Exam 1 Study Guide Flashcards
Patient Client Model - review the order and stages of the model
-Examination(the process of obtaining a history, performing a systems review, and selecting and administering tests and measurements to gather patient data)
-Evaluation(A dymanic process in which the physical therapist makes clinical judgements based on data gathered during the examination)
-Diagnosis(both the process and the end result of evaluating examination data, which the physical therapist organizes into defined clusters, syndromes, or catagories to help determine prognosis and intervention strategies)
-Prognosis(determination of the level of optimal improvement that may be attained through intervention and the amount of time required to reach that level)
-Intervention(Purposeful and skilled interaction of physical therapist with patient using a variety of techniques to produce changes in the condition that are consistent with the diagnosis and prognosis
-Outcomes(Results of patient management, which include the impact of physical therapy interventions such as pathology, impairments, functional limitations
Review the 4-Element movement model and the CASSS model/approach.
-Motion(hypermobility or hypomobility)
-Force(strength and power)
-Energy(circulation, endurance/aerobic capacity, vitals, ventilation/respiration)
-Motor Control(Performance(plan, execute, adapt to reach goal), sensation to action
CASSS
Control, Amount, Speed, Symmetry, Symptoms
Differentiate the timelines of acute pain, sub acute pain and chronic pain.
Acute pain(24-48 hours), Sub-acute pain(3-14 days), Chronic pain(greater than 3-6 months)
Given a patient scenario, identify if the patient is presenting with mechanical or chemical pain.
Mechanical Pain-Constant or intermittent, acute or gradual, directly proportional to activity, movements in one direction may increase the pain vs. movements in another direction may abolish the pain
Chemical Pain-Constant, acute, inflammation signs, all movements are painful, no activity, no movement, or no position decrease pain, generally speaking over time chemical pain will decrease(if not, suspect non-msk pain)
How does the gate control theory of pain different from the newer models of pain control?
Gate control theory’s basic concept is if we stimulate large fibers we close the gate to the small nociceptive fibers(TENS, STM, even vibration/shaking your hand), we sort of distract our brain from the pain. The newer models of pain control focus on how people were raised and how they respond to pain from previous experience, cultural factors, social/work environment, expectations about consequences, beliefs, knowledge, logic.
Differentiate between nociceptive, peripheral neurogenic and central nociplastic pain. What pain interventions would be appropriate for each type of pain.
-Nociceptive(pain that arises from actual or threatened damage to non-neural tissue and is due to activation of nociceptors, can be constant or intermittent, can be sharp with aggravating activity or at rest a dull ache or throb. (not electric or shooting type of pain)
-Peripheral Neurogenic(pain caused by lesion or disease of the peripheral somatosensory nervous system, pathology to the peripheral nerve or surrounding interfacing tissue, described as sharp, electric, shooting type of pain
-Central Nociplastic(pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors, disproportionate pain with disproportionate aggrevating or easing factors, diffuse tenderness and multiple physcosocial factors
What tests and measures do PT’s use to learn about a patients pain AND when interviewing a patient with pain what features of the pain must a PT appreciate (SINSS)?
(SINSS)
Severity: clinicians assessment of the intensity as related to the pts. Functional ability
Irritability: (intensity/quality) amount activity to stir up the symptoms and how long till they reduce Nature: (location/MOI), hypothesis of the structures, potential serious pathology, patient biopsychosocial factors Stage: (temporal characteristics), acute, sub-acute, chronic, acute on chronic Stability (temporal characterisitics), episode over time – getting better/worse or staying the same
What are biophysical agents? What are the roles biophysical agents play in physical therapy practice?
-Materials and energy applied to patients to assist in rehabilitation, promote tissue healing, decrease pain, increase ROM, alter strength.
Review the “Choosing Wisely” recommendations.
Recommendation #1- don’t employ passive physical agents except when necessary to facilitate participation in an active treatment program
Understand and apply the 3 Laws Governing Electromagentic radiation (arndt schultz, grotthus draper, cosine law) found in the thermal agents presentation.
Arndt Schultz Principle- no changes will occur if energy supplied is insufficient to stimulate the tissues
Law of Grotthus-Draper- if the therapeutic energy is not absorbed by one tissue it is transmitted to deeper tissues
Cosine Law- Goal is for continuous energy application at 90 degrees to surface(perpendicular)
Know the difference between a contraindication and precaution
Contraindications are those characteristics in which the risk of the agent always outweighs the benefit. We do not do it.
Precautions are conditions in which the benefits of using the medication may still outweigh the risks
Review the stages of tissue healing and pay attention to the information about selecting an appropriate modality based on the stage of healing.
Stages of tissue healing:
Hemostasis phase- static compression and/or cryotherapy
Inflammation(acute)- cryotherapy, hydrotherapy (cold), E-Stim (sensory), compression, contrast bath
Inflammation(chronic)-thermotherapy, motor E-stim, whirlpool/hydrotherapy, fluidotherapy, laser, pulsed ultrasound and diathermy
Proliferation- Compression garments for scar remodeling, thermotherapy, electrotherapy, compression, water immersion, or exercise, and possibly use of contrast baths to promote circulation, motor level ES for strengthening, aquatic exercise
Remodeling- To regain or maintain strength (motor E-stim, water exercise), to regain or maintain flexibility (thermotherapy), control scar tissue formation (brief ice massage, compression)
Documentation: What are the components of a treatment note when documenting biophysical agent use?
Information on the physical agent used (type of modality), details on the area of the body treated (specific anatomical landmarks), intervention duration and parameters, outcomes (progress toward goal, regressions or complications arising from application of the physical agent), planning for future use and when to discharge the modality.
SOAP, Subjective, Objective, Assessment, Plan
Review PEACE and LOVE and appreciate the difference compared to prior models (RICE, PRICE, POLICE).
(Immediate injury) Protection, elevation, avoid, compression, education & (after injury) Load, optimism, vascularization, exercise
Appreciate the 5 mechanisms of heat transfer and be able to match the appropriate modality to its mode of heat transfer.
Conduction (hot packs, cold packs, ice pack, ice massage, bath), convection (fluidotherapy, whirlpool), conversion(ultrasound or diathermy), radiation(infrared lamps), evaporation(vapocoolant spray)
