  hypercholestemia (210mg/dL) SH: 1 pack per day smoker x 35 years MEDS: takes Tylenol for current pain; started taking over the counter allergy medicine, Zyrtec, by mouth 3 weeks ago because of recent nasal congestion and cough. She is self referred to PT with goals to decrease pain, return to regular activities and exercise, and to feel good enough to be able to start part-time work. PHYSICAL EXAMINATION: Posture and Observation: Posterior pelvic tilt, increased thoracic kyphosis, Mod forward head, C – spine in L side bend.   Height:  1.75 meters  (69 in)    Weight: 55 kg  (121 lbs)       BMI: 18.28 VSs at rest: HR 84 bpm, reg ;  RR 22,  upper chest breathing pattern  BP  120/75 Active Range of Motion: Cervical spine: flexion 0 to 30 degrees; extension 0 to 25 degrees; rotation (R) 0 to 40 degrees, (L) 0 to 15 degrees; sidebending (R) 0 to 30 degrees, (L) 0 to 20 degrees MMT Strength Testing: Upper trapezius (B) 5/5; middle trapezius (R) 3/5, (L) 2/5; lower trapezius (B) 2/5; sternocleidomastoid (B) 2/5; trunk curl 3/5; bilat leg lowering (abdominals)  2/5; Palpation: Tender to light pressure in suboccipital region, medial upper and mid trapezius, SCM origin & insertion L > R Function: sitting tol. 20 mins, standing tol. 15 mins, can lift 5lbs from knee to waist and waist to shoulder level with mild increase in discomfort; unable to lift heavier loads due to significant increase in pain, unable to lift loads from floor level, unable to reach/lift overhead due to pain.  Amb. independently indoor and outdoors w/o assistive device, up to ½ mile on level surfaces with reports of fatigue and increased discomfort/pain; Amb. elevations independently w/o AD but uses 1 rail on stairs for stability.     Question 46: List 4 different impairments of body structure and function in this patient. (2 pts)  

Your 55 year old female patient reports that she walks at a comfortable pace 3 x/week for 30 minutes and lifts weights x2/week at her local gym. Does this patient’s activity level meet the ACSM recommended guidelines for physical activity?

Mary is a 55-year-old female with CC of 3-month history of left sided neck and central – left upper back/scapula pain. SH: married with twin 10 year old children; she is trained as a research lab. technician but is currently a homemaker. CLOF: Mary reports she’s having a hard time keeping up with her husband and children and increasing difficulty managing her home. Even minor activities such as reaching to upper cabinets/closets, lifting and carrying groceries or laundry result in significant pain. As a result she has been very sedentary lately and feels that she fatigues easily. PMH:  hypercholestemia (210mg/dL) SH: 1 pack per day smoker x 35 years MEDS: takes Tylenol for current pain; started taking over the counter allergy medicine, Zyrtec, by mouth 3 weeks ago because of recent nasal congestion and cough. She is self referred to PT with goals to decrease pain, return to regular activities and exercise, and to feel good enough to be able to start part-time work. PHYSICAL EXAMINATION: Posture and Observation: Posterior pelvic tilt, increased thoracic kyphosis, Mod forward head, C – spine in L side bend.   Height:  1.75 meters  (69 in)    Weight: 55 kg  (121 lbs)       BMI: 18.28 VSs at rest: HR 84 bpm, reg ;  RR 22,  upper chest breathing pattern  BP  120/75 Active Range of Motion: Cervical spine: flexion 0 to 30 degrees; extension 0 to 25 degrees; rotation (R) 0 to 40 degrees, (L) 0 to 15 degrees; sidebending (R) 0 to 30 degrees, (L) 0 to 20 degrees MMT Strength Testing: Upper trapezius (B) 5/5; middle trapezius (R) 3/5, (L) 2/5; lower trapezius (B) 2/5; sternocleidomastoid (B) 2/5; trunk curl 3/5; bilat leg lowering (abdominals)  2/5; Palpation: Tender to light pressure in suboccipital region, medial upper and mid trapezius, SCM origin & insertion L > R Function: sitting tol. 20 mins, standing tol. 15 mins, can lift 5lbs from knee to waist and waist to shoulder level with mild increase in discomfort; unable to lift heavier loads due to significant increase in pain, unable to lift loads from floor level, unable to reach/lift overhead due to pain.  Amb. independently indoor and outdoors w/o assistive device, up to ½ mile on level surfaces with reports of fatigue and increased discomfort/pain; Amb. elevations independently w/o AD but uses 1 rail on stairs for stability.   Question 39: List 4 KEY follow up (FUP) questions/topics that should be asked of this patient within the Review of Systems and medical screening for referral process.  These questions should help guide the PT in deciding whether PT and/or referal is approprriate. (2 pts)

You advise the 58 yo patient in the previous question to make an appointment with his primary care physician to discuss his concerns.  What is your most appropriate next step for this patient?

Which statement best characterizes the divide between urban and rural communities in the 1920s?

In September of 2024, John and Matt got into a huge argument about the upcoming presidential election. John got so frustrated that he shoved Matt. Matt (who had been drinking) lost his balance, fell backward, and hit his head on a granite countertop. Matt developed a brain bleed that led to his death. If John is prosecuted for homicide in a traditional common law jurisdiction, which crime(s) could he potentially be convicted of?

Cruz and Micah go to the same high school and do not like each other, though they do like the same girl. Cruz eventually challenges Micah to a “no weapons fight,” to which Micah agrees. The fight begins as a fist fight, but when Cruz starts to get the best of Micah, Micah pulls out a knife and stabs Cruz. If Micah is charged with “assault with a deadly weapon,” should he prevail on a self-defense claim under the traditional common law?

Michael’s wife, Martha, was raped by a man who broke into their home one night while Michael was away on a business trip. After raping Martha, the man said, “Stay alert. I may come back for more.” The man was wearing a black ski mask. Michael is overwhelmed with anger (and other emotions) about what has happened. Three nights later, Michael hears a sound outside in their yard. He looks outside and sees someone in a black ski mask walking across their backyard. Michael immediately gets his gun, shoots at the person, and kills him. When Martha looks outside, however, she begins to weep. She recognizes the victim’s coat. It is their neighbor’s oldest son, and he is definitely not the man who raped her. The State charges Michael with murder. Michael’s defense is that the killing constituted manslaughter, rather than murder. Considering the fact that Michael shot the wrong person, can Michael succeed with a “heat of passion” manslaughter defense under a traditional common law approach? What about manslaughter under the Model Penal Code (MPC § 210.3)? Pick the best answer.