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PM&R > Background/Physical Modalities/Aging > Flashcards

Background/Physical Modalities/Aging Flashcards

1
Q

Impairment

A

loss of structure or function (ex: foot droop)

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2
Q

Disability

A

Inability to preform ADL (ex: inability to ambulate)

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3
Q

Handicap

A

Difficulty with participation in society (ex: cannot climb stairs to get to office)

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4
Q

Therapy Rx components

A

Dx, exercise type, frequency, sets, reps, precautions

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5
Q

Type I muscle fibers

A

slow twitch, aerobic, “red” muscle, “One slow, red ox”

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6
Q

Type II muscle fibers

A

fast twitch, “white”, anaerobic

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7
Q

Sarcomere

A

Sarcomere = Z to Z line

A-band: Myosin

I-band: Actin not overlapped with Myosin

H zone: Myosin not overlapped with Actin

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8
Q

Most useful exercise type for muscle building and tendon health

A

Eccentric

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9
Q

Type of exercise that puts the most stress on tendon

A

fast eccentric

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10
Q

What are 5 contraindications to use of heat?

A
  • Ischemia (heat increases metabolic demands)
  • Scar tissue (inadequate vascular supply)
  • Bleeding disorders (heat increases blood flow)
  • Malignancy (heat may increase tumor growth)
  • Impaired Sensation
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11
Q

Cane height

A

level of greater trochanter or level of hand with elbow flexed to 25 degrees

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12
Q

Two modalities used to increase tendon extensibility

A

heat and stretching

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13
Q

Type of contraction with higher metabolic cost

A

concentric

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14
Q

Transfer of heat through circulation

A

Convection

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15
Q

transfer of heat through direct contact

A

conduction

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16
Q

What are 3 therapeutic modalities that transfer heat through conversion?

A

heat lamp, US, diathermy

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17
Q

deep of tissue heating with superficial heat

A

1-2cm

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18
Q

what is erythema ab igne?

A

superfical heat causing skin mottling characterized by reticular pigmentation and telangiectasia

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19
Q

Where anatomically is US heat absorption the greatest?

A

bone-muscle soft tissue interface

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20
Q

Type of water used when using US to treat small joints?

A

degassed

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21
Q

What are 4 conditions treated with therapeutic US?

A
  • Contracture
  • Arthritis
  • Bursitis
  • Tendinitis
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22
Q

What are 5 areas to avoid with therapeutic US?

A
  • CNS (brain and cord), heart and reproductive organs
  • Pacemakers
  • Tumors
  • Skeletal immaturity (deep heat can damage growth plates)
  • Arthroplasties (TKA, THA)
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23
Q

Frequency used with therapeutic US

A

About 1 MHz = megaHz = 1 million Hz

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24
Q

Average intensity of therapeutic US used for tendinitis and bursitis?

A

1.5 W/cm2

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25
What depth (in cm) can be reached with deep heating via therapeutic US?
8 cm
26
what two types medications can be used to treat tendinits via phonophoresis?
steroids (10% hydrocortisone) and anesthetics (1% lidocaine)
27
what type of energy does shortwave diathermy convert into heat?
electromagnetic radio waves
28
frequency used for shortwave diathermy?
27 MHz (Mega Hz)
29
What depth (in cm) does short wave diathermy reach?
4 - 5cm
30
What are three indications for use of short-wave diathermy?
* Pelvic inflammatory disease (PID) * Prostatitis * Muscle spasms
31
In addition to general heat precautions, what are three contraindications to the use of shortwave diathermy?
* metal items (intrauterine device, surgical implant) * pregnancy * skeletal immaturity
32
Microwave diathermy frequency, depth and indications?
* 1000 MHz * 1-3 cm * superfical structures, **hematomas**
33
therapeutic modality used to reduce inflammation?
cold
34
How does cold reduce spasticity?
It reduces muscle spindle (Ia, II) and Golgi tendor organ (Ib) activity
35
What is spray and stretch?
Using vapocoolant sprays to treat myofascial and MSK pain applied parallel to muscle fibers while muscle is stretched
36
What type of therapy can increase vascularization of wound margins?
Light therapy
37
What is Goeckerman's technique?
Using coal-tar ointment followed by UV light to treat psoriasis
38
Starting dosage for light therapy?
* 1-2 MED (minimal erythema dosage - time to cause erythem on the forearm) * Usually kept below 5 MED
39
What are two proposed mechanisms of pain control with TENS unit?
* Placebo (30%) * Gate Control (stimulation of large IA fibers closes gate in spinal cord blocking C fibers from sending pain signal to the thalamus)
40
Most effective type of TENS?
High-frequency, low-intensity
41
Benefits of neuromuscular electrical stimulation (NMES)?
* increase muscle mass * increase stroke volume and cardiac output * improve cardiorespiratory fitness
42
What are two reflexive effects of massage?
* vasodilation improving circulation * decrease pain via gate control or endogenous opiate release
43
What are two mechanical effects of massage?
* assist in venous blood return from periphery * increase lymphatic drainage
44
How much force is used with cervical traction?
25 - 50lb of force
45
What are four contraindications to cervical spine traction?
* A-A instability (RA, Downs, Marfans, Ehlers-Danlos) * Cervical stenosis * Vertebrobasilar insuffiency * Infection of the spine
46
How much force is used in lumbar traction?
* Posterior distraction: \> 50 lb of force * Anterior distraction: \> 100 lb of force
47
What is optimal positioning to relieve foraminal nerve root compression with cervical traction?
20-30 degrees of flexion
48
What is the I band?
Actin not overlaped with Myosin
49
What is the H zone?
Myosin not overlaped with Actin
50
What is a closed kinetic chain exercise?
Distal segment of a joint is fixed to an object or the ground
51
What is the downside of open kinetic chain exercises?
they increase **shear forces** at the joint
52
What are Delorme's exercises?
* Progressive resistive exercises * Best method for building strength * 3 sets of 50%, 75%, and 100% of 10 repetition maximum
53
List greatest force to least force when it come to fast/slow, eccentric/concentric/isometric
fast eccentric \> slow eccentric \> isometric \> slow concentric \> fast concentric
54
With plyometric exercises, what allows for more powerful concentric contractions?
elastic energy stored in the eccentric phase
55
What amount of exercise does the American College of Sports Medicine recommend?
* At least 30 minutes, 5 days a week * At least 500 METS per week * Flexability for each major group at least 2 days a week
56
What are two things a patient needs to have to participate in biofeedback?
voluntary muscle control and ability to follow commands
57
What type of stretching has a high risk of injury?
Ballistic stretching (repetitive bouncing) can cause bone avulsion or muscle-tendon tears
58
Why causes the gradual increase in systolic and diastolic blood pressure with aging?
decreased arterial elasticity
59
What is the cause of increased orthostatic hypotension and cough/micturition syncope syndromes with aging?
decreased baroreceptor sensitivity
60
What is the cause of increased residual volume with aging?
loss of elastic recoil of lung tissue
61
Most common lab finding associated with NSAID induced kidney injury?
prerenal azotemia
62
Why is digitalis toxicity common in elderly?
impaired renal function
63
What is presbyacusis?
loss of ability to perceive or discriminate sounds with aging
64
What is the most common cause of fecal incontinence in the elderly?
fecal impaction
65
Which TCA has the best side-effect profile (fewer anticholinergic effects, less sedation, and less orthostatic hypotension due to alpha-blockade)?
nortriptyline
66
Why do benzodiazepines tend to accumulate more in the elderly?
fat-soluble drugs accumulate more in the elderly due to changes in metabolism and body composition

PM&R (78 decks)

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