Assortment of Important Lists/Steps/Procedures Flashcards
Observational Arcadia Movement Management
C - Control of movement A - Amount of movement S - Speed of movement S - Symmetry of movement S - Symptom provocation of movement
ICF Steps
- Disease/Disorder
- Body structure/function Impairment
- Activity Limitation
- Participation Restriction
- Environmental Factors
- Personal Factors
List that influences decisions about patients
D - Disease
D - Disorder
G - Goal
P - Personality
Patient Management Model
- Examination (M, C/C, ROS, TM, S/O, E, P)
- Evaluation Referral
- Diagnosis (what is the main issue?) / Prognosis (how are we going to fix?)
- Intervention (Care Coord, Communication, Procedural)
- Outcomes (measure change in health/function/activity)
Procedural Interventions
R - Restorative
C - Compensatory
P - Preventative
Types of Research Categories (6S)
Studies Synopses of Studies Synthesis Synopses of Synthesis Summary System
9 Theories of Neuromuscular Motor Control
- Reflex (bottom up reflex chained from stim/hot stove)
- Hierarchical (top down)
- Reflex-Hierarchical (motor control emerges from reflexes that are nested within hierarchically organized levels of CNS/waiting for bus vs standing on bus/wine glass/feedforward/feedback - prevent movement and as plan changes, adapt to change)
- Motor Program (central motor pattern/CPG/signature)
- Systems (body is a mechanical system and masters redundant DOFs - touching nose/letters, words, sentence)
- Dynamic Action (self organization/flipping hands in air vs on base)
- Dynamic-Systems (self organization and mechanical system/DST velocity that changes behavior)
- Ecological (perceptions about environment guide actions/active exploration)
- Contemporary Model (Task, Individual, Environment)
Primary Organizational Research (Breakdown of Studies)
- RCT (2) - highest level of individ study
- Cohort (3) - OBS, follow group over time
- Case Control (4) - OBS, retrospective
- Cross Sectional (4) - OBS, diff groups
- Case Reports/Studies (4) - DESC, best avail evidence, small groups
Evidence Based Practice Guidelines Steps for Developing and Finding Research
Ask - PICO Acquire - systematic review Appraise - research evidence Apply - integrate with expertise Adjust - evaluate steps
Types of Reflection
In-action
On-action
For-action
Domains of learning and reflection
Cognitive - things you know and learn
Psychomotor - hand skills
Affective - values and communication
Plack-Driscoll Awareness
Analyze Feelings
Thoughts/Knowledge
New Perspective
Ways to Study Anatomy
Regional
Clinical
Systems
Spinal Nerves
Afferent - dorsal - sensory
Efferent - ventral - motor
Sensory Testing
- Superficial - exteroceptors
- Deep - proprioceptors
- Combined Cortical - sterognosis (2-pt discrimination)
Glacers 3 realms
Individual
Organizational
Societal
Tendon Components
Fibroblast (cells - produce, manufacture and secrete comps of ECM)
ECM (Glycoproteins and Type I Collagen, water loving, and rigid)
Mechanotransduction pathway
- Stimulus
- Tissue Force
- Cellular Force
- Molecular Action
Different Ways to Sense Mechanical Stimuli
- Integrins on cell membrane
- Conformational Change (integrin shape change)
- Stretch Activated Ion Channel
- Receptor Shape Change
Transducing Mechanical Stimuli
- Transduction from membrane to nuclei
- Transcription from DNA-RNA
- Translation in ribosomes from RNA-pre procollagen
- Processing of ER and Golgi from pre procollagen-procollagen
- Exocytosis
- Extracellular processing
Biological tissues that respond to mechanical stress
Cardiopulm
integument
neuromuscular
Connective Tissue
Thresholds of Physical Stress
Death Injury Increase Tolerance Maintenance Decrease Tolerance Death
Muscle Synergies
Agonist - muscle/muscle group that has same action
Antagonist - muscle/muscle group that has opposite action
Synergy - work together to create a full movement
Force couples - pull in opposite directions to maintain equilibrium
Functions of Integument
Protection Homeostasis Transport Sensation Metabolic
Integument Layers
- Epidermis (Basale-melanocytes, Spinosum-desmosomes, langerhans, Granulosum-produce lamellae, waterproof, loose nuclei, Lucidum-clear in thick skin, Corneum-deadskin)
- Dermis (Papillary-meissner’s/tactile, wound healing, Reticular-ruffini/stretch,lymph, foreign body extraction, collagen)
- Hypodermis (Pacinean/deep pressure/vib, adipose)
Integument nerve supply
- Free nerve endings - in epi, pain/temp/no CT
- Merkels - in epi, tactile
- Meissners - in pap derm, tactile
- Pacinean - in hypo, deep pressure/vib
- Ruffini - derm, stretch
Strength Testing Approaches
- Isotonic (1rm)
- Isokinetic (dynamometer)
- Isometric (MMT)
MMT Scores
- Normal - n/5
- Good - g/4
- Fair+ - f+/3+
- Fair- f/3
- Fair- - f-/3-
- Poor+ - p+/2+
- Poor - p/2
- Poor- - p-/2-
- Trace - t/1
Key Factors of Strength Testing
Operational Function of Age, Size, Gender Symmetry Compensation Pain Motivation
BBP Breakdown
PISR for
HIV
HBV
HCV
NS impairment
parasthesia diminished/lost sensation weakness pain change in dtr movement dysfunction
Causes of NS impairment
pressure ischemia metabolic trauma disease
24 Bones
Cranium, Vert, Clavicle, Scapula, Ribs, Costal Cartilage, Sternum, Humerus, Costal Margins, Radius, Ulna, Carpus, Metacarpals, Phalanges, Hip Bones, Sacrum, Pubic Symphysis, Femur, Patella, Tibia, Fibula, Tarsus, Metatarsus, Phalanges (toes)
Important features of muscle
Action (ICE)
Origin
Blood Supply
Innervation
Myotomes Upper Quad
c2,3,4 - shoulder shrug c5 - shoulder ab c6 - elbow flex c6 - wrist ext c7 - elbow ext c8 - thumb ext t1 - finger ab
Myotomes Lower Quad
l1,2 - hip flexion l3,4 - knee ext l4,5 - dorsiflex l5 - great toe ext s1 - plantar flex
Clinical Assessment Process
- Move muscle below impairment to ensure nerve activity
- look up nerve, is it sensory distro?
- ensure blood circ (skin color, pain, swelling, pulse drop)
- Determine trauma
Lever Systems
first class - axis of rot in center
second class - external force closer to axis than internal and both on one side
third class - internal force closer to axis than external and both on one side (most common)
Radiography ABCS
A - alignment
B - bone density
C - cartilage assessment
S - soft tissue swelling
Cell junctions in epidermis
- desmosomes - spinsum
- tight junctions - granulosum, prevent H2O loss
- integrins - basale, with communication
Stem cells for new skin generation
- Basale - stem cells
- epidermal derivatives create stem cells - hair follicles, sebaceous glands, sweat glands
- dermis - fibroblasts that are a source for wound repair
types of scars
- hypertrophic - scar maintained in margins, stretched and raised
- keloid - scar overgrowth beyond margins
APTA Brand Characteristics
Sage & Hero
KDOFT
Sage - Known as teacher, deliver knowledge, offer independence, focus understanding, traits expert
Hero - know as rescuer, deliver courage, offer mastery, focus proving, traits motivator
APTA PT Behaviors
Professional
Entrepreneurial
Inspirational
Knowledge
Important Relationship Factors
Location Purpose Structure Length of time Power balance
Professional Behaviorts
Active Listening
Patient Centered Approach
PT Priority with TA
- Attitude of Caring
- Trust
- Dignity
- Collaboration
Patient/Client Collab Model PURPOSE
- Individualized treatment
- improve adherence
- promote successful outcomes
Patient/Client Collab Model Structure
- TA/TR
- Diagnostic Process of Mutual Inquiry
- Negotiate Common Ground
- Intervention
- Follow Up
Key items of accessory motion test
- Motion
- End Feel
- Pain
Accessory Motion Tests
- MP
- RC Wrist Distraction
- Ant Drawer
- Lachman’s Supine
- Lachman’s Prone
- Ankle Ant Drawer
Primary Aspects of Culture
- Race
- Nationality
- Color
- Age
- ANYTHING THAT CAN’T BE CHANGED
Secondary Aspects of Culture
- Socioeconomic status
- Gender
- Occupation
- Religion
- Marital Status
- ANYTHING THAT IS FLUID
Cultural Continuum
CD, CI, CB, CPC, CP, CC
Cultural Knowledge Contexts
W - work ethic (team/individual) D - decisions (intuitive/logical) T - time sense (past/future) C - communication (nonverbal/verbal) R - relationships (tight/loose) M - motivation (family, individual) V - view of change (tradition over change/change over tradition)
Strategies for Improving TA
- Open Communication
- Self-reflection
- Training in healthcare communication
Care Settings
- Acute - 24 hr nursing, daily MD, PT 3hrs
- Inpatient - 24 hr nursing, daily MD, high number of nurses
- SNF/Subacute - 24 hr nursing, MD on call, PT < 3hrs
- Home Care - Intermittent Nursing
- OPT - discharged patients
Principles of Intervention and their Measures
- Motion - Joint Integrity/ROM
- Force - MMT/Dynamometer
- Energy - TUG, 6 minute walk test, sit to stand
- Motor Control - motor planning/sensation
Evaluation Process
- Complete tests on principles of intervention and their measures
- Dx/Px
- Intevention Methodology
- Referrals
- Necessary Interventions
Breaking Down your patient’s problem and determining the best interventions
- Patient’s Goal
- Target muscle group
- Mechanism/test and measures for patient’s target and goal
- Time Frame - understand how long it should take to get her to her goal
- Dose - the amount of exercise and treatment necessary to get her where she needs to be
- Specificity - continue with exercise even if there is pain, give the details of improvement to patient
- Monitor Effects - check effects of treatment on patient by re-assessing skills
- Compensation vs recovery - make clear what you will be able to accomplish
- Education - talk about the strategy