Final Flashcards
To be considered functionally independent, a person must be able to walk at which speed?
1 MPH
Bradycardia-
60bpm
-Tachycardia-
100 bpm
Thrombus-
a blood clot that forms in a blood vessel and remain at the site of formation
Embolus-
blood clot that becomes lodged in a blood vessel and obstructs it flow
-Myocardial infarction-
heart attack
-Angina pectoris
chest pain, unable to supply the heart with enough oxygen
What is stroke volume?
-Amount of blood pumped out by the L ventricle in one contraction
Chambers of the heart and where the blood goes
-Sup/inferior vena cava, R atrium, tricuspid valve, R ventricle, pulmonary artery, lungs, pulmonary veins, L atrium, bicuspid/mitral valve, L ventricle, aorta.
- Right atrium/ ventricle
Body
-Left atrium/ventricle-
Lungs
CHF left or right
-The heart’s inability to pump blood: (L) pulmonary edema, (R) LE dependent edema
Cardiac drugs-
Nitroglycerin dilates arteries to ↓ angina, treat HTN –– ACE inhibitor, Beta blocker, Calcium Channel blocker - in conjunction with diuretic ↑ BP and leads to OH
Signs of Angina/MI
hand to chest
Angina-
Temporary pain, suddent onset, pain may radiate, last 1-5 min, relieved with rest or nitroglycerin
MI-
sudden constant pain or pressure, pain radiate up neck and down arm, SOB, profuse perspiration, unexplained fatigue
-Vital Capacity-
volume of air expelled from lungs by max exhalation after max inhalation
Residual volume
volume of air remaining in lungs after maximum exhalation-Which airway constriction is reversible: Asthma
-Hypoxemia-
-Below norm 02 content in arterial blood due to deficient oxygenation of theblood and result to hypoxia (lower than normal oxygen concentration in arterial blood)
-Hypoxia:
loower than normal oxygen level in tissues
Cyanosis
bluish color of the skin and mucous membranes caused by an insufficient amount of oxygen in the blood
-apnea-
cessation of breathing
Know what COPD
A combination of airway narrowing, parenchymal (tissue of an organ) destruction and pulmonary vascular thickening- Difficulty getting air out - Residual volume increase - Exhale 2x as long- PLB
Pursed lip
breathe out 2x as long, no accessory muscles,
Diaphragmatic
→ use diaphragm
Pulmonary edema positioning
Do not elevate feet as it increases pulmonary pressure. Head at 30-45 degree
Physical changes with COPD
Chronic obstructive pulmonary disease; blue bloater, pink puffer, barrel chest, clubbed fingers
Stratum corneum
superficial, waterproof layer
Stratum basal
deep, contains melanocytes
Epidermis
outermost layer, contain melanocytes, Langerhans cell, and merkel cell
Dermis-
- papillary dermis and reticular dermis, contain blood and lymphatic vessels, nerve fiber, hair follicles, sweat and sebaceous glands
Subcutaneous-
contain major blood vessel, lymph vessels and nerve
Inflammation
WBC’s move in, macrophages, granulocytes, redness, warmth, swelling
Proliferation
Healthy blood supply, nutrients, proteins provide highly vascular granulation tissue
Maturation
Fibroblasts secrete collagen to form scar tissue, wound begins to heal
Inflammation:
normal tissue respond Increase blood flow for healing Vasoconstriction then vasodilation
Proliferation:
Angiogenesis (blood vessels/capillaries)
Granulation tissue (beefy red)
epithelization (new tissue fills wound)
Fibroblast secrete collagen
Remodeling:
Type III to Type I collagen, scar contracts and mature, decreased capillaries
Primary intention-
surgical wound
Secondary intention
wound heals on its own
Tertiary intention-
-allow to heal by secondary intention and then is closed by primary intention
Intrinsic factors
condition within the body that contribute to abnormal healing
Extrinsic factors-
influences that come from outside the body
Iatrogenic factors-
injury or illness that occurs as the result of medical care
Age related changes to the skin
Slower turnover rate in epidermal cells Poor oxygenation to wound ↓ immune system function ↓ Dermal and subcutaneous mass ↓ Skin strength
Alginate
seaweed, ↑ absorption, autolytic
Antimicrobial
inhibit bacteria, used on infected wounds
Foam:
H20 evaporates, allows oxygen, wicks moisture
Hydrogels
: hydrates wounds, softens necrotic tissue, minimal absorption
Hydrocolloids
Carbohydrate based, maintains moist, minimal absorption helps autolytic debridement
Goals of custom made compression garments after burns
↓ Scar formation
Which burns need a skin graft?
Full thickness
Allograft/Homograft:
human cadaver
Autograft:
permanent form patient’s body, usually back of leg
Heterograft/Xenograft:
porary from an animal
Split thickness skin graft:
: contains epidermis and superficial dermis
Full thickness skin graft:
: contains epidermis and dermis
Goals of skin grafts
Skin regrowth, ↓ heat loss, ↓ fluid/electrolyte/protein loss, block infection
Prevention, positions, and treatment of venous and arterial LE ulcers
V: irregular edges, elevated to alleviate pain, semi painful
A: smooth edges, level or dependent positioning, seriously painful
Appearance of skin with ulcers
Red: granulation, healthy. Yellow: slough. Black: necrotic, eschar
Granulation
beefy red, bumpy, shiny tissue in the base of an ulcer
Epithelial
pale or dark pink ,first appears at wound bases
Slough-
soft, yellow necrotic tissue
Eschar
thick hard leathery black tissue
Macerated
white edges, too much water
Early concerns for an amputee
Edema, infection, dehiscence (burst)
Phantom limb pain
Feeling shooting, burning, cramping pain in the missing limb, it can be localized, diffuse, continuous, or intermittent
Why does an LE amputee need to lie prone?
↓ Contractures, to prevent contracture
What is the benefit of an early temporary prosthesis?
↓ Edema, ↑ ambulation
Prosthesis can accommodate up to how many degrees of a knee or hip flexion contracture?
15o
What’s the leading cause of amputation
PVD- peripheral vascular disease
What do you do if a pt becomes violent?
Remove everyone else from the room, contact PT and security if possible.
What do you do if a pt becomes agitated?
Find the source of the problem and address it.
Know Joint Mob Grades
- Grade I – small amplitude movement at the beginning of the available ROM
- Grade II – large amplitude movement at within the available ROM
- Grade III – large amplitude movement that reaches the end ROM
- Grade IV – small amplitude movement at the very end range of motion
- Grade V – high velocity thrust of small amplitude at the end of the
Arthrokinematics-
Unobservable articular accessory motion between adjacent joint surfaces (roll, spin, glide)
Osteokinematics-
observable movement of the bones (sagittal, frontal, horizontal)
Arthrokinematic Roll
New points on one surface come into contact with new points on the other surface
Arthrokinematic glide
Motion in which one constant point on one surface is contacting new points or a series of points on the other surface
Arthrokinematic Spin
Rotation around a longitudinal stationary mechanical axis (one point of contact)
- Convex jt. Surface move on a stationary concave jt. Surface (opposite direction
- Concave jt. Surface move about a stationary convex jt. Surface (same direction)
Empty can:
Supraspinatus.
Neer
: Impingement.
Lift off
tear Subscap
Cross over
AC joint.
O’Brien:
Labrum
Apprehension:
Anterior dislocation.
Core muscles
Rectus abs, transverse abs, internal and external abdominals obliques, erectors spinae, multifidi, etc.
Weak Core
Poor posture, balance, pain, asymmetry
Strong Core:
: ↓ stress in back, neck, shoulders
ADA- American w/ disabilities Act
A physical or mental impairment that substantially limits one or more major life activity
Athletic tape-
(white tape)- stability and support- remove after activity
Kinesotape-
stability and proprioception Circulation - edema - Separate tissue - Gate theory - Ecchymosis
Exccessive Knee Flexion
Contracture
Insufficient plantar flexion
Circumduction
Medial side too high/ high medial wall
Inadequate suspension
Weak quads
Knee socket loose
Cardiac rehab:
2 days post MI (phase 1), increase HR 10-25 above resting HR, Phase 3 (outpatient, PRE-progressive resistant exercise)
Stages of progression ex:
inflammation/ protection (splinting and bracing), isometric ex, AROM, concentric, eccentric, plyometric
To reduce stress on supraspinatus after tear
slightly abduct arm with pillow
Know
what the metatarsal bar does as an external modification to a shoe ( from the last test)