Final Flashcards
What is PT
therap. exercise Pathokinisieology
Prevents and treatment of disorders of motion to restore or maintain function and quality of life
What PT does
Exercise modalities (HP/CP)
manual tech (gait training)
assistive devices, hydro theraphy, braces and splinthing
Fitness testing, work hardening
Edu and prevWhere PT
out and in clinic, hosp, skilled nursing facilities (SNF), health club, school, rehab, priv homes, sports org, hospice
Who do we Treat
Pediatrics, adults, peps, work related inj traumas, congenital, orthopedics, neurologic, cardio pulm, prego
Diff in PT, PTA, D
Education and salary
Responsibilities
PT - doct,5h (NPTE), cal law exam, license,renewal 60-90k
PTA- aa,4h, license approval, con ed 40-60K
Aide – on job training 12/h
PT – eval/diag, set goals, treat plan, treat, doc, discharge, supervise everyone
PTA – implement and progress, treat plan, assess state/progress, document
AID – impl plan, non patient care duties
APTA
serves needs of progession, communication, relations
STANDARDIZES/improves EDU and PROMOTE STANDARDS and Publication
PT board of CA
part of ca dept consumer affairs
Purpose – protect public by making law – pt practice act under medical practice act
License PT and PTA and ADMINISTERS board exam
investigates complaints and disciplines
PT PRACTICE ACT
writes laws depending on standard
defines scope of practice
minimum standards of practice and minimum standards education
CAPTE
accreditation for PT Programs
bases judgements on APTA STANDARDS
PT responsible for who?
Sees pt?
PTA can’t do anything until?
Documents for PTD from PT
PTA and PTD requirements to treat
responsible for PTA and D services
- PTA AND D must be supervised by PT in order to legally provide thera to pt. in cal
- PT must first see patient (“PT of RECORD”)
- doc dx, px, intervention, establish plan of care, follow progress and do re evals and D/C
PT – gives direction and PTA must communicate closely with PT while treating and must document and notify PT of unexpected changes in pt. condition
PTA cant do anything until seen by PT and cant change anything or D/C pt.
PTD – PT must document PTD competency, PT must be present at facility, and PT must see same day as PTD, and PT must doc Rex
Supervision of interns
Who is the clinical instructor?
clinical instructor can be PT/PTA
PTAs must doc and sign chart notes
CL must co-sign notes
Update PT weekly on pt. seen
Document
What we document
E- form standards
Written standards
DOCUMENT – permanent record to prove something
Provides evidence of whats done and to communicate with staff
legal issues, accountability
reimbursement based on document
WHAT WE DOCUMENT – Dx and PT problems, Rx Plan, goals and desired outcome, record of Rx, response to Rx, D/C, consent to Rx
E-FORMS – SOAP NOTES, narrative notes, flow sheet check, insurance medicare, reports and letterd to do, incident report.
IMPORTANT
E-FORM – accurate clear, nature of Rx, name date and sign, same day as Rx
Written – legible, no blank, black ink, no change, single line initial
SOAP NOTES
S
O
A
P
S(Subjective) – what they said
pt. says, states, reports, complain, “my back hurts”
O(Objective) – what you did
Rx content
what you did, instructions, training, etc
what it did – demonstrated, performed, ambulated, exercises
measurements – ROM
OBSERVATIONS – limping, color changes, swelling
communication
A(Assesment) – how it worked
answering ?
hows it going, is it effective,
KEY – increased, decreased, improved, progressing, consistent, does best with , poor/fair/good
NO PERSONAL JUDGEMENTS – pt is angry, lazy, a bitch
P(Plan) – what to do next
cont. w/, add a new exercise, initiate, increase, D/C, call MD, instruct in, arrange family meeting
Medical diagnosis
PT problem
MEDICAL DIAGNOSIS – the pathology or problem by MD
PT PROBLEM – pathokinesiology problem, movement problem caused by pathology
Position
Draping
Hygiene
POSITION – Comfort, allow area to be treated, stabilization
DRAPING – temperature and conceal private
HYGIENE – spread of infection, Plinths should be clean, and pillow cases. New sheet for plinths or paper
Sitting
Supine
Prone
Side lying
Semi-supine
Side-lying
Draping
SITTING – back rest and foot should touch the ground. Pillow on lap or plinth for hand rest. Pillow at neck if needed.
SUPINE – pillow under head and behind patella to prevent curvature on lower back. Towel behind neck if needed or heels.
PRONE – must be nearest to edge for easy access for PT. Feet hanging at end of plinth, pillow on stomach to avoid excess curvature of spine. Hole on plinth or face pillow. Also towel to on top for infection control.
SIDE LYING – Pillow under side of head, knees and hips at 60-90 degrees with pillow between to relieve pressure and to avoid adduction of top of LE. Pillow on top torso for UE to rest on
SEMI-SUPINE – to avoid pressure ulcers.
LONG-SITTING – back against plinth with pillow and feet must be rested on plinth
DRAPING – doors closed so others cant see. Proper clothing, don’t have to remove bra or underwear. Also keep private and only area being treated exposed. Draping should be secure and not too tight.
Anterior-posterior, ventral-dorsal, medial-lateral, proximal-distal, superior-inferior, superficial-deep, contralateral-ipsilateral, cephalic-caudal, infrapatellar-suprasupination-anterolateral Sagittal/midsagittal plane, frontal plane, transverse plane abd-add (frontal plane) med-lateral – horizontal plane plantar flexion – dorsiflexion
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Common measurements
Goniometry and tool
AROM – PROM – AAROM – FROM – EROM – WNL – WFL – GIRTH
Common Measurements – ROM, GIRTH, MUSCLE STRENGTH
Goniometry – measurement of joint position or movement (GONIOMETER) measure in degrees
AROM – assistive rom PROM – Passive AAROM – Active assistive FROM – functional EROM – end WNL – Within normal limits WFL – within functional limits GIRTH – circumference of body part in cm or in. measures mm bulk or edema
MMT
5/5 4 3 3 1 0
MANUAL MUSCLE TEST – manual technique estimates relative strength of specific muscles or muscle group by own manual force of PT by manual resistance for tolerance.
mm strength grades
5/5=normal mm can take normal/max amount resistance
4/5=Good mm can take some/moderate resistance
3/5= fair can move body part against gravity
2/5=Poor “ “ “ with gravity eliminated
1/5=Trace, mm can contract but not move body
0/5=absent, no visible contraction
Massage
Benefits
Circulation of blood and lymph
Reduce edema
Skeletal muscle - increase ROM and circlulation
Control of pain
