Test 1 Flashcards
Lifestyle impact on health and wellness
Rest
Diet
Level of activity
Stress, coping ability
Substance abuse
High risk sex
Travel
Environmental/Occupational status
Benefits of Exercise
Increases cardiovascualr function
Decreases mortality in individuals with CAD
Favorable changes in metabolism of carbs and lipids
Increases hemodynamis, hormonal, metabolic, neurologic, resp function
Increase immune function
Improve psychological functioning
Improve postural stability
Improve strenght and stability
Increase sensitivity to insulin
Facilitates boprythms and thermoregulation
Biopsychosocial benefits of exercise
Reduce/precvent functional decrease assoc with aginh
Aides in weight loss/control
Maintain/Increase cardiovascular function
Strength training helps to maintin muscle mass
Decrease ae related bone loss
Psychological benefits
Decreases disease risk factors
Decrease incidence of some cancers
Contribute to social integration
Disease prevention
3 stages
Primary - decrease risk factors (wear helmet, immunizations)
Secondary - early detection (mamogram, colonoscopy)
Tertiary - Limit impact of the disease. Return pt to highest level of function
Obesity
Excessive accumulation of adipose tissue
Individuals with a BMI > 30 kg/m2
An imalance btwn energy consumed and energy used. Unused energy is stored as adipose.
Obesity
Complications
Metabolic syndrome
Types 2 diabetes
Osteoarthritis
Liver disease
Sleep apnea
Artherosclerosis
HTN
Stroke
Asthma
Cancer
Menstrual disorder
Infertility
Impaired mobility
Premature death
Psychological disturbances (Irritability, loneliness, depression, binge eating, tension)
Obesity
And exercies
Perception of angina pectoris or MI
Excessive rise in BP
Ligamentous injury
Aggrevation of jt problems, degenerative arthritis
Fall injury
Excessive sweating
Skin disorder (chafing)
Heat stroke/exhaustion
Health
Complete state of well being, mental, social, physical.
Illness
Any deviation from a healthy state Pt’s perception and response
Illness –>
DIsibility which may lead to disease
Acute illness
Relatively rapid onset, short duration
Stages of acute illness
First stage: physical symptoms identified and recognized Second: Assumtion of the “Sick” role Third: Acceptance of diagnoses and treatment Fourth: Recovery and rehab
Chronic illness
*Permanent impairments and disibility
*Residual disibility
*Need for special rehab and/or long term managment
*Some have periods of acutness (flare ups)
Sodium
Lab value
Influences blood volumn
Related to the amount of water in the system, not how much sodium itself
N: 135 - 145mmol/ liter
“natremia”
Magnesium
Lab values
Increased: Muscle weakness, confuseion, decrease reflexes
Decreased: Fatigue, weakness, anxiety, irritability
“magnesemia”
Glucose
Lab values
Often tested after fasting blood sugar (FBS)
80-120 mg/dl
Impact on exercise
Eating will increase blood sugar
Exercise will decrease blood sugar; do not treat before eating or after receiving insulin
“glycemia”
Potassium
Lab values
Provides info about renal and adrenal function
decreased: fatigue, muscle cramping, cardiac dysarrythmias (irregular HR, dizziness, palpitations)
Impact on exercise:
Hypokalemia - mvmnt becomes difficult, exercise carefully or not at all
“kalemia”
Calcium
Lab values
Influence the excitability of neurons, cardiac and skeletal muscles
Can produce weakness, spasms, alt sensation, cardiac arrythmias
“calcemia”
Blood urea Nitrate (BUN)
Lab value
Evaluates kidney function. differential diagnosis if kidney disease is suspected and to monitor treatment. (Closely monitored in burn patients)
Impact on exercise:
increased -> renal failure
Decreased - > Liver disease
Levels themselves do not contraindicate therapy, effect on liver and kidney disease may.
Platelets
Lab Values
Decreased by excessive bleeding, coagulation disorders, autoimmune disorder, histocapatability problems
Indications of low platelets include unexplained bruising and long coagulation time.
Red Blood cell count
Lab test
Complete blood count test
Indicates blood capacity to carry oxygen
White blood cells
Lab test
Complete blood count
increase or decrease with disease. May be sign of infection, or inflammatory response (with increase). Decrease with bone marrow disease, chemo, indicates risk for infection.
Hematocrit
Lab Values
Indicates anemia
Decreased exercise tolerance, aerobic capacity, endurance, orthosttatic toleraance
Hemoglobin
Lab values
Influences a person’s endurance and orthostatic tolerance, increase fatigue and tachycardia
decreased: difficulty walking, climbing stairs, house/yard work
Coagulations studies
Lab tests
Prothrombin time (PT) - used to determine coagulability and monitor anticoagulant therapy (heparin, warafin). Ho wlong it takes for blood clot
International Normalized ratio (INR) - Measures the time it takes for blood to clto and compares to an avg.
Patrial Thromboplastin time (PTT) - Measures of clot time
Pulmonary Fucntion Test
Statuc lung volumes
Dynamic breathing tests
Physiologic tests:
tests airways and lung structures. Record volumes of air moved by lungs during respiration and how well O2 is moved into the blood
Stress response
Increased HR and BP
changesin respiratory system
Release of glucose and adrenaline
Redirection of blood supply (brain and muscles)
Decreaseed blood clotting time
Increase sweat production
Decrease paristalsis and gut function
contraction of spleen
decreased immune response (chronic)
Substance abuse
Excessive use of mood effecting chemicals
Alcoholism, drug, tabacco, ceffiene, use of alcohol with meds
Biochemical disorder: may activate brain centers that regulate arousal, reward and satisfaction (dopamine receptors)
50-80% of SCI, TBI were injured while under tht influence
Eating disorders
Anerexia Nervosa
Bulima Nervosa
Binge-eating disorder
Eating Disorder
Implications on PT
Vital sign instability
Muscular weakness/cramping
Por posture
Overuse inj
Easy bruising
Poor wound healing
Eating Disorders
Complications
Electrolyte imbalance
Edema and dehydration
Cardio abnormalities
Kidney Dysfunction
Neurologic abnormalities
Endocrine dysfunction
Muscle weakness
Psychologic disturbance
Alcohol withdrawal symptoms
Dilerium
Motor hyperactivity
Hyperalertness
Diaphoresis
HTN
Pounding HA
N/V/D
Anxiety
Irritability
Tachycardia
Abd pain
Anorexia
Phsychosomatic Disorders
Somatoform Disorder:
Physical symptoms caused by psychological factors. No cause for physical pain
Hypochondriasis - Aches and pains are thought to be worse than they are
Pain disorder - experience pain without a cause
Conversion disorder - SYptoms that are experienced have characteristics of neurological disorders
Anti-Psychotics
(neuroleptics)
Treats psychosis
Used to help normalize thought disturbances
SIde effects: pseudoparksonism, dystonis, restlessness, involuntary mvmts, dry mouth, blurred vision, hypotension
Long term: can cause neurological, musculoskeletal, psychological side effects
Tranquilizers
sedatives
Relax
REduce coordination
Orthostatic falls
Mood disorders
Unipolar depression
Bipolar depression
Organic mood disorder - changes in brain assoc with trauma or disease (TBI, MS)
Schizophrenia
Seasonal affective disorder
Depression
Bipolar Disorder Agents
Mood stabilizer
Controls manic episodes
Chronic Pain disorder
Pain that persists past normal healing time (3-6 months)
Conditions:
Arthritis, back pain, neuralgia, peripheral neuropathies, PVD, Hyperesthesia, phantom pain, fibromyalgia, spinal stenosis
Pt focus: Increase function, not pain relief
Anxiety Disorders
(neuroses disorders)
Genreal emotional state of fear usually assoc with a heightened state of physiologic arousal
Panic disorder
Obsesive Compulsive Disorder
Post traumatic stress disorder
Phobia disorders
Antidepressants
Alleviate depression or anxiety
Side effects:
Dry outh
Blurred visoi
Orthostatic hypertension
Cardiac (arrythmias, tachycardia)
HA
Common drugs to cause adverse RXN in the aging population
Corticosteroids
Digoxin
Aminoglycoside antibiotic
Anticoagulants
Insulin (o.d)
Aspirin
Tranquilizers
Seductive - hpnotics
Antacids
Signs of adverse drug reaction in the elderly
Dry mouth
Restlessness
Nausea
Orthostatis hypertension
Depression
Confusion, delirium
Constipation
Incontinence
Fatigue
Impaired memory/concentration
Extrapyramidal sydrome (involuntary muscle mvmnts)
Tradive Dyskinesia
Repetitve involuntary purposless mvmnts (tongue protrusion, lip smacking, puckering lips, rapid eye blinking)
Developed after prolonged use of neuroleptic drugs
Drug rxn
Implications for PT
Observe and communicate
Known common drugs and their side effects
Exercise influences how meds are metabolized, absorbed, distributed, and excreted.
Rate of perceived exertion
How th pt feels right now not compaire to another time. Valid and accurate
Each facility may use a different scale.
General adverse drug RXN
Rashes
Fever
Jaundice
Nasal congestion
HA
Abd cramps
Shakiness
Vomiting
Alt taste
Jt or muscle pain
Anxiety
Dizzness
Dyspnea
Hypo/hypertension
Tachycardia
Palpitations
Cardica arrest
Seizures
Laryngeal edema
Pulmonary edema
skin rxn (itchy, burn, blisters, uticaria)
NSAID’s
Implications for PT
Caution with prolonged use
Plan treatment to coincide with peak of meds (2hrs)
May increase BP
May influence effects of other meds
May increase plasma concentrate
Antihypertensive agnets
Effects: Hypotension, orthostasis (BP decreases within 3 min of standing) and falls
Reduced exercise capacity
Sedative Hynotic Agents
Alleviate insomnia/ frequent awakings
Insulin and oral Hypoglycemics
Hypoglycemia