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Lifespan- Geriactrics > Lifespan Final- PART 2 > Flashcards

Lifespan Final- PART 2 Flashcards

1
Q

Principles of geriatric rehab: regain _ _ _; recover lost _, _ and _ skills; achieve _, live in personally satisfying _, maintain _ _ _.

A

Principles of geriatric rehab:

  • regain MAXIMUM FUNCTIONAL CAPABILITY
  • recover lost PHYSICAL, PSYCHOLOGICAL, AND SOCIAL SKILLS
  • achieve INDEPENDENCE, live in personally satisfying ENVIRONMENT, maintain MEANINGFUL SOCIAL INTERACTIONS
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2
Q

More than any other age group there is _ _ in the geriatric population. Chronological age is a _ _ of _ and _ function.

A

More than any other age group there is EXTREME VARIABILITY in the geriatric population.

Chronological age is a POOR INDICATOR of PHYSICAL AND COGNITIVE function.

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3
Q

Individuals the same chronological age will show varying levels of decline in? (4)

A

MS RV

  • mental ability
  • strength
  • reaction time
  • visual capabilities
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4
Q

The single most important reason for loss of function in the elderly is? 3 catagories?

A

Most important reason for loss of function in the elderly is INACTIVITY

3 catagories:(CAD)

  • chronic immobilization
  • acute mobilization
  • deconditioning
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5
Q

Trauma, fractures, infections, and acute neurological insults (CVA) are all examples of _ _

A

All examples of ACUTE IMMOBILIZATION

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6
Q

Cardiac and pulmonary diseases, LBP, progressive neurological diseases, amputations and arthritis are all examples of?

A

All examples of CHRONIC IMMOBILIZATION

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7
Q

_ is defined as multiple changes in organ systems physiology that are induced by inactivity and reversed by activity. Dependent upon _ of _ and _ _ of _.

A

DECONDITIONING is defined as multiple changes . . .

Dependent upon DEGREE of INACTIVITY and PRIOR LEVEL of FITNESS

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8
Q

_ _ is defined by the _ as a state of complete physical, mental and social well-being, not merely the absence of disease

A

OPTIMAL HEALTH is defined by the WHO as a state of complete physical, mental and social well-being, not merely the absence of disease.

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9
Q

Optimal health is directly related to _ _, and the greater the _ _, the greater the _, the more likely the sense of -.

A

Optimal health is directly related to FUNCTIONAL ABILITY, and the greater the FUNCTIONAL ABILITY the greater the INDEPENDENCE, the more likely the sense of WELL-BEING

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10
Q

Greater levels of independence are associated with: fewer _, lower _ _, and lower _ of _.

A

Are associated with:

  • fewer HOSPITALIZATIONS
  • lower MORTALITY RATES
  • lower RATES OF INSTITUTIONALIZATION
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11
Q

Geriatric PT’s need to be good _/ _ to detect _ _ _ to avoid a _ _ later (4-tions), and to assess _ and _ _ to improve optimal health.

A

Need to be good EVALUATORS/ SCREENERS to detect MINOR PROBLEMS EARLY to avoid MAJOR PROBLEMS later, and to assess COGNITIVE AND SOCIAL NEEDS to improve optimal health.

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12
Q

_ _ is the corner stone of geriatric rehab. Identifies those _ _ who therefore _ _. Provides information on _ to _.

A

FUNCTIONAL ASSESSMENT is the cornerstone of geriatric rehab.

Identifies those AT RISK who therefore REQUIRE INTERVENTION

Provides information on HOW TO INTERVENE

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13
Q

What are the 3 major functional assessments that are looked at in the geriatric population?

A

FAM

  • Fall assessment
  • ADL assessment
  • Mobility assessment
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14
Q

_ and _ are two types of ADL’s that are functionally assessed. What do they stand for/ brief description.

A

IADL’s (instrumental activities of daily living- include: driving, shopping, housekeeping, cooking, laundry, managing money)

BADL’s (basic activities of daily living- include: bathing, dressing, toileting, and feeding)

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15
Q

What are these functional tests used to assess: Duke mobility scale, POMA, DGI?

A

Mobility assessments

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16
Q

What are these functional tests used to assess: Barthél Index, Katz ADL score?

A

ADL’s

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17
Q

The Berg balance, functional reach test, timed-up and go, ABC (activities specific balance test) and the Falls efficacy scale are all used to assess?

A

Used to assess fall risk

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18
Q

What are the 4 parts of Medicare?

A

Part A, B, C, D

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19
Q

Medicare Part A is basically _ insurance, it is provided typically _ a _ _ and covers? (5)

A

Medicare part A is basically HOSPITAL insurance, it is provided typically WITHOUT A MONTHLY PREMIUM

Covers (IS HHH)

  • Inpatient rehab
  • SNF
  • Hospitalization
  • Hospice
  • Home Health
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20
Q

Medicare Part B is basically _ insurance and requires a _ _. Pays _% of fees, and covers? (3)

A

Is basically MEDICAL INSURANCE and requires a MONTHLY PREMIUM

Pays 80% of fees

Covers (SOP)

  • Some equipment
  • outpatient PT
  • Physicians services
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21
Q

Medicare part C or _ _ includes Medicare _ and , Medicare for _ _ and Medicare _ --.

A

Medicare part C or MEDICARE ADVANTAGE includes Medicare HMO AND PPO, Medicare for SPECIAL NEEDS and Medicare PRIVATE FEE- FOR - SERVICE.

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22
Q

Medicare part D is the _ _ _.

A

Medicare part D is the PRESCRIPTION DRUG PLAN

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23
Q

In what type of setting must the patient be medically stable, have the ability to respond to commands, and be physically capable for 3 hours of combined therapy per day?

A

Inpatient rehab unit/ center

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24
Q

To be eligible for a SNF patient must have a qualifying acute hospital stay of _ _ days, be transferred to the SNF within _ _ of _; and receive care in the SNF for the _ _ that was _ in the _.

A

Must have a qualifying acute hospital stay of 3 CONSECUTIVE DAYS, be transferred to the SNF within 30 DAYS OF DISCHARGE; and receive care in the SNF for the SAME CONDITION that was TREATED in the HOSPITAL

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25
Patient may be admitted to _ _ _ for any reason, or following hospital stay, SNF discharge or doctors visit. Is the _ _ referred Environment.
Patient may be admitted to a HOME HEALTH SERVICE for any reason . . . Is the MOST COMMONLY referred environment
26
_ _ covers all therapies but is limited by therapy caps. It is determined on a _ _ _ by diagnosis, PT and SLP have a combined cap of _ which can be raised to _ if there is a documented need. Medicare will cover 80% and _ is _ for 20%.
OUTPATIENT REHABILITATION covers all therapies but is limited by therapy caps. It is determined on a CALENDAR YEAR BASIS by diagnosis, PT and SLP have a combined cap of $1960 which can be raised to $3700 Medicare will cover 80% and PATIENT IS RESPONSIBLE for 20%
27
Hospice care is primarily symptom management and pain control in the _ _. Used for the final _ _ of life, PT service is not extensive usually consists of _/ _ _.
Primarily symptom management and pain control in the PATIENTS HOME Used for final 6 MONTHS of life PT service is not extensive and usually consists of PATIENT/ CAREGIVER TRAINING
28
2 main pathological changes in the spine?
Lumbar stenosis | Vertebral compression fx
29
Net result of spinal changes in the spine is loss of _, _ and _ _.
Loss of STRENGTH, ROM, and POSSIBLY PAIN
30
Lumbar stenosis is narrowing of the _ _, typically due to _. Causes pain in the _, _ and/ or _ that worsens with _ or _. Is relieved by _.
Lumbar stenosis is narrowing of the VERTEBRAL FORAMEN, typically due to OSTEOPHYTES Causes pain in the HIP, LEG, AND/ OR BACK that worsens with WALKING OR EXTENSION Is relieved by FLEXION
31
PT Intervention for Lumbar stenosis includes: _ exercises, _ for pain and spasms and _ _ with dynamic stabilization.
Includes: - FLEXION exercises - MODALITIES for pain and spasms - FLEXION BIAS with dynamic stablization.
32
Vertebral compression fractures typically occur in the _ _ and _ _ spine. Usually due to _, sometimes it can happen _. In the acute phase _ is the treatment of choice with _ _ min/ hour.
Typically occur in the LOWER THORACIC and UPPER LUMBAR spine Usually due to ACTIVITY, sometimes can happen GRADUALLY In the acute phase, BEDREST is the treatment of choice with OOB 10 min/ hour
33
PT intervention for Vertebral compression fractures includes: _ followed by _ with _; _ for pain, and _ _ with dynamic stabilization.
Includes: - BRACING followed by BRACING with STRENGTHENING - MODALITIES for pain - EXTENSION BIAS with dynamic stablization
34
_ _ or _ _ is often coupled with RC problems in the elderly (secondary _ _). Capsular pattern is _ greater than _ greater than _. Pain occurs at _ _.
ADHESIVE CAPSULITIS or FROZEN SHOULDER is often coupled with RC problems in the elderly (secondary FROZEN SHOULDER) Capsular pattern in ER greater than ABDUCTION greater than FLEXION Pain occurs at END RANGE
35
4 PT interventions for adhesive capsulitis include: _, _ mobilizations, _, and correction of _ _.
Includes: - MODALITIES - JOINT mobilizations - STRETCHING - correction of PRIMARY PROBLEM
36
A _ _ is a fracture of the distal radius. Is usually caused by a _ _, and is casted for _ _.
A COLLES FRACTURE is a fracture of the distal radius Usually caused by a FOOSH INJURY and is casted for 4 WEEKS
37
PT intervention for a Colles Fracture includes: _, specifically _ _; gentle _ and _ mobilization; _; _ _ _ by week 6 (surgeon dependent).
Includes: - MODALITIES, specifically PARAFFIN BATH - gentle ROM and JOINT mobilization - AROM - PROGRESSIVE RESISTIVE EXERCISES (PRE) by week 6
38
_ _ is the most common orthopedic injury/ condition in the elderly. Usually requires _ _.
HIP FRACTURE is the most common Ortho injury/ condition in the elderly Usually requires INTERNAL FIXATION (rods, screws and plates, pins, nails)
39
What are the 4 main types of hip fractures? Typically occur in? (2)
F PT S - femoral neck fractures* - proximal femur fractures - trochanteric fracture* - sub trochanteric fractures *= typically occur in
40
Subcapital, transcervical and basilar are all types of _ _ _. Will usually have _/ _ from _. What is an important question to ask?
Are all types of FEMORAL NECK FRACTURES. Will usually have PRECAUTIONS/ PROTOCOLS from SURGEON Important to ask- did they have to go through the capsule?
41
2 types of trochanteric fractures are _ _ between the lesser and greater trochanters and _ through the _. Has a _ _ _ than femoral neck fractures.
INTERTROCHANTERIC FRACTURES- between the lesser and greater trochanters PERITROCHANTERIC FRACTURES- through the trochanters Has a QUICKER REHAB TIME than femoral neck fractures
42
PT treatment for hip fractures includes: typically treated on a _ _; may be _ or _ depending upon type of internal fixation; _ training; _; _
Includes: - typically treated on a PROTOCOL BASIS - may be PWB or TTWB depending on type of internal fixation - GAIT training - ROM - STRENGTHENING
43
_ _ _ involves the replacement of the femoral head and acetabulum (typically _ _ _). Is performed because of _ _ _ of the hip when conservative management has failed and _ _ that are not _.
TOTAL HIP ARTHROPLASTY involves the replacement of the acetabulum and femoral head (typically BOTH ARE REPLACED) Is performed because of: - ADVANCED ARTICULAR DISEASE of the hip when . . . - HIP FRACTURES that are not REPAIRABLE
44
Hip prosthesis: the bigger the femoral head the _ _, and the _ the lining, the _ they can make the _ _.
Bigger femoral head= more stable Thinner the lining, the BIGGER they can make the FEMORAL HEAD
45
3 types of THA approaches? Which is the most common? Which is becoming more popular?
3 types: (PAL) - posterolateral (most common) - anteriolateral (becoming more popular) - lateral
46
Which THA is being described: incision is anterior to the greater trochanter. Precautions include _ _ past _ and _.
Anterior approach Precautions include HIP EXTENSION past NEUTRAL and ER
47
Which THA is being described: incision is over the greater trochanter, the IT band is divided and Glute Med is incised? _ common.
Lateral approach LESS common
48
With the posterolateral approach the incision is _ to the greater trochanter and _ _ is split.
The incision is POSTERIOR to the greater trochanter and the GLUTE MAX is split
49
_ _ is used more frequently in the ER and for non-elective surgery. _ _ is often preferred if surgery is elective.
POSTEROLATERAL APPROACH is more frequently in ER/ non-elective LATERAL APPROACH is often preferred for elective surgery
50
What are the 3 types of fixation seen with THA? Which one is good for older and/ or osteoporotic patient?
CNH (pure can sugar that's the one) Cemented *good for older/ osteoporotic patients Non-cemented Hybrid
51
_ _ _is not standardized and is based on the individual preferences of the surgeon. Commonly cemented femoral stems are _ to _ and uncemented femoral stems are _.
WEIGHT BEARING STATUS is not standardized . . . Commonly: - cemented = PWB to WBAT - uncemented = TTWB
52
THA precautions attempt to _ _. Patients with _ or _ _ are at the highest risk for _.
Attempt to PREVENT DISLOCATIONS Patients with REVISIONS OR PREVIOUS DISLOCATIONS are at the highest risk for DISLOCATIONS
53
Precautions for Both the posterolateral and lateral approaches: No _ _ past 90 degrees, no _ _ past _, and _ past neutral.
No HIP FLEXION past 90 degrees No ADDUCTION past MIDLINE No IR past neutral
54
Leg length discrepancy post THA: the operated side is _ _, and it is more of a problem if it is _ _. True leg length discrepancy will require a _ _ but typically it is not addressed for _ _ post surgery. (Usually _ _). Always _.
The operated side is USUALLY LONGER, and it is more of a problem if it is TOO SHORT True leg length discrepancy will require a SHOE LIFT but typically it is not addressed for SEVERAL MONTHS (usually 6 MONTHS) Always ASSESS!
55
Ankle pumps, heel slides, hip abduction and isometric adduction, TKE are all examples of _ _ for THA patients that are performed in _. Avoid?
Are all examples of EXERCISES PRESCRIBED for THA patients that are performed in SUPINE AVOID SLR'S
56
Knee _ performed in _ are often prescribed for THA patients.
Knee EXTENSIONS performed in SITTING are often prescribed
57
Exercises prescribed for THA patients in standing include: hip flexion _ _ 90 degrees with the knee _, hip _, knee _, and _ _.
``` Includes: Hip flexion LESS THAN 90 degrees with knee FLEXED Hip ABDUCTION Knee FLEXION HEEL RAISES ```
58
Precautions for driving after a THA: as early as _ _ for a _ hip (unless they drive _ _) and typically _ _ for a _ hip.
As early as 3 WEEKS- for a LEFT hip (unless they drive A STICK) Typically 3 MONTHS for a RIGHT hip
59
55% of patients post THA are able to return to _ _ _ within 2 months
NORMAL SEXUAL ACTIVITY within 2 months
60
_ is indicated for advanced articular disease of the knee when conservative management has failed. It is a very _ procedure however it is more _ than a THA and has more _ _ _ than a THA.
TKA is indicated for advance . . . It is a very SUCESSFUL procedure however it is MORE PAINFUL than a THA and has MORE RISK OF INFECTION than a THA
61
What are the 3 types of approaches seen with TKA?
CUM - conventional - unicompartmental - minimally invasive
62
With a _ _ the incision is approx. 8-10 inches long and cuts through a portion of the VMO.
With a CONVENTIONAL APPROACH
63
With a minimally invasive approach the incision is _, spares _, _ tissue _, and is more _ for _ to access.
The incision is SHORTER, spares VMO, LESS tissue DISRUPTION, and is more DIFFICULT FOR SURGEON to access
64
_ _ only replaces the medial and lateral compartment, uses a shorter incision than _ approach, has less tissue disruption, and has a quicker recovery time. Is becoming _ _.
UNICOMPARTMENTAL APPROACH only replaces the medial and lateral compartment, uses a shorter incision than CONVENTIONAL approach . .. Is becoming MORE POPULAR
65
Use of a _ _ is widespread but remains controversial. According to the literature is provides: increased knee _ _, decreased _, and decreased number of _. Not found to affect knee _ _ or length of _ _.
Use of CPM MACHINE is widespread . . According to the literature it provides: increased knee FLEXION ROM, decreased SWELLING, and decreased number of MANIPULATIONS. Not found to affect KNEE EXTENSION ROM or length of HOSPITAL STAY
66
ROM requirements for knee flexion: _ _ for swing phase of gait, _ _ needed for most ADL's, and_ _ needed to rise from chair.
65 DEGREES for swing phase of gait 90 DEGREES for most ADL's 105 DEGREES to rise from chair
67
Driving precautions for TKA are?
SAME AS HIP - 3 weeks for left knee - 3 months for right knee
68
Return to sports after TKA: there is _ or _ _ _ with cycling or power walking, there is _ _ _ in jogging and downhill skiing.
There is NO OR MINIMAL JOINT OVERLOAD- cycling or power walking There is EXCESSIVE JOINT OVERLOAD- jogging and downhill skiing
69
A _ is defined as an unplanned, unexpected contact with a supporting surface.
a FALL is defined as an . . . .
70
Intrinsic risk factors for falling amongst the elderly include: _ impairments, _/ _ changes, _ system changes, _ deficits, _, _ of falling, _ and _
Include: - VISUAL impairments - PROPRIOCEPTIVE/ KINESTHETIC changes - VESTIBULAR system changes - MUSCULOSKELETAL deficits - MEDICATIONS - FEAR of falling - ATTENTION - DEPRESSION
71
Elderly with _ _ are at greater risk for falling
Elderly with POOR VISION are at greater risk
72
_ _ is the most common vestibular threat to balance.
VESTIBULAR DEHABITUATION
73
Weakness in the _ _ is a significant risk factor for falling and is considered an indicator of fall risk. Specifically? (3)
Weakness in the LOWER EXTREMITIES is a significant risk . . . Specifically: - QUADS - GLUTES/ HIP EXTENSORS - DORSIFLEXORS
74
Regardless of the type more than _ _ significantly increase the risk for falling
Regardless of the type more than 4 MEDICATIONS significantly increases the . . .
75
_ of _ is ranked as the #1 most _ _ in the elderly.
FEAR OF FALLING is ranked as the # most COMMON FEAR in the elderly
76
More than _ of those over 62 have a fear of falling, and _% of elderly _ _ due to fear of falling
More than HALF of those over 62 56% of elderly CURTAIL ACTIVITIES due to fear of falling
77
There is a potential increase in fall risk when _ is _ from the _ _. _ _ creates mobility impairment is the older population.
There is a potential increase in fall risk when ATTENTION IS DRAWN from the CURRENT TASK DIVIDED ATTENTION creates mobility impairments in the older population
78
Risk factor for falls and _ are highly correlated.
Risk factor for falls and DEPRESSION are highly correlated.
79
_ _ _ are associated with the environment and include?(6)
EXTRINSIC RISK FACTORS are associated with environment Includes: BLKS FW - bathroom (low toilet, no bars or shower seat, slippery tub) - lighting (especially at night) - kitchen (slick flooring, step stool w/out rail) - stairs (slick or lacking visual edges, inadequate railing) - flooring (loose carpet, uneven edges, throw rugs)
80
Intervention programs for fall prevention are _ _ when they are designed to reach those at _ _ for _.
Are MOST EFFECTIVE when they are designed to reach those at GREATEST RISK for FALLING
81
The most effective fall prevention interventions include _ _.
Include MULTIPLE COMPONENTS
82
Including _, _ review with modification, and _ about _ _ can reduce falls among community dwelling older adults
Including EXERCISE, MEDICATION review with modification, and EDUCATION ABOUT RISK FACTORS can reduce falls in . . .
83
Exercises that improve _ _ _ and _ reduce the risk of falls and fall related injuries.
Exercises that improve LOWER BODY STRENGTH AND BALANCE reduce the risk of falls and fall related injuries.
84
Among frail individuals living in nursing homes _ _ _ can increase _ and improve _.
. . . .PROGRESSIVE RESISTIVE EXERCISES can increase STRENGTH and improve MOBILITY
85
Simple _ _ _ can accurately _ _ who are _ _ to _.
Simple CLINICAL SCREENING TESTS can accurately IDENTIFY SENIORS who are MORE LIKELY TO FALL

Lifespan- Geriactrics (4 decks)

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