Fundamentals of PTA Week 2 Lab Flashcards
LSP and SSP
Long sitting position - leg extended
Short sitting position - E.g. on a chair
What is joint contracture
A shortening of muscles, tendons, skin, and nearby soft tissues causes the joints to shorten and become very stiff, preventing normal movement.
E.g. knee flexion contracture
Why should a patient’s position be altered frequently?
- To avoid excessive or prolonged pressure, to reduce the development of contractures, to avoid postural malalignment, and to prevent other adverse effects.
- The functional ability or capacity of the patient may be compromised because of problems caused by improper positioning techniques, which may affect the patient’s independence or quality of life.
What is a pressure source
Tissue breakdown
- Common sites include the back of the head and ears, the shoulders, the elbows, the lower back and buttocks, the sit bones, the hips, the inner knees, and the heels. Pressure injuries may also form in places where the skin folds over itself. And they can occur where medical equipment puts pressure on the skin.
Causes ulcers.
What is a dependent position
Hanging down, below the mean level of the body, therefore not emptying the veins passively.
AKA and BKA are also called?
What to avoid?
AKA - Transfemoral amputation; avoid prolonged hip flexion and hip abduction; maintain neutral pelvis
BKA - Transtibial amputation; avoid prolonged hip and knee flexion
What is hemiplegia
Paralysis of one side of the body
- Avoid prolonged shoulder add. and internal rotation, elbow flexion, forearm supination/pronation, wrist, finger or thumb flexion, and finger/thumb adduction. - Avoid prolonged hip/knee flexion, hip external rotation, and ankle plantar flexion and inversion.
- Do not pull on affected UE or LE - may dislocate joints or stretch the joint capsule
- Hemiparesis - weakness or an inability to move on one side of the body.
Flexor synergy spasticity/ flaccidity
Stiff or rigid muscles; increase in tone/ decrease in tone
What is Valsalva maneuver and what happens?
Forced expiration against closed glottis
↑ BP may cause CVA
↓ Cardiac output
Where is the center of gravity in the human body?
Anterior to S2
Important to keep center of gravity within base of support to maintain stability and balance
What are examples of pain sensitive structures?
- Ligaments
- Lumbodorsal fascia
- IVD
- Vertebral facets
- Nerve roots
- Muscle tissue
- Vertebral body
What are the reasons for the proper use of body mechanics and core stability?
- Conserve energy
- Reduces stress and strain on body structure
- Reduce risk of personal injury
- Leads to safe movements of the spine
- Promotes and maintains proper body control and balance
- Promotes effective and efficient respiratory and cardiopulmonary function
Deep squat vs knee bend
Deep squat - knees outside; muscles can take up effects of gravity
Knee bend knees over toes - force on the knee joint
The diaphragm is innervated by…?
Phrenic nerve (C3-C5 nerve roots)
What position to avoid for patients with burns and grafts?
- Positions of comfort to minimize the risk of contractures
- Avoid any motions that would cause shearing - sliding
What are the precautions for patients with THR (posterior)
- No hip flexion beyond 90
- No crossing past midline
- No IR
- Utilize reclining w/c
- No upright sitting position
- No rolling on their side
- Educate them during transfers
What are the precautions for patients with THR (anterior)
- No hip flexion beyond 90
- No crossing past midline
- No IR
- No extension
- Utilize reclining w/c
- No upright sitting position
- No rolling on their side
- Educate them during transfers
What is the elbow joint also called?
Humeroulnar joint
What is the shoulder joint also called?
Glenohumeral joint
What is the hip joint also called?
Acetabulofemoral joint
What is the joint that allows pro/supination of the hand when elbow is flexed?
Proximal radioulnar joint
Tendon vs ligament
Tendon - muscle to bone; causes strain
Ligament - bone to bone; causes sprain
Pronation and supination of feet often caused by?
Pronation - flat feet
Supination - high arch
What are the three cardinal planes of motion that make up foot pronation in NWB?
DAB-E: Dorsiflexion, abduction, and eversion
What are the three cardinal planes of motion that make up foot supination in NWB?
PAD-I: Plantarflexion, adduction and inversion
Positions to avoid for BKA and AKA patients
- Avoid prolonged hip (and knee) flexion
- Limit sitting to 40 min/hr.
- Elevation of limb only a few min/hr.
- Encourage extension
What is Stand by Assistance
Pt. requires verbal or tactile cues
What is Contact guarding?
Hands are on patient
When a patient is independent it means…
Pt. can perform transfer without any type of asst. (verbal or manual)
When a patient is dependent it means…
Pt. requires total physical asst. from 2 or more people to transfer
What is Max. Assistance?
Patient performs 25-50%
What is Mod. Assistance?
Patient performs 50-75%
What is Min. Assistance?
Patient performs 75% or more; therapist performs the rest
What are examples of bed mobility?
- Bend knees up, roll to side, let legs off bed, push to sitting with UE’s
- Raise up on arms, slide one leg out at a time while scooting bottom toward edge of bed
Where should a pillow be placed in supine?
- Under head
- Behind knees: to relieve lumbar lordosis and for comfort
- Under ankles: to relieve pressure on heel
Where should a pillow be placed in prone?
- Under head
- Under lower abdomen: reduce lumbar lordosis
- Under anterior portion of the ankles: relieve stress on the hamstring and feet; allow pelvis and lower back to relax
- Under anterior shoulder area to adduct the scapulae; avoid rhomboids lengthening
Where should a pillow be placed in side-lying?
- Between knees
- Under upper arm
- Behind back
Deep squat lift
- Hips below knees
- Feet straddling the object
- Grasp handles, or bottom
Power lift
- Half squat; hips above knees
- Maintain more vertical trunk and lumbar spine in lordosis with anterior pelvic tilt
Straight leg lift
- Knees slightly bent/straight
- Trunk is vertical/horizontal
- Lumbar spine in lordosis
One leg stance
- Golfer’s lift
- Weight shifted onto the forward leg
- Partially flex hip and knee on weight bearing leg
- Extend non weight bearing leg
Half kneeling lift
- Kneel on one knee
