Final: Geriatric Patient Lab Flashcards
What is the most common MSK complaint of elderly?
Lumbosacral pain
-loss of muscle mass->decrease strength/stamina->pain
How do you assess for fall risk?
Get Up and Go Test
->12s means fall risk
Do old people prefer direct or indirect?
Indirect
Whats the first step in FPR?
Flatten the curve!
-then add compression and localize indirect
Whats the first step in Stills?
Localize to indirect
-then compress/traction and move into RB
LE extension=lumbar ____ E/F?
Extension
So LE F=Lumbar F
Which way would you lumbar sidebend with R LE ABduction?
To the R
Which way would you lumbar sidebend with R LE ADduction?
To the L
Right lower extremity internal rotation rotates the lumber to the..?
Left
-imagine it going the same direction as your knee cap
Right lower extremity external rotation rotates the lumbar to the..?
Right
-imagine it going the same direction as your knee cap
Prone Neutral Lumbar FPR (opposite letter)
Pt prone, doc contra to PTP
- Flatten the curve with pillow under stomach
- Compress with LE
- Slight E and IR contra leg
- ABduct contra leg
Prone Extended Lumbar FPR (same letter)
Pt prone, doc contra to PTP
- Flatten the curve with pillow under stomach
- Compress with LE
- Slight E and IR contra leg
- ADduct contra leg
Prone Flexed Lumbar FPR
Pt prone, doc ipsi to PTP
- Flatten the curve with pillow under stomach
- Compress with LE (knee off table!)
- Slight F and ER contra leg
- ABduct ipsi
Right Superior Pubic Shear Tx (FPR and Still’s)
Flex and compress R knee
Gentle ADduct and ER the LE
–superior motion at pubs
FPR hold for 3-5s
Stills IR to direct barrier
Right Inferior Pubic Shear Tx (FPR and Still’s)
Flex and compress R knee
Gentle ADduct and IR the Right LE
–inferior motion at pubs
FPR hold for 3-5s
Stills ER to direct barrier
Supine Innominate Shear Treatment (FPR and Still’s)
ER and abduct LE to gap SI Joint
-add compression through foot
FPR hold for 3-5
Stills IR while applying traction
How do you do a simplified sacral motion exam?
Pt is prone, Pillow is placed under abdomen
-direct cephalad force at ILA simultaneously
What is a positive test for the simplified sacral motion exam?
(+)=Diminished cephalad motion
-restriction at one side or other
Prone Sacral FPR Tx
Stand Ipsi to Restricted Side
- Flatten curve w pillow
- Flex ipsi leg off table w knee extended until ILA moves posterior
- Slight abduction at hip and fine tune w IR/ER
- Compress through ILA
- Hold 3-5s
How does exercise benefit elderly?
Most efficient lymph pump Sym/Psym balance Proper perfusion of joints Maintians neuroplasticity Encourages bowel movements
Sitting is the new smoking!
What is an attainable goal for elderly?
150 mins of moderate intensity per week
-start at 5-10 if needed
Swimming, walking, or other low impact
What muscles does the trendeleburg test, test?
Your abductors (gluts)
Which way does your hips dip during a trendelenberg gait?
Will fall away from pathologic side
Will raise toward pathologic side
What are some great exercises to strengthen your gluts?
Body weight stuff with chair
Back Bridge
Clamshell
What are some modified stretches with a chair older pts can do?
Modified:
- psoas (still seems kind of excessive, can’t see my grandma doing that?)
- hamstring
- gastroc
Hold for 20s
What is another way to train older people so they don’t fall?
Practice balance!
-use chair, eyes open and closed
Make harder by extending knee or close eyes
