Non-Systems Flashcards
what increased with a heat modality? what decreases with a heat modality?
Increases (1) HR (2) CO (3) RR Decreases / No Change (1) SV (2) BP
what temperature should hot packs be? how many layers should be applied? what should the treatment time be?
(1) 165-170 F
(2) 6-8 layers
(3) 20-30 minutes
what temperature should a paraffin bath be? what should the treatment time be?
(1) 125-127 F
(2) 15-20 minutes
what should the temperature and duration of a contrast bath be?
100-111 F water (4 minutes)
> > > > >
55-65 F water (1 minute)
when shouldn’t a cold modality be applied?
anytime circulation is compromised (peripheral vascular disease, arterial disease)
what is the order of events that occur when ice is applied to the body?
CBAN
Cold
Burning
Aching / Analgesia
Numbness
when using iontophoresis, which medications have a negative charge?
I SAD (I’m sad is negative)
Iodine
Salicylate
Acetate
Dexamethasone
should current be symmetrical or a-symmetrical to minimize skin irritation? should it be biphasic or monophasic?
symmetrical and biphasic
when would monophasic current be used?
wound healing
for FES, how should % of MVC and duty cycle be selected?
(1) Pick highest MVIC (<50% for injured tissues)
(2) Low Duty cycle; can NEVER be more than 50%
*Minimum duty cycle to produce highest MVIC
what is the highest that a duty cycle can be for electrical stimulation?
50% - it can NEVER be more than 50%
what is the highest the MVIC should be for injured tissues?
<50%
what should the pulse frequency and pulse duration be for muscle strengthening, muscle reeducation, muscle spasm reduction, and edema reduction?
(1) Muscle Strengthening
- Pulse Frequency: 35-80 pps
- Pulse Duration: 150-200 small muscles; 200-350 large muscles
(2) Muscle reeducation, spasm reduction, edema reduction
- Pulse Frequency: 35-50 pps
- Pulse Duration: 150-200 small muscles; 200-350 large muscles
when should negative and positive electrodes be used for wound healing?
(1) negative: wound with INFECTION
2) positive: HEALTHY wound (no infection
what should the pulse frequency and pulse duration be for conventional, acupuncture, and brief intense TENS?
(1) conventional
- Pulse frequency: 30-150 pps
- Pulse duration: 50-100
(2) acupuncture
- Pulse frequency: 2-4 pps
- Pulse duration: 100-300
(3) Brief intense
- Pulse frequency: 60-200 pps
- Pulse duration: 150-500
what is brief intense TENS used for?
wound debridement
what MHz is used for deep tissues? what is used for superficial tissues? what depth is considered superficial and deep?
(1) 1.0 MHz for DEEP (>3cm in depth)
2) 3.0 MHz for SUPERFICIAL (<3cm in depth
what is the difference between pulsed and continuous US?
pulsed: non-thermal
continuous: thermal (100% duty cycle)
what position is ideal for traction with a lumbar posterior herniation?
prone
what position is ideal for traction with intervertebral joints, facet joints, and muscle elongation?
supine with pillow under the knees
when should 25% of BW be used for lumbar traction? when should 50% BW be used?
25% - disc protrusion, spasm, elongation
50% - joint distraction
with biofeedback do you want the electrodes closer together or further apart?
closer together as there is greater muscle recruitment
when do you want biofeedback to have high sensitivity? when would you want it to have low sensitivity?
high sensitivity: weak muscles
low sensitivity: spastic muscles
at what rate should chest compressions be performed when administering CPR?
100-120 per minute
what depth should chest compressions reach when performing CPR?
at least 2 inches (5cm)
what is a hickman catheter? where is it placed on the body?
(1) central line for providing antibiotics, nutritional solutions, and taking blood
(2) right side of chest wall
what is a Swanz Ganz Catheter? where is it inserted?
(1) inserted into the pulmonary artery to monitor blood flow and function of the heart
(2) internal jugular or femoral vein
what is a central venous pressure catheter? where is it usually inserted?
(1) measures blood pressure directly from right atrium and super vena cava
(2) usually under the right clavicle
what is an arterial line? where is it inserted?
(1) provides arterial blood gases and measures BP
(2) an artery
what are chest drainage tubes? where are they inserted?
(1) removes air, blood, and purulent matter from patient’s chest or pleural cavity
(2) incision in the chest
how are seat width and depth determined for wheelchair fitting?
(1) seat width: add 2 inches to widest hip measurement
(2) seat depth: subtract 2 from posterior buttock to popliteal fossa
what is the seat height for normal adults, hemiplegic adults, and children?
(1) normal: 20 inches
(2) hemiplegic: 17.5 inches
(3) children: 18.75 inches
how should curbs be ascended when in a wheelchair?
(1) place caster wheels up on curb (may need to wheelie)
(2) push rear wheels up curb with momentum
how should curbs be descended when in a wheelchair?
descend curbs BACKWARDS with forward head and trunk lean
how much space should be under the axilla when using axillary crutches?
2-3 inches
where should loftstrand crutches be situation on the patient?
top of forearm cuff, just distal to the elbow
how should stairs be ascended and descended with a cane?
(1) ascending: GOOD foot first, then bad foot and cane
(2) descending: bad foot FIRST, then cane and good foot
* UP with the GOOD, DOWN with the BAD
what gait pattern should be used for a patient who is NWB?
3-point gait pattern (axillary crutches)
what does a longitudinal arch (scaphoid pad) aim to correct? what does a UCBL aim to correct?
(1) longitudinal arch: pes planus
(2) controls hindfoot valgus, and reduced subtalar motion
what are the FIM levels?
7 - independent 6 - modified independent 5 - guarding (CGA / SBA) 4 - min assist (75% pt. participation) 3 - mod assist (74-50% participation) 2 - max assist (49-25% participation) 1 - dependent (<25% participation)
what % of the body is WBing when water is at the level of the C7, xiphoid process, ASIS, and knees?
(1) C7: 10% WBing
(2) Xiphoid process: 33%
(3) ASIS: 50%
(4) knees: 75%
what is the correct order to don PPE?
gown, mask, gloves
what are alternating isometrics (PNF) patterns?
force is applied in ONE direction and then in the opposite direction and the pt. is supposed to resist movement (no rotational component)
how are alternating isometrics different from rhythmic stabs?
(1) alternating isometrics are consistent between two directions and have NO rotational component
(2) rhythmic stabs is a progression of alternating isometrics; they must resist movement from force applied in multiple directions at the same time (includes rotational component)
what are slow reversals (PNF)?
concentric muscle contraction followed by concentric muscle contraction of opposite muscle group (manual resistance applied throughout) (ex: Pt. does D1 flexion with PT providing resistance, and then moves into D1 extension with therapist providing resistance, thus 2 concentric contractions reversing back and fourth)
what are agonist reversals (PNF)?
concentric muscle contraction followed by eccentric muscle contraction of the SAME MUSCLE (ex. Pt. is doing a bridge and the therapist applies downward pressure; now from the top of a bridge, the therapist applies a downward force and the pt. slowly moves (eccentrically) moves back down to the starting position of a bridge
generally speaking, what positions prevent contractures?
anatomical position (extended and open); the body likes to contracture into a fetal position (MCP flexion is an exception)
what is the minimum door width for wheelchairs? what is the minimum hallway width? how wide does a hallway need to be for a wheelchair to turn?
Doorway: 32 inches
Hallway: 36 inches
Hallway turning: 60 inches
what is the ramp ratio for wheelchairs?
1:12 inches - meaning every inch of step height, there should be 12 inches of slope length