Mo's Study Guide Flashcards
1
Q
Cystocele
A
refers to a forward and downward displacement of the bladder within the pelvic cavity. Cystocele can result from delivery-related muscle weakness or injury to the bladder’s supporting structures.
2
Q
The primary use of a tilt table
A
to provide low grade stress to a patient’s circulatory system to force it to adapt to upright positioning. Initially, the body will have difficulty maintaining blood flow to the brain as the patient attains a vertical position. This will result in symptoms such as dizziness, perspiration, lower extremity edema, and nausea. With training, the circulatory system will improve its ability to continue supplying blood to the brain in an upright position.
3
Q
Homonymous hemianopsia
A
is a condition where a visual field cut exists often due to damage to the middle cerebral artery. This is most common with a right cerebral vascular accident and typically accompanies visual neglect. Visual field cuts can inhibit a patient’s performance with activities of daily living if the patient cannot effectively compensate for the visual loss.
4
Q
The cool down period
A
prevents pooling of the blood within the extremities by continuing to use the muscles and maintaining venous return. The cool down period can also assist in preventing myocardial ischemia, arrhythmias, and other cardiovascular complications.
5
Q
Somatognosia
A
is an impairment of body schema where there is a lack of awareness of a body structure and its relationship to other body parts, to oneself or to others. This patient is attempting to brush their hair, however, does not realize that the mirror image is not the true body part.
6
Q
Anosognosia
A
a severe denial or awareness of the presence or severity of one’s neurologic defect or illness in general, especially paralysis. Patient’s may deny that a paretic extremity belongs to them or lie as to the reasons for why an extremity doesn’t move as it should.
7
Q
Apraxia
A
the inability to perform purposeful learned movements or activities despite the absence of a motor or sensory impairment that would hinder completion of the task.
8
Q
Isokinetic exercise
A
involves constant speed of movement, which is modulated by a machine that provides variable levels of resistance.
9
Q
hyperglycemia
A
the patient’s breath will have a sweet odor due to abnormally high blood sugar levels
10
Q
Hypoglycemia
A
occurs when there is an overabundance of insulin. Irritability and pallor would be most likely present in a patient who is hypoglycemic
11
Q
Hypoglycemia
A
occurs when there is an overabundance of insulin. Irritability and pallor would be most likely present in a patient who is hypoglycemic
12
Q
Hypercalcemia
A
would be more likely to result in muscle weakness and cardiac arrhythmias.
13
Q
Hypocalcemia
A
is typically defined with by cramps, numbness, and tingling in the extremities
14
Q
Thrombophlebitis
A
or deep vein thrombosis, is a critical postoperative concern. Deep aching calf pain is one symptom of this condition.
15
Q
Patients with extremely weak pelvic floor muscles
A
may use a contraction of the hip adductor muscles in performance of an “assisted pelvic muscle contraction”
16
Q
A sudden strong muscular contraction or sudden pull on a ligament is the cause of
A
avulsion fractures. This type of fracture commonly occurs with an ankle inversion fracture. The tendon or ligament pulls off a small portion of bone in an avulsion fracture.
17
Q
A compression fracture
A
is typically caused by pressure to a bone weakened by pathology such as osteoporosis or cancer. This could occur due to a flexion injury or without trauma in the vertebral bodies of an individual with osteoporosis or in the calcaneus when a person falls from a height and lands on the feet.
18
Q
Stress fractures, not avulsion fractures
A
are commonly caused by repeated low force trauma such as is seen in runners or military personnel who train on hard surfaces
19
Q
A bending or tensile force
A
applied to a long bone will typically cause a transverse fracture. It is a fracture defined as being perpendicular to the long axis of the bone.
20
Q
Distributed practice
A
refers to practice where practice time is equal to or less than rest time.
21
Q
Distributed practice
A
refers to practice where practice time is equal to or less than rest time.
22
Q
Massed practice
A
refers to practice where practice time is much greater than rest time.
23
Q
Random practice
A
when a practice sequence includes a variety of tasks ordered randomly across trials.
24
Q
Blocked practice
A
refers to a practice sequence where one task is performed repeatedly, uninterrupted by practice of any other task.
25
Weight bearing
can be used for both facilitation and inhibition of muscle tone
26
Tapping
is a facilitation intervention only
27
Neutral warmth
is an inhibitory intervention only.
28
Prolonged icing
is an inhibitory intervention only
29
Prolonged icing
is an inhibitory intervention only
30
Flank pain
(area between last rib and hip)
31
oliguria
(reduced urine output)
32
hematuria
(blood in the urine)
33
are symptoms that would indicate the ________ system?
genitourinary
34
The cuff placement for forearm crutches
should be 1 to 1.5 inches from the elbow.
35
Pruritus (itching)
is a sign of an allergic reaction
36
Erythema
(redness of the skin)
37
is a sign of an ______ reaction.
is a sign of an allergic reaction.
38
Hypotension
is a sign of anaphylaxis
39
Anaphylaxia
may begin with severe itching of the eyes or face and, within minutes, progress to more serious symptoms. The condition can quickly result in an increased heart rate, sudden weakness, a drop in blood pressure, shock, and ultimately unconsciousness and death.
40
The safest performance of assisting with wheelchair management up and down steps to go up and down steps
steps to go up backward (patient facing away from steps) and lower forward (patient facing away from steps), both with the casters elevated.
41
A patient with an anterior pelvic tilt displays
an increased lumbar curve. The lumbar spine is flat causing the pelvis to be posteriorly rotated.
42
Genu recurvatum
is knee hyperextension.
43
Genu recurvatum
is knee hyperextension.
44
Pressure ulcers
are more likely to be seen on bony prominences, such as the metatarsal heads and bases.
45
Wounds associated with the toes, interdigital spaces, foot, and lateral malleolus
are the areas most often affected by arterial insufficiencies.
46
Neuropathic ulcers
are most likely to be seen on the toes and plantar surfaces, not the lateral malleolus.
47
For osteomyelitis
an opening in the skin is needed so that bacteria can enter and cause infection. It will not occur in multiple areas.
48
ntracranial pressure
of 4-15 mm Hg is considered normal.
49
An inFerior glide
will facilitate knee Flexion based on the concave on convex rule
50
A supErior glide
will facilitate knee Extension
51
The L5 and S1 dermatomes
affect the majority of the hips and legs and can have a significant effect on balance.
52
A Babinski sign
is indicative of corticospinal tract damage, which is located in the cerebrum. Cerebellar damage would be most evident during coordination testing.
53
The compression pressure should be set
should be set between 40 to 70 mm Hg, which corresponds to diastolic blood pressure measures
54
LE Increased lumbar lordosis
is used to substitute for tight hip flexors.
55
Weakness of the hip abductors would be more likely to result in a
lateral lean or hip drop during stance.
56
If the prosthesis is too short
then it will cause the patient to shift the weight to that side.
57
Atelectasis
is the collapse of alveoli with loss of air, and benefits most from deep breathing/inspiratory techniques.
58
Forced expiratory techniques
are effective in airway secretion clearance in patients who have cystic fibrosis.
59
Forced expiratory techniques
are effective in airway secretion clearance in patients who have cystic fibrosis.
60
Pulmonary edema
results from excessive fluid build-up in the lungs (within the alveoli and/or interstitial space) Appropriate positioning and medical intervention is most effective.
61
Pulmonary fibrosis
is a progressive disease in which lung tissue becomes stiff and non-compliant.
62
Characteristics of scleroderma
include atrophy of the fingertips, calcific nodules, digital cyanosis, and tightening of the skin.
63
Systemic lupus erythematosus
belongs to the family of autoimmune rheumatic diseases. It is a chronic, systemic, inflammatory disease that is characterized by injury to the skin, joints, kidneys, heart and blood-forming organs, nervous system, and mucous membranes. The characteristic rash of lupus is a red butterfly rash across the cheeks and nose.
64
Myelomeningocele
is a birth defect in which the backbone and spinal canal do not close before birth.The condition is a type of spina bifida.
65
Dyspnea
is defined as labored breathing as a result of shortness of breath.
66
Cheyne-Stokes breathing pattern.
Cycles of increasing tidal volumes followed by series of gradually decreasing tidal volumes and then a period of not breathing correctly describes a Cheyne-Stokes breathing pattern.
67
Pre-eclampsia
is characterized by hypertension and can progress to convulsions, coma, and death if it becomes severe. The patient's blood pressure should be checked immediately.
68
Preeclampsia usually begins after
20 weeks of pregnancy in a woman whose blood pressure had been normal. Even a slight rise in blood pressure may be a sign of preeclampsia.
69
Discomfort in the midline below the sternum is associated with
dyspepsia. Various conditions cause dyspepsia. The main symptom is usually pain or discomfort in the upper tummy (abdomen).
70
Thyroid hormone production
acts on all body systems, regulating metabolism. Increased thyroid hormone levels produces evidence of increased metabolic activity as indicated by these symptoms.
71
Thyroid hormone production
acts on all body systems, regulating metabolism. Increased thyroid hormone levels produces evidence of increased metabolic activity as indicated by these symptoms.
72
Decreased levels of thyroid hormone
produces the opposite of these signs and symptoms: slower heart rate, slower mental function, intolerance to cold and decreased appetite with weight gain.
73
Decreased levels of thyroid hormone
produces the opposite of these signs and symptoms: slower heart rate, slower mental function, intolerance to cold and decreased appetite with weight gain.
74
Active assistive and deep breathing exercises
are indicated in rehabilitation programs for patients with Amyotrophic Lateral Sclerosis to help to prevent disuse atrophy and encourage good ventilation, since both the respiratory and central nervous system are involved with this condition.
75
Battery
intentional touching without consent. Slander is oral defamation. An invasion of privacy is intentional deprivation of one's right to be left alone.
76
The physical therapist assistant should be positioned
below and to one side of the patient, whether the patient is moving up or down the steps. The assistant should be positioned to the side at which the greatest danger or potential for injury exists. If the patient requires more assistance, then another staff member would be needed.
77
Astereognosis
the inability to recognize familiar objects by touch alone. Asking the patient to identify a quarter placed in the hand when the eyes are closed would challenge this skill.
78
People taking Alendronate (Fosamax)
should not lie down for at least 30 minutes after taking the drug because of potential for esophageal irritation. The drug is to be taken in the morning and so this may be an issue with early morning therapy sessions. The physical therapist assistant would need to avoid / modify any interventions that require the patient to lie flat.
79
Osteochondritis dissecans
is caused by repetitive microtrauma resulting in ischemia and disruption of the subchondral growth and results in pain swelling and giving way.
80
Osteogenesis imperfecta
is a rare congenital disorder of collagen synthesis affecting bones and connective tissue causing frequent fractures and possible bone deformities. It typically presents in infancy or as a toddler begins to ambulate.
81
Chondrosarcoma
is a malignant neoplasm. It presents most often in adult males.
82
Paget's disease
is a metabolic bone disease which presents in adulthood.
83
Diuretics
increase the excretion of sodium and water in the urine and control high blood pressure and fluid retention. r.
84
Vasodilators
dilate the peripheral blood vessels.
85
Nitroglycerin
Nitroglycerin, a medication used to treat angina, is a vasodilato
86
Nitroglycerin
a medication used to treat angina, is a vasodilatoR.
87
Thrombolytics
are used to break down and dissolve already formed blood clots.
88
Anticoagulants
prevent blood clot formation.
89
Anticoagulants
prevent blood clot formation.
90
Melena
is the presence of black, tarry stools and is associated with gastrointestinal bleeding.
91
In the gravity-eliminated position
a force of 15-25 lbs. is required for elongation of the cervical spine
92
Gravity in the seated position
requires an increase from the pull (or poundage) required in the supine position due to the weight of the head.
93
Dizziness
occurs with hyperventilation due to decreased CO2 exchange.
94
Spasticity
results from upper motor neuron lesions associated with diseases such as cerebral palsy, amyotrophic lateral sclerosis, hemiplegia, spinal cord injury and traumatic brain injury.
95
Hypotonia
is more often associated with cerebellar dysfunction, cerebral palsy, hemiplegia.
96
Athetosis
results from lesions in the basal ganglia.
97
Ataxia
results from deficits in the cerebellum.
98
Spastic gait
occurs due to spasticity of the hip adductors, which causes the knees to be drawn together so that the legs can be swung forward, only with great effort.
99
Neurogenic gait
is also referred to as hemiplegic, hemiparetic, or flaccid gait. It occurs when a patient swings the weak or paralyzed leg outward and ahead in a circle or pushes it ahead. In addition, the affected upper limb is carried across the trunk for balance.
100
Steppage gait
occurs with neurological involvement of the dorsiflexors.
101
Festinating gait
occurs when a patient leans forward and walks progressively faster as though unable to stop. It is a characteristic of Parkinsonian gait.
102
In order to prevent insulin from being absorbed too rapidly (and causing hypoglycemia)
it should be injected into a nonexercising muscle, such as the rectus abdominis.
103
A weakness of the gluteus maximus can cause
backward lean of the trunk
104
A possible cause of genu recurvatum (forward lean)
in stance is flaccid/weak quadriceps.
105
Cachexia
is a nutritional wasting disease that can be associated with many conditions that cause the body to burn more nutrients than it can take in. This is often found with cancer.
106
Cachexia
is a nutritional wasting disease that can be associated with many conditions that cause the body to burn more nutrients than it can take in. This is often found with cancer.
107
A pyloric stenosis
involves a constriction of the opening between the stomach and the duodenum. Symptoms include vomiting and weight loss.
108
Emphysema
is a lung condition characterized by abnormal permanent enlargement of the air spaces distal to the terminal bronchioles accompanied by destruction of their walls. The hyperinflation increases the dead space where air is trapped. In auscultating the chest of a patient with emphysema, one would expect decreased breath sounds.
109
Pneumonia
is an acute inflammation of the lungs. The alveoli and bronchioles of the lungs become plugged with fibrous exudate. Movement of the exudate occurs as the patient inspires; therefore, in auscultating the chest of a patient with pneumonia, one would expect to hear crackles.
110
Pneumothorax
causes part of the lung to collapse, creating an empty space in the chest cavity; therefore, in auscultating the chest of a patient with pneumothorax, one would expect absent breath sounds.
111
Pneumothorax
causes part of the lung to collapse, creating an empty space in the chest cavity; therefore, in auscultating the chest of a patient with pneumothorax, one would expect absent breath sounds.
112
Pulmonary embolism
does not cause a change in lung sounds.
113
Orthopnea
an abnormal condition in which a person must keep the head elevated (sit or stand) to breathe deeply or comfortably without experiencing pain. Raising the head of the bed will address this condition.
114
When a nasogastric tube is in place
the infusing solution must be above the patient’s head and the patient’s head should be elevated to avoid risk of aspiration.
115
Parenteral methods of medication administration
do not use the gastrointestinal tract.
116
Enteral administration of drugs
involves the esophagus, stomach, and small and large intestines. The most common routes of enteral administration are oral, sublingual, and rectal.
117
Venous insufficiency
condition in which the veins and valves in the lower extremity are damaged and cannot keep blood flowing toward the heart. This causes the veins to remain filled with blood. Wounds resulting from venous insufficiency occur secondary to impaired functioning of the venous system with eventual tissue damage and ulceration.
118
Venous insufficiency
condition in which the veins and valves in the lower extremity are damaged and cannot keep blood flowing toward the heart. This causes the veins to remain filled with blood. Wounds resulting from venous insufficiency occur secondary to impaired functioning of the venous system with eventual tissue damage and ulceration.
119
A hemi wheelchair frame
is designed to be lower to the ground so that a patient is able to self propel using the lower extremities.
120
The patella tendon bearing (PTB) socket
is designed as a total contact socket to allow for maximum distribution of the load. The socket has a substantial indentation over the area of the patella tendon and is aligned into slight flexion to enhance weight bearing on the patellar tendon
121
A SACH (solid ankle cushion heel) foot
foot is a non-articulated foot assembly that offers limited ankle motion.
122
Orthostatic (or postural) hypotension
is characterized by a sudden decrease in blood pressure that occurs with movement to upright positioning (i.e., sitting or standing). The change in position causes pooling of blood in the lower extremity veins, and thus reduced venous return and cardiac output. This condition is often seen in patients who have experienced prolonged periods of immobility.
123
Elastic stockings,
or other forms of compression garments, are often used in patients experiencing orthostatic hypotension. Elastic stockings help patients acclimate to upright positioning by compressing lower extremity veins and increasing venous return.
124
A tilt table
is a piece of equipment used to gradually acclimate patients to upright positioning after prolonged periods of immobility. When used as a treatment technique, the angle of the tilt table is gradually increased towards a vertical position until the patient experiences the signs and symptoms of orthostatic hypotension (e.g., dizziness, decreased blood pressure).
125
An abdominal binder
is a specialized type of compression garment that wraps around the patient’s lower torso. It is often used in patients experiencing orthostatic hypotension since it compresses blood vessels in the abdominal cavity and increases venous return.
126
Multiple sclerosis
is characterized by demyelination of the myelin sheaths that surround the nerves within the brain and spinal cord. These patches of demyelination decrease the efficiency of nerve impulse transmission. Symptoms of multiple sclerosis vary based on the location and the extent of demyelination.
127
Lesions within the frontal lobe
can result in cognitive impairments including impaired attention and concentration, slowed processing, impaired short-term memory, and impaired executive functioning.
128
Lesions within the corticospinal tract
present with signs and symptoms of upper motor nerve involvement including paresis, spasticity, exaggerated tendon reflexes, involuntary flexor and extensor spasms, clonus, Babinski’s sign, exaggerated cutaneous reflexes, and loss of precise autonomic control.
129
Lesions in the cerebellar tracts
can result in ataxia, postural and intention tremors, hypotonia, and truncal weakness.
130
Osteoporosis
is a metabolic bone disorder where the rate of bone resorption accelerates while the rate of bone formation slows down. This reduction of bone mass decreases the overall bone density and strength. The disease is more common in women and in particular postmenopausal women who are not taking hormone replacement therapy.
131
Guillain-Barre syndrome
is an acute polyneuropathy that primarily affects the peripheral nervous system. The condition often occurs following a relatively benign respiratory or gastrointestinal illness. Guillain-Barre syndrome is characterized by ascending weakness that begins distally in the lower extremities and progresses towards the trunk.
132
Guillain-Barre syndrome
is an acute polyneuropathy that primarily affects the peripheral nervous system. The condition often occurs following a relatively benign respiratory or gastrointestinal illness. Guillain-Barre syndrome is characterized by ascending weakness that begins distally in the lower extremities and progresses towards the trunk.
133
Heart failure
is a progressive condition in which the heart cannot maintain a normal cardiac output to meet the body’s demands for blood and oxygen. Heart failure often develops after other conditions have damaged or weakened the heart. The ventricles weaken and dilate to the point that the heart can’t pump efficiently causing a significant increase in fluid in the system. Heart failure would more commonly be associated with bilateral edema.
134
Heart failure
is a progressive condition in which the heart cannot maintain a normal cardiac output to meet the body’s demands for blood and oxygen. Heart failure often develops after other conditions have damaged or weakened the heart. The ventricles weaken and dilate to the point that the heart can’t pump efficiently causing a significant increase in fluid in the system. Heart failure would more commonly be associated with bilateral edema.
135
A myocardial infarction
occurs when the blood flow through one or more of the coronary arteries is severely reduced or cut off completely. This causes irreversible necrosis to the portion of myocardium supplied by the blocked artery. Symptoms include chest discomfort with pressure, shortness of breath, discomfort in the upper body, vomiting, dizziness, sweating, and palpitations.
136
Venous thrombosis
results from the formation of a blood clot that becomes dislodged and is termed an embolus. This is considered a serious medical condition since the embolus may obstruct a selected artery. Symptoms include unilateral ankle edema, pain, and sensitivity and warmth over the area of the clot.
137
Peripheral arterial disease
is a disease in which plaque builds up in arteries that carry blood to the head, organs, and limbs. Over time, the plaque hardens and narrows the arteries which limits the flow of oxygenated blood. The rubor of dependency test assesses lower extremity circulation using skin color and positional changes.
138
Sanguinous exudate
is red in color and indicates a bloody discharge which may be indicative of either new blood vessel growth (normal healing tissue) or a disruption of blood vessels (abnormal).
139
Serosanguinous exudate
is pink in color and can be a normal exudate in a healthy healing wound
140
Purulent exudate
presents as yellow or green in color with a thick, viscous consistency. Purulent exudate often signals wound infection and may be associated with a foul odor.
141
Serous exudate
is described as clear or light color fluid with a thin, watery consistency. This particular type of exudate is normal during the inflammatory and proliferative phases of healing.
142
Proprioceptive neuromuscular facilitation (PNF)
is a treatment approach developed by Kabat, Knott, and Voss in which movement patterns are diagonal and spiral in nature. It is directed at improving function, performance, and coordinated movement and is commonly used to treat patient with musculoskeletal and/or neuromuscular deficits.
143
Proprioceptive neuromuscular facilitation (PNF)
is a treatment approach developed by Kabat, Knott, and Voss in which movement patterns are diagonal and spiral in nature. It is directed at improving function, performance, and coordinated movement and is commonly used to treat patient with musculoskeletal and/or neuromuscular deficits.
144
Patients with chronic venous insufficiency
often experience ulcer formation in the lower extremities secondary to chronic edema and fluid stasis. Treatment often consists of some form of compression therapy to help move fluid from the periphery back to the heart
145
Ankle pumps in supine
would be the most appropriate intervention for this patient since the patient has both venous and arterial insufficiency. Active movement of the ankle helps move fluid back to the heart via the muscle pump mechanism. The supine position is appropriate since dependent positioning will have a negative effect on the patient’s level of edema, while positioning in elevation will have a negative effect on the patient’s arterial insufficiency.
146
Pusher syndrome (or ipsilateral pushing)
s an abnormal motor behavior commonly seen in patients who have had a stroke. The motor behavior is characterized by the patient actively pushing toward the hemiparetic side. Attempts by the therapist to correct the patient's posture result in the patient pushing more strongly to the hemiparetic side. A patient with pusher syndrome is at an increased risk for falling.
147
A nasogastric tube
is a plastic tube inserted through a nostril that extends into the stomach. The device is commonly used for liquid feeding, medication administration or to remove gas from the stomach. A gastric tube is inserted directly into the stomach for long-term feeding.
148
A serial splint
is a form of corrective splint utilized to immobilize a joint in order to increase range of motion while correcting a deformity such as a soft tissue contracture.
149
A dynamic splint
typically includes a spring or elastic component utilized to exert force on a joint. This force may be utilized to facilitate passive or assisted movement of a joint or to resist movement in the direction opposite the line of pull. Dynamic splints are not typically indicated when treating acute conditions
150
A functional splint
is typically utilized to support, protect, and stabilize a joint during specific activities (e.g., holding a writing or eating utensil) in order to improve efficiency and functional performance of a task. A functional splint is a viable option to assist the patient while working.
151
A resting splint
is typically utilized to maintain a joint in an appropriate position during an acute exacerbation of symptoms allowing the joint to rest while limiting the risk of contracture development.
152
Autonomic dysreflexia
is a condition normally seen in patients with spinal cord injuries above T6 and is characterized by abnormal autonomic reflexes. Symptoms are triggered by a noxious stimulus below the level of the lesion and include hypertension, bradycardia, headache, profuse sweating, increased spasticity, and restlessness
153
The low pressure alarm
of a mechanical ventilator is activated when the ventilator has no resistance to inflate the lung. This is most often associated with a patient being disconnected from the ventilator or a leak in the ventilator circuit.
154
The low pressure alarm
of a mechanical ventilator is activated when the ventilator has no resistance to inflate the lung. This is most often associated with a patient being disconnected from the ventilator or a leak in the ventilator circuit.
155
Compartment syndrome
is a condition associated with increased tissue pressure in a specific muscular compartment. The condition is most commonly seen in the lower leg, especially in the anterior compartment. Compartment syndrome is characterized by pain with exertion, swelling, decreased sensation, and diminished pulses.
156
The deep peroneal nerve
is a branch of the common peroneal nerve, located in the anterior lower leg. Because of its location, this nerve is commonly affected with compartment syndrome. Compression of this nerve can result in a steppage gait due to difficulty performing dorsiflexion.
157
Neurogenic claudication
refers to a collection of symptoms often associated with degenerative spinal stenosis which involves narrowing of the spinal canal or intervertebral foramina of the lumbar spine. The condition is characterized by poorly localized pain, paresthesias, and cramping or weakness in the lower extremities. Neurogenic claudication involves the spinal nerves while vascular claudication involves the circulatory system.
158
Patients with neurogenic claudication
often experience diminished pain when stooping, sitting or bending forward at the waist since the activities require the spine to be in a flexed position. As a result, activities such as climbing stairs, pushing a cart or cycling may be less problematic than anticipated. Activities requiring extension of the spine tend to exacerbate symptoms.
159
An airplane splint
is a type of complex splint that holds the arm in abduction with the elbow in approximately 90 degrees of flexion primarily protecting against a shoulder adduction contracture. Typically, this type of splint is used by patients with shoulder and axillary burns, rotator cuff repair, and shoulder subluxation.
160
A c-bar splint
is a type of a hand-finger splint used to promote thumb abduction and opposition. The splint facilitates improved hand function when weakness exists. This type of splint can be used following surgery to promote tissue healing and provide immobilization of the thumb.
161
A shoulder sling
is used for shoulder pain or subluxation in order to protect and immobilize the shoulder joint. Immobilization promotes tissue healing and prevents overstretching of muscles or ligaments. Typically when using this type of sling, the shoulder is positioned in slight abduction and internal rotation with the elbow in flexion.
162
A hemi-arm sling
is a type of vertical arm sling that uses a humeral cuff with figure-eight suspension to provide a vertical upward force that supports the humerus without restricting the elbow and forearm. This type of sling is typically used with patients with shoulder subluxation.
163
A hemiplegic chair
incorporates a seat that is approximately two inches lower than a standard chair to enable the user to use the lower extremities to propel the chair. The patient typically uses one handrim and one or both feet to help propel and steer the wheelchair. One or both front riggings on the wheelchair are removed to provide the feet with necessary space for propulsion.
164
Jugular vein distention
results from fluid overload when the heart is unable to pump blood efficiently. As the heart’s ability to pump is compromised, the fluid backs up into the lungs and venous system. Assessing distention of the jugular vein is an effective way to evaluate the functioning of the heart.
165
Congestive heart failure
is a condition characterized by an inability of the heart to effectively pump blood to meet the demands of the body. When the heart can no longer effectively pump blood to the body, fluid backs up into the lungs and venous system. A common sign of this type of fluid accumulation is distention of the jugular vein.
166
Amyotrophic lateral sclerosis (ALS)
is an adult-onset progressive neurodegenerative disease. It is most commonly characterized by an onset of ascending muscle weakness beginning in the distal musculature and progressing towards the trunk. Other symptoms may include weakness of the facial muscles and cognitive disturbances.
167
Pneumonia
is an inflammatory condition of the lung that primarily affects the alveoli. The final stages of ALS are characterized by weakness of the respiratory muscles. This decrease in respiratory function can lead to infection of the lungs (i.e., pneumonia). Death usually occurs within 2-5 years from the onset of the disease.
168
Meningitis
is an acute inflammation of the membranes that cover the brain and spinal cord. The condition is caused by a bacterial or viral infection that reaches the meninges.
169
Deep vein thrombosis (DVT)
is the formation of a blood clot in the deep veins of the legs. One of the most common risk factors for DVTs is inactivity or immobilization, especially after a major surgery.
170
The pes anserine
is a grouping of three conjoined tendons that all insert on the anteromedial surface of the proximal tibia. Overuse injuries are common in this area and may lead to pes anserine tendinitis or bursitis. (sartorius, gracilis and semitendinosus.)
171
A heterograft/ xenograft
is a temporary skin graft taken from another species.
172
An autograft
s a permanent skin graft taken from a donor site on the patient’s own body
173
An allograft
is a temporary skin graft taken from another human, usually a cadaver, in order to cover a large burned area. A homograft is synonymous with the term allograft.
174
Congenital torticollis
is a condition that causes the neck to involuntarily unilaterally contract to one side secondary to contraction of the sternocleidomastoid muscle. The head is laterally flexed toward the contracted muscle while the chin faces the opposite direction. A physical therapy plan of care for a patient with congenital torticollis includes patient and caregiver education, passive stretching, active strengthening, positioning, and modalities
175
Duchenne muscular dystrophy
is a progressive disorder caused by the absence of the gene required to produce the muscle proteins dystrophin and nebulin. This results in cell membranes weakening, destruction of myofibrils, and loss of muscle contractility. A physical therapy plan of care for a patient with Duchenne muscular dystrophy often includes passive stretching and is more likely to restrict resistive exercise.
176
Juvenile rheumatoid arthritis
is a common chronic rheumatic disease in children that results in inflammation of the joints and connective tissues. A physical therapy plan of care for a patient with juvenile rheumatoid arthritis often includes passive and active range of motion, however, during exacerbations there may be a precaution to stretching.
177
Cystic fibrosis
is an inherited disease that affects the ion transport of the exocrine glands resulting in impairment of the hepatic, digestive, respiratory, and reproductive systems. In addition to cardiopulmonary rehabilitation, a physical therapy plan of care for a patient with cystic fibrosis often includes general exercise and stretching to optimize overall function.
178
Down syndrome (trisomy 21)
is a genetic abnormality consisting of an extra twenty-first chromosome due to an error in cell division. An important clinical manifestation of Down syndrome is atlantoaxial instability that exists secondary to general hypotonicity and laxity of soft tissue structures. As a result, passive stretching of the head and neck is often contraindicated.
179
Cystic fibrosis
is a multisystem disorder that affects the exocrine glands. This condition is primarily characterized by thick secretions that plug the airways of the lungs. Postural drainage is commonly used in patients with cystic fibrosis to help clear these retained secretions from the lungs.
180
Pulmonary edema
is the accumulation of fluid in the air spaces of the lungs, often caused by left-sided heart failure. Pulmonary edema is an emergent condition characterized by dyspnea, pale skin, anxiety, wheezing, and chest pain. This condition is a precaution to the use of postural drainage as an intervention.
181
Pneumonia
is a pulmonary condition characterized by an inflammatory process of the alveoli usually caused by a viral or bacterial infection. Treatment is aimed at the underlying cause (e.g., antibiotics). Treatment would not include postural drainage since retention of secretions is not a common side effect of this condition.
182
Pneumonia
is a pulmonary condition characterized by an inflammatory process of the alveoli usually caused by a viral or bacterial infection. Treatment is aimed at the underlying cause (e.g., antibiotics). Treatment would not include postural drainage since retention of secretions is not a common side effect of this condition.
183
Ober’s test
is used to evaluate the flexibility of the iliotibial band and the tensor fasciae latae. The patient is positioned in sidelying with the lower leg flexed at the hip and the knee. The therapist moves the test leg into hip extension and abduction and then attempts to lower the test leg. A positive test is indicated by an inability of the test leg to adduct and touch the table.
184
The slump test
is a neural provocation test performed with the patient in sitting. The slump test is a series of progressive active and passive movements. At each portion of the test, the therapist asks the patient if they are experiencing symptoms (e.g., radicular pain, numbness, tingling). If symptoms are produced, the test would be considered positive. If symptoms are not produced, the therapist systematically increases the amount of dural stretch. The therapist initiates the test by asking the patient to flex the thoracic and lumbar spine. The patient is then asked to actively flex their cervical spine and the therapist applies overpressure. The therapist next asks the patient to actively extend their knee and then provides overpressure to ankle dorsiflexion.
185
When treating a patient with contact precautions
it is more appropriate to treat the patient in their room than in the therapy gym. To prevent the spread of MRSA, the therapist should don a gown and gloves upon entering the room.
186
BMI
describes relative weight for height and is a measurement used to identify increased risk for mortality and morbidity due to excess weight and obesity. Obesity (BMI of 30 kg/m2 or greater) refers to the state of excessive adipose tissue accumulation in the body contributing to a variety of chronic conditions that negatively impact multiple body systems and overall health.
187
A maximal exercise test
is performed under a strict protocol in a performance lab. A formal protocol is used with specific increases in the speed and intensity of exercise while the volume and oxygen concentration of inspired and expired air is measured. Although a maximal exercise test is considered the gold standard for measuring aerobic capacity, the utility of the test is limited in many individuals whose performance may be limited by pain or fatigue rather than exertion. A variety of submaximal exercise tests have been developed to meet the needs of individuals with various functional limitations and disabilities.
188
Bilateral carpal tunnel syndrome
caused by compression of the median nerve in the carpal tunnel, is a common finding with a variety of systemic conditions, especially with metabolic and endocrine disorders. Most patients are diagnosed between 35 and 55 years of age, with a greater prevalence in women
189
Hemodialysis
is a treatment process for patients with advanced and permanent kidney failure. Kidney failure creates excess toxic waste, increased blood pressure, retention of excess body fluids, and a decrease in red blood cell production. Hemodialysis removes the blood from the body along with waste, excess sodium, and fluids. The process cleanses the blood and returns it to the body. A patient requires this process on average three times per week.
190
Renal failure
is a condition where the kidneys experience a decrease in glomerular filtration rate and fail to adequately filter toxins and waste from the blood. Symptoms vary based on severity of the condition and can include nausea, vomiting, lethargy, anorexia, peripheral neuropathy, pulmonary edema, seizures, and coma.
191
Diastasis recti
is the separation of the rectus abdominis in the midline at the linea alba. Due to the size of the separation (i.e., four centimeters), aggressive abdominal strengthening exercises should be avoided. If the size of the separation is less than two centimeters, more provocative exercises can be attempted. When exercising, the patient should wrap a sheet around the trunk at the level of the separation to approximate the separated muscle.
192
Osteoarthritis
is a chronic disease that causes degeneration of articular cartilage, primarily in weight bearing joints. Subsequent deformity and thickening of subchondral bone occurs resulting in impaired functional status. Any joint may be involved, however, the most commonly affected sites include the hands and weight bearing joints such as the hips and knees.
193
Osteoarthritis
tends to produce morning stiffness that subsides relatively quickly (e.g., less than 30 minutes) with movement or activity. Rheumatoid arthritis is more likely to produce prolonged stiffness lasting for hours
194
Cor pulmonale
also known as right-sided heart failure, refers to hypertrophy of the right ventricle caused by altered function of the lungs. Signs and symptoms include dyspnea with exertion, fatigue, palpitations, atypical chest pain, swelling of the lower extremities, dizziness, and syncope.
195
Tetralogy of Fallot
s a term used to describe a combination of four heart defects including: (1) ventricular septal defect (VSD); (2) pulmonary stenosis; (3) right ventricular hypertrophy; (4) aorta overriding the ventricular septal defect. It is often diagnosed during infancy, but may not be detected until later in life, depending on the severity of the defects and symptoms. Signs and symptoms include cyanosis of the skin, shortness of breath and rapid breathing (especially during feeding), fainting, clubbing of fingers and toes, poor weight gain, fatigue, irritability, and heart murmur.
196
Rhabdomyolysis
is a condition where breakdown of striated muscle fibers leads to the release of myoglobin into the bloodstream. Myoglobin is harmful to the kidneys and can often lead to kidney damage. Rhabdomyolysis occurs with damage to skeletal muscle tissue, particularly following injury.
197
Potassium
is important for the function of excitable cells such as the heart, nerve, and muscle. Hypokalemia (low serum potassium) or hyperkalemia (high serum potassium) will both place the patient at risk for cardiac arrhythmias. In addition to arrhythmias, potassium imbalance also can produce tetany, muscle weakness, cardiac arrest, muscle pH imbalance, and decreased action potentials.
198
Paraffin wax
is a commonly used heating source for the distal extremities since it is able to maintain maximum contact with irregularly contoured areas. The temperature of the paraffin mixture should be maintained between 113 and 122 degrees Fahrenheit. Methods of paraffin application include dip-wrap, dip-reimmersion, and paint application. Paraffin has a low melting point and low specific heat, which enhances a patient’s ability to tolerate heat from paraffin compared to heat from water at the same temperature.
199
Heart failure
is a progressive condition in which the heart cannot maintain a normal cardiac output to meet the body’s demands for blood and oxygen. Heart failure often develops after other conditions have damaged or weakened the heart and can be acute or chronic. Lasix is a diuretic that can be prescribed to decrease circulating blood volume thereby decreasing preload.
200
Angina
s a transient precordial sensation of pressure or discomfort resulting from myocardial ischemia. Patients typically describe angina as pressure, heaviness, fullness, squeezing, burning or aching behind the sternum. The sensation may be associated with difficulty breathing, nausea or vomiting, sweating, anxiety or fear.
201
Rheumatoid arthritis
is a systemic autoimmune disorder of unknown etiology. The disease presents with a chronic inflammatory reaction in the synovial tissues of a joint that results in erosion of cartilage and supporting structures within the capsule. Rheumatoid arthritis is diagnosed based on the clinical presentation of involved joints, the presence of blood rheumatoid factor, and radiographic changes.
202
Kussmaul’s respiration
includes deep and fast breathing that is often associated with metabolic acidosis. This pattern is characterized by distressing dyspnea, panting, and labored respiration.
203
Eupnea
is a term used to describe a breathing pattern that consists of normal rate, depth, and rhythm of respiration.
204
Orthopnea
is a term used to describe dyspnea that occurs during recumbency that is relieved with sitting upright.
205
Orthopnea can occur
any time of day and is typically secondary to cardiopulmonary disease.
206
Cheyne-Stokes respiration
includes cycles of increasing and decreasing rate and depth of breathing with periods of apnea. This pattern of respiration will occur with central nervous system damage or severe cardiopulmonary disease such as congestive heart failure.
207
Intracranial monitoring
is most often utilized on patients with a head injury, brain tumor, cerebral hemorrhage or overproduction of cerebrospinal fluid. An epidural sensor is one of three methods employed to measure the pressure exerted by the brain, blood, and cerebrospinal fluid against the inside of the skull. An epidural sensor is placed through a hole drilled in the skull and inserted between the skull and dural tissue. This type of intracranial monitoring tends to be less accurate than monitoring with an intraventricular catheter or subdural screw.
208
An intracranial pressure monitor
reports a value using millimeters of mercury (mm Hg). Normal intracranial pressure is 4-15 mm Hg, however, this value can fluctuate substantially based on patient activity
209
Pericarditis
is an inflammation of the pericardium of the heart. Acute pericarditis typically produces a sharp and sudden pain that begins at the sternum and radiates. Pericardial pain differs from the pain associated with an MI since it is often pleuritic, increasing with inspiration and decreasing with forward positioning. A pericardial friction rub found with auscultation is indicative of pericarditis.
210
Spondylolisthesis
refers to a condition where one vertebra slips forward on the one below it due to a bilateral fracture of the pars interarticularis. This condition most commonly occurs at L4-L5 or L5-S1
211
Raynaud’s disease
s a condition that causes arteries supplying blood to the skin to narrow resulting in diminished circulation. Symptoms include pallor, rubor, cyanosis, and numbness and tingling in the digits and hand. Females are up to five times more likely than males to be diagnosed with Raynaud’s disease. Females are more likely than males to be diagnosed with Raynaud’s disease. Peak incidence is between the ages of 20 and 49 years.
212
A dynamic ankle-foot orthosis (DAFO)
is designed with a long footplate with built-up areas to provide stability and reduce abnormal tone. DAFOs provide biomechanical changes that allow for improved motion within the trunk, pelvis, and lower extremities.
213
The DAFO is designed to
to position the midtarsal and subtalar joints in a neutral position. The construction of the orthosis including the anterior straps serve to limit dorsiflexion and plantar flexion allowing for total contact throughout the gait cycle. This allows for reduction of abnormal tone and improved mobility.
214
Osteopenia
is a condition characterized by low bone mineral density and is considered a precursor to osteoporosis, which is characterized by a more significant loss of bone mineral density. Though osteopenia is a condition in which bones become less dense, they would not appear larger in size on an x-ray.
215
Osteomalacia
is a condition characterized by a softening of the bones secondary to a vitamin D deficiency. This deficiency results in a reduced rate of bone formation. Though an x-ray may reveal bones that are less dense, they would not appear larger in size.
216
Paget’s disease
is a condition characterized by inflammation of the bones that causes abnormal bone remodeling. Bone is resorbed and formed at an increased rate and in a disorganized fashion. This results in bones that are larger, less dense, more vascular, and more prone to fracture.
217
Pharmacological management
is utilized with many cardiopulmonary disease processes. Therapists must be aware of the classifications of drugs, their indications, and possible side effects. Medications are used to reduce risk of clotting, reduce cholesterol, treat hypertension, minimize arrhythmias, and manage other cardiac impairments.
218
Anticoagulant medication
is indicated to prevent blood clot formation. This is typically prescribed post surgery to decrease the risk of deep vein thrombosis. Side effects can include frequent bruising, joint pain, excessive bleeding, and gastrointestinal distress.
219
Physical therapist assistants treat patients with multiple myeloma
in order to decrease the effects of the cancer. Fatigue is a hallmark of the disease process along with skeletal muscle wasting and risk for pathologic fractures. Therapists play an important role throughout the progression of the disease in order to minimize effects from the cancer and maintain function and strength.
220
The primary symptoms of multiple myeloma
include fatigue, bone pain, and muscular weakness. Low-level exercise and fall prevention should be considered the primary focus of physical therapy in order to improve the patient’s overall activity level and avoid pathologic fractures which can be life threatening.
221
There is decreased ease of performing wheelies when
the rear wheel axle is positioned posteriorly since this modification increases the overall difficulty of tilting the wheelchair backwards.
222
The walker must be placed
first so that there is adequate room to advance the legs, then the weak leg is moved to the lower step using the strength of the stronger leg. Once the walker and weak leg have been properly placed, the patient can bear weight through the walker to move the strong leg down the step. While descending a curb.
223
Dyspnea
is common to COPD population, and breathing can be aided by the pursed-lip breathing, relaxation, and breath-control.
224
The medial collateral ligament
heals well without surgical intervention secondary to its good vascular supply and anatomical position that prevents undue stress during the healing process.
225
Grades I and II lateral collateral ligament injuries
are often managed non-surgically but greater tears often requires surgical repair.
226
Hydrogel dressings
are nonadherent and have some absorptive qualities and are used when a wound needs moisture
227
Hydrocolloid dressings
are adherent, moldable wafers that have a waterproof backing. They have an absorptive quality and are indicated for wounds with minimal to moderate drainage
228
Alginate dressings
are absorptive dressings derived from seaweed. They are used to absorb excessive exudate and also promote autolytic debridement
229
Transparent film dressings
are clear, adherent, and nonabsorbing. They are used for partial-thickness wounds with minimal drainage and promote autolytic debridement
230
Persons with ankylosing spondylitis
tend to assume flexed postures.
231
Guillain-Barré syndrome
is characterized by rapid paralysis that begins distally and moves proximally. Deep tendon reflexes are absent.
232
Patients who have cor pulmonale
exhibit right-sided heart failure as a result of pulmonary hypertension. These patients tend to present with a decrease in cardiac output (although heart rate increases, stroke volume and systolic blood pressure decrease) during exercise, resulting in pallor, sweating, hypotension, and rapid pulse of small amplitude. Additionally, these patients tend to present with exertional dyspnea.
233
The most common avulsion injury
due to an anterior shoulder dislocation is a Bankart lesion. A Bankart lesion involves avulsion of the capsule and labrum from the glenoid rim of the scapula but does not affect the bony integrity of the humeral head.
234
Hill-Sachs lesion.
A bony defect on the posterolateral aspect of the humeral head
235
A superior labral anterior-posterior (SLAP) tear
involves only the labrum and bicipital tendon and does not extend into bony structure.
236
In carpal tunnel syndrome
pain and paresthesias occur in the median nerve distribution of the hand, which includes the lateral three digits.
237
When the depression created by the pressure
takes 15-30 seconds to resolve, the appropriate grade is 3+ A 2+ grade would be given to a depression that remains momentarily or less than 5 seconds. A 1+ grade would be given to a depression that is barely detectable. A 4+ grade would be given to a depression that lasts greater than 30 seconds.
238
Upper extremity motions
associated with abnormal flexion synergy pattern following a stroke are scapular retraction and elevation, shoulder abduction and lateral (external) rotation, elbow flexion, forearm supination, and wrist and finger flexion.
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Left sidelying
minimizes the flow of acid to the esophagus.
240
Paresthesia
is abnormal sensation such as burning or prickling.
241
Hemianopsia
is loss of half of the visual field. Stereognosis is recognition of something by feeling it with the hand.(no eyes)
242
Constitutional symptoms
are a constellation of signs and symptoms present whenever a patient is experiencing a systemic illness. They include fever, diaphoresis, night sweats, nausea, vomiting, diarrhea, pallor, dizziness/syncope, fatigue, and weight loss.
243
Moist environments
lead to maceration of the skin and contribute to the formation of ulcers. Ensuring that the skin is clean and dry minimizes the formation of a moist environment.
244
Ischemia of the myocardium
causes chest pain, known as angina. Venous distension is a sign of heart failure. Angiogenesis is new blood vessel growth.
245
Excessive upward rotation of the scapula
can result from weakness of the rhomboids and latissimus dorsi (downward rotators).
246
A patient with COPD
has premature collapse of the airways upon exhalation, which leads to air trapping and ultimately poor gas exchange. Breathing out through pursed lips slows the airflow and creates a back pressure that helps to prevent the airways from collapsing while exhaling.
247
When ascending stairs,
a partial weight-bearing patient using crutches should always lead with the uninvolved lower extremity first, followed by the involved lower extremity, and then the crutches.
248
A structural curve
is defined as one that is not reversible. A functional curve is one that can be changed with position. A compensatory curve relates to the defining of curves and usually refers to the second curve (in an "S" curve).
