exam 3 missed questions Flashcards
reciprocating gait orthoses (RGOs)
- assist with hip flexion and hip extension during gait - necessary for L1-L3 spina bifida d/t insufficient strength
on:off time for e-stim for muscle re-ed initially
(I love you!)
- 1:5 used to minimize muscle fatigue
- as patient gets stronger, can use 1:3 or 1:4
- on time should be less than off time to prevent muscle fatigue
- 1:1 might be more appropriate for relieving muscle spasm
if you have a patient with HIV in a pool and the pt has a paper cut, you should
- use appropriate medical asepsis
anterior compartment syndrome - can’t DF foot and has mild sensory disturabance btw first and second toes. what nerve?
- deep peroneal - often affected w/t anterior compartment syndrome
- deep peroneal innervates tib ant, extensor hallucis longus, extensor digitorum longus, extensor digitorum brevis, peroneus tertius
medial plantar nerve
- larger of two branches of tibial nerve
- to cutaneous branches of medial 3 and a half digits, motor branches to abd hallucis, flexor digitorum brevis, flexor hallucis brevical, lumbrical 1
tibial nerve
- innervates tibialis posterior, flexor hallucis longus, flexor digitorum longus, soleus, gastrocnemius, plantaris, popliteus msucles
lateral plantar nerve
- smaller of 2 branches of tibial nerve
- cutaneous branches to lateral 1 and a half toes
- motor branches to muscles of sole of foot not supplied by medial plantar nerve - abductor digiti minimi, flexor digiti minimi, opponens digiti minimi, dorsal interossei, quadratus plantae, adductor hallucis, lumbricals II, III, IV, and plantar interossei
markedly high platelet counts common with
- malignancy
- not emphysema, metabolic acidosis, or renal failure
emphysema
- abnormal permanent enlargment of air spaces distal to terminal bronchioles
- increase in red blood cells to carry O2 and abnormal carbon dioxide and carbon monoxide levels
- increase in total lung capacity, functional recidiual capacity, and residual volume
- vital capacity decreased
metabolic acidosis
(Keep it up, cutie!)
- accumulation of acids or deficit of bases in blood
- d/t renal failure, starvation, diabetic or alcoholic ketoacidosis
- blood values show decr pH d/t decrease HCO3- or increased H+ ions
renal failure
- abrupt or rapid decline in renal filtration and function
- 3 categories: prerenal, intrinsic, post renal
- d/t hypovolemia, CHF, dehydration, sepsis, autoimmune disease
- blood values show hypocalcemia, hyperkalemia, elevated BUN, creatinine, magnesium, uric acid
coordination assessment on pt w/ cerebellar lesion - what findings are associated
- dysmetria: inability to control range of movement and force of muscular activity, overshooting/undershooting
- ataxia: inability to perform coordinated movement in gait, patterns of movement, posture
- nystagmus: abnormal eye movement
- also dysdiadochokinesia, tremor, scanning speech
- NOT hypertonia: cerebellar dysfunction associated with hypotonia
sputum
- asthma: mucoid
- lung abscess: necrosis of tissue, infection, purulent (yellow-green)
- pulmonary edema: frothy
- tuberculosis: airborne, blood tinged sputum
bicep muscle and tricep muscle is innervated by
- bicep: C5-C6
- tricep: C7-C8
how do you assess superficial reflexes
- w/ a blunt object
- ex plantar reflex w/ babinski sign
- NOT feathery object - for light touch sensation
higher than normal erythrocyte sedimentation rate (ESR) consistent w/ what diagnosis
- polymyalgia rheumatic: systemic inflammatory condition in older adults, pn in pelvic and shoulder girdles
gout
(Don’t doubt yourself!)
- acute pain d/t deposition of urate crystals in joint -> hyperuricemia (too much uric acid in blood)
- usually first MTP joint
pseudogout
- calcium crystals in articular and periarticular structures
- most common in knee
transparent film dressing on a wound over anterior surface is thigh border should be how far from wound?
- 3 cm: just over an inch
nerve conduction velocity
- diagnose carpal tunnel, peripheral neuropathy, guillan-barre
- can also use phalen’s test and tinnels for carpal tunnel
wrist radial deviation normal
0-20 degrees
- fulcrum over capitate, stationary arm over dorsal midline of arm, moving arm over third metacarpal
wrist ulnar deviation normal
0-30 degrees
wrist extension normal
0-70
talar tilt assesses what ligament
- calcaneofibular ligament - torn represented by excessive inversion
anterior talotibial ligament
resists abduction of talus in PF and eversion
deltoid ligament
- provides medial ligamentous support by resisting eversion of talus
posterior talotibial ligament
- resists ankle DF and lateral translation and external rotation of talus
if a patient fails to make progress in PT, you should
- alert referring physician
- esp if you’ve tried a variety of treatment techniques and none have helped
dysphonia
disorder of vocalization characterized by abnormal production of sounds from larynx
- hoarseness from mild roughness to inability to produce sound
dysarthria
- defects in articulation, enunciation, or rhythm of speech
- usually caused by malformation of oral structures, poor fitting dentures, impairment of musculature
- characterized by slurring, slow speech, indistinct speech, breaks in normal speech rhythm
dysphasia
- inability to use and understand written and spoken words as a result of damage to cortical centers of speech in brain
first MTP is affected in _ % of cases of gouty arthritis
90%
room air is _ % O2, so O2 concentration is increased _ % for every 1 lpm increase
- RA is 21%, so [O2] is increased 4% for every 1lpm added
- 1 lpm -> 25% O2 delivered
- 2 lpm -> 29%
- 3 lpm -> 33%
- 4 lpm -> 37%
modified plantigrade position
- LE WB in supported standing, leaning w/ UE support on table or WB surface
4 YO w/ CP - PT uses sustained position through LE casting in order to
- decrease hypertonicity - casting improves ROM and decreases hypertonicity through integration of pressure points and diminishing influence of spasticity
- casting: decreases hypertonicity, improve rOM, improve function
aspiration (arthrocentesis)
- using sterile needle to remove fluid from joint
- for bursa/cysts - remove excess fluid to relieve inflammation and prevent further accumulation of fluid
anemia
- decreased RBCs n blood - pallor, cyanosis, cool skin, vertigo, weakness, HA, malaise
- reduced in circulating RBCs or reduction in hemoglobin
- most common disorder of blood
- categories: excessive blood loss (hemorrhage), excess blood cell destruction (hemolysis), deficient RBC production (hematopoiesis)
cor pulmonale
- right sided heart failure d/t disease of lungs
- s/s: elevated central venous pressure, distension of neck veins, SOB
- ascites, peripheral edema of feet and ankles, fatigue
diaphoresis
profuse perspiration
- associated with shock or other emergent medical conditions
osteogenesis imperfecta
- autosomal disorder of collagen synthesis that affects bone metabolism
- delayed developmental milestones s/t ongoing fractures -> immobilization, hypermobility of joints, poorly developed muscles
- do show weakness but no difference in tone
electrical burns
- spread over larger area, contain entrance wound, several poorly defined exit wounds
- appear dry
- can cause cardiac arrhythmias if passes through heart
radiation burn
- excessive exposure to ionizing radiation
- more uniform, noted multiple scattered burn sites
- no cardiac arrhythmias
low blood glucose
below 70 mg/dl
- headache - less glucose to brain
- NOT polyuria, or excessive thirst - more associated with hyperglycemia
- hyperventilation associated with DKA
ECG shows decrease in cardiac output - why?
- cardiac output: amount of blood that leaves heart each minute, CO = HR x SV
- afterload - force LV must generate during systolic phase, related to resistance in aorta and peripheral arteries
- as afterload increases, SV (and thus CO) decrease
- NOT HR - increase would cause CO to increase
- NOT preload - increase would increase CO
- NOT stroke volume - increase would increase CO
HDL and LDL norms
HDL: 40-60 mg/dL
LDL: 100-129 mg/dL
diabetes diagnosing
- oral glucose toelrance test - blood glucose > 200 mg/dL (normal < 140)
- A1c: 6.5% or greater (normal is less than 5.7%)
lachman test degrees of knee flexion
- 20 - 30
- 80-90 is more anterior drawer
compression garments for ambulatory patient w/ LE edema
- 30-40 mmHg for edema in ambulatory patients
- 16-18 mmHg for DVR prevention
- 20-30 mmHg for scar tissue formation control
dorsal scapular nerve injury affects
- levator scapulae and rhomboids
- NOT supraspinatus and infraspinatus - innervated by suprascapular nerve
mechanical lumbar traction in supine w/ flexed position is appropriate to treat
- spinal stenosis - position maximizes opening of intervertebral herniation
functional activity to increases wrist passive ROM d/t shortened wrist flexors
- modified plantigrade: LE WB in supported standing while leaning UE support on table
pt able to make fist but unable to flexor distal phalanx of ring finger d/t rupture of what tendon
- flexor digitorum profundus: originates on ant and med surfaces of proximal oirtion of ulna, interosseous membrane, deep antebrachial fascia; 4 tendons to anterior surface of abses of distal pahalnges
- NOT flexor digitorum superficialis: flexes PIP 2-5, MCP, and wrist
blood test for DMD
creatine phosphokinase
torticollis
- lateral flexion of head toward affected side and rotation toward unaffected side d/t contracture of sternocleidomastoid
- stretch opposite
mechanical traction forces
- 25% for decrease muscle spasm or soft tissue stretch
- 50% for mechanical separation
a pt has a referral w/ pt name and physician signature. pt only knows they had a knee surgery. you try to call but no answer - what should you do?
- wait to receive orders -> need all relevant info for contraindications, precautions
dehydration results in what results for blood labs
- increased BUN: indicative of dehydration, renal failure, heart failure (normal is 10-20 mg/dL)
- NOT hematocrit or hemoglobin - increased levels in dehydration, diarrhea, vomiting, excess sweating, burns, diuretics
shoulder ROM and pain
- 80-90 degrees ER greatest amount of pressure on anterior shoulder - inflammation, irritation, structural damage -> pain
- 60-70/70-80 degrees IR pressures posterior shoulder d/t posterior glenohumeral instability or suprahumeral impingement (70 degrees IR normal)
to test supinator and minimize action of biceps, therapist should place elbow in what position
- terminal flexion
- supinator innervated by radial nerve C5, C6, C7
medial border of foot along first metatarsal is higher than lateral border of foot along fifth metatarsal -> what should this be documented as
- forefoot varus: inverted position of forefoot in relation to rearfoot - pts with low arches in WB
for CHF, PT concerned about pt exercise tolerance. what would be most responsible for limited exercise tolerance
- insufficient stroke volume during ventricular systole
- limited delivery of oxygenated blood to active tissues limits ability to exercise
congestive heart failure can be due to
- diminished pumping ability of ventricles d/t muscle weakening (systolic functioning) - weak heart pumps smaller volume of blood for each contraction of ventricles (SV) and reduces cardiac output
- OR stiffening of heart muscle that impairs ventricles’ capacity to relax and fill (diastolic functioning)
sensory exam for neurological lesion order
- superficial first: temperature, pain, crude touch, pressure
- deep sensations: vibration, kinesthesia
- then combined cortical sensations: 2 point discrimination
if you have end stage renal disease, you probably also have
- diabetes - high blood glucose overworks kidneys
- ESRD (chronic renal failure): progressive decline in kidney’s ability to filter fluids, metabolites, and electrolytes from body
antihypertensives
beta blockers
legg-calve-perthes disease
- degeneration of femoral head d/t disturbance in blood supply (avascular necrosis)
- in 5-7 YO
- boys > girls
apophysitis
- inflammation of apophysis - secondary ossification center that functions as attachment site for musculotendinous unit
- susceptible to injury from repetitive stress or acute injury
- usually in pre-adolescents because exercise training increases strength of muscle and tendon more rapidly than bone
slipped capital femoral epiphysis
- separation between ball of hip and femur at growth plate
- in pre-adolescents who are obese or who have had recent growth spurt
what type of exercises are indicated for spondylolisthesis
- flexion exercises
functional splint
- support, protect, stabilize a joint during specific activities (holding a writing or eating utensil)
- improves efficiency and functional performance of task
dynamic splint
- includes spring or elastic component to exert force on a joint
- can facilitate passive or assisted movement of a joint or to resist movement in direction opposite line of pull
- not typically indicated during acute exacerbations
resting splint
- to maintain a joint in an appropriate position during acute exacerbation of symptoms
- joint can rest while limiting risk of contracture development
anterior drawer test
- supine with knee flexed to 90 degrees and hip to 45
- 2 PT hands on proximal tibia, thumbs on tibial plateau
apley’s compression test
- in prone with knee at 90 degrees flexion
- stabilize femur and grasp heel w/ other hand - ER and IR of tibia while applying compressive force
- (+) is pain or clicking - indicative of mensical lesion
craig’s test
- pt prone w knee flexed to 90
- palpate greater trochanter and ER/IR hip until greater trochanter is parallel with table
- degree of femoral anteversion corresponds to angle formed by lower leg with perpendicular axis of table
- normal adult anteversion is 8-15 degrees
thompson test
- prone with legs extended and feet hanging over edge of table
- PT squeeze belly of gastroc/soleus
- (+) is absence of ankle PF - may be indicative of ruptured achilles tendon
lesion to posterior portion of SC leads to inability to
- determine joint position
sensory info is transmitted to brain through
- spinothalamic tract: ant and lat SC, nondiscriminative sensations (temp, pain, touch)
- OR dorsal column-medial lemniscus tract: posterior portion of SC, discriminative sensations (discriminative touch, stereognosis, kinesthesia)
per ADA, a ramp must have a minimum of _ foot of horizontal run for each inch of rise
1 foot per 1 inch
(so if run of ramp is 48 feet, must be 48 inches)
rheumatoid arthritis
- women>men
- stiffness in hands and visible swelling, diminishes with activity
- effusion, limited ROM, morning stiffness, pain with movement, low grade fever
activity _ s/s of OA
exacerbates
EMG normal muscle at rest
- electrical silence
- NOT spontaneous potentials: in acutely denervated muscles
- NOT polyphasic potentials: from denervated motor units
- NOT occasional motor unit potentials: neurapraxia, occur during minimal effort muscle contractions 2-3 weeks after injury
lisfranc injury
- at midfoot, may include fracture or dislocations often d/t traumatic disruptions of tarsometarsal joints
- ligament strains and tears, as well as fractures and dislocations of bone of midfoot - cuboid, navicular, cuneiforms and articulations w/ 5 metatarsal bones
- does not involve calcaneus
receptor for stereognosis, vibration, 2 point discrimination
- mechanoreceptors
deep sensory receptors
- in muscles, tendons, joins
- golgi tendon organs, pacinian corpuscles, muscle spindles, ruffini endings
baby milstones
- 6-7 months: sitting w/ one hand support for extended time, objects to midline, holding bottle w/ 2 hands, roll to prone
- 8-9: manipulate toys in sitting, raise supine to sit, pull to stand, transfer with controlled release
- 10-11: stand briefly, supine to sitting or quadruped, pull to stand through half kneel, pincer grasp
- 12-15: stand through quadruped, mult sitting positions, walk without support, creep up stairs, throw ball in sitting
pt has a hard time holding a cup but not a pencil. what nerve is affected
- ulnar
- NOT median: involved in both
ape hand deformity
- caused by median nerve palsy - unable to move thumb away from rest of hand
bell curve
viscosupplementation
- hyaluron injected into joint - restores normal viscosity of synovial fluid and helps to restore lubricating properties of synovial fluid within joint
central cord syndrome
- usually d/t cervical hyperextension
- damages spinothalamic tract, corticospinal tract, dorsal columns
- UE > LE affected
- motore > sensory loss
a patient w/ a patellar -tendon bearing prosthesis has redness. what area is greatesting concen?
- distal anterior tibia - not a pressure tolerant area, no adipose tissue to distribute forces
- patellar tendon, fibular shaft, and gastroc are all pressure tolerant
functional independence measure (FIM)
- 7 point scale of 18 areas for self-care, bowel and bladder, transfers, communication, locomotion
- functional status index: ADLs
- physical self-maintenance scale (PSMS): self-care
- katz index of ADLs: nominal scale of 6 areas for ADLs
a physical therapist determines a patient’s cadence is 120 steps per minute. how many seconds does it take for patient to complete 120 strides?
- 120
- cadence: half strides
visceral referral patterns
syndesmotic ankle sprain
- high ankle sprain
- d/t forceful external rotation of foot
diabetes insipidus
body makes too much urine
patellofemoral pain syndrome
- pain in region of patella d/t abnormal contact/tracking between patella and trochanteric groove
- pain increases w/ increasing patellofemoral joint reaction forces
- for closed-chain activity, patellofemoral joint reaction forces are relatively low from 0-30 degrees
- for open chain activities, reaction forces lowest at 90 degrees flexion and increase closer to extension
autonomic dysreflexia
- triggers NS and elevates blood pressure
- position pt in sitting
phenobarbital
- serves to prevent seizures
- side effects: sedation, vitamin deficiencies, nystagmus, ataxia
a prosthesis requires slight ankle _ to allow for subsequent knee flexion during early stance
- dorsiflexion required for knee flexion
- too much PF forces full knee extension in early stance
- softening heel wedge increases extension
- moving foot anteriorly increases extension
how do you know when to schedule maintenance of US unit
- frequency of use - more use needs more calibration
hoover test
- gross test for malingering
- PT hand under each calcaneus - pt performs straight leg raise on uninvolved extremity while PT assesses motor output of uninvolved side
pts on levodopa experience
- lightheadedness and orthostatic hypotension -> makes balance activities difficult
femoral fracture site at greatest risk for delayed union
- femoral neck - can disrupt blood supply and lead to osteonecrosis
cause for periosteal pain from US
- beam nonuniformity ratio (BNR): ratio between spatial peak in intensity and spatial average intensity
- high BNR produces less uniform beam - pt at greater risk for undesirable effects
early knee flexion from midstance to pre-swing w/ trantib amputation. why?
- the socket is aligned in excessive flexion
- or excessive posterior displacement of foot, excessive dorsiflexion
16/20 RPE is what % MHR
- 85%
- 11-12 = 60%
- 13-14 = 70%
- 15/20 = 85%
normal toe-out
- 7 degrees at free speed walking
- 3 degrees at fast walking
ACL HS graft
- semimembranosus (L5-S1) is not used as an ACL graft
- semitendinosis and gracilis are commonly used together for ACL graft: gracilis is hip adduction, L2-L4
- semitendinosus medial, biceps femoris lateral
symptoms of meniere’s
- MD: overaccumulation of endolymph d/t lack of absorption, excess backs up into system, compromises perilymphatic space
- vertigo, hearing loss, tinnitus
- NOT head tilting - usually w/ unilateral vestibular hypofunction
ASIA SCI scale
reading CT
- greater density = less penetration and whiter images appear
- desc density: metal, bone, soft tissue, water, fat, air
- CSF - black, radioluscent
- soft tissue - shades of gray, depend on relative density
- vertebrae - white, very dense bone
substance stimulated by decrease in arterial pressure and acts as a vasoconstrictor
- angiotensin - blood polypeptide, causes vasoconstriction, increases BP, releases aldosterone from adrenal cortex; stimulated by decrease in arterial pressure
where to auscultate aortic valve
- second right intercostal space at right sternal border
- “aortic area”
where to auscultate pulmonary valve
- second left intercostal space at left sternal border
- “pulmonary area”
where to auscultate tricuspid valve
- fourth left intercostal space along lower left sternal border
where to auscultate mitral valve
- fifth left intercostal space at midclavicular line denotes mitral area or apex of heart
to estimate energy expended (calories) of an activity, what do you need to know
- body weight (kg)
- metabolic equivalent value (MET) of the activity
- duration of the activity
cluster sampling
- successive random sampling of a series of units in population
- used when a researcher is unable to know all elements in population in advance
- large subgroups (clusters) are randomly selected first, then small units selected from clusters
- each sample is subject to sampling error
simple random sample
- every element of population has an equal chance of being selected for the sample
systematic sample
- sample elements are chose from lists of population members using specified intervals (like every 4th element)
stratified random sample
- elements of population are chosen at random from homogenous groups based on some characteristic
- organizing elements into homogenous groups before selection decreases sampling error
nitroglycerin function
- dilation of veins to decrease venous return (preload)
- dilation of arteries to decrease afterload
- releaxation of coronary artery smooth muscle to increase coronary blood supply
- all 3 actions decrease myocardial oxygen demand
how do beta-blockers decrease myocardial oxygen demand
- inhibit binding of epinephrine and norepinephrine to beta receptors
- results in decreased HR, contractility of heart, cardiac output, blood pressure
how do anticoagluants increase myocardial oxygen supply
- inhibit platelet aggregation and thrombus formation
- used in acute treatment of venous thrombosis and thromboembolism
lesion to long thoracic nerve presents with
- difficulty elevating arm overhead d/t weakness in serratus anterior muscle (C5-C7)
deltoid innervated by
- axillary nerve (C5-C6) - also innervates teres minor
damage to musculocutaneous nerve causes
- C5-C6
- decreased sensation on lateral forearm
what is a (+) graded exercise test
- graded exercise testing used to measure response of heart to graded increase in O2 demand
- exercise occurs using systematic protocol that can assess variables such as arrhythmias, functional capacity, significance of coronary artery disease
- (+) is ST segment changes: represents initiation of ventricular repolarization and is sensitive indicator of ischemia to ventricles
- (+) is greater than or equal to 1 mm of horizontal or downsloping ST segment depression
why wear a knee immobilizer to prevent hip dislocation after posterolateral THA
- knee immobilizer limits hip flexion by maintaining knee in extended position
a patient misses 3 sessions in a row and does not return calls. what is the appropriate action to take
- discharge pt from PT
- mult missed appoints without response to phone call warrants d/c from PT
typical UMN damage and spasticity pattern for UE
- scapula retraction and downward rotation
- shoulder adduction and internal rotation
- elbow flexion: biceps, brachialis, brachioradialis
- forearm pronation: pronator teres, pronator quadratus
- wrist flexion and adduction: flexor carpi radialis
- finger flexion: flexor digituorum profundus
- thumb adduction
for independence with dressing and bed mobility for a pt with C7 complete tetraplegia, preserving tightness of which muscle groups would most benefit functional potential
- finger flexors and low back
- tight long finger flexors: can use tenodesis grasp
- tight low back: movement of head and UEs while in long sitting
- avoid tightness in wrist flexors and hamstrings
apgar scores
- determine is child requires resuscitation at birth
- range 0-10
- 7-10 indicates good health - no resuscitation required
- 4-6 indicates may need suctioning or oxygen
- 0-3 indicates medical emergency and necessary resuscitation
periventricular leukomalacia
- ischemic disturbance around ventricles, causes white matter damage
- most common ischemic pathology resulting in cerebral palsy
- any type of disturbance resultingi nbrain pathology can be predictive of CP - infection, hemorrhages, brain malformations, pervientricular leukomalacia
creatine phosphokinase is biomarker for
- cardiac
- in blood follow myocardial infarction
- and muscular dystrophy (?)
manual vibration uses what hand placement
- with entire palmar surface of hand
- percussion - cupped hand
- assess tactile fremitus - ulnar border of hand (vibration of spoken words through chest wall)
- mediate percussion to evaluate changes in lung density - distal phalanx of middle fniger
brown-sequard’s
- muscle paralysis on ipsilateral side - also no vibration and position sense (corticospinal tract and dorsal columns)
- loss of pain, temperature, and sensitivity on contralateral side (lateral spinothalamic tract)
- stab or bullet wound
posterior cord syndrome
- rare incomplete lesion d/t compression of posterior spinal artery
- loss of stereognosis, proprioception, two-point discrimination below lesion
- motor function intact
central cord syndrome
- incomplete lesion resulting from c/s hyperextension
- damage to spinothalamic tract, corticospinal tract, dorsal columns
- UE»_space; LE
- motor»_space; sensory
anterior cord syndrome
- incomplete lesion d/t compression of anterior part of spinal cord and anterior spinal artery
- bilateral loss of motor function, pain, and temp below level of lesion (corticospinal and spinothalamic tracts)
modifiable risk factor for osteopenia -> osteoporosis
- modifiable factors: inactive lifestyle, smoking, excessive caffeine intake, alcohol consumption, estrogen or testosterone deficiency, insufficient dietary intake of calcium and vit D, long term use of corticosteroids, low body weight
biphosphonates
- medications commonly used to treat patients with osteopenia and osteoporosis
- maximize formation of bone and reduce rate of bone resorption
- alendronate (fosamax), ibandronate (boniva)
IT band syndrome
- pain about 2 cm above joint line over lateral femoral condyle
- d/t activities requiring frequent knee flexion - running, cycling
- excessive contact btw lateral femoral condyle and IT band when knee is flexed 30 degrees
fibular head tenderness
- bicep femoris insertion
normal platelet counts
- 165,000-415,000/microliter
- thrombocytopenia: low platelet counts
injury to musculocutaneous n would cause difficulty w
- drinking from a gallon of milk
- musculocutaneous nerve innervates brachialis, biceps brachii, coracobrachialis muscles -> injury would weaken elbow flexion
- NOT holding out arm to the side: would require deltoid (axillary n) and supraspinatus (suprascapular n)
arthrometer
- non-invasive instrument to meausre anterior translation of tibia on stabilized femur in 30 degrees of knee flexion
- measure amount of translation in mm at given force
- objective and accurate method of determining degree of ACL instability
iontophoresis on anterior knee w/ low current density
- current amplitude of 4 mA, electrode area of 12 cm^2 -> 4mA/12cm^2 = .33 mA/cm^2
- current density = amplitude (mA)/area (cm^2)
common deformities observed in RA patients
- boutonniere deformity
- swan neck deformity
- ulnar drift
boutonniere deformity
- extension of MCP and DIP
- flexion of PIP
- common in RA
mallet finger
- distal phalanx finger resting in flexed position
- d/t rupture or avulsion of extensor tendon
swan neck deformity
- flexion at DIP and hyperextension at PIP
- d/t contraction of intrinsic muscular or tearing of volar plate
- common in RA
ulnar drift
- ulnar deviation of digits d/t weakening of capsuloligamentous structures of MCP joints and accompanying effect on extensor communis tendons
Roos test
- for TOS
- pt sitting or standing with arms in 90 degrees ABD, ER, and elbow flexion
- open and close hands for 3 minutes - (+) inability to maintain test position, weakness of arms, sensory loss, ischemic pain
- fatigue common, no assessment of radial pulse during this test, no assessment of hand color
radial nerve injury
- weakness of triceps, unable to extend elbow
- can use platform attachment for bilat axillary crutches
pt w/ CVA and R hemiparesis. what WC adaptation is appropriate for stand pivot transfers
- pull-to wheel lock allows for closer access to surfaces in transfers
- brake extensions on R allow pt to reach with uninvolved UE to lock WC prior to transfer
- NOT anti-tippers: more for trunk control issues
- NOT removable arm rests: more for squat pivot or slide board transfer
why use platform attachment for walker
- flexion contracture
