Patient Care, Community Health, Occupational Health Flashcards
CARING
Communicate clearly Accept pt w/o judgement Respect pt by allowing them to make their own decision about their health Inspire confidence in who you are Nurture the pt Give of yourself
Absolute contraindication
AAA, acute muscle spasm, C1-2 instability, bone tumor, cancer, cauda equina syndrome, dislocation, fx, hypermobility, inflammatory arthridities (RA, AS), leukemia, lymphoma, myelopathy, osteomyelitis, osteogenesis imperfecta, LCP disease, radiculopathy w/atrophy or severe muscle weakness, undiagnosed pain, VBAI (diplopia, dizziness, drop attacks, dysarthria, ataxia, nausea, dysphagia, numbness, nystagmus)
Relative contraindication
Anticoagulants (Warfarin, Coumadin), DM, Ehlers-Danlos, Fibrous dysplasia, spinal canal stenosis, osteoporosis, pregnancy, spondylolisthesis, syringomyelia
Side effects of a chiropractic adjustment:
Local discomfort in area of treatment, fatigue, headache, nausea, dizziness
Cancer referrals:
Bone - ortho Brain - neuro GI - gastroenterologist Lung - pulmonologist Ovarian - gynecologist Skin - dermatologist Uterine - gynecologist
SOL referrals:
Spine - neurologist
Chest - thoracic surgeon
Abdomen - General surgeon
Pelvis female and male - gynecologist and urologist
Changes in vitals to be sent to hospital:
BP <90/60, pulse>120 bpm, respiration >28/min, cyanosis, change in LoC, active vaginal bleeding in a pregnant woman
Exercises for:
LBP
Overweight
Poor posture
Core strengthening
Aerobic exercise
Core strengthening
Dietary advice for: Allergies Celiac DM Gout HTN Obesity Urinary stones
Allergies: Elimination of wheat products
Celiac: GF diet
DM: Avoid simple sugars, eat more complex starches, supplement chromium polynicotinate
Gout: Avoid alcohol and high purine containing food
HTN: Avoid excess salt
Obesity: Smaller portions of low fat, high protein and low carbs
Urinary stones: avoid dark green leafs
Massage for
Chronic muscle strain:
RTC Injury:
Chronic LBP:
Chronic muscle strain: transverse friction massage (not if DVT)
RTC Injury: Codman’s exercises
Chronic LBP: William’s exercises
Supplements for: Hypercholeterolemia Inflammatory conditions Iron deficiency nerve damage osteoporosis Osteoarthritis Recurrent infections Wounds Yeast infection Strokes
Hypercholeterolemia: Niacin Inflammatory conditions: Omega 3, Vit D Iron deficiency: Iron w/Vit C nerve damage: Vit B1, B6 and magnesium osteoporosis: Calcium, Vit D3, natural progesterone Osteoarthritis: glucosamine Recurrent infections: Zinc Wounds: Zinc Yeast infection: L. acidophilus Strokes B12
Omega 6’s have linoleic acid which produces what substances in the inflammatory process?
Leukotrienes
Prostaglandins
Prostacyclins
Modalities for: Acute sprain/strain vs chronic Deep joint pain Acute injury vs chronic Traction
Ice vasoconstricts and reduces swelling, heat vasodilates and promotes healing
IFC
US vs low level laser for mitochondrial activity and healing
Relieve muscle spasm or tight capsules or break down scar tissue
ART
Leahy 1985 Scar tissue break up
Scar tissue from acute injury, micro-trauma or hypoxia
Prevention 1o 2o 3o 4o
Specific measures taken to forestall devo of illness
Stopping development to previously unaffected individuals or populations: exercise, hand washing, balanced diet, immunizations
Limit recurrence of illness in patients all ready affected: health screening for cervical cancer
Reducing disability or impact of established disease by restoring function and decreasing disease related complication: rehab
Mitigating consequence of excessive or unnecessary interventions in health system: use of EBCP
SAID Principle
Specific adaptation to imposed demands
Human body can adapt to and function w/in a wide range of external condition given regular exposure
DOA FDA EPA USDA OSHA CDC HSA NIH
Department of agriculture: inspect meat/milk
Food and Drug Admin: quality of drugs, cosmetics, food and medical devices
Environmental protection agency: Water and air quality
United States Dairy Association: Quality of dairy products
Occupational Safety and Health Admin: workplace safety, hazardous material
Centers for Disease Control: epidemiological studies and health stats
Health services admin: care to underprivileged
National institute of health: disease research and funding
Incidence vs prevalence:
# of new cases in population over specific time period # of existing disease cases in defined population during a specific time period
Health Screenings: Ab US Breast exam Cholesterol Colonoscopy DEXA Fasting blood sugar Fecal Occult Blood Mammogram Pap smear PSA
Ab US: for >65 years and smoking Breast exam: for >20 years Cholesterol: >35 in males, >45 in females Colonoscopy: >50 years DEXA: Females >65 Fasting blood sugar: >45 years Fecal Occult Blood: >50 years Mammogram: Females >40 years Pap smear: Females >21, <65 PSA: Males >50, <70
Tobacco use is linked with?
Alcohol
Cocaine
Marijuana
Lung, esophageal, bladder cancers
Cirrhosis, brain atrophy, spousal and child abuse
Heart attack, criminal addictive behaviour
Pulmonary disease, criminal addictive behaviour
Nutrient Use Source Biotin (B7) Chromium Copper Folic Acid Iodine Iron Magnesium Niacin (B3) Riboflavin (B2) Selenium Thiamine (B1) B12 C D A K E Zinc
Nutrient Use Source
Biotin (B7): carboxylation reactions - Liver, egg yolks, nuts, legumes, cauliflower
Chromium: Glucose transport - Liver, brewer’s yeast, whole grains
Copper: ETC - Nuts, peas, mushrooms, shellfish
Folic Acid: DNA/RNA synth - Fresh green leafy vegetables
Iodine: Thyroid hormone synthesis - seafood iodized salt, eggs and dairy products
Iron: Formation of hemoglobin, ETC - beef, liver, clams, peaches, dark green leafy veg
Magnesium: ATP complexes - nuts, whole grains, seafood, green leaves
Niacin (B3): precursor for NAD/NADP - whole grain, legume, fish, red meat, liver
Riboflavin (B2): Cofactor for FADH2 - eggs, milk, cheese, meat, liver
Selenium: protection from free radicals - meats, plants
Thiamine (B1): Cofactor in pyruvate kinase - whole grains, legumes, nuts meat
B12: Synthesis of DNA, methionine from homocysteine and succinyl CoA - meat, fish, eggs, milk + milk products
C: hydroxylation of proline in collagen synth - citrus fruits, tomatoes, broccoli, sweet peppers
D: calcium and phosphate absorption - UV light, egg yolks, fish liver oil
A: Formation of rhodopsin - Dark green leafy/yellow veg and liver
K: Formation of prothrombin and other clotting factors - Green leavy veg, liver, soy beans, veg oils and bacteria in colon
E: intracellular antioxidant protection from free radicals - veg and wheat germ oils and nuts
Zinc: carbonic anhydrase - meat, oysters, liver, eggs, peanuts
Metabolic syndrome/Syndrome X
Presence of >/=3
Elevated fasting blood sugar, HTN, raised triglycrides and increased ab girth (>40” and 35” in females)
Increased risk of T2DM, CVD, stroke
Ideal cholesterol/HDL ratio
4:1 200mg to 50mg
Higher ratio increases risk of heart attack and strokes
Top 5 most dangerous occupations:
Loggers, Fisherman, Airline pilots, Roofers, Refuse and recyclable waste collectors
Water purification
1o tx
2o tx
optional steps
1o tx: filtration, flocculation (add aluminum sulfate), sedimentation, sludge digestion (add anaerobic bacteria)
2o tx: sand filtration (remove anaerobic bacteria), aeration (kill anaerobic bacteria), chlorination
optional steps: softening (add calcium/magnesium), fluorination (promote dental health)
Pasteurization methods: Batch Flash Ultra-high Sterilization
145oF - 30 mins
161oF - 15 s
191oF - 2-5 s
274oF - 15 minutes
Coal miners get? Sugarcane workers get? Cheese makers get? Cotton textile workers get? Parrot handlers get? Iron ore miner gets? Quarry worker/sand blaster gets? Rabbit skinners get?
Anthracosis Bagassosis Brucellosis Byssinosis Psittacosis Siderosis Silicosis Tularemia
Chagas disease is found where? Caused by? Coccidiomycosis? Espundia? Lyme disease? Amebic encephalitis? Histoplasmosis?
Brazil/South America - Trypanosome cruzi San Joaquin valley - Coccidioides immits Brazil, South America - Leishmania brasiliensis Northeast USA Borrelia burgdorferi Florida in summer - Naegleria fowleri Ohio valley Histoplasma capsulatum
