Osul 3 Flashcards
Aphar scores are taken when
At 1 and 5 minutes after birth. Scores between 0-3 are extremely low and indicate a need for resuscitation
Exercise to rest ratio prescription in the inpatient rehab setting following MI? Outpatient ?
An exercise: rest ratio of 1:1 is appropriate for an initial prescription for inpatient setting, goal for OP is 2:1
Clubbing of finger nails caused by
Chronic hypoxia from heart disease or lung cancer and hepatic cirrhosis
Addison’s disease signs and symptoms
Asthenia*** (weakness), anorexia, weight loss, nausea and vomiting, abdominal pain, and syncope
What is the best initial exercise intensity prescription for an elderly pt with no history of CPD
60-90% of HRmax whip is equivalent to 50-85% of vo2 max and hhr
A progressive systemic disease of connective tissue causing fibrosis of skin, joints, blood vessels, and internal organs.
Scleroderma- initial intervention is to exercise in the pool since it will enhance the patient’s movements and decrease pain
A common finding with a pt c COPD stage III
Muscle wasting ( due to impaired functional abilities) and increase AP-to-lateral chest ratio
What dressing is used to prevent adherence to wound bed, keep wound moist, and protect granulation buds
Hydrogel dressing
Differentiate between carpal tunnel and promoter teres syndromes
Pronator teres syndrome produces similar problems to carpal tunnel but also with involvement of the flexors of the wrist and fingers
During valsalva maneuver what occurs
Inc intrathoracic pressure and causes HR to slow down, decreased return of the blood to the heart, and increased venous pressure. Upon relaxation, blood rushes to the heart and can overload the cardiac system, resulting in cardiac arrest
Standardized balance measure scores, signifying Fall risk. Tinetti POMA, tug, functional reach, and berg
Tinetti- 30 indicates an increased risk for falling
Murphys sign is indicative of
Acute cholecystitis
Supplemental oxygen is indicated when SpO2 and PaO2 drop below?
Spo2
What is inclusive on an incident report
Names of those involved, inclusive of witnesses, what occurred, when it occurred, and where it occurred
Initially, proper bandaging of lymphedema require what type of bandaging
Short term compression wrap- low resting and high working pressure. Means that it has enough pressure to enhance lymphatic return during rest, improve the activity of lyphangion, and facilitate increased return during muscle pumping activities
5 criteria for reducing exercise intensity or termination of session during cardiac rehab
- Onset of angina 2. Sbp > or equal to 240 dbp> or equal to 110 3. > 1 mm ST segment depression 4. Inc frequency of ventricular arrhythmias 5. Second or third degree AV block
Walking program parameters for a pt with claudication
2-3x/day, 3-5 days/week, the pt should be instructed to exercise to the point of claudication pain within 3-5 min, not beyond
A hemi or low-sear wheelchair has a seat height of?
17.5 inches and allows for propulsion
Emergency response for an unresponsive pt
Begin CPR and attach the AED as soon as it is available (1 breath every 8 seconds) with chest compressions (at least 100/minute)
Torque output of hamstring in a sitting position is inaccurate because
Higher due to gravity assistance in sitting position
What produces a unilateral sensorineural hearing loss along with vestibular symptoms
Acoustic neuroma
What causes a sensation of fullness in the ear
Ménière’s disease
Atropine is used for a pt c CAD. What are side effects of atropine ?
Anticholinergic agent- blocks the action of acetylcholine at parasympathetic sites in smooth muscle. Produces increased HR and contractility
What pathology is commonly associated with medial femoral torsion and toeing in
Hip anteversion angle >15 between femoral condyles and neck of the femur
The pupillary reflex (constriction of the pupil) is a function of
The efferent portion of the oculomotor nerve CNIII
Downward an lateral eye gaze
CN IV
An exercise tolerance test should be terminated if
Pt has an > 2 mm horizontal or down sloping ST segment depression, or >2 mm ST segment elevation, mod to severe angina, drop in sbp, serious arrhythmias, 260/115 or greater , severe sob, cns signs
Facilitate autolytic debridement and absorb mod-heavy amount of exudate
Calcium alginate
A pt is demonstrating multi focal PVCs. What should the PT do?
Have the pt sit down, cont monitoring, and notify the physician immediately. The emergency medical response should not be activated since the pt has not arrested.
Pts taking antipsychotic or antidepressant meds should avoid
Overheating
Horner’s syndrome hallmark findings
Clinical triad of ptosis (droopy eyelid), miosis (pupillary constriction), and anhydrosis (lack of sweating) all of ththe are side of the face and ipsilateral to side of lesion. Results from a lesion that affects the sympathetic pathway to the head
How to expose the supraspinatus tendon for under the acromion to administer ultrasound
Slog abduction and internal rotation
A donated of >___ makes a necks atypical dysplastic nevus
6 mm or greater. Also variations in colors, irregular boarders, elevation, indicative of malignant melanoma
Left ventricular failure characteristics
Persistent spasmodic cough while lying supine, HR rapid (140), SLIGHT EDEMA in both ankles, s3, paroxysmal nocturnal dyspnea, orthopnea, and signs or pulmonary edema ( dyspnea, pallor, cyanosis, tachypnea)
Right ventricular failure characteristics
DEPENDENT PITTING EDEMA!, weight gain, fatigue, ruq pain, anorexia, nausea, right sided s3 or s4, cyanosis of nail beds
Weakness, osteoporosis, fractures, and joint pain side effect of what drug
Corticosteroids
Child with supinated for optimal orthosis
Viscoelestic shoe insert with forefoot lateral wedge
During initial healing of a posterior lateral THA, stand pivot transfer to what side?
Sound side
A T11 Asia A pt bowel training should focus on a bowel methodology of ?
Digital stimulation of intact defecation reflexes, bowel and anal sphincters respond to rectal/anal stimulation
Pts standing in excessive subtalar pronation, what obligatory motions occur ?
IR of the tibia, femur and pelvis
Interstitial cystitis pelvic floor relationship
Pelvic floor dysfunction is related to muscles that are too tense or in spasm in response to pain and chronic inflammation of the bladder. Thus this is just the opposite of the too relaxed state that leads to incontinence. Thus kegal exercises shouldn’t be done
Chronic constipation, incontinence, vaginal and uterine prolapse all benefit from
Kegel exercises
For NMES, if the pt is complaining of discomfort how should you modify treatment
Decrease Pulse duration
Which GI source can refer pain to the shoulder?
Spleen or diaphragm
Esophagus can refer pain to
Midback, head or neck
Colon or appendix can refer pain to
LB, pelvis, or sacrum
Gallbladder can refer pain to the
mid back and scapular regions
Lesion to what causes uncoordinated eye movements, profound gaits and trunk ataxia, balance deficits, and difficulty with postural orientation
Vestibulocerebellum
Providing a posterior-directed resistance to the right ASIS during stance will?
Inc step length with r amputation
Intractable constipation (obstruction) refer pain to ?
Anterior hip, groin, or thigh region
When the occiput is sidebent in one direction, the C1 rotates into the _____ direction.
Opposite. Side bending and rotation occur to the same side from c2-c7 regardless if the spine is I’m flexion or extension
Normal integration of the stepping reflex
2-3 months
Avg mouth opening distance
35-50 mm
In the upper extremity the spastic muscle groups are?
Scapular retractors, shoulder adductors, depressors, and ir, elbow flexors and pronators, and wrist and finger flexors
A cyclist pt post MI 8 weeks ago is presenting for cardiac rehab. Which exercise test would be most beneficial in order to assess aerobic capacity ?
Lower extremity ergometry
Trigeminal neuralgia presentation
Sudden severe pain occurring in the maxillary or mandibular division on one side of the face
Myalgia, weakness, decreased hr and co are signs of ?
Hypothyroidism
The acl and pcl prevent medial or lateral Tibial rotation ?
Medial
Pt s/p meniscus repair should remain non weight bearing for?
3-6 weeks
The 5th rib is stuck in the position of maximal inspiration. What mob should PT do to improve rib mobility and assist it in returning to its resting position
Grade IV mob of the head of the rib at the costovertebral joint in the superior direction
A swishing sound that occurs in the presence of narrowing of an artery. It is the characteristic finding of PVD present on auscultation
Bruit
Slipped capital femoral epiphysis age range
10-6 years of age- pain worse with weight bearing, limited and painful hip ir, and weak hip abd
Avascular necrosis of the femoral head with insidious onset between 3-12 year of age
Legg calve perthes disease
A prosthetic knee set too far anterior to the trochanter-knee-ankle line is going to
Create a flexion torque at the knee, causing it to buckle easily
A prosthetic knee set too far posterior to the trochanter-knee-ankle line is going to
Will cause genu recurvatum due to extension torque
What is commonly seen on Childers who just begun to walk
Er of hip ie toe out gait for balance
Pt s/p a stroke is ambulating and presents with a pelvis that is elevated and retracted. What manual therapeutic strategy should the therapist utilize
Light resistance to forward pelvic rotation, in order to engage those muscles to help inhibit the tight muscles
Normal WBC ?
5000-10000 mm3
Normal hematocrit in woman
37-47%
Cellulitis vs dermatitis
Cellulitis is an inflammatory condition of the dermis and subcutaneous tissues accompanied by infection and fever VS dermatitis with characterized by edema, in by skin, and pain
Compensation for quad weakness during stance phase
Forward trunk lean vs BACKWARD lean is for glut max weakness
Trendelenburg position in terms of CARDIOPULMONARY
Head lower than the legs
Pt with large right sided bacterial pneumonia. Oxygen level dangerously low. What body position would best improve pt’s arterial oxygen pressure (pao2)
Perfusion and ventilation best matched if the pt assumes a l side lying position, c the unaffected side in a gravity dependent position
When doing biofeedback for a weak muscle, in which there is decreased ability to recruit motor units or there is a decrease in the size of and number of motor units, the protocol should be?
Wider spacing and a high sensitivity would be used in order to create an adequate visible signal
When the focus for biofeedback is non on a specific muscle but rather to encourage a general motion, then _____ spacing is used
Wider
Pt s/p a CVA is having difficulty standing up, so the therapist wishes to do biofeedback in seated position for the quads
Low detection- This would decrease the amplitude of the signals generated by the hypertonic muscles. By initially placing the electrodes close together, the therapist decreases the likelihood of detecting undersized motor units for, adjacent muscles
A negative Murphys sign (percussion in the costovertebral area)
Rules out likelihood of kidney symptoms
A pt is reviewing X-rays from a trimalleolar fracture
Best radiographic view to visualize the bony anomaly is AP and lateral .. Will show the head of talus using the AP view
If pt losses balance and falls with eyes closed on foam will likely demonstrate a
Vestibular deficiency
Obese young individual initial training program
Two daily sessions of 30 mins at 45-70% vo2 max
5 risk factors of metabolic syndrome
- Waist circumference >40 men; >35 women 2. Triglycerides level of 150 mg/dl or higher 3. HDLs 100 mg/dL
Hypokalemia signs and symptoms
Decreased potassium in the blood- Cramps, hypotension, dizziness, depressed st segment, GI disturbances, confusion, respiratory distress
Using FES on spastic muscle what should be the min ramp up time
5 seconds
Post C section PT should include
Postoperative TENS, assisted breathing and coughin techniques, and gentle abdominal exercises with incisional support by a pillow, and pelvic floor exercises
Disordered thinking, fragmented thoughts, errors of logic or abstract reasoning, delusions, poor judgement are signs of
Schizophrenia
Sleep disturbances and flashbacks are signs of
PTSD
Proper high for toilet seat
17-19 inches
Proper height for horizontal grab bars
33-36 inches
An inverted T wave indicates?
Myocardial ischemia - symptom is angina
Bell’s palsy PT interventions
Massage, stretching, and moist heat assist in maintaining pliable musculature and increasing comfort. For pts who can’t shut they’re eye it is especially important to provide protection
After an ST elevated MI three days ago it is okay to administer an exercise test if
HR stays at or below 70% age predicted max
