Final Flashcards
Which fluid is contained by joint capsule, feels like a water balloon, and moves when palpated then returns?
joint effusion
Which fluid is in the interstitial space, and when you press on tissue with finger a dent remains
edema
What does PRICES stand for?
Protect, Rest, Ice Compress, Elevate, Support
Wraps should be done which direction?
distal to proximal
In addition to PRICES, what other modalities could you add to the acute treatment?
Pulsed US, Laser, TENS (sensory level- IF, Premod, HiVolt)
What is the treatment time for intermittent compression?
10-30 minutes, up to 3 or 4 hours
Intermittent compression can be combined with?
cooling
Athletic tape stretches in _____ minutes.
20-30
Bracing may _______ muscle action.
inhibit
When structural and functional integrity of the joint is not severely compromised, ________ is better for ambulatory aids.
weight-bearing
For fitting crutches, the crutch tip should be?
6 inches from outer margin of shoe, 2 inches in front of shoe
For fitting crutches, the arm brace should be?
1-2 inches below anterior axillary fold
For fitting crutches, the hand brace should be?
elbow flexed to 30 degrees
What are the risks of improper use or fit of crutches
abnormal stresses, l(umbar/pelvic subluxation, low back strain, hip strain) crutch palsy (pressure on axillary nerve and vessels, temporary or permanent numbness)
For a tripod gait, the crutch tips move ______ inches ahead of feet.
15-Dec
Which tripod gait is faster?
Swing-through
Which tripod gait requires more coordination?
Swing-through
Which tripod gait is easier?
Swing-to
Tripod gait, partial weight bearing is aka?
four-point
In a four-point gait, the _________ leg and crutches move forward together.
affected
What is the preferred gait for going up and down stairs with crutches?
handrail
Going up stairs on crutches with a handrail stair gait, the _________ leg steps first, followed by _________.
unaffected leg, follow with crutches and involved leg
Going down stairs on crutches with a handrail stair gait, what is the order?
crutches first, then affected leg, then unaffected leg
What is the order for tripod stair gait when going up stairs with crutches?
step up with unaffected leg, crutches and affected leg follow
What is the order for tripod stair gait when going down stairs with crutches?
crutches and affected leg step down first, unaffected leg follows
Where does a properly sized cane line up?
superior aspect of greater trochanter
Cane is used on ________ side of involvement
opposite
Cane moves ______ the involved side
with
What does TLSO stand for?
Thoraco Lumbo Sacral Orthosis
What does CTLSO stand for?
Cervico Thoraco Lumbo Sacral Orthosis
What type of brace is a Boston brace?
TLSO
Boston brace is aka
under arm brace
What kind of curve is a Boston Brace used for?
thoracolumbar scoliosis
How long is a Boston Brace worn for?
at least 23 hours a day
What type of brace is a Milwaukee brace?
CTLSO
The Milwaukee brace is similar to the Boston brace except?
includes a neck ring held in place by vertical bars attached to the body of the brace
How long is a Milwaukee brace worn?
at least 23 hours a day
How long is a Charleston brace worn?
only at night during sleeping hours
What is a Jewett brace?
for spinal fractures, TLSO, hyperextension
What is a Voigt-Bahler brace?
for spinal fractures, TLSO, hyperextension
Trochanteric/Sacroiliac belts support _____________
SI joints and pelvis (force closure of joints)
What patients may benefit from trochanteric/Sacroiliac belts?
pregnant and post-partum females with SI joint pain
Sacroiliac belts causes gapping of SI joints if worn _________
over trochanters
There is weak evidence that lumbar supports may do what?
reduce risk of re-injury for low back injuries
Should lumbar supports be used to protect the low backs of workers who have not been injured?
no- may cause more severe injury
What are some risks associated with lumbar supports?
for those who haven’t been injured, may risk more severe injury, increased blood pressure, may give people the impression that they can lift more, some may have worse biomechanics
Should lumbar supports be used long-term?
no
Before recommending a lumbar support, what should the patient be screened for?
cardiovascular risk
Knee bracing protects from what kind of blows?
lateral
Bracing ______ hamstring reflexes
slows
Elastic taping _______ hamstring reflexes
improves
Both neoprene sleeves and rigid braces appear to improve __________
proprioception in patients with deficits
What is a Cho-Pat brace used for
knee- osgood-schlatters
When is a walking boot used
fracture, severe sprain, post surgical
Ankle stirrup allows what movements? What movements does it inhibit?
allows flexion/extension, not inversion/eversion
What is a Strassburg sock used for?
plantar fasciitis
Which type of cervical collar is appropriate for someone with a suspected neck fracture?
philidephia
Which type of cervical collar is appropriate for someone following sprain/strain injuries
soft cervical
What are some indications for massage?
superficial adhesions, circulatory stasis, congestions, edema, myalgia, tension headaches
What are some contraindications for massage?
arteriosclerosis, thrombosis/embolism, severe varicosities, cellulitis, synovitis, abscesses and skin infections, acute inflammatory conditions
Effleurage is performed ________ the orientation of the fibers of the targeted muscle tissue
in parallel with
Effleurage is applied with
palm of hand or flats of fingers
Long stroking motions is associated with what type of massage
eflleurage
Kneading the muscle with one or both hands is associated with what type of massage
petrissage
Tapotement is?
series of rapid blows (massage)
Manual vibration is performed _________ the orientation of the targeted muscle fibers
perpendicular
What are some types of mechanical vibratory devices
G5, Genie Rub, Thumber
What frequency mechanical vibration should be used to relax spasticity or decrease trigger points?
high
What frequency mechanical vibration should be used to decrease congestion, edema, or stasis?
low
What are the treatment times for vibratory massage for trigger points?
6-8 minutes (1 minute per point)
What is the treatment time for vibratory massage for muscle relaxation?
up to 10 minutes
What is the treatment time for vibratory massage for postural drainage
up to 15 minutes
What is the treatment time for vibratory massage for general body relaxation
5 minutes
What name is associated with cross-friction massage
James Cyriax
Cross-friction massage is used over
ligaments, tendons, muscles
What is cross-friction massage used to do
loosen scar tissue and adhesions, aid in absorption of local edema, mobilize ligaments, tendons, scars, restore mobility
What are some examples of positional traction?
knee to chest, side lying on a roll to open an IVF
What are the theoretical physiologic effects of traction?
encourages spinal mobility, enhances intersegmental mobility, change in overall spine length, change in intervertebral space, decrease pain, parasthesia, decrease pressure on structures
What are the physiologic effects of traction on ligaments?
activation of proprioceptors to decrease pain, restoration of normal length
What are the physiologic effects of traction on discs?
decreased discal pressure, imbibition of disc for proper nutrition, unstable reduction of herniation
What are the physiologic effects of traction on facet joints?
increases separation, decompression, proprioceptive discharge may decrease pain
What are the physiologic effects of traction on musculature?
stretching, improve blood flow, activation of proprioceptors
What are the physiologic effects of traction on nerves?
decrease compression, improved blood supply to nerve tissue, decrease of inflammatory products
What is more tolerable to the patient- intermittent or sustained traction?
intermittent, tolerable both at higher forces and for longer duration
Which allows more decompression of disc- intermittent or sustained traction?
sustained
Which has shorter treatment times- intermittent or sustained traction?
intermittent
What is the traction phase for short phase intermittent traction?
less than 10 seconds
What is the traction phase for long phase intermittent traction?
more than 10 seconds
What are the indications for spinal traction?
disc protrusion, disc herniation/prolapse, nerve root impingement, spondylolisthesis, joint hypomobility, arthritis conditions of facet joints, mechanically produced muscle spasm, joint pain, scoliosis
What are some contraindications for spinal traction?
fractures, joint instability or hypermobility, tumors, osteoporosis and osteomalacia, bone and joint infections, osteo and rheumatoid arthritis, vertebral artery occlucion, pregnancy (cervical is ok), hiatal hernia and abdominal hernia, displaced disc fragment and cord compression
What are some precautions for spinal traction?
acute spinal conditions, hypertension and respiratory disease, spinal surgery, dentures (cervical pulley only), breathing problems (lumbar only)
What is the patient position for mechanical lumbar traction?
2 harness, pelvic and thoracic, patient with hips/knees flexed
How much force is used with mechanical lumbar traction?
30-60% of body weight
What is the treatment time for mechanical lumbar traction?
10-30 min
What is a Saunders device?
harness for mechanical cervical traction
What should the head/neck angle be for cervical traction?
neutral to 30 degrees flexion
How much force is used with cervical traction?
20-30% of body weight
How much weight should you begin with for cervical traction?
15-25 pounds
What is the max tolerance for cervical traction?
usually 40-50 pounds
Is inversion recommended?
no
What are the contraindications and precautions for inversion?
heart disease, hypertension, glaucoma, sinus infections and asthma, migraines, detached retina
What are the stages of the death and dying model
Denial, anger, bargaining, depression, acceptance
How applicable is the death and dying model for athletic injury?
not good
Cognitive Appraisal Models of pain state that response to injury depends on?
understanding of the injury
What is the purpose of pain?
warns of impending injury, essential for survival, protects the body, signifies something is wrong, limits further injury
Which mechanoreceptors are associated with pressure and touch
meissners corpuscles, pacinian corpuscles
Which mechanoreceptors are associated with skin stretch/pressure?
Merkle cells, Ruffini endings
What proprioceptors are associated with change in muscle length and spindle tension
Golgi Tendon organs
Which proprioceptors are associated with change in joint position
pacinian corpuscles
Which proprioceptors are associated with joint end range
Ruffini endings
