PTA Cards Flashcards
1
Q
1/5
A
no movement, but can feel muscle contraction
https://www.dropbox.com/s/zjbheql75eowfg3/2015-03-18_11-21-56.jpg?dl=0
2
Q
2/5
A
completes ROM with gravity eliminated
3
Q
3/5
A
completes ROM against gravity w/o manual resistance
4
Q
4/5
A
completes ROM against gravity with mod resistance
5
Q
5/5
A
completes ROM against gravity with max resistance
6
Q
% Sat
A
95-98%
7
Q
(start of peds) congenital hip dysplasia
A
malalignment of femoral head with acetabulum. develops during last trimester in utero. asymmetrical hip abdution with tightness and apparent femoral shortening of involved side. testing includes ortolani test, barlow maneuver, and u/s. treatment initially attempts to reposition femoral head within the acetabulum thru constant use of a harness, brace, splint or traction. PT may be indicated after cast removal for stretching, strengthening, and caregiver education.
8
Q
2 person lift
A
used to transfer a patient btwn two surfaces of different heights or when transferring a patient to the floor.
9
Q
2 point gait
A
when patient uses 2 crutches or canes. moves left crutch forward while simultaneously advancing rt lower extremity ad vice versa.
10
Q
2 pt discrimination
A
2 point caliper on skin, identify one or two points without sight
11
Q
2 types of cavitation that occur:
A
stable cavitation: microscopic bubbles increase and decrease in size but do not burst. triggers microsteaming. transient (unstable) cavitation: microscopic bubbles increase in size over multiple cycles and implode. this causes brief moments of local temperature ad pressure increases in area surrounding those bubbles. process should not occur during therapeutic u/s since intensities required are much higher than 3 w/cm2.
12
Q
2-/5
A
does not complete ROM in gravity eliminated position
13
Q
2+/5
A
able to initiate mvmt against gravity
14
Q
3 person carry/lift
A
used to transfer patient from a stretcher to a bed or treatment plinth. 3 therapists carry patient in supine position. therapist at head usually gives commands.
15
Q
3 point gait
A
walker or crutches. injured lower extremity may have decreased weight bearing. AD is advanced followed by injured LE and then uninjured LE. AD and each LE are considered separate points
16
Q
3-/5
A
does not complete ROM against gravity, but completes more than half the range
17
Q
3+/5
A
completes ROM against gravity with only minimal resistance
18
Q
4 point gait
A
each advancement of crutch or cane as well as LEs indicates a single point, used one at a time.
19
Q
4-/5
A
completes ROM against gravity with min/mod resistance
20
Q
4+/5
A
completes ROM against gravity with mod/max resistance
21
Q
A fib
A
irregular atrial rhythm, no rate, no P waves, F waves absent, quivers noted, ventricular rhythm varies. common causes: hypertension, CHF, CAD, rheumatic heart disease, cor pulmonale, pericarditis, drug use
22
Q
A fibers
A
large, myelinated, high conduction rate. contained in alpha and gamma motor systems. sensory components in muscle spindles, golgi tendon organs, bare nerve endings, mechanoreceptors
23
Q
abducens
A
voluntary motor: muscle of eyeball, lateral
24
Q
ABI scale
A
Normal=1.0. .5-.9=arterial occlusion, impairment with wound healing. less than .5=severe arterial occlusion.
25
ABI: ankle-brachial index
test that measures arterial perfusion using a Doppler unit. blood pressures are measured in both UEs and LEs and highest LE systolic pressure is divided by brachial systolic pressure.
26
abnormal breath sounds
sounds that are heard outside of their normal location or phase of respiration
27
abnormal end feel: empty
cannot reach end feel due to PAIN, ex: joint inflammation, fracture or bursitis
28
abnormal end feel: firm
ex: increased tone, tightening of capsule, ligament shortening
29
abnormal end feel: hard
ex: fracture, OA, osteophyte formation
30
abnormal end feel: soft
ex: edema, synovitis, ligament instability/tear
31
absent breath sounds
may indicate pneumothorax or lung collapse
32
absolute contraindications for treatment of an unstable cardiac patient
third degree heart block, uncompensated CHF, PVCs of vent tachycardia at rest, multifocal PVCs, chest pain with ST sgmt changes, ECG changes that indicate ischemia, dissecting aortic aneurysm
33
accessory
voluntary motor: SCM and trapezius muscle
34
accommodation
an occurrence where a nerve and muscle membrane's threshold for excitability increases secondary to a stimulation by a pulse that has a slow phase rise time. the quicker the rise time, the less the nerve can accommodate to the impulse.
35
achilles tendon rupture
usually one to two inches above tendinous insertion on calcaneous, greatest btwn 30-50 yrs of age, typically be unable to stand on their toes and tend to exhibit a positive Thompson test
36
acidic/alkaline reaction
acidic reaction can cause hardening of skin. alkaline reaction can cause skin to soften over time.
37
acoustic cavitation
occurs as a result of acoustic energy generated by u/s that develops into microscopic bubbles causing cavities that surround soft tissues. the bubbles expand and contract.
38
acoustic streaming
term for the consistent and circular flow of cellular fluids that results from u/s. responsible for altering cellular activity and the transport of fluids to different portions of the field.
39
active insufficiency
when a 2 joint muscle contracts (shortens) across both joints simultaneously
40
acupuncture like TENS
frequency: 1-4 Hz, 100-200 microseconds, amplitude: 30-80 mA
41
acute alveolar hyperventilation
pH greater than 7.5
42
acute diagnostic management
glasgow coma scale, CAT scan, x-ray, MRI, cerebral angiography, evoked potential/electroencephalogram, positron emission tomography, ventriculography, radioisotope imaging
43
acute ventilatory failure
pH less than 7.3
44
adhesive capsulitis
occurs more in middle-aged population, greater incidence in women, arthrogram can assist with dx by detecting decreased volume of fluid within the joint capsule, ROM restriction typically in a capsular pattern (lateral rotation, abduction, medial rotation)
45
adult w/c specs:
seat width: 18 inches, set depth: 16 inches, seat height: 20 inches
46
ADULT: CPR flow chart
no mvmt-phone 911-open airway, check breathing-if NO breathing, administer 2 breaths that make chest rise. if NO response, check pulse. if pulse, rescue breathing only at 10-12 breaths per minute. if NO pulse, begin CPR with 30 compressions and 2 breaths. continue to perform CPR until medical assistance arrives
47
advantages to alginates
high absorptive capacity, enables autolytic debridement, offers protection from microbial contamination, can be used on infected or uninfected wounds, non-adhering to wound
48
advantages to foam dressings
provides a moist environment for wound healing, available in adhesive and nonadhesive forms, provides prophylactic protection and cushioning, encourages autolytic debridement, provides moderate absorption
49
advantages to hydrocolloids
moist environment for wound healing, enables autolytic debridement, offers protection from microbial contamination, provides moderate absorption, does not require a secondary dressing, provides a waterproof surface
50
advantages to hydrogels
provides a moist environment for wound healing, enables autolytic debridement, may reduce pressure and diminish pain, can be used as a coupling agent for ultrasound, minimally adheres to wound
51
advantages to transparent films
provides a moist environment for wound healing, enables autolytic debridement, allows visualization of the wound, resistant to shearing and frictional forces, cost effective over time
52
adventitous breath sounds
abnormal breath sounds heard using a stethoscope with inspiration and/or expiration. these sounds can be continuous or discontinuous sounds
53
aerobic metabolism
used predominantly during low intensity, long duration exercises. yields by far the most atp, but requires chemical reactions.
54
AFFERENT NERVES
SENSORY
55
AFO
primary purpose is to assist with dorsiflexion and prevent foot drop, can also influence knee control. commonly described for patients with peripheral neuropathy, nerve lesions or hemiplegia
56
aggressive spasticity treatment for sci
phenol blocks, rhizotomies, myelotomies, other surgical interventions
57
agnosia
inability to interpret information
58
agonist reversals
isotonic concentric contraction performed against resistance followed by alternating concentric and eccentric contractions with resistance. (controlled mobility, skill)
59
agraphesthesia
inability to recognize symbols, letters or numbers traced on the skin
60
agraphia
inability to write due to a lesion within the brain
61
akinesia
inability to initiate mvmt; commonly seen with parkinson's
62
alginates
consist of calcium salt of alganic acid that is extracted from seaweed. highly permeable and non-occlusive. requires a secondary dressing. based on the interaction of calcium ions in the dressing and the sodium ions in the wound exudate.
63
alternating current
polarity that changes from positive to negative with change in direction of current flow. biphasic, symmetrical or asymmetrical, and is a waveform that is sinusoidal in shape. used in muscle retraining, spasticity and stimulation of denervated muscle
64
alternating current (biphasic)
alternating current allows for the constant change in flow of ions
65
alternating isometrics
isometric contractions performed alternating from muscles on one side of joint to the other side w/o rest (stability)
66
ampere
unit of measure used to describe rate of current
67
amplitude
magnitude of current. often labeled intensity or voltage.
68
amyotrophic lateral sclerosis
risk is higher in males, usually occurs between 40-70, clinical presentation may include both upper and lower motorneuron involvement with weakness occurring in a distal to prox progression, average course of dx is 2-5 yrs with only 20-30% of patients surviving longer than five years
69
anaerobic clycolysis
major supplier of ATP during high intensity, short duration activities. 50% slower than ATP-PC system and can provide a person with 30-40 secs of muscle contraction
70
anatomic dead space volume (VD)
volume of air that occupies the non respiratory conducting airways
71
aneurysm
weakening in wall of a vessel that produces a sac like area. 50% increase in normal vessel diameter with weakening of all layers of arterial or venous wall. most common sites include aorta, abdominal aorta, femoral, and popliteal arteries. surgical repair prior to rupture has a good prognosis; ruptured aneurysm is a medical emergency with high mortality rate. symptoms: abnormal heart beat, MI, stroke, renal failure, embolization, intermittent or constant pain
72
angina pectoris
when coronary arteries are unable to supply the heart with adequate oxygen. sudden onset is common once the myocardial oxygen demand is higher than the supply. CAD accounts for 90% of all angina.
73
ankle
hinge joint formed by articulation of tibia and fibula w/talus. medial ligaments: deltoid. lateral ligaments: anterior tibiofibular, anterior talofibular, calcaneofibular, lateral talocalcaneal, and posterior talofibular
74
ankle strategy
first strategy to be elicited by a small range and slow velocity perturbation when feet are on the ground. muscles contract in a distal to proximal fashion to control postural sway from ankle joint
75
ankylosing spondylitis
systemic condition, inflammation of spine and larger peripheral joints, males greater risk btwn 20-40, presentation initially includes recurrent and insidious onset of back pain, morning stiffness, and impaired spinal extension
76
anode
positively charged electrode that attracts negative ions
77
antalgic gait
involved step length is decreased in order to avoid weight bearing due to pain
78
anterior cruciate ligament sprain
most commonly occurs during hyperflexion, rapid deceleration, hyperextension or landing in an unbalanced position, females involved in selected sports have higher ligament injury rates, approx 2/3 of time acl is completely torn, there is an associated meniscal tear
79
anterograde memory impairment
inability to create new memory. usually last to recover after a comatose state.
80
anthropometry: skinfold msrmt
determines overall % of body fat thru msrmt of 9 standardized sites.
81
antiarrhythmic agents: prevention of arrhythmias, ischemia and hypertension
sodium channel blockers: norpace, Xylocaine. beta-blockers: tenormin, lopressor, inderal. Refractory period alterations: cordarone, corvert. Calcium channel blockers: norvasc, cardizem, verapamil.
82
antihypertensive agents: assists to lower blood pressure; decreases tension within circulation system
diuretics: lasix, bumex, thiazide. beta-blockers: sectral, inderal, lopressor. calcium channel blockers: cardizem, calan. alpha-blockers: cardura, minipress
83
antiplatelet agents (aspirin, plavix, ascriptin)
reduces atherosclerotic events and decrease the risk for CVA
84
aphasia
acquired neuro impairment of processing for receptive and/or expressive language. result of brain injury, head trauma, CVA, tumor or infection.
85
aphasia
inability to communicate or comprehend due to damage to specific areas of brain
86
apraxia
inability to perform purposeful learned mvmts, although there is no sensory or motor impairment
87
areas of MI
expected damage: anterior heart-left anterior descending artery, high risk of large infarction, heart failure, sudden death. inferior heart-rt coronary artery, right ventricle damage, AV block, medium infarct possible, lateral heart and/or superior heart-least area of muscle affected, usually least overall damage, minor impairment or complications
88
armrest height
measure from seat of chair to olecranon process with user's elbow flexed to 90 and then add one inch. average usually 9 inches above chair seat.
89
arterial blood gases (ABG)
uses as a tool to determine the effectiveness of alveolar ventilation. expressed as the partial pressure of the gas.
90
arterial insufficiency ulcers
occur secondary to ischemia from inadequate circulation of oxygenated blood often due to complicating factors such as atherosclerosis
91
arterial line
monitoring device consisting of a catheter that is inserted into an artery and attached to an electronic monitoring system. used to measure blood pressure or obtain blood samples. considered more accurate than traditional measures of blood pressure and does not require repeated needle punctures
92
arterial ulcers
lower one third of leg, toes, web spaces. smooth edges, well defined, lack of granulation tissue, tend to be deep. severe pain, diminished or absent pedal pulses, normal edema, decreased skin temperature, thin and shiny tissue, hair loss, yellow nails. leg elevation increases pain.
93
ascending and descending tracts
...
94
assistive devices
parallel bars, walkers, axillary crutches, lofstrand crutches, canes
95
associated reaction
involuntary and automatic mvmt of a body part as a result of an intentional active or resistive mvmt in another body part.
96
astereognosis
inability to recognize objects by sense of touch
97
asthma
reversible, obstructive lung condition characterized by increased responsiveness of trachea and bronchi to stimuli, inflammation, and overproduction of mucous glands with widespread narrowing of airways.
98
asystole
no rhythm, absence of P wave, QRS and T waves, can have abrupt onset, requires immediate medical attention. causes: failure of all pacemakers to initiate, conduction system failure, acute MI and ventricular rupture
99
ataxia
inability to perform coordinated movements
100
ataxic gait
gait characterized by staggering and unsteadiness, wide BOS and movements are exaggerated.
101
atherosclerosis
condition of progressive accumulation of fatty plaques on inner walls of vessels that ultimately produces stenosis. begins in childhood and usually affects medium sized arteries. over time the plaque that produces stenosis inside the vessel can also block blood flow. heart attack or stroke can result from atherosclerosis
102
athetosis
condition that presents with involuntary mvmts combined with instability of posture. peripheral mvmts occur without central stability
103
ATP-PC system
energy system producing ATP during high intensity, short duration exercise. Phosphocreatine decomposes and releases large amount of energy used to construct ATP. provides energy for muscle contraction for up to 15 seconds.
104
atrial diastole
atrial filling of blood
105
atrial systole
atrial emptying of blood
106
autolytic debridement
using body's own mechanisms to remove nonviable tissue. methods include transparent films, hydrocolloids, hydrogels and alginates. results in a moist wound environment that permits rehydration of the necrotic tissue and eschar and allows enzymes to digest the nonviable tissue. can be used with any amount of necrotic tissue and is non-invasive and pain free; however takes longer for wound healing to occur. should not be performed on infected wounds.
107
automatic postural strategies
automatic motor responses that are used to maintain center of gravity over base of support.
108
autonomic dysreflexia
dangerious complication of sci. can occur in pts with lesions above T6. noxious stimuls below lesion level triggers autonomic nervous system, causing a sudden elevation in blood pressure. common causes include distended or full bladder, kink or blockage in catheter, bladder infections, pressure ulcers, tight clothing.
109
avulsion fracture
portion of bone becomes fragmented at site of tendon attachment from a traumatic and sudden stretch of tendon
110
axillary crutches
all levels of weight bearing, but requires higher coordination for proper use. 6 inches in front, two inches out (lateral) to patient. crutch height should be adjusted no greater than 3 finger widths from axilla. handgrip height should be adjusted to ulnar styloid process and allow for 20-25 degrees of elbow flexion while grasping.
111
axonotmesis
a more severe grade of injury to a peripheral nerve. is reversible injury to damaged fibers. damage occurs to the axons with preservation to endoneurium. nerve can regenerate distal to the site of lesion by one millimeter per day.
112
B fibers
medium, myelinated, reasonably fast conduction rate. pre ganglionic fibers of ANS.
113
back height
measure from seat of chair to floor of axilla with user's shoulder flexed to 90 and then subtract 4 inches. this will allow final back height to be below inferior angles of scapula. 16-16 1/2 inches average.
114
bainbridge reflex
occurs when mechanoreceptors embedded within the right atrial myocardium respond to an increase in pressure and stretch (distention of the right atrium). stimulates the vasomotor centers of the medulla and results in increased sympathetic input and heart rate. reflex can also influence a decrease in heart rate when heart is beating too fast.
115
balance
state of physical equilibrium needing input from these three systems: somatosensory, visual and vestibular.
116
Balance Reflexes: Vestibuloocular reflex (VOR):
allows for head/eye movement coordination. reflex supports gaze stabilization where eyes can move while head is fixed; visual tracking can also occur when both eyes and head are moving.
117
Balance Reflexes: Vestibulospinal reflex (VSR):
attempts to stabilize body and control movement. reflex assists with stability while head is moving as well as coordination of trunk during upright postures.
118
balance tests (types)
romberg, one legged stance test, tinetti, berg balance, get up and go test, timed get up and go test
119
baroreceptor reflex
produced by a group of mechanoreceptors that are found w/in walls of the heart. the reflex is activated when pressure rises w/in the large arteries above 60 mm Hg. peak in activity at approx 180 mm Hg. results in vasodilation secondary to inhibition of the vasomotor centers w/in the medulla as well as a decrease in heart rate and strength of contraction secondary to vagal stimulation
120
base of support
distance msrd btwn left and right foot during progression of gait. average BOS is 2-4 inches
121
bicipital tendonitis
increased incidence of injury is associated with selected sports such as baseball pitching, swimming, rowing, gymnastics, and tennis; characterized by subjective reports of a deep ache directly in front and on top of the shoulder made worse with overhead activities or lifting, examination may reveal a positive speed's test or yergason's test
122
biofeedback
modality that uses an electromechanical device to provide visual and or auditory feedback. can be utilized to receive information related to motor performance, kinesthetic performance or physiological response. can measure peripheral skin temp, changes in blood volume thru vasodilation and vasoconstriction using finger phototransmission, sweat gland activity, and electrical activity during muscle contraction. electromyographic feedback is the most commonly used biofeedback modality in clinical setting.
123
biofeedback contraindications
any condition where muscle contraction is detrimental, skin irritation at electrode site
124
biofeedback indications
muscle spasm, pain, sci, urinary incontinence, improve neuromuscular control, muscle weakness, hemiplegia, cp, bowel incontinence, promote relaxation
125
biofeedback measures:
muscle activity, heart rate, balance, skin temp, bp, posture, abnormal mvmt, normal mvmt
126
biofeedback therapeutic effects
muscle relaxation, improve muscle strength, decrease muscle spasm, neuromuscular control, decrease accessory muscle use, decrease pain
127
biofeedback treatment guidelines
2 active electrodes and 1 ground electrode in a bipolar arrangement best deletes "noise" (noise is any extraneous electrical activity not produced by the contraction of the muscle). surface electrodes with some form of conduction gel are required to adhere to prepared, clean skin. electrodes should be placed parallel to direction of the muscle fibers, set level of sensitivity on device relative to treatment goals: low level sensitivity settings for muscle re-education, high level sensitivity setting for relaxation
128
biofeedback treatment parameters
2 active electrodes should be placed parallel to muscle fibers and close to each other. reference or ground electrode can be placed anywhere on the body, but is often secured between 2 active electrodes. signals are transmitted to a differential amplifier and info is conveyed thru visual and audio feedback. for muscle re-education, should begin with pt performing a max muscle contraction. sensitivity of bfb unit should be set at a low sensitivity setting and adjusted so that the pt can perform reps at a ratio of 2/3rds of max muscle contraction. isometric contractions should continue for 6-10 secs with relaxation in btwn each contraction. treatment duration for a single muscle group is 5-10 mins. treatment for muscle relaxation requires a high sensitivity setting and a similar electrode placement with active electrodes initially positioned close to each other. as patient improves with relaxation, electrodes should be placed further apart and sensitivity setting increased. during this treatment, patient may also benefit from adjunct relaxation techniques such as imagery. treatment duration of 10-15 mins is usually adequate to attain relaxation.
129
biphasic
pulse that moves in one direction, returns to baseline, then in other direction and back to baseline again within a predetermined amount of time.
130
bipolar
2 active electrodes are placed over target area. electrodes usually same size. used for muscle weakness, neuromuscular facilitation, spasms, and ROM
131
blood supply to brain
PCA: posterior cerebral artery, MCA: middle cerebral artery, and vertebrobasilar artery.
132
blood volume
usually 7-8% of body weight. blood is pumped thru body at 30 cm/sec w/total circulation time of 20 seconds.
133
BNR
beam nonuniformity ratio: ratio of intensity of highest peak to average intensity of all peaks. lower BNR, more favorable, since most patients will be less likely to experience hot spots and or discomfort during treatment. BNR values should range btwn 2:1 and 6:1, most devices often fall in 5:1 or 6:1 range.
134
borg's rate of perceived exertion scale and the revised 10-grade scale
see page 121
135
bp prep and procedure
values are usually slightly higher in left UE vs. the right UE. inflate cuff to 20 mm Hg above reading where brachial pulse disappears. 1st sound indicates systolic pressure, last audible sound indicates diastolic pressure.
136
bradykinesia
mvmt that is very slow
137
Brain (encephalon)
Parts include brainstem, cerebellum, diencephalon, cerebral hemispheres, fissures, sulci, meninges, ventricular system and dural spaces
138
brainstem
midbrain, pons, medulla oblongata
139
brief intense (high intensity)
frequency: 70-100 Hz/burst, duration: 150-200 microseconds, amplitude: 30-60 mA
140
broca's aphasia
major non-fluent aphasia. also known as "expressive" aphasia. most common form. lesions in frontal lobe.
141
bronchial breath sounds
abnormal breath sounds when heard in locations that vesicular sounds are normally present. pneumonia may produce these sounds
142
bronchial drainage positions/procedures
...
143
bronchiectasis
progressive obstructive lung disease that produces abnormal dilation of a bronchus. irreversible condition that usually is associated with chronic infections, aspiration, cystic fibrosis or immune system impairment. bronchial walls weaken over time secondary to infection and allow for permanent dilation of bronchi and bronchioles. symptoms: consistent productive cough, hemoptysis, weight loss, anemia, crackles, wheezes, and loud breath sounds.
144
Brunnstrom's 7 stages of recovery
stage 1: no volitional mvmt initiated. stage 2: beginning of spasticity. stage 3: voluntary synergies. spasticity increases. stage 4: spasticity begins to DEcrease. stage 5: decrease in spasticity. stage 6: jt mvmts are performed with coordination. stage 7: normal motor function is restored
145
buffering
technique used to stabilize the pH of skin during ionto by placing buffering agents into electrode pads that cover drug reservoir area within the electrode
146
buoyancy
(archmides): there is an upward force on body when immersed in water equal to amount of water that has been displaced by the body. ability to float in water results from the body possessing a specific gravity less than that of water.
147
bursitis
condition caused by acute or chronic inflammation of bursae. pain and swelling limits range.
148
burst
interrupted group of pulses that are delivered in a finite series and a predetermined frequency
149
C fibers
small nerve fibers, poorly myelinated or unmyelinated. slow conduction rate. post ganglionic fibers of sympathetic system. exteroceptors for pain, temp, and touch.
150
C1
vertex of skull.
151
C2
temple, forehead, occiput. myotome: longus colli, SCM, rectus capitis
152
C3
entire neck, posterior cheek, temporal area, prolongation forward under mandible. myotome: trap, splenius capitis
153
C4
shoulder area, clavicular and upper scap area. myotome: trap, levator scapulae
154
C5
deltoid area, anterior aspect of entire arm to base of thumb. myotome: supraspinatus, deltoid, biceps
155
C6
anterior arm, radial side of hand to thumb and index finger. myotome: biceps, supinator, wrist extensors.
156
C7
lateral arm and forearm to index, long and ring fingers. myotome: triceps, wrist flexors
157
C8
medial arm and forearm to long, ring and little fingers. myotome: ulnar deviators, thumb extensors, thumb adductors
158
CAD
coronary artery disease: narrowing or blockage of coronary arteries that may produce ischemia and necrosis of the myocardium. inability for vasodilation and as a result the arteries cannot meet the metabolic demands. will produce ischemia and ultimately necrosis. CAD includes thrombus, vasospasms, and atheroscelerosis. results from inheritance, environment, culture, nutrition and smoking. symptoms: appear after significant blockage is present, over 75%. pain in occluded artery's region. if untreated, MI or death.
159
cadence
of steps an individual will walk over a period of time. average value for an adult is 110-120 steps per minute
160
cane
provides minimal stability and support during ambulation, mainly for balance.
161
capacitance
property of an insulator that allows for the storage of energy when opposing surfaces of the insulator have an electrical potential difference
162
cardiac index
amount of blood pumped out of heart per minute per sq meter of body mass. normal ranges btwn 2.5 to 4.2 L/min/meter2
163
cardiac lab testing
hematocrit, hemoglobin, partial thromboplastin time, platelet count, prothombin time, white blood cell count
164
cardiac output
amount of blood pumped out of heart through the aorta each minute. males: 5.6L/min. females: 10-20% less. CO=stroke volume X heart rate
165
cardiac reflexes
quick acting nervous system mechanisms that influence heart rate when triggered.
166
cardiac rehab indications
MI, angina (stable), CABG, cardiac surgery, high risk for CAD, hypertension, end stage renal disease, status post pacemaker insertion, cardiomyopathy, heart transplant, high risk for diabetes
167
cardiac rehab program
consists of 4 phases. 1st phase averages 3-5 days, 2nd phase 2-12 weeks, 3rd phase 6-8 weeks, 4th phase lasts throughout pt's lifetime
168
cardiomyopathy
group of conditions that affect the myocardium muscle itself, impairing the ability for the heart to contract and relax. 3 types are dilated, hypertrophic, and restrictive. symptoms: same as heart failure, neck vein distension, fatigue and weakness, possible chest pain, sudden death, exercise intolerance
169
Cardiopulmonary ABCs
Airway-maintain open airway. Breathing-rescue (look, listen, feel). Circulation-compressions: check pulse.
170
carpel tunnel syndrome
incidence is higher in females with most common age being from 35-55, muscle atrophy is often noted in abductor pollicis brevis muscle and later in the thenar muscles; electromyography studies, tinel's sign, and phalen's test can be used to assist with confirming diagnosis
171
cartilaginous joints
(amphiarthroses) has cartilage to connect one bone to another. slightly moveable joints. ex: syndchondrosis, symphysis
172
cathode
negatively charged electrode that attracts positive ions
173
cerebellar gait
staggering gait
174
cerebellum
responsible for: coordination of motor skills, postural tone, sensory/motor input for trunk and extremities, coordination of gait
175
cerebellum impairments
ataxia, discoordination of trunk and extremities, intention tremor, balance deficits, ipsilateral facial sensory loss, dysdiadochokinesia (inability to perform rapidly alternating movements)
176
CEREBRAL HEMISPHERE FUNCTION
...
177
cerebral hemispheres
cortex, white matter, basal nuclei. 2 hemispheres: deep white matter, basal ganglia, and lateral ventricles
178
cerebral palsy
spastic cp involves upper motor neuron damage; athetoid cp involves damage to cerebellum, cerebellar pathways or both; clinical presentation includes motor delays, abnormal muscle tone and motor control, reflex abnormalities, poor postural control, and balance impairments; mental retardation and epilepsy are present in 50-60% of children diagnosed with cp.
179
characteristics of a brainstem CVA
unstable vital signs, decreased consciousness, ability to swallow, weakness and paralysis on both sides
180
characteristics of a cerebellum CVA
decreased balance, ataxia, decreased coordination, nausea, decreased ability for postural adjustment, nystagmus
181
characteristics of a CVA in LEFT hemisphere
weakness, paralysis of RIGHT side, increased frustration, decreased processing, possible aphasia, dysphagia, motor apraxia, decreased discrimination btwn left and right, right hemianopsia
182
characteristics of a CVA in RIGHT hemisphere
weakness, paralysis of LEFT side, decreased attention span, left hemianopsia, decreased awareness and judgment, memory deficits, left inattention, decreased abstract reasoning, emotional lability, impulsive behaviors, decreased spatial orientation
183
chemoreceptor reflex
responds to need for increased depth and rate of ventilation. chemoreceptors are located on the carotid and aortic bodies and detect lack of oxygen, responding to an increase in arterial CO2 levels.
184
chest physical therapy
indications: patients who have acute or chronic respiratory problems: inability to expel secretions, ineffective cough, swallowing difficulties
185
CHF
congestive heart failure: results usually from coronary artery disease when heart is unable to maintain an adequate cardiac output. characterized by abnormal retention of fluid and results in diminished blood flow to tissue and congestion of the pulmonary and or systemic circulation. symptoms: pulmonary edema, dyspnea, cough (nonproductive), S3 gallop, exertional hypotension, weight gain within hours, increased resting heart rate.
186
chf: congestive heart failure
etiologies include arrhythmia, pulm embolism, hypertension, valvular heart disease, myocarditis, unstable angina, renal failure, severe anemia;
187
cholesterol-lowering agents (lipitor, zocor, pravachol)
decreases the triglycerides and low-density lipoproteins in the bloodstream
188
chopping (PNF):
combination of bilateral UE asymmetrical extensor patterns performed as a closed chain activity
189
chorea
mvmts that are sudden, random and involuntary
190
chronaxie
testing procedure used to measure amount of time required to produce a small muscle contraction at a particular intensity
191
chronic bronchitis
increased mucus secretions from bronchioles as well as structural changes to bronchi. productive cough is usually present for 3 months during two consecutive years. major impairments include hypertrophy of mucus secreting glands and insufficient oxygenation of alveoli due to mucus blockage. symptoms: increased pulmonary artery pressure, thick sputum, increased use of accessory muscles, persistent cough, wheezing, dyspnea, and cyanosis. patients are often called "blue bloaters"
192
circumduction
circular motion to advance leg during swing phase
193
class 1 lever
very few class 1 levers in body. one example is triceps force on olectranon with an external counter force pushing on forearm. (seesaw). axis of rotation is btwn effort (force) and resistance (load).
194
class 2 lever
resistance (load is btwn axis of rotation and effort (force). length of effort arm is always longer than resistance arm. most instances, gravity is effort and muscle activity is resistance. ex: wheelbarrow
195
class 3 lever
effort (force) btwn axis of rotation and resistance (load). shoulder abduction with weight at wrist is a class 3 lever example. most common type of lever in body.
196
clinical application templates executive summaries
...
197
clinical chemistry values
cholesterol: under 200 (LDL 60-180, HDL 30-80). Oxygen= partial pressure (PaO2): 80-100 mm Hg, saturation: 95-98%. pH: arterial blood: 7.35-7.45
198
clonus
characteristic of an upper motor neuron lesion; involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex
199
closed fracture
break in a bone where skin over site remains intact
200
closed-chain activity
involve body moving over a fixed distal segment. example: squat lift
201
clouding of consciousness
state of consciousness that is characterized by quiet behavior, confusion, poor attention, and delayed responses
202
CNS
Brain & Spinal Cord
203
cold bath
used for immersion of distal extremities. water temp ranges from 55 to 64 degrees. immersed for 5 to 15 mins to attain desired effects
204
cold pack
requires a temp of 23 degrees. apply cold pack wrapped in moistened towel to area for 15 mins. application may extend to 30 mins but requires observation every 10 minutes (for spasticity) can be applied every one to two hours for reduction of inflammation and pain control.
205
coma
state of unconsciousness and a level of unresponsiveness to all internal and external stimuli
206
comminuted fracture
bone that breaks into fragments at the site of injury
207
common circulatory pulse locations
carotid, brachial, radial, ulnar, femoral, popliteal, post tib, dorsalis pedis
208
COMMUNICATION DISORDERS
...
209
compensation
ability to utilize alternate motor and sensory strategies due to an impairment that limits the normal completion of a task.
210
complete heart block (3rd degree AV block)
regular rhythm, atrial rate is higher than ventricular rate, requires immediate medical intervention (pacemaker). causes include: infection, electrolyte imbalance, CAD, anteroseptal MI, impairment with the AV conduction system.
211
complete lesion
lesion to SC where there is no preserved motor or sensory function below the level of lesion
212
completed stroke
cva that presents with total neuro deficits at onset.
213
components of a prosthesis
socket, suspension, knee, shank, foot
214
compound fracture
break in a bone that protrudes thru skin
215
compression
physical agent that applies a mechanical force to increase pressure on treated body part. works to keep venous and lymphatic flow from pooling into interstitial space. static compression utilizes bandaging and compression garments to shape residual limbs, control edema, prevent abnormal scar formation, and reduce risk of dvt. intermittent compression with a pneumatic device is used to reduce edema.
216
concentric contraction
when muscle shortens while developing tension
217
conductance
ease at which a particular material will allow current flow (mho)
218
congenital limb deficiencies
malformation that occurs in utero secondary to impaired developmental course. classified longitudinal or transverse. causative factor is an abnormality present at conception when a bone lacks potential to form. primary characteristic is a missing long bone suce as the radius. treatment may focus on symmetrical mvmts, strengthening, ROM, weight bearing and prosthetic training.
219
congenital torticollis
characterized by a unilateral contracture of the SCM muscle. causative factors include malposition in utero, breech position and birth trauma. usually dx'd within first three weeks of life. lateral flexion to same side as contracture, rotation toward opposite side. treatment conservative for the first year with emphasis on stretching, active ROM, position and caregiver education. possible surgery.
220
consciousness
state of alertness, awareness, orientation and memory
221
constructional apraxia
inability to reproduce geometric figures
222
contact guard
patient requires therapist to maintain contact with patient to complete task. usually needed to assist of there is a loss of balance
223
contract-relax
technique used to increase ROM. as extremity reaches point of limitation the pt performs a maximal contraction of the antagonistic muscle group. therapist resists mvmt for 8-10 secs with relaxation following. technique is repeated until no further gains in ROM are noted during session (mobility)
224
contraindication for hydrotherapy:
peripheral vascular disease, gangrene, severe infection, urinary/fecal incontinence, advanced cardiov or pulm disease, buerger's disease w/contrast bath, impaired circulation, renal infection, bleeding surface area, diminished sensation
225
contraindications
cardiac pacemaker, patient with a bladder stimulator, over carotid sinus, seizure disorders, phlebitis, malignancy, over a pregnant uterus, cardiac arrhythmia, osteomyelitis
226
contraindications for cardiac rehab
uncontrolled atrial/ventricular arrhythmias, embolism, thrombophlebitis, orthostatic bp, acute infection, unstable angina, resting ST sgmt deplacement, uncompensated CHF
227
contraindications for compression
malignancy of treated area, DVT, unstable or acute fracture, heart failure, infection of treated area, pulm edema, circulatory obstruction
228
contraindications for diathermy
low back, abdomen, pelvis of a pregnant woman, internal and external metal objects, eyes, malignant area, intrauterine device, cardiac pacemaker, pain and temp sensory deficits, moist wound dressing, testes, acute inflammation, ischemic tissue
229
contraindications for hvpc
cardiac pacemakers, over heavy scarring tissues, malignancy, pregnancy
230
contraindications for joint mobs
active disease, infection, advanced osteoporosis, articular hypermobility, fracture, acute inflammation, muscle guarding, muscle guarding, joint replacement
231
contraindications for massage
infection, arterioscelrosis, thrombus, cellulitis, acute injury, embolus, cancer.
232
contraindications for percussion
fracture, spinal fusion, osteoporotic bone, unstable angina, low platelet count, anticoagulation therapy, pulm embolism
233
contraindications for postural drainage
congestive heart failure, pulmonary edema, pleural effusion, pneumothorax, cardiac arrhythmia, history of recent MI, unstable angina, pulm embolism
234
contraindications for traction
when motion is contraindicated, joint instability, tumor, pregnancy, acute inflammatory response, acute sprain, osteoporosis, fracture
235
contraindications for u/s
over eyes, over pregnant uterus, over cemented prosthetic joint, impaired circulation, impaired pain or temp sensory deficits, over heart, over testes, over epiphyseal areas in children, infection, over malignancy
236
contraindications for UV
photosensitive meds, lupus erythematosus, tb, herpes, renal or hepatic pathology, DM, pellagra
237
contraindications to stop exercising during cardiac rehab
heart rate that increases over 50 bpm with low level activity, increasing bp, any ST segment chgs, severe LE claudication, angina, confusion, extreme fatigue, ventricular gallop
238
contusion
sudden blow to part of body that can result in mild to severe damage to superficial and deep structures. ROM, ice, compression are treatments
239
conventional TENS
frequency: 50-100 Hz, duration: 20-100 microseconds, amplitude: 10-30 mA
240
COPD
chronic obstructive pulmonary disease. increased resistance to passage of air in and out of the lungs due to narrowing of bronchial tree. symptoms: dyspnea, chronic productive cough, excessive mucus production. progression of disease includes alveolar destruction and subsequent increases in amount of air that remains in lungs. overall increased total lung capacity with a significant increase in residual volume. diagnosed by determining the amount of air forcibly expired from lungs in one second.
241
cor pulmonale
sudden dilation of rt ventricle of heart secondary to pulm embolus. rt sided heart failure will occur if condition is not treated. as condition progresses, symptoms resemble congestive heart failure. symptoms include: chronic cough, chest pain, distal swelling, dyspnea, fatigue and weakness.
242
corset
constructed of fabric to provide abdominal compression and support.
243
corticospinal tract (anterior)
pyramidal motor tract responsible for ipsilateral voluntary mvmt
244
corticospinal tract (lateral)
pyramidal motor tract responsible or contralateral voluntary fine mvmt
245
crackles (formerly rales)
discontinuous adventitious sound heard with a stethoscope that bubbles or pops. crackles typically represent the movement of fluid or secretions during inspiration (wet crackles) or occur from the sudden opening of closed airways (dry crackles). crackles that occur during latter half of inspiration typically represent atelectasis, fibrosis, or pleural effusion. crackles secondary to the mvmt of secretions are usually low-pitched.
246
craig-scott KAFO
designed specifically for persons with paraplegia. allows a person to stand with a posterior lean of trunk.
247
Cranial Nerves
olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal
248
cryotherapy
ex: ice massage, cold pack, cold bath, vapocoolant spray
249
cryotherapy contraindications
compromised circulation, peripheral vascular disease, ischemic tissue, cold hypersensitivity, raynaud's phenomenon, cold urticaria, hypertension, infection, cryoglobinemia
250
cryotherapy's indications
acute or chronic pain, myofascial pain syndrome, muscle spasm, bursitis, acute or subacute inflammation, musculoskeletal trauma, reduction of spasticity, tendonitis
251
cryotherapy's therapeutic effects
initial decrease of blood flow to treated area, decreased temp, increase pain threshold, decrease metabolism, decrease edema, initial vasoconstriction, decrease nerve conduction velocity, decrease nerve conduction velocity, reduce spasticity of muscle, produce analgesic effects
252
current
flow electrons from one place to another
253
CVA
cerebrovascular accident
254
CVA risk factors
hypertension, heart disease, DM, smoking, TIAs, obesity, high cholesterol, behaviors related to hypertension, physical inactivity, increased alcohol consumption
255
cva: cerebrovascular accident
types include ischemic (thrombus, embolus, lacunar) and hemorrhagic stroke (intracerebral, subdural, subarachnoid), left CVA may present with weakness or paralysis to rt side, impaired processing, heightened frustration, aphasia, dysphagia, and motor apraxia. right cva may present with weakness or paralysis to left side, poor attention span, impaired awareness and judgment, spatial deficits, memory deficits, emotional lability, and impulsive behavior
256
cystic fibrosis
causes exocrine glands to overproduce thick mucus which causes subsequent obstruction, autosomal recessive genetic disorder located on long arm of chromosome seven, terminal disease but death age has increased to 32 yrs due to early detection and management
257
decerebrate rigidity
characteristic of a corticospinal lesion at level of brainstem that results in extension of trunk and all extremities
258
decorticate rigidity
characteristic of a corticoapinal lesion at level of diencephalon where the trunk and LEs are positioned in extension, and the UEs are positioned in flexion
259
decreased or diminished sounds
less audible sound may indicate severe congestion, emphysema or hypoventilation
260
deep heating agents
diathermy, ultrasound (and phonopheresis)
261
deep pain
squeeze forearm or calf muscle
262
deep vein thrombosis (DVT)
formation of a blood clot that becomes dislodged and is termed an embolus. can become serious since the embolus may obstruct a selected artery. sci pts have a greater risk of developing a DVT due to the absence or decrease of activity in LEs.
263
degenerative spondylolisthesis
caused by weakening of joints that allows for forward slippage of one vertebral segment on one below due to degenerative changes, most common site is L4/L5, william's flexion exercises may be indicated to strengthen abs and reduce lumbar lordosis
264
delirium
state of consciousness that is characterized by disorientation, confusion, agitation, and loudness
265
densitometry: hydrostatic weighing
method of calculating density of body by immersing in water and measuring amt of water that becomes displaced.
266
densitometry: plethysmography
method of calculating body density utilizing amt of air displacement during testing within a closed chamber.
267
dependent
patient is unable to participate and therapist must provide all effort to perform task
268
dependent squat pivot transfer
used to transfer a patient who cannot stand independently, but can bear some weight thru the trunk and LEs. therapist should position patient at a 45 degree angle to the destination surface. patient places UEs on therapist's shoulders, but should not pull on therapist's neck. should position patient at edge of surface, hold patient around hips and under butt, block patients knees in order to avoid buckling. therapist should utilize momentum, straighten his or her legs and raise patient or allow patient to remain squatting, and pivot and slowly lower patient to destination surface.
269
depressed QRS
heart failure, ischemia, pericardial effusion, obesity, COPD
270
dermis
true skin: well vascularized, elastic, flexible and tough.
271
developmental sequence (PNF):
progression of motor skill acquisition. stages of motor control include mobility, stability, controlled mobility, and skill.
272
diabetes mellitus (type 1)
insulin is functionally absent due to destruction of beta cells of pancreas; where insulin would normally be produced. starts in children ages 4 or older, adolescense. symptoms include polyuria, polydipsia, polyphagia, nausea, weight loss, fatigue, blurred vision, and dehydration
273
diaphragmatic breathing
attempts to enhance movement of diaphragm upon inspiration and expiration and diminish accessory muscle use. position patient in bed with head and trunk elevated 45 degrees. place dominant hand over rectus abdominis. place non dominant hand over sternum. direct patient to inspire slowly and feel dominant hand rise. instruct patient to control both inspiration and expiration. non dominant hand should only have minimal movement.
274
diastole
(lower number bp reading) relaxation of cardiac muscle
275
diathermy
converts high frequency electromagnetic energy into therapeutic heat. produces vibration of molecules within a specific tissue, generates heat and elevates tissue temperature. main therapeutic effect is enhancement of soft tissue healing. can be delivered in continuous or pulsed mode. pulsed mode is usually used for thermal effects at 27.12 MHz.
276
diathermy parameters
inductive application: wrap coils around extremity that has been covered by a towel, place drum over treatment area. patient must remain in same position throughout treatment. treatment time varies from 15-30 mins.
277
diencephalon
hypothalamus, infundibulum, optic chiasm
278
diplopia
double vision
279
direct current
also known as galvanic, constant flow of electrons from anode to cathode without interruption. iontophoresis uses direct current
280
direct current (monophasic)
constant unidirectional flow of ions. dependent on polarity
281
disadvantages to alginates
may require frequent dressing changes based on level of exudate, requires a secondary dressing, cannot be used on wound with an exposed tendon, joint capsule or bone
282
disadvantages to foam dressings
may tend to roll in areas of excessive friction, adhesive form may traumatize periwound area upon removal, lack of transparency makes inspection of wound difficult
283
disadvantages to hydrocolloids
may traumatize surrounding intact skin upon removal, may tend to roll in areas of excessive friction, cannot be used on infected wounds
284
disadvantages to hydrogels
potential for dressings to dehydrate, cannot be used on wounds with significant drainage, typically requires a secondary dressing
285
disadvantages to transparent films
excessive accumulation of exudates can result in periwound maceration, adhesive may traumatize periwound area upon removal, cannot be used on infected wounds
286
double step
alternate steps are of a different length or different rate
287
double support phase
refers to the two times during a gait cycle where both feet are on the ground. does not exist when running
288
down syndrome
clinical presentation: hypotonia, flattened nasal bridge, simian line (palmar crease), epicanthal folds, enlargement of tongue and dd.
289
dsymetria
inability to control the range of a mvmt and the force of muscular activity
290
DTR grades
0=no response. 1+=diminished/depressed response. 2+=active normal response. 3+=brisk/exaggerated response. 4+=very brisk/hyperactive, abnormal response.
291
DTR normal responses:
biceps tendon: flexion/contraction of biceps. brachioradialis tendon: elbow flexion and/or forearm pronation. triceps tendon: elbow extension or contraction of triceps muscle. patellar tendon: knee extension. tibialis posterior tendon: PF/inversion of foot. achilles tendon: PF of foot.
292
DTR: deep tendon reflexes
reflex is a motor response to a sensory stimulation that is used in an assessment to observe the integrity of the nervous system. DTRs elicit a muscle contraction when the muscle's tendon is stimulated.
293
duchenne muscular dystrophy
x linked recessive trait manifesting in only male offspring while female offspring become carriers. waddling gait, prox muscle weakness, toe walking, pseudohypertrophy of calf and difficulty climbing stairs. rapid progression of this disease with inability to ambulate by ten to 12 yrs of age with death occurring as teenager or less frequently in the 20's.
294
dural spaces: epidural space
space occupied between the skull and outer dura mater
295
dural spaces: subarachnoid space
space occupied btwn the arachnoid and pia mater that contains CSF and the circulatory system for the cortex
296
dural spaces: subdural space
space occupied btwn the dura and arachnoid meninges
297
duration of stimulus/duration of rest
time period of stimulation and time period of rest btwn periods of stimulation.
298
duty cycle
percentage of time that electrical current is on in relation to entire treatment time.
299
dynamometer
measures strength through use of a load cell or spring loaded gauge. (ex: grip strength-pounds)
300
dynamometry: break test:
eval procedure where patient is asked to hold a contraction against pressure that is applied in opposite direction to contraction.
301
dynamometry: make test
eval procedure where a patient is asked to apply a force against the dynamometer.
302
dysarthria
motor disorder of speech that is caused by an upper motor neuron lesion that affects muscles that are used to articulate words and sounds. speech is often slurred.
303
dysarthria
slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech.
304
dysdiadochokinesia
inability to perform rapidly alternating mvmts
305
dysphagia
inability to properly swallow
306
dystonia
closely related to athetosis; however there is larger axial muscle involvement rather than appendicular muscles
307
eccentric contraction
occurs when muscle lengthens while developing tension
308
ECG
measures electrical activity of heart
309
ectopic bone
(or heterotopic ossification): spontaneous formation of bone in the soft tissue. occurs adjacent to larger joints such as knees or hips.
310
ectopic foci
location where abnormal myocardial depolarization originates
311
edema
increased volume of fluid in soft tissue outside of a joint capsule
312
EFFERENT NERVES
MOTOR
313
effleurage
light in stroke and produces a reflexive response. performed at beginning and end of massage to allow patient to relax and should be directed towards the heart.
314
effusion
increased volume of fluid within a joint capsule
315
elbow
hinge joint, reinforced by ulnar collateral and radial collateral ligaments
316
electrical impedance
resistance of a tissue to electrical current
317
electrode configuration
techniques include: monopolar, bipolar, and quadripolar
318
electrode size
when using a smaller electrode it is particularly important to understand that since the current density is quite high compared to a larger electrode, the patient will be more susceptible to pain and potential tissue damage.
319
electrolysis
decomposition of a compound that results from passing an electrical current through it
320
electromyography
science of evaluating motor units (anterior horn cell, axon, neuromuscular junctions and muscle fibers innervated by unit) through use of intramuscular needle electrodes or surface electrodes. potentials include abnormal: spontaneous and voluntary.
321
electron exchange
occurs during ionto where there is an exchange btwn ions within solutions and electrodes
322
electrotherapy
used for facilitation of skeletal muscle contraction, stimulation of denervated muscle, pain management, to retard muscle atrophy, osteogenesis, driving medications through the skin, and wound management
323
electrotherapy terms
...
324
elevated QRS
hypertrophy of myocardium
325
embolus (20% of ischemic CVAs)
associated with cardiovascular disease, an embolus may be a solid, liquid or gas, and con originate in any part of the body. travels thru bloodstream to the cerebral arteries causing occlusion of a blood vessel and a resultant infarct. middle cerebral artery is most commonly affected by an embolus from internal carotid arteries. often presents with a headache.
326
emotional lability
characteristic of a right hemisphere infarct where there is an inability to control emotions and outbursts of laughing or crying that are inconsistent with the situation
327
emphysema
develops from a long history of chronic bronchitis. alveolar walls present with significant pathology and air spaces are permanently over inflated. pink puffers. expiration is difficult. characterized as centrilobular, panlobular or paraseptal. symptoms include: dyspnea, chronic cough, orthopnea, barrel chest, increased use of accessory muscles, and increased RR.
328
end feel
type of resistance that is felt when passively moving a joint thru end range of motion.
329
enzymatic debridement
topical application of enzymes to surface of necrotic tissue. can be used on infected and non-infected wounds with necrotic tissue. may be used in wounds that have not responded to autolytic debridement or in conjunction with other debridement techniques. can be slow to establish a clean wound bed and should be discontinued after removal of devitalized tissues in order to avoid damage
330
epidermis
avascular, consists of outermost layer of skin
331
equine
gait pattern with high steps, excessive use of gastrocs
332
ERA
effective radiating area. area of transducer that transmits u/s energy. always smaller than total size of transducer head.
333
estim contraindication
malignancy, with all types of electrical implants, during first trimester of pregnancy, over lower abdomen/uterus during pregnancy, over anterior transcervical area
334
estim indications
pain management, urinary incontinence, edema management, osteoarthritic pain, migraines
335
expiration
to breathe air out of the lungs
336
expiratory reserve volume
1000 mL
337
expiratory reserve volume (ERV)
max volume expired after normal expiration
338
external catheter
applied over shaft of penis and is held in place by a padded strap or adhesive tape
339
facial
taste: anterior tongue, voluntary motor: facial muscles. autonomic: lacrimal, submandibular, sublingual glands
340
factors that influence vascular disease
hypertension, aging, diabetes, infection, poor nutrition, cigarette smoking
341
fasciculus cuneatus
sensory tract for trunk, neck and UE proprioception, vibration, 2 pt discrimination, graphesthesia
342
fasciculus gracilis
sensory tract for trunk and LE proprioception, 2 pt discrimination, vibration and graphesthesia
343
festinating
patient walks on toes as though pushed. starts slowly, increases and may continue until patient grabs an object in order to stop
344
FEV1 (forced expiratory volume in one second)
83% of VC
345
FEV2 (forced expiratory volume in 2 seconds)
94% of VC
346
FEV3 (forced expiratory volume in 3 seconds)
97% of VC
347
fibromyalgia
nonarticular rheumatic condition with pain caused by tender points within muscles, tendons, and ligaments. pain exists in all 4 quadrants of body and there is pain in at least 11 of 18 standardized tender point sites
348
fibrous joints
(synarthroses) minimal movement. ex: sutures, syndesmosis, gomphosis
349
firm end feel
(stretch) ex: ankle DF, finger extension, hip medial rotation, forearm supination
350
fissures
interhemispheric fissure: separates the two cerebral hemispheres. Sylvian or lateral fissure: (anterior portion) separates the temporal from frontal lobes; (posterior portion): separates temporal from parietal lobes
351
flexor synergy pattern
seen when patient attempts to lift up their arm or reach for an object. characterized by great toe extension and flexion of the remaining toes secondary to spasticity.
352
fluent aphasia
lesion often in temporoparietal lobe of dominant hemisphere. word output is functional. empty speech or jargon. speech lacks any substance. uses of paraphasias (substitution of incorrect words)
353
fluidotherapy
container that circulates warm air and small cellulose particles. extremity is placed into container and dry heat is generated thru energy transferred by forced convection. promotes tissue healing and prevention of edema. body part should be placed into unit prior to turning machine on. temp should be set between 111-125 degrees. treatment time usually 20 minutes.
354
foam dressings
composed from a hydrophilic polyurethane base. hydrophilic at wound contact surface and are hydrophobic on the outer surface. allows exudates to be absorbed into the foam through the hydrophilic layer. most commonly available in sheets or pads with varying degrees of thickness.
355
foley catheter
indwelling urinary tract catheter that has a balloon attachment at one end. balloon which is filled with air or sterile water must be deflated before catheter can be removed
356
Foot orthotics
semirigid or rigid insert worn inside a shoe that corrects foot alignment and improves function.
357
forced expiratory volume (FEV)
amount of air exhaled in the 1st, 2nd, and 3rd second of a forced vital capacity test
358
forced expiratory volumes
...
359
forced vital capacity (FVC)
amount of air forcefully expired after a max inspiration
360
frequency
determines number of pulses delivered through each channel per second. often labeled "rate"
361
friction
incorporates small circular motion over a trigger point or muscle spasm. deep massage technique that penetrates into the depth of a muscle and attempts to reduce edema, loosen adhesions, and relieve muscle spasm. used with chronic inflammation or with overuse injuries
362
frontal lob impairments
contralateral weakness, contralateral head and eye paralysis, personality changes, antisocial behavior, ataxia, primitive reflexes, broca's aphasia, delayed or poor initiation
363
frontal lobe
responsible for: voluntary motor function, advanced motor planning, initiation of action, cranial nerves 3, 4, 6, 9, 10, 12; emotion interpretation, personality, judgment, planning, motivation, bladder & bowel inhibition, broca's motor speech center, appreciation of intonation, understanding gestures.
364
frontal plane
divides body into anterior and posterior. motions are abduction and adduction, occur around an anterior-posterior axis.
365
full thickness burns
burn causes immediate cellular and tissue death and subsequent vascular destruction, eschar forms from necrotic cells and creates a dry and hard layer that requires debridement. absent sensation and pain due to destruction of free nerve endings
366
functional residual capacity (FRC)
volume in lungs after normal exhalation
367
functional residual capacity (FRC)=
expiratory reserve volume (ERV) + residual volume (RV)
368
FWB
full weight bearing
369
gait cycle
sequence of motions that occur from one initial contact of the heel to the next initial contact of the same heel.
370
gait deviations of amputee: abducted gait
causes: prosthesis may be too long, high medial wall, poorly shaped lateral wall, prosthesis position in abduction, inadequate suspension, abduction contracture, improper training, adductor roll, weak HF and adductors, pain over lateral residual limb
371
gait deviations of amputee: circumducted gait
causes: prosthesis may be too long, too much friction in knee, socket too small, excessive PF of prosthetic foot, abduction contracture, improper training, weak HF, inability to initiate prosthetic knee flexion
372
gait deviations of amputee: excessive knee flexion during stance
socket set forward in relation to foot, foot set in excessive DF, stiff heel, prosthesis too long, knee flexion contracture, hip flexion contracture, poor balance, decrease in quad strength
373
gait deviations of amputee: forward trunk flexion
causes: socket too big, poor suspension, knee instability, hip flexion contracture, weak hip extensors
374
gait deviations of amputee: lateral bending
causes: prosthesis too short, improperly shaped lateral wall, high medial wall, prosthesis aligned in abduction, poor balance, abduction contracture, improper training, short residual limb, weak hip abductors on prosthetic side, hypersensitive and painful residual limb
375
gait deviations of amputee: medial or lateral whip
causes: excessive rotation of the knee, tight socket fit, valgus in prosthetic knee, improper alignment of toe break, improper training, weak hip rotators, knee instability
376
gait deviations of amputee: rotation of forefoot at heel strike
causes: excessive toe-out built in, loose fitting socket, inadequate suspension, rigid SACH heel cushion, poor muscle control, weak medial rotators, short residual limb
377
gait deviations of amputee: vaulting
causes: prosthesis may be too long, inadequate socket suspension, excessive alignment stability, foot in excess PF, residual limb discomfort, improper training, short residual limb
378
gait muscles: gastroc/soleus
activity during late stance phase. concentric raising of heel during toe off.
379
gait muscles: hams
activity during late swing phase. decelerating unsupported limb.
380
gait muscles: quads
single support during early stance phase, and just before toe off to initiate swing phase.
381
Gait muscles: tibialis anterior
activity just after heel strike. eccentric lowering of foot into PF.
382
Gait: Standard - Stance Phase (60% of gait cycle)
Heel strike: instant heel touches ground to begin stance phase
383
gas pressure
mm Hg: see chart on page 132
384
gauze dressings
most readily available used in inpatient environment. commonly used on infected or non-infected wounds of any size. can be used for wet to wet, wet to moist, or wet to dry debridement. readily available and cost effective but has a tendency to adhere to wound bed. requires frequent dressing changes. increased infection rate compared to occlusive dressings
385
genu valgum
knees touch while standing with feet separated. will increase compression of lateral condyle and increase stress to medial structures. also called knock-knee.
386
genu varum
bowing of knees. will increase compression of medial tibial condyle and increase stress to lateral structures. also called bowleg.
387
gfci:
ground fault circuit interrupter: designed to cut off electrical supply to a piece of equipment if it detects any form of leakage or ground fault.
388
glasgow coma scale
neuro assessment tool used initially after injury to determine arousal and cerebral cortex function. total score of 8 or less correlates to coma in 90% of patients. scores of 9-12 indicate moderate brain injuries and scores from 13-15 indicate mild brain injuries.
389
global aphasia
major non-fluent aphasia. lesion of frontal, temporal, and parietal lobes. comprehension (reading and auditory) is severely impaired.
390
glossopharyngeal
touch, pain: posterior tongue, taste: tongue. swallowing
391
goals for chest PT
mobilize secretions, expel secretions, improve breathing patterns, improve ventilation throughout all lobes, improve overall function
392
goals for vestibular rehab:
improve balance and stability, increase strength and ROM, decrease falls, minimize dizziness
393
golgi tendon organ
sensory receptors through which muscle tendons pass immediately beyond attachment to muscle fibers. very sensitive to TENSION when produced from an active muscle contraction. average of 10-15 muscle fibers are connected in series with each golgi tendon organ. stimulated through the tension produced by muscle fibers.
394
grade I
small movement performed at beginning of range
395
grade II
large amplitude movement performed within the range, but not reaching limit of range and not returning to beginning of range
396
grade III
large amplitude movement performed to limit of range
397
grade IV
small amplitude movement performed at limit of range
398
graphesthesia
draw a number or letter on skin with finger, identify without sight
399
greenstick fracture
break on one side of a bone that does not damage periosteum on opposite side. often seen in children.
400
guidelines for chest PT
treatment should be before eating, or at least one hour after meals, percuss and vibrate over each segment to be treated for at least 3-5 mins, cough after each segment is treated, allow for a rest period after each segment is treated, review breathing exercises in each drainage position, not to exceed 45-60 mins secondary to patient fatigue
401
guillain barre syndrome
motor weakness in a distal to prox progression, sensory impairment, and possible respiratory paralysis. may be an autoimmune response to a previous respiratory infection, flu, immunization or surgery. patients usually have full recovery
402
halo vest orthosis
invasive cervical thoracic orthosis that provides full restriction of all cervical motion. commonly used with cervical spinal cord injuries to prevent further damage or dislocation.
403
hard end feel
(bone to bone) ex: elbow extension
404
HCO3
24 mEq/L
405
heart failure
inability of heart to maintain a proper cardiac output of 4 liters per minute while at rest. chronic hypertension is most common cause
406
Heart sounds: S1
lub: mitral and tricupsid valves closing at beginning of systole
407
Heart sounds: S2
dub: aortic and pulmonary valves closing at onset of diastole
408
Heart sounds: S3
ventricular gallop: abnormal in older adults: noncompliant left ventricle. may be associated with CHF
409
Heart sounds: S4
vibration of ventricular wall with ventricular filling and atrial contraction; may be associated with hypertension, stenosis, hypertensive heart disease or myocardial infarction
410
heat conduction
direct contact btwn 2 materials at different temperatures. ex: hot pack, paraffin, ice massage, cold pack
411
heat convection
air or water moving in a constant motion across body. ex: whirlpool
412
heat conversion
transfer of heat when nonthermal energy is absorbed into tissue and transformed into heat. ex: diathermy and ultrasound
413
heat evaporation
transfer of heat as a liquid absorbs energy and changes from to a vapor. ex: vapocoolant spray
414
heat radiation
direct transfer of heat from a radiation energy source of higher temperature to one of cooler temperature. directly absorbed without the need for a medium. ex: infrared lamp
415
heating contraindications
circulatory impairment, area of malignancy, acute musculoskeletal trauma, bleeding, sensory impairment, thrombophlebities, arterial disease
416
heating indications
pain control, chronic inflammatory conditions, trigger point, tissue healing, muscle spasm, decreased ROM, densensitization
417
heating therapeutic effects
increase temp, increase blood flow to area, decrease nerve conduction latency, vasodilation, increase muscle elasticity, increase collagen extensibility, decreases tone
418
hematocrit
percentage of packed RBC in total blood volume.
419
hemiballism
involuntary and violent mvmt of a large body part
420
hemi-height w/c
decreased seat height (17.5 inches) to allow for propulsion using the unaffected foot
421
hemiparesis
condition of weakness on one side of body
422
hemiplegia
condition of paralysis on one side of the body
423
hemiplegic
abducts paralyzed limb, swings it around and brings forward so that foot comes to ground in front of them
424
hemisphere specialization/dominance
left: language, sequence and perform movements, understanding language, produce written and spoken language, analytical, controlled. right: nonverbal processing, processing information in a holistic manner, artistic abilities, general concept comprehension, hand-eye coordination, spatial relationships
425
hemoglobin
iron containing pigment of RBC. function is to carry oxygen from lungs to tissues. used to assess blood loss, anemia, and bone marrow suppression. low hemoglobin=blood loss, high hemoglobin=hemoconcentration caused by polycythemia or dehydration
426
hemorrhage (10-15% of CVAs)
abnormal bleeding in brain due to rupture in blood supply. due to disruption of oxygen to an area of brain and compression from accumulation of blood. hypertension is usually a precipitating factor causing rupture of an aneurysm or arteriovenous malformation. 50% of deaths from hemorrhagic stroke occur within first 48 hours.
427
high volt current
characterized by a waveform greater than 150 volts with a short pulse duration. is intermittent and is used for deeper tissue penetration
428
hip
ball and socket joint. stability provided at joint by: acetabulum, iliofemoral ligament, pubofemoral ligament, and ischiofemoral ligament
429
hip strategy
elicited by a greater force, challenge or perturbation thru pelvis and hips. hips will move in opposite direction from head in order to maintain balance. muscles contract in a proximal to distal fashion in order to counteract the loss of balance
430
HKAFO
indicated for patients with hip, foot, knee, and ankle weakness. can control rotation at hip and abduction/adduction. heavy and restricts patients to a swing to or swing thru gait pattern.
431
hold-relax
isometric contraction used to increase ROM. contraction is facilitated for all muscle groups at the limiting point in the ROM. relaxation occurs and extremity moves thru the newly acquired range to the next point of limitation until no further increases in ROM occur. used for patients that present with pain usually. (mobility)
432
hold-relax active
technique to improve initiation of mvmt to muscle groups tested at 1/5 or less. (mobility)
433
homolateral synkinesis
flexion pattern of the involved UE facilitates flexion of the involved LE
434
homonymous hemianopsia
loss of right or left half of vision in both eyes
435
hot pack
effects include soft tissue healing, promoting relaxation, decreasing pain and stiffness. must be stored in hot water between 158-167 degrees. requires 6-8 towels around hot pack. require approx 20 minutes to achieve desire effects
436
huntingtons disease
chronic progressive genetic disorder that is fatal within 15 to 20 yrs after clinical manifestation. degeneration and atrophy of basal ganglia (stiatum) and cerebral cortex w/in brain. clinically presents with enlarged ventricles secondary to atrophy of basal ganglia, mental deterioration, speech disturbances and ataxic gait
437
hvpc
high voltage pulsed current: twin peak monophasic, pulsed current. produces high electromotive forces. has a phase duration of 5-20 microsecs (fixed in most machines), a short pulse duration that ranges btwn 100-200 microsecs, and voltage greater than 150V to a max of 500V. one large dispersive pad along with one, two or four active electrodes. active electrodes can be positive or negative in polarity based on treatment goals.
438
hvpc parameters
secure one electrode over wound (using warm sterile gauze and sponge) and other over healthy skin a min of 5 cm from wound itself. polarity should be in reversal mode so that it allows for 50% of treatment with positive polarity. frequency is generally 30-200 pps, amplitude 1-500V, and duration of treatment from 10-60 mins per session. dermal wounds should be treated 5-7 days per week for best results
439
hydrocolloid dressing
gel forming polymer such as gelatin, pectin, and carboxymethylcellulose with a strong film or foam adhesive backing. absorb exudate by swelling into a gel like mass and vary from being occlusive to semi permeable. does not attach to actual wound itself and is instead anchored to intact skin surrounding the wound.
440
hydrogels
consist of varying amounts of water and varying amounts of gel-forming materials such as glycerin, dressings are available in sheet form or amorphous form
441
hydrostatic pressure
water exerts pressure that is perpendicular to the body and increases in proportion with the depth of immersion
442
hydrotherapy
the internal and external use of water in the treatment of disease. transfers heat thru conduction or convection and is administered in tanks of varying sizes. main therapeutic effects: wound care, unloading of weight, and reduction of edema.
443
hypercapnia
increased amount of CO2 in blood
444
hyperkalemia
increased amount of potassium in blood
445
hypertension
elevated arterial blood pressure both for systole and diastole.
446
hypertrophic scar
can occur during healing process when collagen production greatly exceeds collagen lysis. will be raised, but remain within borders of original injury
447
hypocapnia
decreased amount of CO2 in blood
448
hypoglossal
voluntary motor: muscles of tongue
449
hypoxemia
when PaO2 is less than 80 mm Hg
450
ice massage
5-10 min treatment time
451
ideational apraxia
inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for mvmt is impaired
452
ideomotor apraxia
condition where a person plans a mvmt or task, but cannot volitionally perform it. automatic mvmt may occur, but a person cannot impose additional mvmt on command.
453
If CVA is in anterior cerebral artery:
impairments include LE involvement, loss of bowel/bladder control, loss of behavioral inhibition, mental changes, may see neglect, may see aphasia, apraxia and agraphia, perseveration
454
if CVA is in middle cerebral artery (most common area)
impairments include wernicke's aphasia, homonymous hemianopsia, apraxia, flat affect in rt hemisphere, impaired body schema
455
if CVA is in posterior cerebral artery
impairments include pain and temp sensory loss, contralateral hemiplegia, ataxia, athetosis or coreiform mvmt, quality of mvmt is impaired, thalamic pain syndrome, anomia, prosopagnosia with occipital infarct, hemiballismus, visual agnosia, homonymous hemianopsia, mild hemiparesis, memory impairment, dyschromatopsia, palinopsia, micropsia, macropsia, alexia, dyslexia, achromatopsia
456
If CVA is in vertebral-basilar artery
impairments include loss of consciousness, hemi or tetraplegia, comatose or vegetative state, inability to speak, locked in syndrome, vertigo, nystagmus, dysphagia, dysarthria, syncope, ataxia
457
impedance
property of a substance that provides resistance to flow of current by offering an alternate current
458
incentive spirometry
used to increase inspiration using a device that provides immediate fb to patient regarding performance. commonly utilized to treat patients status post surgery in order to strengthen weak inspiratory muscles and to prevent alveolar collapse. have patient breathe into spirometer and instruct patient to perform a max inhalation into spirometer. repeat 7 - 10 times per session and repeat 3-4 times per day.
459
incomplete lesion
lesion to the SC with incomplete damage to the cord. there may be scattered motor function, sensory function or both below the level of injury/lesion.
460
incomplete: anterior cord syndrome
results from compression and damage to the anterior part of SC or anterior spinal artery. usually cervical flexion is mechanism of injury. loss of motor function and pain and temp sense below lesion due to damage of the corticospinal and spinothalamic tracts
461
incomplete: brown-sequard's syndrome
usually caused by a stab wound, which produces a hemisection of the sc. paralysis and loss of vibratory and position sense on same side as lesion due to damage to corticospinal tract and dorsal columns. loss of pain and temp sense on opposite side of lesion from damage to lateral spinothalamic tract. rare since most spinal cord lesions are atypical.
462
incomplete: cauda equina injuries
injury that occurs below L1 spinal level where long nerve roots transcend. mostly incomplete but rarely can be complete as well. considered a peripheral nerve injury. flaccidity, areflexia, impairment of bowel/bladder function. full recovery not typical due to distance needed for axonal regeneration.
463
incomplete: central cord syndrome
results from compression and damage to the central portion of sc. injury is usually cervical hyperextension that damages spinothalamic tract, corticospinal tract, and dorsal columns. UEs present with greater involvement than LEs, and greater motor deficits than sensory deficits.
464
incomplete: posterior cord syndrome
rare syndrome that is caused by compression of posterior spinal artery and is characterized by loss of pain perception, proprioception, 2 pt discrimination, and stereognosis. motor function is preserved.
465
independent
patient does not require any assistance to complete task
466
indications for compression
lymphedema, new res limb, risk for DVT, edema, stasis ulcers, hypertrophic scarring
467
indications for hvpc
wound management, pain management, soft tissue edema, levator ani syndrome, muscle spasm, muscle weakness, bell's palsy
468
indications for hydrotherapy:
burn care, superficial heating or cooling, edema control, muscle strain, arthritis, desensitization of residual limb with contrast bath, pain management, wound care, decreased ROM, pool therapy/exercise, sprain, joint stiffness, muscle spasm/spasticity
469
indications for joint mobs
restricted joint mobility, restricted accessory motion, desire neuro effects
470
indications for massage
pain, decreased ROM, edema, adhesions, myositis, lactic acid excess, migraine, trigger point, muscle spasm and cramping, scar tissue, bursitis, tendonitis, intermittent claudication, raynaud's syndrome
471
indications for therapeutic modalities
inflammation and repair, pain, restriction in motion, and abnormal tone.
472
indications for traction
nerve impingement, herniated or protruding disc, subacute joint inflammation, spondylolisthesis, joint hypomobility, paraspinal muscle spasm, degenerative joint disease, osteophyte formation
473
indications for u/s
soft tissue repair, contracture, bone fracture, trigger point, dermal ulcer, scar tissue, pain, plantar wart, muscle spasm
474
indications for UV
acne, psoriasis, tetany, Vit D deficiency, chronic ulcer/wound, osteomalacia/rickets, sinusitis
475
inductance
how easily a certain material will induce an electromotive force (emf) within a circuit
476
infective endocarditis
inflammation of endothelium that lines heart and cardiac valves. most commonly damages mitral valve, then aortic and tricuspid valves. commonly caused by bacteria that are normally present in the body. can also occur after an invasive medical or dental procedure. symptoms: valvular dysfunction, may affect organ systems, chest pain, CHF, clubbing, meningitis, low back pain, arthralgia, arthritis
477
inflammation phase of tissue healing
occurs secondary to trauma or disease. required for healing to occur. presents with calor, rubor, tumor, dolor. clot formation and phagocytosis occur
478
infrared lamp (IR)
produces superficial heating of tissue through radiant heat. form of heating is usually limited to penetration of less than one to three millimeters. use is declining due to risk of burns during treatment. patient should be positioned approx 20 inches from source. 20 inches in distance should equal 20 minutes of treatment. as distance decreases, intensity will increase and time of total treatment should decrease.
479
inspiration
to breathe air into the lungs
480
inspiratory capacity
3000-4000 mL 75-80% of vital capacity, 55-60% of total lung capacity
481
inspiratory capacity (IC)
amount of air that can be inspired after a normal exhalation
482
inspiratory capacity (IC)=
tidal volume (TV) + inspiratory reserve volume (IRV)
483
inspiratory muscle training
used for patients that exhibit decreased chest expansion, SOB, bradypnea, and decreased breath sounds. attempts to increase ventilating capacity and decrease dyspnea through strengthening of diaphragm and intercostal muscles.
484
inspiratory muscle training (treatment protocol)
2-4 sessions of 30 to 60 minutes of deep breathing with proper diaphragmatic breathing
485
inspiratory reserve volume (IRV)
max volume inspired after normal inspiration
486
integumentary system
consists of dermal and epidermal layers, air follicles, nails, sebaceous glands, sweat glands
487
interferential current
combines two high frequency alternating waveforms that are biphasic. used for deep muscle stimulation. attempts to reach deeper tissues using higher frequencies of each waveform along with overall shorter pulse widths. uses a frequency of 50-1250 pps and a pulse width of 50-150 microseconds for pain management; and a frequency of 20-50 pps and pulse width of 100-200 microseconds for muscle contractions
488
interpulse interval
period of time of electrical inactivity btwn each pulse, usually expressed in microsecs or millisecs
489
intervention for arterial insufficiency ulcer
cleansing the ulcer, rest, reducing risk factors, limb protection
490
intervention for venous insufficiency ulcer
cleansing the ulcer, compression to control edema
491
intravenous system
consists of a sterile fluid source, pump, clamp, and catheter to insert into a vein. can be used to infuse fluids, electrolytes, nutrients, and medication. IV lines are most commonly inserted into superficial veins such as basilic, cephalic, or antecubital.
492
ion
positively or negatively charged atome
493
iontophoresis
process by which medications are induced through the skin into the body by means of continuous direct current electrical stimulation. medication is separated into ions based on the polarity of the current.
494
iontophoresis parameters
pt should never lie on top of electrodes. unit should be set to continuous direct current. polarity must be set to same polarity as ion solution. ion solution should be massaged into treatment site or space within electrode. conductive surface area of the negative electrode (cathode) is twice the size of the conductive surface area of the positive electrode (anode) regardless of which on is the active electrode. active electrode must be placed over target area the the dispersive electrode should be placed as far as possible from active electrode. slowly increase intensity towards a max of five milliamperes. treatment should last 15-20 mins. additional time is required for treatment at an intensity of less than five milliamperes.
495
ischemic stroke
when there is a loss of perfusion to a portion of the brain within just seconds, there is a central area of irreversible infarction surrounded by an area of potential ischemia.
496
isokinetic contraction
occurs when tension developed by muscle is maximal over full range of motion while shortening or lengthening at a constant speed.
497
isometric contraction
occurs when tension develops but no change in length of muscle
498
isotonic
occurs when muscle shortens or lengthens while resisting a constant load
499
joint distraction
proprioceptive component used to increase ROM around a joint. manual traction is provided slowly and usually in combo with mobilization techniques. (mobility)
500
joint mobilization
passive movement technique designed to improve joint function
501
1/5
no movement, but can feel muscle contraction
502
2/5
completes ROM with gravity eliminated
503
3/5
completes ROM against gravity w/o manual resistance
504
4/5
completes ROM against gravity with mod resistance
505
5/5
completes ROM against gravity with max resistance
506
% Sat
95-98%
507
(start of peds) congenital hip dysplasia
malalignment of femoral head with acetabulum. develops during last trimester in utero. asymmetrical hip abdution with tightness and apparent femoral shortening of involved side. testing includes ortolani test, barlow maneuver, and u/s. treatment initially attempts to reposition femoral head within the acetabulum thru constant use of a harness, brace, splint or traction. PT may be indicated after cast removal for stretching, strengthening, and caregiver education.
508
2 person lift
used to transfer a patient btwn two surfaces of different heights or when transferring a patient to the floor.
509
2 point gait
when patient uses 2 crutches or canes. moves left crutch forward while simultaneously advancing rt lower extremity ad vice versa.
510
2 pt discrimination
2 point caliper on skin, identify one or two points without sight
511
2 types of cavitation that occur:
stable cavitation: microscopic bubbles increase and decrease in size but do not burst. triggers microsteaming. transient (unstable) cavitation: microscopic bubbles increase in size over multiple cycles and implode. this causes brief moments of local temperature ad pressure increases in area surrounding those bubbles. process should not occur during therapeutic u/s since intensities required are much higher than 3 w/cm2.
512
2-/5
does not complete ROM in gravity eliminated position
513
2+/5
able to initiate mvmt against gravity
514
3 person carry/lift
used to transfer patient from a stretcher to a bed or treatment plinth. 3 therapists carry patient in supine position. therapist at head usually gives commands.
515
3 point gait
walker or crutches. injured lower extremity may have decreased weight bearing. AD is advanced followed by injured LE and then uninjured LE. AD and each LE are considered separate points
516
3-/5
does not complete ROM against gravity, but completes more than half the range
517
3+/5
completes ROM against gravity with only minimal resistance
518
4 point gait
each advancement of crutch or cane as well as LEs indicates a single point, used one at a time.
519
4-/5
completes ROM against gravity with min/mod resistance
520
4+/5
completes ROM against gravity with mod/max resistance
521
A fib
irregular atrial rhythm, no rate, no P waves, F waves absent, quivers noted, ventricular rhythm varies. common causes: hypertension, CHF, CAD, rheumatic heart disease, cor pulmonale, pericarditis, drug use
522
A fibers
large, myelinated, high conduction rate. contained in alpha and gamma motor systems. sensory components in muscle spindles, golgi tendon organs, bare nerve endings, mechanoreceptors
523
abducens
voluntary motor: muscle of eyeball, lateral
524
ABI scale
Normal=1.0. .5-.9=arterial occlusion, impairment with wound healing. less than .5=severe arterial occlusion.
525
ABI: ankle-brachial index
test that measures arterial perfusion using a Doppler unit. blood pressures are measured in both UEs and LEs and highest LE systolic pressure is divided by brachial systolic pressure.
526
abnormal breath sounds
sounds that are heard outside of their normal location or phase of respiration
527
abnormal end feel: empty
cannot reach end feel due to PAIN, ex: joint inflammation, fracture or bursitis
528
abnormal end feel: firm
ex: increased tone, tightening of capsule, ligament shortening
529
abnormal end feel: hard
ex: fracture, OA, osteophyte formation
530
abnormal end feel: soft
ex: edema, synovitis, ligament instability/tear
531
absent breath sounds
may indicate pneumothorax or lung collapse
532
absolute contraindications for treatment of an unstable cardiac patient
third degree heart block, uncompensated CHF, PVCs of vent tachycardia at rest, multifocal PVCs, chest pain with ST sgmt changes, ECG changes that indicate ischemia, dissecting aortic aneurysm
533
accessory
voluntary motor: SCM and trapezius muscle
534
accommodation
an occurrence where a nerve and muscle membrane's threshold for excitability increases secondary to a stimulation by a pulse that has a slow phase rise time. the quicker the rise time, the less the nerve can accommodate to the impulse.
535
achilles tendon rupture
usually one to two inches above tendinous insertion on calcaneous, greatest btwn 30-50 yrs of age, typically be unable to stand on their toes and tend to exhibit a positive Thompson test
536
acidic/alkaline reaction
acidic reaction can cause hardening of skin. alkaline reaction can cause skin to soften over time.
537
acoustic cavitation
occurs as a result of acoustic energy generated by u/s that develops into microscopic bubbles causing cavities that surround soft tissues. the bubbles expand and contract.
538
acoustic streaming
term for the consistent and circular flow of cellular fluids that results from u/s. responsible for altering cellular activity and the transport of fluids to different portions of the field.
539
active insufficiency
when a 2 joint muscle contracts (shortens) across both joints simultaneously
540
acupuncture like TENS
frequency: 1-4 Hz, 100-200 microseconds, amplitude: 30-80 mA
541
acute alveolar hyperventilation
pH greater than 7.5
542
acute diagnostic management
glasgow coma scale, CAT scan, x-ray, MRI, cerebral angiography, evoked potential/electroencephalogram, positron emission tomography, ventriculography, radioisotope imaging
543
acute ventilatory failure
pH less than 7.3
544
adhesive capsulitis
occurs more in middle-aged population, greater incidence in women, arthrogram can assist with dx by detecting decreased volume of fluid within the joint capsule, ROM restriction typically in a capsular pattern (lateral rotation, abduction, medial rotation)
545
adult w/c specs:
seat width: 18 inches, set depth: 16 inches, seat height: 20 inches
546
ADULT: CPR flow chart
no mvmt-phone 911-open airway, check breathing-if NO breathing, administer 2 breaths that make chest rise. if NO response, check pulse. if pulse, rescue breathing only at 10-12 breaths per minute. if NO pulse, begin CPR with 30 compressions and 2 breaths. continue to perform CPR until medical assistance arrives
547
advantages to alginates
high absorptive capacity, enables autolytic debridement, offers protection from microbial contamination, can be used on infected or uninfected wounds, non-adhering to wound
548
advantages to foam dressings
provides a moist environment for wound healing, available in adhesive and nonadhesive forms, provides prophylactic protection and cushioning, encourages autolytic debridement, provides moderate absorption
549
advantages to hydrocolloids
moist environment for wound healing, enables autolytic debridement, offers protection from microbial contamination, provides moderate absorption, does not require a secondary dressing, provides a waterproof surface
550
advantages to hydrogels
provides a moist environment for wound healing, enables autolytic debridement, may reduce pressure and diminish pain, can be used as a coupling agent for ultrasound, minimally adheres to wound
551
advantages to transparent films
provides a moist environment for wound healing, enables autolytic debridement, allows visualization of the wound, resistant to shearing and frictional forces, cost effective over time
552
adventitous breath sounds
abnormal breath sounds heard using a stethoscope with inspiration and/or expiration. these sounds can be continuous or discontinuous sounds
553
aerobic metabolism
used predominantly during low intensity, long duration exercises. yields by far the most atp, but requires chemical reactions.
554
AFFERENT NERVES
SENSORY
555
AFO
primary purpose is to assist with dorsiflexion and prevent foot drop, can also influence knee control. commonly described for patients with peripheral neuropathy, nerve lesions or hemiplegia
556
aggressive spasticity treatment for sci
phenol blocks, rhizotomies, myelotomies, other surgical interventions
557
agnosia
inability to interpret information
558
agonist reversals
isotonic concentric contraction performed against resistance followed by alternating concentric and eccentric contractions with resistance. (controlled mobility, skill)
559
agraphesthesia
inability to recognize symbols, letters or numbers traced on the skin
560
agraphia
inability to write due to a lesion within the brain
561
akinesia
inability to initiate mvmt; commonly seen with parkinson's
562
alginates
consist of calcium salt of alganic acid that is extracted from seaweed. highly permeable and non-occlusive. requires a secondary dressing. based on the interaction of calcium ions in the dressing and the sodium ions in the wound exudate.
563
alternating current
polarity that changes from positive to negative with change in direction of current flow. biphasic, symmetrical or asymmetrical, and is a waveform that is sinusoidal in shape. used in muscle retraining, spasticity and stimulation of denervated muscle
564
alternating current (biphasic)
alternating current allows for the constant change in flow of ions
565
alternating isometrics
isometric contractions performed alternating from muscles on one side of joint to the other side w/o rest (stability)
566
ampere
unit of measure used to describe rate of current
567
amplitude
magnitude of current. often labeled intensity or voltage.
568
amyotrophic lateral sclerosis
risk is higher in males, usually occurs between 40-70, clinical presentation may include both upper and lower motorneuron involvement with weakness occurring in a distal to prox progression, average course of dx is 2-5 yrs with only 20-30% of patients surviving longer than five years
569
anaerobic clycolysis
major supplier of ATP during high intensity, short duration activities. 50% slower than ATP-PC system and can provide a person with 30-40 secs of muscle contraction
570
anatomic dead space volume (VD)
volume of air that occupies the non respiratory conducting airways
571
aneurysm
weakening in wall of a vessel that produces a sac like area. 50% increase in normal vessel diameter with weakening of all layers of arterial or venous wall. most common sites include aorta, abdominal aorta, femoral, and popliteal arteries. surgical repair prior to rupture has a good prognosis; ruptured aneurysm is a medical emergency with high mortality rate. symptoms: abnormal heart beat, MI, stroke, renal failure, embolization, intermittent or constant pain
572
angina pectoris
when coronary arteries are unable to supply the heart with adequate oxygen. sudden onset is common once the myocardial oxygen demand is higher than the supply. CAD accounts for 90% of all angina.
573
ankle
hinge joint formed by articulation of tibia and fibula w/talus. medial ligaments: deltoid. lateral ligaments: anterior tibiofibular, anterior talofibular, calcaneofibular, lateral talocalcaneal, and posterior talofibular
574
ankle strategy
first strategy to be elicited by a small range and slow velocity perturbation when feet are on the ground. muscles contract in a distal to proximal fashion to control postural sway from ankle joint
575
ankylosing spondylitis
systemic condition, inflammation of spine and larger peripheral joints, males greater risk btwn 20-40, presentation initially includes recurrent and insidious onset of back pain, morning stiffness, and impaired spinal extension
576
anode
positively charged electrode that attracts negative ions
577
antalgic gait
involved step length is decreased in order to avoid weight bearing due to pain
578
anterior cruciate ligament sprain
most commonly occurs during hyperflexion, rapid deceleration, hyperextension or landing in an unbalanced position, females involved in selected sports have higher ligament injury rates, approx 2/3 of time acl is completely torn, there is an associated meniscal tear
579
anterograde memory impairment
inability to create new memory. usually last to recover after a comatose state.
580
anthropometry: skinfold msrmt
determines overall % of body fat thru msrmt of 9 standardized sites.
581
antiarrhythmic agents: prevention of arrhythmias, ischemia and hypertension
sodium channel blockers: norpace, Xylocaine. beta-blockers: tenormin, lopressor, inderal. Refractory period alterations: cordarone, corvert. Calcium channel blockers: norvasc, cardizem, verapamil.
582
antihypertensive agents: assists to lower blood pressure; decreases tension within circulation system
diuretics: lasix, bumex, thiazide. beta-blockers: sectral, inderal, lopressor. calcium channel blockers: cardizem, calan. alpha-blockers: cardura, minipress
583
antiplatelet agents (aspirin, plavix, ascriptin)
reduces atherosclerotic events and decrease the risk for CVA
584
aphasia
acquired neuro impairment of processing for receptive and/or expressive language. result of brain injury, head trauma, CVA, tumor or infection.
585
aphasia
inability to communicate or comprehend due to damage to specific areas of brain
586
apraxia
inability to perform purposeful learned mvmts, although there is no sensory or motor impairment
587
areas of MI
expected damage: anterior heart-left anterior descending artery, high risk of large infarction, heart failure, sudden death. inferior heart-rt coronary artery, right ventricle damage, AV block, medium infarct possible, lateral heart and/or superior heart-least area of muscle affected, usually least overall damage, minor impairment or complications
588
armrest height
measure from seat of chair to olecranon process with user's elbow flexed to 90 and then add one inch. average usually 9 inches above chair seat.
589
arterial blood gases (ABG)
uses as a tool to determine the effectiveness of alveolar ventilation. expressed as the partial pressure of the gas.
590
arterial insufficiency ulcers
occur secondary to ischemia from inadequate circulation of oxygenated blood often due to complicating factors such as atherosclerosis
591
arterial line
monitoring device consisting of a catheter that is inserted into an artery and attached to an electronic monitoring system. used to measure blood pressure or obtain blood samples. considered more accurate than traditional measures of blood pressure and does not require repeated needle punctures
592
arterial ulcers
lower one third of leg, toes, web spaces. smooth edges, well defined, lack of granulation tissue, tend to be deep. severe pain, diminished or absent pedal pulses, normal edema, decreased skin temperature, thin and shiny tissue, hair loss, yellow nails. leg elevation increases pain.
593
ascending and descending tracts
...
594
assistive devices
parallel bars, walkers, axillary crutches, lofstrand crutches, canes
595
associated reaction
involuntary and automatic mvmt of a body part as a result of an intentional active or resistive mvmt in another body part.
596
astereognosis
inability to recognize objects by sense of touch
597
asthma
reversible, obstructive lung condition characterized by increased responsiveness of trachea and bronchi to stimuli, inflammation, and overproduction of mucous glands with widespread narrowing of airways.
598
asystole
no rhythm, absence of P wave, QRS and T waves, can have abrupt onset, requires immediate medical attention. causes: failure of all pacemakers to initiate, conduction system failure, acute MI and ventricular rupture
599
ataxia
inability to perform coordinated movements
600
ataxic gait
gait characterized by staggering and unsteadiness, wide BOS and movements are exaggerated.
601
atherosclerosis
condition of progressive accumulation of fatty plaques on inner walls of vessels that ultimately produces stenosis. begins in childhood and usually affects medium sized arteries. over time the plaque that produces stenosis inside the vessel can also block blood flow. heart attack or stroke can result from atherosclerosis
602
athetosis
condition that presents with involuntary mvmts combined with instability of posture. peripheral mvmts occur without central stability
603
ATP-PC system
energy system producing ATP during high intensity, short duration exercise. Phosphocreatine decomposes and releases large amount of energy used to construct ATP. provides energy for muscle contraction for up to 15 seconds.
604
atrial diastole
atrial filling of blood
605
atrial systole
atrial emptying of blood
606
autolytic debridement
using body's own mechanisms to remove nonviable tissue. methods include transparent films, hydrocolloids, hydrogels and alginates. results in a moist wound environment that permits rehydration of the necrotic tissue and eschar and allows enzymes to digest the nonviable tissue. can be used with any amount of necrotic tissue and is non-invasive and pain free; however takes longer for wound healing to occur. should not be performed on infected wounds.
607
automatic postural strategies
automatic motor responses that are used to maintain center of gravity over base of support.
608
autonomic dysreflexia
dangerious complication of sci. can occur in pts with lesions above T6. noxious stimuls below lesion level triggers autonomic nervous system, causing a sudden elevation in blood pressure. common causes include distended or full bladder, kink or blockage in catheter, bladder infections, pressure ulcers, tight clothing.
609
avulsion fracture
portion of bone becomes fragmented at site of tendon attachment from a traumatic and sudden stretch of tendon
610
axillary crutches
all levels of weight bearing, but requires higher coordination for proper use. 6 inches in front, two inches out (lateral) to patient. crutch height should be adjusted no greater than 3 finger widths from axilla. handgrip height should be adjusted to ulnar styloid process and allow for 20-25 degrees of elbow flexion while grasping.
611
axonotmesis
a more severe grade of injury to a peripheral nerve. is reversible injury to damaged fibers. damage occurs to the axons with preservation to endoneurium. nerve can regenerate distal to the site of lesion by one millimeter per day.
612
B fibers
medium, myelinated, reasonably fast conduction rate. pre ganglionic fibers of ANS.
613
back height
measure from seat of chair to floor of axilla with user's shoulder flexed to 90 and then subtract 4 inches. this will allow final back height to be below inferior angles of scapula. 16-16 1/2 inches average.
614
bainbridge reflex
occurs when mechanoreceptors embedded within the right atrial myocardium respond to an increase in pressure and stretch (distention of the right atrium). stimulates the vasomotor centers of the medulla and results in increased sympathetic input and heart rate. reflex can also influence a decrease in heart rate when heart is beating too fast.
615
balance
state of physical equilibrium needing input from these three systems: somatosensory, visual and vestibular.
616
Balance Reflexes: Vestibuloocular reflex (VOR):
allows for head/eye movement coordination. reflex supports gaze stabilization where eyes can move while head is fixed; visual tracking can also occur when both eyes and head are moving.
617
Balance Reflexes: Vestibulospinal reflex (VSR):
attempts to stabilize body and control movement. reflex assists with stability while head is moving as well as coordination of trunk during upright postures.
618
balance tests (types)
romberg, one legged stance test, tinetti, berg balance, get up and go test, timed get up and go test
619
baroreceptor reflex
produced by a group of mechanoreceptors that are found w/in walls of the heart. the reflex is activated when pressure rises w/in the large arteries above 60 mm Hg. peak in activity at approx 180 mm Hg. results in vasodilation secondary to inhibition of the vasomotor centers w/in the medulla as well as a decrease in heart rate and strength of contraction secondary to vagal stimulation
620
base of support
distance msrd btwn left and right foot during progression of gait. average BOS is 2-4 inches
621
bicipital tendonitis
increased incidence of injury is associated with selected sports such as baseball pitching, swimming, rowing, gymnastics, and tennis; characterized by subjective reports of a deep ache directly in front and on top of the shoulder made worse with overhead activities or lifting, examination may reveal a positive speed's test or yergason's test
622
biofeedback
modality that uses an electromechanical device to provide visual and or auditory feedback. can be utilized to receive information related to motor performance, kinesthetic performance or physiological response. can measure peripheral skin temp, changes in blood volume thru vasodilation and vasoconstriction using finger phototransmission, sweat gland activity, and electrical activity during muscle contraction. electromyographic feedback is the most commonly used biofeedback modality in clinical setting.
623
biofeedback contraindications
any condition where muscle contraction is detrimental, skin irritation at electrode site
624
biofeedback indications
muscle spasm, pain, sci, urinary incontinence, improve neuromuscular control, muscle weakness, hemiplegia, cp, bowel incontinence, promote relaxation
625
biofeedback measures:
muscle activity, heart rate, balance, skin temp, bp, posture, abnormal mvmt, normal mvmt
626
biofeedback therapeutic effects
muscle relaxation, improve muscle strength, decrease muscle spasm, neuromuscular control, decrease accessory muscle use, decrease pain
627
biofeedback treatment guidelines
2 active electrodes and 1 ground electrode in a bipolar arrangement best deletes "noise" (noise is any extraneous electrical activity not produced by the contraction of the muscle). surface electrodes with some form of conduction gel are required to adhere to prepared, clean skin. electrodes should be placed parallel to direction of the muscle fibers, set level of sensitivity on device relative to treatment goals: low level sensitivity settings for muscle re-education, high level sensitivity setting for relaxation
628
biofeedback treatment parameters
2 active electrodes should be placed parallel to muscle fibers and close to each other. reference or ground electrode can be placed anywhere on the body, but is often secured between 2 active electrodes. signals are transmitted to a differential amplifier and info is conveyed thru visual and audio feedback. for muscle re-education, should begin with pt performing a max muscle contraction. sensitivity of bfb unit should be set at a low sensitivity setting and adjusted so that the pt can perform reps at a ratio of 2/3rds of max muscle contraction. isometric contractions should continue for 6-10 secs with relaxation in btwn each contraction. treatment duration for a single muscle group is 5-10 mins. treatment for muscle relaxation requires a high sensitivity setting and a similar electrode placement with active electrodes initially positioned close to each other. as patient improves with relaxation, electrodes should be placed further apart and sensitivity setting increased. during this treatment, patient may also benefit from adjunct relaxation techniques such as imagery. treatment duration of 10-15 mins is usually adequate to attain relaxation.
629
biphasic
pulse that moves in one direction, returns to baseline, then in other direction and back to baseline again within a predetermined amount of time.
630
bipolar
2 active electrodes are placed over target area. electrodes usually same size. used for muscle weakness, neuromuscular facilitation, spasms, and ROM
631
blood supply to brain
PCA: posterior cerebral artery, MCA: middle cerebral artery, and vertebrobasilar artery.
632
blood volume
usually 7-8% of body weight. blood is pumped thru body at 30 cm/sec w/total circulation time of 20 seconds.
633
BNR
beam nonuniformity ratio: ratio of intensity of highest peak to average intensity of all peaks. lower BNR, more favorable, since most patients will be less likely to experience hot spots and or discomfort during treatment. BNR values should range btwn 2:1 and 6:1, most devices often fall in 5:1 or 6:1 range.
634
borg's rate of perceived exertion scale and the revised 10-grade scale
see page 121
635
bp prep and procedure
values are usually slightly higher in left UE vs. the right UE. inflate cuff to 20 mm Hg above reading where brachial pulse disappears. 1st sound indicates systolic pressure, last audible sound indicates diastolic pressure.
636
bradykinesia
mvmt that is very slow
637
Brain (encephalon)
Parts include brainstem, cerebellum, diencephalon, cerebral hemispheres, fissures, sulci, meninges, ventricular system and dural spaces
638
brainstem
midbrain, pons, medulla oblongata
639
brief intense (high intensity)
frequency: 70-100 Hz/burst, duration: 150-200 microseconds, amplitude: 30-60 mA
640
broca's aphasia
major non-fluent aphasia. also known as "expressive" aphasia. most common form. lesions in frontal lobe.
641
bronchial breath sounds
abnormal breath sounds when heard in locations that vesicular sounds are normally present. pneumonia may produce these sounds
642
bronchial drainage positions/procedures
...
643
bronchiectasis
progressive obstructive lung disease that produces abnormal dilation of a bronchus. irreversible condition that usually is associated with chronic infections, aspiration, cystic fibrosis or immune system impairment. bronchial walls weaken over time secondary to infection and allow for permanent dilation of bronchi and bronchioles. symptoms: consistent productive cough, hemoptysis, weight loss, anemia, crackles, wheezes, and loud breath sounds.
644
Brunnstrom's 7 stages of recovery
stage 1: no volitional mvmt initiated. stage 2: beginning of spasticity. stage 3: voluntary synergies. spasticity increases. stage 4: spasticity begins to DEcrease. stage 5: decrease in spasticity. stage 6: jt mvmts are performed with coordination. stage 7: normal motor function is restored
645
buffering
technique used to stabilize the pH of skin during ionto by placing buffering agents into electrode pads that cover drug reservoir area within the electrode
646
buoyancy
(archmides): there is an upward force on body when immersed in water equal to amount of water that has been displaced by the body. ability to float in water results from the body possessing a specific gravity less than that of water.
647
bursitis
condition caused by acute or chronic inflammation of bursae. pain and swelling limits range.
648
burst
interrupted group of pulses that are delivered in a finite series and a predetermined frequency
649
C fibers
small nerve fibers, poorly myelinated or unmyelinated. slow conduction rate. post ganglionic fibers of sympathetic system. exteroceptors for pain, temp, and touch.
650
C1
vertex of skull.
651
C2
temple, forehead, occiput. myotome: longus colli, SCM, rectus capitis
652
C3
entire neck, posterior cheek, temporal area, prolongation forward under mandible. myotome: trap, splenius capitis
653
C4
shoulder area, clavicular and upper scap area. myotome: trap, levator scapulae
654
C5
deltoid area, anterior aspect of entire arm to base of thumb. myotome: supraspinatus, deltoid, biceps
655
C6
anterior arm, radial side of hand to thumb and index finger. myotome: biceps, supinator, wrist extensors.
656
C7
lateral arm and forearm to index, long and ring fingers. myotome: triceps, wrist flexors
657
C8
medial arm and forearm to long, ring and little fingers. myotome: ulnar deviators, thumb extensors, thumb adductors
658
CAD
coronary artery disease: narrowing or blockage of coronary arteries that may produce ischemia and necrosis of the myocardium. inability for vasodilation and as a result the arteries cannot meet the metabolic demands. will produce ischemia and ultimately necrosis. CAD includes thrombus, vasospasms, and atheroscelerosis. results from inheritance, environment, culture, nutrition and smoking. symptoms: appear after significant blockage is present, over 75%. pain in occluded artery's region. if untreated, MI or death.
659
cadence
of steps an individual will walk over a period of time. average value for an adult is 110-120 steps per minute
660
cane
provides minimal stability and support during ambulation, mainly for balance.
661
capacitance
property of an insulator that allows for the storage of energy when opposing surfaces of the insulator have an electrical potential difference
662
cardiac index
amount of blood pumped out of heart per minute per sq meter of body mass. normal ranges btwn 2.5 to 4.2 L/min/meter2
663
cardiac lab testing
hematocrit, hemoglobin, partial thromboplastin time, platelet count, prothombin time, white blood cell count
664
cardiac output
amount of blood pumped out of heart through the aorta each minute. males: 5.6L/min. females: 10-20% less. CO=stroke volume X heart rate
665
cardiac reflexes
quick acting nervous system mechanisms that influence heart rate when triggered.
666
cardiac rehab indications
MI, angina (stable), CABG, cardiac surgery, high risk for CAD, hypertension, end stage renal disease, status post pacemaker insertion, cardiomyopathy, heart transplant, high risk for diabetes
667
cardiac rehab program
consists of 4 phases. 1st phase averages 3-5 days, 2nd phase 2-12 weeks, 3rd phase 6-8 weeks, 4th phase lasts throughout pt's lifetime
668
cardiomyopathy
group of conditions that affect the myocardium muscle itself, impairing the ability for the heart to contract and relax. 3 types are dilated, hypertrophic, and restrictive. symptoms: same as heart failure, neck vein distension, fatigue and weakness, possible chest pain, sudden death, exercise intolerance
669
Cardiopulmonary ABCs
Airway-maintain open airway. Breathing-rescue (look, listen, feel). Circulation-compressions: check pulse.
670
carpel tunnel syndrome
incidence is higher in females with most common age being from 35-55, muscle atrophy is often noted in abductor pollicis brevis muscle and later in the thenar muscles; electromyography studies, tinel's sign, and phalen's test can be used to assist with confirming diagnosis
671
cartilaginous joints
(amphiarthroses) has cartilage to connect one bone to another. slightly moveable joints. ex: syndchondrosis, symphysis
672
cathode
negatively charged electrode that attracts positive ions
673
cerebellar gait
staggering gait
674
cerebellum
responsible for: coordination of motor skills, postural tone, sensory/motor input for trunk and extremities, coordination of gait
675
cerebellum impairments
ataxia, discoordination of trunk and extremities, intention tremor, balance deficits, ipsilateral facial sensory loss, dysdiadochokinesia (inability to perform rapidly alternating movements)
676
CEREBRAL HEMISPHERE FUNCTION
...
677
cerebral hemispheres
cortex, white matter, basal nuclei. 2 hemispheres: deep white matter, basal ganglia, and lateral ventricles
678
cerebral palsy
spastic cp involves upper motor neuron damage; athetoid cp involves damage to cerebellum, cerebellar pathways or both; clinical presentation includes motor delays, abnormal muscle tone and motor control, reflex abnormalities, poor postural control, and balance impairments; mental retardation and epilepsy are present in 50-60% of children diagnosed with cp.
679
characteristics of a brainstem CVA
unstable vital signs, decreased consciousness, ability to swallow, weakness and paralysis on both sides
680
characteristics of a cerebellum CVA
decreased balance, ataxia, decreased coordination, nausea, decreased ability for postural adjustment, nystagmus
681
characteristics of a CVA in LEFT hemisphere
weakness, paralysis of RIGHT side, increased frustration, decreased processing, possible aphasia, dysphagia, motor apraxia, decreased discrimination btwn left and right, right hemianopsia
682
characteristics of a CVA in RIGHT hemisphere
weakness, paralysis of LEFT side, decreased attention span, left hemianopsia, decreased awareness and judgment, memory deficits, left inattention, decreased abstract reasoning, emotional lability, impulsive behaviors, decreased spatial orientation
683
chemoreceptor reflex
responds to need for increased depth and rate of ventilation. chemoreceptors are located on the carotid and aortic bodies and detect lack of oxygen, responding to an increase in arterial CO2 levels.
684
chest physical therapy
indications: patients who have acute or chronic respiratory problems: inability to expel secretions, ineffective cough, swallowing difficulties
685
CHF
congestive heart failure: results usually from coronary artery disease when heart is unable to maintain an adequate cardiac output. characterized by abnormal retention of fluid and results in diminished blood flow to tissue and congestion of the pulmonary and or systemic circulation. symptoms: pulmonary edema, dyspnea, cough (nonproductive), S3 gallop, exertional hypotension, weight gain within hours, increased resting heart rate.
686
chf: congestive heart failure
etiologies include arrhythmia, pulm embolism, hypertension, valvular heart disease, myocarditis, unstable angina, renal failure, severe anemia;
687
cholesterol-lowering agents (lipitor, zocor, pravachol)
decreases the triglycerides and low-density lipoproteins in the bloodstream
688
chopping (PNF):
combination of bilateral UE asymmetrical extensor patterns performed as a closed chain activity
689
chorea
mvmts that are sudden, random and involuntary
690
chronaxie
testing procedure used to measure amount of time required to produce a small muscle contraction at a particular intensity
691
chronic bronchitis
increased mucus secretions from bronchioles as well as structural changes to bronchi. productive cough is usually present for 3 months during two consecutive years. major impairments include hypertrophy of mucus secreting glands and insufficient oxygenation of alveoli due to mucus blockage. symptoms: increased pulmonary artery pressure, thick sputum, increased use of accessory muscles, persistent cough, wheezing, dyspnea, and cyanosis. patients are often called "blue bloaters"
692
circumduction
circular motion to advance leg during swing phase
693
class 1 lever
very few class 1 levers in body. one example is triceps force on olectranon with an external counter force pushing on forearm. (seesaw). axis of rotation is btwn effort (force) and resistance (load).
694
class 2 lever
resistance (load is btwn axis of rotation and effort (force). length of effort arm is always longer than resistance arm. most instances, gravity is effort and muscle activity is resistance. ex: wheelbarrow
695
class 3 lever
effort (force) btwn axis of rotation and resistance (load). shoulder abduction with weight at wrist is a class 3 lever example. most common type of lever in body.
696
clinical application templates executive summaries
...
697
clinical chemistry values
cholesterol: under 200 (LDL 60-180, HDL 30-80). Oxygen= partial pressure (PaO2): 80-100 mm Hg, saturation: 95-98%. pH: arterial blood: 7.35-7.45
698
clonus
characteristic of an upper motor neuron lesion; involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex
699
closed fracture
break in a bone where skin over site remains intact
700
closed-chain activity
involve body moving over a fixed distal segment. example: squat lift
701
clouding of consciousness
state of consciousness that is characterized by quiet behavior, confusion, poor attention, and delayed responses
702
CNS
Brain & Spinal Cord
703
cold bath
used for immersion of distal extremities. water temp ranges from 55 to 64 degrees. immersed for 5 to 15 mins to attain desired effects
704
cold pack
requires a temp of 23 degrees. apply cold pack wrapped in moistened towel to area for 15 mins. application may extend to 30 mins but requires observation every 10 minutes (for spasticity) can be applied every one to two hours for reduction of inflammation and pain control.
705
coma
state of unconsciousness and a level of unresponsiveness to all internal and external stimuli
706
comminuted fracture
bone that breaks into fragments at the site of injury
707
common circulatory pulse locations
carotid, brachial, radial, ulnar, femoral, popliteal, post tib, dorsalis pedis
708
COMMUNICATION DISORDERS
...
709
compensation
ability to utilize alternate motor and sensory strategies due to an impairment that limits the normal completion of a task.
710
complete heart block (3rd degree AV block)
regular rhythm, atrial rate is higher than ventricular rate, requires immediate medical intervention (pacemaker). causes include: infection, electrolyte imbalance, CAD, anteroseptal MI, impairment with the AV conduction system.
711
complete lesion
lesion to SC where there is no preserved motor or sensory function below the level of lesion
712
completed stroke
cva that presents with total neuro deficits at onset.
713
components of a prosthesis
socket, suspension, knee, shank, foot
714
compound fracture
break in a bone that protrudes thru skin
715
compression
physical agent that applies a mechanical force to increase pressure on treated body part. works to keep venous and lymphatic flow from pooling into interstitial space. static compression utilizes bandaging and compression garments to shape residual limbs, control edema, prevent abnormal scar formation, and reduce risk of dvt. intermittent compression with a pneumatic device is used to reduce edema.
716
concentric contraction
when muscle shortens while developing tension
717
conductance
ease at which a particular material will allow current flow (mho)
718
congenital limb deficiencies
malformation that occurs in utero secondary to impaired developmental course. classified longitudinal or transverse. causative factor is an abnormality present at conception when a bone lacks potential to form. primary characteristic is a missing long bone suce as the radius. treatment may focus on symmetrical mvmts, strengthening, ROM, weight bearing and prosthetic training.
719
congenital torticollis
characterized by a unilateral contracture of the SCM muscle. causative factors include malposition in utero, breech position and birth trauma. usually dx'd within first three weeks of life. lateral flexion to same side as contracture, rotation toward opposite side. treatment conservative for the first year with emphasis on stretching, active ROM, position and caregiver education. possible surgery.
720
consciousness
state of alertness, awareness, orientation and memory
721
constructional apraxia
inability to reproduce geometric figures
722
contact guard
patient requires therapist to maintain contact with patient to complete task. usually needed to assist of there is a loss of balance
723
contract-relax
technique used to increase ROM. as extremity reaches point of limitation the pt performs a maximal contraction of the antagonistic muscle group. therapist resists mvmt for 8-10 secs with relaxation following. technique is repeated until no further gains in ROM are noted during session (mobility)
724
contraindication for hydrotherapy:
peripheral vascular disease, gangrene, severe infection, urinary/fecal incontinence, advanced cardiov or pulm disease, buerger's disease w/contrast bath, impaired circulation, renal infection, bleeding surface area, diminished sensation
725
contraindications
cardiac pacemaker, patient with a bladder stimulator, over carotid sinus, seizure disorders, phlebitis, malignancy, over a pregnant uterus, cardiac arrhythmia, osteomyelitis
726
contraindications for cardiac rehab
uncontrolled atrial/ventricular arrhythmias, embolism, thrombophlebitis, orthostatic bp, acute infection, unstable angina, resting ST sgmt deplacement, uncompensated CHF
727
contraindications for compression
malignancy of treated area, DVT, unstable or acute fracture, heart failure, infection of treated area, pulm edema, circulatory obstruction
728
contraindications for diathermy
low back, abdomen, pelvis of a pregnant woman, internal and external metal objects, eyes, malignant area, intrauterine device, cardiac pacemaker, pain and temp sensory deficits, moist wound dressing, testes, acute inflammation, ischemic tissue
729
contraindications for hvpc
cardiac pacemakers, over heavy scarring tissues, malignancy, pregnancy
730
contraindications for joint mobs
active disease, infection, advanced osteoporosis, articular hypermobility, fracture, acute inflammation, muscle guarding, muscle guarding, joint replacement
731
contraindications for massage
infection, arterioscelrosis, thrombus, cellulitis, acute injury, embolus, cancer.
732
contraindications for percussion
fracture, spinal fusion, osteoporotic bone, unstable angina, low platelet count, anticoagulation therapy, pulm embolism
733
contraindications for postural drainage
congestive heart failure, pulmonary edema, pleural effusion, pneumothorax, cardiac arrhythmia, history of recent MI, unstable angina, pulm embolism
734
contraindications for traction
when motion is contraindicated, joint instability, tumor, pregnancy, acute inflammatory response, acute sprain, osteoporosis, fracture
735
contraindications for u/s
over eyes, over pregnant uterus, over cemented prosthetic joint, impaired circulation, impaired pain or temp sensory deficits, over heart, over testes, over epiphyseal areas in children, infection, over malignancy
736
contraindications for UV
photosensitive meds, lupus erythematosus, tb, herpes, renal or hepatic pathology, DM, pellagra
737
contraindications to stop exercising during cardiac rehab
heart rate that increases over 50 bpm with low level activity, increasing bp, any ST segment chgs, severe LE claudication, angina, confusion, extreme fatigue, ventricular gallop
738
contusion
sudden blow to part of body that can result in mild to severe damage to superficial and deep structures. ROM, ice, compression are treatments
739
conventional TENS
frequency: 50-100 Hz, duration: 20-100 microseconds, amplitude: 10-30 mA
740
COPD
chronic obstructive pulmonary disease. increased resistance to passage of air in and out of the lungs due to narrowing of bronchial tree. symptoms: dyspnea, chronic productive cough, excessive mucus production. progression of disease includes alveolar destruction and subsequent increases in amount of air that remains in lungs. overall increased total lung capacity with a significant increase in residual volume. diagnosed by determining the amount of air forcibly expired from lungs in one second.
741
cor pulmonale
sudden dilation of rt ventricle of heart secondary to pulm embolus. rt sided heart failure will occur if condition is not treated. as condition progresses, symptoms resemble congestive heart failure. symptoms include: chronic cough, chest pain, distal swelling, dyspnea, fatigue and weakness.
742
corset
constructed of fabric to provide abdominal compression and support.
743
corticospinal tract (anterior)
pyramidal motor tract responsible for ipsilateral voluntary mvmt
744
corticospinal tract (lateral)
pyramidal motor tract responsible or contralateral voluntary fine mvmt
745
crackles (formerly rales)
discontinuous adventitious sound heard with a stethoscope that bubbles or pops. crackles typically represent the movement of fluid or secretions during inspiration (wet crackles) or occur from the sudden opening of closed airways (dry crackles). crackles that occur during latter half of inspiration typically represent atelectasis, fibrosis, or pleural effusion. crackles secondary to the mvmt of secretions are usually low-pitched.
746
craig-scott KAFO
designed specifically for persons with paraplegia. allows a person to stand with a posterior lean of trunk.
747
Cranial Nerves
olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal
748
cryotherapy
ex: ice massage, cold pack, cold bath, vapocoolant spray
749
cryotherapy contraindications
compromised circulation, peripheral vascular disease, ischemic tissue, cold hypersensitivity, raynaud's phenomenon, cold urticaria, hypertension, infection, cryoglobinemia
750
cryotherapy's indications
acute or chronic pain, myofascial pain syndrome, muscle spasm, bursitis, acute or subacute inflammation, musculoskeletal trauma, reduction of spasticity, tendonitis
751
cryotherapy's therapeutic effects
initial decrease of blood flow to treated area, decreased temp, increase pain threshold, decrease metabolism, decrease edema, initial vasoconstriction, decrease nerve conduction velocity, decrease nerve conduction velocity, reduce spasticity of muscle, produce analgesic effects
752
current
flow electrons from one place to another
753
CVA
cerebrovascular accident
754
CVA risk factors
hypertension, heart disease, DM, smoking, TIAs, obesity, high cholesterol, behaviors related to hypertension, physical inactivity, increased alcohol consumption
755
cva: cerebrovascular accident
types include ischemic (thrombus, embolus, lacunar) and hemorrhagic stroke (intracerebral, subdural, subarachnoid), left CVA may present with weakness or paralysis to rt side, impaired processing, heightened frustration, aphasia, dysphagia, and motor apraxia. right cva may present with weakness or paralysis to left side, poor attention span, impaired awareness and judgment, spatial deficits, memory deficits, emotional lability, and impulsive behavior
756
cystic fibrosis
causes exocrine glands to overproduce thick mucus which causes subsequent obstruction, autosomal recessive genetic disorder located on long arm of chromosome seven, terminal disease but death age has increased to 32 yrs due to early detection and management
757
decerebrate rigidity
characteristic of a corticospinal lesion at level of brainstem that results in extension of trunk and all extremities
758
decorticate rigidity
characteristic of a corticoapinal lesion at level of diencephalon where the trunk and LEs are positioned in extension, and the UEs are positioned in flexion
759
decreased or diminished sounds
less audible sound may indicate severe congestion, emphysema or hypoventilation
760
deep heating agents
diathermy, ultrasound (and phonopheresis)
761
deep pain
squeeze forearm or calf muscle
762
deep vein thrombosis (DVT)
formation of a blood clot that becomes dislodged and is termed an embolus. can become serious since the embolus may obstruct a selected artery. sci pts have a greater risk of developing a DVT due to the absence or decrease of activity in LEs.
763
degenerative spondylolisthesis
caused by weakening of joints that allows for forward slippage of one vertebral segment on one below due to degenerative changes, most common site is L4/L5, william's flexion exercises may be indicated to strengthen abs and reduce lumbar lordosis
764
delirium
state of consciousness that is characterized by disorientation, confusion, agitation, and loudness
765
densitometry: hydrostatic weighing
method of calculating density of body by immersing in water and measuring amt of water that becomes displaced.
766
densitometry: plethysmography
method of calculating body density utilizing amt of air displacement during testing within a closed chamber.
767
dependent
patient is unable to participate and therapist must provide all effort to perform task
768
dependent squat pivot transfer
used to transfer a patient who cannot stand independently, but can bear some weight thru the trunk and LEs. therapist should position patient at a 45 degree angle to the destination surface. patient places UEs on therapist's shoulders, but should not pull on therapist's neck. should position patient at edge of surface, hold patient around hips and under butt, block patients knees in order to avoid buckling. therapist should utilize momentum, straighten his or her legs and raise patient or allow patient to remain squatting, and pivot and slowly lower patient to destination surface.
769
depressed QRS
heart failure, ischemia, pericardial effusion, obesity, COPD
770
dermis
true skin: well vascularized, elastic, flexible and tough.
771
developmental sequence (PNF):
progression of motor skill acquisition. stages of motor control include mobility, stability, controlled mobility, and skill.
772
diabetes mellitus (type 1)
insulin is functionally absent due to destruction of beta cells of pancreas; where insulin would normally be produced. starts in children ages 4 or older, adolescense. symptoms include polyuria, polydipsia, polyphagia, nausea, weight loss, fatigue, blurred vision, and dehydration
773
diaphragmatic breathing
attempts to enhance movement of diaphragm upon inspiration and expiration and diminish accessory muscle use. position patient in bed with head and trunk elevated 45 degrees. place dominant hand over rectus abdominis. place non dominant hand over sternum. direct patient to inspire slowly and feel dominant hand rise. instruct patient to control both inspiration and expiration. non dominant hand should only have minimal movement.
774
diastole
(lower number bp reading) relaxation of cardiac muscle
775
diathermy
converts high frequency electromagnetic energy into therapeutic heat. produces vibration of molecules within a specific tissue, generates heat and elevates tissue temperature. main therapeutic effect is enhancement of soft tissue healing. can be delivered in continuous or pulsed mode. pulsed mode is usually used for thermal effects at 27.12 MHz.
776
diathermy parameters
inductive application: wrap coils around extremity that has been covered by a towel, place drum over treatment area. patient must remain in same position throughout treatment. treatment time varies from 15-30 mins.
777
diencephalon
hypothalamus, infundibulum, optic chiasm
778
diplopia
double vision
779
direct current
also known as galvanic, constant flow of electrons from anode to cathode without interruption. iontophoresis uses direct current
780
direct current (monophasic)
constant unidirectional flow of ions. dependent on polarity
781
disadvantages to alginates
may require frequent dressing changes based on level of exudate, requires a secondary dressing, cannot be used on wound with an exposed tendon, joint capsule or bone
782
disadvantages to foam dressings
may tend to roll in areas of excessive friction, adhesive form may traumatize periwound area upon removal, lack of transparency makes inspection of wound difficult
783
disadvantages to hydrocolloids
may traumatize surrounding intact skin upon removal, may tend to roll in areas of excessive friction, cannot be used on infected wounds
784
disadvantages to hydrogels
potential for dressings to dehydrate, cannot be used on wounds with significant drainage, typically requires a secondary dressing
785
disadvantages to transparent films
excessive accumulation of exudates can result in periwound maceration, adhesive may traumatize periwound area upon removal, cannot be used on infected wounds
786
double step
alternate steps are of a different length or different rate
787
double support phase
refers to the two times during a gait cycle where both feet are on the ground. does not exist when running
788
down syndrome
clinical presentation: hypotonia, flattened nasal bridge, simian line (palmar crease), epicanthal folds, enlargement of tongue and dd.
789
dsymetria
inability to control the range of a mvmt and the force of muscular activity
790
DTR grades
0=no response. 1+=diminished/depressed response. 2+=active normal response. 3+=brisk/exaggerated response. 4+=very brisk/hyperactive, abnormal response.
791
DTR normal responses:
biceps tendon: flexion/contraction of biceps. brachioradialis tendon: elbow flexion and/or forearm pronation. triceps tendon: elbow extension or contraction of triceps muscle. patellar tendon: knee extension. tibialis posterior tendon: PF/inversion of foot. achilles tendon: PF of foot.
792
DTR: deep tendon reflexes
reflex is a motor response to a sensory stimulation that is used in an assessment to observe the integrity of the nervous system. DTRs elicit a muscle contraction when the muscle's tendon is stimulated.
793
duchenne muscular dystrophy
x linked recessive trait manifesting in only male offspring while female offspring become carriers. waddling gait, prox muscle weakness, toe walking, pseudohypertrophy of calf and difficulty climbing stairs. rapid progression of this disease with inability to ambulate by ten to 12 yrs of age with death occurring as teenager or less frequently in the 20's.
794
dural spaces: epidural space
space occupied between the skull and outer dura mater
795
dural spaces: subarachnoid space
space occupied btwn the arachnoid and pia mater that contains CSF and the circulatory system for the cortex
796
dural spaces: subdural space
space occupied btwn the dura and arachnoid meninges
797
duration of stimulus/duration of rest
time period of stimulation and time period of rest btwn periods of stimulation.
798
duty cycle
percentage of time that electrical current is on in relation to entire treatment time.
799
dynamometer
measures strength through use of a load cell or spring loaded gauge. (ex: grip strength-pounds)
800
dynamometry: break test:
eval procedure where patient is asked to hold a contraction against pressure that is applied in opposite direction to contraction.
801
dynamometry: make test
eval procedure where a patient is asked to apply a force against the dynamometer.
802
dysarthria
motor disorder of speech that is caused by an upper motor neuron lesion that affects muscles that are used to articulate words and sounds. speech is often slurred.
803
dysarthria
slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech.
804
dysdiadochokinesia
inability to perform rapidly alternating mvmts
805
dysphagia
inability to properly swallow
806
dystonia
closely related to athetosis; however there is larger axial muscle involvement rather than appendicular muscles
807
eccentric contraction
occurs when muscle lengthens while developing tension
808
ECG
measures electrical activity of heart
809
ectopic bone
(or heterotopic ossification): spontaneous formation of bone in the soft tissue. occurs adjacent to larger joints such as knees or hips.
810
ectopic foci
location where abnormal myocardial depolarization originates
811
edema
increased volume of fluid in soft tissue outside of a joint capsule
812
EFFERENT NERVES
MOTOR
813
effleurage
light in stroke and produces a reflexive response. performed at beginning and end of massage to allow patient to relax and should be directed towards the heart.
814
effusion
increased volume of fluid within a joint capsule
815
elbow
hinge joint, reinforced by ulnar collateral and radial collateral ligaments
816
electrical impedance
resistance of a tissue to electrical current
817
electrode configuration
techniques include: monopolar, bipolar, and quadripolar
818
electrode size
when using a smaller electrode it is particularly important to understand that since the current density is quite high compared to a larger electrode, the patient will be more susceptible to pain and potential tissue damage.
819
electrolysis
decomposition of a compound that results from passing an electrical current through it
820
electromyography
science of evaluating motor units (anterior horn cell, axon, neuromuscular junctions and muscle fibers innervated by unit) through use of intramuscular needle electrodes or surface electrodes. potentials include abnormal: spontaneous and voluntary.
821
electron exchange
occurs during ionto where there is an exchange btwn ions within solutions and electrodes
822
electrotherapy
used for facilitation of skeletal muscle contraction, stimulation of denervated muscle, pain management, to retard muscle atrophy, osteogenesis, driving medications through the skin, and wound management
823
electrotherapy terms
...
824
elevated QRS
hypertrophy of myocardium
825
embolus (20% of ischemic CVAs)
associated with cardiovascular disease, an embolus may be a solid, liquid or gas, and con originate in any part of the body. travels thru bloodstream to the cerebral arteries causing occlusion of a blood vessel and a resultant infarct. middle cerebral artery is most commonly affected by an embolus from internal carotid arteries. often presents with a headache.
826
emotional lability
characteristic of a right hemisphere infarct where there is an inability to control emotions and outbursts of laughing or crying that are inconsistent with the situation
827
emphysema
develops from a long history of chronic bronchitis. alveolar walls present with significant pathology and air spaces are permanently over inflated. pink puffers. expiration is difficult. characterized as centrilobular, panlobular or paraseptal. symptoms include: dyspnea, chronic cough, orthopnea, barrel chest, increased use of accessory muscles, and increased RR.
828
end feel
type of resistance that is felt when passively moving a joint thru end range of motion.
829
enzymatic debridement
topical application of enzymes to surface of necrotic tissue. can be used on infected and non-infected wounds with necrotic tissue. may be used in wounds that have not responded to autolytic debridement or in conjunction with other debridement techniques. can be slow to establish a clean wound bed and should be discontinued after removal of devitalized tissues in order to avoid damage
830
epidermis
avascular, consists of outermost layer of skin
831
equine
gait pattern with high steps, excessive use of gastrocs
832
ERA
effective radiating area. area of transducer that transmits u/s energy. always smaller than total size of transducer head.
833
estim contraindication
malignancy, with all types of electrical implants, during first trimester of pregnancy, over lower abdomen/uterus during pregnancy, over anterior transcervical area
834
estim indications
pain management, urinary incontinence, edema management, osteoarthritic pain, migraines
835
expiration
to breathe air out of the lungs
836
expiratory reserve volume
1000 mL
837
expiratory reserve volume (ERV)
max volume expired after normal expiration
838
external catheter
applied over shaft of penis and is held in place by a padded strap or adhesive tape
839
facial
taste: anterior tongue, voluntary motor: facial muscles. autonomic: lacrimal, submandibular, sublingual glands
840
factors that influence vascular disease
hypertension, aging, diabetes, infection, poor nutrition, cigarette smoking
841
fasciculus cuneatus
sensory tract for trunk, neck and UE proprioception, vibration, 2 pt discrimination, graphesthesia
842
fasciculus gracilis
sensory tract for trunk and LE proprioception, 2 pt discrimination, vibration and graphesthesia
843
festinating
patient walks on toes as though pushed. starts slowly, increases and may continue until patient grabs an object in order to stop
844
FEV1 (forced expiratory volume in one second)
83% of VC
845
FEV2 (forced expiratory volume in 2 seconds)
94% of VC
846
FEV3 (forced expiratory volume in 3 seconds)
97% of VC
847
fibromyalgia
nonarticular rheumatic condition with pain caused by tender points within muscles, tendons, and ligaments. pain exists in all 4 quadrants of body and there is pain in at least 11 of 18 standardized tender point sites
848
fibrous joints
(synarthroses) minimal movement. ex: sutures, syndesmosis, gomphosis
849
firm end feel
(stretch) ex: ankle DF, finger extension, hip medial rotation, forearm supination
850
fissures
interhemispheric fissure: separates the two cerebral hemispheres. Sylvian or lateral fissure: (anterior portion) separates the temporal from frontal lobes; (posterior portion): separates temporal from parietal lobes
851
flexor synergy pattern
seen when patient attempts to lift up their arm or reach for an object. characterized by great toe extension and flexion of the remaining toes secondary to spasticity.
852
fluent aphasia
lesion often in temporoparietal lobe of dominant hemisphere. word output is functional. empty speech or jargon. speech lacks any substance. uses of paraphasias (substitution of incorrect words)
853
fluidotherapy
container that circulates warm air and small cellulose particles. extremity is placed into container and dry heat is generated thru energy transferred by forced convection. promotes tissue healing and prevention of edema. body part should be placed into unit prior to turning machine on. temp should be set between 111-125 degrees. treatment time usually 20 minutes.
854
foam dressings
composed from a hydrophilic polyurethane base. hydrophilic at wound contact surface and are hydrophobic on the outer surface. allows exudates to be absorbed into the foam through the hydrophilic layer. most commonly available in sheets or pads with varying degrees of thickness.
855
foley catheter
indwelling urinary tract catheter that has a balloon attachment at one end. balloon which is filled with air or sterile water must be deflated before catheter can be removed
856
Foot orthotics
semirigid or rigid insert worn inside a shoe that corrects foot alignment and improves function.
857
forced expiratory volume (FEV)
amount of air exhaled in the 1st, 2nd, and 3rd second of a forced vital capacity test
858
forced expiratory volumes
...
859
forced vital capacity (FVC)
amount of air forcefully expired after a max inspiration
860
frequency
determines number of pulses delivered through each channel per second. often labeled "rate"
861
friction
incorporates small circular motion over a trigger point or muscle spasm. deep massage technique that penetrates into the depth of a muscle and attempts to reduce edema, loosen adhesions, and relieve muscle spasm. used with chronic inflammation or with overuse injuries
862
frontal lob impairments
contralateral weakness, contralateral head and eye paralysis, personality changes, antisocial behavior, ataxia, primitive reflexes, broca's aphasia, delayed or poor initiation
863
frontal lobe
responsible for: voluntary motor function, advanced motor planning, initiation of action, cranial nerves 3, 4, 6, 9, 10, 12; emotion interpretation, personality, judgment, planning, motivation, bladder & bowel inhibition, broca's motor speech center, appreciation of intonation, understanding gestures.
864
frontal plane
divides body into anterior and posterior. motions are abduction and adduction, occur around an anterior-posterior axis.
865
full thickness burns
burn causes immediate cellular and tissue death and subsequent vascular destruction, eschar forms from necrotic cells and creates a dry and hard layer that requires debridement. absent sensation and pain due to destruction of free nerve endings
866
functional residual capacity (FRC)
volume in lungs after normal exhalation
867
functional residual capacity (FRC)=
expiratory reserve volume (ERV) + residual volume (RV)
868
FWB
full weight bearing
869
gait cycle
sequence of motions that occur from one initial contact of the heel to the next initial contact of the same heel.
870
gait deviations of amputee: abducted gait
causes: prosthesis may be too long, high medial wall, poorly shaped lateral wall, prosthesis position in abduction, inadequate suspension, abduction contracture, improper training, adductor roll, weak HF and adductors, pain over lateral residual limb
871
gait deviations of amputee: circumducted gait
causes: prosthesis may be too long, too much friction in knee, socket too small, excessive PF of prosthetic foot, abduction contracture, improper training, weak HF, inability to initiate prosthetic knee flexion
872
gait deviations of amputee: excessive knee flexion during stance
socket set forward in relation to foot, foot set in excessive DF, stiff heel, prosthesis too long, knee flexion contracture, hip flexion contracture, poor balance, decrease in quad strength
873
gait deviations of amputee: forward trunk flexion
causes: socket too big, poor suspension, knee instability, hip flexion contracture, weak hip extensors
874
gait deviations of amputee: lateral bending
causes: prosthesis too short, improperly shaped lateral wall, high medial wall, prosthesis aligned in abduction, poor balance, abduction contracture, improper training, short residual limb, weak hip abductors on prosthetic side, hypersensitive and painful residual limb
875
gait deviations of amputee: medial or lateral whip
causes: excessive rotation of the knee, tight socket fit, valgus in prosthetic knee, improper alignment of toe break, improper training, weak hip rotators, knee instability
876
gait deviations of amputee: rotation of forefoot at heel strike
causes: excessive toe-out built in, loose fitting socket, inadequate suspension, rigid SACH heel cushion, poor muscle control, weak medial rotators, short residual limb
877
gait deviations of amputee: vaulting
causes: prosthesis may be too long, inadequate socket suspension, excessive alignment stability, foot in excess PF, residual limb discomfort, improper training, short residual limb
878
gait muscles: gastroc/soleus
activity during late stance phase. concentric raising of heel during toe off.
879
gait muscles: hams
activity during late swing phase. decelerating unsupported limb.
880
gait muscles: quads
single support during early stance phase, and just before toe off to initiate swing phase.
881
Gait muscles: tibialis anterior
activity just after heel strike. eccentric lowering of foot into PF.
882
Gait: Standard - Stance Phase (60% of gait cycle)
Heel strike: instant heel touches ground to begin stance phase
883
gas pressure
mm Hg: see chart on page 132
884
gauze dressings
most readily available used in inpatient environment. commonly used on infected or non-infected wounds of any size. can be used for wet to wet, wet to moist, or wet to dry debridement. readily available and cost effective but has a tendency to adhere to wound bed. requires frequent dressing changes. increased infection rate compared to occlusive dressings
885
genu valgum
knees touch while standing with feet separated. will increase compression of lateral condyle and increase stress to medial structures. also called knock-knee.
886
genu varum
bowing of knees. will increase compression of medial tibial condyle and increase stress to lateral structures. also called bowleg.
887
gfci:
ground fault circuit interrupter: designed to cut off electrical supply to a piece of equipment if it detects any form of leakage or ground fault.
888
glasgow coma scale
neuro assessment tool used initially after injury to determine arousal and cerebral cortex function. total score of 8 or less correlates to coma in 90% of patients. scores of 9-12 indicate moderate brain injuries and scores from 13-15 indicate mild brain injuries.
889
global aphasia
major non-fluent aphasia. lesion of frontal, temporal, and parietal lobes. comprehension (reading and auditory) is severely impaired.
890
glossopharyngeal
touch, pain: posterior tongue, taste: tongue. swallowing
891
goals for chest PT
mobilize secretions, expel secretions, improve breathing patterns, improve ventilation throughout all lobes, improve overall function
892
goals for vestibular rehab:
improve balance and stability, increase strength and ROM, decrease falls, minimize dizziness
893
golgi tendon organ
sensory receptors through which muscle tendons pass immediately beyond attachment to muscle fibers. very sensitive to TENSION when produced from an active muscle contraction. average of 10-15 muscle fibers are connected in series with each golgi tendon organ. stimulated through the tension produced by muscle fibers.
894
grade I
small movement performed at beginning of range
895
grade II
large amplitude movement performed within the range, but not reaching limit of range and not returning to beginning of range
896
grade III
large amplitude movement performed to limit of range
897
grade IV
small amplitude movement performed at limit of range
898
graphesthesia
draw a number or letter on skin with finger, identify without sight
899
greenstick fracture
break on one side of a bone that does not damage periosteum on opposite side. often seen in children.
900
guidelines for chest PT
treatment should be before eating, or at least one hour after meals, percuss and vibrate over each segment to be treated for at least 3-5 mins, cough after each segment is treated, allow for a rest period after each segment is treated, review breathing exercises in each drainage position, not to exceed 45-60 mins secondary to patient fatigue
901
guillain barre syndrome
motor weakness in a distal to prox progression, sensory impairment, and possible respiratory paralysis. may be an autoimmune response to a previous respiratory infection, flu, immunization or surgery. patients usually have full recovery
902
halo vest orthosis
invasive cervical thoracic orthosis that provides full restriction of all cervical motion. commonly used with cervical spinal cord injuries to prevent further damage or dislocation.
903
hard end feel
(bone to bone) ex: elbow extension
904
HCO3
24 mEq/L
905
heart failure
inability of heart to maintain a proper cardiac output of 4 liters per minute while at rest. chronic hypertension is most common cause
906
Heart sounds: S1
lub: mitral and tricupsid valves closing at beginning of systole
907
Heart sounds: S2
dub: aortic and pulmonary valves closing at onset of diastole
908
Heart sounds: S3
ventricular gallop: abnormal in older adults: noncompliant left ventricle. may be associated with CHF
909
Heart sounds: S4
vibration of ventricular wall with ventricular filling and atrial contraction; may be associated with hypertension, stenosis, hypertensive heart disease or myocardial infarction
910
heat conduction
direct contact btwn 2 materials at different temperatures. ex: hot pack, paraffin, ice massage, cold pack
911
heat convection
air or water moving in a constant motion across body. ex: whirlpool
912
heat conversion
transfer of heat when nonthermal energy is absorbed into tissue and transformed into heat. ex: diathermy and ultrasound
913
heat evaporation
transfer of heat as a liquid absorbs energy and changes from to a vapor. ex: vapocoolant spray
914
heat radiation
direct transfer of heat from a radiation energy source of higher temperature to one of cooler temperature. directly absorbed without the need for a medium. ex: infrared lamp
915
heating contraindications
circulatory impairment, area of malignancy, acute musculoskeletal trauma, bleeding, sensory impairment, thrombophlebities, arterial disease
916
heating indications
pain control, chronic inflammatory conditions, trigger point, tissue healing, muscle spasm, decreased ROM, densensitization
917
heating therapeutic effects
increase temp, increase blood flow to area, decrease nerve conduction latency, vasodilation, increase muscle elasticity, increase collagen extensibility, decreases tone
918
hematocrit
percentage of packed RBC in total blood volume.
919
hemiballism
involuntary and violent mvmt of a large body part
920
hemi-height w/c
decreased seat height (17.5 inches) to allow for propulsion using the unaffected foot
921
hemiparesis
condition of weakness on one side of body
922
hemiplegia
condition of paralysis on one side of the body
923
hemiplegic
abducts paralyzed limb, swings it around and brings forward so that foot comes to ground in front of them
924
hemisphere specialization/dominance
left: language, sequence and perform movements, understanding language, produce written and spoken language, analytical, controlled. right: nonverbal processing, processing information in a holistic manner, artistic abilities, general concept comprehension, hand-eye coordination, spatial relationships
925
hemoglobin
iron containing pigment of RBC. function is to carry oxygen from lungs to tissues. used to assess blood loss, anemia, and bone marrow suppression. low hemoglobin=blood loss, high hemoglobin=hemoconcentration caused by polycythemia or dehydration
926
hemorrhage (10-15% of CVAs)
abnormal bleeding in brain due to rupture in blood supply. due to disruption of oxygen to an area of brain and compression from accumulation of blood. hypertension is usually a precipitating factor causing rupture of an aneurysm or arteriovenous malformation. 50% of deaths from hemorrhagic stroke occur within first 48 hours.
927
high volt current
characterized by a waveform greater than 150 volts with a short pulse duration. is intermittent and is used for deeper tissue penetration
928
hip
ball and socket joint. stability provided at joint by: acetabulum, iliofemoral ligament, pubofemoral ligament, and ischiofemoral ligament
929
hip strategy
elicited by a greater force, challenge or perturbation thru pelvis and hips. hips will move in opposite direction from head in order to maintain balance. muscles contract in a proximal to distal fashion in order to counteract the loss of balance
930
HKAFO
indicated for patients with hip, foot, knee, and ankle weakness. can control rotation at hip and abduction/adduction. heavy and restricts patients to a swing to or swing thru gait pattern.
931
hold-relax
isometric contraction used to increase ROM. contraction is facilitated for all muscle groups at the limiting point in the ROM. relaxation occurs and extremity moves thru the newly acquired range to the next point of limitation until no further increases in ROM occur. used for patients that present with pain usually. (mobility)
932
hold-relax active
technique to improve initiation of mvmt to muscle groups tested at 1/5 or less. (mobility)
933
homolateral synkinesis
flexion pattern of the involved UE facilitates flexion of the involved LE
934
homonymous hemianopsia
loss of right or left half of vision in both eyes
935
hot pack
effects include soft tissue healing, promoting relaxation, decreasing pain and stiffness. must be stored in hot water between 158-167 degrees. requires 6-8 towels around hot pack. require approx 20 minutes to achieve desire effects
936
huntingtons disease
chronic progressive genetic disorder that is fatal within 15 to 20 yrs after clinical manifestation. degeneration and atrophy of basal ganglia (stiatum) and cerebral cortex w/in brain. clinically presents with enlarged ventricles secondary to atrophy of basal ganglia, mental deterioration, speech disturbances and ataxic gait
937
hvpc
high voltage pulsed current: twin peak monophasic, pulsed current. produces high electromotive forces. has a phase duration of 5-20 microsecs (fixed in most machines), a short pulse duration that ranges btwn 100-200 microsecs, and voltage greater than 150V to a max of 500V. one large dispersive pad along with one, two or four active electrodes. active electrodes can be positive or negative in polarity based on treatment goals.
938
hvpc parameters
secure one electrode over wound (using warm sterile gauze and sponge) and other over healthy skin a min of 5 cm from wound itself. polarity should be in reversal mode so that it allows for 50% of treatment with positive polarity. frequency is generally 30-200 pps, amplitude 1-500V, and duration of treatment from 10-60 mins per session. dermal wounds should be treated 5-7 days per week for best results
939
hydrocolloid dressing
gel forming polymer such as gelatin, pectin, and carboxymethylcellulose with a strong film or foam adhesive backing. absorb exudate by swelling into a gel like mass and vary from being occlusive to semi permeable. does not attach to actual wound itself and is instead anchored to intact skin surrounding the wound.
940
hydrogels
consist of varying amounts of water and varying amounts of gel-forming materials such as glycerin, dressings are available in sheet form or amorphous form
941
hydrostatic pressure
water exerts pressure that is perpendicular to the body and increases in proportion with the depth of immersion
942
hydrotherapy
the internal and external use of water in the treatment of disease. transfers heat thru conduction or convection and is administered in tanks of varying sizes. main therapeutic effects: wound care, unloading of weight, and reduction of edema.
943
hypercapnia
increased amount of CO2 in blood
944
hyperkalemia
increased amount of potassium in blood
945
hypertension
elevated arterial blood pressure both for systole and diastole.
946
hypertrophic scar
can occur during healing process when collagen production greatly exceeds collagen lysis. will be raised, but remain within borders of original injury
947
hypocapnia
decreased amount of CO2 in blood
948
hypoglossal
voluntary motor: muscles of tongue
949
hypoxemia
when PaO2 is less than 80 mm Hg
950
ice massage
5-10 min treatment time
951
ideational apraxia
inability to formulate an initial motor plan and sequence tasks where the proprioceptive input necessary for mvmt is impaired
952
ideomotor apraxia
condition where a person plans a mvmt or task, but cannot volitionally perform it. automatic mvmt may occur, but a person cannot impose additional mvmt on command.
953
If CVA is in anterior cerebral artery:
impairments include LE involvement, loss of bowel/bladder control, loss of behavioral inhibition, mental changes, may see neglect, may see aphasia, apraxia and agraphia, perseveration
954
if CVA is in middle cerebral artery (most common area)
impairments include wernicke's aphasia, homonymous hemianopsia, apraxia, flat affect in rt hemisphere, impaired body schema
955
if CVA is in posterior cerebral artery
impairments include pain and temp sensory loss, contralateral hemiplegia, ataxia, athetosis or coreiform mvmt, quality of mvmt is impaired, thalamic pain syndrome, anomia, prosopagnosia with occipital infarct, hemiballismus, visual agnosia, homonymous hemianopsia, mild hemiparesis, memory impairment, dyschromatopsia, palinopsia, micropsia, macropsia, alexia, dyslexia, achromatopsia
956
If CVA is in vertebral-basilar artery
impairments include loss of consciousness, hemi or tetraplegia, comatose or vegetative state, inability to speak, locked in syndrome, vertigo, nystagmus, dysphagia, dysarthria, syncope, ataxia
957
impedance
property of a substance that provides resistance to flow of current by offering an alternate current
958
incentive spirometry
used to increase inspiration using a device that provides immediate fb to patient regarding performance. commonly utilized to treat patients status post surgery in order to strengthen weak inspiratory muscles and to prevent alveolar collapse. have patient breathe into spirometer and instruct patient to perform a max inhalation into spirometer. repeat 7 - 10 times per session and repeat 3-4 times per day.
959
incomplete lesion
lesion to the SC with incomplete damage to the cord. there may be scattered motor function, sensory function or both below the level of injury/lesion.
960
incomplete: anterior cord syndrome
results from compression and damage to the anterior part of SC or anterior spinal artery. usually cervical flexion is mechanism of injury. loss of motor function and pain and temp sense below lesion due to damage of the corticospinal and spinothalamic tracts
961
incomplete: brown-sequard's syndrome
usually caused by a stab wound, which produces a hemisection of the sc. paralysis and loss of vibratory and position sense on same side as lesion due to damage to corticospinal tract and dorsal columns. loss of pain and temp sense on opposite side of lesion from damage to lateral spinothalamic tract. rare since most spinal cord lesions are atypical.
962
incomplete: cauda equina injuries
injury that occurs below L1 spinal level where long nerve roots transcend. mostly incomplete but rarely can be complete as well. considered a peripheral nerve injury. flaccidity, areflexia, impairment of bowel/bladder function. full recovery not typical due to distance needed for axonal regeneration.
963
incomplete: central cord syndrome
results from compression and damage to the central portion of sc. injury is usually cervical hyperextension that damages spinothalamic tract, corticospinal tract, and dorsal columns. UEs present with greater involvement than LEs, and greater motor deficits than sensory deficits.
964
incomplete: posterior cord syndrome
rare syndrome that is caused by compression of posterior spinal artery and is characterized by loss of pain perception, proprioception, 2 pt discrimination, and stereognosis. motor function is preserved.
965
independent
patient does not require any assistance to complete task
966
indications for compression
lymphedema, new res limb, risk for DVT, edema, stasis ulcers, hypertrophic scarring
967
indications for hvpc
wound management, pain management, soft tissue edema, levator ani syndrome, muscle spasm, muscle weakness, bell's palsy
968
indications for hydrotherapy:
burn care, superficial heating or cooling, edema control, muscle strain, arthritis, desensitization of residual limb with contrast bath, pain management, wound care, decreased ROM, pool therapy/exercise, sprain, joint stiffness, muscle spasm/spasticity
969
indications for joint mobs
restricted joint mobility, restricted accessory motion, desire neuro effects
970
indications for massage
pain, decreased ROM, edema, adhesions, myositis, lactic acid excess, migraine, trigger point, muscle spasm and cramping, scar tissue, bursitis, tendonitis, intermittent claudication, raynaud's syndrome
971
indications for therapeutic modalities
inflammation and repair, pain, restriction in motion, and abnormal tone.
972
indications for traction
nerve impingement, herniated or protruding disc, subacute joint inflammation, spondylolisthesis, joint hypomobility, paraspinal muscle spasm, degenerative joint disease, osteophyte formation
973
indications for u/s
soft tissue repair, contracture, bone fracture, trigger point, dermal ulcer, scar tissue, pain, plantar wart, muscle spasm
974
indications for UV
acne, psoriasis, tetany, Vit D deficiency, chronic ulcer/wound, osteomalacia/rickets, sinusitis
975
inductance
how easily a certain material will induce an electromotive force (emf) within a circuit
976
infective endocarditis
inflammation of endothelium that lines heart and cardiac valves. most commonly damages mitral valve, then aortic and tricuspid valves. commonly caused by bacteria that are normally present in the body. can also occur after an invasive medical or dental procedure. symptoms: valvular dysfunction, may affect organ systems, chest pain, CHF, clubbing, meningitis, low back pain, arthralgia, arthritis
977
inflammation phase of tissue healing
occurs secondary to trauma or disease. required for healing to occur. presents with calor, rubor, tumor, dolor. clot formation and phagocytosis occur
978
infrared lamp (IR)
produces superficial heating of tissue through radiant heat. form of heating is usually limited to penetration of less than one to three millimeters. use is declining due to risk of burns during treatment. patient should be positioned approx 20 inches from source. 20 inches in distance should equal 20 minutes of treatment. as distance decreases, intensity will increase and time of total treatment should decrease.
979
inspiration
to breathe air into the lungs
980
inspiratory capacity
3000-4000 mL 75-80% of vital capacity, 55-60% of total lung capacity
981
inspiratory capacity (IC)
amount of air that can be inspired after a normal exhalation
982
inspiratory capacity (IC)=
tidal volume (TV) + inspiratory reserve volume (IRV)
983
inspiratory muscle training
used for patients that exhibit decreased chest expansion, SOB, bradypnea, and decreased breath sounds. attempts to increase ventilating capacity and decrease dyspnea through strengthening of diaphragm and intercostal muscles.
984
inspiratory muscle training (treatment protocol)
2-4 sessions of 30 to 60 minutes of deep breathing with proper diaphragmatic breathing
985
inspiratory reserve volume (IRV)
max volume inspired after normal inspiration
986
integumentary system
consists of dermal and epidermal layers, air follicles, nails, sebaceous glands, sweat glands
987
interferential current
combines two high frequency alternating waveforms that are biphasic. used for deep muscle stimulation. attempts to reach deeper tissues using higher frequencies of each waveform along with overall shorter pulse widths. uses a frequency of 50-1250 pps and a pulse width of 50-150 microseconds for pain management; and a frequency of 20-50 pps and pulse width of 100-200 microseconds for muscle contractions
988
interpulse interval
period of time of electrical inactivity btwn each pulse, usually expressed in microsecs or millisecs
989
intervention for arterial insufficiency ulcer
cleansing the ulcer, rest, reducing risk factors, limb protection
990
intervention for venous insufficiency ulcer
cleansing the ulcer, compression to control edema
991
intravenous system
consists of a sterile fluid source, pump, clamp, and catheter to insert into a vein. can be used to infuse fluids, electrolytes, nutrients, and medication. IV lines are most commonly inserted into superficial veins such as basilic, cephalic, or antecubital.
992
ion
positively or negatively charged atome
993
iontophoresis
process by which medications are induced through the skin into the body by means of continuous direct current electrical stimulation. medication is separated into ions based on the polarity of the current.
994
iontophoresis parameters
pt should never lie on top of electrodes. unit should be set to continuous direct current. polarity must be set to same polarity as ion solution. ion solution should be massaged into treatment site or space within electrode. conductive surface area of the negative electrode (cathode) is twice the size of the conductive surface area of the positive electrode (anode) regardless of which on is the active electrode. active electrode must be placed over target area the the dispersive electrode should be placed as far as possible from active electrode. slowly increase intensity towards a max of five milliamperes. treatment should last 15-20 mins. additional time is required for treatment at an intensity of less than five milliamperes.
995
ischemic stroke
when there is a loss of perfusion to a portion of the brain within just seconds, there is a central area of irreversible infarction surrounded by an area of potential ischemia.
996
isokinetic contraction
occurs when tension developed by muscle is maximal over full range of motion while shortening or lengthening at a constant speed.
997
isometric contraction
occurs when tension develops but no change in length of muscle
998
isotonic
occurs when muscle shortens or lengthens while resisting a constant load
999
joint distraction
proprioceptive component used to increase ROM around a joint. manual traction is provided slowly and usually in combo with mobilization techniques. (mobility)
1000
joint mobilization
passive movement technique designed to improve joint function
