PTA Cards Flashcards
1/5
no movement, but can feel muscle contraction
https://www.dropbox.com/s/zjbheql75eowfg3/2015-03-18_11-21-56.jpg?dl=0
2/5
completes ROM with gravity eliminated
3/5
completes ROM against gravity w/o manual resistance
4/5
completes ROM against gravity with mod resistance
5/5
completes ROM against gravity with max resistance
% Sat
95-98%
(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.
2 person lift
used to transfer a patient btwn two surfaces of different heights or when transferring a patient to the floor.
2 point gait
when patient uses 2 crutches or canes. moves left crutch forward while simultaneously advancing rt lower extremity ad vice versa.
2 pt discrimination
2 point caliper on skin, identify one or two points without sight
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.
2-/5
does not complete ROM in gravity eliminated position
2+/5
able to initiate mvmt against gravity
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.
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
3-/5
does not complete ROM against gravity, but completes more than half the range
3+/5
completes ROM against gravity with only minimal resistance
4 point gait
each advancement of crutch or cane as well as LEs indicates a single point, used one at a time.
4-/5
completes ROM against gravity with min/mod resistance
4+/5
completes ROM against gravity with mod/max resistance
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
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
abducens
voluntary motor: muscle of eyeball, lateral
ABI scale
Normal=1.0. .5-.9=arterial occlusion, impairment with wound healing. less than .5=severe arterial occlusion.
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.
abnormal breath sounds
sounds that are heard outside of their normal location or phase of respiration
abnormal end feel: empty
cannot reach end feel due to PAIN, ex: joint inflammation, fracture or bursitis
abnormal end feel: firm
ex: increased tone, tightening of capsule, ligament shortening
abnormal end feel: hard
ex: fracture, OA, osteophyte formation
abnormal end feel: soft
ex: edema, synovitis, ligament instability/tear
absent breath sounds
may indicate pneumothorax or lung collapse
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
accessory
voluntary motor: SCM and trapezius muscle
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.
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
acidic/alkaline reaction
acidic reaction can cause hardening of skin. alkaline reaction can cause skin to soften over time.
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.
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.
active insufficiency
when a 2 joint muscle contracts (shortens) across both joints simultaneously
acupuncture like TENS
frequency: 1-4 Hz, 100-200 microseconds, amplitude: 30-80 mA
acute alveolar hyperventilation
pH greater than 7.5
acute diagnostic management
glasgow coma scale, CAT scan, x-ray, MRI, cerebral angiography, evoked potential/electroencephalogram, positron emission tomography, ventriculography, radioisotope imaging
acute ventilatory failure
pH less than 7.3
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)
adult w/c specs:
seat width: 18 inches, set depth: 16 inches, seat height: 20 inches
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
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
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
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
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
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
adventitous breath sounds
abnormal breath sounds heard using a stethoscope with inspiration and/or expiration. these sounds can be continuous or discontinuous sounds
aerobic metabolism
used predominantly during low intensity, long duration exercises. yields by far the most atp, but requires chemical reactions.
AFFERENT NERVES
SENSORY
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
aggressive spasticity treatment for sci
phenol blocks, rhizotomies, myelotomies, other surgical interventions
agnosia
inability to interpret information
agonist reversals
isotonic concentric contraction performed against resistance followed by alternating concentric and eccentric contractions with resistance. (controlled mobility, skill)
agraphesthesia
inability to recognize symbols, letters or numbers traced on the skin
agraphia
inability to write due to a lesion within the brain
akinesia
inability to initiate mvmt; commonly seen with parkinson’s
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.
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
alternating current (biphasic)
alternating current allows for the constant change in flow of ions
alternating isometrics
isometric contractions performed alternating from muscles on one side of joint to the other side w/o rest (stability)
ampere
unit of measure used to describe rate of current
amplitude
magnitude of current. often labeled intensity or voltage.
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
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
anatomic dead space volume (VD)
volume of air that occupies the non respiratory conducting airways
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
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.
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
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
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
anode
positively charged electrode that attracts negative ions
antalgic gait
involved step length is decreased in order to avoid weight bearing due to pain
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
anterograde memory impairment
inability to create new memory. usually last to recover after a comatose state.
anthropometry: skinfold msrmt
determines overall % of body fat thru msrmt of 9 standardized sites.
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.
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
antiplatelet agents (aspirin, plavix, ascriptin)
reduces atherosclerotic events and decrease the risk for CVA
aphasia
acquired neuro impairment of processing for receptive and/or expressive language. result of brain injury, head trauma, CVA, tumor or infection.
aphasia
inability to communicate or comprehend due to damage to specific areas of brain
apraxia
inability to perform purposeful learned mvmts, although there is no sensory or motor impairment
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
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.
arterial blood gases (ABG)
uses as a tool to determine the effectiveness of alveolar ventilation. expressed as the partial pressure of the gas.
arterial insufficiency ulcers
occur secondary to ischemia from inadequate circulation of oxygenated blood often due to complicating factors such as atherosclerosis
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
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.
ascending and descending tracts
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assistive devices
parallel bars, walkers, axillary crutches, lofstrand crutches, canes
associated reaction
involuntary and automatic mvmt of a body part as a result of an intentional active or resistive mvmt in another body part.
astereognosis
inability to recognize objects by sense of touch
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.
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
ataxia
inability to perform coordinated movements
ataxic gait
gait characterized by staggering and unsteadiness, wide BOS and movements are exaggerated.
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
athetosis
condition that presents with involuntary mvmts combined with instability of posture. peripheral mvmts occur without central stability
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.
atrial diastole
atrial filling of blood
atrial systole
atrial emptying of blood
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.
automatic postural strategies
automatic motor responses that are used to maintain center of gravity over base of support.
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.
avulsion fracture
portion of bone becomes fragmented at site of tendon attachment from a traumatic and sudden stretch of tendon
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.
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.
B fibers
medium, myelinated, reasonably fast conduction rate. pre ganglionic fibers of ANS.
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.
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.
balance
state of physical equilibrium needing input from these three systems: somatosensory, visual and vestibular.
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.
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.
balance tests (types)
romberg, one legged stance test, tinetti, berg balance, get up and go test, timed get up and go test
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
base of support
distance msrd btwn left and right foot during progression of gait. average BOS is 2-4 inches
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
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.
biofeedback contraindications
any condition where muscle contraction is detrimental, skin irritation at electrode site
biofeedback indications
muscle spasm, pain, sci, urinary incontinence, improve neuromuscular control, muscle weakness, hemiplegia, cp, bowel incontinence, promote relaxation
biofeedback measures:
muscle activity, heart rate, balance, skin temp, bp, posture, abnormal mvmt, normal mvmt
biofeedback therapeutic effects
muscle relaxation, improve muscle strength, decrease muscle spasm, neuromuscular control, decrease accessory muscle use, decrease pain
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
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.
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.
bipolar
2 active electrodes are placed over target area. electrodes usually same size. used for muscle weakness, neuromuscular facilitation, spasms, and ROM
blood supply to brain
PCA: posterior cerebral artery, MCA: middle cerebral artery, and vertebrobasilar artery.
blood volume
usually 7-8% of body weight. blood is pumped thru body at 30 cm/sec w/total circulation time of 20 seconds.
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.
borg’s rate of perceived exertion scale and the revised 10-grade scale
see page 121
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.
bradykinesia
mvmt that is very slow
Brain (encephalon)
Parts include brainstem, cerebellum, diencephalon, cerebral hemispheres, fissures, sulci, meninges, ventricular system and dural spaces
brainstem
midbrain, pons, medulla oblongata
brief intense (high intensity)
frequency: 70-100 Hz/burst, duration: 150-200 microseconds, amplitude: 30-60 mA
broca’s aphasia
major non-fluent aphasia. also known as “expressive” aphasia. most common form. lesions in frontal lobe.
bronchial breath sounds
abnormal breath sounds when heard in locations that vesicular sounds are normally present. pneumonia may produce these sounds
bronchial drainage positions/procedures
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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.
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
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
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.
bursitis
condition caused by acute or chronic inflammation of bursae. pain and swelling limits range.
burst
interrupted group of pulses that are delivered in a finite series and a predetermined frequency
C fibers
small nerve fibers, poorly myelinated or unmyelinated. slow conduction rate. post ganglionic fibers of sympathetic system. exteroceptors for pain, temp, and touch.
C1
vertex of skull.
C2
temple, forehead, occiput. myotome: longus colli, SCM, rectus capitis
C3
entire neck, posterior cheek, temporal area, prolongation forward under mandible. myotome: trap, splenius capitis
C4
shoulder area, clavicular and upper scap area. myotome: trap, levator scapulae
C5
deltoid area, anterior aspect of entire arm to base of thumb. myotome: supraspinatus, deltoid, biceps
C6
anterior arm, radial side of hand to thumb and index finger. myotome: biceps, supinator, wrist extensors.
C7
lateral arm and forearm to index, long and ring fingers. myotome: triceps, wrist flexors
C8
medial arm and forearm to long, ring and little fingers. myotome: ulnar deviators, thumb extensors, thumb adductors
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.
cadence
of steps an individual will walk over a period of time. average value for an adult is 110-120 steps per minute
cane
provides minimal stability and support during ambulation, mainly for balance.
capacitance
property of an insulator that allows for the storage of energy when opposing surfaces of the insulator have an electrical potential difference
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
cardiac lab testing
hematocrit, hemoglobin, partial thromboplastin time, platelet count, prothombin time, white blood cell count
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
cardiac reflexes
quick acting nervous system mechanisms that influence heart rate when triggered.
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
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
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
Cardiopulmonary ABCs
Airway-maintain open airway. Breathing-rescue (look, listen, feel). Circulation-compressions: check pulse.
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
cartilaginous joints
(amphiarthroses) has cartilage to connect one bone to another. slightly moveable joints. ex: syndchondrosis, symphysis
cathode
negatively charged electrode that attracts positive ions
cerebellar gait
staggering gait
cerebellum
responsible for: coordination of motor skills, postural tone, sensory/motor input for trunk and extremities, coordination of gait
cerebellum impairments
ataxia, discoordination of trunk and extremities, intention tremor, balance deficits, ipsilateral facial sensory loss, dysdiadochokinesia (inability to perform rapidly alternating movements)
CEREBRAL HEMISPHERE FUNCTION
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cerebral hemispheres
cortex, white matter, basal nuclei. 2 hemispheres: deep white matter, basal ganglia, and lateral ventricles
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.
characteristics of a brainstem CVA
unstable vital signs, decreased consciousness, ability to swallow, weakness and paralysis on both sides
characteristics of a cerebellum CVA
decreased balance, ataxia, decreased coordination, nausea, decreased ability for postural adjustment, nystagmus
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
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
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.
chest physical therapy
indications: patients who have acute or chronic respiratory problems: inability to expel secretions, ineffective cough, swallowing difficulties
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.
chf: congestive heart failure
etiologies include arrhythmia, pulm embolism, hypertension, valvular heart disease, myocarditis, unstable angina, renal failure, severe anemia;
cholesterol-lowering agents (lipitor, zocor, pravachol)
decreases the triglycerides and low-density lipoproteins in the bloodstream
chopping (PNF):
combination of bilateral UE asymmetrical extensor patterns performed as a closed chain activity
chorea
mvmts that are sudden, random and involuntary
chronaxie
testing procedure used to measure amount of time required to produce a small muscle contraction at a particular intensity
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”
circumduction
circular motion to advance leg during swing phase
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).
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
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.
clinical application templates executive summaries
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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
clonus
characteristic of an upper motor neuron lesion; involuntary alternating spasmodic contraction of a muscle precipitated by a quick stretch reflex
closed fracture
break in a bone where skin over site remains intact
closed-chain activity
involve body moving over a fixed distal segment. example: squat lift
clouding of consciousness
state of consciousness that is characterized by quiet behavior, confusion, poor attention, and delayed responses
CNS
Brain & Spinal Cord
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
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.
coma
state of unconsciousness and a level of unresponsiveness to all internal and external stimuli
comminuted fracture
bone that breaks into fragments at the site of injury
common circulatory pulse locations
carotid, brachial, radial, ulnar, femoral, popliteal, post tib, dorsalis pedis
COMMUNICATION DISORDERS
…
compensation
ability to utilize alternate motor and sensory strategies due to an impairment that limits the normal completion of a task.
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.
complete lesion
lesion to SC where there is no preserved motor or sensory function below the level of lesion
completed stroke
cva that presents with total neuro deficits at onset.
components of a prosthesis
socket, suspension, knee, shank, foot
compound fracture
break in a bone that protrudes thru skin
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.
concentric contraction
when muscle shortens while developing tension
conductance
ease at which a particular material will allow current flow (mho)
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.
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.
consciousness
state of alertness, awareness, orientation and memory
constructional apraxia
inability to reproduce geometric figures
contact guard
patient requires therapist to maintain contact with patient to complete task. usually needed to assist of there is a loss of balance
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)
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
contraindications
cardiac pacemaker, patient with a bladder stimulator, over carotid sinus, seizure disorders, phlebitis, malignancy, over a pregnant uterus, cardiac arrhythmia, osteomyelitis
contraindications for cardiac rehab
uncontrolled atrial/ventricular arrhythmias, embolism, thrombophlebitis, orthostatic bp, acute infection, unstable angina, resting ST sgmt deplacement, uncompensated CHF
contraindications for compression
malignancy of treated area, DVT, unstable or acute fracture, heart failure, infection of treated area, pulm edema, circulatory obstruction
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
contraindications for hvpc
cardiac pacemakers, over heavy scarring tissues, malignancy, pregnancy
contraindications for joint mobs
active disease, infection, advanced osteoporosis, articular hypermobility, fracture, acute inflammation, muscle guarding, muscle guarding, joint replacement
contraindications for massage
infection, arterioscelrosis, thrombus, cellulitis, acute injury, embolus, cancer.
contraindications for percussion
fracture, spinal fusion, osteoporotic bone, unstable angina, low platelet count, anticoagulation therapy, pulm embolism
contraindications for postural drainage
congestive heart failure, pulmonary edema, pleural effusion, pneumothorax, cardiac arrhythmia, history of recent MI, unstable angina, pulm embolism
contraindications for traction
when motion is contraindicated, joint instability, tumor, pregnancy, acute inflammatory response, acute sprain, osteoporosis, fracture
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
contraindications for UV
photosensitive meds, lupus erythematosus, tb, herpes, renal or hepatic pathology, DM, pellagra
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
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
conventional TENS
frequency: 50-100 Hz, duration: 20-100 microseconds, amplitude: 10-30 mA
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.
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.
corset
constructed of fabric to provide abdominal compression and support.
corticospinal tract (anterior)
pyramidal motor tract responsible for ipsilateral voluntary mvmt
corticospinal tract (lateral)
pyramidal motor tract responsible or contralateral voluntary fine mvmt
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.
craig-scott KAFO
designed specifically for persons with paraplegia. allows a person to stand with a posterior lean of trunk.
Cranial Nerves
olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal
cryotherapy
ex: ice massage, cold pack, cold bath, vapocoolant spray
cryotherapy contraindications
compromised circulation, peripheral vascular disease, ischemic tissue, cold hypersensitivity, raynaud’s phenomenon, cold urticaria, hypertension, infection, cryoglobinemia
cryotherapy’s indications
acute or chronic pain, myofascial pain syndrome, muscle spasm, bursitis, acute or subacute inflammation, musculoskeletal trauma, reduction of spasticity, tendonitis
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
current
flow electrons from one place to another
CVA
cerebrovascular accident
CVA risk factors
hypertension, heart disease, DM, smoking, TIAs, obesity, high cholesterol, behaviors related to hypertension, physical inactivity, increased alcohol consumption
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
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
decerebrate rigidity
characteristic of a corticospinal lesion at level of brainstem that results in extension of trunk and all extremities
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
decreased or diminished sounds
less audible sound may indicate severe congestion, emphysema or hypoventilation
deep heating agents
diathermy, ultrasound (and phonopheresis)
deep pain
squeeze forearm or calf muscle
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.
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
delirium
state of consciousness that is characterized by disorientation, confusion, agitation, and loudness
densitometry: hydrostatic weighing
method of calculating density of body by immersing in water and measuring amt of water that becomes displaced.
densitometry: plethysmography
method of calculating body density utilizing amt of air displacement during testing within a closed chamber.
dependent
patient is unable to participate and therapist must provide all effort to perform task
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.
depressed QRS
heart failure, ischemia, pericardial effusion, obesity, COPD
dermis
true skin: well vascularized, elastic, flexible and tough.
developmental sequence (PNF):
progression of motor skill acquisition. stages of motor control include mobility, stability, controlled mobility, and skill.
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
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.
diastole
(lower number bp reading) relaxation of cardiac muscle
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.
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.
diencephalon
hypothalamus, infundibulum, optic chiasm
diplopia
double vision
direct current
also known as galvanic, constant flow of electrons from anode to cathode without interruption. iontophoresis uses direct current
direct current (monophasic)
constant unidirectional flow of ions. dependent on polarity
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
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
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
disadvantages to hydrogels
potential for dressings to dehydrate, cannot be used on wounds with significant drainage, typically requires a secondary dressing
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
double step
alternate steps are of a different length or different rate
double support phase
refers to the two times during a gait cycle where both feet are on the ground. does not exist when running
down syndrome
clinical presentation: hypotonia, flattened nasal bridge, simian line (palmar crease), epicanthal folds, enlargement of tongue and dd.
dsymetria
inability to control the range of a mvmt and the force of muscular activity
DTR grades
0=no response. 1+=diminished/depressed response. 2+=active normal response. 3+=brisk/exaggerated response. 4+=very brisk/hyperactive, abnormal response.
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.
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.
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.
dural spaces: epidural space
space occupied between the skull and outer dura mater
dural spaces: subarachnoid space
space occupied btwn the arachnoid and pia mater that contains CSF and the circulatory system for the cortex
dural spaces: subdural space
space occupied btwn the dura and arachnoid meninges
duration of stimulus/duration of rest
time period of stimulation and time period of rest btwn periods of stimulation.
duty cycle
percentage of time that electrical current is on in relation to entire treatment time.
dynamometer
measures strength through use of a load cell or spring loaded gauge. (ex: grip strength-pounds)
dynamometry: break test:
eval procedure where patient is asked to hold a contraction against pressure that is applied in opposite direction to contraction.
dynamometry: make test
eval procedure where a patient is asked to apply a force against the dynamometer.
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.
dysarthria
slurred and impaired speech due to a motor deficit of the tongue or other muscles essential for speech.
dysdiadochokinesia
inability to perform rapidly alternating mvmts
dysphagia
inability to properly swallow
dystonia
closely related to athetosis; however there is larger axial muscle involvement rather than appendicular muscles
eccentric contraction
occurs when muscle lengthens while developing tension
ECG
measures electrical activity of heart
ectopic bone
(or heterotopic ossification): spontaneous formation of bone in the soft tissue. occurs adjacent to larger joints such as knees or hips.
ectopic foci
location where abnormal myocardial depolarization originates
edema
increased volume of fluid in soft tissue outside of a joint capsule
EFFERENT NERVES
MOTOR
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.
effusion
increased volume of fluid within a joint capsule
elbow
hinge joint, reinforced by ulnar collateral and radial collateral ligaments
electrical impedance
resistance of a tissue to electrical current
electrode configuration
techniques include: monopolar, bipolar, and quadripolar
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.
electrolysis
decomposition of a compound that results from passing an electrical current through it
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.
electron exchange
occurs during ionto where there is an exchange btwn ions within solutions and electrodes
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
electrotherapy terms
…
elevated QRS
hypertrophy of myocardium
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.
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
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.
end feel
type of resistance that is felt when passively moving a joint thru end range of motion.
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
epidermis
avascular, consists of outermost layer of skin
equine
gait pattern with high steps, excessive use of gastrocs
ERA
effective radiating area. area of transducer that transmits u/s energy. always smaller than total size of transducer head.
estim contraindication
malignancy, with all types of electrical implants, during first trimester of pregnancy, over lower abdomen/uterus during pregnancy, over anterior transcervical area
estim indications
pain management, urinary incontinence, edema management, osteoarthritic pain, migraines
expiration
to breathe air out of the lungs
expiratory reserve volume
1000 mL
expiratory reserve volume (ERV)
max volume expired after normal expiration
external catheter
applied over shaft of penis and is held in place by a padded strap or adhesive tape
facial
taste: anterior tongue, voluntary motor: facial muscles. autonomic: lacrimal, submandibular, sublingual glands
factors that influence vascular disease
hypertension, aging, diabetes, infection, poor nutrition, cigarette smoking
fasciculus cuneatus
sensory tract for trunk, neck and UE proprioception, vibration, 2 pt discrimination, graphesthesia
fasciculus gracilis
sensory tract for trunk and LE proprioception, 2 pt discrimination, vibration and graphesthesia
festinating
patient walks on toes as though pushed. starts slowly, increases and may continue until patient grabs an object in order to stop
FEV1 (forced expiratory volume in one second)
83% of VC
FEV2 (forced expiratory volume in 2 seconds)
94% of VC
FEV3 (forced expiratory volume in 3 seconds)
97% of VC
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
fibrous joints
(synarthroses) minimal movement. ex: sutures, syndesmosis, gomphosis
firm end feel
(stretch) ex: ankle DF, finger extension, hip medial rotation, forearm supination
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
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.
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)
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.
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.
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
Foot orthotics
semirigid or rigid insert worn inside a shoe that corrects foot alignment and improves function.
forced expiratory volume (FEV)
amount of air exhaled in the 1st, 2nd, and 3rd second of a forced vital capacity test
forced expiratory volumes
…
forced vital capacity (FVC)
amount of air forcefully expired after a max inspiration
frequency
determines number of pulses delivered through each channel per second. often labeled “rate”
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
frontal lob impairments
contralateral weakness, contralateral head and eye paralysis, personality changes, antisocial behavior, ataxia, primitive reflexes, broca’s aphasia, delayed or poor initiation
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.
frontal plane
divides body into anterior and posterior. motions are abduction and adduction, occur around an anterior-posterior axis.
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
functional residual capacity (FRC)
volume in lungs after normal exhalation
functional residual capacity (FRC)=
expiratory reserve volume (ERV) + residual volume (RV)
FWB
full weight bearing
gait cycle
sequence of motions that occur from one initial contact of the heel to the next initial contact of the same heel.
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
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
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
gait deviations of amputee: forward trunk flexion
causes: socket too big, poor suspension, knee instability, hip flexion contracture, weak hip extensors
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
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
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
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
gait muscles: gastroc/soleus
activity during late stance phase. concentric raising of heel during toe off.
gait muscles: hams
activity during late swing phase. decelerating unsupported limb.
gait muscles: quads
single support during early stance phase, and just before toe off to initiate swing phase.
Gait muscles: tibialis anterior
activity just after heel strike. eccentric lowering of foot into PF.
Gait: Standard - Stance Phase (60% of gait cycle)
Heel strike: instant heel touches ground to begin stance phase
gas pressure
mm Hg: see chart on page 132
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
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.
genu varum
bowing of knees. will increase compression of medial tibial condyle and increase stress to lateral structures. also called bowleg.
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.
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.
global aphasia
major non-fluent aphasia. lesion of frontal, temporal, and parietal lobes. comprehension (reading and auditory) is severely impaired.
glossopharyngeal
touch, pain: posterior tongue, taste: tongue. swallowing
goals for chest PT
mobilize secretions, expel secretions, improve breathing patterns, improve ventilation throughout all lobes, improve overall function
goals for vestibular rehab:
improve balance and stability, increase strength and ROM, decrease falls, minimize dizziness
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.
grade I
small movement performed at beginning of range
grade II
large amplitude movement performed within the range, but not reaching limit of range and not returning to beginning of range
grade III
large amplitude movement performed to limit of range
grade IV
small amplitude movement performed at limit of range
graphesthesia
draw a number or letter on skin with finger, identify without sight
greenstick fracture
break on one side of a bone that does not damage periosteum on opposite side. often seen in children.
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
