Comprehensive Flashcards
anterior deltoid action:
shoulder flexion
posterior deltoid action:
shoulder extension
supraspinatus and deltoid (all fibers) action:
should abduction
Shoulder adductors:
pect major
shoulder internal rotators:
subscapularis
shoulder external rotators:
infraspinatus
elbow flexors:
brachioradialis (with forearm neutral)
triceps brachii action:
elbow extension
pronation muscles:
pronator teres
supination muscles:
supinator
wrist flexion:
palmaris longus
wrist extension:
extensor carpi radialis longus and brevis
radial deviation:
extensor carpi radialis longus and brevis
ulnar deviation:
extensor carpi ulnaris
hip flexion:
iliopsoas
hip extension:
gluteus maximus (with knee flexed)
hip abduction:
gluts
hip adduction:
adductors
hip internal rotation:
gluteus medius
hip external rotation:
Lat 6
knee extension:
quads
knee flexion:
hamstrings
ankle dorsiflexion:
tibialis anterior
ankle plantar flexion:
gastrocnemius and soleus
ankle inversion:
tibialis anterior
ankle eversion:
peroneus longus
cervical extension:
bilateral upper trap
cervical flexion:
bilateral sternocleidomastoid
cervical rotation:
sternocleidomastoid (to opposite side)
trunk flexion:
rectus abdominus
trunk extension:
bilateral erector spinae
trunk lateral flexion:
(all unilaterally)
scapular retraction:
rhomboids
scapular protraction:
serratus anterior
scapular elevation:
upper trap
scapular depression:
lower trap
asymmetrical tonic neck reflex:
stimulus: head position, turned to one side
ATNR interferes with:
-feeding
symmetrical tonic neck reflex:
stimulus: head position, flexion or extension
STNR interferes with:
-ability to prop on arms in prone position
Tonic Labyrinthine reflex:
stimulus: position of labyrinth in inner ear-reflected in head position
TLR interferes with:
-ability to initiate rolling
Galant reflex:
stimulus: touch to skin along spine from shoulder to hip
Galant reflex interferes with:
development of sitting balance
palmar grasp reflex:
stimulus: pressure in palm on ulnar side of hand
palmar grasp reflex interferes with:
ability to grasp and release objects voluntarily
plantar grasp reflex:
stimulus: pressure to base of toes
plantar grasp reflex interferes with:
ability to stand with feet flat on surface
rooting reflex:
stimulus: touch on cheek
rooting reflex interferes with:
oral-motor development
moro reflex:
stimulus: head dropping into extension suddenly a few inches
moro reflex interferes with:
balance reactions in sitting
startle reflex:
stimulus: loud, sudden noise
startle reflex interferes with:
sitting balance
positive support reflex:
stimulus: weight placed on balls of feet when upright
positive support reflex interferes with:
standing and walking
walking (stepping) reflex:
stimulus: supported upright position with soles of feet on firm surface
walking (stepping) reflex interferes with:
standing and walking
C1 Nerve Root:
dermatome: vertex of skull
C2 Nerve Root:
dermatome: temple, forehead, occiput
C3 Nerve Root:
dermatome: entire neck, posterior cheek, temporal area, prolongation forward under midline
C4 Nerve Root:
dermatome: shoulder area, clavicular area, upper scapular area
C5 Nerve Root:
dermatome: deltoid area, anterior aspect of entire arm to base of thumb
C6 Nerve Root:
dermatome: anterior arm, radial side of hand to thumb index finger
C7 Nerve Root:
dermatome: lateral arm and forearm to index finger, long and ring fingers
C8 Nerve Root:
dermatome: medial arm and forearm to long, ring, and little fingers
T1 Nerve Root:
dermatome: medial side of forearm to base of little finger
T2 Nerve Root:
dermatome: medial side of upper arm to medial elbow, pectoral and midscapular areas
T3-T12 Nerve Roots:
T3-T6: upper thorax
T1-T2 Nerve Root:
disk lesions at upper two thoracic levels do not appear to give rise to root weakness. Weakness of intrinsic muscles of hand is due to other pathology.
T3-T12 nerve Root:
articular and dural signs and root pain are common. Root signs (cutaneous analgesia) are rare and have such indefinite area that they have little localizing value. Weakness is not detectable
L1 Nerve Root:
dermatome: back, over trochanter and groin
L2 Nerve Root:
dermatome: back, front of thigh to knee
L3 Nerve Root:
dermatome: back, upper buttock, anterior thigh and knee, medial lower leg
L4 Nerve Root:
dermatome: medial buttock, lateral thigh, medial leg, dorsum of foot, big toe
L5 Nerve Root:
dermatome: buttock, posterior and lateral thigh, lateral aspect of leg, dorsum of foot, medial half of sole, first, second and third toes
S1 Nerve Root:
dermatome: lateral and plantar aspect of foot
S2 Nerve Root:
dermatome: buttock, thigh, and leg posterior
S3 Nerve Root:
dermatome: groin, medial thigh to knee
S4 Nerve Root:
dermatome: perineum, genitals, lower sacrum
antalgic gait:
a protective gait pattern where the involved step length is decreased in order to avoid weight bearing on the involved side, usually secondary to pain.
ataxic gait:
a gait pattern characterized by staggering and unsteadiness. There is usually a wide BOS and movements are exaggerated.
cerebellar gait:
a staggering gait pattern seen in cerebellar disease.
circumduction gait:
a gait pattern characterized by a circular motion to advance the leg during swing phase; this may be used to compensate for insufficient hip or knee flexion or dorsiflexion.
double step gait:
a gait pattern in which alternate steps are of a different length or at a different rate.
equine gait:
a gait pattern characterized by high steps; usually involves excessive activity of the gastrocnemius.
festinating gait:
a gait pattern where a patient walks on toes as though pushed. It starts slowly, increases, and may continue until the patient grasps an object in order to stop.
hemiplegic gait:
a gait pattern in which patients abduct the paralyzed limb, swing it around, and bring it forward so the foot comes to the ground in front of them.
Parkinsonian gait:
a gait pattern marked by increased forward flexion of the trunk and knees; gait is shuffling with quick and small steps; festinating may occur.
scissor gait:
a gait pattern in which the legs cross midline upon advancement
spastic gait:
a gait pattern with stiff movement, toes seeming to catch and drag, legs held together, and hip and knee joints slightly flexed. Commonly seen in spastic paraplegia
steppage gait:
a gait pattern in which the feet and toes are lifted through hip and knee flexion to excessive heights; usually secondary to dorsiflexor weakness. the foot will slap at initial contact with the ground secondary to decreased control.
tabetic gait:
a high steppage ataxic gait pattern in which the feet slap the ground
trendelenburg gait:
a gait pattern that denotes gluteus medius weakness; excessive lateral trunk flexion and weight shifting over the stance leg.
vaulting gait:
a gait pattern where the swing leg advances by compensating through the combination of elevation of the pelvis and plantar flexion of the stance leg.
weak dorsiflexors or dorsiflexor paralysis can cause what gait deviation?
foot slap
toe down instead of heel strike can be caused by?
-plantar flexor spasticity
clawing of toes causes:
-toe flexor spasticity
heel lift during midstance causes:
-insufficient dorsiflexion range
no toe off gait deviation causes:
-forefoot/toe pain
exaggerated knee flexion at contact causes:
-weak quads
hyperextension in stance causes:
-compensation for weak quads
exaggerated knee flexion at terminal stance causes:
-knee flexion contracture
insufficient flexion with swing causes:
-knee effusion
excessive flexion with swing causes:
-flexor withdrawal reflex
insufficient hip flexion at initial contact causes:
-weak hip flexors
insufficient hip extension at stance causes:
-insufficient hip extension ROM
circumduction during swing causes:
-compensation for weak hip flexors
hip hiking during swing causes:
-compensation for weak DF
exaggerated hip flexion during swing causes:
-lower extremity flexor synergy
Lateral Bending (prosthetic causes):
-prosthesis may be too short
Lateral Bending (amputee causes):
-poor balance
Abducted Gait (prosthetic causes):
-prosthesis may be too long
Abducted gait (amputee causes):
-abduction contracture
Circumducted gait (prosthetic causes):
-prosthesis may be too long
circumducted gait (amputee causes):
-abd contracture
excessive knee flexion during stance (prosthetic causes):
-socket set forward in relation to foot
excessive knee flexion during stance (amputee causes):
-knee flexion contracture
vaulting (prosthetic causes):
-prosthesis may be too long
vaulting (amputee causes):
-residual limb discomfort
Rotation of forefoot at heel strike (prosthetic causes):
-excessive toe-out built in
Rotation of forefoot at heel strike (amputee causes):
-poor muscle control
forward trunk flexion (prosthetic causes):
-socket too big
Forward trunk flexion (amputee causes):
-hip flexion contracture
medial or lateral whip (prosthetic causes):
-excessive rotation of the knee
medial or lateral whip (amputee causes):
-improper training
heparin (anticoagulant):
most common side effect: excessive bleeding
nerve root pain:
sharp, shooting and burning
muscle pain:
cramping, dull, aching, worsens when muscle’s contracted or lengthened
bone pain:
deep, intolerable, boring and highly localized
vascular pain:
diffuse, throbbing, aching and poorly localized. often referred to other parts of the body
volumetric measurements:
are used to quantify the presence of edema in the wrist and hand by examining the amount of water displaced following immersion.
stages of ulcers: stage I-
observable pressure related alteration of intact skin whose indications as compared to another area of skin, may have changes in skin color, temperature, stiffness or sensation.
stages of ulcers: stage II-
partial-thickness skin loss that involves the epidermis and/or dermis. ulcers superficial and presents as an abrasion, a blister or shallow crater.
stages of ulcers: stage III-
full thickness skin loss that involves damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia. clinically presents as a deep crater with or without undermining adjacent tissue.
stages of ulcers: stage IV-
full thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone, or supporting structures (ex tendon, joint capsule)
epigastric area:
upper central region of abdomen. located between costal margins and the subcostal plane. Applying manual hand pressure INWARDS & UPWARDS over the epigastric area can assist the patient to cough and promote airway clearance.
hip extension end feel:
firm due to anterior joint capsule and the iliofemoral ligament
ultrasound:
3mhz-treats less than 2 cm
wheelchair measurements:
-between edge of seat and posterior aspect of leg should be 2” (3-4 fingers).
wheelchair ramp measurement:
MAX recommendation-8.3%. 1 inch rise/12 inch run.
hertz:
unit of measure describes the number of cycles per second using alternating current.
coulomb:
amount of electrical charge transported in one second by a steady current of one ampere.
S&S of Anemia(decreased RBC’s, delivery of oxygen to tissues is impaired):
SOB and heart palpitations, pallor, cyanosis, cool skin and malaise.
RULE OF 9’S (adult burn % of body):
head-9%
QRS complex:
depolarization of Right and Left ventricles of heart seen on ECG machine. Normally lasts .06-.10s (ex. 81 bps x 10=.80 bpm)
Cor Pulmonale:
right sided heart failure, secondary lung disease.
intermittent claudication:
lower extremity cramps which develop during activity and disappear after rest. Peripheral pulses are often diminished.
pulmonary embolism:
one or more arteries in the lungs becomes blocked, secondary to blood clots in LE’s.
dysmetria:
inability to modulate movement where patients will either overestimate or underestimate their targets.
cerebellum:
is normally responsible for the timing, force, extent and direction of the limb movement in order to correctly reach a target.
dysdiadochokinesia:
inability to perform rapid alternating movements. (ex: pronation/supination quickly). Secondary to cerebellum damage
rotator cuff:
-large tears (3-5 cm). Able to return to recreational activities @ 24-28 weeks.
medial ligament of talocrural joint aka:
deltoid ligament
kinesthesia:
aweareness of the position and movement of body parts by means of sensory organs in muscles and joints.
fibrous joints:
synarthroses
cartilaginous joints:
diarthroses
dyspnea:
shortness of breath
Semmes-Weinstein monofilaments:
effective and inexpensive device for identifying diabetic patients at risk of foot ulceration.
Hodgkins lymphoma:
cancer affecting lymphatic system
Graves disease:
immune system disorder that results in overproduction of thyroid hormones
exophthalmos:
protruding eyeball anteriorly out of socket
Legg Calve perthes disease:
childhood disease effecting the hips. Ages 4-8. Occurs when blood supply to ball and socket joint is interrupted, breaking easily and healing poorly.
Spina Bifida:
part of group of birth defects called neutral tube defects. Neural tube doesn’t develop or close properly causing defects in the spinal cord and backbones.
Spina Bifida Occulta:
mildest form. separation/gap of vertebrae.
Meningocele (form of spina bifida):
meninges of spinal cord pushes out through vertebrae. can be surgically removed with little to no damage.
Myelomenigocele (form of spina bifida):
open spina bifida-most sever. spinal canal remains open along several vertebrae. Causing both membranes and spinal cord to protrude at birth forming a sac on the babys back.
emphysema:
COPD characterized by abnormal and permanent enlargement of the air spaces distal to the terminal bronchiole, accompanied by obstructive changes in the walls. Lungs become hyperinflated due to the loss of elastic recoil, obstruction to airflow is seen as an increase in total lung capacity, residual volume and functional residual capacity.
superficial burn:
only outer epidermis. may be red with slight edema. healing without scarring within 2-5 days.
superficial partial thickness burn:
involves epidermis and the upper portion of the dermis. The involved area may be extremely painful and exhibit blisters. Healing occurs with minimal to no scarring within 5-21 days.
deep partial thickness burn:
complete destruction of the epidermis and the majority of the dermis. Discolored with broken blisters and edema. Damage to nerve endings may result in only moderate levels of pain. Healing occurs with potential for hypertrophic scars and keloids in 21-35 days.
full thickness burn:
destruction of epidermis and dermis completely with partial damage of subcutaneous layer. presents with eschar formation and minimal to no pain. Patients w/ full thickness burns requiregrafts and may be susceptible to infections.
compression garments:
10mmHg-50mmHg
max effort:
failure of the heart rate to increase with further increases in intensity
perceived exertion scale:
6/20/2016
dyspnea scale:
ex: 2-4 = moderate, bothersome degree of breathlessness.
Quantitative gait analysis:
*acceleration: rate of change of velocity with respect to time.
iontophoresis:
process by which medications are induce through the skin into the body by means of continuous direct current e-stim. Check pt every 3-5 minutes.
primary purpose of arterial line:
to measure blood pressure and can sample arterial blood.
balloon tipped catheter:
measures right arterial pressure or pulmonary pressure.
graded oscillation techniques:
*GRADE I: small amplitude at the beginning of the range
dexamethasone:
corticosteroid. used to treat inflammation.
Innvervations:
S1-S2: lateral hamstring reflex
max heartrate:
220-age
weak ____ gluteus medius–>____ pelvic dropping during _____ swing phase.
Right, left, left
athetosis:
slow, writhing, and involuntary movements that may occur with damage to the BASAL GANGLIA. May look “worm like”.
cerebellar degeneration S&S:
dysmetria, nystagmus, dysdiadochokinesia.
nystagmus:
gaze evoked attempt to look toward an object in periphery, but eyes will drift back to neutral.
infant development:
*6-7 months: sitting for prolonged period of time
Autonomic dysreflexia:
occurs when a noxious stimulus below the level of the lesion triggers the autonomic nervous system causing a sudden elevation IN BLOOD PRESSURE. Common in patients with SCI ABOVE T6 level.
stereognosis:
the perception of a form of an object by means of TOUCH.
posterior cord syndrome:
refers to a relatively rare incomplete lesion caused by compression of the posterior spinal artery.
Brown Sequards Syndrome:
incomplete lesion usually caused by a stab wound, which produces hemisection of the spinal cod.
Cauda Equina injury:
occurs BELOW the L1 spinal level where the long nerve roots transcend. can be complete, however, are frequently incomplete due to the large number of nerve roots in the area.
areflexia:
absence of reflexes
Brunnstrom stages of Recovery:
stage 2: movement occurs primarily in the form of associated reactions and spasticity develops.
sulfadiazine:
eliminates bacteria that causes infection, especially UTI’s.
_____ helps maximize all steps of an effective cough.
sitting
osteognosis imperfecta:
genetic disorder where bones break easily. caused by one of several genes not working right.
Guillain Barre Syndrome:
BODY’S IMMUNE SYSTEM ATTACKS YOUR NERVES.
Hydrotherapy tanks:
transfers heat through water (wound care, edema control).
extremity tanks:
used for distal UE or LE.
lowboy tank:
used for larger parts of the extremities and permits long sitting with water up to the midthoracic level.
highboy tank:
used for larger parts of the extremities and the trunk. This tank permits sitting in chest high water with hips and knees flexed.
hubbard tank:
used for fully body immersion.
therapeutic pool:
temperature 78-97 degrees. Depending on patient age, health and goals. Used for exercising in a water medium.
whirlpool:
varied sizes: can accommodate whole body or isolated body part. 10-13 minutes.
mechanoreceptors:
are sensory receptors that respond to mechanical deformation of the area surrounding a receptor. They are cutaneous sensory receptors that are located at the terminal end of the afferent fibers. Responsible for sensations of touch, pressure, itch, tickle, vibration, and discriminative touch.
nociceptors:
are specialized peripheral free nerve endings that are found throughout different tissues with in the body that response to noxious stimuli and result in the perception of pain.
deep sensory receptors:
are sensory receptors that are located in the muscles, tendons and joints. Muscle and joint receptors are both classified as deep sensory receptors and include Golgi tendon organs, Pacinian corpuscles, muscle spindle, Ruffini endings, free nerve endings and joint receptors. They evaluate position sense, proprioception, muscle tone and movement.
ankylosing spondylitis:
aka Marie Strumpell disease.
alternating isometrics:
isometric contractions that are performed alternating from muscles on one side of the joint to the other side without rest. Emphasizes endurance and strengthening.
Resisted progression:
used to improve coordination of proximal components during gait. Resistance is applied an area such as the pelvis, hips or extremity during the gait cycle in order to enhance coordination, strength or endurance.
agonistic reversal:
concentric contraction that is performed against resistance followed by alternating concentric and eccentric contractions with resistance. It’s used in a slow and sequential manner and may be used to incrementially through out the range to obtain max control.
contract-relax:
used specifically to increase ROM. as the extremity reaches the point of limitation, the patient performs a max contraction of the antagonistic muscle group. The therapist resists movement for 8-10 seconds with relaxation to follow movement into the shortened range. The technique is repeated until no further gains in ROM are noted.
descriptor differential scale:
consists of 12 descriptor items each centered over 21 horizontal dashes. At the extreme left dash is a minus sign and at the extreme right dash is a plus sign. Patients are asked to rate the magnitude of their pain in terms of each descriptor.
verbal rating scale:
most often used to assess pain affect. The scale typically consists of a series of adjectives describing increasing levels of unpleasantness such as “distracting” “oppressive” or “agonizing”
visual analogue scale:
is a tool used to assess pain intensity using a 10-15 cm line with the left anchor indicating “no pain” and the right indicating “worst pain ever”. The level of perceived pain is indicated on the line and is reassessed frequently over the course of PT to qualify changes in the pain level and to assess progress.
numerical rating scale:
asks patients to rate their perceived level of pain intensity on a numerical scale from 0-10 or 0-100. “0”-no pain, “10”-worst pain ever.
olfactory nerve (I):
sensory. smell.
optic nerve (II):
sensory. eye
oculomotor nerve (III):
motor.
trochlear nerve (IV):
motor. superior oblique muscle of eye.
trigeminal nerve (V):
sensory/motor.
abducens nerve (VI):
motor. lateral movement of eye.
facial nerve (VII):
sensory/motor.
vestibulocochlear/acoustic nerve (VIII):
sensory. hearing and balance.
glossopharyngeal nerve (IX):
sensory/motor.
vagus nerve (X):
sensory/motor.
accessory/spinal nerve (XI):
motor. SCM and trapezius muscles.
hypoglossal nerve (XII):
motor. muscles of tongue.
droplet precautions:
individuals within 3 feet of patient to wear a mask.
contact precautions:
gloves, gown, mask
airborne precautions:
mask,
interrater reliability:
refers to the reproducibility of measurements made by two or more raters who measure the same subjects.
intrarater reliability:
refers to the reproducibility made by one individual across two or more trials.
internal validity:
focuses on cause and effect relationships. Specifically, if there is evidence that, given a statistical relationship between the independent variable and the dependent variable in an experiment, one causes the other.
external validity:
refers to the extent to which the results of a study can be generalized beyond the study sample to persons, settings, and times that are different from those employed in the experimental situation. It is concerned with the usefulness of the info outside the experimental situation.
sciatic nerve:
extends to the tibial nerve to the medial & lateral plantar nerves.
deep peroneal nerve:
innervates triangular area between 1st and 2nd toes.
superficial peroneal nerve:
innervates lateral aspect of leg and dorsum of foot.
tight hip flexors =
lordosis (anterior pelvic tilt)
kyphosis:
excessive curve of spine in posterior direction usually in thoracic spine
spondylolysis:
defect in the pars interarticularis or the arch of the vertebra. most common in L5.
respiration rate:
is an objective measure that can be used as a gross method to assess endurance.
platelet count:
high: increased risk of thrombosis
hemoglobin-
iron in RED BLOOD CELLS
hemoglobin count:
high: polycythemia or dehydration
hematocrit:
percentage or red blood cells in blood count
blood urea nitrogen:
used to assess kidney function.
axillary nerve (C5, C6):
innervates teres minor and deltoid.
femoral head movement on acetabulum during hip flexion:
posteriorly and inferiorly
Guillain Barre Syndrome:
S&S:
Cardiac rehab/coronary artery disease:
which factor would be most relevant for the patient? elevated serum cholesterol (desirable range: less than 200mg/dL)
amitriptyline:
tricyclic antidepressant. most common side effect–sedation.
dysarthria:
motor disorder of speech caused by UMN lesion that affects muscles used to articulate words/sounds.
Brocas Aphasia (experessive aphasia):
most common. can understand, but can’t verbally say what they want to.
Conduction aphasia-
fluent aphasia noted by severe impairment with repetition, intact fluency, good comprehension and speech interrupted by word-finding difficulties. Reading-intact. Writing-impaired.
global aphasia:
non fluent aphasia noted by severely impaired comprehension (reading/auditory). impaired naming/writing skills and impaired repetition skills. may involuntarily verbalize but without correct context.
Wernickes aphasia (receptive aphasia):
is a fluent aphasia characterized by impaired comprehension (reading & auditory) impaired writing and poor naming. Possess good articulation but use words incorrectly.
AIDS/HIV:
center for disease control and prevention places significant emphasis on the concept of treating each patient as if they have a transmissible or infectious disease.
isokinetic contractions:
occur when a muscle contracts and shortens at a constant speed. can only occur when a muscles max force of contraction exceeds the total load on the muscle.
osteogenesis imperfecta:
is an autosomal disorder of collagen synthesis that affects bone metabolism. children with this often have delayed developmental milestones. Secondary to ongoing fractures with immobilization, hypermobility or joints, and poorly developed muscles. the disorder is classified into 4 types ranging from mild to severe.
six minute walk test:
used to determine a patients functional exercise capacity. Requires a therapist to measure the distance the patient walks within a six minute period with rest periods permitted as necessary.
Duchenne Muscular Dystrophy:
an inherited disorder, characterized y rapidly worsening muscle weakness that starts in the proximal muscles of the lower extremities and pelvis and progresses to the muscles of the shoulder and neck, followed by loss of UE’s muscles and respiratory muscles.
spondylitis:
inflammation of a vertebrae.
spondyloptosis:
vertebral body is completely off the adjacent vertebrae body (grade 5). usually in lumbar/sacral area.
spondylolisthesis:
refers to the forward displacement of one vertebrae over another. The severity of it is based on a scale of 1-5 based on how much the VB has slipped over the VB beneath it.
anemia:
is a common cause of fatigue. Fatigue often results since there are inadequate number of RBC’s available to transport oxygen to the tissues of the body.
approximation (PNF technique):
a therex technique designed to facilitate contraction and stability through joint compression. the compression force is most often applied to joints through gravity on body weight, manual contacts or weight belts.
rhythmic initiation (PNF technique):
is a facilitation technique that begins with voluntary relaxation followed by passive movement through increments in range. this is followed by active assistive movements progressing to resisted movements. the technique is indicated when there is a need to relax, hypertonicity, inability to initiate movement, motor learning deficits and communication deficits.
Timing for emphasis (PNF Technique):
is a facilitation technique that uses max resistance to elicit a sequence of contractions from major muscle components of a pattern of motion. this technique allows overflow to occur from strong to weak muscles. the technique is indicated when there is weakness and/or incoordination and is commonly used in conjunction with repeated contractions.
beta blockers:
decrease heart rate, blood pressure and myocardial contractility. can cause sinus bradycardia (less than 60 bpm).
pronation of the foot:
abd, DF, eversion
supination of the foot:
add, PF, inversion
expiratory reserve volume:
(ERV) is the additional volume of air that can be exhaled beyond the normal tidal exhalation. ERV is one component of vital capacity.
inspiratory reserve volume:
(IRV) is the additional volume of air that can be inhaled beyond the normal tidal inhalation. IRV is one component of vital capacity.
total lung capacity:
is the max volume to which the lungs can be exhaled after a max inhalation. Its the sum of vital capacity and residual volume.
vital capacity:
the max volume of gas that can be exhaled after a max inhalation. It’s equal to the sum of IRV, ERV and tidal volume. ERV + IRV +TV=VC
tidal volume:
is the amount of air inspired and expired during normal resting ventilation. This volume is approx. 500 mL.
residual volume:
amount of air remaining in the lungs after the expiratory reserve volume has been exhaled. this volume is approx. 900-1200 mL
ankle bones:
navicular-medial border between talus & cuneiforms
repeated contractions:
used to initiate movement and sustain a contraction through the ROM. The therapist provides a quick stretch followed by isometric or isotonic contractions. Should be applied at point of where the contraction begins to diminish.
hold relax:
uses isometric contractions to increase ROM. the contractions are facilitated for all muscle groups at the limiting point within the ROM. Relaxation occurs and the extremity moves through the newly acquired range to the next point of limitation.
landau reflex:
is an equilibrium response that occurs when a child responds to prone suspension by aligning their head and extremities in line with the plane of body. 3 months -2 years of age.
ACL repair contraindication:
lack of skeletal maturity
righting reflex:
general term used to describe a group of reflexes that are responsible for the development of upright posture and smooth transitional movements. Equilibrium reactions occur in response to a change in body position or surface supports to maintain body alignment.
traction of lumbar spine:
typically 25% of patients body weight is generally recommended when the goal of treatment is to decrease muscle spasm or stretch soft tissue.
dehydration status:
increased hematocrit
blood urea nitrogen test:
is performed to assess kidney function. An increased blood urea nitrogen level can be indicative of dehydration, renal failure or heart failure. Normal levels are 10-20 mg/dL.
normal hemoglobin level:
13.3.-16.2 gm/dL (males)
endobronchial tube:
also called Carlens catheter, is a flexible catheter for bronchospirometry and for isolation of a portion of the lung to control secretions into the remainder of the tracheobronchial tree during general anesthesia.
endotracheal tube:
is an airway catheter inserted in the trachea for endotracheal intubation.
tracheostomy:
refers to an opening made in trachea in order to insert a catheter or tube, most often to facilitate breathing.
orthostatic hypotension:
a decrease in systolic BP by 20 mmhg or greater
spinal muscular atrophy:
is a progressive autosomal recessive genetic disorder characterized by anterior horn cells degeneration, paralysis and intact cognition.
spinal muscular atrophy:
spinal muscular atrophy: Type 1 (Werdnig-Hoffman disease): has a life expectancy of less than 3 years.
Type 2 has a slower progression
Type 3 (Kugelberg-Welander) has a normal life expectancy.
median cubital vein:
communication between the basilica and cephalic veins in cubital fossa.
the basilic vein:
a large and superficial vein on the UE that assists with drainage of the hand and forearm.
cephalic vein:
located along the anterolateral surface of the biceps and is often visible through the skin.
saphenous:
in LE. extending from foot to the saphenous opening.
scapula adductors;
rhomboids and middle trapezius
types of autolytic debridement:
transparent films, hydrocolloids, hydrogels, and alginates
calcific tendonitis:
is often visible on xrays because of the relative density of calcium. the greater the density of the tissue, the more visible it will appear on xray. the supra/infraspinatus are common sites for calcific tendonitis.
bicipital tendonitis:
is an inflammatory process of the tendon of the long head of the biceps. The condition is characterized by subjective reports of a deep ache directly in front and on top of the shoulder made worse with overhead activities or lifting. Repeated full abduction and ER of the humeral head can lead to irritation that produces inflammation, edema, microscopic tears within the tendon and tendon degeneration.
supraspinatus impingement:
is caused by an inability of a weak supraspinatus muscles to adequately depress the head of the humerus in the glenoid fossa during elevation of the arm. The patient may experience a feeling of weakness and identify the presence of a painful arc of motion most commonly occurring between 60-120 degrees of abduction.
subacromial bursitis:
refers to inflammation of the subacromial bursa between the deltoid muscle, supraspinatus tendon and the fibrous capsule of the shoulder joint. The bursa facilitates movement of the deltoid muscle over the fibrous capsule of the shoulder joint and supraspinatus tendon.
anthropometric measurements:
common adult ones include height, weight, BMI, waist-to-hip ratio and percentage of body fat. They’re then compared to reference standards to assess items such as weight status and risk of disease.
inclinometer:
aka gravity dependent goniometers, use gravitys effect on pointers and fluid levels to measure joint position and motion.
Evidence based practice steps 1-4 of a well built clinical question:
PICO-
Romberg test:
a positive outcome is indicative of a loss of proprioception often associated with a posterior column lesion in the spinal cord or a peripheral neuropathy.
Claudication pain:
is a symptom of ischemia of the LE muscles caused by peripheral artery disease (PAD). Resting claudication pain is typically considered a contraindication to exercise with PAD and may be an indication that the disease process is more advanced.
Standard wheelchair measurements:
(for adults)
Degree of toe out:
3 degrees: may be associated with walking at a relative fast rate of speed
the normal degree of toe out _________ as the speed of walking increases.
decreases
Balance grades:
Normal: can weight shift all directions and accept max perturbations while maintaining their balance.
Firm end feels:
muscular stretch- “rubbery”
soft end feel:
soft tissue approximation.
Drug administration:
oral-swallow
walker height:
elbow flexion should be between 20-25 degrees.
quad/hamstring strength ratio:
3:02
e-stim:
small electrodes increase electrode resistance, while large electrodes decrease the resistance.
most common cause of amputations:
peripheral vascular disease
Peripheral vascular disease:
is caused by atherosclerosis or inflammatory process causing lumen narrowing (stenosis), embolism, vasospasm, trauma or thrombus formation. initially, symptoms may include intermittent claudication and in severe cases, amputation
intermittent claudication:
pain in the leg during walking or exercising due to little blood flow. It’s intermittent because pain goes away when the patient rests.
acromioclavicular joint:
consists of a concave acromion and convex clavicle. Osteokinematic motion and arthokinematic glide occur in OPPOSITE directions.
the GH joint consists of a concave glenoid and convex humerus, arthrokinematic glide and orthrokinematic motion occur in _______ motions.
opposite
the radiocarpal joint consists of a ______ radius and a ______ humerus. Motion & glide occur in ______ directions.
concave, convex, opposite
the radiohumeral joint consists of a concave radius and a convex humerus. the glide and motion occur in the ______ direction.
same
the distal row of carpals from lateral to medial:
trapezium, trapezoid, capitate, hamate.
femoral anteversion:
or forward torsion of the femoral neck is measured by the angle of the femoral neck in relation to the femoral condyles. The mean angle of anteversion in an adult is 8-15 degrees. the amount of femoral anteversion can be quantified using Craigs test.
retroversion:
occurs when the plane of the femoral neck rotates backward in relation to the coronal condylar plane.
normal scapulothoracic abduction:
120 degrees
conduction:
gain or loss of heat as a result of direct contact between two materials at different temperatures.
convection:
gain or loss of heat as a result of air or water moving in a constant motion across the body. The rate of convection increases with air movement from wind.
evaporation:
refers to the transfer of heat as a liquid absorbs energy and changes to a vapor.
radiation:
direct transfer of heat from an energy source of higher temperature to one of cooler temperature.
wrist movements/goni measurements:
wrist ext: 0-70
plumb line:
a cord with a plumb bob attached which creates a vertical line down the body. Assuming normal posture the plumb line would fall directly through ear lobe, slightly posterior to hip joint, anterior to midline of knee, anterior to lateral malleolus.
Congestive heart failure:
may be due to diminished pumping ability of the VENTRICLES secondary to muscle weakening (systolic dysfunction) or to stiffening of the heart muscle that impairs the ventricles capacity to relax and fill (diastolic dysfunction). with systolic dysfunction, the weak heart pumps a smaller volume of blood for each contraction of the ventricles (stroke volume), reducing cardiac output.
wheelchair measurement:
back of chair:
ice massage:
tx time: requires 5-10 minutes due to intensity of cooling.
allograft/hemograft:
temporary skin graft taken from another human, usually a cadaver, to cover a burn.
autograft:
permanent skin graft taken from a donor site on the patients own body
heterograft/xenograft:
temporary skin graft taen from another species
serratus anterior innervation:
long thoracic nerve
pectoralis minor innervation:
medial pectoral nerve
levator scapulae innervation:
dorsal scapular nerve
rhomboids innvervation:
dorsal scapular nerve
latissimus dorsi innervation:
thoracodorsal nerve
teres major innervation:
lower subscapular nerve
supraspinatus innervation:
suprascapular nerver
infraspinatus innervation:
suprascapular nerve
lumbar spine pressure positions from lowest load to greatest load:
-lying in supine
wheelchair measurements;
32 inches: minimum required width of a doorway
Four rules of asepsis:
-know which items are sterile
TENS (transcutaneous nerve stimulation):
frequency is significantly greater with sensory level stim than with motor level stim.
concurrent validity:
is demonstrated when the measurement to be validated and “gold standard” are measured at relatively the same time so that they both reflect the same incident or behavior.
quad cane:
used on UE opposite affected LE. Longer legs face AWAY from the patient.
Tendons behind the knee (posterior knee):
semitendinosis (medial tendon) and biceps femoris of hamstrings tendons. prominent during a leg curl.
C6 Nerve Root:
damage results in diminished sensation on the anterior arm and index finger (assessed using light touch from a cotton ball).
C7 Nerve Root damage:
paresthesias of the long and ring fingers. also, weakness of the triceps and wrist flexors and a diminished triceps reflex
Checking BP: only let the cuff deflate _____mmhg/second.
2/3/2016
attention:
can be assessed by asking a patient to count from 1-25 by 3’s. The task should be relatively easy for most individuals, however, It requires the person to exert a sustained, consistent effort.
constructional ability:
can be assessed by asking a person to copy figures consisting of various sizes and shapes.
orientation:
identify time, person, place.
abstract ability:
can be assessed by asking a person to interpret a common proverb or to describe similarities/differences between two objects.
scaphoid fracture:
will feel bony tenderness localized in the anatomical snuffbox.
cardiac output:
volume of blood pumped into the systemic circulation per minute and is equal to the product of HR and stroke volume
.Hickman catheter:
(indwelling right atrial catheter) inserts into the R atrium of the heart. The catheter permits removal of blood samples, administration of medications and monitoring of central venous pressure.
potential complications of Hickman Catheter:
sepsis and blood clots
alginate dressing:
good wound dressing for significant exudate/drainage.
maceration:
softening of connective tissue fibers due to excessive moisture. The result is a loss of pigmentation and a wound that is highly susceptible to breakdown or enlargement.
granulation:
refers to perfused, fibrous connective tissue that replaces a fibrin clot in a healing wound. the tissue is highly vascular and fills the defects of full-thickness wounds
epithelialization:
refers to the process of epidermal resurfacing and appears as pink or red skin.
cerebellar dysfunction would typically be associated with _________, not ________.
hypotonia, hypertonia
After ACL surgery, Wb on a flexed knee can result in excessive irritation of the ________ _________.
patellofemoral joint
Vertebrae and finding points.
L4-L5: same level as top of iliac crest
Parkinsons disease:
is a degenerative disorder characterized by a decrease in production of dopamine (neurotransmitter) within the corpus striatum portion of the basal ganglia. Clinical presentation may include hypokinesia, difficulty initiating and stopping movement, festinating and shuffling gait, bradykinesia, poor posture and “cogwheel” or “lead pipe” rigidity.
Cogwheel rigidity:
jerky, rachet like resistance to passive movement as muscles sequentially tense and relax.
Lead pipe rigidity:
a state of stiffness and inflexibility that remains uniform throughout the range of passive movement, associated with diseases of the basal ganglia.
hypokinesia:
abnormally decreased muscular movements
ballistic movements:
large amplitude involuntary movements affecting the proximal limb musculature, manifested in jerking, flinging movements of the extremity. Ballismus usually results from a lesion in the subthalamic nucleus. often only one side of the bodys involved resulting in hemiballismus.
a patient with bilateral LE amputations requires ________________ to accommodate for the change in the COG. Also, anti tippers.
offset rear wheels
offset rear wheels:
adaptation that moves the axis posterior to the center support and provides greater stability during propulsion over varying surfaces.
friction surface handrims:
are used when patients don’t have a functional grip or strength to adequately propel a wheelchair. pts with C6-C7 tetraplegia commonly rely on this feature.
sip and puff controls:
are used only on power wheelchairs. these types of controls are often used on patients with C4 tetraplegia. Innervation of the C4 level includes diaphragm, traps, face and neck muscles.
C6-C7 tetraplegia:
manual wheelchair with friction surface handrims.
C8 and below:
standard handrims
C5 tetraplegia:
manual wheelchair with handrim projections to assist with propulsion. Typically angled at 30 degrees.
Adhesive Capsulitis:
frozen shoulder. patients with diabetes mellitus have an increased incidence of getting it and often experience longer duration of symptoms and greater limitation of motion.
hemophilia:
is a bleeding disorder of genetic etiology. It’s a sex-linked autosomal recessive trait.
osteomalacia:
refers to softening of the bone without loss of bone matrix. There is insufficient mineralization of the bone matrix normally caused by insufficient calcium absorption and increased renal phosphorous loss.
hip flexion contracture:
(in prosthetic ambulation)-would cause decreased hip extension during late stance on the prosthetic side allowing for a shorter step on the uninvolved side and a longer step with the prosthetic side.
weak residual limb:
would typically result in a shorter step on the prosthetic side or the use of compensatory techniques (vaulting or circumduction) to advance the leg.
hydrostatic weighing:
calculates the density of the body by immersing a person in water and measuring the amount of water that becomes displaced. Considered “gold standard” for body composition.
skinfold measurements:
can be used to determine the overall percentage of body fat through the measurement of nine standardized sites.
post-polio syndrome:
term used to describe symptoms that occur years after the onset of poliomyelitis. the condition is characterized by a weakening of the muscles that were originally affected by polio.
the Red-Yellow-Black system:
uses a wounds surface color to direct treatment
bivalved LE cast:
can be removed by PTA. is just Velcro.
Pusher Syndrome:
significant lateral deviation toward the hemiplegic side. more common in patients with a right CVA.
parapodium:
is a HKAFO with a thoracolumbar orthosis that supports the trunk and LE’s. It has a large BOS and is used with or without an assistive device.
wheelchair ramp:
1:12 ratio, 1 inch rise. 12 inch run. 8.3%
thresholds in doors beheveled edges up to _____ are permissible.
one-half inch
loftstrand crutches:
requires the highest level of coordination to use.
rigid dressing:
allows for earlier ambulation and earlier fitting of prosthesis. Does NOT allow for wound inspection. Helps limit development of post-op edema. It is applied in operating room and remains on 7-14 days until sutures are removed and proper shaping occurs.
Q angle:
refers to the angle between the quads and patella tendon. Normal Q angle is 13 degrees (males) and 18 degrees (females). An increased Q angle above 18 degrees may be associated with patellar tracking dysfunction, subluxing patella, increased femoral anteversion or increased lateral tibial torsion.
3 bony landmarks used to measure Q angle:
ASIS, midpoint of patella and tibial tubercle.
Clonus:
refers to rhythmic oscillation of a body part resulting from a quick stretch. The tests ideally performed by providing a stretch to the PF’s with the gastrocnemius in a RELAXED position.
Ankylosing Spondylitis:
MOST typical standing posture is FLATTENED LUMBAR CURVE AND EXAGGERATED THORACIC CURVE.
Limited DF causes:
patient to compensate with a vault or bounce through mid to late stance. 10 degrees DF is required for late stance-toe off.
Weak DF:
will typically create a “steppage gait pattern”. the patient will present with foot slap at initial contact and compensate by lifting the knee higher than normal to clear the foot and avoid dragging the toe.
acute burn:
produces hypermetabolism that results in increased oxygen consumption, increased minute ventilation and an increased core temperature. Intravascular, interstitial, and intracellular fluids are all diminished. Also, hyponatremia (low sodium), decrease in intravascular fluid and increase in core temp will occur.
Autonomic nervous system:
maintains homeostasis.
Increased sympathetic activity:
S&S: anxiety, distracted, increased sweating, abnormal circulation, lowered pain threshold and heightened reflex activity. Also, mottled and shiny skin, rapid HR, dilation of the lungs, and increased muscle tension & strength, rapid & shallow breathing.
parasympathetic response:
constriction of pupils, decrease HR, stimulate digestion, constrict the lung and stimulate other internal organs.
straight cane:
measure from greater trochanter to floor for proper fit. Elbow should be flexed 20-25 degrees.
rheumatoid arthritis:
chronic systemic autoimmune disorder of unknown etiology. Characterized by inflammatory changes in joints. Two times more common in women.
effusion:
is the process in which individual molecules flow through a hole without collisions between molecules
osteoarthritis:
is a chronic disease that is characterized by degeneration of articular cartilage typically in WB joints. Subsequent deformity and thickening of subchondral bone results in impaired function status. Most commonly affected–hands, spine, hips & knees.
superficial cutaneous reflexes:
are elicited with a light stroke of the skin.
light touch sensation:
is assessed by brushing the skin with a light, feathery object.
deep tendon reflexes:
assessed by muscle tapping.
corticospinal tract:
largest descending pathway where 80% of the fibers decussate and descend on the opposite side; 20% continue to descend ipsilaterally. This tract carries info from the motor cortex directly to the spinal cord. It’s primarily concerned with skilled fine motor control primarily of the distal limbs.
vestibulospinal tract:
responsible for gross postural adjustments subsequent to head movements and acceleration.
tectospinal tract:
responsible for visual info related to spatial awareness. The tract ends at the C-spine and controls the musculature of the neck as well as head position.
Rubrospinal tract:
communicates with the thalamus and cerebellum plays an important role in the coordination of movement.
thoracodorsal nerve: (C6, C7, C8)
branch of posterior cord of brachial plexus. Innervates latissimus dorsi causing shoulder extension weakness in injured.
malaise:
feeling of general discomfort or uneasiness, feeling “out of sorts”.
hydrostatic pressure:
refers to the pressure exerted by fluid on a body immersed in the fluid. It increases as the depth of immersion increases.
When positioned _______, the feet would experience the greatest amount of hydrostatic pressure because they are the deepest immersed body part.
vertically
progressive relaxation:
can be incorporated using gentle rocking or segmental trunk rotation.
respiratory alkalosis:
a condition marked by low levels of carbon dioxide in the blood due to breathing excessively. Any lung disease causing SOB can cause this.
PaCO2:
partial pressure of carbon dioxide.
elevated arterial blood pH and low PaCO2 are consistent with _____ ______>
respiratory alkalosis. Can be caused by alveolar hyperventilation due to dizziness or syncope (fainting).
rhomboids nerve:
is C4, C5. dorsal scapular.
diaphragm nerve:
C3-C5. phrenic nerve
alkalosis:
condition where body fluids have excess base (alkali)
acidosis:
body fluids have excess acid
alkalosis & acidosis are ________.
opposites
respiratory acidosis:
is a condition that occurs when the lungs cannot remove all of the CO2 the body produces. Causing body fluids, especially blood, to become too acidic. Can be caused by alveolar hypoventilation due to anxiety, confusion and coma.
Low arterial blood pHand elevated PaCO2 are consist with ____ _____.
respiratory acidosis
metabolic alkalosis:
a pH imbalance in which the body has accumulated too much of an alkaline substance, such as bicarbonate and doesn’t have enough acid to effectively neutralize the effects of alkali.
metabolic alkalosis causes:
bicarbonate indigestion, vomiting, diuretics, steroids and adrenal disease. elevated arterial blood pH and elevated PaCO2 are consistent with this.
metabolic acidosis causes:
metabolic diseases or disturbances such as diabetes, lactic acid, uremic acidosis and chronic diarrhea. Consistent with low arterial blood pH and low PaCO2.
a patient with a lesion above ______ wouldn’t be a functional ambulation due to extreme energy demands and therefore would need a wheelchair.
T12
prosthetic training:
1-2 weeks inpatient. includes donning/doffing, management, transfers, ambulation and stair training.
hypovolemia:
decreased blood volume.
to facilitate palpation of the rotator cuff is passive _______ to the humerus. ______ would obscure it.
extension. abduction.
proximal row of carpal bones:
(lateral to medial)
distal row of carpal bones:
(lateral to medial)
maintained pressure:
effective technique that can be used to increase ROM by facilitating local muscle relaxation, however, it’s a passive technique.
derotation braces:
most effective in patients with ligamentous instability. Usually involving PCL and ACL.
duty cycle:
is defined as the ratio of the on time to the TOTAL time (not just ‘off’ time).
graphesthesia:
refers to the ability of a patient to verbally identify letters or numbers traced on the palm of the hand typically with a fingertip or the eraser of a pencil.
infants pulse is typically felt:
brachial artery or femoral artery.
dermatomes:
L5: medial portion of the dorsum of the foot
lumbricals:
act to FLEX the metatarsophalangeal joints and assist in extending the interphalangeal joints of the second-fifth digits. Innervated by the tibial nerve.
dependent squat transfer:
is used when a patient can bear some weight through the LE’s, however, cannot transfer independently.
electrodes:
cathode-negative
Rinne Test:
is designed to compare bone conduction hearing with air conduction hearing. A vibrating tuning fork is placed on the mastoid process and then placed next to the ear. Air conducts should be approx. 2x as long as bone conducted sound.
Weber Test:
hearing test that requires placing a tuning fork on the midline of the skull of patients forehead.
CHF:
patients tend to have excessive fluid retention in the pulmonary and systemic circulation. As a result, a diet high in potassium is prescribed, while items high in sodium are restricted.
LDL: ____ cholesterol
bad
CT scan:
the relative color of each item using CT is dependent on the relative density. The GREATER the density, the LESS penetration of xrays and the WHITER the image will appear. Specific structures listed in descending degree of density are metal, bone, soft tissue, water, fat and air.
GH Joint ligaments/capsules and end feels:
anterior joint capsule: firm end feel caused by ER of GH joint
GH Movement of humeral head:
flex: posteriorly & inferiorly
the primary determinant of WB status following a fracture is based on the relative stability of the fracture. Seen via ______.
x-ray
perseveration:
is the continued repetition of a word, phrase or movement.
distraction:
is a general term that refers to something that diverts attention.
extinction:
refers to removing selected variables that reinforce a specific behavior can also refer to lack of any consequence.
classical conditioning:
is a process where learning occurs when an unconditioned stimulus is repeatedly preceded by a neutral stimulus. The neutral stimulus serves as a conditioned stimulus and the learned reaction that results is the conditioned response.
operant conditioning:
is learning that takes place when learner recognizes the connection between the behavior (completing an exercise progression) and it’s consequences (lengthy rest period).
acute pulmonary edema contraindication:
DON’T use intermittent compression (controls edema). since the shift of fluid from the peripheral to central circulation can increase stress on the heart.
condom catheter:
an external catheter is applied over the shaft of the penis and is held in place by a padded strap or adhesive tape. (not for females, obviously).
suprapubic catheter:
is an indwelling urinary catheter that is surgically inserted directly into the patients bladder. insertion performed under general anesthesia.
wheelchair measurements:
seat width: measuring widest aspect of users butt, thighs, or hips and ADDING two inches.
serous exudate:
clear or light color fluid with a thin, watery consistency. Normal.
serosanguinous exudate:
(pink) can be normal in a healing wound.
sanguinous exudate:
(red) can be indicative of either new blood vessel growth (normal) or disruption of blood vessels (abnormal).
purulent exudate:
(yellow) means infection
wrist and finger muscles:
flexor carpi radialis tendon: flex & abducts wrist
anterior talofibular ligament:
thickening of the anterior joint capsule that extends from the anterior surface of the lateral malleolus to the lateral facet of the talus and the lateral surface of the talar neck. Functions to RESIST ankle inversion with the foot in PF. Most likely ligament torn with an ankle inversion sprain
calcaneofibular ligament:
is a round cord that passes posteroinferiorly from the tip of the lateral malleolus to the lateral surface of the calcaneus. The ligament functions to resist ankle inversion and DF
anterior tibiofibular ligament:
provides support to the distal tibiofibular joint. The ligament resists distal and posterior glide of the fibula.
deltoid ligament:
refers to the collective medial ligaments of the ankle. the ligament as a whole attaches proximally to the medial aspect of the medial malleolus and fans out to the various distal attachments.
anticoagulant drugs:
are often prescribed post-op for patients at risk for acquiring DVT.
hematocrit:
is used in the ID of abnormal states of dehydration, polycythemia, and anemia. A low hematocrit may result in feeling weakness, chills or dyspnea. A high hematocrit may result in increased risk of thrombus.
hemoglobin:
is used to asses blood loss, anemia and bone marrow suppression. Low hemoglobin may indicate anemia or recent hemorrhage, while elevated hemoglobin suggests hemoconcentration caused by polycythemia or dehydration.
prothrombin time:
is often used as a screening procedure to examine extrinsic coagulation factors (V, VIII, X, prothrombin, fibrinogen) and to determine the effectiveness of oral anticoagulant therapy. An abnormal prothrombin time is most often caused by liver disease, injury or by treatment with blood thinners. Abnormal values can place patients at risk for side effects ranging from high likelihood of bleeding to a high likelihood of developing a clot.
WBC Count:
is commonly used to identify the presence of infection, allergens, bone marrow integrity or the degree of immunosuppression. An increase in WBC count can occur after hemorrhage, surgery, coronary occlusion or malignant growth.
lung volumes:
tidal volume: 4,000-6,000 mL 10% total lung capacity.
cerebral palsy:
is a neuromuscular disorder of posture and controlled movement, however, the clinical presentation is highly variable based on the area and extent of CNS damage. It is not uncommon to see bilateral differences in reflexes, however, it is unlikely that a reflex would be absent in an UMN disorder like cerebral palsy.
multiple sclerosis:
is a chronic autoimmune inflammatory disease of the CNS characterized by demyelination of the myelin sheaths that surround nerves within the brain and spinal cord. symptoms can include visual problems, paresthesias and sensory changes, clumsiness, weakness, ataxia, balance and dysfunction, and fatigue. Deep tendon reflexes would not typically be absent with MS since it’s an UMN disorder.
peripheral neuropathy:
is a broad term that describes a lesion to a peripheral nerve. Patients with peripheral neuropathy may exhibit motor, sensory and autonomic changes including extreme sensitivity to touch, loss of sensation, muscle weakness and loss of vasomotor tone. Deep tendon reflexes may be asymmetrical based on location of the involved peripheral nerve and usually present as diminished or absent.
intermittent claudication:
occurs as a result of insufficient blood supply and ischemia in active muscles. The condition occurs with activity, subsides during periods of rest, and often limits the duration off exercise activities. Symptoms may include pain and cramping in muscles distal to the occluded vessel. Deep tendon reflexes would not typically be affected.
nurse:
works to promote health, prevent disease, and help patients cope with illness. Patient care activities are extremely diverse including tasks such as assisting physicians during treatments and examinations, administering medications, recording symptoms and reactions, and instructing patients with families.
physical therapist:
provide services to help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease.
occupational therapist:
help people improve their ability to perform activities of daily living, work, and leisure skills. OT most commonly work with individuals who have conditions that are mentally, physically, developmentally or emotionally disabling.
case managers:
plan and coordinate health care services appropriate to achieve established rehab goals. Work activities include coordinating a medical care plan with health care providers and the patient
