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Treatments 5 (H's version) > Shannon's Review for Midterm > Flashcards

Shannon's Review for Midterm Flashcards

1
Q

What are different Blood Pressure Values?

A 
Normal: 120/80
Hypotension: 90 or less/6o or less
Prehypertension: 130-139/85-89
Stage 1 (mild): 140-159/90-99
Stage 2 (moderate): 160-179/100-109
Stage 3 (severe): 180-209/110-119
Stage 4 (very severe): 210+/120+
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2
Q

What is Hypertension?

A

High BP

elevation of BP above normal for prolonged period of time

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3
Q

What is Primary Type of Hypertension and it’s sx/sx

A

Idiopathic/essential
silent, long term condition
90-95%

sx/sx:
Silent killer
Could have dizziness, headaches, nausea, blurred vision, fatigue, leathery, nose bleeds, mild edema, nocturne, tinnitus, exertion dyspnea

Complications:
Chronic, slow, progressive damage to vital organs
atherosclerosis
death in 20-40 years
aneurysms formation/rupture
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4
Q

What is Secondary Hypertension? Sx/SX?

A

Secondary to another condition
Kidney disease, vascular disease, adrenal dysfunction (Tumour) eclampsia

SX/Sx:
Nosebleeds, severe headaches, double vision, considerable edema, nausea/vomiting, personality changes, severe tinnitus, convulsions, emotional changes, coma

Complications:
Death in few days to few years
damage to blood vessels
Onion skinning
other pathological changes in BV
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5
Q

Risk factors of Hypertension?

A 
45+
Family history
Smokers: double risk
Diabetes
Races of darker skin
Men over Women (until menopause then equal)
Pregnancy
People with high stress levels
high sodium/alcohol intake
Taking Oral Contraceptives (birth control)
Obesity
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6
Q

Different classifications of BP meds?

A

Diuretics: reduce SNS effects on vascular smooth mm
Angiotensin-converting enzyme inhibitors: Reduces Vasoconstriction
Beta-Blockers: inhibit action of SNS on vascular smooth mm causing vasoconstriction
Calcium channel blockers: reduce tone in venous/arterial smooth mm and reduce cardiac output by inhibiting movement of calcium into cardiac, and smooth mm
Vasodilator drugs: To decrease peripheral resistance through relaxation of smooth mm of arterioles

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7
Q

What is Congestive Heart Failure?

A

Hearts inability to pump sufficient blood to supply body’s needs
Can be secondary to heart disease, chronic high BP

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8
Q

Risk factors for CHF?

A

Myocardial infarctions: Ischemic Heart Disease: Cardiomyopathy
Hypertension
cigarette smoking: Obesity
Diabetes
Exacerbating factors: stress, fever, anemia, etc

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9
Q

Classes of CHF?

A

Class 1: no limitation experienced in activities; no symptoms from ordinary
Class 2: slight, mild limitation of activity patient is comfortable at res/mild exertion
Class 3: marked limitation of activity; patient comfortable only at rest
Class 4: any physical activity brings on discomfort and symptoms occur at rest

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10
Q

What is the difference between L&R ventricular failure?

A

Left:
Pulmonary congestion and edema; more located with the lungs
Hacking cough with frothy bloody sputum

Right:
Ceneralized edema distal to heart; including lower lips
impaired liver function and possible enlarged spleen
Breathing is affected less

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11
Q

Warning signs of cardiac distress?

A 
Increased heart rate
rapid pulse
laboured breathing
sweating or clamminess of skin
extreme facial flushing (red/purple)
tissue bigness and edema post massige
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12
Q

CI’s for Hypertension and CHF?

A

Severe hypertension, complicating pathology, non-compliant clients, and CHF, you must need a physician check with treating
Prolonged painful techniques
Vigorous stimulating techniques/repetitive long broad techniques
prolonged rotation of neck/simultaneous bilateral neck treatment
repetitive full ROM
full body MLD
prolonged elevation of arms/legs above heart
Prone position must be limited
full-body/extreme hydrotherapy or hydro to chest, back, neck
some essential oils (Rosemary, sage, thyme, cypress, etc)

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13
Q

Treatment modifications that are taken for Hypertension and CHF?

A

Depends on the severity of the hypertension
BP must be monitored before/after tx
Work distally to proximal
positioning modifications
hydrotherapy modifications
technique modifications: stimulating techniques, painful, etc
segmental back treatment

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14
Q

What are the appropriate positions for Hypertension types and CHF?

A

Prone: limited to 10 mins, no ab pillow
Supine; 2 or more pillows under head
Side-lying: left side up

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15
Q

Homecare for Hypertension and CHF?

A

Relaxation techniques such as yoga, meditation
gentle modified exercising (mild to mod of aerobic exercise)
Swimming, walking
improved diet
essential oils: Marjoram, Ylang Yland, Lavender, Lemon

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16
Q

What is Hypotension?

A

Decrease in systolic/diastolic BP below normal

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17
Q

Precautions for Hypotension?

A

Assisting client off table to prevent injury
Encourage gradual movement to standing position
Have client sit at edge of table and move legs to assist in skeletal mm contraction to normalize blood flow
educate excessive use of diuretics, loss of builds and situations encouraging vasodilation

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18
Q

What are varicose veins?

A

Distended/dilated abnormally large, elongated and bulging veins
leads to venous insufficiency

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19
Q

What veins are primarily affected by varicose veins?

A

Great Saphenous Vein

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20
Q

Types of varicose veins?

A

Primary: varicosities which originate in superficial veins
Secondary: varicosities reuniting from impaired flow in deep venous channels

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21
Q

Causes of varicose veins?

A

Habits impairing circulation (prolong sitting/standing, legs crossed, tight clothing)
Increase pressure on pelvic veins
Secondary; due to impaired/blocked blood flow
(DVT, pregnancy)
Vit C deficiency
Can have family tendency

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22
Q

SX&SX of varicose veins?

A 
Enlarged/bulging veins
Bluish veins, appearing lumpy
tortuous pain
prominent veins when standing
asymptomatic or cause dull achy pain
edema around ankles and lower legs
itchiness on/around affected veins
heavy, fatigues feeling of legs
nocturnal leg cramps (calf mm)
skin is shiny, bluish brown
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23
Q

CI”s for Varicose Veins?

A

Deep specific techniques over varicosities/local tissue appearing dystrophic
massaging directly over swollen, tortuous/painful veins
massaging over esophageal varicosities
CI’D local massage within 24 hrs of tx
open wounds
anticoagulant meds
MT to legs if no previous diagnosis but presenting with DVT symptoms

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24
Q

Treatment approach for varicose veins?

A

Elevative legs
Cool hydro
MLD to redirect fluid (move towards heart)
Decrease Pain with relaxing GSM
Light pressure techniques
increase ROM of affected joints, mm strength, etc

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25
homecare for Varicose veins?
Encourage client to check with MD Education on; wearing looser clothing, prolonged periods of sitting/standing, sleeping with feet elevated care to not scratch skin over varicosities maintain food foot care standing in cold foot bath self-massage AF ROM (drawing alphabet with ankles) Elevate legd at least 3 times a day for 10 mins
26
What is Thrombophlebitis?
Inflammation of superficial or deep vein that leads to formation of thrombus
27
What are the CI"s for Thrombophlebitis treatment?
NO TREATMENT- REFER OUT
28
SX/Sx of thrombophlebitis?
``` Heat Redness Swelling Deep mm pain Fever General malaise, pain discomfort (described as localized, deep, aching, cramping and throbbing) Worse with activity Can be asymptomatic Pulmonary Embolism SX ```
29
SX/SX of pulmonary embolism?
``` Extreme distress Dyspnea sharp localized chest/sternal pain general chest discomfort distension of veins of neck person may collapse or go into shock ```
30
What contributing factors can cause thrombophlebitis
``` Age 40+ fracture of lower limb prolonged immobilization cardiac failure, stroke, heart disease anesthesia/surgery trauma previous history of venous disorder pregnancy/postpartum oral contraceptives diabetes mellitus cancer clotting disorders ```
31
Special test that can determine DVT?
Homan's | If acute, refer out
32
Differences between Raynauds disease and phenomenon?
Disease: Arterial spasms Primary, is caused without reason (idiopathic) Usually more common in women Phenomenon: Peripheral vascular disorder Secondary, caused from underlying condition
33
SX/Sx of disease vs phenomenon?
``` Disease: In Young women Idiopathic Wrist pulses present/normal None-min trophic tissue change ``` ``` Phenomenon: Affects women and men equally secondary to another condition ulnar/radial pulses may be obstructed severe trophic tissue changes ``` ``` The same: affected by cold/emotion Triphasic/Biphasic color change 15-45 mins episodes doesn't progress past MCP/affect thumb Paresthesia during attack, some throbbing as circulation returns Pain not symptom ```
34
Causes of disease/phenomenon?
Disease: Idiopathic Phenomenon: Obstructive arterial disease: arteriosclerosis, burgers, TOS connective tissue disorder: lupus, RA, scleroderma drug side effects: Beta-blockers, decongestants, etc trauma neurogenic lesions myoedema pulmonary hypertension
35
CI's for Raynauds?
``` Cold hydro extremes of temp stimulating/painful techniques deep techniques around affected area frictioning limbs hanging off table ```
36
What does COPD stand for?
Chronic Obstructive Pulmonary Disorder
37
What are CI's for Chronic Bronchitis?
``` Fever, infection Osteoporosis is a precaution Meds can alter clients sensation to pain people with sever asthma need tx altered some positions no overstimulating joint play with hypermobility postural drainage with several conditions: blood in sputum, etc exhausting client thyme essential oil if pregnant no increase in daily water if cardiac/renal disorders ```
38
What is Chronic Bronchitis?
Condition of production of purulent sputum for at least 3 months in a row over 2 constructive years can cause persistent productive cough
39
Types of bronchitis?
Acute: acute inflammation of tracheobronchial tree Chronic: prolonged exposure to nonspecific bronchial irritants Simple chronic: Mild, persistent cough with clear sputum Mucopurulent: Thick, yellowish sputum due to bacterial infection Obstructive: structural damage
40
SX/Sx of Bronchitis?
Acute: proceeded by cold/flu cough is initially dry and non-productive, then worsens when lying, and then cold air/smoke creases cough dyspnea may be noticed ``` Chronic: chronic productive cough (worse in morning/evening/winter months) Shortness of breath/difficulty expiring Obstruction in airways Dyspnea Apical breathing ```
41
What is asthma?
Chronic inflammatory disorder | espisodes of acute bronchospasm triggered by exposure to various stimuli
42
What is CI'D for asthma?
No treatment during acute attack overstimulating/exhausting client triggers of attacks (scents) joint play over diploid/floating ribs Be careful with clients on steroids (can weaken tissue) increasing water intake if cardiac or renal disorders Postural drainage if they have sever hemoptysis, pulmonary edema, CHF, pulmonary embolism, etc BE AWARE OF LOCATION OF INHALER
43
What is the SX/Sx of asthma?
tendency to breathe with upper chest: barrel chest Hypertonicity of accessory mm of respiration fatigue due to decrease O2 anxiety triggered with cold, exercise, allergies, pollen, smoke, stress, foot allergies, drugs, hormones, etc
44
What is Emphysema?
Condition in which alveoli of lungs because fibrous and inelastic alveoli merge with each other and decrease SA, limiting exchange of O2 and CO2
45
What is CL'D with Emphysema?
Contact MD for severity overstimulating/exhausting client can't be treated in supine or prone if severe (semi-reclined or seated) No postural drainage due to serval reasons Tapotement over bony provinces, floating ribs, breasts Prolonged tapotement with: chest paint, unstable angina, anticoagulant therapy, osteoporosis, rib fractures, steroid therapy joint play on hypermobility and rib fractures/subluxations heavy hydro increase water intake with cardiac/renal disorders
46
SX&SX for Emphysema
``` Dyspnea Pain with breathing bubbles/rasps when breathing wheexxing breathlessness decrease Diaphragmatic breathing productive cough little interest in eating loss of federal mm tone barrel chest/hyperkyphosis/ant head carriage lung congestion hypoxia (PINK PUFFERS) ```
47
What is cystic Fibrosis?
Genetic disorder of apocrine glands increase in size/number of mucus glands increase salivary, sweat, pancreatic gland secretions over time airway obstruction occurs
48
What are the types of asthma?
Extrinic: Type !, irritating substances from outside body Intrinic: lack of clearly defined precipitation factors (idiopathic) Exercise-induced cardiac: related to congestive cardiac failure resulting in excessive lung fluid
49
Which COPD may spontaneously reverse itself?
asthma, especially in childhood
50
What position would you use to treat each COPD?
Bronchitis: Supine- with towel roll down spine if hyperkyphosis Prone-Folded towel under shoulders Asthma: Prone- folded towels under clients shoulders if protracted Supine-Towel roll down spine if hyperkyphosis If severe chronic asthma, avoid spending too much time supine Emphysema: Side lying, seated, or fowlers
51
What position is the client placed in to drain each lobe?
Upper: seated, with two (or more) pillows on stomach to rest against Lower: Prone, with 2+ pillows under hips Middle: 1/4 Supine- pillows under right side of body (Only right, as right is the only one with 3 lobes)
52
TP's seen in asthma?
``` Diaphragm intercostals scalenes SCM pec major/minor abdominals Latissimus dorsi (axillary attachment) Costal margins thoracic erectors post cervicals ```
53
Special Tests used in each COPD?
``` Mediate Percussion Test Vocal Fremitus Rib motion test Rib palpation test Ant/Lat spinous challenge Levatores Costarum Fixation First rib mobility test Breath sounds (asthma) ```
54
What is sinusitis?
Acute/Chronic recurrent inflammation of mucous membranes in paranasal sinuses
55
What are predisposing factors of sinusitis?
Deviation of nasal septum Dairy and wheat products Upper molar abscess
56
What are CI's of sinusitis?
``` Fever local MLD with acute infection refer to MD or dentist if chronic, recurrent/dental infection present avoid placing client in face cradle work within pain tolerance ```
57
Homecare for sinusitis?
Facial steams cold compresses to face and warm to post cervical area proper nose blowing (one nostril at a time) AF ROM for C-spine and jaw Strengthening for neck/upper back teach full diaphragmatic breathing self massage
58
Special test for sinusitis?
Trans illumination of Maxillary and Frontal sinuses | ROM
59
What hydro modalities are used to treat sinusitis?
Facial steams cold compresses over cheeks, eyes, forehead hot towels around neck
60
What is degenerative disc disease?
Degeneration of annals fibrosis of intervertebral disc | wear and tear
61
What is a disc herniation?
Tearing of both inner/outer layers of annulus fibrosis causing nucleus pulpous to bulge directly into intervertebral space
62
What aggravating movements/positions for each area of DDD or Esch type of disc herniation?
Forward flexion if herniation present Posterior/Posterolateral lesion: sitting most painful Small Postlat protrusion: pain across back and into gutless/thighs Large Postlat protrusion: may cause spinal cord compression with loss of bladder control anterior lesion: standing and walking most painful
63
What diagnostic tool is used to determine DDD?
X-rays?
64
If client has nerve room impingement from DDD what myotome is affected?
I honestly have no idea if you do know pls let me know
65
What are the types of disc herniation?
Prolapse: Outermost annular fibers hold uncle Extrusion: annulus fibrosis is pierced Sequestration: fragments of nucleus and annulus found outside disc
66
Special tests used for disc herniation?
Kemp's and Spurling's Valsalva for C/S or L/S Upper limb tension test for cervical Slump/SLR for lumbar
67
Mechanisms of injury that can cause disc herniation?
``` Chronic overloading of disc Postural dysfunction Direct trauma Mm imbalences Poor blood supply ```
68
What exercises can be used for client with DD? Hyperlordosis vs flat back?
HL: Long axis traction to L/S FB: resisting straight leg raise for 10 secs
69
What is prognosis for DD/disc herniation?
Better if symptoms are recent/sudden onset gradual onset with mm weakness and atrophy have poorer prognosis few weeks of sx, Asx period, flare-ups onset by overuse or poor posture?
70
What are the pillowing protocols for Post/Postlat herniation?
Lumbar: Supine- no pillow under knees to extend spine Prone- no ab pillow Side-lying: towel roll under waist/between knees Cervical: Supine-small towel roll under neck side-lying- keep spine aligned with pillow under head
71
What is the pillowing for Ant protrusions?
Lumbar: Supine- pillow under knees to flex spine Prone- ab pillow maintains flexion Cervical: Supine- pillow under head Prone- pillow under thorax maintains cervical flexion

Treatments 5 (H's version) (6 decks)

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