Misc Flashcards
Uveitis is commonly associated with what condition
Ankylosing spondylitis
Reiter syndrome (reactive arthritis)
“can’t see, can’t pee, can’t take a knee”
hallmark symptoms are:
conjunctivitis
frequent UTI
joint arthritis
Best method of practice for long term retention
Distributed, variable practice
Active vs Passive insufficiency
Active: multi joint muscle is activated (thus shortened) leading to decreased tension and strength
Active/passive insufficiency:
With the knee extended, you can only achieve 80 degrees of hip flexion
Your patient achieves more flexion (120) at the hip with the knee flexed
Passive insufficiency
The hamstring is stretched when the knee is extended, thus limiting hip flexion
Grades of concussion
Grade 1 - no loss of consciousness, transient confusion, symptoms resolve in less than 15 mins
Grade 2 - no loss of consciousness, transient confusion, symptoms resolve in more than 15 mins
Grade 3 - loss of consciousness
Compensations associated with seat depth that is too deep
posterior pelvic tilt/sacral sitting
increased kyphosis
lack of circulation posterior knee
Examples of ordinal data in PT
pain (can be a large difference between 7/8 and 10/10 - subjective)
MMT
levels of assistance
Median
Examples of interval data in PT
temperature
Examples of ratio data in PT
ROM, gait speed, time, NCV
Normal balance grade
able to stand with no support, accepts max challenge of dynamic shifting of weight in all directions
Good balance grade
maintain balance witout handheld support, only accepts moderate challenge with weight shift
ex. able to pick item off floor
Fair balance grade
Able to maintain balance with handheld support
Able to maintain balance with head or trunk turns
Poor balance
requires handheld support and mod to max assist
no dynamic balance
Mild TBI
loss of conciousness less than 30 mins
GCS 13-15
less than 1 day of amnesia
GCS 13-15
Mild TBI
GCS 9-12
Moderate TBI
GCS less than 9
Severe TBI
Moderate TBI
30 mins - 24 hours unconsciousness
1-7 days amnesia
GCS 9-12
Severe TBI
loss of consciousness 24 hours+
7+ days amnesia
GCS less than 9
Ranchos Los Amigos scale acronym
NiGL
Confused, AIA
6 and 7 normal
Level 1 Ranchos
no response
Level 2 Ranchos
Generalized response
very limited, nonpurposeful and inconsistent responses
GCS scoring
4, E
5, v
6, m
Level 3 Ranchos
Localized response - responds specifically and consistently to external stimuli; can follow simple motor commands
Level 4 Ranchos
Confused, agitated
short attention span, no recall, nonpurposeful
Level 5 Ranchos
Confused, inappropriate (not agitated)
nonpurposeful responses, new info not retained well, memory and attention impaired
Level 6 Ranchos
Confused, appropriate
can give appropriate responses
carryover from relearned tasks, but no new memory
dependent on cueing for direction
Level 7 Ranchos
behaves appropriately, ADLs are automatic
still shows slower than normal retention of new tasks but able to learn
judgement remains impaired
Level 8 Ranchos
Reasoning decreased compared to baseline but otherwise normal
If patient has to sit down during 6MWT, how does that affect your scoring?
Only record distance UP TO point which they sit down
Patient can take standing rest breaks with this test, but sitting would end the amount of distance recorded
Isokinetic exercises
By definition, speed remains constant, resistance varies
Biodex
Bike
Closed motor skills
stable, predictable environment such as walking in a quiet hall, practicing transfers in a quiet room, or brushing teeth in a bathroom.
Open motor skills
walking across a busy gym, reception area, or a shopping mall, and driving on a busy highway
Complex motor skills
coordinated movement response such as running and kicking a soccer ball during a game, or completing a gymnastics routine
Pinch an inch test
pinch over mcburneys point, let skin go
if it slaps back and produces pain - positive test
Obtunded
diminished arousal and awareness where the patient is difficult to arouse from sleep, and once aroused, appears confused. The patient responds slowly and demonstrates little interest in or awareness of the environment.
Lethargic
level of arousal is diminished. The lethargic patient easily falls asleep if not continually stimulated and does not fully appreciate the environment.
Obtunded vs Stupor
once aroused, appears confused, slowly drifts back
can only be aroused with vigorous or unpleasant stimuli
stupor is worse
Stupor
state of altered mental status and responsiveness to one’s environment, and can only be aroused with vigorous or unpleasant stimul
How do diuretics work
increase excretion of sodium and urine - reducing plasma volume = decreaseing BP
ACE inhibitors how do they work
decrease BP by blocking enzyme that converts angiotension 1 to 2 (these are potent vasoconstrictors)
How does digitalis work
positive inotropic agents improve cardiac pumping ability
Decreases HR increases force of contraction
used to improve the primary symptoms of CHF
Hemoptysis
(coughing up blood) is a sign of pulmonary or bronchial hemorrhage
not really a 911 emergency, but contraindication to percussion and vibration therapy
Symptoms of respiratory acidosis
dsypnea
restlessness
anxiety
Calcium channel blockers are most commonly prescribed for
HTN
cardiac arrythmias
Diuretics are most commonly prescribed for
CHF
Cor pulmonale
right sided heart failure
jugular vein distension
Terminate exercise session BP redings
250 or more systolic
115 or more diastolic
Operant conditioning
engaging in certain behaviors in order to receive certian reward
Classical conditioning
unconditioned stimulus (e.g., food) is repeatedly preceded by a neutral stimulus (e.g., bell).
2 stimuli are repeatedly paired
Retrograde amnesia
acute onset amnesia where there is a loss of memory for events immediately prior to the onset of the disorder.
Anterograde amnesia
acute onset amnesia where there is a loss of memory for events immediately following the onset of the disorder.
Procedural memory
memory of how to do certain things
riding bike, tying shoes, cooking, musical instrument
LE extensor spasticity can be helpful with what functional movement
sit to stand
Cauda equina sympotms
bladder/bowel dysfunction
saddle perineum anesthesia
LMN signs - hyporeflexia
bilateral or unilateral LE weakness
Testing olfactory nerve
test one nostril at a time
Working memory
temporarily holds information in storage for short periods, and is used to guide decision-making
ex remembering a cell phone number or address someone just sent you
episodic memory
recalling past personal experiences
Primary prevention
preventing a target condition in a susceptible or potentially susceptible population
general health promotion
Secondary prevention
early disease detection in healthy individuals;
diagnosis and prompt intervention
ex. annual mammogram
Tertiary prevention
is limiting the degree of disability and promoting rehabilitation and restoration of function in patients with chronic and irreversible conditions.
Common medications for epilepsy
Secondal, Tegretol, Klonopin, Dilantin
STKD
Common meds for MS
Baclofen, corticosteriods, SSRI
MS increased or decreased tone
increased
Which muscles are typically affected first with MG
ocular
X linked recessive disorder
DMD
Autosomal dominant disorder
Huntingtons disease
Swan Ganz catheter
monitors pulmonary artery pressure (PAP) and central venous pressure (CVP)
Ruebela precaution
measles - airborne
Whooping cough precaution
droplet
SACH foot
often the basic first foot
little motion in any direction
cushion heel permits early PF
SAFE foot
allows walking on uneven surface
heavier than sach
Seattle foot
slightly flexible plastic keel
bends at heel and stores energy
Flex foot
Carbon fiber
long toe acts as leaf spring and stores energy in late toe off
Single xis foot
no lateral or transverse motion
only sagittal plane PF and DF
Multi axis foot
allows slight movement in all planes
good for uneven surfaces
not very durable and heavy
To test. vertebral artery you should rotate toward or away
away - gets kinking
DCML produces fine or crude touch
fine
DCML decussates where
medulla
Slight subluxation of a hemi shoulder can be treated with
sitting weightbearing, weight shifting
Dislocation of shoulder most commonly will affect
axillary nerve - deltoid weakness
Type 1 error
false positive
Type 2 error
false negative
Erbs palsy - hand is held in
waiter tip position
adduction, forearm pronation, wrist/finger flex
How to examine visual field
confrontation test
Who are three people who can have access to PHI without pt consent
Insurance payor
State agency
Another provider on their case
Pectus carinotum
pigeon chest - decreased thoracic expansion
Acoutic neuroma - unilateral hypofunction best treatment
movements that provoke dizziness and vertigo - habituation
Prostheitc - Excessive knee flexion in early stance =
socket too far anterior
K0 prosthetic
Non ambulatory
K1 prosthetic
Household ambulator, transfers
K2 prosthetic
Limited community ambulator - can go up stair or curb but not doing a lot
K3 prosthetic
Ability or potential to be full community ambulator, variable cadence - negotiate most barriers
Best treatment strategy for festinating gait
toe wedge to prevent LOB anteriorly during gait
apparently increasing cadence or step length does no good here
K4 prosthetic
ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high impact, stress or energy levels. This is typical of the prosthetic demands of the child, active adult or athlete.
