Session 3

Question 1

normal range for WBC?

Answer 1

5-10 thousand is the general range.

Question 2

normal range for platelets ?

Answer 2

150,000-400,000 range cells/mm3

Question 3

what is the range for heemoglobin?

Answer 3

12-18 range g/DL
(hematocrit is 3x the amount of hemoglobin. )
(for TKA remeber 10 and 30. hemoglobin below 10 and hematocrit below 30)

Question 4

normal range for hematocrit?

Answer 4

38%-55%

hemoglobin <8 you should probably wait to ambulate.

Question 5

what percentage of effort would be accurate is a person reports a BORG of 14?

Answer 5

75%.
(multiply the borg # by 10, should approximate the heart rate)
(9=50%)
(goes up by 5% for each number after)

Question 6

a patient reports having tremors, heart arrythmias an cannot sleep at night. ALso reports polyuria and increases hair loss with heat intoleranace. What is the following condition?

Answer 6

Hyperthyroidism.

Question 7

an individual has increased pigmentation, weakness, weight loss, salt cravings, dizziness with standing, and hypoglycemia. what condition do they have?

Answer 7

addisons disease (adrenal hypocortisolism)

Question 8

is a person has moonface, buffalo hump, protuberant abodomen, and osteoporosis they have what condition?

Answer 8

cushing syndrome (adrenal hypercortisolism)

Question 9

what is graves disease?

Answer 9

hyperthyroidism

elevated body metbolism
heat intolerance
weight loss
polyuria
tremors/anxiety

Question 10

patient with history of CAD, is taking metoprolol to improve heart function. What would you see on the ECG?

Answer 10

increased PR interval.

Question 11

what is metoprolol and how does it work?

Answer 11

its a beta blocker. given for high blood pressure and angina (chest pain)
- beta blockers block the beta adrenergic receptors of the heart, decreasing sensitivity to floating catecholamines like EPI or NOREPI. thus the PR interval will be increased (meaning a slower heart rate).

Question 12

What is an increased PR interval called?

Answer 12

1st degree heart block

Question 13

what is preload?

Answer 13

left ventricular end diastolic pressure

Question 14

what is afterload?

Answer 14

systemic vascular resistance

how hard the heart has to push to get blood out into the vasculature

Question 15

what is normal ejection fraction?

Answer 15

normal is above 55%

Question 16

what condition would an individual be put on warfarin?

Answer 16

A-fib. this thins the blood and stops any type of blood clotting in the heart.

Question 17

if an individual with bells palsy has trouble closing their eyes, what muscle could be involved and what nerve?

Answer 17

orbicularis oculi and facial nerve CN VII

Question 18

if an individual with bells palsy has trouble opening their eyes what muscles could be involved and what nerve?

Answer 18

levator palpebrae, oculomotor nerve CN III

Question 19

what is the main difference between bells palsy (CNVII) and trigeminal neuralgia (CN V)?

Answer 19

palsy is about weakness and numbness

neuralgia is more about pain. also jaw and corneal reflex will be absent

neuralgia can be exacerbated with stress or cold while bells palsy will be exacerbated by use of muscles.

Question 20

what is the difference between CVA and bells palsy in terms of

1) onset
2) facial paralysis
3) weakness
4) sensory changes

Answer 20

CVA has more acute onset versus bells which is hours to days

2) CVA effects lower facial ms more than upper facial muscles. BElls is full hemi facial paralysis
3) CA will results in extremity weakness versus bells which results in CN VII damage (wont be able to close their eyes)
4) with CVA you will have the 4 D’s (dizziness, diplopia, dysarthia, dysphasia) and with bells you will have limited to no sensation changes

Question 21

Differential diganosis between osgood-schlatter disease and patellofemoral syndrome

Answer 21

Osgood-Schlatter disease (OS) is an overuse injury causing pain in the knee area and often a visible growth just below the kneecap to appear. OS occurs when there is irritation to the top, front portion of the shin bone (tibia) where the tendon attached to the kneecap (patella) meets the shin bone. This irritation at the attachment sit of bone and tendon is most often a consequence of excessive stress to the front of the knee during periods of rapid skeletal growth. Adolescents are most commonly affected by OS because they experience the greatest rate of skeletal growth. OS is most frequently experienced in adolescents who regularly participate in sports related activities.

Patellar tendinitis is comparable to Osgood Schlatter’s Disease but occurs in adults and is an injury to the tendon connecting your kneecap (patella) to your shinbone. The patellar tendon works with the muscles at the front of your thigh to extend your knee so you can kick, run and jump. Patellar tendinitis, also known as jumper’s knee, is most common in athletes whose sports involve frequent jumping, such as basketball and volleyball. However, people who don’t participate in jumping sports can get patellar tendinitis as well. For most people, treatment of patellar tendinitis begins with physical therapy to stretch and strengthen the muscles around the knee.

Question 22

what is Sinding Larsen Johansson syndrome (SLJS)

Answer 22

osteochrondrosis and tracction epiphysitis affecting the extensor mechanism of the knee which disturbs the patella tendon attachment to the inferior pole o the patella. Tenderness of the inferior pole of the patella is usually accompanied by x-ray evidence of splintering of that pole.

most patient with SLJS also show a calcification at the inferior pole of the patella.

Question 23

A person with weak qauds after back surgery, what would you see during their gait during initial contact through the loading response.

Answer 23

Forward trunk flexion. weak quads means that the normal loading response is altered. The patient could not tolerate any knee flexion or they would collapse to the floor. Thus, they will lock the knee, and the easiest way to prevent the quads from firing is to shift the body weight forward onto straight leg, relying on the passive structures of the knee to maintain the extension, rather than relying on quadricep strength.

Question 24

patient fitting for an AFO, upon observation the therapist notes that there is moderate to severe genu recurvatum with stand phase on the affected side. Which of the following will most likely decrease the amount of hyperextension?

Answer 24

plantarflexion stop
the combined movements are: 
1) dorsiflexion and knee flexion
2) plantarflexion and knee extension
3) think about the pull on the gastroc muscle.

Question 25

what is the cutoff for blood sugar for the APTA before you discontinue exercise

Answer 25

less than 60 no therapy at all.

70 or more you have to be cautious