exam 2 Flashcards
is polio a UMN or LMN
LMN
nmeumonic on how to remember blood gasses
“ROME”
Respiratory
Oppisite
Metablic
Equal
if ph is normal = compensated
if ph is abdnormal = uncompensated
if all 3 componets (ph, CO2, HCO3) are NOT normal = partially compensated
common sign of respiratory alkalsis
hyperventilition which can cause a reduction in CO2.
you need to give your pt reassurance and relaxed breathing. you can also give them a paper bag/rebreather mask to help. pain control is also essential a this can decrease hyperventilation
when is sodium bicarbinate used?
respiratory alkalosis
what movements are decreased with avascular necrosis
flexion
IR
ABduction
“FABIR”
conjugate gaze center looks at what
can be horizontal or vertical
you have them look to the same direction
if they cant follow (looking to the R) for example, R Abducens is affected
ultrasound needed for deep and superficial structures (MHz)
superficial: 3MHz
deep: 1MHz
pulsed US vs continuous US
pulse: acute
continuous: chronic
pulsed=non-thermal. continuous=thermal
physiological changes with pregnancy and aerobic exercise
- respiration rate will not increase proportionally with mod to severe exercise
- hematocrit levels will be lowered (however will rise with vigorous exercise)
- decrease cardiac reserve
- SV and CO will increase with steady state
normal Q angle
13-18
what characteristics are seen with an increase Q angle
femoral anteversion
geni valgum
lateral patellar tracking
abnormal femoral torsion
hyper pronated foot = toe in
bone healing times
- children
- adolecents
- adults
- children: 4-6 weeks
- adolecents: 6-8 weeks
- adults: 10-18 week
cubital tunnel syndrome
ulnar nerve
a neuropathy of the ulnar nerve causing symptoms of numbness and shooting pain along the medial aspect of the forearm, also including the medial half of the fourth digit and the fifth digit. It is caused by compression of the ulnar nerve at the elbow region.
Guyon Canal syndrome
ulnar nerve
a relatively rare peripheral ulnar neuropathy that involves injury to the distal portion of the ulnar nerve as it travels through a narrow anatomic corridor at the wrist. The ulnar nerve originates from C8-T1
characteristics of pulmonary fibrosis
dry hacking cough
fatigue
mm weakness
SOB
weight loss due to loss of apetite
anterior STT
Lateral STT
anterior STT: crude touch
Lateral STT: pain and temp
LPT - licensed PT, lateral pain temp
A STT: also is for itch and sexual sensations
spinocerebellar tract
unconcious proprioception info from mm spindles, golgi tendons, and touch and pressure from the cerebellum for control of voluntary movements
spinoreticular tract
conveys deep and chronic pain to reticular formation of the brainstem
spondylolisthesis
fwd displacement of one vertebra over another
sondylolysis
defect in the pars interarticularis or the arch of the vertebra
guidelines of exercising and dialysis
- can exercise within the first hour of dialysis to avoid hypotensive episodes
- 3-5 METS without discomfort
- RPE used
- no exercising after dialysis
how do sodium channel blockers work
block fast sodium which slow the conduction in fast channel tissues
they also treat arryhthmias
how do calcium channel blockers work
they interrupt the movement of calcium inot the heart and blood vessel tissue.
they are used to treat high blood pressure, angina and arrhthmias
how do ACE inhibitors work
highly selective drugs that interrupt a chain of molecular messengers that constrict blood vessels
they can improve cardiac function in individuals with HF and are used for patients with DM or early kidney damage
how do beta blockers work
decrease HR and CO which lowers the patient’s BP by blocking the effects of adrenalin.
used to treat arrhythmias and angina pectoris
reticulospinal tract
infuence mm tone and reflex activity via influence on the mm spindle activity. great influence on posture and gait
medial medullary syndrome
ipsilateral paralysis of tongue due to CN 12
contralateral paralysis of UE/LE due to effect of CST
NYHA classifications
1: no limation of physical activity
2: slight limation of physical activity/ comfortable at rest but ordinary physical activity results in fatigue, palpation of dyspnoea
3: slight limation of physical activity/ comfortable at res tbut less than ordinary physical activity results in fatigue, palpation of dyspnoea
4: unable to carry out any PA without discomfort
respiratory acidosis can be caused by what other etiologies.
what are the sign and symptoms?
chest trauma
L CHF
COPD
airway obstruction
visual disturbance, confusion, dizziness, decreased DTRs, ventricular fibrilation
metabolic acidosis characteristics
can be caused by: diabetic acidosis
renal failure
shock
salicylate overdose
sepsis
s/s
HA
mental dullness
kussmaul breathing
stupor
cardiac arhthmia s
respiratory acidos can be caused by? and s/s
high altitude
pregancy
fevers
hypoxia
increased tidal volume in vented patients
s/s:
light headedness
numb digits
tentany
convulsions
cardiac arrhythmias
metabolic alkolosis can be caused by? what are the s/s
caused by GERD and emesis
s/s
decreased respiration, numb digits, tetany, convulsions and cardiac arrhthymias
boutonniere deformity
extension of the MTP and DIP
flexion of PIP
result of central tendon of extensors
swan neck deformity
contracture of the intrinsic mm along with dorsal subluxation of the lateral extensor tendons
mallet finger
rupture of the extensor tendon where it inserts in the distal phalanx of the finger
in what phases of gait would you need 0 deg of knee ext
initial contact
end of terminal stance
end of terminal swing
what mobilization would be needed to help with the swiping motion of the thumb on your phone
radial glide - extension of thumb
roll and glide in same direction for flexion and extension
what glides would you do to help with elbow flexion? extension?
anterior= flexion
posterior=extension
inverterd T waves are caused by what
caused by hypokalemia
difference between ideomotor apraxia and ideational motor apraxia
ideomotor apraxia
- unable to produce any movement on command yet the patient will be able to perform habitual tasks when not provided on command
ideational motor apraxia
- inablity to produce movement on command as the patient is unable to formulate the required motor task
ideomotor - i deo task (motor) = can do the task when not asked
compression levels for UE an LE garments
UE: 30-40
LE: 40-50
compare complex regional pain syndrom, CRPS, 1 and 2
1: the physician has to confirm the nerve injury
2: not confirmed by pcp
CRPS: burning, pins and needles, abnormal sweating, changes from hot to cold, shiny thin skin, and changes in nail and hair growth
where are Bouchards nodes found?
Heberden nodes?
Bouchards: PIP (BP)
Heberdens: DIP (HP)
Heberdens seen with OA.
Herb is an old name, old people get OA
smith fracture:
scaphoid fracture:
colles fracture:
lunate fracture:
smith fracture:
- fall on a flexed wrist causing volar displacement of the disal part of the radius
(smith had VD)
scaphoid fracture:
- most common
- FOOSH injuries with the wrist extended and RD
colles fracture:
- fall on anextended wrist causing dorsal displacement of the distal radius
- aka Dinner fork deformity
lunate fracture:
- direct blow to the wrist or recurrent trauma to a hyperextended wrist .
- can cause AVN = kienbocks disease
how do you place the electrodes when the mm is weak? pain?
weak = widely spaced and high sensitivity to recruit more motor units
pain/spasms: closert with low sensisitivty
ramp time:
pulse frequency:
on:off :
ramp time: 2 sec
pulse frequency: 35-80
on:off : 1:5
what LE PNF pattern would help with ambulation
D1 flexion
flexion
abduction
ER
DF
Inversion
considered emergency with cancer patients
- sudden loss of limb function
- spinal cord compression
- fever immune compromised patients
- superior vena cava syndrome
not inferior vena cava
primary risk factors of atherosclerorsis
HTN
hyperlipidemia
cigarette smoking
secondary risk factors: obesity, stress, activity level
what position do you want to avoid with sponylolithesis
EXTENSION
where should the lesion be to lose sight on one eye
optic nerve
does the lymphatic system absorb fats or protetins
fats
to improve eversion or inversion, what glide should be performed
eversion: medial glide of subtalar
inversion: lateral glide of subtalar
what type of burn would most likley produce a keloid scar
deep partial thickness
what type of precaution is Cdiff
contanct
c diff= c= contact
correct order to donn PPE
gown
mask
goggles
gloves
think gloves are the thing thats in the pts room so thts what you put on last
order to doff PPE
Gloves
Gown
goggles
Mask
face is last
- blisters:
- vesicles:
- wheal:
- pustules:
- blisters: large, serous filled
- vesicles: small, serous filled
- wheal: irregular edematous eruptions are called wheals
- pustules: puss filled eruptions
side effects of diuretics
excessive loss of potassium leading to hypokalemia, which that causes flattened or inverted t waves on the ecg.
nausea
weakness
polyuria
hyperglycemia
hypokalemia
postural hypotension
rhabdomyolysis
rapid breakdown of skeletal musculature as a consequence to mechanical, chemical, or physical injury. the patient will report mm pain and weakness
polymyaglgia rhematica
- females over age of 70
- unexplained stiffness and soreness that lasts for longer than 1 hour
- affects shoulders and pelvis
- difficulty with performing ADLs including rolling in bed and STS
hetertropic ossifications
bone formation in non-osseous tissue. mm pain and loss of motion is the most common presenting symptom within 2 weeks of trauma.
will present with swelling, warmth, erythema, and tenderness with possible low grade fever
painful arcs
- GH
- AC
glenohumeral: 45-120
acromioclavicular: 170-180
when can you start phase 2 and 3 cardiac rehab
2, when stable for 24 hours
3, at 4-6 weeks after MI
what is turgor
elasticity in the skin
think the top of the hand, if you pull on the skin, it returns fast.
ex: older adults have poor turgor, it takes a while for the sking to return to normal
ex: with dehydration, the skin becomes less elastic (turgor) due to decrease in fluids
explain gloscow coma
levels to COPD levels
mild: greater than 80 >=
mod: 50 <= x < 80
severe: 30 <= x < 50
very severe: <30
neurogenic shock
hypotensive
bradycardia
cyanosis
warm dry extremeties
decreased CO
peripheral vasodilation
venous pooling
occurs with patiens T6 and above
normal INR
1.1 or below
what would an increase of INR indicate
the blood is thiner than normal
- a pt who is dehydrated would be lacking vitamin K and or would have malabsorption of multiple vitamis
- a lack of vitamin k would cause the blood to become thinner
what would a decrease in INR indicate
cause the blood to become thicker and would increase the risk of patients developing a clot
what are the pelvic floor mm
levator ani: iliococcygeal, pubococcygeus, puborectalis
i PP
RA classifications
- able to perform usual activities (self care, vovational and avocation)
- able to perform usual self care and vocational acitivities BUT IS LIMITED in avocational acticities
- able to perform usual self care activities BUT IS LIMITED IN VOCATIONAL AND AVOCATIONAL activities
- limited in ability to perform usual self care, vocational and avocational activities
difference between cortisol and aldosterone
cortisol
- helps control bodys use of BP, increase blood sugar and helps control your sleep-wake cycle
- the body releases cortisol during times of stress to help your body get an energy boost and better handle an emergency
aldosterone
- regualting BP and levels of sodium and potassium (electrolytes) in your blood
- regulates blood pH by controlling the levels of electrolyes in your blood
closed pack positions for
- ulnohumeral
- radiohumeral
- proximal radioulnar
ulnohumeral: extension with supination
radiohumeral: 90deg flex + 5deg supination
proximal radioulnar: 5deg supination
glide for shoulder h. adduction and h. abduction
h adduction = anterior
h abduction = posterior
special precautions for pool therapy
special precautions:
- open with with occlusive dressing
- fear of water
- patients with G tube
what artery does the posterior cerebral arteries arise from
basilar artery
what gland is responsible for the secretion of TSH
pituitary
