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Advanced Spine > M8: 2 > Flashcards

M8: 2 Flashcards

1
Q

Deciding if fatigue is cancer related:

Things to consider

A
  • look at reference ranges for RBC and HgB (watch O2 stats if low)
  • are they having SOB or palpitations?
  • Platelet values: low or have they got significant bleeding that may play a role?
  • How long since last chemo? Consider nadir
  • Any s/s of systemic infection?
  • Any dull or sharp bone pain?
  • Rule all other causes out
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2
Q

What is the most appropriate response to a pt with cancer ℅ new onset bone pain?

A
  • treat them as having metastasis to the bone until proven otherwise
  • confirm with radiograph, bone scan, MRI, or CT
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3
Q

What should lead a PT to suspect bony metastasis?

A

First sign: bone pain that is aching or sharp in nature

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4
Q

What should be done if a bone met is confirmed?

A

Caution should be used to avoid pathologic fx

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5
Q

What is the most common problem affecting cancer survivors?

A

Cancer related fatigue

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6
Q

What does FEWS stand for?

A

Function
Education
Wellness
Safety

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7
Q

Explain the FEWS framework

A

Assures interventions are comprehensive and can be applied to pts with all types of impairments

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8
Q

FEWS

F

A

Function

Optimize pt’s functional status

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9
Q

FEWS

E

A

Education

Educate pt/caregiver

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10
Q

FEWS

W

A

Wellness

Promote wellness to prevent disease progression and/or development of comorbidities

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11
Q

FEWS

S

A

Safety

Stress safety within the pt’s typical environments

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12
Q

When should exercise programs begin for a cancer pt? How long should they continue?

A
  • should begin when pt begins cancer tx

- should continue throughout active tx

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13
Q

What type of program should a cancer pt have?

A
  • warm-up/cool-down for each session
  • flexibility
  • strength
  • aerobic exercise (emphasize this)
  • low/mod intensity
  • progress based on cardio conditioning
  • exercise log
  • SAFETY AT ALL COSTS
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14
Q

From where should you progress a cancer patient (duration/frequency/intensity)?

A

From

15-30 mins
3-5 days/wk
Low-mod intensity » higher (intensity should NOT provoke sx)

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15
Q

What is meant by low-mod intensity?

A

50-70% MHR
RPE 11-13 on Borg scale
Avoid exhaustion

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16
Q

Surgery basics of breast cancer: overall types

A
  1. Breast conservation
  2. Mastectomy
  3. Node dissection
17
Q

Breast conservation

A
  • removal of tumor

- preservation of majority of normal breast tissue

18
Q

Mastectomy

A

Removal of entire breast

19
Q

Node dissection

A
  • lymph nodes assessed during surgery for invasive CA

- can be removed if necessary

20
Q

PT implications for BC

A
  • lymphedema
  • reduced ROM
  • adhesions, fibrosis, soft tissue contracture
  • shoulder mm weakness
  • decreased trunk strength
21
Q

Types of radiation for BC

A

Internal

External

22
Q

What is the most common type of radiation for BC?

A

External beam - radiation delivered to specific breast tissue

23
Q

PT implications for radiation tx (BC)

A
  • fatigue
  • impaired mobility
  • adhesions
24
Q

Systemic therapy types for BC

A
  • chemo
  • hormonal
  • biologic
25
Q

Systemic therapy for BC: PT implications

A

Peripheral neuropathy

26
Q

What are the types of breast reconstructions?

A
  • TRAM
  • DIEP
  • lat dorsi flap
27
Q

TRAM =

A

Transverse abdominal myocutaneous flap

28
Q

What happens with TRAM?

A
  • large elliptical transabdominal incision made

- skin, RA, and underlying fat removed and transferred to chest

29
Q

PT implications for TRAM procedure

A
  • trunk weakness
  • abdominal wall laxity
  • hernia
30
Q

DIEP =

A

Deep inferior epigastric artery perforator

31
Q

What is DIEP?

A
  • spares the RA

- transplants skin, fat, and perforating branches of deep inferior epigastric artery

32
Q

What is the lat dorsi flap procedure?

A

skin, subcutaneous fat, and ipsilateral lat is transplanted

33
Q

Lat dorsi flap procedure

PT implications

A

decreased strength/mobility of shoulder due to adhesions of scar tissue to underlying tissue

34
Q

Which reconstruction procedures keep their original blood supplies?

A
  • lat flap

- TRAM

35
Q

Which reconstruction has the least of the implications for PT and why?

A
  • DIEP
  • doesn’t cut through any muscles
  • Plus, you get rid of the pooch!

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