Orthotics, Skin Issues & Positioning

Question 1

philadelphia spinal orthotic

Answer 1

restricts flex/ext

Question 2

aspen spinal orthotic

Answer 2

restricts in all 3 planes

Question 3

miami spinal orthotic

Answer 3

restricts in all 3 planes

Question 4

cervical collar

Answer 4

not alot of restriction
on at all times
may have to sleep in them

Question 5

cervicothoracic spinal orthotic

Answer 5

• lower cervical/thoracic

- upper back/cervical support

Question 6

halo spinal orthotic

Answer 6

absolute restriction

actual spinal cord injuries

Question 7

hyperextension orthoses

Answer 7

jewett
CASH
HE brace with neck support

Question 8

TLSO spinal orthotic

Answer 8

support from thoracic down to lumbar spine

Question 9

what should you do with pillows

Answer 9

float heels
elevate UE
use for sidelying
prevent hip ER in supine

Question 10

what do you not do with pillows

Answer 10

place under knees

keep neck flexed

Question 11

whats important to do with speciality beds

Answer 11

inflate maximally during mobility

return to proper setting at end of tx

Question 12

what can you use to off load the pt

Answer 12

cushions in wheelchair

tilt WC

Question 13

foam cushion

Answer 13

least amount of pressure

most stability

Question 14

gel cushion

Answer 14

little more pressure relief

Question 15

air cushion

Answer 15

best pressure relief

Question 16

gold standard for off loading for diabetic ulcers

Answer 16

total contact cast

Question 17

role of PT in wound care

Answer 17

• promote wound healing
• education
• maximize pt mobility
• minimize pain
• recommendations for interdisciplinary care
• recommendations for follow up care

Question 18

what will you see with arterial insuffiency wounds

Answer 18

• decreased pedal pulse
• intermittent claudication
• anteriolateral foot/ankle, toes
• full thickness - well defined borders
• pale, minimal drainage, often with eschar
• shiny, anhydrous, pale to cyanotic

Question 19

arterial insufficiency will create what kind of wounds

Answer 19

dry wounds

Question 20

what will u see with venous insufficiency wounds

Answer 20

• pedal pulse present
• lower limg discomfort
• edema worse in dependent position, less when LE raised
• irregular shape, shallow wound on medial lower leg and malleolus
• mod to copious drainage
• hemosiderin staining and lipodermatosclerotic changes

Question 21

venous insufficiency will create what kind of wounds

Answer 21

wet wounds

Question 22

diabetic foot ulcer will look like what

Answer 22

• pedal pulse often absent
• ulcers painless with decreased temp
• at pressure points
• pale wound, nonviable tissue, minimal drainage
• trophic changes

Question 23

pressure injury

Answer 23

• pulses intact
• on pressure areas
• painful
• varying depth
• stages 1-4

Question 24

superficial wound stage

Answer 24

• damage to epithelium

- heals rapidly through regeneration of epithelial cells

Question 25

partial thickness wound stage

Answer 25

- dermal layer | - vessel damage

Question 26

full thinkness wound stage

Answer 26

- subcutaneous fat and deep - longest time to heal - contraction

Question 27

stage 1 pressure injury

Answer 27

intact | reddened skin that does not lighten when palpated

Question 28

stage 2 pressure injury

Answer 28

partial thickness when exposed viable dermis no slough, eschar

Question 29

stage 3 pressure injury

Answer 29

full thickness with exposed subQ may include epibole, tunneling, undermining slough and eschar

Question 30

stage 4 pressure injury

Answer 30

full thickness exposed muscle, tendon, ligament, fascia, cartilage, bone epibole, tunneling, undermining slough, escar

Question 31

unstageable pressure injury

Answer 31

slough, escar covers full thickness wound | unable to detect depth

Question 32

deep tissue pressure injury

Answer 32

intact or nonintact skin appearing as non-blanchable red, maroon or purple in color

Question 33

phases of wound healing

Answer 33

hemostasis inflammation proliferation remodeling

Question 34

hemostasis

Answer 34

begins immediately minimize bleeding and create barrier form contamination localized vasoconstriction, activation of platelets

Question 35

inflammation

Answer 35

10-15 min after injury control bioburden, establish clean wound localized vasodilation, inc tissue permeability bring exudate to wound localized response in proportion to injury

Question 36

proliferation

Answer 36

2-5 days post injury restoration of vascular integrity, formation of connnective tissue, wound contraction, reepitheliazation fibroblasts --> granulation tissue

Question 37

remodeling

Answer 37

up to 2 yrs post injury immature collagen organized into mature collagen scar tissue only up to 80% or original tissue strength lacks elastin, stiffer than original tissue

Question 38

acute wounds

Answer 38

known cause moves through phases of healing in reasonable timeframe achieves successful wound closure

Question 39

chronic wounds

Answer 39

underlying condition or from negative effect delayed healing in one or more phases of healing wound closure not sustained

Question 40

acute wounds last how long | chronic wounds last how long

Answer 40

4-6 weeks | longer 6 weeks

Question 41

examples of acute wounds

Answer 41

``` surgical wounds bites burns abrasions traumatic wounds ```

Question 42

examples of chronic wounds

Answer 42

leg/foot ulcers | pressure sores

Question 43

treatment for acute wound clean/minor: severe and contaminated:

Answer 43

- minimal intervention - surgical debridement - antimicrobial therapy - wound lavage

Question 44

chronic wound treatments

Answer 44

``` wound dressing antimicrobial agents footwear PT educational strategies optimise tx for co-morbidities ```

Question 45

sharp debridement

Answer 45

using a scalpel cutting away non-viable tissue

Question 46

autolytic debridement

Answer 46

dressing placed and bodies enzymes heal it

Question 47

enzymatic debridement

Answer 47

certain enzymes added to the dressing that help heal it

Question 48

mechanical debridement

Answer 48

dressing placed on wound and when pulled off - it pulls all the skin off

Question 49

ideal wound bed

Answer 49

clean and moist