Quiz 1 Flashcards

1
Q

what is wellness?

A

active process of becoming aware of and making choices towards a healthy and fulfilling life; a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity; condition where all components of health are in good balance

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2
Q

where do PTs fit in wellness?

A

primary care in rehab

primary and secondary prevention and health promotion

across the lifespan

in all healthcare settings

guiding through safe physical activity

promoting health and wellness among individuals with comorbid health conditions

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3
Q

what is primary care?

A

prevention and general health promotion

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4
Q

what is secondary care?

A

decrease the duration, severity, or sequella (secondary impairments) of illness through early intervention

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5
Q

what is tertiary care?

A

limiting the degree of disability and promoting rehab and restoration of function in clients w/chronic and irreversible disease

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6
Q

what is physical fitness?

A

the ability to meet life’s demands and still have enough energy to respond to unplanned events.

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7
Q

what are the 5 basic components of wellness?

A

cardiorespiratory (aerobic) endurance

muscular strength

muscular endurance

flexibility

body composition

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8
Q

what is cardiorespiratory endurance?

A

the ability to supply and use oxygen over a period of time and in sufficient amounts to perform normal and unexpected activities

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9
Q

what is muscle strength?

A

the ability of a muscle to generate force over a given # of repetitions

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10
Q

what is muscle endurance?

A

the ability of a muscle to contract repeatedly or to sustain force for a given period of time

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11
Q

what is muscle power?

A

the ability of a muscle to generate max force in a short period of time (P=F x D/T

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12
Q

what is flexibility?

A

ability of a muscle to elongate sufficiently to meet the demands of the underlying joint

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13
Q

what is mobility?

A

ROM available at a joint which is influenced by several factors

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14
Q

what is body composition?

A

the relationship b/w the % body fat and lean body mass

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15
Q

what is body composition used for?

A

to monitor effectiveness of training/diet

to estimate competition weight in weight-category sports

to monitor health status in the prevention of disorders

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16
Q

what is normal body composition?

A

essential body fat for females=12%

essential body fat for males=3%

total body fat for females=25-28%

total body fat for males=12-15%

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17
Q

what are some ways body composition is measured?

A

BMI

height and weight tables

waist to hip ratio

bioelectric impedence

skin fold measurements

hydrostatic weighing

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18
Q

what are the stages of change in the stages of change theory?

A
  1. pre-contemplation
  2. contemplation (often deal with ambivalence here)
  3. preparation (decision and determination)
  4. action
  5. maintainence
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19
Q

when are programs more likely to be maintained?

A

when positive feelings are induced by exercise, feeling good, improved self-esteem, and higher energy levels

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20
Q

what are some tips to maintain exercising?

A

material reinforcement (not the best)

social reinforcement

joining a group

self motivating

make it fun!

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21
Q

what are some positive interviewing techniques?

A

active listening

encouragers

paraphrasing

asking probing follow up ?s

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22
Q

what are some negative interviewing techniques?

A

pushing or persuading patients to make change

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23
Q

how should you respond to ambivalence?

A

listen

unpack

explore

give pt place to sort it out

reflect change talk

ask ?s

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24
Q

what is sustain talk?

A

pt communication opposing change or in favor of staying the same

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25
what are the benefits of cardiorespiratory fitness?
increased max O2 consumption (VO2 max) improved submax exercise efficiency faster recovery from aerobic exercise session improved blood lipid profile enhanced body composition increased bone density enhanced ability to cope with stress decreased susceptibility to and severity of chronic disease like cancers increased quality of life
26
what are some benefits of flexibility training?
increased ROM and improved performance injury prevention reduction in LBP (Low back pain) warms deep muscles fibers prepares you mentally for vigorous activity maintains joking flexibility an reduces pain as you age reduced loss of function and inability to perform ADLs and IADLs
27
what are the benefits of weight training?
manage body weight and fat improved appearance, body image, and self-concept increased strength and endurance for work and everyday activities increased bone-mineral content and bone density heart health (reduced cardiovascular risks) less tendency to develop OA, obesity, diabetes improved geriatric vigor improved mobility and balance in elderly improved completion of ADLs
28
what is pathophysiology?
the structural and functional changes caused by disease or trauma
29
what some causes of injury?
ischemia infectious agents immune reactions chemical factors nutritional factors psychosocial factors mechanical factors
30
what is ischemia?
blood flow is insufficient to maintain cell function obstruction of bronchi--> poor transport of O2 in lungs--> reduced transport of O2 in blood--> inability of cells to use O2
31
what is hypoxia?
partial reduction in O2
32
what is anoxia?
total reduction in O2
33
what does loss of aerobic metabolism lead to?
decreased ATP synthesis which increases ions and fluids in cells which then lowers metabolism and cell function
34
what are infectious agents?
bacterial/viral infections may lead to cell injury and inflammation initiate inflammation in an attempt to inactivate the pathogen
35
what is sepsis?
extreme response to infection leading to widespread inflammation, identified by toxins that are present in the blood
36
what is clostridium tetani?
releases exotoxins that interfere with inhibitory NTs and cause involuntary muscle contractions
37
what are immune reactions?
hypersensitivities ranging from a mild allergy to autoimmune disorders
38
what is a mild allergy?
runny nose due to histamine release
39
what are moderate reactions?
possible hypoxia due to bronchoconstrictions
40
what is a severe reaction?
anaphylaxis-life threatening due to whole body reaction
41
what are autoimmune disorders?
cross reaction b/w foreign and host antigens
42
what are chemical factors?
toxic substances direct cell injury free radical formation nitric oxide
43
what is direct cell injury?
heavy metals such as mercury alkylating agents
44
what is free radical formation?
formed by the metabolism of food and O2 for energy production normal O2 loses an electron and the unstable atom steals an electron from a healthy cell creating another unstable atom (chain reaction known as oxidation) also created unpaired electrons that bind to O2 which binds to H+ to stabilize and creates O2 toxicity part of normal aging process
45
what neutralizes free radical formation?
anti-oxidants that have a free electron to give to the unstable atoms endogenous-w/in the cell exogenous-outside the body via diet (vit C, E, beta-carotene, etc) exercise: regular moderate exercise strengthens antioxidant system
46
what is nitric oxide?
NO=1 N+1O2 a free radical that is an important regulator of a great # of physiological responses
47
what are the positive affects of nitric oxide?
assist in LT memory assist GI mucosa to resist injury by toxins inhibits virally induced cytokines and chemokines (combats the common cold) stimulates collagen production, modulates fx healing, useful in Rx of tendinopathy prevents platelet clumping and helps provide non-stick coating of blood vessels reduction of physiological stress
48
what are genetic factors?
alteration in structure and # of chromosomes that induce abnormalities single mutations of genes that cause change in amount or function of proteins multifactorial disorders from multiple gene mutations that interact w/environmental factors
49
what are nutritional factors?
imbalances in essential nutrients and vitamins and minerals can cause cell injury and death malnutrition excessive nutrition
50
what is Kwashiorkor?
protein malnutrition-inhibits replication and healing
51
what is Marasmus?
malnutrition from generalized dietary deficiencies
52
what is excessive nutrition?
obesity
53
vitamin A deficiency
leading cause of preventable blindness
54
vitamin D deficiency
rickets-inadequate mineralization of bone
55
vitamin E deficiency
deficiency is rare
56
vitamin K deficiency
formation of thrombin and other blood clotting factors
57
B1 thiamine deficiency
Beri-Beri-dry and wet types - dry: loss of appetite, confusion, loss of coordination - wet: edema common in cultures that eat a lot of white rice and raw fish
58
B2 riboflavin deficiency
ariboflavinosis-after several months of deficiency magenta inflamed tongue, dry cracked corners of the mouth
59
niacin deficiency
pellagra-post 2 months niacin deficiency
60
B6 deficiency
pyridoxine-protein metabolism and NT synthesis
61
folic acid deficiency
decreased RBCs=anemia can be caused by alcoholism found in leafy greens
62
B12 deficiency
megaloblastic anemia normally maintains the myelin sheath nerve damage found in animal products pernitious anemia
63
what are psychosocial factors?
fear, tension, and anxiety may influence threshold values for tissue adaptation and injury
64
what are mechanical factors?
physical stress theory: changes in relative level of physical stress causes a predictable adaptive response in all biological tissues (Wolff's Law) some conditions begin with an inflammatory response and lead to a degenerative response (tendinopathy)
65
what is cellular aging?
deterioration of cell due to aging leads to organ deficiencies and expression of aging or disease prime target is the mitochondria (DNA) - changes in info content of a cell can change function and effect cell homeostasis
66
what is the wear and tear theory?
in organs that have no cell regeneration
67
what is the free radical theory?
most popular and widely tested theory DNA damage and oxidative stress
68
what is the telomere aging clock theory?
structure at the end of chromosomes telomere acts as molecular clock and signals senescence (viable non-dividing state of a cell)
69
what is the inflammation stage?
complex set of overlapping vascular and cellular processes removal of injurious agents, cellular debris, and marks initiation of the healing process protective role, but becomes deleterious if it persists
70
what is acute inflammation?
sudden onset, short duration exudation of fluid and plasma proteins w/migration of neutrophils and leukocytes redness, heat, swelling, pain, and reduced function
71
what is chronic inflammation?
extensive necrosis inability of cells to regenerate insulting agent not eliminated repeated episodes of acute inflammation persistent immune reaction chemotaxis of monocytes results in macrophages that modulate lymphocyte function resulting in growth of endothelial cells and fibroblasts results in granulation tissue and connective tissue scar
72
what are the characteristics of a well healing wound?
red, beefy tissue pinpoint red dots granular surface composed of newly formed collagen
73
what are the components of the inflammatory reaction?
exudation (escape of fluid from the vascular system into tissue or body cavity) - high protein concentration, cellular debris, and high specific gravity transudate (fluid w/low protein count, little/no cellular debris, low specific gravity) effusion (fluid leaks from blood vessels and accumulates inside an anatomical space such as pleural, pericardial, or peritoneal cavity or joint spaces.
74
what are neutrophils?
constitute defense against foreign substances (usual bacterial infection)
75
what are lymphocytes?
produce antibodies, fight tumor cells, respond to viral infections
76
what are monocytes?
clean up debris after neutrophils have completed tasks
77
what are eosinophils?
attack parasites and play a role in asthma and allergies
78
what are basophils?
release histamine during allergic reactions
79
what chemical mediators of inflammation?
histamine: quick and short acting - inactivated in < 30' - causes endothelial contraction-causes gaps in blood vessels increasing vessel permeability - potent vasodilator and bronchoconstrictor platelet activating factor: potentiates activity of other inflammatory mediators arachidonic acid derivatives: cleavage of AAD from cell membrane leads to... - cyclooxygenase enzyme or a lipooxygenase enzyme further metabolizes the arachidonic acid - cyclooxygenase pathway leads to production of several types of prostaglandins which mediate fever and pain associated with inflammation cytokines: interleukin 1 and TWF raises production of prostaglandin producing fever --> increased systemic metabolisma nd O2 consumption-->decreased systemic vascular resistance-->hypertension leads to decreased systemic vascular resistance causing increased HR
80
what do corticosteroids do?
block production of arachidonic acid Prednisone, dexamethasone, triamcinolone, kenalog
81
what do NSAIDS do?
block production of prostaglandins and cyclooxygenase ASA, ibuprofen
82
what do cyclooxygenase-2 (Cox-2) inhibitors do?
block production of cyclooxygenase celebrex, meloxicam, mobic
83
what is the blood coagulation/clot formation stage of healing?
formed by plasma proteins balance b/w coagulation (clot formation) and lysing (clot dissembling) protects against hemorrhage and catastrophic clotting platelets circulate always ready to engage any damage w/injury: - prothrombin converted to thrombin which converts fibrinogen to fibrin (essential component of blood clots) - fibrin forms meshwork at site of insult and stops bleeding, traps, exudate, and microorganisms
84
what is the 1st stage of healing?
inflammation
85
what is the role of the inflammation stage?
break down necrotic tissue w/phagocytes and enzymes
86
what are the components of healing?
fibronectin: provides scaffolding, tensile strength, binds cells proteoglycans/elastin: binds to fibronectin and collagen and stabilizes tissue undergoing repair, aids in hydration of tissues collagen: glue producer, provides tensile strength and structural support for most tissues and organs - type 1: most common, structurally strong; main component of mature scars and predominant in tissues such as tendon and bone - type 2: thin filaments found in cartilage - type 3: elastic filaments found in skin and blood vessels; 1st to be laid down in healing tissue
87
what are the 4 stages of healing in order?
hemostasis and degeneration inflammation proliferation and migration remodeling and maturation
88
what is the hemostasis/degeneration stage of healing?
process of stopping blood flow through the locally damaged vessels into the injury site via coagulation shortest phase characterized by: - vasoconstriction followed by vasodilation - influx of platelets creates clots - damage to lymph vessels - chemotactic factors to summon inflammatory cells - degeneration: formation of hemotoma, necrosis of dead cells, start of inflammatory cell response
89
what is the inflammatory stage of healing?
vascular and cellular response that eliminates microbes in preparation for repair increased neutrophils, macrophages that phagocytize microbes and mesenchymal cells which become fibroblasts. inactivate the injurious agents, break down and remove dead cells, initiate healing allow inflammation but minimize it 1-3 days and sometimes up to 10 days post injury goal: replace damaged tissue w/healthy tissue, fibrous scar, or both characterized by: - chemicals released to attract other cells and chemicals to the area - cytokines: express GHs, attract macrophages, fibroblasts, and neutrophils, stimulate neovascularization - platelet release: fibronectin, growth factor, fibrinogen debris removal 5-6 hours post injury neutrophils and polymorphonuclear leukocytes (PMN) inflammatory exudate formed chemotaxis histamine release prostaglandins (PG)
90
what are the signs of inflammation?
redness, edema, pain, increased temp, loss of normal functioning
91
what is the proliferation phase of healing?
increased fibroblasts, decreased PMNs=transition from inflammation to proliferation excessive growth of epithelial cells beneath scab deposition of collagen fibers by fibroblasts growth of blood vessels (neovascularization/angiogenesis) - leaky at first cell migration occurs
92
what is the remodeling/maturation phase of healing?
scar tissue reduced and remodeled can cause contractures near joints or organs returns to more natural skin color reduced capillary and fibroblast density scab sloughs off more organized collagen, fibroblasts decreased, blood vessels restored to normal
93
what is arthrofibrosis?
local/global periarticular scarring from surgery or trauma thickened fibrotic capsule can inhibit motion common in shoulders and knees caused by prolonged immobilization, infection, graft malposition post reconstruction
94
collagen transition in remodeling stage of healing
type 3 collagen replaced by type 1 collagen type 1 is more insoluble and resistant to destruction strength increases w/more optimal arrangement of fibers - more parallel= increased cross linking
95
what factors affect healing?
growth factors nutrition
96
what is rheumatoid arthritis?
example of how chronic inflammation can damage healthy tissue diagnosed by erythrocyte sedimentation rate and rheumatoid factor (antibody that attacks antibodies) edema, loss of cartilage, resorption of bone, capsular laxity leading to deformity autoimmune reaction and inflammation synovial fluid hyperplasia endothelial cell activation bone and cartilage destruction