Sullivan & Siegelman Flashcards
Most beneficial tx for PD
Locomotor training using Body Weight Support and Treadmill Training
S/E of Tricyclic Antidepressants
- Orthostatic Hypotension
- d/t significant anticholinergic and sedative properties
- may cause lethargy, sedation, arrhythmias, blurred vision, hypotension
S/E of Tricyclic Antidepressants + MAO Inhibitors
Htn, tachycardia, convulsions
Primary disease duration of PTB
10 days - 2 weeks
When is a PTB pt. non-infectious?
2 weeks on appropriate anti-tuberculin drugs; can be safely treated in the PT gym s precautions
Meds are taken for 9-12 mos.
Spasticity pattern in LE and associated sitting
Hip and knee extensors, adductors, and plantarflexors; results in sacral sitting c PPT, kyphotic upper spine, and forward head
Can be caused by developmental failure of the talar neck to derotate, osseous abnormality of the midtarsal jts., or by increased muscle activity of the mm that invert the foot
Forefoot varus
Dull, aching pain sensation travel through the:
Anterior spinothalamic tract
Discriminative, fast pain travel through the:
Lateral spinothalamic tract
Discriminative touch is carried through the:
Proprioceptive pathways (fasciculus gracilis/cuneatus, medial lemniscus)
Recommended time duration for endotracheal suctioning
10-15 secs
15-20 s - serious hypoxemia
1-10 s - ineffective secretion removal
Hypoglycemia, hypokalemia, Htn, muscle weakness, and wasting; Abnormal fat distribution (moon fascie; truncal obesity)
Cushing’s Syndrome
Primary adrenal insufficiency (dec cortisol and aldosterone); hypotension, weakness, anorexia, nausea, and vomiting
Addison’s disease
Hypocalcemia and neuromuscular irritability
Chronic hypoparathyroidism
Treatment for pt. c difficulty clearing the more affected foot during the swing phase of gait
Forward step ups in standing, using graduated height steps (weak hip and knee flexors)
Ability to select the correct movement in response to a stimulus
Response orientation
Impaired ability to perform rapidly alternating movements
Dysdiadochokinesia
Impaired ability to associate muscles together for complex movement
Dyssynergia
Impaired ability to judge the distance or range of movement
Dysmetria
An ASIA A C6 SCI pt should be taught to initially transfer with a sliding board using:
Shoulder extensors, ER, and anterior deltoid to position and lock the elbow
Most pertinent factor to include in a referral for a child with probable AUTISM
Defensive when touched - possible sensory integration issue
S/sx of anabolic steroid use
Rapid wt. gain, inc BP, acne on face & upper back, and changes in body composition c marked mm hypertrophy esp in the upper body
Prolonged use: jaundice, mood swings
Important predictor of lymphedema after treatment for breast CA
Obesity
Most beneficial way to manage long-standing flexion contractures
Mechanical stretching c low-intensity force (5-15 lbs.) applied over a prolonged period (20’-several hours)
Appropriate criteria for determining initial exercise intensity in post-MI pts.
RPE <13
HR <120 bpm (HR rest +20 bpm)
Post-surgery pts - HR rest + 30 bpm
Possible s/e of Prednisolone
Chronic: adrenal suppression (hyperglycemia)
Muscle wasting and pain, weakness and osteoporosis; Wt. loss with nausea and vomiting
When is resistance training initiated in post-MI pts.
After pts. have completed 4-6 wks of supervised cardiorespiratory endurance exercise.
Exercise capacity >5 METs s anginal sx or ST segment depression
Post MI: When should exercise be terminated
RPE 15-16
Tight pelvic floor muscles in a pt. c chronic prostatitis
Obturator internus, piriformis, pubococcygeus
Instrument designed to evaluate and document a pt’s ability to modify goals in response to changing task demands; gait adaptability
Dynamic Gait Index
Initial treatment option for a pt. dx c DVT who was immediately started on an anticoagulant (LMWH)
Early amb while wearing compression stockings
Most appropriate activity for a 6 y/o DMD pt. who is till amb c AD for short distances.
Recreational physical activities: Swimming
Fine pincer grasp
11 mos
Stacking 2 blocks
12-15 mos
Stacking 6 blocks
16-24 mos
Holding a cup by the handle when drinking
12 mos
In providing radiation therapy, it is important to
Observe skin care precautions
Appears in late stages of lymphedema; inability or difficulty lifting up or pinching the skin over the dorsal proximal toes or fingers
Stemmer’s sign
Stage I (reversible) lymphedema
Pitting edema
Stage II Lymphedema
Pitting is difficult d/t (+) fibrotic tissue
Movement of a tracer substance back down the limb during a lymphoscintigram
Dermal Backflow
Normal fasting plasma glucose
<115 mg/dL
Fasting plasma glucose level on more than 1 occasion indicative of diabetes
> 126 mg/dL
Pt. is unable to transfer from w/c to mat even c enough instructions and verbal cueing from PT; during assisted transfer, pt. is unable to participate and doesn’t seem to get the idea of the transfer; failure in the conceptualization of the task
Ideational apraxia
Inability to select and attend to a specific stimulus while simultaneously suppressing extraneous stimuli
Cognitive inattention
DMD pt., pulmonary function test value that is unlikely to show any deviation from normal
Functional Residual Capacity
Episodic vertigo, nausea, blurred vision, and autonomic changes occurring c head movement and typically stops within 30 seconds once the head is static
BPPV
Benign tumor on CN VIII; associated c progressive hearing loss, tinnitus, and dysequilibrium
Acoustic neuroma
Associated c nausea and vomiting, episodic vertigo, and fullness in the ear with low-frequency hearing loss
Meniere’s disease
Initial POC for a newborn c whole arm paralysis
Partial immob of the limb across the abdomen, followed by gentle ROM p immob
Lumbar spondylosis s disc herniation has a left neural compression, what structure is most likely compressing the nn root?
Ligamentum Flavum
Anterior drawer test of the ankle appears to be most useful when performed within
4-7 days of the initial injury
Absolute indications for terminating exercise
Onset of moderate to severe angina Acute MI Drop in SBP c increasing workload Serious arrhythmias Unusual or severe SOB CNS sx Pt.'s request
Medications related to increased risk for falls
Psychotherapeutic drugs; anti-Htn; anti-arrhythmics; diuretics; analgesics
Drug for prevention/treatment for osteoporosis
Raloxifene
Mx for a child c full-thickness burns developing hypertrophic scars
Application of custom-made pressure garments, maintained 23 hr/day, for 6-12 mos.
Indicates rejection in a pt. c a solid organ transplant in either the acute or the chronic stage; appearance of these sx requires the PT to refer the pt. to his PCP
Myopathy and neuropathy
Maintains the relative position of the urethra to the urinary bladder; lossening could result in bladder prolapse or herniation
Pubourethral ligament
Causes difficulty initiating voiding
Cystocele
Caused by motor-detrusor instability or detrusor hyperreflexia c impaired contractility
Urge incontinence
Reason for termminating a maximum exercise tolerance test for a pt. c pulmonary dysfxn
Dyspnea and a drop of 20 mmHg in PaO2
Feedback that provides the best means of allowing for introspection
Occasional feedback
S/E of Digitalis
Emergence requires contacting of the PCP: weakness and palpitations
Fatigue, H/A, mm weakness, bradycardia, and supraventricular or ventricular arrythmias (v-fib)
Best initial intervention for pot-polio syndrome pt.
Activity pacing and energy conservation techniques
Effects of Digitalis on pt’s ECG
Gradual downsloping of ST segment with a flat wave and shortened QT interval
Hallmark of claudication pain
Relief with rest
Low-grade fever, wt. loss, malaise, anemia, fatigue, leukocytosis, and lymphocytosis
Chronic inflammatory state; systemic effects of HIV
Fever, tachycardia, and a hypermetabolic state
Systemic effects of an acute inflammation
Optimal position of a pt. c C5 SCI
Supine, head of bed flat
RA pt. who experienced a severe whiplash injury from an MVA 1 wk. ago. X-ray: osseous structures intact; main complaints: cervical pain and sudden falls c LOC; (+) Romberg sign and hyperreflexia; PT’s initial action:
Fit c hard cervical collar and contact referring MD recommending a CT scan
Can be accomplished by designing or modifying the workstation, work methods, and tools to eliminate/reduce exposure to excessive exertion, awkward postures, and repetitive motions.
Engineering control technique
Primary constraint in resisting valgus stress when the knee is flexed <20 deg
Bony congruency and cruciates
Primary constraint in resisting valgus stress when the knee is flexed >30 deg
Jt. capsule
Most important factor to consider in managing the residual limb of an elderly pt. c AKA
Residual limb healing
Most important factor to consider in managing the residual limb of an elderly pt. c AKA
Residual limb healing
PCL attachment
Lateral aspect of the MFC to just posterior to the posterior horn of the medial meniscus
Usual mechanism of ACL injury
Noncontact deceleration producing a valgus twisting injury.
Others: knee hyperextension and severe tibia IR
PCL attachment
Lateral aspect of the MFC to just posterior to the posterior horn of the medial meniscus
Usual mechanism of ACL injury
Noncontact deceleration producing a valgus twisting injury.
Others: knee hyperextension and severe tibia IR
PCL attachment
Lateral aspect of the MFC to just posterior to the posterior horn of the medial meniscus
Usual mechanism of ACL injury
Noncontact deceleration producing a valgus twisting injury.
Others: knee hyperextension and severe tibia IR
Causes painful bowel movement and constipation
Rectocele
Usually caused by a crush injury, such as when a heavy object falls onto the midfoot, or when landing on the foot after a fall from a significant height; one or all of the metatarsal bones are displaced from the tarsus;
Often occurs when an athlete has his foot PF and another player lands on his heel
Lisfranc injury
Poss extra-articular complication of RA
Vasculitis
Psoriatic skin and nail changes
Conjunctivitis and iritis
Psoriatic arthritis
Least appropriate intervention to help c mx of atelectasis
Paced breathing (controls rate, not depth)
S/P flexor tendon reattachment: goal is to minimize adhesion formation; mx 72 hrs post-surgery
Block MCP into full flexion
Actively extend IP
Passive PIP flexion and active extension
NO active flexion for weeks 1-3
Primary reason a compression garment decreases edema
It exceeds the internal tissue hydrostatic prejossure
Metabolic abnormalities associated c adrenal insufficiency
Hyponatremia
Hyperkalemia
Hypoglycemia
poss acidosis
Jts. more likely to demonstrate more arthritic changes in Chronic Lyme’s dse
Large jts. esp the knee
Sharp pain, usally localizes to the lower esophagus/ upper stomach area
Hiatal Hernia
Produces persistent burning pain in the esophagus, throat, or chest
GERD
Vertebral artery test: extension, lat flexion, and rotation to same side; positive test indicated when dizziness or nystagmus occurs; which side is being compressed?
Opposite side artery
Positioning: extreme hyperextension of the neck and spine; both LE flexed, heels touching then buttocks
Opisthotonus
A51 2015