POSITIVE VIBES Flashcards
Peak incidence of scoliosis
11-13 in F
13-14 in M
Prostaglandins - stomach
Prostaglandins helps protect the lining of the stomach by inhibiting gastric acid secretion and increasing the production of mucous in the stomach lining
NSAIDs and prostaglandins
NSAIDs inhibit the production of prostaglandins which results in stomach becoming more susceptible to damage from the gastric acids
Sarcoidosis
Occurs primarily btw ages 20 and 40
W more than M
Primary characteristics = Tiny clumps of abnormal tissue (granulomas) that form on certain organs or over certain regions of the body
Most commonly the lungs, skin, bones, mm, and nervous system
Systemic sclerosis
Scleroderma = autoimmune disorder affecting CT that results in fibrosis of skin, BVs, joints, and internal organs
Primary characteristic of initial stages is bilateral non pitting edema that is eventually replaced by thick, hard skin
Bronchiectasis
Progressive and obstructive lung disease secondary to a chronic bacterial infection
Irreversible destruction and dilation of the airways
Primary characteristic = persistent cough, large amounts of purulent sputum
PKU - if untreated can lead to
Intellectual disability
Tremors
MM coordination deficits
Seizures
Weak PF - what is possible gait deviation from foot flat to midstance
Foot flat to midstance = PF cx eccentrically to control DF moment and ant translation of tibia
Weakness in PF = excessive DF
Normal Q angle
13 in M
18 in F
Normal anteversion
8-15 degrees
More = anteversion
Less = retroversion
End stage renal disease - pt will develop s/s associated with
Impaired fluid and waste excretion - systemic and pulmonary edema
Urine output is decreased
Kidney plays role in development of erythropoietin so will often see anemia too
Assoc of CP rehab classifies an EF of 45% as what risk for increased mortality and morbidity
Moderate risk
Still able to participate in exercise program
Assoc of CP rehab classifies pt with hx of uncomplicated MI and/or cardiac surgery as what risk for increased mortality and morbidity
Low risk
Assoc of CP rehab classifies pt with ST segment depression of 1 mm as what risk for increased mortality and morbidity
Moderate risk
If was greater than 2 mm then would be high risk
Assoc of CP rehab classifies pt with ventricular arrhythmias at rest as what risk for increased mortality and morbidity
High risk
Pts with uncontrolled arrhythmias should be excluded from exercise
Following cardiac transplant - what changes with HR
Increased resting HR (often greater than 80 bpm)
Dec HR response with exercise
Dec peak HR during exercise
Cushing syndrome - common s/s
Hypertension caused by potassium depletion and Na and H20 retention
Hypertension can cause left ventricular hypertrophy and inc risk of CHF or CVA
Central obesity, moon shaped face, hyperfunction of adrenal cortex
Tarsal tunnel is located
Posterior to the medial malleolus
Pain typically around the ankle region and may extend into toes
Half kneeling - anterior vs. posterior LE
The posterior LE is maintaining hip extension and lower trunk control
Order them from easiest to hardest for someone post CVA - half kneel with involved ant, half knee with involved post, tall kneel, bridge
Bridge
Half kneel with involved ant
Tall kneel
Half kneel with involved post
Controlled mobility refers to what
Ability to move within a WB position or rotate around a long axis
Activities emphasize weight shifting and trunk control with rotation
Stages of motor control
Mobility
Stability
Controlled mobility
Skill
Stability refers to what
Ability to maintain a position or posture through cocontraction and tonic holding around a joint
Unsupported sit with midline control is example
Gag reflex - which nerve
Glossopharyngeal
PT touches pharynx with tongue depressor
Jaw jerk reflex - which nerve
Trigeminal nerve
Somatoagnosia
Impairment of body schema where there is a lack of awareness of a body structure and its relationship to other body parts, to oneself or to others
Anosognosia
Severe denial or awareness fo the presence or severity of one’s neurologic defect or illness
Pt may deny that a paretic limb belongs to them or lie about why an extremity does not move as it should
Highest level of SCI that would be able to drive an adapted van
C6
Positive predictive value =
estimates prob that a person who tests pos on screening test actually has the condition
TRUE POS
Bobath =
NDT
Pt learns to control movement through functional activities that promote normal mvmnt patterns that integrate function
Focused on reinforcing normal mvmnt through key points of control and avoiding all reflex movement patterns and associated reactions
Kabat, Knott, and Voss approach =
Based on premise that stronger parts of the body are utilized to stimulate and strengthen weaker parts
Rood approach =
Based on sherrington and reflex model
Believed that all motor output was result of both past and present sensory input
Introduced sensory stimulation to facilitate or inhibit responses - like icing
Brunnstrom approach =
Created and defined the term synergy and initially encouraged the use of synergy patterns during rehab
Sympathetic pupil response
Dilation
Parasympathetic pupil response
Constriction
Raimiste’s phenomenon
Involved LE abducts or adducts with applied resistance to the uninvolved LE in the same direction
Souques’ phenomenon
Pt raises involved UE above 100 deg with elbow ext and leads to extension and abd of involved fingers
Coordination synkinesis
Voluntary cx of certain mm groups on involved side that in turn gives rise to involuntary cx of synergistic mm
Homolateral synkinesis
Mutual dependency btw the involved UE and LE
See mass flexion of LE as apply resistance to elbow flexion on ipsilateral side
Brachial plexus - Lateral cord gives off what
Musculocutaneous nerve
Median nerve
Lateral pectoral nerve
Brachial plexus - Posterior cord gives off what
Axillary nerve
Radial nerve
Thoracodorsal nerve
Upper and lower subscapular nerves
Brachial plexus - Medial cord gives off what
Ulnar nerve
Median nerve
Medial pectoral nerve
Weight gain can be associated with what medical conditions
Hypothyroidism Cushings syndrome Organ disease CHF Essential fatty acid deficiencies Blood sugar imbalance
Menieres s/s
Overaccumulation of endoymph due to lack of absorption
Hearing Loss
Tinnitus
Vertigo from 30 min to 24 hrs
Digitalis - common uses
Arrhythmias
CHF
Enhances parasympathetic activity or decreases symp
ASIA B
Intact sensory, but not motor, function below the neurological level including sacral segments
Incomplete - sensory but not motor is preserved below lesion level
ASIA A
Complete - no motor or sensory
ASIA C
Incomplete - motor is preserved below lesion level but key mm have mm grade less than 3
ASIA D
Incomplete - motor is preserved below lesion and key mm have mm grade higher than 3
ASIA E
Motor and sensory are normal
Cluster sampling involves
Successive random sampling of a series of units in the population Large subgroups (clusters) are randomly selected first and then smaller units are selected from the clusters
High sampling error with cluster sampling - why?
Because the technique requires two or more samples to be drawn and each sample is subject to sampling error
3 classes of meds that decrease myocardial oxygen demand
Beta blockers
Ca channel blockers
Nitrates
All can alleviate symptoms of angina
Beta blockers decrease myocardial oxygen demand by
Inhibiting the binding of epinephrine and norepinephrine to beta receptors
Dec in HR, cx of the heart, CO, and BP
Ca channel blockers decrease myocardial oxygen demand by
preventing arterial vasospasm and inc cellular metabolic rate
Nitroglycerin decreases myocardial oxygen demand by
Dilating veins to dec venous return (preload)
Dilating arteries to dec afterload
Relax coronary artery smooth mm to inc coronary blood supply
Positive graded exercise test results when
there are ST segment changes present
Greater than or equal to 1 mm of horizontal or downsloping ST segment depression is a standard criterion for positive test
Common disturbances that may lead to development of CP
Insult to fetal or infant brain Infections Hemorrhage Brain malformations Perivenricular leukomalacia
Hand contact for percussion
Cupped hand
Hand contact for vibration
Palmar aspect of the PTs hand in full contact with the affected lung segment
Vibration applied at the end of deep inspiration and maintained through the end of expiration
Ligament most likely torn with an inversion ankle injury
Anterior talofibular!
Ionto - calculatin for current density
Current amplitude (mA) divided by the electrode size (cm^2)
Thrombocytosis - can be the result from
Compensation after severe hemorhage, surgery, iron deficiency, and as a manifestation of certain cancers
Thrombocytosis is a high platelet count
Ratio scale
Absolute zero point
0 represents total absence of the property being measured
Ex = height, weight
Interval scale
No true zero point
Temperature - 0 is not the absence of temp
Knee arthrokinematics
Femur - Convex
Tibia - concave
Concave on convex = SAME
Knee mob to inc ext
Anterior glide of the tibia on the femur
Contract relax is used to
Improve ROM
Repeated contractions is used to
Improve strength
Therapist provides a quick stretch followed by isometric or isotonic cx
Rhythmic stabilization is used to
Increase ROM and coordinate isometric contractions
Hold relax is used to
Improve ROM
Relaxation occurs and the extremity moves through the newly acquired range to the next point of limitation
Bony landmark used for measuring with functional reach test
Third metacarpal after asking the patient to make a fist
Corticosteroids provide
Hormonal, antiinflammatory, and metabolic effects
Reduce inflammation
Dermatitis is often treated with
Corticosteroids
Antihistamines
Immunomodulators
Folliculitis is often treated with
Antiseptic cleansers or antibiotics
Melanoma is often treated with
Surgery, chemo, radiation, immunotherapy
Rosacea is often treated with
Antibiotics, Vitamin A derivatives, or laser surgery
Barthel index
10 ADLs
Scores range from 0-100 in increments of 5
Score of 100 = ind
Tinetti
Measures balance and gait using ordinal scale 0-2
Possible of 28 points; less than 19 is high risk of falling
Pronation - foot - nonweightbearing
DF, Abd, Eversion
Supination - foot - nonweightbearing
PF, Add, Inversion
Emphysema - total lung capacity
Increased!
Because lungs become hyperinflated
C8 myotome
Thumb extension
T1 myotome
Finger abduction and adduction
Sip and puff controls used with
POWER wc!
Most often in those with C4 tetra
Neurontin =
Gabapentin
used to prevent and control seizures
Also used to relieve nerve pain in shingles, trigeminal neuralgia, diabetic neuropathy
Primary side effects of neurontin
Dizziness, ataxia, sedation, fatigue
Idiopathic pulmonary fibrosis = restrictive or obstructive
Restrictive!
So will have nromal FEV1/FVC ratio
Epidermis includes
AVASCULAR
flat, scale like squamous cells, round basal cells, and melanocytes
Dermis includes
VASCULAR
Hair follicles, arrector pilli mm, sebaceous glands, sweat glands, Meissners, lymphatic and BVs, nerve endings
PCA is ineffective form of pain management for who
People with altered cog status
Hydration status - impact of dehydration on hematocrit
Hematocrit may be inc when body’s water content is decreased
Hydration status - impact of dehydration on BUN
Increased BUN can be indicative of dehydration, renal failure, or heart failure
Normal BUN
10-20 mg/dL
Hydration status - impact of dehydration on hemoglobin
Hemoglobin may be increased when body’s water contect is decreased
Abdominal exam - what first and why
Auscultation
Percussion and palpation first would impact what you hear
Taylor brace =
TLSO - primarily limits trunk motion in sagittal plane (flex/ext)
Two post rigid struts that attach inf to a pelvic band and sup to axillary straps
Milwaukee brace =
CTLSO
Jewett brace =
TLSO - two plates ant - primarily limits trunk flexion
Corset brace =
non rigid
Does not restrict spinal motion
Inc intra-abdominal pressure
Arterial line - inserted where and measures what
Inserted directly into an artery and is used to continuously monitor BP and obtain blood samples
Swan Ganz - measures what and inserted where
Right atrial pressure. pulmonary artery pressure
Advanced from femoral, brachial, or IJV into pulmonary artery
Humeroradial joint arthrokinematics
Humerus - capitulum - convex
Radius - radial head - concave
Humeroulnar joint arthrokinematics
Humerus - olecranon fossa- concave
Ulna - olecranon process - convex
When performng sensory testing - what should be done first?
Superficial sensation testing - Temperature, pain, crude tough, pressure
Diazepam
Valium - benzodiazapine - used to calm severe anxiety and agitation
Diazepam side effects
Sedation
Impaired balance
Dec neuromuscular function
Dec central processing
Ice massage requires what treatment time
5 to 10 minutes
Central venous pressure catheter measures
Right atrium or SVC pressure
Measures pressures associated with the filling of the right ventricle (DBP)
Hickman catheter inserts where and functions for what
Inserts into the right atrium
AKA Indwelling right atrial catheter
Permits removal of blood samples, admin of meds, monitoring of central venous pressure
Spinothalamic tract = what part of cord
Anterior and Lateral
DCML - which part of cord
Posterior
Spinothalamic function
Temp
Pain
Touch
DCML function
Discriminative touch
Stereognosis
Kinesthesia
