Exam 1 Flashcards
Active cancer (treatment ongoing, treatment
within last 6 months or receiving palliative
care) Well’s score? Well’s score?
+1
Calf swelling ≥ 3 mm compared to
asymptomatic calf (measured 10 cm below
tibial tuberosity) Well’s score?
+1
Swollen unilateral superficial veins (nonvaricose,
in symptomatic leg) Well’s score?
+1
Unilateral pitting edema (in symptomatic leg) Well’s score?
+1
Swelling of entire leg Well’s score?
+1
Localized tenderness in center of posterior
calf, popliteal space, or femoral vein in
anterior thigh/groin, or along distribution of
Deep Venous System Well’s score?
+1
Paralysis, paresis, or recent immobilization of
lower extremities Well’s score?
+1
Recently bedridden ≥ 3 days, or major
surgery in last 12 weeks requiring general or
regional anesthesia Well’s score?
+1
Alternative diagnosis at least as likely (i.e.
cellulitis, postoperative swelling, calf strain) Well’s score?
-2
-2 to 0 Well’s score?
Low probability of DVT (3%)
1 to 2 Well’s score?
Moderate probability of DVT (17%)
≥ 3 Well’s score?
≥ 3 High probability of DVT (75%)
FLACC stands for?
Face Legs Activity Cry Consolability
For FLACC Each category is scored on the 0–2 scale, which results in a total score of ?
0–10
FLACC score of 0 means?
Relaxed and comfortable
FLACC score of 1-3 means?
Mild discomfort
FLACC score of 4-6 means?
Moderate pain
FLACC score of 7-10 means?
Severe discomfort or pain or both
Using the FLACC in patients who are awake?
Observe for 1 to 5 minutes or longer. Observe legs and body uncovered. Reposition patient or observe activity. Assess body for tenseness and tone. Initiate consoling interventions if needed.
Using the FLACC in patients who are asleep?
Observe for 5 minutes or longer. Observe body and legs uncovered. If possible, reposition the patient. Touch the body and assess for tenseness and tone.
The McGill Pain Questionnaire can be used to?
Evaluate a person experiencing significant pain. It can be used to monitor the pain over time and to determine the effectiveness of any intervention.
The McGill Pain Questionnaire minimum pain score?
0 (would not be seen in a person with true pain)
The McGill Pain Questionnaire maximum pain score?
78
The McGill Pain Questionnaire, the higher the pain score?
The greater the pain
An embolus (a mass of undissolved matter present in a blood or lymphatic vessel) in a pulmonary artery or one its branches?
Pulmonary Embolism
PE Well’s score for Clinical signs of DVT?
3
PE Well’s score for HR >100 bpm?
1.5
PE Well’s score for immobilization for 3 days or longer, or surgery in previous 4 weeks?
1.5
PE Well’s score for previous dx of PE or DVT?
1.5
PE Well’s score for hemoptysis?
1
PE Well’s score for patients receiving cancer tx, stopped in past 6 months, or receiving palliative care?
1
PE Well’s score for alternative dx less likely than PE?
3
PE Well’s score of <2 pts?
Low
PE Well’s score of 2-6 pts?
Moderate
PE Well’s score of >6 pts?
High
This scale quantifies muscle spasticity by assessing the response of the muscle to stretch applied at
specified velocities?
TARDIEU scale
For Tardieu grading is always performed at?
The same time of day, in a constant position of the body for a given limb.
For Tardieu each muscle group, reaction to stretch is rated at?
A specified stretch velocity with 2 parameters x and y.
For Tardieu V1 is used to measure?
PROM
For Tardieu V2 & V3 are used to rate?
Spasticity
For Tardieu V means?
Velocity to stretch
For Tardieu X means?
Quality of muscle reaction
For Tardieu Y means?
Angle of muscle reaction
No resistance throughout passive movement = Tardieu?
Tardieu score 0
Slight resistance throughout, with no clear catch at a precise angle= Tardieu?
Tardieu score 1
Clear catch at a precise angle, followed by release = Tardieu?
Tardieu score 2
Fatigable clonus (<10 secs) occurring at a precise angle = Tardieu?
Tardieu score 3
Unfatigable clonus (>10 secs) occurring at a precise angle
Tardieu score 4
Joint immobile= Tardieu?
Tardieu score 5
Angle of catch seen at Velocity V2 or V3 ?
R1
Full range of motion achieved when muscle is at rest and
tested at V1 velocity?
R2
A large difference between R1 & R2 values in the outer to middle range of normal m. length indicates?
A large dynamic component
A small difference in the R1 & R2 measurement in the middle to inner range indicates?
Predominantly fixed contracture
No increase in muscle tone
Modified Ashworth score of?
0
Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension
Modified Ashworth score of?
1
Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM
Modified Ashworth score of?
1+
More marked increase in muscle tone through most of the ROM, but affected part(s) easily moved
Modified Ashworth score of?
2
Considerable increase in muscle tone, passive movement difficult
Modified Ashworth score of?
3
Affected part(s) rigid in flexion or extension Modified Ashworth score of?
4
Which is the newest special interest group?
Assistive Technology/Seating & Wheeled Mobility
PD, MS, ALS, HD & others fall under which special interest group?
Degenerative Diseases
Payment for each patient is based on information in the?
Patient Assessment Instrument (PAI)
IRF PPS stands for?
Inpatient Rehabilitation Facility Prospective Payment System
Section GG?
Functional Abilities and Goals**
Section GG: Prior Function: Scores range from?
Dependent (1) - Independent (3)
Unknown (8)
N/A (9)
Section GG: Mobility: Scores range from?
Dependent (1) - Independent (6)
Patient refused (7)
N/A (9) for both self care and mobility
Interdisciplinary Team Model 3 key elements?
Activities
Problem solving
Collaboration
Scheduling: for easier patients?
Early
Scheduling: more debilitated patients?
Later
Scheduling: morning?
ADL’s
Transfers
(HOAC II) stands for?
The Hypothesis-Oriented Algorithm for Clinicians II
APTA Client Management Model order?
Examination Evaluation Diagnosis Prognosis Intervention Outcomes
What is Phase 1?
Medical screening (systems review) for disease and pathology
What is Phase 2?
Examination and Evaluation
Categorizing examination findings into specific categories through evaluation that will generate diagnosis of movement dysfunction, prognosis and guide choice of interventions.
Client remains within the scope of physical/occupational therapy practice and proceeds with the diagnostic process
The Guide to PT Practice describes the systems review: brief or
limited examination of the anatomical and physiological status of?
- cardiovascular/pulmonary system
- integumentary system
- musculoskeletal system
- neuromuscular system
RLQ pain?
McBurney’s Appendix
Examination consists of?
History
System Screening
Tests and Measures**
(ICF) stands for?
International Classification of Functioning
Disability and Health
Domestic, community, social, civic life situations,
education life, work life. (e.g questionnaires)
What part of ICF?
Participation
Self care, domestic care (i.e. ADL, IADL respectively)
what part of ICF?
Functional activities
Systems and subsystems, identification of strengths and impairments
what part of ICF?
Body functions and structures
First: Choose Appropriate Test and Measures
Start with tests that fall under?
- Participation
2. Activity/Functional Performance
Second: Analyze?
Posture and Strategy
Divide Functional Activity Observed into 3 phases?
Initiation
Transition
Completion
Ability to carry out purposeful movement?
Apraxia
CNS integration – it weighs: what 3 things?
- 1) somatosensory input first
- 2) vision input second
- 3) vestibular input third
What test looks at the 3 CNS integrations?
CTSIB test looks at these
Location in space?
Proprioception
Perception of the movement?
Kinesthesia
Purpose of Evaluation? order?
Diagnosis
Prognosis
Goals
Interventions
DON’T use impairment goals*** (not ideal), instead use?
Activity goals
Participation goals
“The ? is the determination of the predicted optimal level of improvement in function and the amount of time needed to reach that level and also may include a prediction of levels of improvement that may be reached at various intervals during the course of therapy”
Prognosis
Standardized tests that have predictive validity?
Motricity index
NIHSS (National Institute of Health Stroke Scale)
Fugl-Meyer Assessment Scale
***Orpington Prognostic Scale
5 Essential Components of Plan of Care?
- 1) goals and outcomes
- 2) rehabilitation potential
- 3) specific interventions to be used
- 4) duration and frequency of interventions
- 5) criteria for discharge
Goal Writing must be what 3 things?
- Objective
- Measurable
- Time limited
List of Interventions Should Include?
1) Coordination, communication, documentation
2) Patient/client-related instruction
3) Procedural intervention
An upward and equal force which is equal to the fluid
which the body has displaced?
Buoyancy
Archimedes prinicple
If in water up to ASIS?
50% weight bearing
If in water up to Xiphoid Process?
30% WB
If in water up to C7?
10% WB
The pressure exerted by a fluid on any body at
rest?
Hydrostatic pressure
Hydrostatic pressure at the surface?
14.7 lbs/in²
A person of average height at neck level will
experience how much hydrostatic pressure?
16.43 lbs/in²
at the calf: for reference – an ace bandage can produce
pressure from ? around the calf
1-7 lbs/in²
? ml vital capacity contraindicated to
be in chest-deep
<1400 ml
The resistance occurring between molecules of a
liquid, affecting flow?
Viscosity
Water becomes ? viscous as temperature rises
less
The tendency of masses to resist changes in motion?
Which Newton law?
Law of inertia ***
(e.g) having pt. quickly switch from 1 direction to another direction
the acceleration of an object is directly proportional to a force acting upon that object, inversely proportional to the mass, and has the same direction as the resultant force?
Which Newton law?
Law of Acceleration
For every action, there is an equal and opposite reaction.
Which Newton law?
Law of Action/Reaction
The product of the force times the length of the force arm is equal to the product of the resistance times the length
of the resistance arm
Which Newton law?
Law of leverage
HOW LONG CAN A THERAPIST BE IN THE WATER?
No more than 4 continuous hours per day
WHAT TEMPERATURE IS THE WATER SUPPOSED TO BE? for more active patients or patients with MS
82-88
WHAT TEMPERATURE IS THE WATER SUPPOSED TO BE?
for less active patients such as those with arthritis or women
88-92
