Classroom Stuff Flashcards
Greek and Roman PT History
therapeutic touch and massage
True False: is exercise equipment separate from modalities?
True!
weights - dumbbells barbells
bicycles
treadmills
isokinetic equipment ?
stair machines
total gym
theraband, theraputty, theratubing - resistance bands
Mechanical Modalities
massage
traction
compression
hydrotherapy
ultrasound
Electromagnetic Modalities
TENS
Iontophoresis
diathermy
UV
Laser
E-stim
Massage
manually move fluid tissues through the body and body systems
- increase blood flow
- decrease edema
- increase relaxation and flexibility
- Delicious unless in pain
Traction
plug it in, put straps
Joint spaces
decreases pressure
Compression
compression socks, ace wraps, air braces, tedhose (compression socks)
counteract pressure
reduce edema
residual limb reshaping so that it can receive a prosthesis
prevent deep vein thrombosis and scarring
Whirlpool
hydrotherapy
good for both kinds of arthritis
decreases edema
used for a lot of patients with paralysis
hydrostatic pressure - compresses nerves in nervous system, tells brain where your body is in space almost immediately
walk on toes
elevates circulation
cardiovascular response, bloodflow higher into chest. careful with patients with cardiac disease
saltwater thicker than non salt water
clean wounds
ultrasound
soundwaves penetrate tissue
increase circulation
increase metabolic rate
brings attention to all the cells moving in your body, get rid of waste materials, help cuts
Iontophoresis
electric current takes medication through the skin without the need for needles
pain relief, anti-inflammatory
sharp sensation that hurts a bit
Diathermy
microwave therapy, wound healing
shortwave or microwave current
thermal or nonthermal
if patient feels like its burning - listen to patient, something is wrong
Ultraviolet
treats skin disorders like acne, psoriasis, and wound healing
treats jaundice
Lasers
red light therapy
healing
works on a cellular level, deep not superficial
E-stim
electrical stimulation
- used to facilitate a muscle pump
- facilitate muscle contraction for patient who has nerve damage, use alongside biofeedback
- milk out excess fluid from muscle tissue, especially after exercise
-
TENS
Transcutaneous Nerve Stim
high frequency but below motor contraction
bugs running under skin
brain picks up on dominant sensation and helps focus on stimulation rather than pain
can move through exercise where the pain might be otherwise debilitating
use for 15-20
use in clinic setting under supervision so excess damage doesn’t happen
Can DPT’s inject medication?
No
DPTs dry needling only, but against law for PTAs to do dry needling
Hippocrates
460bc to 370bc; one of first to prescribe ????
Galen
120-200 ad: used massage and other modalities on Gladiators
Tip: Galen = Gladiators
Pehr Henrik Ling/Leng
father of physical therapy; swedish gymnastics and massage
Dudley Allen Sargent
1849; founded early schools
TIP
Sargent = schools
John Harvey Kellog
1852-1943 - hydrotherapy, comprehensive health and wellness
Andrew Taylor Still
osteopathic medicine
Daniel Davic Palmer
chiropractic
Willamena Wright
1907; worked with Dr. Lovett (orthopedic surgeon)
asked to join gym to treat ppl
did testing on muscle strength
built solid foundation for what we do today
Marguerite Sanderson
Reconstruction aide
Mary McMillan
1880-1959; recon aide wwi; born in us grew up in england. Forerunner for physical therapy. program director, first president
6 month program
Emma Vogel
PT education programs walter reed hospital
legitimized field
Hazel Furscott
private practice san francisco
Margarett Knott
Influential leader
Catherine Worthingham
Profession changed dramatically, from technical profession to true profession
Tip
Worthinghame made profession worthy
Lucy Blair
Navy physical therapist in WW2, polio consultant who selected the pt’s who went out on polio assignments across the whole country
Mildred Elson
president of first international organization, PT associated with money and dues
Mildred = Money ?
mIldred = International asdfs idk
Sprain
stretch injury - rolling an ankle
TIP
sPrain= Pull = stretch
Strain
tear injury
sTrain = Tear
Steps for Stance Phase in Gait
Stance Phase (60%): Target foot stays in contact with the floor
Traditional Terminology
(RLA Terminology)
- Heel strike (Initial Contact)
- Foot Flat (Loading Response)
- Midstance (Midstance)
- Heel off (Terminal Stance)
- Toe off (Preswing)
Steps for Swing Phase in Gait
Swing Phase (40%): foot is swinging
Traditional Terminology
(RLA Terminology)
- Acceleration (Initial Swing)
- Midswing (midswing)
- Deceleration (Terminal Swing)
First Step in Stance Phase
Traditional: Heel Strike
RLA: Initial Contact
Double Support (10%)
both feet on floor, target foot heel on floor, opposite foot toes on floor
Uses: Gluteus Maximus, posterior capsule, tibialis anterior
Second Step in Stance Phase
Traditional: Foot flat
RLA: Loading Response
Single Support (part of 40%)
Foot flat on target leg, opposite leg lifting up
Quadriceps femoris
Third Step in Stance Phase
Traditional: Midstance
RLA: Midstance
Single Support (part of 40%)
target leg straight foot on floor, other foot in middle of swinging forward
Triceps Surae
Fourth Step in Stance Phase
Traditional: Heel off
RLA: Terminal Stance
Single Support (part of 40%)
Heel lifts up on target leg, other leg swung forward
Triceps Surae
Fifth Step in Stance Phase
Traditional: Toe Off
RLA: Preswing
Double Support (10%)
target foot toes on floor, opposite foot heel on floor
Deep plantar flexors, toe flexors, intrinsic foot muscles, rectus femoris
First Step of Swing Phase
Traditional: Acceleration
RLA: Initial Swing
Single Support (second 40%)
target foot lifting up, opposite foot flat
contralateral abductors of hip, iliopsoas and rectus femoris
Second Step of Swing Phase
Traditional: Midwing
RLA: Midswing
Single Support (second 40%)
Target foot swinging forward, opposite foot still mostly flat ?
contralateral abductors of hip, iliopsoas and rectus femoris
Third Step of Swing Phase
Traditional: Deceleration
RLA: Terminal Swing
Single Support (40%)
Target foot swung forward, about to heel strike, opposite foot on toes
Hamstrings, quadriceps femoris, tibialis anterior
True/False: Did Medicare and Medicaid affect field of PT?
important event that changed field
Definition: Scope
What you can practice, level of things you can do, what you can do in this setting
Education: Physical Therapist
Graduate APTA federal program
Terminal degree is a doctorate (used to be masters)
Physical Therapist Role
Responsible for all PT patient treatment
makes decisions regarding patient care
Supervises PTAs and PT techs
Interpret referrals and prescriptions
Evaluate patient and create plan of care
Perform evaluations, reevaluations, and discharge planning
Evaluation
Initial session, identifying problems, difficulties, weaknesses
Reevaluation
measure gains, look for deficits, see if patient has plateaued. what is and isn’t working.
Nevada law: PT must reassess patient every 7th visit or 21 days.
Average length for short term goals
3-6 months
shorter in orthopedic settings where patients aren’t expected to stay for as long, so can sometimes be two weeks
Average length for long term goals
Usually 6 months to a year
NEVADA LAW: How often must PT reassess the patient?
Every 7th visit or 21 days.
How many credit hours must a PT/PTA take to maintain licensure?
15 credit hours, usually a full weekend
Can PTs prescribe medication?
no
PTA level of education
graduate of an APTA accredited program (associates of applied science)
education at csn does not cross over to a PT degree at unlv
NEVADA LAW: How many hours of supervision must be maintained after graduation?
2000 hours of supervision
PT TECH and supervision
must be in direct line of site of PT
cannot put hands on patient, cannot teach, no modalities and no procedures
Cannot work if PT calls out sick
PTA who has graduated cant do anything until after first 2000 hours
How must letters of recommendation be signed to get into the program?
Must be signed across the seal
When is packet due?
June 1st
How many people get into the program?
Took 10 last year, a maximum of 12
What is the Juris Prudis exam?
Knowing local and state laws
Classes for PTA
Anatomy (phys)
kinesiology
path 1&2
observations and measurement
physical Agents ?
Fundamentals of pt
ther ex 1&2
O&P (orthotics and prosthetics)
ADMIN
psych social
cardio/pulm
neurology
2 clinical affiliations (8 weeks each)
320 affiliation hours, 8 40 hour weeks each
UNLV DPT Program Prerequisites?
BS in any field
GPA 3.0 or above
Bachelors has to have
2 anatomy and phys
1 stats
2 bio
2 chemistry with labs
2 physics with labs
2 psychology
3 letters (2 from pts)
oral interview
100 hours PT observation
GRE graduate record exame: score of 300 minimum
UNLV DPT PROGRAM CLASSES
Anat/phys
neuro anat
kines
path
neurophys
obs/measure
phys agents
electro therapy
spec. topics
ther ex 1&2
O&P
Admin/leadership
psych social
cardio pulm
eval tech
pro. dev
peds
geriatrics
pharmacology
imaging
electives
research
women’s studies
4 affiliations (5-12 wks each)
6 month internship
RLA stands for?
Rancho Los Amigos
STEP is
initial contact of one foot and ends with initial contact of other foot
Right heel contact until left heel strikes
TTWB
Toe Touch Weight Bearing
only allowed to touch toe to ground, really for body awareness
Default Weight Bearing Status
immediately ask doctor
while waiting, the general is 30% of body weight
WBAT
Weight Bearing As Tolerated
whatever the patient feels comfortable with
often towards end of process
FWB
Full Weight Bearing
NWB
Non Weight Bearing
PWB
Partial Weight Bearing
Five Cardinal Signs
(Bed Mobility and Transfers)
Keep the Load Close
Create a Base of Support
Use Isometric Contractions of the Trunk
Lift with the legs (do not twist) (where hips go everything else follows)
Use Verbal Clues
General Considerations for Bed Mobility and Transfers
review chart for weight bearing precautions
ask patient or family what transfer works best for them
consider your own weight and height
allow patient to do as much as they can
orient the patient and demonstrate what you want them to do
use gravity, transfer downhill or level
secure items
use gait belt
Passive ROM
(range of motion)
Produced entirely by external force, little voluntary muscle movement
Active Assistive ROM
(range of motion)
assistance provided by outside force because muscles need assistance to move
Active ROM
produced by active muscles
Self Assisted ROM
patient taught to use stronger extremity to assist weaker extremity
Surgical term for TKR
Total Knee Replacement = Total Knee Arthroplasty
AD
Assistive Devices
QUAD SET exercise
lying down
push knee into bed and push foot up while leg is flat or with towel under knees, tightening quads
STRAIGHT LEG RAISE exercise
lying down
raise leg a few inches, lower slowly and then relax
ANKLE PUMP exercise
lying down
point ankle forward and then up
ANKLE CIRCLES
lying down
moving ankle in circles, reverse direction, relax
HEEL SLIDE
lying down
Bend knee up by sliding heel back and then slide it back flat
BRIDGES
lying down
feet bent and flat and lifting hips up
Terminal Knee Extension
lying down
Pillow under knee, lift toe and foot up
MINI SQUATS
Standing exercise
Very small knee bend
HEEL RAISES
Standing Exercise
Lifting heels up and weight on toes
Seated Knee Flexion
chair exercise
Hemiplegic Gait
one-sided paralysis, weakness can’t do knee flexion or foot flexion
compensate by moving leg in a circle pattern
Diplegic Gait
spasticity, high muscle tone, stiff in legs
crouched gait pattern
turn feet and legs inward, up on tippy toes, bent forward, staggering walk
same circle movement but on both legs, use arms for counterbalance
Neuropathic Gait
nerve issue, inability to dorsalflex the foot
must step high to clear the foot, like marching but dragging toe
Lifts foot high up and drags forward
Myopathic Gait
Muscle issue
trendelenburg gait, abnormal hip abductor mechanism, pelvis drop/swaying hips
waddle as pelvis drops and comes back up instead of remaining perpendicular
Ataxic Gait
no coordination or stability, constant trembling or tremor kind of state
difficult to start and stop, difficulty watlking in straight line
Four simple rules for active listening
- Show you’re willing to listen
- Listen for both feeling and content
- Clarify - ask questions and make sure you understand
- Verify - sum up what you understand from talk
Seven Deadly Dont’s for active listening
- don’t make assumptions
- don’t deny the senders feelings
- don’t jump to conclusions
- don’t offer a quick fix
- don’t talk about yourself
- don’t be judgemental
- don’t interrupt
Definition of Physical Therapy from APTA
Definition amended in 1993
PT is a health profession whose primary purpose is the promotion of optimal human health and function through the application of scientific principles to prevent, identify, asses, correct, and alleviate acute or prolonged dysfunctions.
Expanded.
Evaluate, alleviate, prevent, educate; EAPE
- evaluates patients of all ages with impairments, functional limitations, and/or disability to determine appropriate intervention/type of therapy
- attempts to alleviate impairments and functional limitations by designing, implementing, and modifying appropriate therapeutic interventions using tools, exercises, modalities, training
- attempts to prevent injury, functional limitations, and disabilities by promoting health, fitness, and quality of life through wellness programs, work hardening programs, and industrial health.
- engages in education and research to be at the forefront of the field and to meet the needs of their patients.
5 criteria to meet definition of a profession
- commitment to the particular field of work or service
- specific service to clients
- recognized, official representative organization
- specialized education is necessary and standardized.
- autonomy of judgement
Commitment, service, organization, education, autonomy
CSOEA
Definition of Physiotherapy
science of corrective exercises
used in England and France before the US
When was the Division of Special Hospitals and Physical Reconstruction created?
1917, goal of the division was to “reconstruct” injured soldiers to as near normal as possible.
Reconstruction Aides
first physical therapists, all women, unmarried, 25-40 years old, US citizen, 60-70 inches tall, 100-195 pounds, cheerful, subordinate, cooperative, team player. eugh
Who was Mary McMillan
US citizen, trained in England as a physiotherapist. Head reconstruction aide at Walter Reed Hospital in Washington D.C. in 1918. Later appointed to Reed College in Portland, Oregon to start the first pt program. Called “War Emergency Training Course in Physiotherapy”. lasted 6 months.
When was the AWPTA created?
American Women’s Physical Therapeutic Association
January 15, 1921
In Keen’s Chop House in New York City with Mary McMillan as its first president. also started first journal called Physiotherapy review.
What did the AWPTA change its name to in 1922?
American Physiotherapy Association (APA) and began admitting men.
When was the first standardized curriculum published by the APA and how long did it last?
in 1928, lasted 9 months.
When were the first schools for physical therapy technicians accredited?
1933 jointly by the APA and AMA. in 1935 the first competency exams were given.
When was the National Foundation for Infantile Paralysis (polio) established?
1938, source of support for pt profession both financially and vocally
What roles were created in the 1940s?
Doctors established “Physiatrist” - a doctor who specializes in rehabilitation medicine
Physical therapy technicians officially became known as “Physical Therapists”
in 1945, became a four year degree independent of other curricula
When did the name change to American Physical Therapy Association (APTA)?
1947
When were the first schools created for the idea of physical therapist assistants?
1967, two schools in Miami and Minneapolis.
Two year programs with the first graduates in 1969
TIP
graduates in 1969 nice, - 2 for 1967
When was the APTA recognized by the United States office of education as an accrediting agency?
1977, but it took until 1983 for the AMA to no longer be involved in physical therapy school accreditation.
Porgram Prerequesite courses
HHP 123, HHP 124 - Introduction to Human BOdy and lab
Math 116, 120, 124 or higher
ENG 100, 101, 107, 113
PT 100
What do you need to complete before selection
Health programs Orientation, meet with Health Programs Advisor, complete limited entry workshop (within 2 yars of application deadline)_
what is minimum GPA for all program prerequesites
2.50
How many times can you attempt prerequisite courses?
three times
Additional Gen Ed Requirements
communications
US & Nevada constitution
SOcial sciences/humanities
Human relations ** can only enroll once accepted into program
limited entry applicatoin fee
20 per application
Program course work
Fall sem, program course work starts
pt 105, 1 cr, musculoskeletal anatomy review
PT 110; 2 cr; Principles of Kinesiology
PT 11;1; 2 cr; Problems of Kinesiology
PT 117; 2 cr; Fundamental Principles for the Physical Therapist Assistant
Spring sem
PT 120; 2 cr; Observation and Measurement Prin. for the Physical Therapist Assistant
PT 121; 2 cr; Observation and Measurement Procedures
PT 122; 3 cr; Psychological-Social Considerations in Patient Care
PT 125; 2 cr; Principles of Physical Agents
PT 126; 2 cr; Physical Agents Procedures and Practices
PT 130; 2 cr; Administration in Physical Therapy
PT 134; 2 cr; Clinical Affiliation
Second Fall
PT 225; 3 cr; Therapeutic Principles for Musculoskeletal Pathologies
PT 226; 2 cr; Therapeutic Procedures for Musculoskeletal Pathologies
PT 238; 3 cr; Pathophysiology I
PT 240; 1 cr; Orthotic and Prosthetic Considerations in Patient Care
PT 244; 2 cr; Clinical Affiliation I
PT 250; 2 cr; Therapeutic Principles for Cardiopulmonary Pathologies
PT 251; 1 cr; Therapeutic Procedures for Cardiopulmonary Pathologies
Second Spring
PT 248; 3 cr; Pathophysiology II
PT 254; 3 cr; Therapeutic Principles for Neuromuscular Path.
PT 255; 2 cr; Therapeutic Procedures for Neuromuscular Pathologies
PT 256; 2 cr; Clinical Affiliation
