Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

physiotherapy MSc term 1 > MSK clinical skills > Flashcards

MSK clinical skills Flashcards

1
Q

What are the contraindications to check for with ultrasound non thermal

A

Active DVT
Current tissue bleeding
cancer
pregnancy
Tuberculosis
electronic implants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the contraindications to check for with ultrasound thermal

A

Active DVT
acute injury/inflammation
current tissue bleeding
impaired circulation/sensation
pregnancy
skin disease (eczema)
tuberculosis
electronic implants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some risks associated with ultrasound

A

superficial burns (with thermal)
Internal bleeding/scarring
no clinical benefit alone, needs to be used with exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does ultrasound therapy work

A

sound waves generated by machine cause oscillation in tissue

does not increase inflammatory response but optimizes it to help move onto next stage of healing

targets mast cells which release arachidonic acid, causing an increase of prostaglandins and leukotriene which act as inflammatory mediators

best used on soft tissue injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 3 ways ultrasound therapy helps

A

Micromassage
The sound waves cause the tissue to vibrate and micromassage, which heats the tissue and improves blood circulation.

Cavitation
The sound waves cause microscopic bubbles to form in the tissue, which expand and contract, creating a microstreaming effect. This microstreaming causes nearby cells to rotate and twist, which can help reduce edema.

Acoustic streaming
The sound waves cause tissue fluids to move along cell walls, which can increase cellular metabolic activity and permeability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When are different intensities used

A

acute - 0.1-0.3
subacute - 0.2-0.5
chronic - 0.5-1.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When do you use different pulse rates

A

continuous is for most chronic, then 1;1 , then 1;2, 1;3, etc as it gets more acute

machine offers 2ms output followed by 2ms x second number in pulse rate rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When do you use different frequencies

A

1MHz - deeper applications
3MHz - superficial applications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how do you know how long to do ulltrasound for

A

number of times head fits into tissue to treat x pulse factor with both numbers added together =time in min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you use the ultrasound machine

A

Avoid bones, and keep moving in circular motions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is PNF stretching

A

when stretched, muscle spindles activate the sensory neurons and synapse onto alpha motor neurons, causing activation and contraction of the stretched muscle to limit it. at the same time inhibitory interneurons in the spinal cord are also synapsed onto, which causes inhibitory impulses onto the antagonistic muscle to relax it. (reciprocal inhibition)

when the muscle contracts, the golgi tendon organ is activated and a type 1b afferent signal is sent to the spinal cord, where it synapes on the inhibitory interneuorns for the alpha motor neurons for the agonist muscle to inhibit the contraction (autogenic inhibition)

doing this in quick succession will lead to increased ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is PNF for hamstring performed

A

muscle stretched to the resistance point, hold for 10s

20% strength contraction for 5s (isometric)

stretch forward and hold for 10s

strength for 5s

hold for a 30s stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the contra indications for PNF

A

acute inflammation
local infection
bony block
haematoma
disruption of surgical repair
increased pain
increased inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are precautions for PNF

A

Recent fracture
osteroporosis
elderly
recent prolonged immobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is joint ROM used for

A

joint stiffness
immobilization
nerve injury
muscle weakness, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 2 types of joint ROM?

A

Active - moving joint with no external resistance/assistance, just the use of muscles surrounding the joint

active assisted - mobility exercise performed with muscles and some external assistance (other limb, belt, towel, etc)

use active assisted when pt isnt allowed to or cannot fully activate muscles, or extra force is needed to obtain desired range

17
Q

How does joint ROM help

A

increase ROM and maintain elasticity

reduce pain

prevent DVT

restore mechanical and structural properties of ligaments, joint capsules, and tendons

18
Q

How should joint ROM exercises be performed

A

free from restrictive clothing

make movement as easy as possible/remove as much resistance as possible

isolated joint/movement, moving through complete ROM

short hold at 3s, 5-10 reps 3 times a day daily

19
Q

what are some joint ROM contraindicationss

A

disruption of surgical repair
increased pain or inflammation

20
Q

how can resistance be added with strength exercises

A

manipulating body position to alter gravity effects

consider weight of limb

free weights (less stable but more freedom)

resistance bands (not constant resistance)

ankle weights (limited by total resistance)

self resistance

machine weights (stable but locked position with less development of stabilizer and accessory muscles, so less functional strength)

21
Q

what are open and closed kinetic chains

A

open - distal segments free to move

closed - distal segments not able to move

stronger muscles take over with a closed chain

22
Q

How does resistance training increase strength

A

more neural activation (more motor units recruited)

hypertrophy of muscle (growth of muscle fibers after microtears are formed and regrown)

increased PCr, ATP, and glycogen content

increased glycolytic activity

decreased mitochondrial density

23
Q

what is the dosage

A

ideally 8-12 reps per exercise, with 3-5 sets

ideal rep range for hypertrophy of the muscle, leading to strength increases while being balanced with muscular endurance.

depends on types of fibres, muscle groups mainly made up of type 1 fibres would benefit from endurance training, while type 2 fibre muscles would benefit from hypertrophy strength training

24
Q

what are the contraindications to strengthening

A

movements shouldnt increase pain/inflammation and shouldnt disrupt healingprocess

should be careful prescribing to kids and those with CVD/hypertension

25
Q

describe when and how you would use walking stick

A

used to take some weight of impaired leg, but nearly full WB

arm opposite to bad leg and lined up to wrist crease

stick moves with bad leg (2point)

26
Q

describe when and how you would use axillary crutches

A

only NWB, for those who have more upper body strength

5cm below armpit, with handgrip at wrist crease height

pt should bear through the andles and not armpits to avoid nerve damage, upper portion of the ribs should. be squeezed between arms and ribs

swing to gait - More stable but slower
Pt moves both crutches forwards, has affected leg lifted up, and then the sound leg swings upto the crutches

swing though gait - Faster but less stable
Same as swing to gait but sound leg swings past the crutches and lands infront ot them

27
Q

describe when and how you would use elbow crutches

A

pwb mainly, as they cant bear as much weight

pt must be less than 25 stone and crutches must be new

handles at wrist crease and cuff just below elbow

PWB gait consists of
Crutches, followed by affected leg and then the sound leg

28
Q

describe when and how you would use zimmer frames

A

Can be PWB or NWB, mainly for pts who need a lot more stability compared to crutches
Cant be used on stairs
Line up handles with wrist creases
Frame, affected leg, sound leg
Ensure that the pt remains inside the base of the frame to promote stability

29
Q

how do patients turn with aids

A

3-point turn, keeping aids in front of them at all times

30
Q

how do pts go from sit to stand with aids

A

To stand up from a seated position, hold both crutches on affected side in h-position, extend affected leg, push up using sound leg and the other hand on the chair, not using walking aid to stand

31
Q

how do pts go from stand to sit with aids

A

Sitting down is the exact same process, only opposite (crutches on affected side, lift up affected leg, hold chair with hand, and sit using the sound leg and hand to lower urself down)

32
Q

should pts hold zimmer frames when sitting or standing

A

no

33
Q

how do PWB pts go up and down stairs with crutches

A

Non affected side holds railing, other hand holds crutches in t-shape, then up with the good (good leg, bad leg, crutch
Going down stairs is the same, just opposite (crutch, bad leg, good leg)

34
Q

how do NWB pts go up and down stairs with crutches

A

Same hand position, going up is hop up on good leg, then crutch
Going down is a crutch, then hop down good leg

35
Q

How do walking aids help patients

A

assist in keeping pt stable and allows them to maintain the ability to continue walking with varied degrees of weight bearingg

36
Q

what are the contraindications to walking aids

A

floor should be dry and pt should have proper footwear

aids should be new

take pts strength into account when prescribing

stay at pts side w arms ready when teaching, and have another person follow pt with wheelchair incase they feel faint

physiotherapy MSc term 1 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions