Equipment, Devices and Technologies; Therapeutic Modalities Flashcards
A dependent patient must be ___ when changing positions in order to avoid shearing of skin across the bed.
lifted
Practice moving ____ from one side of the bed to the other.
segmentally
Min A is ___%.
Mod A is ___%.
Max A is ___%.
25%
50%
75%
Dependent transfer of three person carry/lift.
Used to carry someone from stretcher to…
One therapist holds ____ , the second supports___, and the third supports ____.
Therapist at the ____initiates commands.
bed or plinth
head and upper trunk
trunk
LE
head
Dependent transfer of two person lift.
Used to transfer patient between….
One therapist holds…..
Other therapists holds….
two surfaces of different heights or when transferring a patient to the floor.
underneath axilla; grab L forearm in R hand and R forearm in L hand.
mid to distal thighs and LE
Stand pivot transfer requirements…
Lead with ….
Can also be used therapeutically for someone with CVA leading with….
unilateral WB restrictions or hemiplegia
uninvolved
involved
Measuring seat height in w/c
measured from heel to popliteal fold and add 2 inches
Measuring seat depth in w/c
posterior buttock to popliteal fold and subtract 2 inches
Measuring seat width in w/c
measure widest aspect of buttocks, hips or thighs and add 2 inches
Measuring back height in w/c
measure seat of chair to floor of axilla with users shoulder flexed to 90 degrees and subtract 4 inches
Final back height of w/c should be below the ____of the scapulae
inferior angles
Back height is affected by
cushion
Measuring armrest height in w/c
seat of chair to olecranon process with users elbow flexed to 90 degrees and add one inch
Hemi frame w/c is used for those who
self propel using LE
One-hand drive frame w/c is used for those who
self propel using one UE
Amputee frame w/c is used for those who
self propel but center of gravity is shifted posteriorly due to amputation
Geri chair w/c is used for those who
are not able to self propel or safely operate a power mobility device
Reclining chair w/c is used for those who are
unable to perform weight shifting or unable to sit upright for extended periods.
moderate to severe trunk involvement
Backward tilt-in-space frame w/c is used for those who
are unable to sit upright or perform weight shifts but also has issues sliding or has extensor tone
Sling back in w/c is for those who
require no postural support and has no neuromuscular deficits.
usually not for long term
Planar back in w/c is for those who
require mild to moderate trunk support due to tone
Curved back in w/c is for those who
require moderate trunk support
Custom molded insert in w/c is for those who
require significant trunk support
If the back height is below inferior angle of scapula the pt is able to
self propel and has good trunk control
If the back height is above inferior angle of scapula the pt is
able to self propel but requires additional spinal support
Planar seat in w/c is for those who
have no seated deformity
Curved seat in w/c is for those who
require mild to aggressive supportive curvature to provide increased contact between lower body and seat
Custom molded seat in w/c is for those who
require customized seat support to correct pelvic obliquity or a fixed asymmetrical deformity
Bevel (undercut) front edge of seat in w/c is for those
who self-propel using LE
Planar lateral supported for trunk in w/c is for those who
require mild to moderate lateral support duet o listing or scoliosis
Contoured or curved lateral supports for trunk in w/c is for those who
require total contact lateral support for significant lateral listing or scoliosis
Chest strap in w/c is for those who
require trunk support to correct for anterior listing
Chest harness in w/c is for those who
require both trunk and shoulder support to correct for anterior listing
Full length arm rests in w/c are for those
who perform STS
require additional postural support
pt utilizing lap board
Tubular or single posted arms in w/c are for those who
require minimal support for UE and easy access to wheels for propulsion and easily removal of arms
Fixed or non-removable armrests in w/c are for those who
require durable UE support
Covered rim wheel in w/c are for those that
require assistance for adequate grasp or friction when hands are in contact with wheel rims
Proportional control of power w/c
modulate speed
Non-proportional control of power w/c
pre-set speed
Bariatric w/c has weight limit of
300-1,000 lbs
Proper fit positioning of crutches
6 inches in front
2 inches lateral
crutch height should be no greater than 3 finger widths from the axilla
Lofstrand crutches can be used with all levels of ….
They require the ___ level of coordination.
Arm cuff should be positioned ….
Platform attachment can be utilized.
WB
highest
one an one half inches below olecranon process so it doesnt interfere with elbow flexion
Quad canes can better assist with limited ___ on an involved LE.
WB
Canes can be used in what types of gait patterns?
2 point
4 point
modified 2 and 4 point
When guarding during ambulation what side do you stand on as the therapist?
to the affected side
2 point gait
two crutches or canes
opposite crutch and LE move forward together.
Each step is one point and a complete cycle is two points.
3 point gait
walker or crutches
involves one injured LE that may have decreases WB
AD is advanced, then the injured LE, then the uninjured LE.
AD and each LE is a separate point.
4 point gait
similar to 2 point gait but doesnt move extremities simultaneously with device.
This is for those with impaired coordination, balance or significant strength deficits.
Each advancement of LE and crutch is a point.
Guarding during ascending stairs using handrail
stand opposite side and behind
Guarding during ascending stairs not using handrail
stand behind patient slightly toward affected side
Ascending stairs with crutches/cane
turn crutch sideways and hold HR and crutch in same hand
Those with a femoral line, hip flexion WOM should be limited to
not >80 degrees
CVP catheter is aka
and what does it do?
central line
measures pressures in RA or superior vena cava by means of indwelling venous catheter and pressure manometer.
Used to evaluate R ventricular function, R atrial venous pressure and circulating blood volume.
With a CVP catheter, avoid ….
For internal jugular insertion limit….
For subclavian insertion limit…..
If this is dislodged it is a…
excessive movement and physical activity
limit head and neck movement
limit ipsilateral shoulder ROM to 90 degrees
life-threatening emergency
Indwelling R atrial catheter is aka
and is used for ….
Limit what kind of movements with this one?
Avoid what else?
Hickman
long-term use of substances in to venous system
limited repeated ipsilateral shoulder movements
limit aquatic therapy
avoid soft tissue mobilization and manual techniques over access point
Pulmonary artery catheter is aka
and is used for..
Limit….
For internal jugular insertion limit….
For subclavian insertion limit….
For femoral insertion limit….
Dislodging this is a…
Swan-Ganz
continuous monitoring of pulmonary artery pressure
excessive movement and physical activity
head and neck movement
ipsilateral shoulder ROM to 90 degrees
ipsilateral hip flexion to 70
life threatening
Intracranial pressure monitor:
Must notify… before starting physical activity.
Changing bed height might….
Maintain head and neck….
What position of bed, neck and hip increase ICP?
nursing
alter transducer reading
neutral
Trendelenburg
neck flexion
excessive hip flexion
NG tubes need to be stopped with patient in what position?
upright or semi-Fowler’s position for at least 30 min prior to supine activities
Those with G tube or PEG tube should not
lie flat during feeding
PEJ (jejunostomy tube) is used for
long-term feeding
also should not lie flat
PICC line is used for ….
precautions for this
long-term administration of medications
ROM exercise of involved extremities allowed
Use of axillary crutches is often contraindicated due to risk of occluding blood flow or causing thrombus
Avoid excessive ___and ___ movements but functional mobility can still be performed with ….and tracheostomy tube.
head and neck movements
endotracheal tube (intubated)
Displacement of ET tube is a …
PTs should develop what kind of communication with those who are intubated?
Are out of bed activities allowed?
life-threatening
nonverbal
yes
With an oxygen tent, avoid ….
Electrical devices should…. be used inside.
opening more often than necessary
not
Those with woundvac if it is how full… it should be emptied before activity.
more than half full
Arteriography
catheter inserted into artery either through groin or arm to heart.
Used to identify arteriosclerosis, aneurysm, vascular malformations, tumors or blockages.
Arthrography
visualize joints
CT used to diagnose
spinal lesion
diagnostic studies of brain
EEG does what?
record electrical activity of the brain
epilepsy or narcolepsy
EMG doe what?
records electrical activity of selected muscle or group of muscles during voluntary contraction
Fluoroscopy can show motion
within joints or movement of dye within digestive tract
Myelography looks at
spinal cord
nerve roots
meninges
diagnoses:
bone displacement, spinal stenosis, disk herniation, spinal cord compression, infection/inflammation of meninges or tumors
PET looks for
tumors or other lesions
Venography diagnoses
DVT
tumors
valve dysfunction
Ice massage can be used as a stimulus to
facilitate a desired motor response in those with impaired motor control.
applied with direct pressure over muscle belly for 3-5 seconds or quickly stroked over targeted muscle belly to enhance contraction.
Ice massage area and time
10cm x 15 cm
5-10 minutes
Phases of cooling
intense cold
burning
aching
analgesia
Cold packs should be applied for how long?
Can be reapplied every…
If treatment goal is spasticity reduction, can extend treatment time to …
20 min
1-2 hours
30 min
Vapocoolant spray is used for
trigger points
Standard size of hot pack is
12x12 inches
How many layers of towel need to be used with a hot pack ?
If commercial hot pack, how many layers of towels?
6-8
2-3
Pts cannot lie___ of hot back
on top of
Fluidotherapy used for
tissue healing, skin desensitization, edema management
Infrared lamp use for
soft tissue healing
Amount of infrared lamp tissue temperature increase is
directly proportional to amount of radiation that penetrates tissue
What should you do to protect outside target area tissue in infrared lamps?
protective toweling
How many times do you dip the hand in parrafin in a dip-wrap method?
6-10 times
What do you document when using modalities?
body part treated
modality used
treatment duration
parameters
response to treatment
outcome measure
Deep heating agents can heat to depths of
3-5 cm
Deep thermotherapy examples are
ultrasound and diathermy