Exam 3 Study Flashcards
A 60 year old female had a THA. What advice would you give for home?
- Precautions: No bending hip, no crossing legs, no toeing in, pillow between legs in bed, up with good and down with bad with stairs. Avoid sleeping on affected side.
- Home exercise: Walker. Ankle pumps. Quad sets. Glute squeezes. Standing Abduction. Isometric strengthening.
- Family education
You have 2 patients with s/p TKA 4 weeks . One with 60 degrees flexion and edema and the other with 90-120 Flexion with mm weakness. What HEP would you give for each?
Patient 1:
- Edema Control: PRICE, Patellar mobilization, Self Massage
- Exercises : Quad sets, Heel slides, SLR, calve pumps. Nustep.
Abduction/Abduction. Mini lunge stretch. Patellar mobilization. Soft tissue massage.
Patient 2:
- Exercises: Recumbent Bike, Standing leg curls, terminal knee Extension with TB, SLR, Abduction/Adduction, ankle pumps. Mini lunges, heal slides. Hip extensions. LAQ, SAQ.
A truck driver comes in with an ACL tear. What are his options and what would you do?
Options:
- Allograft: From a cadaver. Higher infection rates which may delay return to function and work. Wouldn’t have to recover another part of body.
- Autograph: From a hamstring/ patellar tendon. More stable. Lower infection rates. Would have to recover from hamstring tendon cadaver.
Exercises:
What would you do for Ankle sprain management?
Phase1: wbat
- PRICE
- Estim
- Joint protection
- Isometric dorsiflexion/eversion (Avoid plantarflexion/inversion)
Phase2: FWB (avoid stresses)
- PRICE
- Heel cord
- Theraband exercises
- Stationary bike
- Protection
Phase3: FWB (Protection during activities)
- Cold/Hot pack
- Running/Jumping
- Plyometric
- Balance and stability exercises on BAPS
What does achilles tendon repair/rehab depend on?
Protocol and surgery
*(Relative rest, eccentric calf stretch and strengthening, plyometrics, gradual return to activity)
What is medicine half-life? What is the reaction in older pt?
- Rate that drug clears from body
- Slower in elderly (due to slower body functions)
What can corticosteroids steroids cause? What is the truth about its application?
- Osteoporosis
- Only a little goes to bloodstream
What is not an anti-inflammatory medicine for pain?
Acetaminophen (Tylenol)
What causes a MCL injury?
Knee Valgus
When should CMP (continuous passive motion) not be used?
Vigorous exercise (During sleep)
What doesn’t have to be done with a meniscus tear?
Surgery
With THA (THR), when would you use a dislocation protection brace?
Past history of hip dislocation
What is the best bed position for THA (THR)?
Supine
What can we tell a healthy person about hip fx
Exercise and mobility can improve the prevention of a hip fx
What is it called when there is necrosis of the head and femur? How would you treat a child or hold a baby with this condition?
- Legg Calve Perthes Disease (Coxa Plana)
- Treat child with abduction orthosis, hold baby with leg abducted
What type of shoe should you give to a pronated foot pt?
Shoe last with heel-counter