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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
Q

homecare for Varicose veins?

A

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

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26
Q

What is Thrombophlebitis?

A

Inflammation of superficial or deep vein that leads to formation of thrombus

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27
Q

What are the CI”s for Thrombophlebitis treatment?

A

NO TREATMENT- REFER OUT

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28
Q

SX/Sx of thrombophlebitis?

A 
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
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29
Q

SX/SX of pulmonary embolism?

A 
Extreme distress
Dyspnea
sharp localized chest/sternal pain
general chest discomfort
distension of veins of neck
person may collapse or go into shock
30
Q

What contributing factors can cause thrombophlebitis

A 
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
Q

Special test that can determine DVT?

A

Homan’s

If acute, refer out

32
Q

Differences between Raynauds disease and phenomenon?

A

Disease: Arterial spasms
Primary, is caused without reason (idiopathic)
Usually more common in women

Phenomenon: Peripheral vascular disorder
Secondary, caused from underlying condition

33
Q

SX/Sx of disease vs phenomenon?

A 
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
Q

Causes of disease/phenomenon?

A

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
Q

CI’s for Raynauds?

A 
Cold hydro
extremes of temp
stimulating/painful techniques
deep techniques around affected area
frictioning
limbs hanging off table
36
Q

What does COPD stand for?

A

Chronic Obstructive Pulmonary Disorder

37
Q

What are CI’s for Chronic Bronchitis?

A 
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
Q

What is Chronic Bronchitis?

A

Condition of production of purulent sputum for at least 3 months in a row over 2 constructive years
can cause persistent productive cough

39
Q

Types of bronchitis?

A

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
Q

SX/Sx of Bronchitis?

A

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
Q

What is asthma?

A

Chronic inflammatory disorder

espisodes of acute bronchospasm triggered by exposure to various stimuli

42
Q

What is CI’D for asthma?

A

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
Q

What is the SX/Sx of asthma?

A

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
Q

What is Emphysema?

A

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
Q

What is CL’D with Emphysema?

A

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
Q

SX&SX for Emphysema

A 
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
Q

What is cystic Fibrosis?

A

Genetic disorder of apocrine glands
increase in size/number of mucus glands
increase salivary, sweat, pancreatic gland secretions
over time airway obstruction occurs

48
Q

What are the types of asthma?

A

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
Q

Which COPD may spontaneously reverse itself?

A

asthma, especially in childhood

50
Q

What position would you use to treat each COPD?

A

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
Q

What position is the client placed in to drain each lobe?

A

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
Q

TP’s seen in asthma?

A 
Diaphragm
intercostals
scalenes
SCM
pec major/minor
abdominals
Latissimus dorsi (axillary attachment)
Costal margins
thoracic erectors
post cervicals
53
Q

Special Tests used in each COPD?

A 
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
Q

What is sinusitis?

A

Acute/Chronic recurrent inflammation of mucous membranes in paranasal sinuses

55
Q

What are predisposing factors of sinusitis?

A

Deviation of nasal septum
Dairy and wheat products
Upper molar abscess

56
Q

What are CI’s of sinusitis?

A 
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
Q

Homecare for sinusitis?

A

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
Q

Special test for sinusitis?

A

Trans illumination of Maxillary and Frontal sinuses

ROM

59
Q

What hydro modalities are used to treat sinusitis?

A

Facial steams
cold compresses over cheeks, eyes, forehead
hot towels around neck

60
Q

What is degenerative disc disease?

A

Degeneration of annals fibrosis of intervertebral disc

wear and tear

61
Q

What is a disc herniation?

A

Tearing of both inner/outer layers of annulus fibrosis causing nucleus pulpous to bulge directly into intervertebral space

62
Q

What aggravating movements/positions for each area of DDD or Esch type of disc herniation?

A

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
Q

What diagnostic tool is used to determine DDD?

A

X-rays?

64
Q

If client has nerve room impingement from DDD what myotome is affected?

A

I honestly have no idea if you do know pls let me know

65
Q

What are the types of disc herniation?

A

Prolapse: Outermost annular fibers hold uncle
Extrusion: annulus fibrosis is pierced
Sequestration: fragments of nucleus and annulus found outside disc

66
Q

Special tests used for disc herniation?

A

Kemp’s and Spurling’s
Valsalva for C/S or L/S
Upper limb tension test for cervical
Slump/SLR for lumbar

67
Q

Mechanisms of injury that can cause disc herniation?

A 
Chronic overloading of disc
Postural dysfunction
Direct trauma
Mm imbalences
Poor blood supply
68
Q

What exercises can be used for client with DD? Hyperlordosis vs flat back?

A

HL: Long axis traction to L/S

FB: resisting straight leg raise for 10 secs

69
Q

What is prognosis for DD/disc herniation?

A

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
Q

What are the pillowing protocols for Post/Postlat herniation?

A

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
Q

What is the pillowing for Ant protrusions?

A

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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