Final Exam Flashcards
Kinesio Tape Theory
KT is applied unstretched over manually stretched skin above the injured muscle to form convolutions which lift the skin
Convolutions facilitate the body’s natural healing process by increasing interstitial space resulting in decreased pressure and irritation on neural, sensory, and lymphatic structures which results in decreased pain, decreased swelling, and more free drainage of the lymphatic system
Reasons to use Kineso Tape
Decreased muscle strength
- Facilitation muscle contraction
- Stabilize joint
- Promote active range of motion through spring assistance
Hypertonicity
- Inhibits muscle contraction
Muscle overuse or myalgia
- Promote recovery of inflammed, swollen or stiff muscles by increasing space between skin and muscle and promote flow of lymphatic tissue and decrease compression of pain receptors
Swelling/edema
- Tape is positioned to recoil and promote drainage toward healthy lymph node
- Increase space between skin and muscle to improve flow of lymphatic tissue
Pain
Reduce muscle fatigue
Scar tissue
Asymmetrical posture/movement
Sensory stimulation
Hypermobility
Hematoma/bruising
Athletic tape
Used for acute injuries and injury prevention
Several layers of tape are rolled around affected area to restrict movement of affected muscle and joints
Applies significant pressure and compression to skin, joint, and muscle which may lead to an obstruction of flow of bodily fluids
Generally applied immediately before sports activity and removed immediately after
Requires pre-tape or spray adhesive
Contains latex
McConnell Taping
Provides bracing or strapping with extremely rigid cotton mesh tape
Requires pre-tape
Poor adhesive quality when wet and has limited wear time
Qualities of Kinesio Tape
100% cotton and latex free
Safe for pediatric and geriatrics
Heat sensitive adhesive
Breathable and flexible material
Can be kept on for up to five days
Benefits of Kinesio Tape
Facilitate body’s natural healing process
Improves lymphatic flow
Provides support and stability to muscles and joints without restricting the body’s range of motion
Enhances muscular and joint function
Reduce muscle fatigue
Restore epidermal tissue homeostasis
Can be worn for 3-5 days without re-application
Radiation
Light beam irradiates 1-3 inches below the skin to interrupt the DNA molecule so it is unable to replicate
Keloid scarring occurs below skin
Side effects of radiation
Effects of radiation are present more than two years post treatment
- Rash
- Hair loss
- Fibrosis
- Decreased ROM
- Partial thickness burns
- Fatigue
- Infertility
- Heart disease
- Secondary cancers
Chemotherapy
Using toxic drugs to interfere with synthesis or function of nucleic acid to kill cancer and health cells
Reoccurrence of cancer may occur since treatment will not affect 5% of cells in dominant phase)
Side effects of chemotherapy
Hair loss
Fatigue
Weight gain/loss
Lean muscle mass loss
Cardiotoxicity
Myelosuppression
Fatigue
Chemo induced peripheral neuropathy
Cogntive changes
Other possible side effects of chemo and radiation
Flu-life symptoms
Pain
GI problems
Skin changes
Weight changes
Anemia
Risk for infection
Oncology pain
70% report cancer pain
Bone pain
Tumor pain
Pain secondary to treatment
Cachexia
Weight loss of 5% of pre-illness weight
Primarily caused by tumor draining metabolic energy
Osteolytic
Pertaining to bone being eaten away
Osteoblastic
Pertaining to osteoblasts becoming more active and bone becoming like chalk
Superior vena cava syndrome
Occurs when tumor compresses superior vena cava or may be due to radiation
Results in facial/arm edema, headache, vein distention on chest, plethora (redness in face), dizziness
Precautions
- Monitor vitals at all times
- Avoid activities that will increase intracranial pressure
- Work on mobility, safety, and ADL training
Pleural effusion
Excess fluid in pleural space due to tumor or obstruction of lymph flow or pulmonary vein
Results in cough, dull chest pain, dyspnea, labored breathing
Intervention
- Energy conservation
- Mobility/ADL training
- Breathing/relaxation exercise
- Increase comfort
- Elevate HOB
- Monitor for edema in lower extremities
Ranges of platelet count
Normal range: 150,000-450,000 per cubic mm
Low range is below 50,000
Side effects of low platelet count
Easy bruising
Bleed longer with injuries
Gum and/or nose bleeds
Bleeding in stomach, throat, intestinal tract, bleed into muscles and or joints
Intervention when platelet count is less than 10,000
Walk in room with assistance
ADLs, safety, basic active or active assistance exercises
Look for signs of bleeding or bruising
Intervention when platelet count is from 11,000-50,000
Walk in room or hallway, complete ADLs, and educate on safety
Stationary bicycle/ergometer with no resistance
Increase exercise effort and time slowly
Intervention when platelet count is over 50,000
Increase walking distance
Slowly introduce active exercises with low resistance
Hemoglobin range
Normal range: 12-16 grams per deciliter
Low range is below 8
Hematocrit range
Normal hematocrit 37%-52%
Low range is below 35%
Side effects of low hemoglobin or hematocrit
Fatigue and shortness of breath
Dizziness
Leg cramping
Headaches
Increase in heart rate and respiration rate
Intervention when hemoglobin is less than 8
Minimize activity
Save energy for daily activities such as bathing/dressing
Intervention when hemoglobin is between 8-12
Walk short distances
Use stationary bike/ergometer for 5-10 minutes with no resistance
Intervention when hemoglobin is more than 12
Walk in room or hallway
Stationary bike/ergometer
UE/LE/trunk exercise with no more than 5 pounds
Increase exercise effort and time slowly
Axillary web syndrome (cording)
Visible or palpable tight cords from axilla to medial arm that become more pronounced and painful in shoulder abduction
May extend to antecubital space and to base of thumb , more pronounced and pinaul with shoulder abduction
Caused by interruption of lymphatics in axilla usually due to a fibrin clot
Intervention for axillary web syndrome
Soft tissue work with gentle myofascial release
Scar tissue massage
AROM/AAROM of shoulder and elbow
Interventions for scar adhesions
May appear secondary to surgical intervention
Manual scar mobilization to soften scar tissue to provide desensitization, prevent adhesions of tissue, and improve lymph circulation
Myofascial release
ROM/manual stretching
Lymphedema
Swelling due to build up of lymph fluid
May occur secondary to surgical resection of lymph node, radiation damage, or scar tissue impeding lymphatic flow after surgery
Complete decongestive therapy is required
Complete decongestive therapy
Manual lymph drainage massage
- Mild superficial massage aimed to manually move lymph out of limb or body part
- Improve lymph production
- Improve lymph circulation
- Special strokes break down fibrotic tissue
- Promotes relaxation and analgesia
Compression with multi-layer bandaging and compression garments
- Reduces ultrafiltration
- Improves efficiency of muscle pumps
- Prevent accumulation of evacuated lymph fluid
- Helps break up accumulated scar and connective tissue
Client education
Meticulous skin care and infection prevention
Exercise
Adhesive capsulitis symptoms
Associated with diabetes and thyroid disorders, presents with diffuse shoulder pain, and restricted passive range of motion on examination
Iontophoresis mechanisms
Direct current is used
Charged drug is repelled by electrode with the same charge and pulled toward the elctrode with the opposite charge
Indications for iontophoresis
Treat musculoskeletal and inflammatory condtions
Decrease joint pain
Decrease inflammation
Local anesthesia
Carpal tunnel syndrome
Epicondylitis
Ulnar nerve inflammation
Elbow strain/sprain
Radiohumeral bursitis
Triceps tendonitis
Gleno-humeral bursitis
Reflex sympathetic dystrophy
Hand and wrist tendinitis/tenosynovitis
DeQuervain’s disease
Hyperhydrosis
Iontophoresis adminsitration
Administer every other day
Patient should notice a decrease in pain or symptom after 4-6 treatments and acute inflammation should subside
Continue for 9 to 12 sessions if patient shows continuous improvement
Treatment should be stopped if patient is not getting at least 50% relief
Iontophoresis precautions
Attraction of positive ions at negative pole may cause alkaline reaction resulting in formation of bases
Acids and bases forming at electrodes may affect ability to deliver a drug due to changes in pH of medicated solution
Alkaline reactions will be more irritating to the skin
Ask if they have any known allergies to food or medications
Accumulation of electrodes under elctrodes may lead to electrochemical skin irritation and burns under the negative electrode
Use lower level of current when treatment electrode is negative
Be aware of possible drug interactions
Iontophoresis contraindications
Should not be applied over scratches, cuts, lacerations, or abrasions due to risk of discomfort and burns
Skin sensitivty reactions
Sensitivity to aspirin (salicylates)
Gastritis or activity stomach ulcer (hydrocortisone)
Asthma (mecholyl)
Sensitivity to metal (zinc, copper, magnesium)
Sensitivity to seafood (iodine)
Commonly used NSAIDs for inflammation
Dexamethasone is the gold standard
Glucocorticoid medications are used to treat acute and chronic inflammatory conditions such as tendinitis, bursitis, and lateral epicondylitis
Corticosteroids
Anti-inflammatory drug
Suppress immune response and reduce inflammation
Naturally produced by adrenal cortex
Glucocorticoids
Anti-inflammatory durg
Synthetically produces
Anti-inflammatory, metabolic, and immunosuppressant effects
Include
□ Beclomethasone
□ Betamethasone
□ Cortisone
□ Dexamethasone
□ Hydrocortisone
Methylprednisolone
Salicylates
Anti-inflammatory drug
Less costly and available without prescription
Ex.
□ Aspirin
□ Choline magnesium trisalicylate
Choline salicylate
Sodium salicylate
Current density
As electrode size decreases, current density increases which leads to increased perception of stimulation and greater physiologic response
If current density is excessive, it will result in discomfort, skin burns, and potential tissue damaged
Maximum current of 4 milliamps for iontophoresis
Benefits of electrotherapeutic agents
Facilitate tissue healing
Improve muscle strength and endurance
Decrease edema
Modulate pain
Decrease the inflammatory process
Modify the healing process
Neuromuscular electrical stimulation (NMES)
Type of pulsed, alternating current used to stimulate a motor response by depolarizing intact peripheral nerves
NMES stimulates nerves that correspond to a targeted muscle or muscle group to contract tissue
Intact peripheral nerve and healthy muscle tissue is required for activation
TENS electrode placement
Most units have four electrodes in which two originate from each of the two channels
Place electrodes over or around painful site
Can also place over motor points, trigger points, or acupuncture points
Can be placed parallel to painful site, on either side of scar or surgical incision, crossed at the site of pain, bracketed or linear
Initial placement should be changed if outcome is less than expected or if the patient is experiencing pain or discomfort
Transcutaneous electrical nerve stimulation
Delivers pulsatile alternating current through the skin for pain relief by stimulating the opioid system
Decreases pain perception by decreasing conductivity and transmission of noxious impulses from small pain fibers
Iontophoresis
Delivering medication into tissue with direct electrical current
Charged drug is repelled by electrode with the same charge and pulled toward the elctrode with the opposite charge
Iontophoresis electrode placement
Delivery electrode has the medication on it and is positioned on the target area
Dispersive pad is placed over a major muscle at least 4 to 6 inches away from the delivery electrode
Peripheral sensitization
Damage to high-threshold nociceptors leads to hypersensitivity
Areas adjacent to those of the actual injury hurt as if injured
Tissues respond to stimuli that ordinarily do not produce pain such as touch, clothing, light pressure, or a hairbrush as if they are painful (allodynia)