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Ortho > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What type of heat transfer is US

A

Conversion

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2
Q

3 types of US

A

Diagnostic
Therapeutic
Surgical

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3
Q

How deep does therapeutic US go

A

2-5 cm

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4
Q

What is US most commonly used for?

A

deep heating and biophysical effects

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5
Q

what type of tissue does US travel best through

A

Dense material
Ligaments, tendons, joint capsule, scar tissue etc.

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6
Q

What does frequency of US determine

A

depth, wavelength and temperature

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7
Q

1 MHz

A

goes deeper 2-5 cm
slower absorption
long wave length

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8
Q

3.3 MHz

A

shower wavelength
quick absorption
reaches only 2 cm

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9
Q

What is the effective radiating area

A

The inner portion that propagates sound

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10
Q

What is the beam non-uniformity ratio with US

A

the middle of transducer has the highest peak and the outside has less

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11
Q

Continuous mode for US

A

100% duty cycle
sound energy is constant
thermal effects

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12
Q

Pulsed Mode for US

A

10, 20, or 50% duty cycle
minimizes thermal effects

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13
Q

Thermal effects of US

A

increase metabolic rate for tissue healing
elevate motor and sensory nerve conduction (pain reduction)
Reduces spasm
Vasodilation
increased ROM

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14
Q

what is ultrasound not ideal for heating?

A

Muscles

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15
Q

how to increase thermal effects of ultrasound

A

Increase duration and/or increase intensity 1.5 watts/cm

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16
Q

non-thermal effects of US

A

increased skin and cell permeability
increased cell degranulation
increase phagocytic activity
increased rate of protein synthesis by fibroblast
Enhances wound healing

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17
Q

Clinical applications of non-thermal US

A

Edema
pain control
wound healing
Trigger points

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18
Q

Documentation of US

A

Frequency
Intensity
Duty cycle
time
location
transmission medium
Pt tolerance
results

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19
Q

phonophoresis

A

delivery of medicated lotion via ultrasound
“upgraded ultrasound and downgraded iontophoresis”

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20
Q

What level does TENS and Iontophoresis reach

A

sensory level

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21
Q

Contraindications for electrical modalities

A

cardiac pacemakers/ electronic implants
over carotid sinus
near venous or arterial thrombosis
over areas of indwelling phrenic nerve or urinary bladder stimulators

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22
Q

Direct current

A

continuous unidirectional flow of electrons

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23
Q

alternating current

A

uninterrupted bilateral flow of electrons

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24
Q

pulsed current

A

when electron flow is interrupted for milliseconds or microseconds
can be either AC or DC

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25
Q

Types of pulsed waveform

A

mono-phasic
biphasic- 2 phases with current flow in both direction
polyphasic

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26
Q

amplitude/intensity of wave form

A

distance the impulse rises above or below a baseline

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27
Q

duration of waveform

A

length of time to complete one wave

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28
Q

modulation of waveform

A

changes made in one or more aspect of the current (duration or amplitude)

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29
Q

Subsensory level of stimulation

A

no nerve fiber activation
no sensory awareness

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30
Q

sensory level of stimulation

A

non-noxious paresthesias
tingling
cutaneous A-beta nerve fiber activation

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31
Q

What level of stimulation do we typically stay in during TENS

A

Subsensory and sensory

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32
Q

Motor level of stimulation

A

strong tingling and pins and needles
muscle contraction
A-alpha nerve fiber activation

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33
Q

Noxious level of stimulation

A

strong
uncomfortable paresthesia
strong contraction
A delta and C fiber activation

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34
Q

Pulse duration/ width

A

length of time between beginning and end of all phases in a single pulse
commonly set to 50-150 usec for TENS

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35
Q

what does pulse duration determine?

A

Which types of fibers are stimulated
Short-sensory (less than 100)
longer- motor (more than 100)
longest-pain (more than 200)

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36
Q

What does frequency determine

A

type of muscle contraction that occurs
1-20 pps (subsensory and sensory)
20-40 (necessary for muscle contraction)
50-80 (creates tetany with significant fatigue

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37
Q

what is the average intensity that is tolerated?

A

35-80 mA

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38
Q

What is intensity responsible for

A

level of sensory and motor response
number of fibers being stimulated

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39
Q

What is TENS utilized for?

A

acute and chronic pain management

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40
Q

How is TENS beloved to decrease pain

A

by counter-irritant theory
creates a signal to counter pain that a person is feeling

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41
Q

Elements of TENS

A

Pulse duration - less than 150 is short
Frequency- Greater than 8- is high
amplitude is determined by patient

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42
Q

precautions of TENS

A

narcotic pain med usage
unclear diagnosis
general E-stim precautions

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43
Q

Contraindications for TENS

A

Driving
MG or MS (rapid fatigue)
Contralaterally- transthoracically
Children

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44
Q

Documentation for TENS

A

treatment parameters
electrode placement
Pain description
Change in occupational performance or biomechanics components

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45
Q

Conventional TENS

A

High rate
sensory
most commonly used for acute pain
effect doesn’t last ling
patient feels pins and needles

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46
Q

Motor TENS

A

low rate
sub-acute or chronic pain
Effects last longer
patient feels thump

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47
Q

Iontophoresis

A

Delivery of ions into body for therapeutic purposes
E-stim for medication delivery
Need referral and prescription

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48
Q

Causes of soft tissue injuries

A

minor and persistent repetitive trauma
Direct blunt trauma
Sudden uncontrolled and excessive overuse

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49
Q

What is a contusion

A

a region of inured tissue or skin in which blood capillaries have been ruptured

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50
Q

Early and later stage of contusion

A

Early- erythema
Later- swelling and loss of function

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51
Q

tx for contusion

A

prevent tissue form further injury
compression wrapping
MICE

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52
Q

Definition of a strain

A

damage of some part of contractile unit of muscle caused by overuse or over stress

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53
Q

Where does a strain occur

A

the weakest link of the muscle tendon unit

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54
Q

3 degrees of strain from lowest to highest

A

mild pulling without tearing
damage to a portion of the junction
complete rupture of the junction

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55
Q

Tx for acute strain

A

RICE for at least 1 week
muscle is vulnerable to re-injury
Later warm-up, stretch and resume activity as long as there’s no pain

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56
Q

Tx for chronic strain

A

High risk for re-injury so prevention is key
Gradually build ip activities including closed chain

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57
Q

Strain

A

involves ligamentous attachment
usually sudden
minor tears and hemorrhage without loss of joint stability

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58
Q

Grading for strain

A

similar to sprain
mild damage to complete ligament rupture (ACL tear)

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59
Q

tx for strain

A

protect ligament from stretch
gentle movements that maintain joint motion but do not reach full stretch
increase strength of surrounding musculature in case ligament is not back to full strength

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60
Q

Occult

A

occurs only when the joint is stretched or stressed, otherwise stable
no Pain or symptoms

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61
Q

Subluxation

A

joint loses some stability but maintains joint contact

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62
Q

3 degrees of joint instability

A

occult
subluxation
dislocation

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63
Q

Dislocation

A

joint stability is in jeopardy and the joint surfaces are not in contact

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64
Q

Late effects of dislocation

A

after 4 weeks
joint stiffness
recurrent dislocation
post-traumatic arthritis epically if further damage to capsule

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65
Q

When is immobilization always necessary

A

dislocation and sometimes subluxation

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66
Q

Effects of immobilization on soft tissue

A

stiffness and weakness of CT
loss of extensibility
atrophy and adaptive length changes in muscles
loss of fibers/shortening of fibers lead to contracture

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67
Q

How much stretch should you bring a client in for immobilization

A

some stretch but not into new pain
submaximal

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68
Q

olecranon bursitis

A

inflammation of olecranon bursa
caused by trauma or prolonged pressure on elbow

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69
Q

tx for olecranon bursitis

A

rest, avoid pressure on elbows, custom padding

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70
Q

Lateral epicondylitis

A

tennis elbow
insidious onset of pain over extensors felt at lateral epicondyle
aggravated by wrist flexion/extension with pronation or supination and gripping

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71
Q

Tests for lateral epicondylitis

A

Cozens test and Mill’s Test

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72
Q

Cozens test

A

provocative test
elbow stabilized by thumb
patient makes a fist and prints, radially deviates and extends wrist
Clinician resists wrist extension

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73
Q

Mill’s Test

A

passive elbow extension and wrist flexion

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74
Q

What tendons/muscles are most commonly effected during lateral epicondylitis

A

extensor digitorium
Extensor carpi ulnaris

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75
Q

tx for Lateral epicondylitis

A

stop doing what makes it hurt
NSAIDS
US
compression brace
activity modification

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76
Q

What muscles are involved for medial epicondylitis

A

pronator tires and flexor capri radialis
sometimes FCU and PL

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77
Q

Medial epicondylitis cause

A

throwing athletes
repetitive trauma

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78
Q

Testing for Medial Epicondylitis

A

resistive wrist flexion with pronation
elbow extension with passive wrist extension
decreased grip strength

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79
Q

What should be ruled out when testing for medial epicondylitis

A

UCL rupture
Cubital tunnel syndorme

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80
Q

Tx for medial epicondylitis

A

similar to lateral epicondylitis

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81
Q

Tinels sign

A

tingling or prickling sensation elicited by tapping injured nerve trunk
if positive nerve, if negative tendon

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82
Q

symptoms of overuse syndromes of muscles

A

vague diffuse pain
cramping
fatigue
loss of strength and control for an extended period of time

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83
Q

tx for overuse syndromes of muscles

A

rest until symptoms subside
modalities to decrease pain
progressive exercise and strengthening programs

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84
Q

Where is compartment syndrome most common

A

volar compartment

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85
Q

When does compartment syndrome occur

A

sustained excessive pressure develops in one of the 3 forearm compartments following acute trauma

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86
Q

Signs and symptoms of compartment syndrome

A

Significant swelling
severe pain not relived with immobilization
tense to palpation

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87
Q

Tx for compartment syndrome

A

rest
modalities
progress to exercise
faciotomy if blood is not getting to hand

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88
Q

Tendonitis and stenosing tensosynovitis

A

inflammation of tendons leads to fibrosis
structures become thick, unyielding and restrictive to tendon excursion
tendon will not be able to slide through sheath/retinaculum

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89
Q

tx for tendonitis

A

initially conservative
edema management
gentle exercise

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90
Q

Dequervains tensosynovitis

A

most common stenosing tensosynovitis
inflammation of APL and EPB at the level of the radial stolid in 1st compartment

91
Q

When does DeQuervains Tensosynovitis occur

A

with repetitive ulnar deviation and grasping
or repetitive use of the thumb

92
Q

Symptoms of DeQuervains Tensosynovitis

A

pain, stiffness, and weakness of pinch

93
Q

What test shows DeQuervains Tensosynovitis

A

finkelsteins test positive

94
Q

Finkelsteins test

A

passive stretching of extensor thumb tendons
Clinical brases wrist in ulnar deviation and then passively flexes thumb across palm
Dorsal thumb pain will be present

95
Q

tx for DeQuervains Tensosynovitis

A

stop doing what motion causes pain
thumb spica splint
rest from activities
modalities
gentle stretching and thumb

96
Q

Intersection Syndrome

A

involves 1st and 2nd dorsal compartments

97
Q

signs and symptoms of intersection syndrome

A

point tenderness 3 fingers proximal to the wrist joint
squeaking on A&PROM
pain during flexion or extension

98
Q

Where is intersection syndrome compared to DeQuervains

A

proximal

99
Q

What tests for intersection syndrome

A

negative Finkelsteins test

100
Q

Tx for intersection syndrome

A

similar to DeQuervains but no dumb splint

101
Q

Trigger Finger

A

painful snapping as FI tendons suddenly pull through a tight A1 pulley
can occur during fl or ext

102
Q

What comes first A1 stenosis or tendon thickening in trigger finger

A

either one

103
Q

Most common occurrences of trigger finger

A

thumb, mid, ring
women
DM or RA and other tendonitis

104
Q

tx for trigger finger

A

limit snapping/ tendon excursion for a bit of time
modalities ot help decrease swelling

105
Q

TFFC injury causes

A

traumatic or degenerative
falls
rotational injuries
repetitive axial loading

106
Q

Symptoms of TFCC causes

A

ulnar wrist pain
clicking
credits with forearm rotation, gripping or UD

107
Q

Tx for TFCC injury

A

brace
injection
Gentle AROM, don’t want to stretch too far
surgery

108
Q

UCL of Thumb sprain

A

gamekeepers/skiers
occurs with values stretch
stability of MP by adductor aponeurosis, AP, UCL and the solar plate

109
Q

Eval for UCL of thumb sprain

A

valgus stretching testing with MP 30 degrees of flexion
30-35 degrees of RD indicates complete rupture requiring surgery

110
Q

Tx for UCL of thumb sprain

A

partial tear: 3-4 weeks of immobilization then some AROM but no stretch

111
Q

Dupuytrens Disease

A

gradual thickening and tightening of fascia under the skin in he hand

112
Q

Genetic origin of Dupuytren’s Disease

A

Northern European s
more men than women
5th decade

113
Q

1signs of Dupuytrens Disease

A

nodule in palm near DPC and in line with ring finger
continues to get tighter and tighter

114
Q

Indications of Dupuytrens Disease that do not require tx

A

nodule, MCP joint contracture less than 30 degrees

115
Q

Indications for tx for Dupuytrens Disease

A

finger joint contracture
MCP flexion more than 30
PIP flexion contracture of 15
DIP hyper extension
Contracture or tightness in the thumb

116
Q

Most common Radial collateral ligament sprain of fingers

A

PIPJ

117
Q

What are radial collateral ligament sprains vulnerable to

A

flexion contracture

118
Q

What does untreated PIP collateral ligament injury lead to

A

stiff and painful
lack of PIP ROM

119
Q

Tx for “itis” vs sprain/injury

A

“itis”= RICE
Injury/sprain= immobilization then MICE

120
Q

Ganglion cyst

A

soft-fluid-filled cyst attached to or near joint capsule, tendon, or tendon sheath
palpable mobile mass

121
Q

Who is more likely to get ganglion cysts

A

women

122
Q

Symptoms and signs of ganglion cyst

A

cosmetic
pain
weakness if it gets too big

123
Q

tx for ganglion cyst

A

Temporary immobilization and strengthen

124
Q

3 parts of cardiac rehab

A

exercise counseling and training
education for heart-healthy living
counseling to reduce stress

125
Q

post pacemaker precautions

A

Standard sling for L UE for 24 hrs
No exercise to involved shoulder for 4-6 weeks
No shoulder flexion/abduction greater than 90 degrees for 4-6 weeks
no lifting more than 5 lbs
use minimal weight bearing

126
Q

Sternal Precautions

A

avoid unilateral shoulder flexion greater than 90 degrees
avoid bilateral and unilateral shoulder abduction greater than 90 degrees
No lifting/pushing greater than 10 pounds
don’t want traction of sternum

127
Q

1st area of consideration of cardiac recovery

A

monitoring progression of early mobilization and activity

128
Q

OT role in 1st steps of cardiac recovery

A

want early mobilization but in structured and monitored way
need to find a balance of too much or too little movement

129
Q

method of monitoring exertion/energy expenditure

A

MET- monitors energy, metabolism
RPE or BORG- how much is being exerted
Vital signs

130
Q

MET

A

measures the oxygen or calorie consumption is during specific activities
1 MET generally is equal to the resting metabolic rate
Can be used in conjunction to where they are in rehab
Want to help individuals understand their energy expenditures

131
Q

Using MET to determine activities

A

each activity has a MET value that correlates
individuals only have so much energy in the day so MET values can be used to determine what can be done during the day

132
Q

BORG

A

Has to do with what person perceives/ how they feel
Rating scale of 6-20 to correlate with heart rate range 60-200
In phase 1 of rehab RPE should not exceed 11-13

133
Q

When should the BORG scale be used

A

when used in conjunction with vital sign monitoring
helps patients be more in tune with their body and when they feel overexterion

134
Q

recommendations for Phase 1 of cardiac rehab

A

Intensity: RPE below 13 or HR below 120
Duration: intermittent sessions lasting 3-5 minutes, 20 minutes total
Resting periods: as patient wants, lasting 1-2 minutes, shorter than time of activity
Frequency: 3-4 times per day for 1st to 3rd days

135
Q

Methods for monitoring progession of early mobilization

A

MET levels as an index for profession
BORG scale in conjunction with vital signs to help patient become more intone with body and know when they need to stop activities
Pre/post vital sign ,monitoring

136
Q

2nd area of consideration for cardiac rehab

A

cognitive factors

137
Q

Cognitive factors of rehab patients

A

Non surgical: premorbid changes, ischemic hypoxia after MI, decreased perfusion
Complications of cardiac surgery: Type 1- stroke, TIA, Type 2- delirium and post op cognitive dysfunction due to decrease in O2

138
Q

3rd area of consideration for cardiac rehab

A

Psychosocial factors

139
Q

Psychosocial factors during cardiac rehab

A

Depression
anxiety
perceived decreased quality of life

140
Q

Heart-focused anxiety

A

a specific fear of cardiac-related stimuli and sensations because of their expected negative consequence

141
Q

Instrument for screwing depression/anxiety in cardiac population

A

Beck depression inventory

142
Q

Areas of focus for education during cardiac rehab

A

energy conservation
tips for coping with stress or anxiety
tips for managing cognitive impairments

143
Q

Phase 1 of cardiac rehab

A

Acute inpatient hospitalization
Vital signs
patient and family education
improve ADLs
Discharge to phase 2 at MET 3.5

144
Q

Phases of cardiac rehab

A

Acute inpatient hospitalization
outpatient rehabilitation
community exercise and support programs

145
Q

Phase 2 of cardiac rehab

A

outpatient
activity tolerance
improve ADLs
Graded exercise program
improve ability for occupational roles and work

146
Q

phase 3 of cardiac rehab

A

No more therapy
less intensive monitored exercise programs
nutrition programs
senior community programs

147
Q

Purpose of workplace assessments

A

prevent injuries
promote comfort
safety and productivity

148
Q

Workplace assessment inputs

A

Workers
Supervisors
Employers
not just looking at what they are doing but also looking at policies and standards

149
Q

2 components of workplace assessments

A

Clearance
Reach

150
Q

Clearance of workplace

A

sufficient headroom, legroom and elbowroom in the work area
posture
Designed for largest user

151
Q

Reach in workplace

A

location of controls and materials accessed to perform job tasks
looks at posture and repetitive motions
designed for the smallest user

152
Q

Reach envelope

A

Want most used objects within 10 inches
want least used things within 20 inches
past 20 inches is high risk for injuries

153
Q

Visual requirements in workplace

A

Head position
locations of visual cues, object placement, information placement
visual input should be directly in the line of sight

154
Q

Placement of equipment in workplace

A

postures and motions
are objects too high or too low
is equipment too far away leading to extensive extension

155
Q

Seated workstations

A

Ergonomic chair- height adjustable, lumbar and thoracic support, seat pan length
Desk/surface height- low height at 90 degrees

156
Q

Standing workstations

A

surface height, clearance and posture should be assessed
Flooring and mats
can be really hard on back to stand all day on hard floor

157
Q

Workplace intervention

A

start with problem list
include recommendations and education then follow up
promote neutral posture and change layout of work surfaces

158
Q

Work place intervention for group

A

OT as a consultant at community level or company levels

159
Q

Seddon Classification

A

Neuropraxia
Axonotmesis
Neurotmesis

160
Q

Neuropraxia

A

damage to myelin but axon is still intact
impacts conduction

161
Q

Axontmesis

A

Axon and myelin is damaged

162
Q

Neurotmesis

A

Full nerve is damaged

163
Q

Problem of nerve with PNI

A

divided into proximal and distal segment
distal segment undergoes degeneration

164
Q

What is required for recovery after full severance

A

Extension of proximal segment back to distal
orientation of proximal segment to distal, needs ot find its way back

165
Q

Anatomy fo nerve fiber

A

axon encased by endoneurium
nerve fibers bundled into fascicule encased in perineurium
many fascicule are embedded in epineurium

166
Q

Sunderland classification

A

1- myelin damage
2- axon damage
3- endoneurium damage
4- entire fascicle/perineurium damage
5- entire nerve including epineurium is damaged

167
Q

Seddons vs Sunderland

A

Neurapraxia=Grade 1
Axonotmesis- Grade 2
Neurotmesis= grade 3, 4, and 5

168
Q

Metabolic conduction block

A

caused by compression
Temporary
6-12 week recovery
severe falling asleep with sensory and motor impairment
Recovery signs start with itching, shooting pain, and then parenthesis

169
Q

Neurapraxia/Sunderland Type 1

A

complete motor paralysis
minimal sensory loss
complete recovery
short term focused intervention

170
Q

Axonotmesis/ Sunderland Type 2

A

Transection of axon
complete motor paralysis and sensory loss
usually complete recovery
moderate intervention

171
Q

Neurotmesis/ Sunderland type 3

A

often a traction injury
complete motor and sensory loss
surgery may be required
incomplete recovery
moderate intervention

172
Q

Neurotmesis/ Sunderland type 4

A

Complete motor and sensory loss
Surgery recommended
nerve may not be able to locate distal end on its own
incomplete recovery
long-term intervention

173
Q

Neurometsis/ sunderland type 5

A

complete motor and sensory loss
surgery mandatory
never complete recovery
long-term intervention

174
Q

2 phases of nerve response

A

Disintegration of the axon and breakdown of myelin sheath (wallerians)
neuronal regeneration (extension and orientation)

175
Q

Wallerian degeneration

A

occurs distal to level of injury
distal end shrinks and collapses
fascicle gets smaller

176
Q

When can nerve response begin

A

at grade II

177
Q

Rate of recovery of nerve

A

1-3 mm per day after initial latency period of 3-4 weeks

178
Q

Techniques of nerve repair

A

Epinerual repair- stitching segments together
group fascicular repair
nerve grafting
Nerve conduit

179
Q

What is classic posture when referring to a PNI

A

resting/active hand posture
all 3 nerves have this, if individual has it you can rule in nerve injury

180
Q

Radial nerve injury

A

high injury often caused by humeral fracture- will effect upper arm all the way to hand
Classic hand posture- wrist drop
Radial nerve innervates extensors

181
Q

Median nerve injury

A

cannot flex digits on medial side and no wrist flexion depending on location of injury
Classic posture- benediction during active fist (only ulnar side flexes)

182
Q

Ulnar nerve injury

A

intrinsics in digits and wrist flexion is effected
classic posture: ulnar claw deformity at rest of lesion is at wrist

183
Q

Tx for PNI

A

Immobilization based on what nerve is injured
preserve unaffected joints and muscles
slow lengthening of repaired nerve segment

184
Q

entrapment vs injury

A

there is not typically a full loss of sheath with an entrapment
getting compressed for some reason

185
Q

Radial Nerve Palsy

A

injury to radial nerve at level of humerus
often follows humerus fracture

186
Q

What are symptoms of radial nerve palsy

A

absence of all wrist and finger extensors and supination
loss of sensation at the dorsoradial aspect of the hand

187
Q

Tx for radial nerve palsy

A

wrist extension splint while healing
strengthening as motor function returns

188
Q

Radial Tunnel syndrome

A

compression as the nerve lies against the capitulum by the ECRB

189
Q

Symptoms of radial tunnel syndrome

A

sensory only!!!
aching in the prox/distal forearm with wrist flexion and forearm rotation
night pain
point tenderness 4-5 cms distal to lateral epicondyle
pain with resisted supination and MF extension

190
Q

Radial tunnel syndrome treatment

A

activity modification
nerve glides

191
Q

PIN syndrome

A

compression of the nerve between the two heads of the supinator

192
Q

PIN syndrome symptoms

A

paralysis of ECU, EDC, EDM, and EI
Loss of MP extension of digits and full thumb extension

193
Q

median nerve entrapment syndromes

A

Pronator syndrome
AIN syndrome
Carpal Tunnel Syndorme

194
Q

Pronator Syndrome

A

compression between two heads of pronator teres

195
Q

Symptoms of pronator syndrome

A

pain in volar forearm
no night pain or paresthesias
parenthesis in digits and thenar eminence
positive tingles over pronator tunnel

196
Q

2 special tests for pronator syndrome

A

pronator teres test- resisted pronation with the gradual extension of the elbow, if there’s pain then +
Resisted middle finger flexion- compression at FDS fibrous arch

197
Q

Pronator syndrome treatment

A

Elbow splint
activity modification
modalities
nerve glides

198
Q

AIN Syndrome

A

Compression as it branches off the median nerve

199
Q

Symptoms of AIN

A

Motor symptoms only
Paralysis of FDP of digits 2 and 3 and the FPL
Pain with resisted pronation
paralysis of PQ

200
Q

AIN treatment

A

PROM
Elbow splint or thumb IP flexion splint

201
Q

Carpal tunnel syndrome symtpoms

A

numbness
nocturnal pain and paresthesias
positive tinels and phalens at wrist
Sensitivity to cold
positive berger test

202
Q

Carpal tunnel treatment

A

splint
activity modifications
nerve and tendon gliding
modalities

203
Q

Ulnar nerve compressions

A

Thoracic outlet
cubital tunnel
Guyon tunnel

204
Q

Thoracic outlet syndrome

A

compression of the brachial plexus and subclavian vessels

205
Q

Tx for TOS

A

rest
pain modalities
nerve glides
gentle massage

206
Q

Cubital tunnel syndrome

A

Compression at elbow from leaning on it

207
Q

Sx of cubital tunnel

A

numbness and tingling along ulnar forearm and hand
pain at medial aspect of elbow esp. with extreme elbow flexion

208
Q

Tests for cubital tunnel

A

Positive elbow flexion test
positive tinels at elbow
Positive froments sign
Positive Wartenbergs

209
Q

Cubital tunnel treatment

A

Elbow pad, activity modification
modatilies
edema control
nerve glides

210
Q

Guyon Tunnel syndrome

A

Ulnar nerve at wrist
repetition
ganglion
pressure
fascia thickening

211
Q

Symptoms of guyon tunnel syndrome

A

pure sensory, pure motor or both depending on level
decreased pinch and power grip
pain over volar waist and 5th digit

212
Q

GTS tests

A

+ froments
+ wartenbergs

213
Q

GTS treatment

A

work/activity modification
modify hand position, wear padded gloves
nerve glides

214
Q

What is the first goal for the healing process of the wound

A

infection control if present

215
Q

3 phases of wound healing

A

Inflammation
Proliferation
Remodeling/Maturation

216
Q

Inflammatory phase of wound healing

A

Contain exudate, reduce edema, remove dead tissue, promote granulation
Length= 1-10 days
Goal is to be able to manage wound care on own or with caregiver

217
Q

Proliferation phase

A

stimulate angiogenesis, promote epithelialization, protect wound, maintain a moist environment
Length: 3-21 days

218
Q

Remodeling phase

A

Educate on pressure relief, skin inspection, mobilize soft tissue
Length= 3 weeks-2 years

219
Q

Red wound

A

what we want to see
cellular activity- oxygen and nutrients
Therapeutic goals protect/ keep moist

220
Q

Yellow wound

A

Slough, biofilm
cellular activity- fibrin
Therapeutic goals- remove yellow
may or may not heal with further intervention besides cleaning

221
Q

Black wound

A

Necrotic tissue
must be removed or healing wont occur
no cellular activity

222
Q

Types of wound closure

A

Primary closure- staples, stitches, glue
Secondary closure- no intervention, healing on its own
Delayed primary closure- primary closure after surgery

223
Q

Types of scar

A

Soft- how we want scars to heal
Hypertrophic- raised red rigid
Keloid- spread beyond wound boundaries
Contracture- very tight that restricts motion

224
Q

Scar management

A

compression garments, wear 23-24 hours for a year
massage
silicone/gel inserts
ROM
Thermal agents

Ortho (7 decks)

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