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PTA Procedures II > 160 Final > Flashcards

160 Final Flashcards

1
Q

Signs of Wound Infection

A

Redness

Swelling

Warmth

Odor

Yellow Crust formation

Pus, cloudy, watery fluid

Low grade fever, chills

Tender lumps/swelling at neck, armpit, groin

Tissue texture

Red streaks running from wound out

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2
Q

Post Surgical Swelling

A

Sweeling near the incision site is rish in protein. Distally is softer and pitting

Swelling occurs to the whole arm

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3
Q

Cellulitis

A

localized swelling and redness of the subcutaneous tissue

Sometimes combined with fever

commonly LE, can occur UE and face, torso

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4
Q

Manual Techniques for Lymph edema

A

Message, light gentle strokes in direction of lymph flow

Proximals to distal to proximal

Fibrotic tissue requires more “kneading”

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5
Q

Exercise techniques for lymphedema

A

Low exertion, slow and rhythmic

Diaphragmatic Breathing

Careful with weight lifting

Aerobic

Exercise with compression garments if possible

Posture

ROM in all extremities

Swimming is good, cautious with skin care

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6
Q

Documentation of a Wound

A

Size, Depth Location

Color

Odor

Alt Sensation

Circulation

Wet/Dry

Surrounding skin appearance

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7
Q

Stages of Wound Infection

A

Stage 1 - Erythemia of the skin. Epidermis still intact.

Stage 2 - Dermis penetrated. Wound is usually moist and pink with no necrotic tissue

Stage 3 - Subcutaneous penetrated. Tunneling and Undermining can ossur. Exudates and infection may be present.

Stage 4 - Deep tissue (fascia, bone, tendons) are affected. Tunneling, infecetion, exudates can occur.

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8
Q

Wound Dressings

A

Wet to wet - Stage II, III, IV, and unstaged

Wet to Dry - Stage II, IV for debridement

Transparent film - Satge I, II, with blister formation, over boney prominences, and non infected wounds

Hydrocollid - Stages II, III with minimal drainage

Hydrogel - Stages II, III

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9
Q

Wound Dressing Purpose

A

Stop the spread of infection, from wound to other areas

Prevent contamination

Control hemmorhage

Absorb wound drainage

Assist in wound healing

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10
Q

Compression Wrap Purpose

A

Prevent re-accumulation of Evacuated lymph fluid

Pressure applied to reduce filtration

Improves muscle and joint pumps

Breaks up fibrotic tissue

Facilitate protein absorption

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11
Q

Debridement Methods

A

Sharp - scalpel

Mechanical - hydrotherapy

Chemical - rarely used

Autolytic - bodies own enzymes to rehydrate necrotic tissue

Enzymatic - application of gels to rehydrate necrotic tissue

Bilogical - maggot therapy

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12
Q

Pressure relief techniques

A

Chair pushups

Lean from side to side

Airflow beds

Freq position changes

Bed incline at min 30 degrees to prevent sliding

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13
Q

Lymphedema

(characteristics)

A

Feeling of fullness in area

Tightness of skin

Affects LE, sometimes UE

Loss of motion in wrist, hands, ankle

Uncomfortable, not painful

Asymmetrical

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14
Q

Lymphedema

(Skin Changes)

A

Shiny

Tough

Blisters

Papillomas: small benign epithelial tumors

Hyperkaratosis: Thickening of the outer layer of skin

weeping, oozing lyph fluid

Superficial skin lesions

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15
Q

Lymphedema

(treatment)

A

Compression bandages help to prevent further swelling

Manual exercise, and exercise

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16
Q

Hyperglycemia

A

*Too little systmeic insulin

Flushed, dry skin

drowsy

thirsty

high glucose in urine

fruity odor breath

Vomiting

Loss of appetite

*Treat with insulin

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17
Q

Hypoglycemia

A

*Low blood sugar d/t excessive insulin

Perspiration

Anxiety, irritability

Shakey, trembling

Weakness

Pale moist skin

Convulsion

Confusion

*Treated with candy, juice, rest

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18
Q

Measuring edema accuracy

A

Boney landmarks

Same tape meaurer

Tension gauge

Same person to meaure (if possible)

Taken in CM

Relaxed position

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19
Q

Steril Field Rules

A
  1. Steril person’s withing a sterile field only
  2. Once package is opened, borders are contaminated
  3. Waist/Table top above is sterile
  4. Top of table is sterile only
  5. Movement within, breaks field
  6. Particles (coughing, talking) breaks field
  7. Prepare close to time needed
  8. Non-sterile person can prepare sterile field
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20
Q

Venous insufficiency

A

Venous flow in poor

Dark dusky appearance

Dry and flaky

Low protein

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21
Q

Arterial Insufficiency

A

Thin, red, shiny skin appearance

Hairloss

Painful with elevation

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22
Q

Ascites

A

Abdominal swelling. Can travel into LE

Commonly caused by liver cirrhosis

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23
Q

Anasarca

A

General edema in very ill pts

CHF, Renal failure, Electrolyte imbalance

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24
Q

Lipedema

A

Low protein primarily in the LE

Women

Does not include dorsal swelling

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25
Q

Lymphedema and Kinesio taping

A

10 % tension

high anchor

increases space for fluid to flow back up into

26
Q

Amputation Levels

A

Preserve as much boneand joints as possible. Determined by presence of pulse.

TT - Mid Tibia

TF - Mid Femoral

Hip Disartic - Removal through acetabulum

Symes - Ankle (malleoli and below)

Transtarsal - Mid tarsals

Chopart - Ankle (saves Calcaneus and talus)

27
Q

Jewett Hyperextension

A

Limits flexion and puts paient into extension

TLSO

28
Q

Milwaukee Brace

A

Extended up to the neck

Scoliosis

29
Q

Boston Brace

A

Helps with scoliosis

Clamshell, TLSO

30
Q

Clamshell Brace

A

Used when the spine/spinal cord has been injured

Prevents flex, ext, twisting

31
Q

Phantom Pain

A

Pain sensation felt where the limb used to be

Treatment: TENS

Message

Heat

Biofeedback

32
Q

Subtalar Neutral

A

About 0-5 degress inversion

33
Q

Femoral anti- retro version

A

Antiversion of 12-15 is normal

The angle of the femoral head within the acetabulum

34
Q

Tibial Torsion

A

Normal is 15-20 ER

35
Q

Pulmonary Edema

A

Excessive accumulation in the lungs

Often caused by L ventricular Failure. Also from injury

36
Q

Heat stroke

A

Diaphoresis, dry

Flushed or gray

Elevated temp

Nausea

Labored breathing

Strong rapid pulse

Pupils contract then dilate

Collapse, convulsing

Unconsciousness

37
Q

Heat exhaustion

A

Profuse sweating

No fever

Weak rapid pulse

Shallow rapid breathing

Pale

Collapse

Nausea

Unconsciousness

Norm pupils

38
Q

Heat exhaustion & stroke treatment

A

Move to cool shaded area with good airflow

Ice to groin, axilla, forehead

EME personell

Heat exhaustion can lead to heat stroke

  1. Refusal of liquids
  2. Vomiting
  3. Schock
  4. LOC
39
Q

Fracture

Procedure

A

Gather info on cause, location, pain

Restrict mvmnt

Monitor HR, BP

Palpate for swelling, tenderness, deformity, bruising

Apply support with firn object

Cover with sterile dressing

If Spinal fx is suspected (use 3 ppl to log roll onto a flat board)

Evaluate neurological function and sensation

Call for transport

40
Q

Burn

Procedure

A

Remove agent causing the burn

If chemical dilute with water

Remove clothing around burn, not what is a part of the wound

Remove jewelry

Call EME if bad

Observe for shock, resp distress

Call for transport

41
Q

Seizures

Procedure

A

Place pt in safe location, position. Move objects out of way

Keep airways open. (not by placing anything in the mouth) Head tilt, jaw thrust

Monitor respiration. May have an episode of tonic contraction of all muscles, ceasing resp for 50-70 secs. when breathing returns it will be slower and deeper.

Allow rest

42
Q

Fall

Risk Factors

A

>65

Impaired vision/hearing

Use of A.D.

Decreased strength, flexibility, balance, coordination, proprioception

Prev Hx of falls

Seizure, syncope, vertigo

Medication

Inattentiveness to while walking

43
Q

Shock

Procedure

A

Determine cause

Calm pt

Cool compress

Monitor HR BP

Place person supine, legs elevated

Control bleeding if present

Call for Treatment

Monitor

44
Q

Allergic RXN

Procedure

A

Initial

  1. Calm Pt
  2. Identify/remove agent
  3. Apply ice/calime for itch
  4. Observe for increased signs
  5. Obtain/refer for med assist

Severe

  1. Check aiways (if compromised, get assist and begin CPR)
  2. Assist with ingestion/injection of meds (if DIB, do not ingest)
  3. Pt supine, LE elevated to prevent shock
45
Q

Allergiv RXN

Signs

A

Acute:

  1. Itchy skin
  2. Rash
  3. Redness
  4. Swelling
  5. Sneezing
  6. Hives
  7. Itchy/watery eyes

Severe

  1. Facial swelling
  2. DIB, wheezing
  3. Abd pain, Nausea, Vomiting
  4. Dizziness, syncope
46
Q

Autonomic Hyperreflexia

A

Dysreflexia

Sympathetic response to a noxious stimulus below the lesion of injury. (Cervical to T6 injury)

  • HTN
  • Headache
  • Profuse sweating
  • Red skin blotches
  • Goosebumps
  • General ill feeling
  • Convulsion
  • Poss unconsciousness
47
Q

Autonomic Hyperreflexia

Treatment

A

Place pt recumbant or sitting (not supine)

Identify and remove stimulus

Monitor vitals

Obtain Med assist

48
Q

Cardiac Arrest

Treatment

A

CPR

911

AED

49
Q

Plantar Fascia

A

Plantar aponeurosis

Originates medially off calcaneal tuberosity and atatches at the base of the proximal phalanges

Provides stability durig toe off phase.

Support longitudinal arch or foot

50
Q

Metatarsalgia

A

Pain at the metatarsal heads due to fatty pad atrophy causing compression of th plantar digital nerve

51
Q

Morton’s Syndrome

A

Neuroma in the plantar digital nerve because of compression

Try to redistribute the pressure from the 2nd and 3rd MTP to the proximal hallux and stabilize rearfoot

Shoe: Longe medial counter, wide oe box, thomas heel or wedge

52
Q

Post Surgery Pre Porsthetic

Limb care

A

Edema control

  • Wrapping
  • RIgid removal dressings

Desensitization

Preventing scar tissue

Phantom sensation

Strengthening (prevent contractures)

  • Hip flex/ext
  • Kne flex, ext
53
Q

Quadrilateral socket construction

A

Post wall - Brim to Ischial Tuberosity (hip in 15-20 flex

Medial wall - Same height as post wall, groove cut out for pressure releif. Slight Add for abd stretvh

Ant wall - 2 1/2 inches taller to keep ischium on seat

Lat wall - Same as ant wall to stabilize limb in prosthesis

Distal end - Designed for pt comfort

  • Total contact, hard plastic end
  • Distal air chamber - soft leather pad
  • Open
54
Q

Abducted Gait

Prosthetics

A

High Medial Wall

Too long

Abductor contracture

55
Q

Circumducted gait

Prosthetic

A

Knee locked in ext

No PF

Too long

Weak hip flex

Abd Contracture

56
Q

Lat trunk bend gait

Prosthetics

A

Short limb

Weak Abductors

High medial wall (pain)

Low lateral wall (stability)

57
Q

Vaulting Gait

Prosthetics

A

Knee locked in ext

Weak hip flex

Too long

58
Q

Lumbar lordosis gait

Prosthetics

A

Tight hip flex

Short ant wall

Painful ischial WB

Weak hip ext

Weak abdominals

59
Q

Unever step length gait

Prosthetics

A

Weak stump

Poor balance

Hip flex contracture on unaffected side

Weak hip ext

Improper socket fit

Pain

Not enough flex

60
Q

Terminal swing impact gait

Prosthetics

A

Not enough knee friction

Excessive hip flex with strong hip ext

61
Q

Foot slap gait

Prosthetic

A

Heel too soft

DF foot

Knee Flex

Foot too posterior

PF bumper too soft

62
Q
A

PTA Procedures II (1 decks)

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