Other systems Flashcards
Dependent Rubor
a condition of redness that appears when the extremity is placed in a dependent position and resolves with elevation
- most observed with PAD
Initial Contact
- AKA Heel Strike
Loading Response
Foot Flat
Terminal stance
Heel off
Pre Swing
toe off
Initial Swing
Acceleration
Terminal Swing
Deceleration
What phases of the gait cycle are double limb support?
Initial Contact and Pre Swing
What percentage of the gait cycle is stance and what percentage of the gait cycle is swing?
60% stance
40% swing
What do the anterior muscles do in gait and who are they?
The anterior muscles propel us forward
- hip flexors
- knee extensors
- dorsiflexors
- abs
What do the posterior muscles do in gait and who are they?
The posterior muscles push us to leave the ground
- hip extensors
- hamstrings/knee flexors
- plantar flexors
- erector spinae
How much range of motion does the HIP need for each phase of gait?
Stance Phase: 0-30 knee flexion, 10-20 extension
Swing phase: 20-230 flexion
How much ROM does the KNEE need for each phase of gait?
Stance phase: 0-40 degrees of Flexion
Swing phase: up to 60 degrees of flexion
How much ROM does the ANKLE need for each phase of gait?
Stance Phase (0-10 DF) (0-20 PF)
Swing Phase (0-10 PF_
Signs and Sx of Metabolic Syndrome
Waist Size > 40 inches male and >35 inches female
Triglycerides > 150 mg/dl
Elevated BP (130/85 or more)
Fasting Blood Sugar > 100
HDL Cholesterol <50 (female), <40 (men)
HBA1C Levels
Pre-Diabetes 5.7-6.4
Diabetes > 6.5-7
Horners Syndrome
drooping of eyelid, lack of sweating, pupil constriction
Symptoms of a Pancoast Tumor
compression of paravertebral sympathetic nerves
hoarseness, atrophy, and weakness of muscles and hand
Kehr’s Sign
(+) Kehr Sign
pain in the left shoulder with pressure placed on the upper abdomen
- can be caused by perforation of viscus (stomach ulcer), laparoscopy, rupture of the spleen
Where will pancreatic pain refer to?
the right shoulder
What is a long-term complication of Type 1 DM?
Cardiac denervation syndrome which results in a fixed HR that is unresponsive to exercise, stress or sleep
Sx of Hypoglycemia
shakiness
weakness
abnormal swearing
nervousness
anxiety
tingling of moth and fingeres
Wagner Ulcer Classification System
Used for diabetic foot when neuropathy and ischemia are present
Grade 1: superficial ulcer
Grade 2: ulcer extension, involves lig, tendon, joint capsule, or fascia. no abscess or osteomylitis
Grade 3: abscess or osteomyelitis
Gangrene!
Typical IBS Pattern
LEFT lower quadrant pain
pain that disappears at night/with rest
abdominal pain, constipation, and diarrhea
relief with defecation
Sx of Hyponatremia
low sodium levels
nausea
headache
confusion
fatigue
Sx of Hypokalemia
low potassium levels in blood
feeling tired
leg cramps
constipation
abnormal heart rhythm
Rhabdomyolysis Presentation
potentially fatal condition
muscle disintegration
increased creatine kinase
(>145 female, > 170 male)
tea/dark urine color
liver failure
aches cramps and soreness of muscles
Side Effects of Chemotherapy
fatigue
anorexia
nausea
diarrhea
ulcers
hemorrhage
bone marrow suppression
anemia
leukemia
thrombocytopenia
fatigue
skin rashes
neuropathies
phlebitis
hair loss
What is Murphy’s Sign?
Murphy’s sign is a test for cholecystitis
It assesses the right upper quadrant by placing the patient in a supine position and placing your hands on the right upper quadrant at the inferior costal margin. The patient breathes in and the examiner palpates deeply in the subcostal region with the fingertips. Test = (+) if pt stops inspiring bc of pain or has pain
What is cholecystitis?
The blockage or impaction of gallstones in the cystic duct which leads to infection or inflammation of the gallbladder. Pt may feel steady severe pain that rapidly increases in intensity lasting several minutes to hours. May also experience nausea, vomiting, and fever
TMN
Tumor node metastasis
- classifies cancer into stages the most common system for the body except the brain is TNM
T refers to main tumor and describes size
N refers to the lymph nodes and whether the cancer has spread there
M indicates whether there is a distant metastasis fo the cancer
Metabolic Syndrome Risk Factors/Criteria
Metabolic Syndrome is strongly associated with type 2 DM, CV, and stroke
diagnosis made if 3 or more are present
WEIGHHT
WE: waist expansion, circumference >40 in men, >35 in women
IG: impaired glucose, >100 (fasting glucose)
H: Hypertension >/= 130 SBP >/= 85 DBP
H: HDL (good cholesterol) <40 M, < 50 women
T: triglyceride >150 mg/dL
Which hormones does the anterior pituitary gland release?
ACTH
TSH
FSH AND LH
GH
PROLACTIN
What hormones does the posterior pituitary gland release?
ADH/VASOPRESSIN
OXYTOCIN
What does the parathyroid gland stimulate?
calcium and phosphate metabolism
(direct relationship with calcium, inverse relationship with phosphate)
Addison’s Disease
Hypofunction of the adrenal gland
cortisol and aldosterone are decreased
Signs and Sx include
- LOW BP
- dehydration
- inflammation
- Hyperkalemia (aldosterone Kicks it out)
- low glucose
- bronze skin
- weight loss and anorexia
- intolerance to cold or stress (STRESS IS HIGH)
- generalized weakness
Cushing’s Disease
- cushing’s disease is a hyperfunction of the adrenal gland so there is hella cortisol and aldosterone
SX INCLUDE - hypokalemia
- increased glucose
- ruddy appearance
- larger tummy (centripetal obesity) moon face
- proximal muscle weakness
- prone to infection, osteoporosis, humps in the back, poor wound healing
What is Cushing’s syndrome?
a problem in the adrenal cortex whereas disease is a problem in the pituitary gland
So if there is too much ACTH this is from the anterior pituitary and its cushing’s disease not syndrome
Sx of Hyperthyroidism
TOO MUCH OF EVERYTHING GOING ON
- weight loss due to inc. metabolism
- heat intolerance
- sweaty
- diarrhea
- increased glucose absorption (low blood sugar)
- hyperreflexia
- fatigue bc their body is going too crazy
- insomnia and restlessness –> can’t slow down
- increased heart rate and lower diastolic blood pressure but higher systolic
Grave’s Disease
Expopthalmos: their eyeballs be bulging
Sx of Hypothyroidism
Not enough the metabolism is too slow
- weight gain
- higher blood sugar
- cold intolerance
- sleepy, tired, muscle weakness
- constipation
- DRY AS HELL nails are breaking
- decreased sweating
- delayed reflexes
- Hashimoto’s
Myxedema: uncontrolled hypothyroidism leads to puffiness and swelling of hands and feet
Hyperparathyroidism
Elevated calcium and decreased serum phosphate –> increased calcium in the blood
Sx
BONES: osteopenia, fx, arthralgia
STONES: kidney stones
GROANS: tummy pain, peptic ulcers, nausea/vomiting
MOANS: fatigue, don’t want to get up, depression, confusion
SENSORY: stocking/glove sensory deficits
Hypoparathyroidism
Low calcium and high serum phosphate
CATS Are NUMB
C- convulsions
A- arrhythmias
T- tetany
S- spasms
- muscle weakness, paresthesia of mouth, fingertips
Dx of DM
Fasting Glucse > 126 mg/dL
Random Blood Glucsoe > 200 mg/dL
HbA1C: >8%
HbA1C
average of blood glucose over last 3 months
4-6% normal
Between 6-10 DM
>10% immediate insulin therapy
Signs of Hypoglycemia
<70 glucose
Sweating
pallor
shakiness
poor coordination/unsteady gait
tachycardia, palpitations
excessive hunger
Later you’ll see slurred speech, confusion, even coma
“cold and clammy give me a candy”
Signs of Hyperglycemia
Hot and dry is a sugar high
- weakness
- dry mouth
-PPP: polydispia, polyuria, polyphagia
- signs of diabetic ketoacidosis
- excessive thirst
- late signs can also include coma
- >300 glucose
Exercise Precautions for patients with DM
avoid exercise during peak insulin hours (2-4)
apply insulin in abdomen or non-active extremity
reduce insulin dosage post exercise
no extreme temperatures
Safe blood glucose to exercise
101-250
Can you exercise a patients with DM whose blood sugar is 70-100?
only if you give them a carbohydrate snack first and then check their BG, if higher proceed
When to not exercise a patient with DM
BG <70 or greater than 300
FITT Principle for DM
Frequency: 3-7 days per week
Intensity: 11-13 RPE can build to 17
Time: 150 mins per week can progress to 300
Type: moderate intensity aerobic with larger muscle groups
Functional incontinence
due to mobility, dexterity, or cog deficits
treat with clearing clutter, improve accessibility, prompted voiding
Treatment of Stress Incontinence
strengthen levator ani muscles
Overflow Incontinence Treatment
behavioral modification like double voiding, medication, catheterization
key word: dribbling, underactive detrusor
Hyponatremia Sx
headache
cramps
lethargic
confusion
Hypernatremia Sx
Thirst (polydipsia)
irritable
vascular collapse
ataxia
seizures
Hypokalemia Sx
EKG Changes
Dec. cardiac muscle contractility
LEG cramps
weakness
dizziness
hypotension
Hyperkalemia Sx
EKG changes
muscle weakness
paresthesias
nausea
Hypocalcemia Sx
tetany
osteopenia
anxiety/confusion
cardiac arrhythmias
numbness
fatigue
Hypercalcemia Sx
cardiac arrythmias
stupor/coma
weakness
decreased deep tendon reflexes
lethargy
INR
1.0 Normal
Therapeutic Range 2.0-3.0
>4 NO
Absolute Contraindications for Exercise in Pregnancy
Type 1 DM
Preeclampsia
Restrictive Lung Disease
severe anemia
Appendicitis Tests
Rebound tenderness (Blumberg’s Sign)
McBurney’s Point
Rovsing’s Sign
Psoas Sign
Obturator Sign
Markle’s Sign
Pinch an inch on the RIGHT
- pinch an inch on the left = diverticulitis
