Exam Flashcards
Multidiscinplinary care vs interdiscinplinary care
Multi: each profession is a stand alone. Discipline specific goals
Inter: each professional overlaps (e.g. the psycologist reinforces what the physio has said). they work collaboriatively and have the same goal
PROMIS 29
assesses symptoms and function:
pain interference, sleep, physical function, anxiety, depression, satisifaction with social roles, fatigue, etc.
Ageing skeleton
lose bone marrow and calcium, bones shrink, lose flexbilit and become brittle, break after 5 deg of bending (15 deg in young person), discs dry so we lose 2-5cm of height,
Ageing muscles and soft tissue
3-5% of musle mass per decade after 30, by age 70 you may have lost 30%
40% loss of strength at 70 if you are inactive
10 of mass and 15% of strength after 10 days in hospital
soft tissue is generally weaker, less elastic
Ageing skin and fat
become thinner in your 70s and 80s because loss of muscle mass, loss of appetite and losing teeth,
skin and epithelial tissue become thinner, less elastic and brittle therefore may break, bruise, tear and become pigmentned
Ageing cells
cell walls change therefore less easy to takke up 02 ad nutrients therefore decreased healiing rates
Incresed rates of cell mutation
Ageing CVS
blood vessel walls harden and thin, plaque build up, heart loses 1% per year of resrve capacity after 30,
Ageing vision and hearing
visual accomodation goes (distance)
develop cataracts (becasue of UV)
lose 40% of night vision by age 70
hearing loss begins at 40s, high frequencies go first
Ageing mind
short term memory loss is nomral but loss of how to do thigs, how to at appropraitely, difficulty with comprehnsion is not good sign
will always rememeber music
Surgery consideraions
Hip OA and surgery: avoid FADIR
Knee replacements: do not flex past 110 deg
Shoulder reco: loss of 10-15% of ROM, abduction elevaation, external rotation
Chronic pain coping inventory
assesses guarding, resting, asking for help, relaxation, task persistane, exercise stretch, seeking socail suppport, coping self statmetns
FABQ
assess fear avoidance beleifffs of work and of PA.
Forms for EPC
General pracitioner mngmnet plan (GPMP)
team care arrgementes (TCA)
Seperate referral for ecah service
Requirements of osteo for EPC
need to do written report at first and last consultation, must treatfor at least 20 mins and only 1:1 must keep erferral form for 2 years
DVA elligibility
veterans, former members of ADF, members of peacekeeping, war widowers, austalian mariners, children of veterans, person from overseas who is entitle for treeamtne
DVA requirements
MUST have referral from GP, can only treat what htey have been referred for, need updte every 12 months, GOLD: anything they need for all conditions, they are permanently incapacitated, covered for equiptment and medical aids. covers injuries from war, cacners or mental health. TB within 15 years of service
WHITE: can only be covered for their accpeted services
ORANGE: only pharmaceuticals!
DVA and osteo
can only treat them as needed- unncessary treatmentn will not be coered, you have the power to determine treatment, $64.25 and NO GAP, DVA does not cover late fee
Work Safe
do not need referral first pre- approved, a certificate of capacity needs to be filled out, first COC has to be done by GP (ax 14 dys) and then thereafter osteo (max 28 days)
osteopathy treatment notification (OS100) by 5th consultation, one for you, one for agent, one for employer
Types of TAC
rapid recovery: 80% of tac, sprains, strains,
Supported revoery: were rapid recovery but becasue of other issues they do not heal within the nrormal healing time.
Independance branch: serious, brain or spinal cord injuries, 1%, lifelong journey with TAC
Ageing brain
20-60 loss of 0.1% of neuron tissue per year, acccelerateaes after 60, by 90 you lose 10% of brain tissue, 150g
noxious stuff is in higher concentrations, ie aluminum, iron, free radials. leads to cognitive decline
other systems become less efficient: kindys, loss of BBB (hippocampus first), toxins in bone nad fat are relase at 60
gyri thin and sulci become deeper, bigger ventricles
27% loss of cerebral flow , 0.38 per year
Ageing neurotransmitters
loss of noreadrenaline- memory, learning, F or F
glutamate, plasticity,
dopaine, reward and movements
serotinin,mood and food
peripheral nerves and age
die back: mitochondrial loss, myelin degen, axonn shrink, particularly c fibres which autonomic function
arent protected by BBB+ increase in toxins
affect of ageing on function
short + episodic memory loss word skill loss after 70 slower reaction time mood changes more suscepitable to neuroactive drugs
Definition of disability and frailty
Disability: restriction in performing usual tasks
Frailty: propensity to deteriorate in he face of a stressor
PULSE acroym
P-physical condition: frailty, hand wasting, tremors, oedmea,
U- upper limb function: gross movements and manual dexterity
L- Lower limb: 6m walk test, 10-12 obstacles, transfers, TUG test: armless chair- walk 3m, turn 180, sit down again, <14 sec
S-sensory:
E- excretory function
objective measurements of pain sensitivity
sharp hyperalgesia allodynia cold hyperalgesa< 5/10 pain nerve mechanosensitivity (neurodyanmic tests + palpation of nerves > 1 sensitsd) pressure hyperalgesia conditioned pain modulation temporal summation
