Cpt assessments Flashcards
Common medications people take with health problems
- beta blockers
- calcium channel blockers
- nitrates
- Diuretics
- bronchodilators
- vasodilatiors
- antidepressants
Similar Basic functions of medications •beta blockers • calcium channel blockers •nitrates •Diuretics •vasodilatiors
Hypertension & congestive heart failure
- Diuretics also help with peripheral edema
- Calcium channel blockers also treats chest pain
Effects of medications On blood pressure
Beta blockers Calcium channel blockers Nitrates Diuretics Vasodilatiors Antidepressants
Decrease blood pressure
Diuretics- sometimes stay same
Nitrates also can stay the same
Effects of medications on heart rate.
Calcium channel blockers
Nitrates
Vasodilatiors
Antidepressants
All increase heart rate
Beta blockers -decrease heart rate
Calcium channel blockers can also decrease heart rate or stay same.
Diuretics have no effect
Bronchodilators have no effect
What would be considered
Subjective info
Par Q General history Occupation Extended periods of sitting Repetitive movements lifestyle Medical history (past injuries) Past surgery Chronic conditions Medications
Objective information would include:
Physiological measurements Body composition assessments Cardiorespiratory assessments Static posture assessments Performance assessments
Maximal heart rate is found by subtracting what?
What is the formula for
Zone 1
Zone 2
Zone 3
Age- 220
Zone 1 take your maximal HR x 0.65
HR x 0.75
Zone 2 maximal HR x 0.76-0.85
Zone 3 maximal HR x 0.86-0.95
What is the karvonen method predicting HHR( Heart Rate reserve) ?
(Target heart rate)THR=[(HRmax - HR rest ) x desired intensity Zone 1• 0.65-0.75 Zone 2 0.76-0.85 Zone 3 0.86-0.95 \+ (heart rate rest ) HR rest
What is the YMCA 3 min test?
A client performs a 3min step test on a 12 inch box with a metronome that follows up up down. Then you measure the rest heart rate after 5 sec for 1 min.
Then look at chart to determine level to start with. After that is concluded take the clients age - 220 to determine maximal heart rate x it by the zone that is appropriate for them.
What levels are there and what do they represent?
Zone one (65-75% HR max) - Very poor/ poor
Zone one below average (65-75% HR max)
Zone two (76%-85% HR max) average / above average
Zone two (76%-85% HR max ) good
Zone three 86-95% HR max) Excellent
Chart on pg 130-131
What is the rock port test and how is it done?
Rockport test is a measured Heart rate after a client performs a walk test of 1 mile as fast as they can control. Record how long it took to finish duration. Then record heart rate then use formula, locate the Vo2 chart score of 132, determine starting program based on zone. Then minus client age by 220 to determine max heart rate.
132.853-(0.0769 x Weight) - (0.3877 x age) + (6.315 x Gender) - (3.2649 x Time) - (0.1565 x Heart rate)= Vo2 score
- Weight is in pounds (lbs)
- Gender Male= 1 and female = 0
- Time is expressed in minutes and 100ths of minutes
- Heart Rate is in beats per minute
- age is in yrs
What types of distortion patterns are there?
•Pronation distortion syndrome.
•Lower crosses syndrome
By an anterior tilt to pelvis. ( arched lower back)
• Upper crossed syndrome
What muscles are short with pronation distortion syndrome?
Gastrocnemius Soleus Peroneals Adductors Iliotibial band Hip flexors Complex Biceps demotic short head
What muscles are lengthen with pronation distortion syndrome?
- Anterior tibialis
- Posterior tibialis
- Vastus medialis
- Gluteus medius/ Maximus
- hip externals rotators
What altered joint mechanics are affected with pronation distortion syndrome?
Increased:
knee adduction
Knee internal rotation
foot pronation
Foot external rotation
Decreased:
Ankle dorsiflexion
Ankle inversion
What are possible injuries affected with pronation distortion syndrome?
Plantar fasciitis
Posterior tibialis tendinitis
Patellar tendinitis
Low back pain
What muscles are short with lower crossed syndrome?
Gastrocnemius Soleus Hip flexor complex Adductors Latissimus Dorsi Erector spinae
What muscles are lengthened with lower crossed syndrome?
Anterior tibialis Posterior tibialis Gluteus Maximus Gluteus medius Transverse abdominis Internal oblique
What altered joint mechanics are affected with lower crossed syndrome?
Increased:
Lumbar extension
Decreased:
Hip extension
What are possible injuries affected with lower crossed syndrome?
Hamstring complex
Anterior knee pain
Low back pain
What muscles are short with upper crossed syndrome?
Upper trapezius Levator scapulae Sternocleidomastoid Scalenes Latissimus dorsi Teres major Subscapularis Pectoralis Major/ minor
What muscles are lengthened with upper crosses syndrome?
Deep cervical flexors Serrated anterior Rhomboids Mid-trapezius Teres minor Infraspinatus
What altered joint mechanics are affected with upper crossed syndrome?
Increased:
Cervical extension
Scapular protraction/elevation
Decreased:
Shoulder extension
Shoulder external rotation
What are possible injuries affected with upper crossed syndrome?
Headaches
Biceps tendinitis
Rotator cuff impingement
Thoracic outlet syndrome
What are the kinetic chain checkpoints?
Foot ankle Knee Lumbo pelvic hip complex Shoulders Head and cervical spine
What do you look for in the Anterior view for postural assessment?
Foot/ankles: straight and parallel not flattened or externally rotated.
Knees: In line with toes not adducted or abducted.
Lumbo pelvic hip complex: pelvis level with both anterior superior iliac spines in same transverse plane.
Shoulders: level not elevated or rounded.
Head: Neutral position, not tilted nor rotated.
What do you look for in the Lateral view for postural assessment?
Foot/ankle: neutral position leg vertical at right angle to sole of foot
Knees: Neutral position, not anteriorly ( lumber extension) or posteriorly ( lumbar flexion) rotated
Shoulders: normal kyphotic curve not excessively rounded
Head: Neutral position,not in excessive extension (jutting forward)
What do you look for in the Posterior view for postural assessment?
Foot/ankle: heels are straight and parallel not overly pronated
Knees:Neutral position not adducted or abducted
LPHC: pelvis is level with both posterior superior iliac spines in same transverse plane.
Shoulders / scapulae: level not elevated or protracted ( medial borders essentially parallel and approximately 3 to 4 inches apart)
Head: Neutral position, neither tilted nor rotated.
Overhead squat assessment purpose?
To Assess
Total body alignment
dynamic flexibility, core strength, balance and overall Neuromuscular control
Bilateral standing posture
Overhead squat assessment procedure Position ?
- The client stands with feet shoulder width apart pointed straight ahead. Foot and ankle neutral position with shoes off.
- Have client raise his or her arms overhead, with elbows fully extended. The upper arms should bisect the torso.
Overhead squat assessment procedure movement ?
- Instruct the client to squat
To roughly the height of a chair seat and return to the starting position. - Repeat 5 reps observe anterior and lateral
Overhead squat assessment lateral compensations?
• lumbo pelvic hip complex
excessive forward lean
low back arches
•Upper body
Arms fall forward
Overhead squat assessment (lateral view) probable LPHC,overactive muscles with excessive forward lean?
Soleus
Gastrocnemius
Hip flexor complex
Abdominal complex
Overhead squat assessment(lateral view) LPHC, probable overactive muscles with low back arches?
Hip flexor complex
Erector spinae
Latissimus dorsi
Overhead squat assessment (lateral view) probable LPHC,under-active muscles with excessive forward lean?
Anterior tibialis
Gluteus Maximus
Erector spinae
Overhead squat assessment (lateral view) probable LPHC,under-active muscles with low back arches?
Gluteus Maximus
Hamstring complex
Intrinsic core
Stabilizers ( transverse abdominis, multifidus, transversospinalis, internal oblique pelvic floor.
Overhead squat assessment (lateral view) probable Upper body,overactive muscles with arms falling forward?
Teres Major
Pectoralis Major/minor
Latissimus dorsi
Overhead squat assessment (lateral view) probable Upper body,underactive muscles with arms falling forward?
Mid/ lower trapezius
Rhomboids
Rotator cuff
Overhead squat assessment (anterior view) probable overactive muscles with feet turned out?
Soleus
Lateral gastrocnemius
Biceps femoris short head
Overhead squat assessment (anterior view) probable under active muscles with feet turned out?
Medial gastrocnemius Medial hamstring complex Gracilis Sartorius Popliteus
Overhead squat assessment (anterior view) probable overactive muscles with knees move inward?
Adductor complex
Biceps femoris short head
TFL
Vastus lateralis
Overhead squat assessment (anterior view) probable underactive muscles with knees move inward?
Gluteus medius/ Maximus
Vastus medialis oblique (VMO)
Single leg squat assessment position?
1.
Client hands on hips eyes focused on an object straight ahead.
2.foot pointed ahead, foot ,ankle , knee and LPHC should be neutral.
Single leg squat assessment movement?
- Have client squat perform 5 reps before switching sides.
Single leg squat assessment views?
Knee from front should be on track of foot.
Single leg squat assessment compensation ?
Knee move inward (adduce and internally rotate)
Single leg squat assessment knee move inward probable overactive muscles?
Adductor complex
Biceps femoris short head
TFL
Vastus lateralis
Single leg squat assessment knee move inward probable underactive muscles?
Gluteus medius/Maximus
Vastus medialis oblique (VMO)
Pushing assessment position?
Abdomen drawn inward feet split stance toes pointing forward.
Pushing assessment movement?
Press handles forward then return to start position , up to 20 reps controlled fashion. Lumbar and cervical spines should remain neutral and shoulders stay level.
Pushing assessment
Compensations?
Low back arch
Shoulders elevate head migrated forward
Pushing assessment low back arch probable overactive muscles?
Hip flexors
Erector spinae
Pushing assessment low back arch probable underactive muscles?
Intrinsic core stabilizers
Pushing assessment shoulder complex & elevation probable overactive muscles?
Upper trapezius
Sternocleidomastoid
Levator scapulae
Pushing assessment shoulder complex & elevation probable under active muscles?
Mid/low trapezius
Pushing assessment head migrates forward probable overactive muscles?
Upper trapezius
Sternocleidomastoid
Levator scapulae
Pushing assessment head migrates forward probable underactive muscles?
Deep cervical flexors
Pulling assessment position?
Abdomen brought drawn inward feet shoulders width apart and toes pointing forward.
Pulling assessment movement?
Instruct Pull handles toward body return starting position, 20 reps controlled.
Pulling assessment compensations?
Low back arch
Shoulders elevate
Head migrates forward
Pulling assessment low back arches probable overactive muscles?
Hip flexors
Erector spinae
Pulling assessment low back arches probable underactive muscles?
Intrinsic core stabilizers
Pulling assessment shoulder complex &elevation probable overactive muscles?
Upper trapezius
Sternocleidomastoid
Levator scapulae
Pulling assessment shoulder complex &elevation probable underactive muscles?
Deep cervical flexors
Pulling assessment, head protrudes forward, probable overactive muscles?
Upper trapezius
Sternocleidomastoid levator scapulae
Push up test position?
In push up position( ankles, knees,hips,shoulders and head in straight line)
Push up motion and procedure?
athlete lowers body to touch partners closed fist places under the chest repeats for 60 sec or exhaustion without compensation (arches low back, extends cervical spine) variation to this assessment includes doing it in kneeled position with chest touching ground.
- Record number of touches
- When reassessed again should be able to do it more.
Davies test position?
Place two pieces of tape on floor 36 inches apart. Client places one hand on each piece of tape.
Davies test movement?
Have client move his or her hand to touch left hand perform alternating touching on each side 15sec, repeat 3 trails.record number of lines touched by hands. Reassess in future.
Davies test purpose?
Measures upper extremity agility and stabilization.
Assesses agility
May not be suitable for clients who lack shoulder stability.
Push up test purpose?
Measures muscular endurance of upper body, primarily the pushing muscles.
Purpose of pulling assessment?
Assess movement efficiency and potential muscle imbalances during pulling movements
Pushing assessment purpose?
Assesses movement efficiency and potential muscle imbalances during pushing movements.
Single leg squat assessment purpose?
Assesses dynamic flexibility, core strength, balance,and overall neuromuscular control.it also measures lower extremity movement patterns when standard applications protocols are applied. Evaluates knee Valgus which influences by decreased hip abductor and hip external rotation strength.
Overhead squat assessment purpose?
Assess dynamic flexibility, core strength, balance and overall neuromuscular control. Has shown to reflect Lower extremity movement patterns when standard protocols are applied such as jumping and landing tasks , knee valgus which in turn influences the hip and can affect hip abductor and hip external rotation strength.
Shark skill test position?
Client in center box of grid with hands on hips standing on one leg.
Shark skill test movements and procedure?
Client hop to each box in designed pattern, always returning to the center box.be consistent with patterns. Perform one practice run through boxes with each foot. Perform test twice with each foot four times total. Keep track of how long it takes(time)also record times. Add 0.10 if:
Non hopping leg touches ground
Hands cone off hips
Foot goes into wrong square
Foot does not return to center square.
Purpose of shark skill test?
Assess lower extremity agility and neuromuscular control.
Assesses agility & control
Also considered a progression to single leg squat.my not be suitable for all individuals.
Upper body strength assessment bench press position?
Client on bench lying down on back feet pointed straight ahead. Low back neutral position.
Upper body strength assessment bench press movement and procedure ?
1.Warm up light resistance performs 8-10 reps,
2.take 1min rest,
3. add 10-20 lbs ( 5-10% load initial load) and perform 3-5 reps
4. take 2 min rest.
5 Repeat steps 3 -4 until failure between 2-10 then use the one rep maximum estimation chart.
Upper extremity strength assessment bench press purpose?
Estimate the one rep maximum on overall upper body strength of pressing musculature. Should not be performed with general fitness or weight loss goals.
Lower extremity strength assessment squat position?
Feet shoulder width apart pointed straight ahead with knees in line with toes. Low back should be neutral position.
Lower extremity strength assessment squat movement and procedure?
- Client warm up light resistance 8- 10 reps
- Take 1 min break
- Add 30-40 lbs (10%-20 intital load ) perform 3-5 reps
4 take two minute rest
5 repeat 3 and 4 until client achieves failure between 2-10 reps. 3-5 reps for greater accuracy - Check one rep maximum chart.
Lower extremity strength assessment squat purpose?
One rep squat maximum and overall lower body strength also used for the squat exercise intensities.
YMCA 3 minute step test purpose?
Assesses cardiorespiratory fitness, so you can help assign Appropriate HR zones.
Strength assessment purposes for bench and squat?
Assesses and measures intensity
Vertical jump test is determining what?
Lower extremity power
The 40 yd dash assesses what?
Acceleration & speed
Pro shuttle test measures?
Speed
Body control
Ability to to change direction
The left test assesses what?
Agility
Acceleration
Deceleration
Postural control
What is the first Most common compensations for a seated job and sedentary lifestyle?
Feet turn out
So the calves do not have
To work as hard to dorsiflex.
What muscle would need to be performed in SMR static stretching?
Static stretching the gastrocnemius.
What is the second primary compensations?
Knees move inward also suggests that there might be poor range of motion at the ankle. ( when they are no in-line day with the second and third toe this happens)also could mean the adductors are working to hard and adductors are not working hard enough. The do activation of gluteus medius minimus to assist internal and external range at the hip.
What muscle would you SMR & static stretch with knees moving inward?
Adductor complex. Then strengthen abductors.
What is the third primary compensation during OHS assessment? What muscles would you correct for this problem and how?
Excessive anterior pelvic tilt. Which leads to a hyperextended lumbar spine. Increased the chance of low back pain. This reason is because of the average time a person spends sitting. Corrective flexibility for the hip flexors and quads. Follow by activation exercises that focus on abdominals and gluteals.
What is the fourth primary compensation of an OHS assessment? What muscles are effected? How would you correct them?
Excessive forward lean
Calves are shortens( soleus and gastrocnemius) also shorten hip flexors and abdominal muscles or weak glutes or erector spinae muscles.
What is the Fifth primary compensation of OHS assessment? What muscles are affected and how to correct them?
Arms fall forward ( shoulders should be able to flex to 180 degrees) that way the arms should maintain over the above overhead and inline with the torso. Core should be working properly then the arms will stay were they are. The muscles affect are short chest and back muscles. Then include corrective flexibility for pectoral muscles and latissimus dorsi muscles. Exercises include prone cobra,
