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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
Q

What depth (in cm) can be reached with deep heating via therapeutic US?

A

8 cm

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26
Q

what two types medications can be used to treat tendinits via phonophoresis?

A

steroids (10% hydrocortisone) and anesthetics (1% lidocaine)

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27
Q

what type of energy does shortwave diathermy convert into heat?

A

electromagnetic radio waves

28
Q

frequency used for shortwave diathermy?

A

27 MHz (Mega Hz)

29
Q

What depth (in cm) does short wave diathermy reach?

A

4 - 5cm

30
Q

What are three indications for use of short-wave diathermy?

A
  • Pelvic inflammatory disease (PID)
  • Prostatitis
  • Muscle spasms
31
Q

In addition to general heat precautions, what are three contraindications to the use of shortwave diathermy?

A
  • metal items (intrauterine device, surgical implant)
  • pregnancy
  • skeletal immaturity
32
Q

Microwave diathermy frequency, depth and indications?

A
  • 1000 MHz
  • 1-3 cm
  • superfical structures, hematomas
33
Q

therapeutic modality used to reduce inflammation?

A

cold

34
Q

How does cold reduce spasticity?

A

It reduces muscle spindle (Ia, II) and Golgi tendor organ (Ib) activity

35
Q

What is spray and stretch?

A

Using vapocoolant sprays to treat myofascial and MSK pain applied parallel to muscle fibers while muscle is stretched

36
Q

What type of therapy can increase vascularization of wound margins?

A

Light therapy

37
Q

What is Goeckerman’s technique?

A

Using coal-tar ointment followed by UV light to treat psoriasis

38
Q

Starting dosage for light therapy?

A
  • 1-2 MED (minimal erythema dosage - time to cause erythem on the forearm)
  • Usually kept below 5 MED
39
Q

What are two proposed mechanisms of pain control with TENS unit?

A
  • 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
Q

Most effective type of TENS?

A

High-frequency, low-intensity

41
Q

Benefits of neuromuscular electrical stimulation (NMES)?

A
  • increase muscle mass
  • increase stroke volume and cardiac output
  • improve cardiorespiratory fitness
42
Q

What are two reflexive effects of massage?

A
  • vasodilation improving circulation
  • decrease pain via gate control or endogenous opiate release
43
Q

What are two mechanical effects of massage?

A
  • assist in venous blood return from periphery
  • increase lymphatic drainage
44
Q

How much force is used with cervical traction?

A

25 - 50lb of force

45
Q

What are four contraindications to cervical spine traction?

A
  • A-A instability (RA, Downs, Marfans, Ehlers-Danlos)
  • Cervical stenosis
  • Vertebrobasilar insuffiency
  • Infection of the spine
46
Q

How much force is used in lumbar traction?

A
  • Posterior distraction: > 50 lb of force
  • Anterior distraction: > 100 lb of force
47
Q

What is optimal positioning to relieve foraminal nerve root compression with cervical traction?

A

20-30 degrees of flexion

48
Q

What is the I band?

A

Actin not overlaped with Myosin

49
Q

What is the H zone?

A

Myosin not overlaped with Actin

50
Q

What is a closed kinetic chain exercise?

A

Distal segment of a joint is fixed to an object or the ground

51
Q

What is the downside of open kinetic chain exercises?

A

they increase shear forces at the joint

52
Q

What are Delorme’s exercises?

A
  • Progressive resistive exercises
  • Best method for building strength
  • 3 sets of 50%, 75%, and 100% of 10 repetition maximum
53
Q

List greatest force to least force when it come to fast/slow, eccentric/concentric/isometric

A

fast eccentric > slow eccentric > isometric > slow concentric > fast concentric

54
Q

With plyometric exercises, what allows for more powerful concentric contractions?

A

elastic energy stored in the eccentric phase

55
Q

What amount of exercise does the American College of Sports Medicine recommend?

A
  • 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
Q

What are two things a patient needs to have to participate in biofeedback?

A

voluntary muscle control and ability to follow commands

57
Q

What type of stretching has a high risk of injury?

A

Ballistic stretching (repetitive bouncing) can cause bone avulsion or muscle-tendon tears

58
Q

Why causes the gradual increase in systolic and diastolic blood pressure with aging?

A

decreased arterial elasticity

59
Q

What is the cause of increased orthostatic hypotension and cough/micturition syncope syndromes with aging?

A

decreased baroreceptor sensitivity

60
Q

What is the cause of increased residual volume with aging?

A

loss of elastic recoil of lung tissue

61
Q

Most common lab finding associated with NSAID induced kidney injury?

A

prerenal azotemia

62
Q

Why is digitalis toxicity common in elderly?

A

impaired renal function

63
Q

What is presbyacusis?

A

loss of ability to perceive or discriminate sounds with aging

64
Q

What is the most common cause of fecal incontinence in the elderly?

A

fecal impaction

65
Q

Which TCA has the best side-effect profile (fewer anticholinergic effects, less sedation, and less orthostatic hypotension due to alpha-blockade)?

A

nortriptyline

66
Q

Why do benzodiazepines tend to accumulate more in the elderly?

A

fat-soluble drugs accumulate more in the elderly due to changes in metabolism and body composition

PM&R (21 decks)

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