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Final Frontier > Recordings > Flashcards

Recordings Flashcards

1
Q

rate pressure product =

A

RPP = HR x BP

used to determine myocardial O2 demand of the pt at the onset of chest symptoms

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2
Q

blood pressure norms

A

normal: 120/80
elevated: 120-129/80
stage 1: 130-139/80-89
stage 2: 140+/90+

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3
Q

initial changes of exercises in altitude and in pool

A
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4
Q

what happens to HR, BP, CO, SV after being acclimized to altitude

A
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5
Q

explain the respiratory effects of aquatic therapy

A

pressure of water on the chest wall will give it more resistance and it will be harder to expand, making the vital capacity smaller (decrease) AND work of breathing harder (increase)

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6
Q

heart sounds:
where is S1 and S2

A

S1: apex of heart (mital valve and tricuspid)
S2: base of hear (pulmonary and aortic)

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7
Q

erb’s point

A

S1 and S2 sounds equally heard

located in the third intercostal space close to the sternum.

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8
Q

describe fwd head posture

A

lower c/s = flexed
upper c/s = extended

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9
Q

janda’s cross syndrome

A
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10
Q

screw home mechanism

A

IN OPEN CHAIN:
to achieve terminal knee extension - the tibia has to laterally rotate

“TOLL”
Tibia Open chain Lateral Lock. EXTENSION
FLEXION: need to unlock, therefore, tibia medially rotates

CLOSED CHAIN:
femur moves on tibia.
extension: MEDIAL rotation
flexion: LATERAL rotation

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11
Q

mm of the scapula

A
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12
Q

active insuffiency

A

inability of a two joint mm to SHORTEN stimultaneously at both joints

“simply the function of the mm”

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13
Q

passive insuffiency

A

the inability of a two joint mm to LENGTHEN simultaneously at both joints

“opposite of the mm function” or the stretch of the mm

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14
Q

kinematic chain of a pronated foot

A

ankle: pronation
knee: internal roation, knee valgum
hip: internal rotation and pelvis tilts fwd

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15
Q

malalignment of:
excessive anterversion

A
  • toe in
  • subtalar pronation
  • lateral patellar subluxation
  • medial tibial torsion
  • medial femoral torsion
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16
Q

malalignment of:
excessive retroversion

A
  • toe out
  • subtalar supination
  • lateral tibial torsion
  • lateral femoral torsion
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17
Q

malalignment of:
coxa vara

A
  • pronated subtalar joint
  • medial rotation of leg
  • short ipsilateral leg
  • anterior pelvic tilt
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18
Q

malalignment of:
coxa valga

A
  • supinated subtalar joint
  • lateral roation of leg
  • long ipsilateral leg
  • posterior pelvic tilt

think vara and valga - vara is smaller/less letters, so the knees come closer together

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19
Q

open chain: supination of ankle

A

‘IPAD is Superior”
Supination: Inversion, Plantarflexion, Adduction

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20
Q

open chain: pronation of ankle

A

eversion + DF + Abduction

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21
Q

what glide to perform for adhesive capsulitis?

A

posterior-inferior glides

capsular pattern: ER - ABd- IR

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22
Q

for shoulder extension and ER, name the mechanisms (roll and glide)

A

posterior roll
anterior glide

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23
Q

f

for shoulder flex and IR, whats the mechanisms (roll and glide)

A

anterior roll
posterior glide

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24
Q

what glide is used for limited wrist extension

A

volar glide

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25
Q

joint mobilization grades

A
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26
Q

if you want to improve supination at the proximal radioulnar joint, what glide do you perform?

A

anterior glide

prox. RUJ move in oppisitie direction when thinking about convex on concave rull.
think anatomical postion, when you supinate, arm moves posteriorly and with pronation, it moves anteriorly. therefore oppisite = anterior for supination,

also:
pronation = “PPP”
pronattion proximal RUJ, posterior

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27
Q

stage 0 lymphedema

A

latency stage
- no clincal edema, occasional reports of heaviness
- stemmer sign negative
- tissue and skin appear normal

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28
Q

stage 1 lymphedema

A

reversible stage
- edema present (soft and pitting); can go back to normal
- edema increases with standing and activity but REDUCES ON ELEVATION
- stemmer sign negative

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29
Q

stage 2 lymphedema

A

spontaneoulsy irrversible
- hard swelling present
- progresses to non pitting “brawny” edema
- stemmer sign positive
- tissue appears fibrosclerotic; proliferation of adipose tissue

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30
Q

stage 3 lymphedema

A

lymphostatic elephantiasis
- edema is present; severe “brawny” non pitting edema
- stemmer sign positive
- skin changes (papillomas, deep skin folds, warty protrusions, hyperkeratosis, mycotic infections, etc)
- bacterial and viral infections are common

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31
Q

grading scale of edema

A
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32
Q

difference between lymphedema and lidedema

A
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33
Q

lymphedema

proximal =
distal =
pre/post surgery =
lymphatic insufficiency =

A
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34
Q

bandages vs compression garments for lymphedema

A

phase 1- short stretch/low stretch and to be worn 23 hours
phase 2 - compression garments during the day and short stretch at night

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35
Q

what can cause toe drag in swing phase

A

weak DF
PF spasticity
pes equines
weak hip flexors

prosthetic:
- knee lock
- inadequate DF assist
- inadequate PF asisst

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36
Q

what causes circumduction in swing phase

A

weak hip flexors
extensor energy
knee and/or ankle ankylosis
weak DF
pes equines

prosthetic:
- knee lock
- inadequate DF assist
- inadequate PF asisst

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37
Q

what causes hip hiking in swing phase

A

anatomical:
- short contralateral LE
- contralateral knee and or hip flexion contracture
- weak hip flexors
- extensory energy
- knee and or ankle ankylosis
- pes equines

prosthetic:
- knee lock
- inadequate DF assist
- inadequate PF asisst

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38
Q

what causes vaulting in swing phase

A

anatomical
- weak hip flexors
extensor spasticity
pes equines
short contralateral LE
contralateral knee and/or hip flexion contracture
knee and/or ankle ankylosis
weak DF

prosthetic:
- knee lock
- inadequate DF assist
- inadequate PF asisst

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39
Q

too soft heel cushion (soft plantar flexion) =

A

causes hyperextnesion of the knee joint

(think david in high heels)

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40
Q

too hard heel cushion (hard plantar flexion) =

A

excessive knee flexion

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41
Q

what causes lateral heel whip

A

internal rotation of the prostethic knee

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42
Q

what causes medial heel whip

A

external rotation of prosthetic knee

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43
Q
  • meissner corpuscles=
  • krause end bulbs=
  • golgi tendon organs=
  • ruffini endings=
A
  • meissner corpuscles= fin touch/vibration
  • krause end bulbs= kold = cold
  • golgi tendon organs= contractions
  • ruffini endings= hot
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44
Q

clinical presentation:
arterial vs venous insuffiency

A
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45
Q

diabetic ulcers

A

generally located on weight bearing surface of the foot

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46
Q

venous insufficiency ulcers

A

frequently are proximal to the medial malleoli. they are edematous

VENMO: venous medial malleoli

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47
Q

arterial ulcers

A

generally located on the lateral malleoli, distal toes or areas of trauma

ALMA - arterial lateral mall

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48
Q

pressure ulcers

A

result of unrelieved external pressure on an area

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49
Q

heel whips

A

LIME
lateral - internal
medial - external

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50
Q

pressure tolerant areas

A

patellar tendon
medial tibial plateau
tibial and fibualr shafts
distal end

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51
Q

who assures min standards are met in a hospital to maintain accredidaton and safety of patients

A

jahco

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52
Q

who assures min standards are met by rehabiliation centers to maintain accredidaton and safety of patients

A

CARF

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53
Q

paraffin bath

A

temp: 125-127 F
time: 15-20min
used on wrist and hands or feet, irregular body areas, distal extremities
- dip 6-8 times

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54
Q

ultrasound contraindications

A
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55
Q

ergonomic requirments

A
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56
Q

isolation precautions

A
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57
Q

parametric vs nonparametric data

A

parametric= quantitative
interval: temperatue (no true zero)
ratio: ROM (has true zero)

non-parametric: qualitative
nominal: gender
ordinal: MMT

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58
Q

seat height

A

heel to popliteal fold + 2 inches

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59
Q

seat depth

A

posterior buttock along lateral thigh to popliteal fold - 2 inches

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60
Q

seat width

A

widest aspect of buttock or thighs + 2 inches

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61
Q

back height

A

chair seat to axilla - 4 inches (consider any seat cushion and ADD the thickness to final value)

back has 4 lettters, subtract 4

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62
Q

armrest height

A

seat of chair to olecranon + 1 inch (consider cushion)

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63
Q

wheelchair axle position:
- normal axle position

A

in line with shoulder or slightly posterior

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64
Q

wheelchair axle position:
- bariatric patient

A

move the rear wheel axle FWD

think bariatric = fat= fwd

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65
Q

wheelchair axle position:
- B transfemoral amputation

A

move the rear wheel axle behind the patients shoulder

bilateral, B, behing

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66
Q

describe an UMN lesion

A

structures: cortex, brainstem, spinal cord

tone: hypertonia, spasticity

reflexes: hyperreflexia, abdnormal reflexes (babinski, clonus,hoffmans)

sensation: decreased

involuntary movements: mm spasms

voluntary movements: movements in synergic patters

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67
Q

describe LMN lesions

A

structures: peripheral nerves, nerve roots, cranial nerves

tone: hypotonia

reflexes: hyporeflexia or absent

sensation: decreased

involuntary movements: denervation - fasiculations

voluntary movements: weak or absent

68
Q

describe basal ganglia lesion

A

structures: basal ganglia

tone: rigidity (only associayed with basal ganglia)

reflexes: decreased or normal

sensation: normal

involuntary movements: resting tremor

voluntary movements: bradykinesia, akinesia

69
Q

describe a cerebellum lesion

A

structures: cerebellum

tone: decreased or normal

reflexes: decreased or normal

sensation: normal

involuntary movements: none

voluntary movements: ataxia: intention tremor, dysdiadochonkinesia, dysmetria, nystagmus

70
Q

t

types of rigidity

A
  • cogwheel
  • lead-pipe
71
Q

Hoehn and Yahr classification 1

A

minimal or absent
unilateral if present

unilateral = 1

72
Q

Hoehn and Yahr classification 2

A

minimal bilateral or midline involvement

balance is NOT impaired

bilateral - 2

73
Q

Hoehn and Yahr classification 3

A

impaired righting reflexes (balance is affected)

unsteadiness when turning or rising from chair

some activities are restricted, but patient can live independently and continue some forms of employment

B has a backwards 3, b=balance

74
Q

Hoehn and Yahr classification 4

A

all symptoms present and severe

standing and walking possible only with assistance

walker has 4 legs 4th stage

75
Q

Hoehn and Yahr classification 5

A

confined to bed or wheelchair

76
Q

early signs and symptoms of PD

A
  • loss of smell
  • constipation
  • sleep disorders

motor: hypophonia (mono voice); mask like face; micrographia

cardio: orthostatic hypotension, abnormal response to exercises fatigue, weakness

respiratory: restrictive lung diseasse due to decreased chest expansion

cognition/behaivor: difficulty with dual tasking, depresion, dementia

77
Q

compare dyskinesia and dystonia

A

effects of medication- levedopa and carbidopa
- on/off phenomenon: random fluctuations in motor performance and responses

dyskinesia - snake skin - smooth

dystonia - theres already an ‘on’ therefore we want off

  • scheudle PT 1 hour after dose
78
Q

gait in PD

A
  • freezing gait: sudden inability to initiate movement
  • festinating gait: short stride, shuffling, increases speed, anteropulsive; (trying to catcht their BOS so they are usually leaning fwd)
  • decreased step width and length
  • decreased trunk rotation and arm swing
  • en bloc turning
79
Q

unique signs and symptoms with MS

A

1.** lhermitte’s sign:** neck flexion causes electric shock sensation from spine to leg
her-mitt-ee’s
“hair messy” when you perform neck flexion

  1. Uhthoff’s phenomenon: when there’s heat present - pseudo (false) exacerbation < 24 hrs
    U-turn-off
    treat the pt in cold or AM
  2. Charcot’s triad: brain, spinal cord, cerebellum
    “SIN”
    scanning speech
    intention tremor
    nystagmus
  3. Cranial nerve 2
    normally, the pupillary light reflex will constrict when light is infront of the eye. With those with MS, it would cause paradoxically dilate = Marcus Gun Pupil

other things, optic neuritis: inflammation of optic nerve. causes pain and can lead to blindness.

other nerves, CN 2-6 are affected
CN 5= trigeminal neuralgia

80
Q

signs and symptoms of MS

A

spasticity
numbness and paresthesia
nystagmus, coordination, balance, ataxia, intention tremor
scissoring, extenstor spasticity in LE, ataxia, uneven steps
spastic and flaccid bladder
dysphagia and dysphonia (CN 7.9,10)
pseudobulbar affect (abnormal emotional resposne)
diminished attnetion, concentration
fatigue
optic nueritis
trigeminal neuralgia

81
Q

MS types

A

1. relapsing remitting, RR:short duration attacks with full or partial recovery, may or maynot leave lasting symptoms/deficits; MOST COMMON
2. primary progressive: steady increase in disability without attacks/exacerbations
3. secondary progressive: initially RR, then symptoms increase without periods of remission
4. progressive relapsing: steady increase in disability with superimposed attacks

82
Q

MS interventions

A

low intensity- 3-5METS
50-70% VO2max
30min sessions

83
Q

signs and symptoms of ALS

A

UMN and LMN presentation without sensory loss
- mm atrophy, fasiculations (LMN)
- spasticity, hyperreflexia (UMN)
- dysphagia, dysarthria (bulbar) ((LMN))

only motor neurons will be affected
dementia, attn deficits
pseudobulbar affect - emotional lability
c/s extensor weakness
respiratory mm weakness

84
Q

signs and symptoms of GBS

A

AKA acute inflammatory demyelinating polyradiculoneurpathy

LMN

distal to proximal weakness

sensory: glove and stocking; burning, tingling, numbess

decreased reflexes/areflexia

respiratory and cranial nerve involvement: 7, 9,10, 11, 12

fatigue

85
Q

difference between cushings disease and cushings sydrome

A

cushings disease= comes from PITUITARY
cushings syndrome = comes from ADRENAL GLAND

86
Q

addisons disease

A

insuffiency of aldosterone and cortisol

Mrs. Addison - thin brown old lady walking with a stick

87
Q

cushings disease

A

Mr. Cushing’s: white chubby man that is lying in bed/lazy and loves chugging beer

elevated cortisol and aldosterone
- increased BP, water retention
- hyokalemia
- increased glucose
- ruddy appearance, straie on skin
- weight gain
- centripetal obesity
- round moon face
- proximal mm weakness and atrophy
- increased susceptibility to infection
- osteoporosos (buffalo hump)
- poor wound healing

adrenal cortex: cortisol and aldosterone

think Mr. Cushings - white chubby man that loves chugging beer

Ruddy appearance- that their face is a reddish colour, usually because they are healthy or have been working hard, or because they are angry or embarrassed.

88
Q

hashimoto’s disease

A

autoimmune disease of hypothyroid

89
Q

hyperthyroidism

A
90
Q

hypothyroidism

A
91
Q

examples of hypo/hyper thyroidism

A

hypo: hashimoto’s, myxedema

hyper: graves, exophthalmos

92
Q

hyperparathyroidism

A

elevated calcium and decreased serum phosphate

calcium and phosphate are inversly related

  • can demineralize bone making bones weak and decreasing its density

symptmosm:
- osteopenia
- gout
- arthalgia
- kidney stones
- renal insufficiency
- peptic ulcers
- proximal mm weakness
- fatigue
- depression
- cofusion
- drowsiness
- glove/socking sensory loss

BONES: osteopenia, brittle, arthralgia, uric acid
STONES: kidney. renal insuffiency
GROANS: peptic ulcers
MOANS: fatigiue, depression, mm weakness
SENSORY LOSS: hands and feet

93
Q

hypoparathyroidism

A

low calcium and high phosphorus

symptoms:
- convulsions
- cardiac arrythmias
- mm twitching
- tetany
- mm cramps
- mm spasms
- paresthesia of fingertips and mouth
- fatigue
- weakness

“CATS are Numb”
convulsions
arrythmias
twitches/tetany
spasms

numbness of fingertips

94
Q

how to diagnose DM

A

fasting glucose > 126+
random blood glucose 200+
HbA1c >6%

95
Q

hypoglycemia

A

cold and clamy give them candy

96
Q

hyperglycemia

A

hot and dry - sugar is high

97
Q

DM and exercise

A
98
Q

what are changes with CVS with pregnany

A

blood pressure is low in the 1st-2nd trimester and increases in the 3rd

no supine after 1st trimester

resting HR increases by 10-20bmp

HRmax will decrease

lest sidelying is considered the bets as it decreases compression IVC, maximizes CO, decreases GERD as internal organs are relaxed and improves maternal and fetal circulation

98
Q

supine hypotensive syndrome

A

symptoms: dizziness
nausea
fainting

supine lyinng can cause decompression of inferior vena cava (after month 4). this declines CO

98
Q

what happens with respiration and pregnany

A

respiration depth increases but the rate remains the same

99
Q

typical pain pattern in the RUQ

A

peptic ulcers
gall bladder
head of pancreas

100
Q

typical pain pattern in the RLQ

A

appendix
crohns disease

101
Q

typical pain pattern in the LLQ

A

diverticulitis
ulcerative colitis
IBS

LLQ, Lou DUI, lou is short so lower quadrant

102
Q

whats seen in the LUQ

A

tail on pancreas
spleen

103
Q

cholecystitis

A

blockage or impaction of gallstone in the cystic duct resulting in inflammation of gallbladder

  • pain in RUQ, radiaitng to R scapula
  • n/v
  • low grade fever
  • pain icnreases with ingestioin of fatty food

special tests: murphys sign
palpate near R subcostal margin as pt takes deep breath- if pin and tenderness is elicited during inspiration, test is +

104
Q

elaborate the levels of evidence
strong to weak

A

meta analysis
systemic review
RCT
cohort study
case control study
cross sectional study
case report/series

105
Q

type 1 error

A

false positive

106
Q

type 2 errors

A

false negative

107
Q

example of face validity

A

survey

weak form; does not consider gold standard

“what does the test appear to be”

108
Q

strongest form of validity

A

concurrent

its compared to the gold standard

109
Q

cross sectional studies look at what

A

diagnostic

110
Q

RTC are good for what

A

interventions

111
Q
A
112
Q

dependent v independent variable v covariate

A

dependent: the outcome or variable of interest in the study

independent: variable that is manipulated or chnaged by the researcher to observe its effect on the dependent variable

ex: the effect of the intervention on step length

intervention = independent
ROM= dependent
covariate = heights height (can influence step length)

113
Q

compare parametric and non-parametric

A

parametric:
- more powerful
- bell shaped, normal curve
- equal distribution
- quantitative data

non parametric
- unequal distribution
- non-normal distribution
- qualitative
- less powerful

114
Q

at what level is near normal respiratory function at

A

T11 and below

115
Q

spastic bladder

A

above t12

intervention: suprapubic tapping

116
Q

flaccid bladder

A

below t12

valsava or crede manever

117
Q

mm associated with different levels of SCI

c5

A

elbow flexors

118
Q

mm associated with different levels of SCI

c6

A

wrist extensors

119
Q
A
120
Q

mm associated with different levels of SCI

c7

A

elbow extensors

121
Q

mm associated with different levels of SCI

c8

A

finger flexors

122
Q

mm associated with different levels of SCI

t1

A

finger abductors

123
Q

mm associated with different levels of SCI

L2

A

hip flexors

124
Q

mm associated with different levels of SCI

l3

A

knee extensors

125
Q

mm associated with different levels of SCI

l4

A

ankle df

126
Q

mm associated with different levels of SCI

l5

A

bigtoe ext

127
Q

mm associated with different levels of SCI

s1

A

ankle pf

128
Q

what levels of SCI would be considerd
- dependent
- mod. dependent
- independent

A
  • dependent = c1-4
  • mod. dependent= c5-6
  • independent= c7 and below
129
Q
A
130
Q

what level of SCI can independently transfer with slideboard on even surface?

A

c6

131
Q

what level of SCI can dependently transfer with slideboard on even surface?

A

c5

132
Q

what level of SCI can independently transfer with slideboard on uneven surface?

A

c7-c8

133
Q

what level of injury may be able to transfer from floor to wc?

A

c8

for sure t1

134
Q

what level of injury can independently propel with wc on even surfaces

A

c7

135
Q

what level of injury can independently propel with wc on uneven surfaces

A

c8

136
Q

ASIA A

A

complete

no motor or sensory function at S4-5

137
Q

ASIA B

A

sensory but no motor present below level and s4-5 present

138
Q

ASIA C

A

they have sensory and motor

majority below the lesion are <3/5 (more than half)

139
Q

ASIA D

A

both sensory and motor

majority of the mm below are greater than 3/5 (half or more)

140
Q

symptoms of AD

A

increase BP (20-30)
decrease HR
severe HA
anxiety
constricted pupils
blurred vision
flushing, piloerection (goosebumps) above level of lesion
dry pale skin below lesion
increased spasticity

141
Q

symptoms of pre-eclampsia

A
  • increase in protein in urine
  • hyperreflexia
  • edema
  • HA
  • sudden weight gain
  • BP in excess of 140/90
    second BP reading 4 hours later, confirms dx
142
Q

treatment for diastasis recti

A

head lift
head lift with pelic tilt

greater than 2cm = diastasis recti

143
Q

when does BP change with pregnancy

A

decrease 1-2 trimester
increase on 3rd

144
Q

GERD

A
  • heartburn 30min after eating and at night lying down
  • dysphagia (difficulty swallowing)
  • sour taste
  • hoarness in voice
  • atypical pain of the head and neck

lower esophagueal sphincter

145
Q

referral pattern to midback and scapula

A

esophagus
gall bladder
stomach
pancreas

146
Q

referral pattern to shoulder

A

R: gall bladder, liver, head of pancreaus

L: heart, diaphragnm splee, tail of pancreas

147
Q

what tumor mimics TOS

A

pancoast tumor (upper lung tumor)

148
Q

RUQ pain

A

peptic ulcers
gall bladder pathology
head of pancreas

149
Q

LUQ pain

A

tail of pancreas
spleen pathology

150
Q

RLQ pain

A

appendix
chrons

151
Q

LLQ

A

DUI
diverticulitis
ulcerative colitis
IBS

152
Q

what kind of hernia occurs when the diaphragm is weak

A

hiatal

which can cause shoudler pain and symptoms are similar to GERD

153
Q

types of peptic ulcers

A
  • gastric ulcer
  • duodenal ulcer
154
Q

what are characteristics of peptic ulcers

A

coffee ground emisis (vomit) and melena tarry stools

155
Q

when do you notice gastric ulcers

A

pain icnreases with the presence of food due to acid secretion

pain after eating

pain relieved by anatcid and/or clearing infection

156
Q

duodenal ulcers

A

pain increases with the absence of food, early mornings and in between meals

157
Q

ulcerative colitis

A

only in large intestine and rectum

  • rectal bleeding/pain
  • bloody diarrhea with mucus and pus
  • fecal urgency
  • weight loss
  • lbp
158
Q

chrons disease

A

can occur anywhere in GI tract

  • pain relieveed by farting/pooping
  • abdominal pain
  • weight loss
  • joint arthritis
159
Q

reiters syndrome

AKA reactive arthritis

A

“cant see. cant pee. cant climb a tree”

conjunctivitis
urethritis
knee OA

160
Q

irritable bowel syndrome

A

spastic, nervouse or irritable colon
causes: emotional stress, anxiety, high fat, lactose foods

  • pain is relieved by defecation
    *- sharp cramps in the AM or after eating *
  • n/v
  • bloating
  • foul breath
  • diarrhea
    - ribbon like stools
161
Q

appenicitis

A
  • pain in RLQ
  • comes in waves
  • progressing to steady
  • anorexia
  • n/v
  • elevated temps
  • leukocytosis
  • fever

special tests:
mcburneys
rovsings
blumbergs

162
Q

in what phase do the plantar flexors work concentrically

A

pre swing only

163
Q

what phases does the ankle move into DF?

and what phases does it work concentrically?

A

move:
mid stance 5deg
terminal stance 10-15deg

concentrically:
mid stance 5deg
terminal stance 10-15deg
inital swing
mid swing

Final Frontier (20 decks)

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