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Unit 11 > Cancer > Flashcards

Cancer Flashcards

1
Q

How is cancer defined/characterized

A

Abnormal cells that divide without control over division. DNA of cells becoming damaged leading to abnormal gene function

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2
Q

What are the differences in structure between a normal cell and a cancer cell?

A

Normal: large cytoplasm, single nucleus with smooth border, single nucleolus, fine chromatin

Cancer: small cytoplasm, multiple nuclei with irregular border, multiple large nucleolus, coarse chromatin

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3
Q

True or false hyperplasia of cells is abnormal tissue

A

False. Hyperplasia is still an abnormality in the transition to invasive cancer, but at this point it is still normal tissue, just an increase in the number of normal cells

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4
Q

Describe the 5 steps from a normal cell to invasive cancer

A

normal cell –> cell mutation –>hyperplasia (normal tissue) –> dysplasia –> cancer in situ (more abnormal than normal cells) –> invasive cancer

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5
Q

Describe dylpasia

A

Abnormal changes in cellular shape, size or organization. There is a replacement of a mature cell type with a less mature cell type.

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6
Q

True or false, in situ tumors do not invade the basement membrane

A

true

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7
Q

True or false, benign tumors continue to grow in size abnormally

A

true, however they will not invade other unrelated tissues or organs in the body

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8
Q

Describe a malignant tumor

A

Cells that invade the basement membrane and invade other parts of the body

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9
Q

Name two ways malignancy occurs

A

Direct extension: neighboring organs, tissues

Indirect extension: to distant sites via the vascular, lymphatic system or seeding of CA cells into body cavities

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10
Q

Carcinoma arises from what tissue?

A

Skin or tissues that line or cover internal organs

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11
Q

How are cancer categorized?

A

The tissue which they arise

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12
Q

Sarcoma arises from

A

supportive and CT: bone, cartilage, fat, muscle, blood vessels

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13
Q

Which is more malignant carcinoma or sarcoma?

A

Sarcoma

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14
Q

Where does leukemia arise from

A

blood forming tissue/bone marrow

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15
Q

Where does lymphoma and myeloma arise from

A

cells of the immune system

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16
Q

Where does CNS cancer arise from

A

brain and SC

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17
Q

Most breast cancers are categorized as what kind?

A

Carcinoma

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18
Q

how many CA survivors are there in the US

A

15.5 million

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19
Q

Talk about the overall estimated trends in cancer prevalence and survivor rate

A

CA survivors is going to increase, however more people are going to be diagnosed with CA

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20
Q

What is the most prevalent CA among men? women?

A

Prostate

Breast

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21
Q

What is a major risk factor for CA?

A

AGE: the older you are the more at risk

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22
Q

What is the lifetime probability of having cancer in your lifetime for males? females?

A

Males: 1 in 2

Females: 1 in 3

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23
Q

Where age is 89% of CA prevalence located?

A

50+

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24
Q

True or false, more people are surviving their CA diagnosis as time goes on

A

true

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25
Q

What are african american women more likely to be diagnosed with?

A

triple negative breast cancer, they are not positive on three hormone receptors making it much more difficult to breast

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26
Q

True or false, african americans have lower survival rates than whites for most cancer types

A

true: later stage diagnosis, lower likelihood of receiving quality treatment, triple negative breast cancer

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27
Q

What cancer is the leading cause of death in men an women?

A

lung and bronchus CA

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28
Q

What mechanism does radiation work through vs. chemotherapy?

A

Radiaiton: direct damage to DNA (CA cells are more fragile than healthy ones so they will die more easily)

Chemotherapy: targets an aspect of cell growth cycle

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29
Q

Name the phases of the proliferative cycle

A

GI: postmiotic period - protein synthesis and cell growth
Synthesis: DNA replication

G2: premiotic: cell checks DNA and gets ready to divide

Mitosis: cell division

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30
Q

Chemo agents target what?

A

Either one phase of cell growth (postmitotic, synthesis, premitotic, mitosis) or all phases

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31
Q

Define neoadjuvant chemotherapy

A

before surgery: shrinks the CA to allow it to be removed

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32
Q

Define adjuvant chemotherapy

A

after surgery: used to kill undetected cells that have traveled from the tumor

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33
Q

Metastatic disease

A

goal is to keep CA at bay

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34
Q

Name the neurotoxic chemotherapy agents

A
  • Taxanes: commonly used with breast cancer
  • Alkaloids
  • Platinum based
  • epothilones
  • PI
  • Thalidomine and lenalidomide
  • Eribulin
  • Nelarabine
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35
Q

Chemotherapy targets what kind of cells

A

rapidly dividing ones

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36
Q

What is alopecia

A

hair loss

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37
Q

What is the premise of targeted therapy

A

specifically attach to different receptors on CA hormones

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38
Q

How do targeted therapies differ from standard chemo?

A

Targeted act on specific molecular targets where chemo acts on all rapidly dividing cells

Targeted are cytostatic (block proliferation) and chemo is cytotoxic (kill cells)

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39
Q

What kind of therapy is SERM and Aromatase inhibitor? and what are they generally used for?

A

Hormone therapy commonly used for breast cancer

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40
Q

What kind of therapy is HER2 and herceptin and what CA is it gernally used for?

A

Monoclonal antibodies used for breast cancer

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41
Q

Autologous, syngeneic, allogenic transplants generally used for what kind of CA?

A

Blood/liquid

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42
Q

Define: autologous, syngeneic, allogenic in terms of transplants

A

Autologous: your own stem cells have been removed and used

Syngeneic: identical twin

Allogenic: someone who is a relatively close match to you

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43
Q

What is BMT and PBSCT?

And why are they used in cancer treatment?

What types of CA are treated with it?

A

BMT: bone marrow translplant

PBSCT: peripheral blood stem cell transplantation

Used in CA treatment bc with high dose chemo and/or radiation can destroy pts bone marrow. They can no longer make WBC, WBC, platelets. This allows them to

Commonly used in liquid CA’s (leukemia, lymphoma, multiple myeloma, neuroblastoma)

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44
Q

How are stem cell transplantations received? and how long does an individual stay in the hospital for?

A

IV then you wait for engraftment (in hospital for 100 days)

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45
Q

What is GVHD

A

graft vs. host disease: long term complication of transplants

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46
Q

Name some less common treatments of CS

A

vaccines, cyrosurgery, hyperthermia, lasers, photodynamic

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47
Q

Name the 3 decreasing CA diagnosis

3 increasing?

A

Decreasing: Colorectal, prostate, lung

Increasing: thyroid, melanoma, liver

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48
Q

50% of CA death due to which four diagnoses

A

Lung, prostate, breast, colorectum

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49
Q

BRCA 1 and 2 are what?

A

tumor suppressor genes, therefore when they have a mutation cells go crazy

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50
Q

Change in CA population in head and heck cancers

Then and now

Whats the difference?

A

Then: 50+ males, alcohol and tobacco use

Now: 30+ females or males, no h/o ATOH or smoking

Difference = HPV!

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51
Q

Breast CA screening recommendations

40?
45-54?
>55?

Known BRCA mutation, 1st degree relative, 25% lifetime risk of breast cancer start at when

A

40: start annual exams if hx of breast CA

45 - 54: annual screens for all

> 55: biennial screening and should continue as they have a life expectancy >10 yrs

High risk: Start at 30 yrs

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52
Q

What makes you high risk for breast cancer?

A
  • known or likely BRCA mutation and other gentic syndroms

- treated with chest wall radiation for Hodgkin disease

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53
Q

Down the line radiation used to treat Hodgkins lymphoma led to what?

A

Breast CA

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54
Q

When should an individual be referred to a genetic counselor (concerning breast CA)

A

family hx of multiple relatives w/breast or ovarian CA, or if relative was diagnosed <50 yrs old

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55
Q

What are the five red flag signs for CA?

A

1) unexplained weight loos >10 lbs
2) fever, chills, night sweats
3) rest/night pain
4) Fatigue
5) skin changes

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56
Q

ABCDE’s of melanoma

A 
A: assymetry
B: border
C: color
D: dimeter (pencil eraser)
E: enlargement or evolving
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57
Q

Signs and symptoms of CA

CAUTION

A 
C: change in bowel and bladder
A: A sore that is not healing
U: unusal bleeding or discahrge
T: thickening or lump
I: indigestion or trouble swallowing
O: obvious change in wart/mole
N: nagging cough or hoarseness
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58
Q

CA staged as In situ:

A

In situ: abnormal cells are present only in the layer of cell in which they developed

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59
Q

CA staged as regional

A

CA has spread beyond primary site to nearby lymph, tissues or organs

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60
Q

CA staged as localized

A

CA is limited to organ which it began without evidence of spread

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61
Q

CA staged as unknown

A

not enough to determine stage

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62
Q

CA staged as distant/metistatic

A

CA has spread to distant tissue, lymph or organs

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63
Q

Explain the T of cancer staging

A

T: size or extent of tumor

Tis: in situ
T1: <20mm
T2: 50<20 mm
T3: >50 mm
T4: any size with direct extension to the chest wall and or to the skin
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64
Q

Explain the N of cancer staging

A

N: amount spread to lymph nodes

pN0: no regional lymph node metastasis
pN1: 1-3 axillary lymph nodes
pN2: 4-9 nodes
pN3: > or = 10 nodes

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65
Q

Explain the M of cancer staging

A

M: metastasis

0: non
1: metastasis

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66
Q

Stage IV CA means what

A

CA has spread to distant tissue or organs

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67
Q

Stage 0 CA means what

A

In situ: not within the membrane

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68
Q

Tests used for stagin

A

Physical exam, imaging, lab tests, pathology reports, surgical reports

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69
Q

What were the most common functional cited problems in CA patients in the cited study

A

Balance and ambulation

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70
Q

True or false oncology clinicians adequately document functional problems in CA patients

A

False!

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71
Q

True or false oncology is a specialization by the ABPTS?

A

True

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72
Q

In what stage (pre-screening, screening, treatment etc) is rehab appropriate?

Most appropriate?

A

Always appropriate but particularly pre-treatment

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73
Q

Does a PT’s role in CA care include diagnose?

A

According to her slide yes

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74
Q

What does the following describe?

Brief investigation of:
Anatomical & physiological status of body systems
Communication ability, affect, cognition, learning style
Review of “red flags” and other screening data

A

A systems review

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75
Q

What is an orange flag?

A

Psychiatric symptoms

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76
Q

What is a yellow flag?

A

Beliefs and judgments

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77
Q

Name some causes of concern or red flags that occur with CA rehab?

A

Compression of neurologic tissue

Cardiac ventricular funciton

Bone health

Anemia, neutropenia, thrombocytopenia

78
Q

Common location of metastasis for breast cancer?

A

bone, liver, lung, pleura

79
Q

Common location of metastasis for colorectal cancer

A

Liver, periotoneal cavity

80
Q

Common location of metastasis for small cell lung cancer

Non small

A

bone, liver, opposite lung, brain, pancreas, adrenal glands

Opposite lung, brain

81
Q

Common location of metastasis for multiple myeloma

A

Osteolytic bone lesions

82
Q

Common location of metastasis ovarian

A

peritoneal cavity

83
Q

Common location of metastasis pancreatic cancer

A

liver, lungs, local tissues

84
Q

Common location of metastasis prostate cancer

A

Bone

85
Q

Common location of metastasis for sarcoma

A

Lung

86
Q

The metastatic sites to know

Breast 
Small lung
Multiple myeloma
Pancreatic
Prostate
A 
Breast: bone
Small lung: bone
Multiple myeloma: Osteolytic bone lesions
Pancreatic: liver, lung, local tissue
Prostate: bone
87
Q

What are the precautions for >50% of cortex involvement?

A

This is high risk of pathologic fracture

No twisting, or exercises!

Do: Touch down, NWB, use of AD, AROM exercise,

88
Q

What indicates high risk for bony metastasis

A

cortical lesions >2.5-3 cm

> 50% cortical involvement

Painful lesions

Unresponsive to radiation

89
Q

What are the precautions for 25-50% cortex involvement

A

This is moderate risk

No stretching, lifting, straining

Do: PWB, light aerobic activity

90
Q

What are the precautions for 0-25% cortex involvement

A

None, full WB

91
Q

When risk of pathologic fracture is high what kind of things do you avoid? focus on?

A

Avoid: Open chain exercises, ballistic movements, risk of falling

Focus on : WB exercises (except with cortical involvement >50%), general conditioning

92
Q

What level of hematocrit would you not exercise someone

A

25%

93
Q

What level of hemoglobin would you not exercise someone?

A

<8g/dL

94
Q

What WBC count would you not exercise someone at

A

<5.0 10^9 w/ fever

95
Q

What platelet count would you not exercise someone at

A

<20 k/uL

96
Q

Common CA causing spinal cord compression

A

Thoracic, breast, lung, lumbar, prostate, melanoma, GI

Most commonly extradural mass from vertebral metastasis: 60% in Tspine

97
Q

Common CA causing malignant pericardial effusion

A

BREAST, chest wall radiation

98
Q

What diagnosis does SBP fall in and why

A

malignant pericardial effusion

they have a space occupying fluid in the pleura therefore there is too much pressure against the heart when they inhale

99
Q

Common CA causing superior vena cava syndrome.

A

MEDIASTINUM LOCATION: lung, lymphoma, breast

100
Q

What is this?

Early Recognition CRITICAL
Most commonly extradural mass from vertebral metastasis
Location:
60% in thoracic spine 
30% in LS spine
10% cervical spine
A

Acute spinal cord compression

101
Q

Common symptoms of acute SC compression

A

worsening back pain, NIGHT PAIN, change in neurological status

102
Q

What are these common treatments for?

high dose steroids, focused radiotherapy to shrink the tumor, surgical resection

A

Acute SC compression

103
Q

Prognosis for acute SC compresion

A

3-6 months survival

1 yr survival rate 30%

104
Q

Pre-treatment ambulatory status and acute SC compression

A

if they were not ambulating before it is very unlikely they will resume ambulating after

105
Q

Vena Cava syndrome is loss of what?

A

drainage to the head, neck, arms and upper thorax

106
Q

Symptoms of Superior vena cava syndrome

A

Jugular venous distention, facial edema, collateral veins of chest, SOB, arm edema

107
Q

True or false Superior vena cava syndrome is emergently life threatening?

A

false

108
Q

Name common treatments for superior vena cava syndrome

A

High dose steroids, intravascular stenting, localized radiotherapy

109
Q

When does tumor lysis occur?

A

After stem cell therapy, shortly after chmotherapy = when a large number of neoplastic cells are killed rapidly

110
Q

What is very common in hematologic CA issues?

A

DVT’s

111
Q

Who does neutropenic fever occur in?

What does it present like

A

pts recieving chemo

Neutropenia at onset –> temperature –> septic shock

112
Q

What are the Wells rules used for?

A

Determine risk of DVT’s

113
Q

Tumor lysis syndrome and hypercalcemia are what kind of cancers?

A

Metabolic

114
Q

What classification of cancer are the following symptoms related to?

  • Fatigue, bone pain, polyuria
  • GI: Constipation, abdominal pain
  • Neurological: muscle weakness, lethargy, confusion, delirium, and coma
  • Cardiac: EKG changes, MI
A

Hypercalcemia - a metabolic cancer

115
Q

Cancers with rapidly proliferating cells

  • Acute lymphoblastic leukemia
  • High grade lymphomas

Solid tumors that are chemo sensitive
-Neuroblastoma, breast, small-cell lung

A

Tumor lysis syndrome - a metabolic cancer

116
Q

Score of ______ on Well rules = 75% probability of _____

A

> or = to 3

DVT

117
Q

Unexplained unilateral limb swelling is a tumor or clot unless what?

A

PROVEN OTHERWISE

118
Q

What are unusually engorged or numerous veins in atypical local called and what do they indicate

A

Collateral veins: indicate tumor, clot and is a red flag unless hx offers an explanation

119
Q

Name some common neuromuscular complications in CA pts

A

nerve palsy (eye movement), plexopathy, dystonia, peripheral neuropathy

120
Q

Explain somatic pain

A

localized, activation of peripheral nociceptors (no damage to peripheral nerve or CNS); sharp, reproduced by movement

121
Q

Explain visceral pain

A

diffuse, difficult to localize, referred to superficial structure, activation of nociceptors of thoracic, pelvic, or organs/viscera

122
Q

Explain neuropathic pain

A

burning, stabbing, shooting, damage to somatosensory NS.

Dysethesias: abnormal sensations

Allodynia: pain from normally non-painful

123
Q

Contraindications to superfiial heat

A

acute inflammation, over tumor, recently irradiated area, impaired sensation, mental status, DVT, over area of long term steroid use

124
Q

Contrainications to superficial cold

A

post radiation, impaired sensation, cold hypersensativity or intolerance, Raynaud’s

125
Q

When do we commonly see dysvascular tissue?

A

Post-radiation

126
Q

Contraindications to ESTIM

A

carotid sinus, implanted device, thrombosis

127
Q

TENS can be very helpful for what kind of pain

A

bone pain

128
Q

When is NMES contraindicated

A

increased fracture risk

129
Q

When is US contraindicated

A

thromosis/thrombophlebitis, malignancy, breast implants, internal stimulators, pregnancy, central nervous tissue

130
Q

True or false, US is generally a modality used in the CA population

A

FALSE! usually contraindicated - increased tumor growth and metastatic spread in mice

131
Q

What is CIPN

A

Chemotherapy induced peripheral neuropathy

132
Q

Neurotixic chemotherapy agents

A 
TAXANES: commonly used in breast CA
PLATINUM BASED 
Vinca-alkaloids
Epothilones
PI's
Thalidomide, and lenalidomide
Eribulin 
Nalarabine
133
Q

Treatment for CIPN

A

dose reduction

134
Q

Severity of CIPN based on what generally

A

dose and duration of medication

135
Q

When does CIPN come on and how long does it last

A

Comes on 24 hrs after chemo infusion

May last for weeks, months or indefinitely

136
Q

CIPN symptoms

A

Neurogenic issues: burning, allodynia, electric, cold sensitivity, feels like wearing gloves or stockings

Automomic: diarrhea, constipation, irregular heart beat

Motor: less common if present - foot drop

137
Q

PT exam for CIPN

A

sensory testing, deep tendon reflexes, strength, balance/proprioception, gait

138
Q

CIPN treatment

A

Neuromuscular electrical STIM, education, falls prevention (balance and gait training, orthotics, AD), exercises, desensitization, compression

139
Q

hallmark of CA fatigue

A

not proportional to recent activity and interferes with usual functioning

140
Q

when does CRF present

A

nearly every day or every day

141
Q

What causes CRF in patients lives?

A

Everything

142
Q

What score on the numeric rating scale for fatigue shows that patients have decreased functioning and should be referred to PT

A

> or = 7/10

143
Q

What has shown to be the most effective non-pharma intervention for CRF?

A

Exercise

144
Q

True or false: Exercise reduces CA related fatigue both during and after CA treatment?

A

True

145
Q

What two CA is the evidence for aerobic exercises strongest?

A

Breast and prostate

146
Q

3 guidelines for CA exercise

A

Activity enhancement

Across all stages of survivorship

AVOID INACTIVITY!!!!

147
Q

True or false: exercise is safe during and after most types of CA treatment

Both unsupervised and supervised have shown to be helpful

A

TRUE!

True!

148
Q

True or false for exercising: Time is more important than distance

A

True

149
Q

one major consideration for pts exercise prescription

A

pretreatment aerobic fitness

150
Q

What kind of exercise is good for prostate CA and why

A

resistance, aerobic: they have lost testosterone with medication

151
Q

Moderate-intensity, resistance exercise (3–6 METs, 60%–80% 1-RM) reduced CRF more so than those engaging in lower intensity resistance or aerobic exercise of any level of physical exertion (Brown et al., 2011)

A

duration and frequency have been reported to have no effect on magnitude of CRF reduction in studies across mixed cancer types and delivery methods

152
Q

What is the best mode of exercise for CA treatment

A

aerobic and resistance training = largest treatment effect

153
Q

What is the montra for CA exercise programs

A

Start low, progress slow

154
Q

Moderate vs. vigorous intensity exercise

A

Moderate: talk but not sing, 3 on modified borg (12-14), 50-79% maxHR

Vigorous: can only say a few words, 70-85% max, 5 on modified borg (>14)

155
Q

Caution performing exercise with any of the following

A

boney metastasis
thrombocytopenia (low plateltes)
Anemia
neutropenia

156
Q

General exercise program for someone who can tolerate moderate exercise

A

30 min of moderate aerobic exercise 5 days a week

resistive exercise 2-3x a week (not to failure)

Flexibility
Balance

157
Q

Radiation fibrosis through what mechanism

A

cell death via free radial mediated DNA damage: radiations goal is to cause inflammation so cells die, ongoing response in normal tissue = fibrosis

158
Q

phases of fibrosis

A

prefibrotic = inflammation
organized fibrosis = high myofibroblasts
Fibroatrophic phase: skin tightens

159
Q

Radiation causes what kind of tissue, what does this mean for PT

A

Avascular

Don’t crank on it

160
Q

Global radiation side effect short term and long term

A

fatigue!!

161
Q

Result of radiation on soft tissue (3)

A

decreased vascular perfussion
Decreased ability to heal
Decreased ability to disperse heat

However it is relatively tolerant of radiation and able to heal post expsure, the issues are due to the vascular changes

162
Q

What is cervical dystonia

A

SCM so tight = torticollis

Radiation symptom

163
Q

What is Trismus

A

masseter msucle becomes tighter so they cannot open their mouth

Radiation symptom

164
Q

What is L’Hermitte’s sign

A

flex their head they get shooting sensation in lower half of body

Radiation symptom

165
Q

Tissue fiborsis and scaring interventions

A

myofascial techniques, compression, kinesio tape for mobilization of scar tissue when patient moves

Flexibility exercises LONG TERM for shoulder and trunk AROM (if supraclavicular add C-spine)

166
Q

When shoud you not mobilize a scar

A

while they’re in chemo or radiation because this will create even more rapidly dividing cells

167
Q

Where is the breast implant placed

A

beneath pec major

168
Q

TRAM, DIEP and SIEA are what kind of procedures

A

autologous breast reconstruction surgery

169
Q

Explain a TRAM

A

transverse rectus abdominis myocutaneous flap

Release rectus abdominus, free all the tissue on the abdomen wall and fold it over to make a breast

170
Q

Sentinel node

A
  • lymph node to which cancer cells are most likely to spread from a primary tumor.
171
Q

What is the following procedure?

A surgeon injects a radioactive substance, a blue dye, or both near the tumor to locate the position of the sentinel lymph node. The surgeon then uses a device that detects radioactivity to find the sentinel node or looks for lymph nodes that are stained with the blue dye. Once the sentinel lymph node is located, the surgeon makes a small incsion (about 1/2 inch) in the overlying skin and removes the node.

A

Sentinel Lymph Node Biopsy

172
Q

Axillary Lymph Node Dissection requires what

A

retracting pec major and minor

173
Q

Any kind of breast surgery is trauma to the chest wall. They have a very short pec major and minor creating a kyphosis, then they get radiation and again shorten the tissue and put it at risk for fibrosis

A

Women have altered resting scapular alignment due to protective posturing (fear pain)

Reduced tissue flexibility –> altered alignment

174
Q

What is the one movement we talked about at the shoulder that decreases tension on the pec major?

A

Flexion to 90 degrees

175
Q

Pec minor dysfunciton leads to what

A

Reduced scapular posterior tilt therefore elevation is compromised

More internal rotation during elevation

176
Q

What is the cause of axillary cording?

A

Portions of the neurovascular bundle getting inflammed and stuck after surgery

177
Q

What do you do for axillary cording?

A

Nerve glides (mediaN) and ROM exercises

178
Q

What does the Spinal accessory nerve innervate

A

SCM and trap

179
Q

TORS surgery

A

Trans oral robotic surgery

180
Q

TLM used for what

A

transoral laser micosurgery: access to tumors the robot can’t reach (oropharyngeal and laryngeal)

181
Q

Radial, modified or selective neck dissection

Removal of cervical level I-V lymph nodes, spinal accessory nerve (SAN), internal jugular vein (IJV), and sternocleidomastoid (SCM)

A

Radical

182
Q

Radical, modified or selective neck dissection:

Removal of cervical level I-V lymph nodes, but preserves at least 1 of the following structures: SAN, IJV, and SCM

A

Modified radical neck dissection

183
Q

Radial, modified or selective neck dissection

One or more cervical lymph node levels removed during radical neck dissection are preserved

A

selective neck dissection

184
Q

True or false: Above the clavicle there are 50 lymph nodes?

A

False: 200

185
Q

Explain the level of nodes

A

the higher the number of level, the more nodes that are dissected traveling down the head and neck area

186
Q

I II III IV V level of nodes

A 
I: submental
II: upper jugular
III: middle jugular
IV: lower jugular
V: posterior triangle - generally the spinal acessory nerve with get damaged with surgery here
187
Q

Scapular flip sign is to show what?

A

if pt has spinal accessory nerve palsy

188
Q

Plus test

A

looking at serratus function: arm is in flexion with thumb up and you apply pressure

189
Q

If someones spinal acessory nerve is weak so their scap is flying all over the place, but they need to strengthen their serratus, how can you accomplish this?

A

Supine! their body weight will stabilize the table

190
Q

GVHD is a risk for what kind of tranplant

A

allogeneic

191
Q

What is key to working with GVHD patients

A

Joint contractures: ROM and soft tissue work, thermal modalities

Steroid myopathy: exercises for proximal muscles, transfer and balance training

surgical release is NOT effective

Unit 11 (5 decks)

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