PEAT 2 questions Flashcards
effect size
- magnitude of difference between two mean values
efficacy
- extent to which an intervention produces a desired outcome under ideal conditions
effectiveness
- extent to which an intervention produces a desired outcome under usual clinical conditions
minimal clinically important difference
- smalles treatment effect that would result in a change in patient management, given its side effects, costs, and inconveniences
moist hot pack time
- ideal time is 15-30 minutes
knee MOI and injuries
- PCL: hyperflexion, hyperextension
- ACL: excessive hip adduction, IR, ER
- popliteal ligament –> reinforces lateral capsule, limits anterior/medial rotation of tibia, hyperextension of knee
- LCL: varus force in extended position
assessment of patellar tendon reflex is test of _
- L4 nerve root function
- L5 nerve root assessed with deep tendon reflex test of hamstrings
deep tendon reflex testings tests _ and does not incldue _
- tests monosynaptic reflex
- does not include spinal cord tracts/columns
should you ask direct or indirect questions
- direct
habituation exercises
- for vestibular hypofunction, not BPPV
brandt-daroff
- BPPV treatment
- nonspecific
- outcome not as good as canalith repositioning for BPPV
gaze stability exercises
- for vestibular hypofunction that resuts in impaired gaze stability
avascualr osteonecrosis
- d/t undetected chilhood developmental hip dysplasia
- in adolescence or adulthood
- s/s: hip or groin pain, limited hip IR/flexion/ABD
- TTP over hip joint
legg calve perthes disease
- 3-13 YO male, often small in stature
- avascular necrosis - disrupts blood flow to capital femoral epiphysis
- 4 defined stages
slipped capital femoral epiphysis
- in adolescents
- s/s: antalgic gait and pain in groin, knee, medial thigh
- externally rotated knee
- in acute stage, adolescent unable to bear weight on affected extremity
- obesity often a factor in development of condition
s/s of hypothyroidism
- lethargy
- decreased appetite
- constipation
- muscle aches
- cold intolerance
- decreased cerebral blood flow leads to cerebral hypoxia and slowed neurologic functions - reduced peristaltic activity -> constipation and decreased appetite, decreased muscle contraction and relaxation rate -> aches, decreased circulation -> cold intolerance
s/s of hyperthyroidism
- restlessness
- increased appetite
- diarrhea
- heat intolerance
parkinson disease s/s
- erratic breathing d/t dyskinetic movement patterns of respiratory muscles
- decreased chest excursion and inspiratory volume d/t rigidity and respiratory muscle weakness
hoehn and yahr stages
- for parkinson disease
functional knee braces
- reduce anterior translation at low external loads
- neoprene knee braces improve proprioception
e-stim parameters
- lower pulse frequency - promotes muscle strength
- short pulse duration - for pain
basal ganglia lesions
- difficulty with initiation of movement
motor info is processed in
- primary motor cortex in precentral gyrus of cerebral cortex
sensory info is processed in
- primary somatosensory cortex, located in postcentral gyrus of cerebral cortex
exercises for osteoporosis should avoid
- flexion –> compression fractures associated w/ trunk flexion
- instead, emphasize stretching antagonists muscles: shoulder horizontal adductors, shoulder IR, hip flexors, hip IR
food to avoid with GERD
- large meals that distend the stomach
- chocolate, peppermint, alcohol, caffeinated coffee, fried/fatty foods
- dairy foods and high-sugar foods have no effect on reflux
stress incontinence
- due to weak pelvic floor muscles, internal urethral sphincter failure, hypermobility of ureterovesical junction, damage to pudendal nerve
- due to increased in abdominal pressure - laughing, sneezing, straining, coughing, exercise
- not caused by anxiety
overflow incontinence
- d/t underactive detrusor muscle
- constant leaking of small amounts of urine and sensation of bladder not being fully emptied after voiding
urge incontinence
- detrusor muscle spasms
- sudden urge to void, involuntary leakage of urine
3rd trimester and inferior vena cava
- IVC pressures rise in late pregnancy - rise more in supine
- leads to decrease in venous return and cardiac output
- leads to s/s of dizziness, nausea, SOB
diminished dorsalis pedis pulse expected with
- arterial insufficiency
venous filling time
- for pts w/ venous insufficiency that present with hemosiderin staining
- venous insufficiency if venous filling time is < 15 seconds
normal respiratory rate for 8 YO child
- 18-30 breaths/minute
normal respiratory rate for toddler (1-3 YO)
- 24-40 breaths per minute
normal respiratory rate for infant (birth to 1 year)
- 30-60 breaths/minute
klumpke palsy
- c8-t1 brachial plexus injury
- weakness of finger extensors and intrinsic hand muscles for MCP abduction
erb palsy
- C5-C6 brachial plexus injury
- s/s: shoulder held in extension, IR, and adduction with forearm pronated
a patient feeling light-headed from sit to stand should
- sit and do ankle pumps
pulmonary edema is a symptom of
- L ventricular failure
paroxysmal nocturnal dyspnea
- d/t inability of L ventricle to adquately distribute oxygenated blood through body
management of scoliosis
- orthotic management: for children with idiopathic scoliosis who are skeletally immature, have a Cobb angle of 25-45 degrees
- spinal fusion: for documented, progressive idiopathic curve, cobb angle > 40 degrees
varus displacement at elbow results in
- lateral collateral ligament instability
valgus displacement at elbow results in
- (+) stress test for medial collateral ligament
anterior displacement at the elbow occurs when
- olecranon is displaced anteriorly
posterolateral displacement at elbow
- displacing the coronoid process inferior to the trochlea - requires ulna displaced posterolateral to humerus
freiberg disease
- avascular necrosis of second metatarsal epiphysis - leads to collapse of osteochondrotic deformity
- s/s: pain in met heads with activity, ROM limitations, joint swelling, occasional plantar callosity under under second met head
- no neuro signs
anterior tarsal syndrome
- deep aching pain in medial and dorsal aspect of foot
- burning around nail of great toe, pins and needles sensations exacerbated with plantar flexion
morton neuroma
- mechanical entrapment neuropathy of interdigital nerve
sesamoiditis
- pain on WB and swelling of plantar soft tissue
- passive DF of MTP joint while palpating sesamoids exacerbates pain
- no neuro signs
short stretch bandages
- bandage of choice for lymphedema - latex free, stretch about 60% more than original length
- provide high resting pressure - can lead to compression of more supeficial lymphatic and venous vessels
loose packed position for hip
- 30 flexion
- resting position: 30 flexion, 30 abduction
loose packed GH joint
- 55 degrees abduction
- resting: 55 abduction, 30 horizontal adduction
loose packed position for tibiofemoral joint
- 25 flexion is resting or loose packed position
loose packed humeroulnar joint
- 70 flexion
myocardial ischemia associated with
- chest pain and ST segment changes on ECG
cardiovascular pump failure
- S3 heart sound
- crackles (rales) heard on inspiration - do not disappear with coughing, may appar with exercise
- terminate exercise
axillary nerve innervates
- deltoid: shoulder flexion, abduction, extension
- teres minor: shoulder lateral rotation, horizontal abduction
subscapular nerve innervates
- teres major: shoulder extension, IR, adduction
suprascapular nerve
- supraspinatus: shoulder ER and abduction
- infraspinatus: ER, horizontal abduction
long thoracic nerve
- serratus anterior: upward rotation and protraction of scapula
a right thoracic hump upon forward bending indicates a _ thoracic structural scoliosis
- right
patients with SI joint dysfunction
- aggravated by prolonged standing, asymmetrical WB, stair climbing, running, long strides, extreme postures
- won’t have pain w/ sitting, lying in prone, lying in supine
contraindications to PT
- dissecting aortic aneurysm
- decompensated chronic heart failure
- third degree heart block
- NOT a-fib: new onset a-afib with rapid ventricular rate (>100 bpm) is a contraindication
stages of lymphedema
- 0: no clinical signs of edema though reduced lymph transport capacity present
- 1: ptting edema reversible w/ elevation, edema increases with activity, heat, humidity, better in morning
- 2: nonpitting edema, irreversible with fibrotic skin changes
- 3: increase in severe nonpitting fibrotic edema and atrophic changes in skin, hyperkeratosis, papillomas, warts
babinski sign is indicator of damage to
- corticospinal tract - motor pathway
spinal shock
- period of areflexia immediately after acute SCI
- characterized by absence of reflex activity - impairs autonomic regulation and results in hypotension and loss of ability to swet
clunk test
- to confirm tear of glenoid labrum
heat moldable healing shoe
- molded directly to patient’s foot
- common after amputation or skin grafting
- does not alleviate WB on metatarsal heads
heel rocker shoe
- for extreme forefoot relief
- transfers patient’s weight to heel area
- facilitates wound healing for metatarsal and distal toe ulcers
e-stim for pain relief w/ muscle spasm
- coventional TENS - produces sensory-level stimulation
- tolerated well w/ acute pain
types of TENS setting
- burst: like acupuncture setting, appropriate for chronic pain conditions
- acupuncture: produces painful noxious stimulus to release endorphins, may not be tolerated w/ acute symptoms
- conventional: produces sensory-level stimulation, tolerated well by patient in acute pain
- low frequency: releases endorphins by providing noxious stimulus, may not be tolerated well by pt in acute pain
liver, pancreas, and gallbladder pain referral patterns
- liver: right shoulder, upper back, chest
- pancreas: middle or lower back, LUQ
- gallbladder: R shoulder, chest, upper back
desired hamstring length for paraplegia or tetraplegia
- want HS to be long enough to allow for 100 degrees of SLR
tight lower trunk muscles improve _ in paraplegic patients
- tight lower trunk muscles improve sitting stability
trunk _ is contraindicated in spondylisthesis
- extension
- trunk flexion is indicated for individuals w/ spondylisthesis
trunk _ is indicated for individuals with herniated lumbar discs
- extension
volar plate injuries
- d/t PIP extension force
- results in excessive passive PIP extension and empty end-feel d/t pain, swelling, guarding
venous vs arterial ulcers
- venous
- irregular shape
- highly exudative
- frequently develop at medial distal leg
- arterial
- round
- dru
_ (med) likely to increased risk for peptic ulcer disease
- ibuprofen (motrin)
- impairs gastric protective mechanism against corrosive acids
polycythemia
- bone marrow stem cells produce excessive RBCs
precautions for THA w/ transtrochanteric surgical approach and reattachment with wire
- no resisted hip abduction
- no isotonic hip abduction against gravity
common finding with radial nerve mobility issue
- decreased extensor carpi ulnaris strength
heart sounds
- S1: normal sound when mitral and tricuspid valves close
- S2: normal sound when aortic and pulmonic valves close
- S3: normal in children and young adults, abnormal over 40; indicative of ventricular failure in heart failure
- S4: abnormal sound w/ cardiomyopathies and coarctation of aorta but not with L ventricular failure
heart sounds auscultation points
- aortic - R 2 sternal border
- pulmonary - L 2 sternal border
- tricuspid - L 4 sternal border
- mitral - L 5 midclavicular line
what is entrapped in a hiatal hernia
stomach - protrudes through cardiac or lower esophageal sphincter
lateral foot posting
- for forefoot valgus
metatarsal bar
- for reducing pressure on MTP joint by transferring stress to metatarsal shaft
medial rearfoot posting
- corrects rearfoot varus in pronated foot
you need _ passive MTP joint extension at heel off
- 55-90 degrees
knee ROM for sitting in 18 inch chair, to tie shoelaces, ascending a 5 in step, descend a 5 inch step
- for sitting in 18 inch chair: 80ish degrees
- bringing foot up to tie shoelace: 110
- ascend or descend 5 in step: 85ish
normal respiratory rates for 1 year old
- 30 breaths per minute
sensory distribution of hand
head thrust test
- for semicircular canal function
- if pt has a unilateral lesion, will not be able to maintain gaze when head is rotated quickly toward side of lesion
huffing
- moves mucus into large airways to produce effective cough
order of cervical positions that put most -> least stress on verterbal artery
- rotation-extension-traction
- rotation-extension
- rotation alone
- side flexion
- extension
- flexion
right torsional nystagmus w/ Dix-Hallpike test indicates
right posterial canal
nystagmus is provoked when affected ear is
inferior
mobilization w/ hand placement affects
- that vertebrae and the one below it
_ diameter nerve fibers are activated first during e-stim muscle contraction
- large
bell palsy involves paralysis of _
- facial nerve (CN VII) - impairs strngth of frontalis
stemmer sign
a child w/ CP and strong extensor tone in trunk and extremities should be carried _
- in a sitting position - promotes visual attending, use of UEs, social interaction
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