Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Musculoskeletal System > Rehab > Flashcards

Rehab Flashcards

1
Q

Physiatrist or Rehab Physician

A

specialize in FUNCTION

practical approach to patient care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Common Physiatric subspecialities

A 
acquired brain injury
spinal cord injury
sport's medicine 
pain management
pediatric physiatry
palliative care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Spinal cord injury -> paraplegia

A

not necessarily restoring function

but improve function within his or her limitations or restrictions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Goals of Rehab

A
  1. Function (FIM)
  2. Independence (Oswestry Disability Index)
  3. Quality of Life (SF-36)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute Rehab facility

A

must show how much progress patients made

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

FIM score

A

Functional Independence Measurement

  • used to measure progress of functional skills
  • can be used for outcome predictor: 1. LOS 2. prognosis 3. discharge destination
  • Rehab dependent of many subjective, non-measurable factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

FIM Score interpretation

A

over 90 - patient goes home

below 40 - go to nursing home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ADLs

A

Dressing
Eating
Ambulating - must ambulate otherwise will lead to DVTs, osteoporosis, etc.
Toileting/Transfers
Hygiene - leads to skin breakdown, cellulitis
ask at bedside !!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Loss of independence

A

Impairment - any loss of abnormality of physiologic, psychological, or anatomic structure or function
Disability - restriction due to impairment in the ability to perform an activity within the range of what is considered “able bodied”
Handicap-???

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

radial nerve palsy

A

disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

impairment for RNP

A

wrist drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

disability for RNP

A

inability of the work as surgeon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

handicap for RNP

A

job loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

60/40 rule

A

average of 60% its admitted to acute inpatient rehab needed one of the impairment categories per Medicare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Functional deficits

A

2/2 pain, immobility, cognitive dysfunction, communication disorder, motor deficit
NOT SAFE TO RETURN TO PREVIOUS LIVING ARRANGEMENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Medical necessity

A

controversial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

functional improvement

A

for > 3 wks
Dx
Premorbid status
ability to tolerate/particopate 3hr/daily, 5 days/weekly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Members of the Rehab team

A 
Physiatrist 
PT
OT
Speech therapy 
neuropsych
Rehab nursing 
social worker
patient/social supports
MOST IMPORTANT IS COMMUNICATION!!!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Normal gait patterns

A

focus on one leg
5 parts of the stance phase
3 parts of the swing phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Gait cycle

A

stride

functional unit of gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

step length

A

distance b/n both heels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

stride length

A

distance b/n heel of same foot after two steps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

gait analysis

A

faster the walk, the 80% (single limb support) goes up to 100% (person is running, jogging)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

speed for gait

A

length per time
most energy efficient and comfortable
walking speed = 3 mph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Stance phase

A 
I Like My Tea Presweetened
Initial contact
Loading response
Midstance 
terminal stance 
preswing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Eccentric contraction

A

muscle tenses while it lengthens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Length-tension relationship

A

reason for sprains for runners
Heel strike - hamstrings max contracts while greatest length
if not trained, will get sprains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Swing phase

A

In My Teapot
Initial swing
mid swing
terminal swing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

8 most common gait dysfunctions

A 
Antalgic
Trendelenburg
Steppage 
vaulting 
circumduction 
genu recurvatum 
ataxic 
festinating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Antalgic gait

A

stance phase abnormally shortened relative to the swing phase
shortened the amount of time on the leg that hurts
circumduction is possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Bilateral tendelenburg gait (uncompensated)

A

myopathic gait

=result in waddling type gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

compensated trendelenburg gait

A

patient leans the trunk on the side that hurts
so that contralateral pelvis does not drop
=pts with osteoporosis

Proximal (pelvis) problem!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Foot drop

A

fibular head fx can result in common fibular n. dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Foot slap

A

tibalis ant. has mild strength deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

steppage gait

A

uses proximal m. to hip hike

hip flexes to clear the foot with the foot drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

vaulting

A

good leg is excessively plantar flexing to allow toes of swing leg to clear the ground

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

circumduction

A

swing leg excessively hip abducts so that the toes of swing leg can clear the ground

WIDE ARCH is seen

can also circumduct in antalgic gait

38
Q

genu recurvatum

A

weak quads or limited ankle dorsiflexion/excessive plantar flexion

BACKABENDING OF KNEE CAUSING EXCESSIVE EXTENTION AT THE TIBIOFEMORAL JOINT
dorsiflexion stretched gastrocnemius causing knee flexion movement at knee???

39
Q

ataxic gait - DRUNKEN APPEARANCE

A

seems like don’t know where in space

unsteady, uncoordinated walk, employing a wide base and the feet thrown out. seen with cerebellar pathology

40
Q

Festinating gait

A

Parkinson’s patient

Involuntary advancement of legs with short, accelerating steps often on tiptoes (shuffling)

41
Q

Limb innervation

A

PROXIMAL TO DISTAL GRADIENT INN: brachial plexus - C5-6 : shoulder girdle
C8-T1 - hand
OVERLAPPING: Elbow flexion - C5-6 (even some C7)
patellar MSR - L4 (some L3)

Limb=extremity = arm/leg

42
Q

Manual muscle testing

A

LMN and UMN

43
Q

LMN

A

anterior horn cell -> root-> plexus-> branch ->NMJ -> muscle

44
Q

UMN

A

corticospinal tract -> anterior horn of spinal cord

45
Q

Key dermatomes

A

UL : C5-T1

LL: L2-S1

46
Q

Manual muscle testing grading scale

A

Dont confuse this with true neurological deficits
5/5, 4/5, 3/5, 2/5, 1/5, 0/5
e.g. neck and back pain radiates to the limbs -> pain inhibition function (not a true weakness of the muscle)

47
Q

MMT UL and LL

A 
C5
C6
C7
C8
T1
L2
L3
L4
L5
S1
48
Q

Muscle stretch reflexes

A

muscle spindle (sensory reflexes) in skeletal muscles are stimulated by stretch, causing a nonosynaptc reflex contraction of that same muscle

49
Q

Grading reflexes

A

indicative of hyperreflexia when other tendons are active when only one tendon is strikened
reflex will be 3 = hyperactive without clonus

50
Q

Clonus

A

rapid alternating contractions and relaxations of muscle after forced stretch

51
Q

UL reflexes

A

biceps
brachioradialis tendon
triceps tendon

52
Q

LL reflexes

A 
patellar tendon 
medial hamstring (unreliable)* - pt with ipsilateral below-knee amputation (no L5 dermatome test) = will work for asymmetry when one hamstring is missing? 
archilles tendon
53
Q

Sensation testing: light touch

A

wisp of cotton, gauze, fingers

54
Q

sensation testing: pain

A

differentiating sharp and blunt ends of safety pin

55
Q

dermatome deficit

A

side to side demarcation

56
Q

sclerotome (cervical)

A

regional area of pain

57
Q

cervical spine disc herniation

A

C6 impingement

foraminal, posterolateral, and central

58
Q

lumber spine disc herniation

A 
L5-S1 - L5 root emerges but only forminal herniation will affect it 
Posteriolateral herniation (lateral recess?) and central herniation - S1 root and/or below
59
Q

posterolateral disc herniation

A

can result in herniate into the subarticular zone or lateral recess

60
Q

3 reasons why posterolateral herniations are common

A
  1. lack PLL
  2. posterior annulus is thinner than the anterior portion due to nucleolus pulpous being located posterior
  3. flexion is the predominant motion of the lumber spine resulting in the posterior annulus receiving most repetitive tensile and shear stresses
61
Q

disc herniation into the thecal sac

A

no spinal cord below L2-L3

only spinal cords are impinged

62
Q

Pathological tests

A

Babinski
Oppenheim
Chaddock
Hoffman

63
Q

Brabinski

A

lateral plantar aspect of foot is stroked with blunt object causing dorsiflexion of great toe and fanning of other toes

64
Q

Oppenheim

A

downward pressure on tibia causing great toe dorsiflexion

65
Q

Chaddock

A

stroking lateral foot causing great toe dorsiflexion

66
Q

Hoffman

A

hand pronated with passive D3 MCP hyperextension
DIP is passively flexed and suddenly released, causing thumb flex/add. and flexion of other fingers.
Most meaningful when correlated with MMT

67
Q

Low back pain

A

recurrent for life

self-limiting

68
Q

Proper Dx

A

nonspecific diagnoses -> nonspecific treatments-> nonspecific outcomes

must do Hx first
then Dx

69
Q

Lumbago (LBP)

A

is a symptom not a Dx

70
Q

Facet joints

A

1/3 of the pain generator

71
Q

DDx

A 
Mechanical
discogenic
SIJ mediated
Facet joint
fracture
infection
cancerous 
medical causes 
piriformis syndrome
spinal stenosis
Somatic dysfunction (TART is the criteria) - overlap with primary pain generators
72
Q

Mechanical low back pain

A

axial and multifactorial nature
RESULT FROM POSTURE/EXERCISE
MOST OF THE TIME IT IS THE JOINT , NOT NECESSARILY A MUSCLE

73
Q

acute back pain

A

MAY NOT HAVE NO LONG TERM CONSEQUENCES

74
Q

Discogenic

A

don’t need to have disc herniation

long lasting 
dull and vague pain 
morning stiffness 
axial unloading - lean off to the side (weight off the disc)
better with laying down 
relieved with walking
75
Q

straight leg raise

A

dural tension sign

sciatic n.

76
Q

SI mediated

A

pain over PSIS = Fortin Finger sign

iliolumber ligament is important

77
Q

Iliolumber ligament

A

MAINTAIN SI JOINT
MOST RESTRICTING MOVEMENT
attach to the transverse processes of L4-L5?

78
Q

Fortin sign test

A

more reliable than faber test, yeoman’s test

no tenderness = not the source of pain

79
Q

posterior pelvic pain provocation test

A

highest sensitivity
start with this in PE
assess the SI joint dysfunction or sacroiliolitis
pain over PSIS reproduced = POSITIVE TEST

80
Q

Decision tree

A

copy from lecture

81
Q

Facet joint mediated

A

TTP over transverse processes to rarely below the knee; never goes below the knee
sclerotomal referred pain
pain with extension and rotation

82
Q

Medial branches of the dorsal rami

A

medial branches of L4 = inferior portion of the facet joint
medial branch of L5 = superior portion of the face joint

every medial branch innervate corresponding facet joint
e.g. L4-5 facet joints are inn. by L3 and L5?

83
Q

Spinal stenosis

A

dont rely on imaging
go in order: Hx -> PE -> imaging
not necessarily back pain

84
Q

spondylosis

A

Fx - pars articularis
translation of the bodies
step-off sign - spinal processes will dip off
low back pain is present

L4/L5 facet fx
L5 is affected

85
Q

Tx of LBP

A

specific dx -> specific tx -> specific outcomes

86
Q

Global finding

A
  1. neck and low back - if there is one area of the spinal stenosis from disc herniation
  2. dont do HVLA
87
Q

progressive neurological deficit

A

get imaging

88
Q

infection and malignancy

A

low back pain at night

89
Q

pain and problem urinating

A

prostate cancer

90
Q

PT

A

if patient will be more compliant

OR discogenic herniation

91
Q

multimodal

A

low back pain

tx with many different modalities synergistically

92
Q

Epidural injections

A
  1. transforminal - through the nerve sheet - goes to the PLL and posterior annulus
  2. interlaminar
  3. caudal

Musculoskeletal System (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions