Therapeutic Practice Flashcards

1
Q

active rom

A

patient does it them selves

can use goniometry

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2
Q

passive rom

A

patient moves with assistance

see if movement is possible but muscles can’t produce it

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3
Q

goniometry

A

measuring joint angles

use anatomical landmarks

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4
Q

limiting factors

A

pain
soft tissue apposition
apprehension
bone on bone

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5
Q

measuring crutches

A

put at an angle
hand piece at level of greater trochanter or middle wrist crease
elbows slightly bent

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6
Q

crutches positioning

A

sit to stand - crutches on same side in a H

stairs - opposite hand to bannister in a letter T

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7
Q

crutches and stairs

A

nwb
up - hop up, crutches, good leg
down - crutches, hop, good leg

pwb
up - good leg, bad leg, crutch
down - crutch, bad leg, good leg

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8
Q

frames

A

dont use frame to get up and out of chairs with push up from seat
more stability

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9
Q

stick measurement

A

take ferrule off
turn upside down and hold a few inches away from body
mark level of greater trochanter - a few for ferrule
saw off and replace ferrule

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10
Q

sticks

A

hold on opposite side to bad leg

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11
Q

wheelchair - kurbs

A

up - move till wheels touch kerb, push down on tipping lever, move forwards and then lift back end up
down - move backwards until wheels at edge, lower wheels, keep tilted until front wheels clear

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12
Q

wheelchair - taking it apart

A

brakes on, foot rests off, arm rests off, collapse it in the middle, fold down the back, remove wheels

putting it back together - make sure everything clicks in place

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13
Q

wheel chair transfers

A

no assistance - pop over, move to edge of chair, take arm off, push arm with arms onto transfer surface
one person - positioned at the front, puts hands under pelvis and hips to help lift patient over
two people - one leans patient forward, other hands under hips to help guide pelvis over

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14
Q

massage pain gate theory

A

gate in dorsal horn of the spine called pain gate receives sensory info and passes it onto the brain
during massage - non painful fibres are stimulated and blocks the transmission of painful fibres being sent to the brain
the non painful fibres send info about touch and these excite the interneurone which inhibits the pain signal and closes the pain gate

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15
Q

soft tissue healing

A
  1. bleeding - couple hours
  2. inflammatory - few hours to couple days, bring blood and chemicals to the area
  3. proliferation - generation of repair materials, 24-48 hours to a couple weeks, scar formation
  4. remodelling - functional scar similar to parent tissue, couple weeks after trauma
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16
Q

lymphatic systems

A

get rid of waste and toxins
transports lymph
helping lymph flow = important

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17
Q

energy crisis

A

increased muscle fibre tension = sustained contraction = increased pressure = tissue hypoxia = can’t break down atp = switch to anaerobic system = lactic acid = sarcomeres can’t unhook

18
Q

motor end plate

A

increased acetylcholine = trigger point location

could lead to energy crisis and increased tension

19
Q

central sensitivity

A

referred pain = intensity and size correlates with cns excitability
chronic pain = more sensitised nervous system = more pain travels to brain

20
Q

descending inhibition

A

inhibitory affect from the brain down to the spinal cord to inhibit pain pathways
excite inhibitory inter neurones which inhibit pain

21
Q

DTFM

A

continuous for 10 mins
pain relief - may bruise
mechanically break down scar tissue
exact localisation at 90 angle

22
Q

trigger points & technique

A

deep taut bands localised areas
increase blood flow
5 holds of 60-90 seconds
gradually apply pressure pain should reduce

23
Q

efflurage

A

stroke pressure towards heart and lymph distal to proximal

remove chemical irritants

24
Q

stroking

A

pt gets used to touch
increase flow to superficial muscles
proximal to distal

25
Q

petrissage

A

increase mobility between surface interfaces

compress soft tissue

26
Q

kneading

A

proximal to distal
circular motions
hands in opposite directions
pressure up middle of spine

27
Q

wringing

A

grab tissue
tissue compressed to get a roll of tissue
push one hand away and one hand towards

28
Q

rolling

A

create diamond shape with hands
proximal to distal along fibres
grab tissue and pull back towards self

29
Q

picking up

A

compress and scoop tissue to end feel

continue along tissue length

30
Q

pnf

A

proprioreceptive neuromuscular facilitation
max contraction = max relaxation
form of stretching

31
Q

pnf method

A
stretch - hold 10 secs
isometric or concentric contract - resistance for 10 secs
relax
passive stretch 30 secs 
repeat 2-5 times
32
Q

pnf hold / relax - autogenic

A

stretching same muscle as tight muscle

isometric contraction at end of range

33
Q

pnf hold / contract - autogenic

A

stretching same muscle as tight muscle

concentric contraction of agonist through range from end of range

34
Q

pnf hold / relax - reciprocal inhibition

A

stretch antagonist of tight muscle

ismometric contraction at end of range

35
Q

MET

A

muscle energy technique
muscle held at resistance barrier
relax and lengthen muscle

36
Q

MET technique

A
20% strength 
5-10 secs hold 
use agonist or antagonist 
use resistance from physio or object 
stretch within 15 sec latency period - 30 secs
2-5 reps
37
Q

Massage questioning points

A

J - increase blood flow, pain gate theory, break down scar tissue, accelerate healing
B - increase mobility, reduced pain and tension
S - patient positioning, consent, finger nails short, only expose areas needed
C - open wounds, allergies, inflammation, bone growth, infection
P - fragile skin, pain, oil staining clothes
PT - continue until improved function
O - medical history

38
Q

Active / passive ROM questioning points

A

J - see if joint capable of movement, identify weak muscles
B - improve flexibilty
S - over stretching, patient positioning
P - pain, different end feels
C - injury, early healing stages
PT - test at beginning and end of treatment

39
Q

PNF questioning points

A

J - tight restrictive muscles
B - improve rom, flexibility, mobility, reduce pain
S - over stretching, previous injury
C - bony block, inflammation, sharp pain, early healing
P - over stretch, muscle weakness, elderly, immobilisation

40
Q

walking aids questioning points

A

J - unbalanced, pwb, nwb, poor posture
B - increase stability, help posture, reduce falls, weight relief
S - stairs, chairs, p/nwb, ferrule isn’t worn, correct height
P - working brakes, tipping up frames, correct use
PT - injury, increase weight bearing capacity, and less reliant
C - body strength, hand dexterity, type of walking aid, access to home

41
Q

wheelchair questioning points

A

J - safety, injury, balance disturbances, lower limb problems, CR issues
B - mobility
S - getting in and out, kerbs, secure arm and foot rests, brakes work, free spinning wheels
C - stairs, home layout, space in house
P - correct use, manipulation of doorways, previous experience
O - upper body strength, family members / carers, preference of wheelchair, leg length, height, weight