CP 1 Flashcards
1
Q
4 key fundamental of progressive mobility
A
1). dependence to independence 2). as much as possible, as normally as possible 3). control centrally, direct distally 4). stability to mobility
2
Q
Types of Loads
A
Tension, compression, distraction, shear, bending, torsion, combined
3
Q
define base of support
A
contact area of an object with its supporting surface
4
Q
define static stability
A
property of maintaining and controlling the body’s orientation in space, usually by keeping the COM within the BOS
5
Q
define stabilization
A
ability to hold one attachment site while allowing the other attachment sit to move
6
Q
what is controlled mobility?
A
occurs when the COM intentionally moves beyond the BOS and then back within the BOS
7
Q
what moves in an open kinetic chain movement?
A
distal segment
8
Q
what move in a closed kinetic chain movement
A
proximal segment
9
Q
what spinous process can be felt at the level of the scapular spine?
A
T3
10
Q
what spinous process can be felt at the level of the inferior angle of scapula?
A
T7
11
Q
where would you find T12?
A
bottom of rib cage
12
Q
where would you find L4?
A
level to iliac crest
13
Q
where would you find S2?
A
at the level of the PSIS
14
Q
Draping provides ______
A
1). access to areas of the body for exam and trx 2). protection of pt’s modesty and dignity 3). pt comfort and warmth 4). protection of vulnerable sites 5). protection of pt’s clothing
15
Q
goals of short-term pt positioning
A
safety, comfort, therapist access
16
Q
things to consider for short-term pt positioning
A
primary (ideal position) vs alternative, normal spinal curves
17
Q
supine positioning considerations
A
neck position, pillow under knees, arms folded across chest
18
Q
prone positioning considerations
A
support head and neck, pillow under belly and ankle
19
Q
side lying considerations
A
head/neck position, hips (place pillow under side), bend knees (place pillow/towel between)
20
Q
short-term sitting considerations
A
feet and knee position (consider bolster), arm position,
21
Q
Long-term pt positioning goals/considerations
A
safety (open airways/falls) prevention (ulcers/contractures etc.), comfort (spine alignment/pressure)
22
Q
preventing pressure ulcers
A
reposition pt, max of 2 hrs in 1 position in bed, max of 15 min in one position while seated
23
Q
preventing contractures
A
reposition frequently, flexion contractures are most common, avoid positions of comfort
24
Q
long-term positioning checklist (1-5)
A
1). clear airway 2). good spinal alignment 3). minimized pressure over bony prominences 4). minimized gravity creating shearing forces 5). cushioned support surfaces
25
long term positioning checklist (5-10)
6). immobile extremities elevated 7). joint and soft-tissue contractures prevented 8). trunk and extremities supported and stabilized 9). positioned to optimize interaction with environment 10). special needs accommodated
26
long-term positioning sitting guidelines
approximate 90 degrees (for hip, knee and ankle), avoid sacral sitting, support arms
27
Assistance levels
1). Independent (I) 2). Supervision 3). close guarding (stand-by assist) 4). Contact guarding 5). minimum assistance 6). moderate assistance 7). maximum assistance 8). dependent
28
difference between close guarding and contact guarding?
close guarding (hands raised but not touching pt) contact guarding (hands on, not giving any assistance)
29
Weight bearing status
1). full weight bearing (FWB) 2). Partial weight bearing (PWB) 3). Toe-touch weight bearing (TTWB) 4). Non-weight bearing (NWB)
30
which weight bearing status is utilized only for balance assistance?
toe-touch/touch down weight bearing
31
Elements of bed mobility
1). scooting up and down 2). scooting sideways 3). rolling: supine to side lying 4). supine to sit 5). scooting in sitting
32
things to remember when providing assistance in bed mobility
1). maintain good body mechanics 2). use bed height to your advantage 3). utilize draw sheet 4). direct distally, control centrally
33
Lateral sheet transfer
move a dependent pt form one bed to another while laying down
34
vertical lift
quickly transfer an unconscious pt from wheelchair to bed
35
pivot transfer
squat pivot and stand pivot
36
squat piot
pt often requires higher level of assist, doesn't achieve fully extended position, complete in one motion
37
stand pivot
pt often requires less assistance, achieves full extension, standing allows for a pause mid-transfer
38
why would you utilize a transfer board?
easier on clinician, teaches pt how to be more independent
39
what are the 4 internationally recognized vital signs?
HR, BP, respiratory rate, temperature
40
other vital measures
pain, pulse oximetry, PRE
41
what HR is considered tachycardic?
\>110 bpm
42
what HR is considered bradycardic?
\<60 bpm
43
difference between sign and symptom?
sign - objectivesymptom - subjective
44
HR after a long rest
basal HR
45
HR while sitting still/relaxing
resting HR
46
HR during an intervention
periactivity HR
47
HR 1-3 minutes following intervention
Recovery pulse rate
48
what is patency?
presence of a pulse, indicates blood is getting to where it needs to
49
other signs of poor patency?
loss of hair, dry/flaky skin, muscle atrophy, skin temperature changes, blanching
50
what is Peripheral arterial disease?
intermittent claudication especially in lower extremities with activity
51
how to measure peripheral arterial disease?
w/Doppler or Ankle-brachial index
52
Pulse Quality grade scale
0 = absent1 = thready2 = weak 3 = normal 4 = bounding
53
T/F: younger individuals have higher HRs?
TRUE
54
Methods of determining HR?
Manual palpation, auscultation, Doppler measurement, pulse oximeter, ECG
55
what is the purpose of taking BP?
determine vascular resistance to blood flow, determine effectiveness of cardiac muscle in pumping blood to overcome vascular resistance
56
T/F: younger individuals have higher blood pressure?
FALSE
57
how long should you wait between taking BP?
at least a minute
58
a high BP reading along with what signs/symptoms could warrant a medical referral?
headache, dizziness, flushed face, spontaneous epistaxis, vision changes, nocturnal urinary frequency
59
orthostatic hypotension would be interpreted with either \_\_\_\_\_
drop \> 20 mmHg systolic drop \>10 mmHg diastolic
60
what score on the ABI score would indicate peripheral arterial disease?
0.90 or less
61
what ABI score would also be an abnormal finding?
\>1.50, may be due to diabetes and calcified arteries
62
pulse pressure equation
systolic - diastolic
63
normal RR for adults
12-20 breaths/min
64
respiration rating scales
Borg, ATS Dyspnea Scale
65
factors that can affect temperature
Time of day, menstrual cycle, pregnancy, aging, season (controversial), physical fitness, shift work, meals, alcohol
66
normal range for pulse oximetry?
\>94%
67
severe hypoxia pulse oximetry reading
\<85%
68
what is the difference between acessibility and universal design?
accessibility - relative to individual's level of function,
universal design - relative to population
69
evironmental examination purpose
identify design barriers that compromise performance of tasks. Determine patient’s safety and level of function within the environment
70
areas of environmental intervention strategies
1. assistive or adaptive devices
2. safey devices
3. structural adapations
4. modification or altered location of environmental objects
5. task modification
71
methods of examination
1. patient interview
2. self-report instruments
3. visual depictions
4. on-site visit
72
exterior inspection sites
1. surfaces
2. steps
3. handrails
4. ramps
73
standards for steps measurements
≤ 7 inches high and ≥11 inches deep
74
ratio for ramps
1:12 rise to run (1:20 if inclement weather will affect surface)
75
what to assess at entrances
1. platform
2. opening mechanisms
3. threshold
4. width of entrance
5. kick plate
76
what should the width of a doorway/entrance be?
32-34”, greater if accommodating a bariatric wheelchair
77
which ROM measurement is the most functional?
AROM
78
which ROM measurement will allow us to assess end-feel?
PROM
79
Normal End Feels
1. Soft = soft tissue approximation
2. Firm (capsular) = muscular/capsular/ligamentous stretch (ex MCP joint)
3. Hard (bony) = bone on bone (ex. elbow)
80
abnormal end feels
1. Empty – pain limited, no restriction
2. Springy – indicated that a loose body is limiting the ROM. Feels “bouncy” like you are compressing a spring
3. Soft – occurs in joints normally firm or hard
4. Firm – occurs in joints normally soft or hard
5. Hard – occurs in joints normally soft or firm
81
what would indicate an abnormal end feel for a joint?
it occurs earlier or later than expected for that joint
82
capsular patterns for restricted PROM
1. GH --\> loss of ER then ABD then IR
2. Hip joint --\> loss of IR and flexion then ABD then EXT
3. Knee joint --\> loss of flexion then EXT
83
causes for hypermobility at a joint
1. Trauma to joint
2. Hereditary disorders of connective tissue
3. Down syndrome
4. Benign hypermobility syndrome (HMS or BJHS)
5. Beighton Hypermobility Score
84
define kinematics
study of motion without regard to the forces that create the motion
85
define arthrokinematics
movement of joint surfaces
86
types of arthrokinematic movements
1. Slide (glide) – translator motion (braked wheel skidding)
2. Spin – rotary motion where all points rotate around a fixed axis (lightbulb in socket)
3. Roll – rotary motion where axis moves with the rotation (tire on road, rocking chair)
87
T/F: Roll and Slide/Glide occur together creating angular motion for most joints
TRUE
88
what is the Convex/Concave Rule?
1. Convex on concave – slide opposite roll/bone motion
2. Concave on convex – slide same as roll/bone motion
89
define osteokinematics
gross movements of the shaft of the bones --\> motions that occur within planes
90
define degrees of freedom
the number of planes a joint can move in
91
testing position guidelines for gonimetric measurements
1. Allow stabilization of proximal segment
2. Permit the complete ROM
3. Allow for the joint to be placed in a starting position at 0 degrees
92
Mean ROM for shoulder complex
1. FL – 1800
2. EX – 600
3. Abduction – 1800
4. IR – 70-900
5. ER – 900
93
Mean ROM for Glenohumeral
1. FL – 1150
2. EX – 200
3. Abduction – 120-1250
4. IR -490
5. ER – 940
94
Mean ROM for elbow
1. FL – 1500
2. EX – 00
95
Mean ROM for radioulnar joint
1. Pronation - 800
2. Supination – 800
96
what are participation restrictions?
1. problems in life roles
2. ADLs (instrumental), relational activities, work activities, etc.
3. cooking dinner with family
97
what are ways to make interior floors more accessible?
1. bright colors for uneven areas
2. pathways between rooms are clear
3. floor coverings are attached firmly
98
lack of patency should result in what?
red flaf - immediate referral to MD
99
3 components of ICF model that affect function?
1. body structure and functions
2. activity
3. participation
100
3 principles of note writting
1. accuracy
2. brevity
3. clarity
101
central or neuropathic pain is caused or iniatied by
a primary lesion or dysfunction of the CNS
102
example of central or neuropathic pain
diebetic neuropathy in the foot
103
what movements together create angular motion in most joints
roll and glide
104
example of modifying environmental objects
1. moving furniture
2. removing clutter
3. disabling a stove
105
The McGill pain questionnaire is best used for \_\_\_\_\_
adult patient who can understand meaning of terms
106
patient can complete 75% of the task
minimum assistance
107
if moderate or maximal assitance, gait belts provide \_\_\_\_\_\_
mechanical advantage in the transfer
108
within the patient-client management model, what is diagnosis?
identify impact of a condition on function; categorize impariments
109
what is included in the intial evaluation?
1. History
2. systems reveiw
3. tests and measures
4. evaluation
110
examples of task modification
1. sensory, visual, or auditory cueing
2. energy conservation
3. work simplification
111
contact guarding: assitance level
therapist is postioned as with close guarding, with hands on patient but not giving any assitance. High probability of patient requiring assistance
112
what are activity limitations?
1. difficulty in executing tasks
2. ADLs (basic)
3. functional mobility
4. learning
5. walking
6. the -ing verbs
113
patient-client management model, prognosis
predicted optimal level of function AND time to acheive;
includes planned interventions
114
Plan of Care (POC) is what?
where the PT selects and documents appropriate interventions & documents goals for PT episode of care
115
patient-client management model, evalutaion
clinical judgements based on data collected.
116
2 factors of the ICF model that can affect a health condition
1. environmental factors
2. personal factors
117
establish testing criteria. Includes measurement of \_\_\_\_\_\_\_\_\_
level of improvement in impairment
118
what can PTs do for pain?
recognize patterns, screen, & refer
119
patient-client management model, outcome
measures of intended result,
120
components of the patient-client management model
1. examination
2. evaluation
3. diagnosis
4. prognosis
5. intervention
6. outcome
121
patient-client management model, intervention
procedures and techniques appropriate to diagnosis to produce change; re-examination to make change
122
examples of safety devices
1. lighting
2. sensing detectors
3. alarms
4. color contrast
5. labeling
123
2 different respiratory ratings
1. Borg scale breathlessness
2. ATS dyspnea
124
types of notes
1. initial note
2. daily note
3. progress notes/re-evaluation
4. D/C notes
125
components of patient's pain history
Observation, origin, position, pattern, quality, quantity, radiation, signs/symptoms, trx, visceral symptoms
