Medical/General Rehab Flashcards
When in the gait cycle is the center of gravity at its lowest point?
Loading phase
Where is the center of gravity located in gait cycle?
5cm anterior to S2 vertebrae
What are the six determinants of gait?
1) Pelvic tilt - pelvis on side of swinging leg (opposite to weight-bearing) is lowered 4.5 degrees to lower COG at midstance
2) Pelvic Rotation - pelvis rotates medially on swinging leg side, lengthens leg in prep to bear weight
3) Pelvic Lateral excursion - displacement toward the stance limb
4) Foot Mechanisms
5) Knee Mechanisms
6) Knee Flexion - early knee flexion at heel strike
Cause of genu recurvatum?
Treatment options?
weak or overly spastic knee extensors
Spastic or tight plantar flexors
Swedish knee cage
Plantar flexor stretching/spasticity treatment
First muscles to weaken in Duchenne muscular dystrophy?
Neck muscles
What is the relationship between cardiac output, HR and stroke volume?
CO = HR x SV
Cardiac oxygen consumption?
Calculated using the rate-pressure product (RPP)
HR x SBP = cardiac O2 consumption (MVO2)
What scale allows patients to report their perceived level of challenge with an activity?
The Borg scale (6-20)
14-15 is a good level of exercise
What are the phases of cardiac rehabilitation?
Phase 1: inpatient phase
Phase 2: supervised outpatient phase (3-6 months)
Phase 3: less supervised outpatient phase
Phase 4: unsupervised outpatient, maintenance phase
Activity limitations for New York Heart Association (NYHA) Heart Failure 1?
can do anything over 7 METs
No real daily limitations or symptoms
Activity limitations for New York Heart Association (NYHA) Heart Failure 2?
Can do anything between 5-7 METs, dyspnea with more than a little activity
Activity limitations for New York Heart Association (NYHA) Heart Failure 3?
Can do anything between 2-5 METs
Dyspnea with the smallest activities
Activity limitations for New York Heart Association (NYHA) Heart Failure 4?
Can’t really do any activities with comfort
Dyspnea at rest
What are features of a new heart following orthotopic heart transplant (HR, peak HR?)?
New heart is denervated, will have a higher resting HR (lack of vagal influence), lower peak HR, and early atherosclerotic disease (due to being foreign tissue and accelerated inflammatory response)
What are the patient benefits from pulmonary rehabilitation?
increase AVO2 difference - peripheral muscles become more conditioned; thus they take up more oxygen and increase the AVO2 difference (difference b/t O2 content of arterial blood vs. venous blood)
What are the effects of aging on cardiac output, VO2 max, vital capacity, FEV1, muscle mass, # of motor units, swallow function?
All decline
With aerobic and strength conditioning - can increase cardiac output, Hgb, strength
What effect does aging have on fat metabolism/fat-soluble medication considerations?
Aging causes increased fat, careful with dosing with fat-soluble medications
Cancer pts most notably battle what symptoms?
fatigue, pain
Dysphagia also common
Common presentation of brain tumor?
HA
focal weakness, seizures
Common presentation of SCI tumor? Common location?
back pain worse at night
Thoracic extradural location
Most common brain tumor in adults?
astrocytoma (often glioblastoma)
Most common metastatic brain tumors?
lung, breast, GI
Most common brain tumor in children?
cerebellar astrocytoma, medulloblastoma
Most common primary osseous tumor?
osteosarcoma (usually knee)
