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Cheat sheet

NPTE-PTA Cheat Sheet

Practice QuestionsStudy Guide

Musculoskeletal

22-29%of exam

ROM + MMTJoint ConditionsPost-Op PrecautionsGait + PostureOrthopedic Tests

Neuromuscular + Nervous

19-25%of exam

Stroke + TBITone + ReflexesBalance + CoordinationPNF PatternsSCI Levels

Cardiopulmonary

14-19%of exam

Vital SignsExercise ResponseAirway ClearanceCardiac RehabCOPD + CHF

Other Systems

10-22%of exam

IntegumentaryWound StagesMetabolicLymphedemaSystem Interactions

Non-Systems

15-21%of exam

ModalitiesEquipmentSafetyPTA ScopeProfessional Duty

Quick Facts

Exam
NPTE-PTA
Body
FSBPT
Items
180 (140 scored)
Time
4 hours
Pass
Scaled 600/800
Fees
$485 + $92
Provider
Prometric
Eligibility
CAPTE PTA grad

MMT Quick Recall

None Flick Gone Gravity Some Max

3 = antigravity4 = moderate5 = full resistance2 = gravity eliminated

ROM vs MMT

ROM

  • Joint motion
  • Goniometer
  • Degrees measured
  • AROM or PROM

MMT

  • Muscle strength
  • Manual resistance
  • 0-5 grade
  • Antigravity tested

Motion vs strength

MMT Grades

0/5
No contraction
1/5
Trace flicker only
2/5
Gravity-eliminated full ROM
3/5
Antigravity, no resistance
4/5
Antigravity, moderate resistance
5/5
Antigravity, max resistance

Acute Injury

RICE: Rest Ice Compression Elevation

First 48-72 hoursReduces edemaLimits inflammationAdd NSAIDs if ordered

AROM vs PROM

AROM

  • Patient moves
  • Tests willing motion
  • Strength involved
  • Pain limits

PROM

  • Clinician moves
  • Tests joint integrity
  • No muscle effort
  • End-feel assessed

Patient vs clinician

Normal AROM

Shoulder flexion
0-180 degrees
Shoulder abduction
0-180 degrees
Elbow flexion
0-150 degrees
Hip flexion
0-120 degrees
Knee flexion
0-135 degrees
Ankle dorsiflexion
0-20 degrees
Ankle plantarflexion
0-50 degrees

Concentric vs Eccentric

Concentric

  • Muscle shortens
  • Lifts load
  • Less force output
  • Quad ascending stairs

Eccentric

  • Muscle lengthens
  • Controls load
  • More force output
  • Quad descending stairs

Shorten vs lengthen

Normal End-Feels

Hard
Bone-to-bone
Soft
Tissue approximation
Firm
Capsular or muscular
Empty
Pain stops motion
Springy block
Loose body
Boggy
Joint effusion

Open vs Closed Chain

Open chain

  • Distal segment free
  • Leg extension
  • Isolated joint
  • Single muscle

Closed chain

  • Distal segment fixed
  • Squat, lunge
  • Multi-joint
  • Functional task

Free vs fixed

THA Precautions

Posterior approach
No flexion past 90
Posterior approach
No adduction past midline
Posterior approach
No internal rotation
Anterior approach
No extension or ER
Duration
6-12 weeks typical
Crossing legs
Always avoid

Gait Quick Facts

Stance
60% of cycle
Swing
40% of cycle
Double support
20% of cycle
Cadence
100-120 steps/min
Velocity
1.2-1.4 m/s
Trendelenburg
Weak gluteus medius
Steppage
Foot drop pattern

Stroke Side Cue

Left lost language, right rushes risk

Left CVA: aphasiaLeft CVA: cautiousRight CVA: neglectRight CVA: impulsive

Spasticity vs Rigidity

Spasticity

  • Velocity dependent
  • UMN lesion
  • Clasp-knife pattern
  • Stroke, SCI

Rigidity

  • Velocity independent
  • Basal ganglia
  • Cogwheel or lead-pipe
  • Parkinson disease

Speed-driven vs constant

Tone + Reflexes

Hypertonia
UMN lesion sign
Hypotonia
LMN or cerebellar
Spasticity
Velocity-dependent resistance
Rigidity
Velocity-independent resistance
Clonus
Rhythmic stretch beats
Babinski
Toe extension, UMN
DTR 2+
Normal reflex
DTR 4+
Hyperactive, clonus

SCI Functional Levels

C1-C4
Ventilator dependent
C5
Power chair, biceps
C6
Tenodesis grasp
C7
Independent transfers
T1-T9
Wheelchair independent
T10-L1
Household ambulation
L2-S5
Community ambulation

Stroke Side Profile

Left CVA
Right hemiparesis
Left CVA
Aphasia, slow cautious
Right CVA
Left hemiparesis
Right CVA
Neglect, impulsive
Brunnstrom 1
Flaccid stage
Brunnstrom 4
Movement out synergy
Brunnstrom 6
Near normal

Abnormal Vitals Response

  1. Chest pain begins→Stop, sit, notify(Call PT/RN)
  2. SBP drops >10→Stop activity(Recheck)
  3. SBP >200→Stop exercise(Report PT)
  4. SpO2 <90%→Rest, reassess(Add O2 if ordered)
  5. HR irregular→Stop, monitor(Document)
  6. Sudden dyspnea→Position upright(Notify nurse)

Stop Exercise If

SBP drop
>10 mmHg with exercise
SBP rise
>250 mmHg
DBP rise
>115 mmHg
HR drop
Below resting
SpO2
Below 90%
RPE
Borg above 15
Symptoms
Chest pain, dizziness

Normal Adult Vitals

HR rest
60-100 bpm
BP normal
<120/80 mmHg
Resp rate
12-20 breaths
SpO2
>=95% room air
Temp
97-99 F
MaxHR
220 minus age
Target HR
60-80% max

Pressure Injury Stages

Stage 1
Nonblanchable erythema
Stage 2
Partial dermis loss
Stage 3
Full thickness, fat
Stage 4
Bone, tendon, muscle
Unstageable
Eschar covers wound
DTI
Deep tissue injury

Stairs Order

Up with good, down with bad

Good leg leads upBad leg leads downCane with bad legHeaven up, hell down

PT vs PTA Scope

PT

  • Initial evaluation
  • Develops POC
  • Discharge decision
  • Sharp debridement

PTA

  • Implements POC
  • Collects data
  • Modifies within POC
  • Reports to PT

Evaluate vs implement

Modality Picker

  1. Acute injury <48h→Cryotherapy(Cold pack)
  2. Chronic muscle spasm→Moist heat(Hot pack)
  3. Deep tissue heating→US 1 MHz(Continuous)
  4. Tissue healing→US pulsed(Nonthermal)
  5. Acute pain→TENS high(Gate control)
  6. Muscle reeducation→NMES(Strengthening)
  7. Wound healing→ES wound(Polarity protocol)

Therapeutic Modalities

US continuous
Thermal, deep heat
US pulsed
Nonthermal, tissue repair
US 1 MHz
Deep, 3-5 cm
US 3 MHz
Superficial, 1-2 cm
TENS
Pain modulation
NMES
Muscle reeducation
Hot pack
8 layers towel
Cold pack
10-20 min max

Isolation Types

Contact Droplet Airborne

Contact: MRSA, gownDroplet: flu, maskAirborne: TB, N95Standard: always

PTA Task Allowed

  1. Initial evaluation→PT only(Never PTA)
  2. Develop POC→PT only(Never PTA)
  3. Sharp debridement→PT only(Outside PTA)
  4. Spinal manipulation→PT only(Not PTA scope)
  5. Implement POC→PTA okay(Within plan)
  6. Collect data→PTA okay(Report PT)
  7. Modify intensity→PTA okay(Within POC)
  8. Discharge decision→PT only(PTA reports)

Assistive Devices

Cane
Opposite affected side
Cane height
Greater trochanter level
Crutch height
2 fingers below axilla
Walker WBAT
Most stable choice
Stairs up
Good leg first
Stairs down
Bad leg first
Elbow flex
20-30 on handgrip

Device Picker

  1. Min support balance→Single cane(Opposite side)
  2. Mod support balance→Quad cane(Wider base)
  3. PWB one limb→Axillary crutches(3-point gait)
  4. NWB short term→Walker(Most stable)
  5. Bilateral weakness→Rolling walker(Easier propulsion)
  6. Long-term LE weak→Forearm crutches(Lofstrand)

Safety + Infection

Standard
All patients, all fluids
Contact
MRSA, C. diff, gown
Droplet
Flu, mask within 6 ft
Airborne
TB, N95, negative room
Gait belt
Required for transfers
Fall risk
Locked brakes always

Common Traps

Evaluate vs implement

PT evaluates ≠ PTA implements POC

MMT 3 vs 4

3 = no resistance ≠ 4 = some resistance

US thermal vs not

Continuous heats ≠ Pulsed does not

Cane side error

Cane opposite side ≠ Not same side

Stairs direction

Good leads up ≠ Bad leads down

Spastic vs rigid

Spastic velocity dependent ≠ Rigid not dependent

Hot pack burn

Use 8 layers ≠ Not direct skin

Posterior THA limit

No flexion past 90 ≠ No adduction past midline

Last Minute

  1. 1.180 items, 4 hours, scaled 600
  2. 2.PT evaluates; PTA implements POC
  3. 3.PTA cannot debride sharp wounds
  4. 4.MMT 3 = antigravity, no resistance
  5. 5.Knee normal ROM 0-135 degrees
  6. 6.Cane opposite affected leg
  7. 7.Up good leg; down bad leg
  8. 8.Stop if SBP drops >10 mmHg
  9. 9.Stop if SpO2 below 90 percent
  10. 10.1 MHz deep; 3 MHz superficial
  11. 11.Continuous US heats; pulsed nonthermal
  12. 12.Hot pack: 8 layers, 15-20 minutes
  13. 13.Posterior THA: no flexion past 90
  14. 14.Left CVA aphasia; right CVA neglect
  15. 15.Contact gown; droplet mask; airborne N95

FSBPT PTA Physical Therapist Assistant

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