DPT 5000 Quiz 1 Flashcards
Elements of the Patient/Client Management Model
Examination --> gather data Evaluation --> analyze the date Diagnosis --> PT DIAGNOSIS Prognosis/ Plan of Care --> determine pt's potential goals Intervention --> Outcomes --> Results/ Discharge pt
Functions of Bone
- Support
- Protection of Vital Organs
- Mechanical Leverage
- Storage for Minerals (calcium)
- New blood cell formation - bone marrow
Cortical Bone; % of skeleton; Constructed with what two structures?
(Compact or Dense Bone) 80% of Skeleton Lamellae w/ Haversion canal Canaliculi (Volkmann's) Thicker in the middle of long bones for added strength
Lamellae
Collagen fibers forming concentric rings
Haversion canal
Core center of lamellae, contain blood vessels and nerves (need to know for healing) –> allows for circulation
Canaliculi (Volkmann’s)
Tiny canals within lamellae for diffusion of nutrients and waste to and from haversian canals
Cortical Bone- X-ray Images
Treatments (Cortical Screws)
X-ray shows more dense white–> representing thicker bone
Orthopaedic surgeons try to anchor screws to cortical bone (cortical screws). Goes through both side of hard bone.
When bone is broken and treated with rod implant –> bone is weight bearing!
Medullary Canal
- Manufacturing of RBCs in children, contains yellow fatty marrow in adults.
- Ream out and place metal rods for fixation of fxs & amp; joint replacement stems
- X-ray examples: femur fx, tibia fx, Total Hip Replac, THA w/ fx from inserting stem
Periosteum
Fibrous membranes that cover bones, (pain) nerves, and blood vessels pass thru.
- Contains pain nerves so trauma to bone is very painful.
- This is what you palpate (tibia, elbow, skull, malleoli)
- Fx through periosteum very painful. Thicker in children, so fractures are sometimes less serious than adults.
Cancellous (spongy) Bone; % skeleton; Structure
20% of skeleton
Lamallae deposited in parallel (vs concentric rings)–> called Trabeculae- irregular arranged w/ lattice work or woven mesh.
Bone marrow contained between layers of mesh. Thin layers, but show layers of bone stress (hip x-ray)
Where is cancellous bone located and what areas have the highest density.
Found @ end of long bones, near joint.
Highest Density: Proximal femur, distal radius, vertebral body.
These are often the sites of osteoporosis fracture
Cancellous bone fractures
Bone becomes compacted w/ fxs and can be more difficult to manage.
Impaction or compression fxs.
X-ray examples: tibial plateau fx, femoral neck fx, thoracic vertebrae compression fx, humeral head dislocation
Compression Fractures
Cancellous bone is susceptible to these. (Rather than snapping fractures)
- WAY more difficult to manage
- long time b4 weight bearing
Osteoarthritis Breaks
most common where?
Hip, Wrist, Spine
Use of Medullary Canal for treating fractures
- Ream out and place metal rods for fixation of fxs & joint replacement stems
- Old method of fx management: traction & bedrest for 3mo.
- New method: rod fixation and discharge in 2-3 days.
Bone Parts
- Diaphysis
- Epiphysis
- Epiphyseal Plate
Diaphysis
Long axis of bone. Compact bone surrounding medullary canal.
In adults, canal contains marrow and yellow fat which can break off and enter the veins in the form of globules.
–> which lodges in arteries of lung forming a pulmonary emboli (fat vs blood clot)
Epiphysis
- bone ends. Thin layer of compact bone surrounding interior of spongy bone.
Epiphyseal Plate
Growth plate.
AKA Salter-Harris plate
Bone Growth
Diaphysis= primary development growth
Epiphyseal plate= secondary growth centers that fuse @ end of puberty and represents end of growing
Epiphyseal Plate fractures vs. non-fracture
X-ray of open epiphysis can be mistaken for fractures
Salter-Harris fracture- through growth plate must be managed properly or it will stunt growth of that bone
Articular Cartilage
And what disease involves this cartilage?
Cushions bone ends and absorbs stress @ joints.
Degenerative joint disease (DJD) is wearing away of cartilage.
What is a PTA
Physical THERAPIST assistant
Components of preferred PT-PTA team that promote efficient, high faulty patient/cline care.
- Pt needs suppressed team needs
- Ea. professional being knowledgeable of rules that apply to one’s own role and the other’s role within the team.
- Ability to recognize when the team isn’t working.
- Acknowledging tendencies, preferences and pet peeves.
PT/ PTA Relationship
Roles
-PT directs PTA to perform selected interventions
-PT provides ongoing supervision as needed and mandated by law
-PTA performs tasks w/ patient
PTA documents performance/ response
PT- retains ultimate responsibility
Both responsible for following state and APTA regulations
What should be considered when determine PT/PTA involvement?
- Predictability of consequences
- Stability of situation
- Observability of basic indicators
- Ambiguity of basic indicators
- Criticality of results
- Purpose of dimension
Instrumental or Expressive functions of tasks? - Locale dimension
Explain the purpose of the Guide to Physical Therapist Practice
- It describes the PT practice (who PTs are and what their role is in healthcare)
- Explains the settings in which we work
- Standardizes Terminology
- It reviews our education
Define the primary components of the ICF Model
“Health Condition” (Disorder/Disease/Pathology/Condition)
Diabetes, pregnancy, fracture, etc.
“Functioning and Disability”
Body Functions and Structures Impairments
Activities Limitations
Participation Restrictions
“Contextual Factors”
Personal Factors
Environmental Factors
Global purpose(s) for using ICF model terminology in PT practice?
It standardizes the terminology that we use so that it is clear and understandable across disciplines.
Elements of the Patient/Client Management Model
PT Examination- Pt history, previous notes, gather data via pt interview/tests
Evaluation- analyze data
PT diagnosis- impairments, activity limitations
Prognosis/ Plan of Care- identify patient’s potential goals
Intervention-
Outcomes- Results/ Discharge patient
Data to be gathered during a Patient History
Activities and Participation Current Condition(s) Family Hx General Demographics General Health Status Growth and Development Living Environment Medical/Surgical Hx Medications Other clinical tests? Review of Systems Social/Health Habits Social History
Primary Care
1st line of care (sees patient 1st)
Family Physician, Family Dentist
Secondary Care
Referred care
Pharmacist (who is referred to)
Tertiary Care
Specialized Team
Burn-unit team, transplant team
Primary Prevention
Screenings; blood pressure, weight, scoliosis
Secondary Prevention
Preventing further injury when a patient already has a health issue (splinting a fx, providing medication for strep throat)
Tertiary Prevention
optimizes what the patient can do, environment/equipment modifications- modify living Slow progression (ex. Cerebral Palsy)
What is included in the Guide to Physical Therapist Practice
- What is a PT and what is their role in healthcare
- The general accepted elements of patient/client management provided by PTs
- Types of tests and measures used by PTs as part of examination for specific client/patient diagnostic groups
- Types of interventions provided by PTs, and what the anticipated goals are of these interventions
- What the desired outcome is of patient/client management provided by PTs
Trabeculae
Irregular arranged w/ lattice work or woven mesh.
