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DPT 516 > Quiz 1 > Flashcards

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
Q

what are the benefits of cardiorespiratory fitness?

A

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

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26
Q

what are some benefits of flexibility training?

A

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

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27
Q

what are the benefits of weight training?

A

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

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28
Q

what is pathophysiology?

A

the structural and functional changes caused by disease or trauma

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29
Q

what some causes of injury?

A

ischemia

infectious agents

immune reactions

chemical factors

nutritional factors

psychosocial factors

mechanical factors

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30
Q

what is ischemia?

A

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

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31
Q

what is hypoxia?

A

partial reduction in O2

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32
Q

what is anoxia?

A

total reduction in O2

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33
Q

what does loss of aerobic metabolism lead to?

A

decreased ATP synthesis which increases ions and fluids in cells which then lowers metabolism and cell function

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34
Q

what are infectious agents?

A

bacterial/viral infections may lead to cell injury and inflammation

initiate inflammation in an attempt to inactivate the pathogen

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35
Q

what is sepsis?

A

extreme response to infection leading to widespread inflammation, identified by toxins that are present in the blood

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36
Q

what is clostridium tetani?

A

releases exotoxins that interfere with inhibitory NTs and cause involuntary muscle contractions

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37
Q

what are immune reactions?

A

hypersensitivities ranging from a mild allergy to autoimmune disorders

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38
Q

what is a mild allergy?

A

runny nose due to histamine release

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39
Q

what are moderate reactions?

A

possible hypoxia due to bronchoconstrictions

40
Q

what is a severe reaction?

A

anaphylaxis-life threatening due to whole body reaction

41
Q

what are autoimmune disorders?

A

cross reaction b/w foreign and host antigens

42
Q

what are chemical factors?

A

toxic substances

direct cell injury

free radical formation

nitric oxide

43
Q

what is direct cell injury?

A

heavy metals such as mercury

alkylating agents

44
Q

what is free radical formation?

A

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
Q

what neutralizes free radical formation?

A

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
Q

what is nitric oxide?

A

NO=1 N+1O2

a free radical that is an important regulator of a great # of physiological responses

47
Q

what are the positive affects of nitric oxide?

A

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
Q

what are genetic factors?

A

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
Q

what are nutritional factors?

A

imbalances in essential nutrients and vitamins and minerals can cause cell injury and death

malnutrition

excessive nutrition

50
Q

what is Kwashiorkor?

A

protein malnutrition-inhibits replication and healing

51
Q

what is Marasmus?

A

malnutrition from generalized dietary deficiencies

52
Q

what is excessive nutrition?

A

obesity

53
Q

vitamin A deficiency

A

leading cause of preventable blindness

54
Q

vitamin D deficiency

A

rickets-inadequate mineralization of bone

55
Q

vitamin E deficiency

A

deficiency is rare

56
Q

vitamin K deficiency

A

formation of thrombin and other blood clotting factors

57
Q

B1 thiamine deficiency

A

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
Q

B2 riboflavin deficiency

A

ariboflavinosis-after several months of deficiency

magenta inflamed tongue, dry cracked corners of the mouth

59
Q

niacin deficiency

A

pellagra-post 2 months niacin deficiency

60
Q

B6 deficiency

A

pyridoxine-protein metabolism and NT synthesis

61
Q

folic acid deficiency

A

decreased RBCs=anemia

can be caused by alcoholism

found in leafy greens

62
Q

B12 deficiency

A

megaloblastic anemia

normally maintains the myelin sheath

nerve damage

found in animal products

pernitious anemia

63
Q

what are psychosocial factors?

A

fear, tension, and anxiety may influence threshold values for tissue adaptation and injury

64
Q

what are mechanical factors?

A

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
Q

what is cellular aging?

A

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
Q

what is the wear and tear theory?

A

in organs that have no cell regeneration

67
Q

what is the free radical theory?

A

most popular and widely tested theory

DNA damage and oxidative stress

68
Q

what is the telomere aging clock theory?

A

structure at the end of chromosomes

telomere acts as molecular clock and signals senescence (viable non-dividing state of a cell)

69
Q

what is the inflammation stage?

A

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
Q

what is acute inflammation?

A

sudden onset, short duration

exudation of fluid and plasma proteins w/migration of neutrophils and leukocytes

redness, heat, swelling, pain, and reduced function

71
Q

what is chronic inflammation?

A

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
Q

what are the characteristics of a well healing wound?

A

red, beefy tissue

pinpoint red dots

granular surface composed of newly formed collagen

73
Q

what are the components of the inflammatory reaction?

A

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
Q

what are neutrophils?

A

constitute defense against foreign substances (usual bacterial infection)

75
Q

what are lymphocytes?

A

produce antibodies, fight tumor cells, respond to viral infections

76
Q

what are monocytes?

A

clean up debris after neutrophils have completed tasks

77
Q

what are eosinophils?

A

attack parasites and play a role in asthma and allergies

78
Q

what are basophils?

A

release histamine during allergic reactions

79
Q

what chemical mediators of inflammation?

A

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
Q

what do corticosteroids do?

A

block production of arachidonic acid

Prednisone, dexamethasone, triamcinolone, kenalog

81
Q

what do NSAIDS do?

A

block production of prostaglandins and cyclooxygenase

ASA, ibuprofen

82
Q

what do cyclooxygenase-2 (Cox-2) inhibitors do?

A

block production of cyclooxygenase

celebrex, meloxicam, mobic

83
Q

what is the blood coagulation/clot formation stage of healing?

A

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
Q

what is the 1st stage of healing?

A

inflammation

85
Q

what is the role of the inflammation stage?

A

break down necrotic tissue w/phagocytes and enzymes

86
Q

what are the components of healing?

A

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
Q

what are the 4 stages of healing in order?

A

hemostasis and degeneration

inflammation

proliferation and migration

remodeling and maturation

88
Q

what is the hemostasis/degeneration stage of healing?

A

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
Q

what is the inflammatory stage of healing?

A

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
Q

what are the signs of inflammation?

A

redness, edema, pain, increased temp, loss of normal functioning

91
Q

what is the proliferation phase of healing?

A

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
Q

what is the remodeling/maturation phase of healing?

A

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
Q

what is arthrofibrosis?

A

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
Q

collagen transition in remodeling stage of healing

A

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
Q

what factors affect healing?

A

growth factors

nutrition

96
Q

what is rheumatoid arthritis?

A

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

DPT 516 (14 decks)

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