Exam 1 Flashcards
Takes Ca out of bone
PTH
Puts Ca into bone
Calcitonin
Accelerated bone loss with what type of osteporosis
Postmenopausal
What type of fx with postmenopausal
vertebral
what type of fx with age related osteoporosis
hip
What type of bone does postmenopausal osteoporosis impact
trabecular
What is the purpose of the FRAX Tool
evaluates 10 year probability of hip fracture and major osteoporosis fracture
- can be a guide as to whether meds or needed or not
- available for 4 U.S. populations (white, black, asian, hispanic)
Type of osteporosis med that can lead to femoral insufficincy fractures
Alendronate (Fosamax, Boniva)
Type of osteoporosis med that decr number of osteoclasts an is a nasal spray
Calcitonin
Type of osteoporosis med that prevents bone loss in the spine and is a selective estrogen receptor modulator
Raloxifene (Evista)
Type of osteoporosis med that simulates osteoblastic proliferation and new bone formation. Taken intermittently and used with Ca citrate
Sodium Fluoride
What age needs the most Ca
9-18
Management of acute vertebral fractures
- ) Intermittant Horizontal Rest Regime (supine, SL, standing)….no sitting
- ) TENS for pain
- ) Isometric exercises with breathing
- ) Gentle AROM or AAROM
Management of subactue vertebral fractures
- ) Start to include some flexibility, strengthening, and balance
- ) Limit the amount lifting to less than 10 lbs
- ) Education on proper posture and body mechanics
- ) Evaluate need for orthotic
What two tests would you want to avoid in someone who has osteoporosis
BBS and Fullerton
What RPE for 60-80% of 1 RM
13-15
What RPE for 40-60% of 1 RM
11-13
Older adults and children rely on what sense more for balance
vision
Adults rely on what sense more for balance
somatosensory
What was were the two most predictive things of having a fall after D/C from hosptial
- ) Previous fall
2. ) Use of AD
When protein clumps together and cloud a small area of the lens, making it harder to see
Cataracts
Degneration of the macula which is responsible for sharp, central vision
Age-related macular degeneration (AMD)
Category of eye disorders associated with a dangerous buildup of internal eye pressure which can cause eye damage
Glaucoma
Glaucoma leads to loss of what type of vision
peripheral
Is glaucoma painful
no
What score is indicative on fall risk for the GDS
More than 6 points
What score is indicative on fall risk for the FES-I
More than 24 points
5 Medical History Questions Predictive of Falls
- ) Previous falls
- ) Psychoactive meds
- ) AD for ambulation
- ) Assistance with ADLS
- ) Fearful of falling
What score is indicative on fall risk for the BBS
Less than 50
What score is indicative on fall risk for the TUG
More than 11 sec
What score is indicative on fall risk for the SLS, EO
Less than 6.5 sec
What score is indicative on fall risk for the 5x STS
More than 12 sec
What score is indicative on fall risk for the Self selected walking speed
Less than 1 m/sec
What constitutes a hypertensive crisis
- ) SBP more than 180
- ) DBP more than 120
- ) RR more than 35
- ) HR more than 130 bpm
- ) HR less than 40 bpm
What score is indicative on fall risk for the ABC Scale
Less than 67%
What score is indicative on fall risk for the Functional Reach/Modified Functional Reach
Less than 6-7 inches
What score is indicative on fall risk for the Fullerton means high fall risk
Less than 25
What score is indicative on fall risk for the 4 Square step test
More than 15 sec
What score is indicative on fall risk for the DGI
Less than 19
What score is indicative on fall risk for the Tinetti (POMA)
Less than 19
What measures static and dynamic balance in higher functioning adults
Fullerton Advance Balance Scale
What time on the TUG would mean dependent in mobility and ADLs
More than 30 sec
What percent slow on inside the parallel lines vs outside the parallel lines = fall risk
15%
How long and wide is the corridor for the parallel walk test
6m long, 20cm wide
What is a high fall risk on the tandem walk
Unable to walk 5 steps with eyes closed
What test looks at dynamic balance with change in direction
4 Square Step Test
What score on the FGA is indicative of falls
22/30 or less
What score is indicative on fall risk for the 30 second chair stand
Less than 8
What do you need to do before beginning the 30 second chair stand
Measure BP, HR, RR pre and post test
More than ____cm = fx with arm span to height measurement
4cm
More than ___cm on flexicurve = clinical kyphosis
13 cm
Index of Kyphosis =
(TW/TL) x 100
Less than or equal to ___cm = vertebral compression fx with the iliocostal distance measurement
3.6 cm
What do you need to do pre and post test on the 2 min walk test
Measure BP, HR, RR
What do you need to do pre and post test on the 2 min step test
Measure BP, HR, and RR
What are the 4 categories on the Mini BEST
Anticipatory, reactive, sensory orientation, and dynamic gait
3 evidence based community fall prevention program
- ) Otago
- ) Tai Chi
- ) Stopping Elderly Accidents Deaths and Injuries (STEADI)
3 components of STEADI
- ) Screen
- ) Assess
- ) Intervene
What 3 muscles make up the Levator Ani
- ) Puborectalis
- ) Pubococcygeus
- ) Illiococcygeus
Are there more endurance or quick twitch fibers in the pelvic floor
endurance
which trimester has the highest rate of miscarraige
first
What is full term
37-42 weeks
What causes the supine hypotension in pregnancy
compression to the inferior vena cava
Posture changes that occur with pregnancy
- cervical ext
- scapular ab
- protraction
- increased thoracic flex
- increased lumbar ext
- increased anterior pelvic tilt
- increased BOS
- increased hip ER
What BP is gestational HTN
140/90
What types of movement can cause round ligament pain
anterior pelvic tilt or a cough or sneeze or another quick motion with pull
True or false: ribcage expansion occurs early in pregancy
true
Things to avoid when exercising someone who is pregnant
- prolonged static positions
- extreme assymetrical LE positions, vigorous stretching of hip adductors, positions that strain pelvic floor or abdominal muscles, supine for longer than 3 min, inverted, buttocks higher than chest (bridging)
Is cryotherapy safe in someone who is pregnant
yes
What motion do you want to avoid for 6-8 weeks postpartum
hip extension
Type of urinary incontinence with a strong unconrollable sensation to void
Urge
leakage with cough, laugh, sneeze, exertion, exercise
Stress incontinence
urinary leakage secondary to lack of sensation to urinate…..common in those who hold their urine for long periods of time or those who have a neurological conditions like MS
Overflow incontinence
Weakness of the anterior vaginal wall (and most common type of pelvic organ prolapse)
Cystocele
Weakness of posterior vaginal wall
Rectocele
Prolapse of the small bowel
Enterocele
If someone has pelvic organ prolapse what might they complain of
back pain, pelvic heaviness/pressure, feeling something fall out
What is the tx for dyssynergia of the pelvic floor muscles
biofeedback
Things to screen for to see if pelvis is the issue:
- ) Pelvic Pain greater than 3/10
- ) Hx of tailbone fall
- ) urinary dysfunction such as incontinence, difficulty emptying bladder, pain with urination
- ) Nocturia
- ) Feeling of pelvic pressure
- ) Hx of LBP, hip, or groin pain
- ) Painful intercourse
- ) Pain with sitting
- ) Bowel dysfunction such as incontinence, difficulty emptying, pain, or straining
What are the two subtests on the POMA
Balance and Gait
