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PTA Patho > 195 Test 2 > Flashcards

195 Test 2 Flashcards

1
Q

Skin Disease

(signs and symptoms)

A

Pruritis

Rash

Blisters

Unusual moles, spots, nodules, cysts

Uticaria

Xeroderma

Changes in nail bed

Changes in color, texture, turgor

edema, swelling

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2
Q

Integument and Aging

A

Lost of elastin - poor wound healing

Decrease in Langerhans cells - poor immunological response

Epidermis and dermis compress - changes in permeability

Decrease in sweat glands - Poor thermoregulation

Decrease in number of nerve endings - Increase pain tolerance

Decreased vascularization - Poor circulation

Change in basil cells - decreas inflammatory response

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3
Q

Cellulitis

A

Infection of the skin and subcutaneous tissues

Localized Swelling, erythemia, warmth, tenderness

Often in LE, but can occur in UE torso and face

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4
Q

Cold Injuries

A

localized or systemic exposure to cols

Treatment:

Warm gradually, with warm water or against warmer body

Analgesics

Avoid WB

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5
Q

Burns

(definition)

A

Results from exposure to thermal, chemical, electrical, and radiation element

Classified by depth, size, location, age(<3 y.o., >70 y.o.) general health, and mechanism of injury

Superficial - Penetrates the epidermis (sun burn)

Partial-thickness - Pentrates the Dermis

Full-thickness - penetrates Subcutaneous

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6
Q

Superficial burn

A

1st degree

Penetrates the epidermis

Pain relieved with cold

Erythemia, dry, no blisters, skin blanches with pressure

Discomfort for 48 hrs. Heals in 3-7 days

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7
Q

Partial-thickness Burn

A

2nd degree

Penetrates dermis

Large thick walled blisters covering extensive area. Edema, mottled red base, broken epidermis, wet shiny weeping surface

Painful, sensitive to cold

Superficial heals in 14-21 days

Deep heals in 21-28 days

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8
Q

Full-Thickness burn

A

3rd degree

Penetrates subcutaneous

Painless

DRy surface, edema, fat exposed, tissue disrupted

Color varies (dark red, black, white, brown)

Heals with grafting (req’s eschar removal). Small areas can heal without grafting.

Wound contracture and hypertrophic scarring can occur if not prevenaive measure is aken

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9
Q

Rule of Nine’s

A

Head 9%

Torso front/back 18% ea

Arms 9% ea

Genitalia 1%

Legs 18% ea

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10
Q

Role of PT

Burns

A

Increase ROM, strength, mobility (dressings off)

Prevent and minimize deformities

Pulmonary hygiene

Wound care and positioning

Pt on meds, can feel pain but will forget.

* Pt has pain medication but can still feel the pain. They will later forget about it.

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11
Q

Arterial Ulcer

A

Arterial insufficiency

Located on lower leg, dorsal feet, distal toes, and lateral malleouli

Deep, well defined, dry with necrosis

Severe pain that increases with motion and LE elevation

Decreased skin temperature

Thin, shiny skin with hairloss

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12
Q

Venous Ulcer

A

Venous insufficiency

Dark, dusky pigmentation. Dry and Flakey skin

located medially on the LE

Irregular in shape, shallow, superficial, with moderate drainage

Mild to moderate pain, relieved with LE elevation

Increased edema

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13
Q

Pressure Ulcer

A

Located over boney prominences

Results from prolonged immobilization, shear force, medication, muscular atrophy

Stages 1-4

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14
Q

Neuropathic Ulcer

A

Associated with ischemia, and nerve damage

Over plantar surface of feet often over metatarsal head

Well defined wound, prominent callus, round crater like with minimal drainage. Usually deep

Without pain, unless neuropathy is painful

Shiny skin appearance

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15
Q

Lymphatic System

(purpose)

A

Maintain fluid balance within the tissues

Fight infection

Assist in cellular waste removal (destroy foerign bacteria, CA cells)

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16
Q

Lymphedema

A

Swelling of soft tissue from the accumulation of protein-rich interstitial fluid. May be idiopathic (primary) or acquired (secondary)

Primary - malformation of lymph vessels from birth

Secondary - Deformation of lymph vessels d/t trauma, surgery, ect.

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17
Q

Lymphedema

(signs and smptoms)

A

Commonly presents in the LE, can occur in the UE

Sensation of tightness, fullness

Decreases flexibility in wrist, ankle, hands

Increased limb circumfrence

Postural changes

Discomfort more than pain

Neuromuscualr defects

Increased risk of injury

Increased healing time (decrease oxeygen to the tissue decreases metabolic rate)

Integumet changes (hairloss, loss of sweat glands, Keratotic skin patches)

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18
Q

Lymphedema

(Causes)

A

Surgery

Burns

Crush injury

Raditaion Treatment

Chemotherapy

Paralysis

Severe laceration

Degloving skin injury

Lipedema

Air travel

Liposuction

Chronic venous insufficiency

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19
Q

Lymphedema

(Stages)

A

Stage 0 - Lymph transport capacity reduced. No noticible edema

Stage 1 - Pitting edema, reversible with elevation. (Normal size in the AM) Increases with heat, humidity, activity

Stage 2 - Non pitting edema with connective scar tissue. non reversible, fibrosis present. Skin changes occur in severe stage 2

Stage 3 - Lymphostatic elephantitis. Increase in connective and scar tissue. Severe non pitting edema with atrophich skin changes.

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20
Q

Lymphedema

(complications)

A

Thickening dermal layer

Skin dries and cracks causing poor healing ulcers

Skin folds and flaps develop and become sites of fungal and bacterilal infection.

Postural changes, ROM and functional changes

Changes in sensation, and kinesthetic awareness increasing the risk of injury

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21
Q

Implications form PT

A

Avoid trauma to the skin and minimize the risk of infection

Phase 1 - Skin care, manual lymph therapy, compression bandages, Individual home program

Phase 2 - Compression garments, skin care and exercise

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22
Q

Lipedema

A

Symmetrical swelling and accumulation of fatty tissue of the LE (not including feet)

Stage 1 - Soft and regular with nodular changes felt upon palpation. Subcutaneous tissue has spongy feel

Stage 2 - Tissue more nodular and tough. Pitting edema is common when associated with lymphedema.

Occure primarily in women

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23
Q

Cardiopulmonary

(signs and symptoms)

A

Chest, neck and arm pain

Palpitations

Dyspnea

Syncope

Fatigue

Cough

Cyanosis

Peripheral edema

Claudications

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24
Q

Chest Pain

A

Can radiate to jaw, neck, upper trap, shoulder or arm (commonly left)

Caused by ischemia, MI, pericarditis, endocarditis, mitral valve prolapse

Accompanied by Nausea, vomiting, diaphoresis, dyspnea, fatigue, pallor, syncope

Angina - refers to specific chest pain. Heart not gettin enough oxygen.

*R/O muscle pain with contraction and mvmnt through full range

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25
Q

Dyspnea

A

Breathlessness, SOB

DOE - May be caused by poor L ventricle function causing pulmonary congestion.

May progresss to dyspnea on rest, dyspnea at night, orthopnea, and sudden unexplained episodes of SOB.

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26
Q

Cough

A

Associated with pulmonary complications of cardiovascular disease

Associated with poor L ventricle function resulting in pulmonary edema

Fluid in lungs

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27
Q

Peripheral edema

A

Indicates R ventricle failure, renal failure and CHF

Usually bilateral and may be accompanied by jugular venous distention, cyanosis, and abd distention.

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28
Q

Claudication

A

Cramping or leg pain associated with activity. Indicated PVD

Usually associated with skin discoloration and trophic skin changes. (Thin, dry, hairless skin)

Accompanied by decrease in peripheral pulses and skin changes during/after exercise.

*Walking takes more oxeygen which causes more pain

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29
Q

Cardiopulmonary and Aging

A

Less blood circulated to the skin

Heart works harder, and vascular system loses elasticity

Cardiovascualr stsem is less able to respond to demands (decreased reserve capacity)

Effects are lessened by physical activity and regular exercise

D/t sedentary lifestyles and complications of disease, treatment, ect.

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30
Q

Ischemic Heart Disease

A

CAD and CHD

Narrowing and hardening of the arteries

Arterirosclerosis - thickening and lose of elasicity of the arterial walls

Athersclerosis - thickening of arterial wall through the build up of lipids and cells

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31
Q

Ischemis Heart Disease

(Risk Factors)

A

Modifiable - Smoking, poor nutrition, excess ETOH, stress, HTN, Obesity, inactivity, Elevated LDL and HDL

Non-modifiable - Age, Male, Family HX, ethnicity, infection

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32
Q

Ischemic Heart Disease

(Medical Management)

A

Decrease LDL levels before arteries are damaged

Exercise, Diet, Modify risk factors, cholesterol lowerinf drugs.

Treatment

Surgery, PTCA (with stint), CABG

Cardiac rehab - prescribed ex program

I) in-patient II) Out-patient III) intermediate IV) long term rehab

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33
Q

Ischemic Heart Disease

(Exercise)

A

Increase exercies - lengthy and intense. Total Caloric expenditure is more important than short or long period of exercise

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34
Q

Sternal Precautions

A

Place hands on chest and ask pt to cough. Asymetry = unstable

No pulling up in bd

Hand held assist during mobilization

No pulling/pushing/lifting more than 10 lbs - 6 wks post op

No driving motorized vehicles or sitting shotgun - 4 wks post op

Avoid H. ABD extreme ER

Full neck, shld, torso ROM permitted with stable sternum.

Skin of muscle flap present limits flex.abd 90 degrees

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35
Q

Hypertensive Cardiovascular Disease

A

Increased BP leads to arteriosclerosis which leads to HTN Cardiovasular Disease

Persistant elevation of systoli >140 or diastolic >90 or both. Measured at least 2 wks apart

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36
Q

Hypertensive Cardiovasular Disease

(Risk factor)

A

Modifiable - High sodium intake, obesity, sedentary lifestyle, personality traits, DM, smoking

Nonmodifiable - Family HX, age, gender, ethnicity

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37
Q

Hypertensive Heart Disease

(Medical Managment)

A

Prevention

Activity, Weight control, Decrease sodium and ETOH intake, Alt modifiable risk factors

Medication

Beta blockers, calcium channel blockers, ACE inhibitors, Diuretics

Exercise - Health beneofts for HTN can be achieved with fitness, and increase in activity

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38
Q

Myocardial Infarction

A

Developement of ischemia with heart muscle necrosis

Exercise begins within 24 hrs, in uncomplicated cases, to decrease complications/effects of bedrest and to begin retraining the heart (pacing with periods or rest)

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39
Q

CHF

A

Heart can’t pump enought blood to supply the bodies needs

L ventricle failure

R ventricle failure - cause by pulmonary emboli and L ventricular failure

Common complication of HTN and ischemis Heart Disease

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40
Q

CHF

(exercise)

A

Monitor vitals

Aerobic capacity decreased

Position (fowler’s, head elevated 20 degrees)

Mod intensity exercise for 2-6 mins followed by 2 min rest

Note: Decrease in aerobic activiyy

41
Q

Orthostatic Hypotension

A

Decrease in 20 mmHg systolic

or Decrease in 10 mmHg in both systolic and diastolic with an increase of 15 bpm when going from sit to stand

Caused by

Medicine side effects, prolonged immobilization, malnutrition, valsalva maneuver, venous pooling

42
Q

Orthostatic Hypotension

(Treatment)

A

Slow rise from bed to stand

ankle pumps

raise hands over head with deep breaths

Abd compression (binders, stockings)

Increase HR, BP

43
Q

PVD

A

Disease of the blood vessles suppling the extremities and abd organs(commonly intestines and kidneys)

Inflammatory

Arterial occlusive

Venous Disorder

Vasomotor Disorder

44
Q

Thrombophlebitis

A

PVD (Venous disorder)

Partial or complete occlusion of a vein by a clot along with an inflammatory reaction in the wall of the vein.

Superficial (vericose, IV)

Deep (DVT)

45
Q

DVT

A

Increases risk for pulmonary emboli

Caused by venous stasis, abn coagulation, injury to vein wall

Usually occurs in the LE, may be in UE (Edema without pain)

Many are asymptomatic.

Symptomatic would include tightness, edema, calf pain

Diagnosed through doppler.

46
Q

DVT

(Medical Managemnet)

A

Goals

Prevent progression of emboli

limit damage to vein

prevent the development of another clot

Treatment

Anticoagulation therapy

Elastic stockings

Prevenative (early mobilization, anti-coag tx)

47
Q

DVT

(Risk Factors)

A

Immobility - bedrest, cardiac failure, travel

Trauma - Vericose veins, surgery, fx, childbirth

Lifestyle - smoking, hormonal status

Hypercoagulation - hereditary thombotic disorder, increased levels of coagulation

Other - DM, Obestiy, older than 60, prev dvt

48
Q

Raynaud’s Disease

A

PVD (vasomotor disorder)

intermittent vasospasms of distal extremities in reponse to cold exposure or strong emotion

Takes long for hands to warm

49
Q

Chronic Venous Insufficiency

A

PVD (Venous disorder)

Inadequate venous return over a long period of time.

Chronic pooling of the blood prevents adequate oxygen and waste removal which can lead to skin ulcers

50
Q

Chronic Venous Insufficiency

(Risk Factors)

A

Leg trauma

varicose veins

Prev DVT

51
Q

Chronic Venous Insufficiency

(Implications for PT)

A

Prevention of ulcers

exercise

compression therapy

education

52
Q

Alpha Adrenergic Blockers

A

Decrease BP by dilating peripheral blood vessels which reduce peripheral resistance.

Smooth Muscle relaxer

Side effects:

Headache, palpitations, dizziness, fatigue, nausea, fainting, weakness, drowsiness

53
Q

ACE Inhibitors

A

1st line of defense for HTN

Prevents the constriction of blood vessles and retention of sodium and fluid

Improves HR during exercise in early phase of MI to prevent Heart Failure

Side effects:

Insomia, Headache, weakness, dizziness, rash, dry cough, palpitations, fainting, abd/feet swelling, numbness and tingling in hands, feet, and lips

54
Q

AT-II receptor antagonistic agents

A

Vasodilate arterioles and enhace renal clearance of water and sodium

Side effects:

Myalgia, dizziness, insomnia, anxiety, hypotension, visual changes, cough

55
Q

Antiarrhythmic agents

A

Alter conduction patterns in the heart

Side effects:

Nausea, vomiting, rash, electrolyte imbalance, insomnia, dizziness, SOB, swollen ankles, coughing blood

56
Q

Beta Blockers

A

Relaxes blood vessels of the heart which reduce HR, BP, dysrhythmias, angina and myocardial oxygen demands

Side effects:

Decrease rest/ active HR, DIB, chest tightness, syncope, orthastic Hypotension, weakness, Asthmatic attacks, dizziness, nausea, fatigue, insomnia

57
Q

Nitrate

A

Treats angina, CHF, HTN, pulmonary edema

Dilate coronary arteries to decrease blood flow to the heart

Side effects:

Headache, dizziness, orthostatic hypotension, tachycardia

58
Q

Statins

(Lipid lowering drugs)

A

Blocks tge absorption of Cholesterol. Helps increase HDL and slightly lowe LDL

Side effects:

Nause, Vomiting, Diarrhea, constipation, myalgia, rhabdomyolysis, neuropathy

59
Q

Rhabdomyolysis

A

Inflammation of the muscles causing skeletal break down. Large particles that get released in to the blood stream which can cause kidney damage.

60
Q

Pulmonary Disease

(Signs and symptoms)

A

Cough

Cyanosis

Chest Pain

Clubbing

Dyspnea

Alt breathing patterns/sounds

Rate, depth, regularity, effort, use of accessory muscles, Adventitious breath sounds.

61
Q

Adventitious Breath Sounds

A

Identified via auscultation.

typical of airway constriction or fluid accumulation

crackles

rales

rhonchi

wheezing

stridor

dimished breath sounds

Absent breath sounds

62
Q

Diagnostic Procedures

(Pulmonary)

A

PFT

ABG - Measures O2 and CO2 in alt blood, arterial PH

Cultures and sensitivity- Presence, type of microorganisms

Thoracentesis - Remove pleural fluid

Bronchoscopy - Direct visualization of bronchioles

CT and MRI

Pulse Oximetry - Measure O2 saturation

63
Q

Pulmonary Funtion Tests

A

Screen for specific pulmonary dieases. Reveal abnormalities

Tests - Static lung volumn, dynamic breathing, physiologic tests

Values recorded

VC, IC, IRV, ERV, FRC, RV, TLC, Vt, f

64
Q

Aging and the Pulmonary

A

Infections, environmental/occupational pollutants and the normal aging process is what decreases lung function

Aging causes structural changes in upper and lower resp system

Leads to increase work to breath

Decrease in muscle strength

Decrease movement of cilia

Increased chest wall stiffness

Loss of elastic recoil

Surface area for gas diffusion changes

65
Q

Pneumonia

A

Inflammation of the lungs or alveoli

Bacterial, fungal, viral, mycoplasmal

Inhale toxi or caustic chemical, smoke, dust, grease

Aspiration of food, fluids, vomit

66
Q

Pneumonia

(Signs)

A

Sudden sharp chest pain aggrevated by mvmt

Hacking, productive cough-rust/green colored

Dyspnea

Tachypnea + decreased excursion

cyanosis

Headache

fatigues

Fever, chills

General aches and pains

Myalgia

67
Q

Pneumonia

(Implications)

A

Early ambultion

Potisioning

Adequate hydration

pulmonary hygeine (deep breathing, coughing, ect)

68
Q

Pulmonary Tuberculosis

A

Inflammatory systemic disease

Bacterial infection in the lungs effecting the upper lobe

Risk factors

Pt with HIV, poor population, prisonors, DM, older than 65, infants, druggies, end stage renal disease, immunocompromised.

Commonly transmitted by inhalation

69
Q

Emphysema

A

Pathalogical accumulation of air in the lungs particularly found in pt’s with COPD

Signs

Dyspnea, cough, Wheezing

Chronic allergies, liver problems, asthma that does not respond to treatment

70
Q

Asthma

A

Obstructive lung disease

Inflammation and increase of smooth muscle reaction of airways to various stimuli

Symptoms:

Coughing, chest tightness, wheezing, SOB

Treatment:

Fowler’s position

Encourage pursed lip, deep breathing

71
Q

Near Drowning

A

Survived the effects of fluid submersion. (lack of O2 effects blood acidosis)

Leads to cognitive and motor deficiency

72
Q

Peripheral Edema

A

INdicates r ventricular failure and CHF

Usually bilateral and dependant . May be accompanied by jugular venous distention, cyanosis and abd distention

73
Q

Ischemia

A

Obstruction in blood flow to tissue causing hypoxia on a cellular level

Precursor to infarction

74
Q

Hypoxia

A

Decrease oxygen to a cell

75
Q

Infarction

A

Cell death

76
Q

Pulmonary Embolism and infarction

A

Obstruction to the blood supply to the lings due to a blood clo in the pulmonary artery. Most common cause of DVT

77
Q

Pulmonary embolism and infarction

(Risk Factors)

A

Contraceptive

DVT occuring after surgery

78
Q

Pulmonary embolism and infarction

(Implications for PT)

A

Ankle pumps post op

Do not message leg cramp

Avoid - Restrictive clothing, crossing legs, prolonged sitting/standing

Elavate legs, knees bent, hip <90

79
Q

Pleural Effusion

A

Collection of fluid in pleural space. Commonly caused by heart failure and lymphatic obstruction.

Asymmtomatic, DOE, CP(sharp, stabbing)

Implications: Deep breathing, position changes (carefully)

80
Q

COPD

A

Chronic airflow limitation. Not fully reversible. Caused by environmental irritants (ie. smoking)

Preventable, no cure

81
Q

COPD

(Implications for PT)

A

exercise

Smoking Cessation

Nutrition/ wt control

Breathing exercises

Monitor vitals (pulse ox)

82
Q

Atelectasis

A

Collapse of the lung tissue at the structural level due to obstruction of the bronchus by mucus, tumor, foreign body, shallow breathing (hyperventilation, after coma…)

Secondary effect to thoracic, abd and cardiac surgery

83
Q

Atelectasis

(Implications for PT)

A

Frequent, gentle position changes

Depp breathing

Coughing

Early ambulation

Pot op treatment: Once atelectasis occurs, remove the cause

84
Q

Pulmonary Edema

A

Excessive fluid in the lungs that accumulates in the interstitial tissure and/or air space

Commonly caused by L sided heart failure, acute HTN, mitral valve disease, or other non-cardiac diseases

85
Q

Pulmonary Edema

(signs)

A

Asymptomatic

restlessness, anxiety

cough

dyspnea

diaphoresis, intolerance to exercise

Adventious breath sounds

Paroxysmal noctural dyspnea

86
Q

Pneumothorax

A

Accumulation of air and gas in the pleural cavity. leads to collapsed lung on affected side

Symptoms: dyspnea,

Sudden sharp chest pain

decreases BP

weak rapid pulse

87
Q

Pneumothorax

(Implications for PT)

A

Monitor vital signs (BP, Pulse)

88
Q

Endocrine system

Rule and function

A

System of gland responsible to the formation and release of hormones used to regulate cell and organs. Works with the nervous system to regulate homeostasis.

Functions:

Differentiate btwn reproductive and CNS of fetus

Stimultaion of sequential gorwth and development during childhood and adolescence

Coordintaion of male/female reproductive systems

Maintain optimal internal environment

Inititate and coordination of response to emergencies

89
Q

Aging and the endocrine system

A

Influences production, metabolism, and action of hormones

changes in tissue makeip of a gland

Decrease in hormone secretion (organs themselves change in size, secretions themselves are the same in relation to size)

Lessened response/inability to turnoff response

90
Q

Cushing’s Syndrome

A

Excess production of the glucocorticoid from th adrenal gland. Results of pituitary adenoms -> secrete excess ACTH -> overstimultaion of the sdrenal gland; or from large doses of cortisol or corticol derivitives

Signs:

Protuberant abd

Stretch marks

Poor wound healing

Thinning of skin

Gen m. weakness

Osteoporosis

Moon face

91
Q

Addison’s Disease

A

Pituitary adrenal insufficiency with insifficient cortisol release. Idiopathic or auto immune

Risk factors:

Surgery

pregnancy

Acc/ injury/ trauma

Infection

Salt loss from profuse diaphoresis

Medically managed with pharmacology. Moitor vitals

92
Q

Gigantism and Acromegaly

A

Results from GH secreting adenomas.

Gigantism - overgrowth of long bones. Developes in children

Acromegaly - Increased bone thickeness and hypertrophy of the soft tissue. Effects face, jaw, hands, feet of adults

Implications:

Post op: Vital signs and neurologic status is to be monitored. Alt LOC, visual acuity, decreased pulse and increased BP. Blood glucose

Acromegaly - Weakenss, changes in jt mobility, poor exercise tolerance

93
Q

Hypothyroidism

A

Thyroid hormone deficiency -> slowed body metabolism -> slowed GI motility, bradycardia, decreased heat production, increase serum cholesterol and triglyceride levels

94
Q

Hypothyroidiams

Symptoms

A

Fatigue

Mild sensitivity to cold

Mild wt gain

Forgetfulness

Depression

Dry skin/hair

Advanced: myxederma, flexor tenosynovitis, CTS, proximal m weakness, poor peripheral circulation

95
Q

Hypothyroidism

Exercise

A

Activity intolerance

Weakness (d/t m. loss)

Changes in jt synovium (similar to arthritis)

Assoc with rhabdomyolysis

96
Q

Hyperthyroidism

A

Excessive secretion of thyroid hormone -> generalized elevation of the body’s metabolism

Immunologic or genetic derived

Implications:

Exercise and heat intolerance

Fatigue

increase in norm HR

97
Q

Grave’s Disease

A

Most common form of hyperthyroidism. Autoimmune over function of the entire gland

Syptoms:

Enlarged thyroid

Nervousness

Heat intolerance

Wt loss with increased appitite

Diarrhea

Tremor

Palpitations

98
Q

Grave’s Disease

Implications for PT

A

Proximal m. weakness with myopathy

exercise and heat intolerance

Fatigue

Increased or norm HR

99
Q

Adenoma

A

Benign tumor of glandular origin

PTA Patho (4 decks)

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