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Acute > Acute Final > Flashcards

Acute Final Flashcards

1
Q

Functional Excursion

A

The full range of extensibility and contractility of a muscle

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2
Q

How can PROM be produced?

A

gravity
machine
another individual
another part of individual’s body

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3
Q

Benefits of CPM?

A

prevents adhesion, contractures, joint stiffness
healing incisions
quicker ROM

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4
Q

Active insufficiency:

A

when a muscle can shorten no more

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5
Q

Passive insufficieny:

A

when a muscle can no longer be elongated

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6
Q

When would you use PROM?

A
  1. areas of acute, inflammed tissue
  2. following a surgical repair of muscular or tissue
  3. comatose, paralyzed
  4. therapist is examining, teaching or demonstrating
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7
Q

When would you use AAROM?

A
  1. pt has weak musculature and is unable to move joint thru desired ROM
  2. used in areas above and beloew an immboilzed joint to maintain ROM
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8
Q

When would you use AROM>

A

Any time the patient is able to contract muscles to actively move a segment through the desired ROM

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9
Q

PROM does not:

A

Prevent muscle atrophy
Increase strength or endurance
Assist circulation to the same degree active, voluntary muscle contractions do

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10
Q

AROM does not

A

Maintain or increase strength in strong muscles

Develop skill or coordination except in the movement patterns used

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11
Q

Contraindications to ROM

A

-When motion is disruptive to the healing process
Immediately after acute tears, fractures, and surgery
When patient response or condition is life-threatening

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12
Q

Functional ROM

A

ability of structures to move or be moved to allow the presence of ROM for functional activities

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13
Q

Functional Mobility

A

ability of an individual to initiate, control, or sustain active movements of the body to perform simple to complex motor skills

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14
Q

Flexibility or extensibility:

A

ability of a muscle and other soft tissue to yield a stretch force

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15
Q

Contracture:

A

Adaptive shortening of the muscle-tendon unit and other soft tissues that cross or surround a joint that results in significant resistance to stretch, limits ROM, and may compromise functional abilities

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16
Q

Muscle spindle

A
  • stretch receptor
  • transmits info about velocity and duration and changes in muscle via type Ia and type II
  • stimulate via stretch and via gamma efferent neural pathways
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17
Q

Golgi Tendon Organ

A
  • transmit afferent stimuli via II B fibers

- sensitive to tension in muscle from passive stretch or and active muscle contraction

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18
Q

When is stretching indicated?

A
  • result of contracture, adhesion or scar tissue
  • vigorous exercise to minimize post exercise soreness/fitness program
  • muscle weakness results from opposing muscle tightness
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19
Q

Contraindications for streching

A
  1. bony block limits joint motion
  2. after a recent fracture
  3. acute inflammatory process
  4. sharp, acute pain
  5. hematoma
  6. hypermobility
  7. contractures provide stability
  8. contractures are basis for functional ability
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20
Q

Precautions for Stretching

A
  1. beyond normal ROM
  2. recent fractures
  3. osteoporosis
  4. joint pain lasting more than 24 hours=too much force
  5. edematous tissue
  6. overstretching weak muscles
  7. overstretching tissues that have been immobilized for a long period of time
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21
Q

Therapeutic Exercise:

A

Systematic, planned performance of bodily movements, postures, or physical activities

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22
Q

Intent of therapeutic exercise:

A

prevent or improve impairements
enhance physical function
prevent or reduce health related risk factors
improve overall health

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23
Q

Balance

A

the ability to maintain or move the body against gravity within the available BOS without falling

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24
Q

Cardiopulmonary fitness

A

the ability to perform moderate-intensity, repetitive, total body movements over an extended period of time

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25
Q

Coordination

A

performing effective, guided, graded movements using the proper timing and sequencing of muscle firing and contraction intensity

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26
Q

Flexibilty

A

the ability to move freely without restrictions

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27
Q

Mobility

A

the ability of the body (or body parts) to move to allow ROM for functional activities

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28
Q

Muscle performance

A

the capacity of muscles to produce tension to do physical work

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29
Q

Neuromuscular control

A

the interaction of the sensory and motor systems to control the body in response to proprioceptive or kinesthetic information

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30
Q

Neuromuscular control utilizes:

A
  • synergists
  • agonists
  • stabilizers
  • antagonists
  • neutralizers
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31
Q

Discrete

A

Has a recognizable beginning and end

quad set, push up, locking a wheelchair, kicking a ball

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32
Q

Serial

A

Made up of a series of discrete movements combined in a particular sequence
eating with a fork, wheelchair transfer, getting dressed

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33
Q

Continous

A

Repetitive, uninterrupted movements that have no distinct beginning or ending
walking, ascending or descending stairs, cycling

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34
Q

Stage of motor learning

A

cognitive
associative
autonomous

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35
Q

Cognitive stage

A

learning how to do motor task safety and correctly

frequent feedback

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36
Q

Associative Stage

A

-patient is fine tuning motor task
infrequent feedback
-focused on consistency and errors

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37
Q

Autonomous Stage

A

movements are automatic
easily adapts to variations in task demands
little or no instruction needed

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38
Q

Variables affecting motor learning

A

-pt understanding of the purpose of exervise
-pt interest in exercise
-pt attention
-pt observation
feedback

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39
Q

Ligament or tendon stage inflammation:

A

48-72 hours

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40
Q

Ligament or tendon stage proliferation:

A

48 hours - 6 weeks

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41
Q

Ligament or tendon stage remodeling:

A

6 weeks to 6 months

42
Q

Tissue injury grade 1:

A

mild pain at time of injury, mild swelling

43
Q

Tissue injury grade 2:

A

Moderate pain that requires stopping the activity. If ligamentous injury, some of the fibers are torn, thus increasing joint mobility.

44
Q

Tissue injury grade 3:

A

Near complete or complete tear or avulsion of the tissue (tendon or ligament) with severe pain. Stress to the tissue is usually painless; joint instability is usually present.

45
Q

Acute stage inflammation duration:

A

4-6 days

46
Q

Subacute stage: repair and healing

A

decreased signs of inflammation
pain w/tissue stress
weakened tissue
14-21 days; can last up to 6 weeks

47
Q

Bone inflammatory:

A

1-7 days

48
Q

Bone soft callus formation:

A

2-3 weeks

49
Q

Bone hard callus:

A

3-4 months

50
Q

Bone remodeling

A

up to one year s/p injury or surgery

51
Q

What are Neuromuscular facilitation and inhibition procedures?

A

relax tension in shortened muscles reflexively prior to or during muscle elongation.

52
Q

Agonist Contraction

A

agonist muscle opposite the range-limiting muscle

reciprocal inhibition of the antagonist

53
Q

Contract-Relax with Agonist Contraction

A

Combines autogenic inhibition and reciprocal inhibition

54
Q

agonist

A

refers to the muscle opposite the range-limiting target muscle

55
Q

antagonist

A

refers to the range-limiting muscle

56
Q

Precautions for Resistance Exercise:

A 
Valsalva maneuver
Fatigue
Recovery from exercise
Overwork/overtraining
Substitute motions
Osteoporosis
Exercise induced muscle soreness
57
Q

Contraindications for Resistance exercise:

A

pain, inflammation, cardiopulmonary disease

58
Q

Progressive Overload

A

For muscle performance to improve the muscle must be challenged to perform at a higher level than it was accustomed.

59
Q

Programs to increase muscular strength and hypertrophy:

A 
Both multiple and single joint exercises
Slow to moderate lifting velocity
1 to 3 sets per exercise
60-80% of 1 RM for 8-12 repetitions 
1-2 minutes of rest between sets
60
Q

Programs to increase muscular power:

A 
Both multiple and single joint exercises
High Repetition Velocity
1 to 3 sets per exercise
Light to moderate loading (40-60% of 1 RM) for 6-10 repetitions 
1-2 minutes of rest between sets
61
Q

Programs to increase muscular endurance:

A

Low to moderate loads
Moderate to high repetitions (10-15 or more)
Short rest intervals

62
Q

Fitness

A

The ability to perform physical work

63
Q

VO2MAX

A

Measure of the body’s capacity to use O2.

mL of O2/kg per minute

64
Q

Endurance

A

Ability to work for prolonged periods of time

65
Q

3 Major Energy Systems

A

ATP-PC
Anaerobic Glycolytic
Aerobic System

66
Q

ATP-PC

A 
PC 
short, quick bursts
anaerobic
first 30 seconds
replenished within cell
67
Q

Anaerobic Glycolytic

A 
glycogen
moderate intensity
anaerobic
30-90 seconds
latcic acid produced
68
Q

Aerobic System

A 
glycogen, protein,fat
long duration
aerobic
after 2nd minute
ATP resynthesized in mitochondria
69
Q

Slow twitch

A

used in low-intensity exercise
low anaerobic capacity
Type I
endurance

70
Q

Fast twitch

A

Type IIB

Recruited for activities requiring power

71
Q

Fast Twitch

A

type IIA

72
Q

METs

A

Approx. 3.5 mL of O2/kg per minute

73
Q

4 P’s needed for an exercise program:

A

principle
purpose
preparation
precautions

74
Q

Karvonen’s Formula

A

HR = Hrrest + 60-70% (HRmax-HRrest)

75
Q

Inpatient Phase I

A

Self care, education, orthostatic challenge (transfers, ambulation)

76
Q

Outpatient: (Phase II)

A

Starts upon d/c from hospital OR 6-8 weeks post cardiac event
Undergo symptom limited exercise stress test
Circuit-Interval Training is common; monitored with telemetry

77
Q

Outpatient: (Phase III)

A

Continue to improve or maintain fitness levels

78
Q

Is myocardial oxygen consumption is higher with what exercises?

A

arms exercises than with leg exercises

79
Q

Creatinine Phospho - Kinase

CPK

A

30-170 U/L

80
Q

O2 sat

A

> 94%

81
Q

PaO2

A

> 80 mm Hg

82
Q

Adult male Red blood cells,

(RBCs

A

25-35 mL/kg

83
Q

Adult male hematocrit (Hct):

A

41-51%

84
Q

Adult male hemoglobin(Hgb

A

14-17Gm/dL

85
Q

Critical Illness Polyneuropathy

A

Distal extremity weakness, muscle wasting, sensory loss, decreased or absent DTRs

86
Q

Critical Illness Myopathy

A

Steroid induced

Muscle weakness affects large, proximal muscles

87
Q

Treatment goals in acute care?

A

Prevent/minimize adverse effects of immobility/inactivity
Prevent contractures
Improve general conditioning, bed mobility, respiration, prevent pressure ulcers

88
Q

Guidelines for acute care :

A

shorter treatment sessions, fewer repetitions, less demand for active participation

89
Q

Adult male hemoglobin (Hgb)

A

14-17Gm/dL

90
Q

Adult female RBCs

A

20-30 mL/kg

91
Q

Adult female Hct:

A

36-47%

92
Q

Adult female Hgb:

A

12-16 Gm/dL

93
Q

Hct less than 25%

A

essential
activities of daily living,
assistance as needed for safety

94
Q

Hct 25-35%

A

essential activities of daily living;
assistance as needed for
safety; light aerobics, light
weights (1-2 lbs)

95
Q

Hct greater than 35%

A

Ambulation and
self care as tolerated;
resistance and aerobic
exercises

96
Q

Hgb less than 8gm/dl

A

essential daily activities

97
Q

Hgb between 8-10gm/dL

A

Essential activities
of daily living, assistance
as needed for safety; light
aerobics, lightweights (1-2lbs)

98
Q

Hgb greater than or equal to 10 gm/dL

A

Ambulation and self care as tolerated; resistance exercises

99
Q

PLT less than 10,000 and/or temperature greater than 100.5 degrees:

A

No therapeutic exercise/Hold

therapy

100
Q

PLT: 10,000-20,000

A

Therapeutic exercise/bike

without resistance

101
Q

PLT greater than 20,000

A

Therapeutic exercise/bike with or without resistance

Acute (16 decks)

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