Orthotics, Skin Issues, Positioning, Integ and Burns Flashcards
List several types of hyperextension orthoses
- Jewett
- CASH
- HE brace with neck support
List several types of reinforced cervical collars
- Philadelphia → good to limit flex/ext but not rotation
- Aspen → good for limiting in all 3 planes
- Miami J
List several types of spinal orthotics
- reinforced cervical collars
- cervicothoracic
- Halo
- hyperextensive orthoses
- TLSO
List several types of LE orthotics
- Walking boot
- AFO
- Knee splints
- Hip ABD wedge
List some types of adaptive equipment and DME
- Dressing aids
- Sock butler/arm butler
- Raised toliet seats
- DME
- Geri Chairs, cardiac chairs
What are the goals of pt positioning?
- Pt comfort
- skin hygiene → reduce risk of pressure sores
- joint mobility → reduce risk of joint contractures
Things to keep in mind w/pt positioning
- Avoid static positioning
- edu pt on pressure relief
- turning schedule for individuals unable to reposition themselves
- use positioning devices to off-load at-risk skin or reposition pt
- pillows
- DO: float heels, elevate UE, use sidelying, prevent hip ER in supine
- DO NOT: place under knees, keep neck flexed
- speciality beds → inflate max during mobility then return to proper setting at end of PT trx
List some examples of Off-loading devices
- pressure relief mattresses
- heel floats
- cushions
- air provides highest pressure relief and least postural stability
what is the gold standard for diabetic foot casts?
total contact casts
custom made or off the shelf varieties
What components make up a thorough integumentary eval?
- check skin:
- at high-risk areas (heels, bony prominences)
- uder orthotics
- at surgical sites
- location, color, temp, condition, edema
- look for nonblanching skin
- observe skin for pressure areas caused by med devices (ie catheters)
- ask pt to ID areas of discomfort
what are the functions of the epidermis?
- functions in temp regulation
- mositure regulation
- sensation
- protection from infection/disease
- cosmesis
- interacts w/environment
List the 5 layers of the epidermis
Come Lets Get a Sun Burn
- Stratum Corneum
- Stratum Lucidium
- Stratum Granulosum
- Stratum Spinosum
- Stratum Basale
List other important epidermal cells
- Melanocytes → produce melanin, give skin pigment
- Merkel cells → specialized mechanoreceptors
- Langerhan cells → help fight infection
describe the dermis
- 2 layers that are highly vascularized
- fibroblasts produce collagen and elastin
- Support structures:
- hair follicles
- sudoriferous glands
- sebaceous glands
- vasculature
- lympathics
- nerve endings!
List risk factors for acquiring wounds and wound healin
- meds → anti-coagulants, steroids, immunosuppressive
- DM
- tobacco use
- poor nutritional status
- albumin
- pre-albumin
- CV co-morbidities
- reactive/autoimmune processes
- reduced mobility