Readings (days 70-80) & Lectures 26-30 Flashcards
one stride =___________
one gait cycle
During closed chain ankle DF, the ____ moves on the _____
tibia; talus
_____ rocker occurs in IC and LR
Heel rocker
_____ rocker occurs in MSt and TSt
Ankle rocker
_____ rocker occurs in PSw and ISw
forefoot rocker
What orthosis helps with DF assist in the swing phase?
Posterior leaf spring
Posterior leaf springs assist ________ in the swing phase
DF
Hinged AFO allows _____ or ____ and prevents _____ to _____ movement
DF or PF; lat to med
Which prosthetic allows DF/PF but prevents lat to medial movement?
Hinged AFO
Which prosthesis limits all motions?
Solid AFO
stops/pegs ________ movement
restrict
springs ____ movement
assist
Rate Product Pressure (RPP)= ____ x ____
RPP= HR x SBP
LUB DUB=
S1 & S2
APT M 2245
Auscultation
A 60 y/o male in IP Acute. Acute exacerbation of COPD sx. 25-pack year hx of smoking, been educated on risks of continued smoking, but defers getting help to stop.
pH: 7.28
PCO2: 62 mmHg
HCO3: 25 mmHg
FEV1/FVC: <70%, FEV1: 45%
HR: 80 bpm
RR: 24 breaths/min
SpO2: 85%
Barrel shaped chest, elevated shoulder girdles and increased use of accessory mm while breathing. Crackles heard over the lung.
Which of the following is the MOST likely treatment?
A. Bicarbonate infusion to decrease metabolic acidosis
B. Have the patient to breath into a rebreathing mask to decrease
respiratory alkalosis
C. Fluid and saline infusion to
decrease metabolic alkalosis
D. Use of supplemental oxygen to decrease respiratory acidosis
D
A 60 y/o male in IP Acute. Acute exacerbation of COPD sx. 25-pack year hx of smoking, been educated on risks of continued smoking, but defers getting help to stop.
pH: 7.28
PCO2: 62 mmHg
HCO3: 25 mmHg
FEV1/FVC: <70%, FEV1: 45%
HR: 80 bpm
RR: 24 breaths/min
SpO2: 85%
Barrel shaped chest, elevated shoulder girdles and increased use of accessory mm while breathing. Crackles heard over the lung.
The PT decided to use postural drainage for airway clearance in this patient. The PT positions the patient in a seated position leaning forward over a folded pillow. Based on the position of the patient, which lobe is MOST likely being drained?
A. Posterior apical segments of upper lobe
B. Anterior apical segments of upper lobes
C. Superior segments of the lower lobes
D. Anterior basal segments of lower lobes
A
B= backwards lean
C= prone
D= elevate bed
A 60 y/o male in IP Acute. Acute exacerbation of COPD sx. 25-pack year hx of smoking, been educated on risks of continued smoking, but defers getting help to stop.
pH: 7.28
PCO2: 62 mmHg
HCO3: 25 mmHg
FEV1/FVC: <70%, FEV1: 45%
HR: 80 bpm
RR: 24 breaths/min
SpO2: 85%
Barrel shaped chest, elevated shoulder girdles and increased use of accessory mm while breathing. Crackles heard over the lung.
Which of the following exercises would be MOST likely recommended for this patient?
A. Inspiratory muscle training
B. Pursed lip breathing exercises
C. Segmental breathing exercises
D. Incentive spirometry
B
A= strengthening
C= to expand segment or lobe of lung
D= inflating collapsed lung or after atelectasis
How long should you hold positions for postural drainage?
5-10 minutes
postural drainage in prone w pillows under pelvis
superior segments lower lobes
postural drainage sitting on a chair leaning forward over pillows
post apical segments of upper lobes
postural drainage supine lying, pillows under knees
ant segments of upper lobes
postural drainage sitting in recliner leaning slightly backwards
Ant apical segments of Upper lobes
A PT instructed a patient in home postural drainage positioning. Which of the following position will be MOST appropriate for right lateral segment?
A. Position A
B. Position B
C. Position C
D. Position D
B
A= L side
C= sup segments of lower lobes
D= L middle/lingular lobe
Contraindications of postural drainage:
1.
2.
3.
4.
5.
6.
7.
- Increased intracranial pressure 2. Hemodynamically unstable
- Recent esophageal anastomosis
- Recent spinal fusion or injury
- Recent head trauma
- Diaphragmatic hernia
- 9 months pregnant (cant be supine)
An 85-year-old patient with chronic congestive heart failure was recently admitted to the hospital. Which of the following plans for prophylactic respiratory care is LEAST appropriate?
A. Frequent turning and positioning every 2 waking hours
B. Gentle percussion 2 times per day
C. Vigorous chest vibrations, with the foot of the bed elevated,
4 times per day
D. Gentle coughing and deep breathing exercises every 4 hours
C, foot end of bed increases overload, pt also elderly and will not tolerate this
A= true, to prevent development of atelectasis and pneumonia
B= true, good
D= true, prevent development of atelectasis
HR Max=
HR max= 220 - age
OR
HR Max= 207-0.7x age
Karvonen formula
HRR x exercise intensity + Resting HR
(HR Reserve= HR max- Baseline HR)
A 75-year-old individual has limited endurance. There is no history of cardiorespiratory problems. After an exercise tolerance test, which was negative for coronary heart disease, the BEST initial exercise prescription for this individual would be:
A. 90-100% HR max
B. 60-70% HR max
C. 40-50% HR max
D. 30-40% of HR max
B, no cardio probs so can start higher but not too high
A= athletes
C & D= too conservative
A patient diagnosed with congestive heart failure is participating in cardiac rehabilitation. During treadmill training the patient becomes fatigued with an increased pulse and respiratory rate. In which situation would the PT terminate the exercises?
A. Having an S1 and S2 heart sound
B. Onset of diaphoresis
C. An increased respiratory rate of 30 breaths per minute.
D. A decrease in diastolic blood pressure of 5 mmHg
B, red flag, cold sweats
A= normal
D= within range of 10mmHg
Cardiac Rehab phases:
- 4.
- Acute/Monitoring phase
- Subacute/conditioning phase
- Training phase
- Maintenance period
No resistance training in which phases of cardiac rehab?
Phases I & II
Which phase of cardiac rehab?
F - Short sessions 2-3 times a day I - 50%-70% HR max
T - 10-15 mins (phase I) and 30 mins (phase II) per session
T - ADLs, supervised ambulation
Phases I & II
A 60-year-old male is undergoing cardiac rehabilitation post complicated MI in the hospital. On day two, the PT wants to progress the patient to sitting. Which of the following is an appropriate INITIAL task for this patient?
A. Make the patient stand and do weight-bearing activities
B. Make the patient sit on the upright chair during the visitor’s
time
C. Make the patient sit on reclining chair and check vitals
D. Patient is not ready for upright posture yet
C
A 60-year-old male is undergoing cardiac rehabilitation post MI in the hospital. On day 3, the patient has progressed to walking. Which of the following is the MOST appropriate statement to document the activity?
A. Patient ambulated for 20 minutes with RPE 10/20
B. Patient ambulated 300 ft with RPE 4/20
C. Patient ambulated 500 ft in 6 minutes with RPE 10/20
D. Patient ambulated in the ICU hallway with RPE 10/20
C
A= didn’t state how far
B= distance? RPE is 6-20
D= not detailed enough
What phase of Cardiac Rehab?
F - 2-3 sessions/week
I - 70%-to-85% of the peak achieved on the test (i.e., HR max)
T - 30-60 minutes with 5-10 min of warm up and cool down
T - Single mode of training (walking) or multiple modes using
(treadmill, cycle, ergometer)
OP Phase III
Strength training in Phase III Cardiac Rehab
Begin with the use of elastic bands and light hand weights
(1-3 pounds) or 30-50% of max weight used to complete 1RM
Begin with 8-10 reps, progress to 12-15 reps
Avoid upper extremity resistance as soft tissue is still healing
A 58-year-old female patient with uncomplicated MI, has been discharged from the acute care. Which of following activities would be MOST appropriate during early phase 2 rehabilitation?
A. 30 minutes walking at 3 mph with no incline
B. 15 minutes of elastic band training with yellow elastic bands
C. 15 minutes upper limb workout with 2-pound hand weights
D. 30 minutes walking at 5 mph with 5% incline
A
B & C= too much, for Phase III
D= progress to this
Phase 4 of Cardiac Rehab
-Progression: 50-85% of functional capacity, 3-4/week, 45 minutes or more/session
-Discharge: Typically, 6-12 months
Which phase of Cardiac Rehab?
-Progression: 50-85% of functional capacity, 3-4/week, 45 minutes or more/session
-Discharge: Typically, 6-12 months
Phase IV
A 45-year-old patient has been walking three days/week for 20 minutes for the past three weeks. When progressing the exercise program, which of the following modifications will MOST likely accomplish the weight loss goal?
A. Walk 6 days/week at current walking speed and increase the duration to 45 minutes
B. Increase the walking speed and keep the duration at 20 minutes
C. Walk 5 days/week and decrease the duration to 10 minutes
D. Decrease the walking speed and increase the duration at 25 minutes
A
degeneration of intervertebral discs
Spondylosis
Spondylosis
degeneration of intervertebral discs
Spondylolysis
breaking in the pars or arch of vertebra
breaking in the pars or arch of vertebra
Spondylolysis
Forward slipping of one vertebra over another
Spondylolisthesis
Spondylolisthesis
Forward slipping of one vertebra over another
Retrolisthesis
Backward slipping of one vertebra over another
Backward slipping of one vertebra over another
Retrolisthesis
T or F: All spinal conditions starting with “S” are relieved by sitting and worsened by standing
T
T or F: Disc herniation is relieved by sitting and worsened by standing
F, relieved by standing and worsened by sitting
19 y/o female in OP Ortho. Severe LBP that started 2 weeks ago after a gymnastic competition, she can sit comfortably, walking to the bus stop with her backpack on or standing in the kitchen to bake worsens the pain, she’s been a gymnast for 12 yrs, Extension AROM painful at end ranges, negative SLR, ODI: 40.
Which other special test will be positive to confirm the diagnosis?
A. Stork standing test
B. Gillet test
C. Van Gelderen bicycle test
D. Quadrant test
A
B= SIJ dysfunction
C= stenosis
D= facet joints
19 y/o female in OP Ortho. Severe LBP that started 2 weeks ago after a gymnastic competition, she can sit comfortably, walking to the bus stop with her backpack on or standing in the kitchen to bake worsens the pain, she’s been a gymnast for 12 yrs, Extension AROM painful at end ranges, negative SLR, ODI: 40.
Which of the following is the MOST appropriate intervention based on the patient’s presentation?
A. Bed rest for two weeks along
with hot packs 3x/day for 15 mins each
B. Flexion-biased exercises
C. High velocity thrust to the lumbar spine to improve lumbar extension
D. Extension-biased exercises
B, sitting relieving, standing aggravating
19 y/o female in OP Ortho. Severe LBP that started 2 weeks ago after a gymnastic competition, she can sit comfortably, walking to the bus stop with her backpack on or standing in the kitchen to bake worsens the pain, she’s been a gymnast for 12 yrs, Extension AROM painful at end ranges, negative SLR, ODI: 40.
After 4 weeks of PT, the patient was reevaluated again and the score on the Oswestry disability index was 25. What can be interpreted from this score?
A. Patient’s condition is improving
B. Patient’s condition is getting worse
C. Patient can be discharged from care as the patient is fine
D. Patient needs to see their physician for pain management
A, higher score= more disability
T or F: In scoliosis, the vertebral bodies deviate toward the concave side and the spinous process rotates to the convexity of the curve.
F,
Vertebral bodies rotate to the
convexity of the curve
̶
Spinous process deviates toward the concave side
Concave or Convex side of scoliosis?
- High pelvis
- Tight muscles
- Spinous process rotation
- Anterior rib distortion
- A decrease in vertebral height
- Narrowing of the intercostal spaces
- Decrease in lung volume
Concave
Concave or Convex side of scoliosis?
- muscles lengthen
- body of vertebra rotates towards
- posterior rib distortion
- opening of the intercostal spaces
- increase in lung volume
Convex
A 13-year-old girl has been diagnosed with structural idiopathic scoliosis. The physical therapist notices a left thoracolumbar structural scoliosis. Which postural deviation would be expected in this patient:
A. The body of the thoracic vertebrae rotated to the right
B. High right shoulder
C. Spinous processes of thoracic spine rotated to the left
D. Right anterior rib hump and left posterior rib hump
D
Spinal mobs:
Gapping, increased space, upglide, flexion= _______
Opening
Spinal mobs:
Closing, decreased space, downglide, extension = ___________
closing