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PTA Patho > Test 3 > Flashcards

Test 3 Flashcards

1
Q

Aging and the Renal and Urologic system

A

*Kidneys become less efficient at removing waste

*Urine volumn decreases d/t the decrease in efficiency of waste removal

*Decrease effectivness of sodium regulation(where Na goes, H2O goes)

*Bladder capactiy decreases causing an increase in frequency of voiding

*Urinary time table moves from day to night *Increase in pelvic floor disorders

*Increase for risk of urinary tract disease d/t multiple meds

*Incontinence (dependant living required)

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2
Q

UTI

A

Urinary Tract infection can develope on the upper and lower tract Lower includes: Cystitis, Urethritis Common in the general population, increases with age and those in nursing homes

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3
Q

Cystitis

A

Bladder infection

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4
Q

Urethritis

A

Urethra infection

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5
Q

UTI (Risk factors)

A

Age

Immobility

Catheterization

Atonic bladder (SCI, diabetic, neuropathy)

STD

DM

Female

Obstruction

Kidney transplant

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6
Q

UTI (SIgns and Symptoms)

A

Frequent Urination

Pain (Shld, bk, flank, low abd)

Urinary urgency

Fever, chills

Hematuria

Costovertebral tenderness

Nocturia

Pyuria

Dysuria

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7
Q

Pyuria

A

Urine containing puss

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8
Q

UTI Implications for PT

A

Recognize signs (Mental status change) May interfere with therapy

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9
Q

Renal Calculi

A

“Kidney stone” 3rd most common urinary tract disorder effects men 30-60 y.o. and women 20-30 y.o.

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10
Q

Renal Calculi Risk Factors

A

Excess intake of Ca, Na and sucrose Lack of Ca, K in diet Obese women

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11
Q

Renal Calculi Signs and symptoms

A

blood in the urine

pain in the abd

decreases urinary volumn

Flank to groin pain

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12
Q

Renal Calculi Implications for PT

A

Recognize syptoms Fever Chill Sweats

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13
Q

Chronic Renal Failure

A

The loss of ability for the kidney’s to filter waste and fluids from the blood for greater than 3 months

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14
Q

Chronic Renal Failure

Cause

A

Diabetes

Hypertension

Glomerulonephritis

Excessive use of the OTC drugs Age

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15
Q

ESRD

A

End stage renal disease 90% loss of kidney function Treated with dialysis and transplantation

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16
Q

Renal Transplant Complication

A

Hypertension

Lipid Disorder

Hepatitis

Cancer

Tendinopathies

Osteopenia

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17
Q

Dialysis Complications

A

Increase thirst

Weight gain/abd distention leading to distress Increases risk of infection

Fluid retention leading to Hypertension (beginning) Hypotension

Chest and back pain

Hypersensitivity (itching, uticaria)

Thrombosis causing stenosis

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18
Q

Chronic Renal Failure Implications for PT

A

NSAID’s and other analgysics can induce renal syndrome Be alert to: malnutrition Med side effects # of body dydtems involved Cognitive changes Renal transplant complications Dialysis Complications Impaired 02 limits exercise

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19
Q

Neurogenic Bladder Disorder

A

Malfunctioning bladder d/t a disruption in the innervation

CVA,

dementia,

Parkinson’s,

MS,

Brain tumors,

SCI,

HNP,

Vascualr lesions,

Myelitis,

DM

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20
Q

Neurogenic Bladder Disorder Implications for PT

A

Treated with Catheterization, Bladder training, Surgery, and meds Prevent incontinence, bladder distention, UTI’s, and renal damage Empty cath bag encourage pee breaks recognize UTI signs

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21
Q

Urinary Incontinence

A

Inability to hold urine. Occurs most often when the bladder’s pressure excees the sphincters resistance Functional Incontinence Stress Incontinence Urge Incontinence Overflow Incontinence Significant factor to pressure sores, UTI’s, institutionalization, Depression and isolation

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22
Q

Functional Incontinence

A

Normal urine control with difficulty reaching a toilet in time Muscle of joint dysfunction

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23
Q

Stress Incontinence

A

Loss of urine when bladder is under pressure (coughing, laughing, lifting)

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24
Q

Urge Incontinence

A

Sudden unexpected urge and uncontrolled loss of urine

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25
Q

Overflow Incontinence

A

Constant leaking of urine from a full bladder that is unable to empty

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26
Q

Urinary Incontinence Implications for PT

A

Rehab m. imbalance pelvic alignment Pelvic m. awareness and function through biofeedback E-stim Thera ex Behavioral managment Designed to prevent reoccurance of impairment and restore m. function. Weight loss, core ex, kegel ex, surgery

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27
Q

Male Genitalia and aging

A

Sex hormone decreases leading to protein synthesis

salt water balance

bone growth and homeostasis

cardiovascular function

Decreases sexual interest

Memory changes

Physical changes (decrease strength, body mass, bone density)

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28
Q

Prostate cancer

A

Adenocarcinoma of the prostate arises from the glandular cells. 1 in 6 men have a lifetime risk of prostate cancer. More die with it rather than from it.

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29
Q

Prostate Cancer Risk Factors

A

>50 y.o.

Environmental exposure to cadmium

Alcohol consumption

High fat diet

African American

Fam Hx

Geographic (US, Scandonavia)

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30
Q

Hormonal Manipulation Side Effects

A

Muscle atrophy

Decreased bone density

Loss of Labido

Erictile Dysfunction

Hot flashes

Bloating,

Pedal edema

Weight Gain

MI, CVA, DVT

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31
Q

Prostate Cancer Implications for PT

A

Undiagnosed: Be aware of the signs (trouble initiating/ continuing urine strem, frequency, dribbling/continuous leaking) Pain Post-op: Pelvic floor rehab Prevent Osteoporosis with WB exercises

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32
Q

Female Genitalia and Aging

A

Menopause (45-50 y.o.)

Increases risk for: Heart disease HTN CVA Osteoporosis

Depression

Primary reson for rehab: Pelvic floor disorder Post-op rehab following CA

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33
Q

Female Genitalia and Exercise

A

Increas Cardio fitness Decrease adiposity

Helps maintain m. mass and bone density

Excessive may be negative primary/secondary amenorrhea

decrease dietary intake + exercise = infertility + decreased bone density

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34
Q

Female Obesity and the reproductive system

A

Menstrual disorder

Infertility

Miscarriage

Poor pregnancy outcomes

Impaired fetal wellness

Diabetes

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35
Q

Pelvic Floor Dysfunction

A

Pelvic musculature dysfunction and pelvic pain

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36
Q

Pelvic Floor Disorder Cause

A

Pregnancy

Prolapsed Uterus

PMS

Endometriosis

Musculoskeletal injury

Fibromyalgia

Hernia

SCI, Stroke, Parkinson’s, MS

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37
Q

Pelvic Floor Dysfunction Implications for PT

A

Educate the patient on Muscualture Consider your pt (modesty, abuse) Postural education

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38
Q

Breast Cancer Rsk Factors

A

>60 y.o.

Menarche

First live birth at 35 y.o.

Fam Hx

of previoud breast biopsies

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39
Q

Breast Cancer Implications for PT

A

Pre-op: Posture Jt ROM Upper quadrant motion Flexibility Exercise Lymohedema Precautions

Post-op: Acknowledge side effects Breathing Coughing Exercise Functional activity

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40
Q

Post-Mastectomy Pain Syndrome

A

Burning Numbness/tingling or stabing around the incision Axilla, arm, shld imediately, or 3 months post op

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41
Q

Down Syndrome

A

Chromosomal disorder

Characteristics:

Hypotonia

Cognitive delays

Abnormal facial features

Short limbs

Assoc with congenital Heart defects

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42
Q

Down Syndrome Implications for PT

A

Atlantoaxial instability

Resp Problems

Joint hypermobility

Early intervention

Low level aerobics (low peak HR, Low VO2)

43
Q

Scoliosis

A

Lateral curvature of the spine Idiopathic Osteopathic - d/t bone abn Myopathic - d/t m. weakness Neuropthic - d/t CNS disorder Functional (goes away when caue remedied) Structural

44
Q

Scoliosis Implications for PT

A

Pediatric: Early detection Trunk strengthening and flexibility

Post-op: Check color, sensation, capillary fill in extremities Deep breathing Mobility withing 24 hrs (surgeon protocol) Bracing

45
Q

Spina Bifida

A

Congenital neural tube defects resulting in weakness, sensory impairments, hydrocephalus seen as early as birth. prenatal dx

46
Q

Spina Bifida Implicaions for PT

A

Neonatal ICU - Prone, slight hip flex, leg abd, ankles neutral skin care

Care continues through school age

Be aware of the signs of:

CSF pressure

Shunt failure

Tethering of spinal cord

47
Q

Muscualar Distrophies

A

Inherited Neuromuscular disorders

Several Varieties characterized by symmetrical m. wasting leading to increaing deformity and disibility

Linked to protein dystophin, enzymatic defects and defects in modifcation of proteins

48
Q

Muscualr Distrophies

Implications for PT

A

When ill/injuried and immobilized, they can loose all functional abilities

Caution with exercise - too strenuous = m. fiber breakdown

resp precautions

splinting

night positioning

AROM PROM

49
Q

Duchenne’s Muscular Atrophy

A

Onset: 2-4 y.o.

Rapid progression

Loss of walkign by 9-10 y.o.

Death in 20’s

M. cells replaced by fatty connective tissue leads to contractures

Fat cells accumulate btwn damage m. fibers

Disorganization of tendon insertion

50
Q

Spinal Muscualr Atrophy

A

Progressive weakening, m. wasting d/t ant horn degeneration

Severe to mild (TYpe 0-IV)

Inherited (both parents must have mutation)

51
Q

SMA

Implications for PT

A

Postural support

Bracing

Improve, maintain function

Resp weakness

Prevent musculoskeletal complications

52
Q

Torticollis

A

“Twisted neck” Contracted SCM

Spasomadic

Positional

53
Q

Torticollis

Implications for PT

A

Postioning

Exercise to encourage symmetry

Bracing

54
Q

Erb’s Palsy

A

UE paralysis usually assoc with brcahial plexus injury at birth (traction force)

Characteristics: ADD, IR of shoulder, lower arm Pronated with fingers flexed

55
Q

Erb’s Palsy

Implications for PT

A

Encourage UE use

Prevent deformity

PROM

56
Q

Osteogenesis Imperfecta

A

Congenital disorder of collagen synthesis effecting bones and connective tissue leadin to and increas in fx

Shortened stature

Bruise esaily, thin skin

Increased tendon laxity

Jt hypermobility

Scoliosis

Cardiovasular complications

Delayed motor skills

57
Q

Osteogenesis Imperfecta

Implications for PT

A

Gentle ROM

Caution with motion, strengthening

Avoid rotation

Family education

Strengthening of hip ext, abd, trunk ext, abd

Positioning

58
Q

Arthrogryposis

A

Congenital, multiple jt contractures

m. weakness

Articular rigidity

59
Q

Arthrogryposis

Implications for PT

A

Max benifit a 0-2 y.o

Funtional mobility

AFO’s

Post surgical rehab

60
Q

Aging and Bones

A

Decrease bone formation

Decrease strength

Decrease density

Bone loss (osteoporosis)

61
Q

Aging and Muscles

A

Decrease in m. fibers

Decrease in fiber size

Decrease response to neural excitation

Loss of m. mass

Loss of m. function

62
Q

Aging and the joint and connective tissue

A

Decrease in flexibility

CHanges in collagen

Articular catrilage breakdown

Increase in tissue stiffness

Decrease in tendon tensil strength

63
Q

Effects of exercise on the bones

A

Increases bone mass with WB activities

Resistance exercise

Mod-High intensity

64
Q

Effects of Exercise on the Muscles

A

Increase in:

strength

Endurance

Function

65
Q

Effects of exercise on the joint and connective tissue

A

Well regulated exercise does not exacerbate changes

66
Q

Effects of strength training

A

Increase strength, mass, quality of skeletal m.

Increase endurance

Normalize BP

Increase metabolic rate

Prevent loss of mineral density

Reduce risk factorsfor falls

May reduce pain and dysfunction of OA

67
Q

Exercise guidelines for >65 y.o.

A

3-5x a wk

2x a wk (m. strengthening)

8-10 different exercises per session

20- 60 mins cardio

High intensity resistance training (>60% one rep max)

68
Q

Exercise guideling for >85 y.o.

A

2x a wk

20 min total time

40-60% of HR reserve

Resistance training:

2-3sets, 8-12 reps

progress by increasing by 5% wt and decreasing reps

69
Q

Exercise guidelines for an adult

A

M. mass, endurance and strength

Single set of 15 reps

2x a wk

8-10 diff exercises

Cardio, flexibility

3-5x a wk

55/65-90% of HR max

20-60 mins

70
Q

Osteopororsis

A

Metablic decrease in bone mass and microdamage to bone sturctures

Primary occure at any age but increases with age

Secondary assoc with meds, or other diseases

Characteristics:

Loss of height

Postural changes

Pain

Fractures (vertebreal compression, Femoral neck, Metatarsal)

71
Q

Osteoporosis

Risk Factors

A

>50 y.o.

Women > Men

Caucasian, Asian

Depression

Estrogen

Physical activity

Meds

Alcoholism

Smoking

Steroid therapy

Androgen withdraw from prostate CA

72
Q

Daily Calcium Req’

A

Women 25-50: 1000-1200 mg

Post Menopausal (no estrogen therapy): 1500 mg

Men up to 65: 1200 mg

Men >65: 1500 mg

73
Q

Osteoporosis

Prevention and managment

A

Prevention:

Education

Increase Ca, Mg intake

Vitamin D

WB physical activity

Decrease soda, caffiene

Decrease animal protein

Decrease meds assoc with osteoporosis

Managment

same as above plus

Meds

Fall prevention

74
Q

Osteoporosis

Implications for PT

A

Balance of vitamins and exercise

Resistive Exercise:

Builds bone mass

slows bone mass decline

reduce fx risk

Maintain m. mass and strength

Parameters:

Overload

Reversibility

Specificity

Intiial values

Diminishing returns

Maintainence

75
Q

Paget’s Disease

A

Metabolic disease characterzed by excessive bone reabsorption and formation, high bone turnover leading to weaker bones

Bone is replace by coarse irregular bones.

Thicker but weaker

Slow progression

76
Q

Paget’s Disease

Implications for PT

A

Strengthen m. to decrease pain

Exercise to:

Weight control

increase Cardio

Maintain strength

Maintain jt motion

Depends on severity

77
Q

Osteomyelitits

A

Inflammation of the bone cause by an infection (viral, bacterial, fungal, parasitic)

Can be chronic (persistant) or acute (new)

C/c in adults: back pain, low grade fever

C/c in child: High fever, intense pain, occasionally edema, erythemia, localized tenderness

78
Q

Osteomyelitis

Implications for PT

A

Prevention of infection

AROM, PROM

Skin care

Position changes

79
Q

Implant and Prosthesis infections

A

30% caused by hematogenous route

70% caused by wound infection near prosthesis or operative contamination

Persistant jt pain be be the onl symptom

Early infection: fever, jt pain, warmth, redness

Delayed infection: lack of systemic symptoms, jt pain/loosening

MAy req removal of implant

Tx of pathogen

80
Q

Prosthesis and Implants

Implications for PT

A

Recognize signs of infection

Redness, warmth, heat, decrease function, swelling

Know pt’s hx

Weakening of prosthesis

Post-op care

81
Q

Myositis

A

M. inflammtaion d/t an autoimmune condition or viral, bacterial, parasitic agent. Also assoc with cholestorol lowereing statins

Can be the first sign of malignancy

Types

Dermatomyositis

Polymyositis

Inclusion body myositis

Myositis ossificans

Idiopathic Inflammatory Myopathies

Rhabdomyolysis

Pyomyositis

82
Q

Dermatomyositis

A

Multpile weak muscle

rash

83
Q

Inclusion body Myositis

A

Isolation of an infection within a muscle

Slow progressive

Freq falling

trouble with stairs

trouble standing from sitting

84
Q

Myositis

Signs and symptoms

A

Malaise

Fever

M. swelling

Pain

Tenderness

Lethargy

Flu like symptoms

** for Derma and Poly, symptoms are located in connective tissue and m. fibers

85
Q

Myositis

Implications for PT

A

M. pain and weakness + Lipid lowering statins = Predispose pt to myotoxicity

Exercise can be a risk factor for the symptomatic presentation of myotoxicity

86
Q

Osteosarcoma

A

Malignant tumore commonly located in the long bones (femur)

Rapidly destructive = increased pain + swelling = Limited motion

Males <30 y.o.

Diagnosed with x-ray, CT scan, MRI, biopsy

Tx: Complete surgical removal, limb salvage procedure

87
Q

Osteosarcoma

Implications for PT

A

Rehab is indivualized, long and intensive

Deep breathing, coughin, precussion, and postural drainage

88
Q

Ewing’s Sarcoma

A

Malignant tumor found in bone or soft tissue

<20 y.o rare in blacks

Intermittent local bone pain after an injruy (makes it hard to diagnose)

Long bone and pelvis (Femur, tibia, fibula, humerus)

Tx: Chemotherapy

89
Q

Ewings Sarcoma

Implications for PT

A

patient specific

Intermittent

90
Q

Heterotrophic Ossification

A

Bone formation in the soft tissue

Cause:

Trauma, fx, surgery

SCI, Traumatic Brain INjury

Burns

Amputations

Dx with:

X-ray, CT, Ultrasound

91
Q

Myositis Ossificans

A

Bone formation in bruised, damaged or inflammed muscle

92
Q

Heterotrophic Ossification

Implications for PT

A

Directly related to the cause of changes (Disease, trauma, surgery)

Acute phase (1-2wks post-op):

Decrease swelling

Decrease scar formation

Pain mngmt

Gentle ROM

Inflammatory Phase (2-6wk post injury)

ROM

Gentle strengthening

93
Q

Myofascial Compartment Syndrome

A

Increased Interstitial fluid within a myofascial compartment comprised of vessel, nerves and muscle

Risk factors include:

Injury, fx, Contusion, Crush inj, Skeletal traction, burns

restictive dressings, cast

94
Q

Myopathy

A

Non specific M. weakness

May be metabolic, hormonal, autoimmune disease, hereditary, acquired

Diabetes leas to vascular, metabolic, and nurological myopathy

Dx:

M. biopsy

EMG

Lab findings (CPK, aldolase, AST, ALT, LDH)

95
Q

Myofascial Pain syndrome

A

Overuse, m. stress sydrome

M. developes trigger points

Implications:

Modalities: US, E-stim, compression

Myofascial release

Strengthening

Stretching

96
Q

Diabetic Ketoacidosis

A

Extreme hypoglycemia

Assoc with the body in a state of saturation

Fruity Breathe

Weak, rapid, pulse

Admin fruit, juice, honey

97
Q

Asthma

A

Chronic, obstructive lung disease

The imflammation of inner walls, and constriction of smooth m.

Symptoms: Wheezing, coughing, SOB, chest tightness

Risk Factors: Everyone, cold weather, emotional stress, pollen dust

Tx: Fowler’s positionm, encourage pursed lip deep breathing

98
Q

Cystic Fibrosis

A

Inherited chronic defect. Creating a predisposition to airway infections, obstructive lung disease which lead to loss of pulmonary function.

Production of thinick music

Symotoms: Increase in ant/post chest diameter, digital clubbing, weight loss, reccurrent pneumonia, wheezing/SOB, constipation, abd distention

Implications: Airway clearance tech, breathing exercises, improve posture, mobilize thorax

99
Q

Chronis Myelogenous Leukemia

A

CA of the white blood cells in bone marrow. Uncontrolled production of immature and mature granulocytes

Sign: Fatigue

weght loss

weakness

Abd pain

increased bleeding, bruising

100
Q

Fibromyalgia

A

M. pain and stiffness

Increase in substance P

Symptoms:

Fatigue

Sleep problems

ANxiety, depression

Spsecific tender points

101
Q

Systemic Lupus Erythematosus

A

Autoimmune disease effeceting multiple organ systems and skin rashes, poly arthritis and m. pain

Characterized by remission and exaccerbations

Effects the heart, CNS, Renal system, lung, connective tissue (not all at once)

Symptoms: CP with deep breath, Fatigue, m. weakness, mouth sores, jt pain, arthritis, skin rash, vasculitis

Monitor pt’s vitals

102
Q

DM

General Guidelines

A

Safe is btwn 100-250mg/dl, goal is to tighten and moderate

Btwn 70-100 mg/dl = provide carb snack and 15 min rest (symptom dependant)

Do not exercise when pt is over 250 mg/dl with ketosis

Hypoglycemic = juice and honey

Do not exercise at peak insulin times

Increased insulin may be requires if the patient is stressed

Avoid night exercising

103
Q

DM + Exercise

Before

A

Min 17 oz of fluid

Monitor glucose

Do not exercise when levels are >250 mg/dl

Exercise i hr after meal (min 2 hrs)

DM1 increase food, or decrease insulin

Increase insulin while menstruating

PTA Patho (4 decks)

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