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becky: THER EX > THEREX FINAL REVIEW > Flashcards

THEREX FINAL REVIEW Flashcards

1
Q

tendonitis healing timeline

A

3-4 weeks to 5-7 weeks

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2
Q

lacerations of tendons healing time

A

5-7 weeks to 3-6 months

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3
Q

exercise induced muscle strain takes ___ days to recover

A

0-3 days

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4
Q

grade 1 mm strain takes

A

0-14 days to recover

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5
Q

grade 2 mm strain takes ___time to recover

A

4-14 days to 2-3 months

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6
Q

grade 3 mm strain takes up to ___time to recover

A

6 months to recover

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7
Q

ligament grade 1 sprain takes ___ to recover

A

0-3 days

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8
Q

ligament grade 2 sprain recover time

A

3-4 weeks-3-6 months

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9
Q

ligament grade 3 sprain recover time

A

5 weeks-6 mo/1 year

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10
Q

ligament graft takes how long?

A

2-3 mo-up to 2 years

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11
Q

bone takes how long to recover?

A

5-7 weeks to 2-3 months

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12
Q

cartilage repair takes how long to recover?

A

2-3 months up to 2 years

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13
Q

pre-op management should include

A

focus on restoring full ROM (pre-op ROM affects post-op ROM)
*education
*expectations
*precautions post-op education
*pain management

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14
Q

post-op primary care should include what?

A
  1. clean dressing
  2. distal pulses
  3. look for compartment syndrome
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15
Q

5 post op complications that can occur early or late in healing

A
  1. infection (red, hot, pain, LOF, swelling)
  2. DVT/PE
  3. delayed wound or bone healing
  4. nerve entrapment/compression
  5. adhesion/scarring
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16
Q

BENCH 3 PTS

A
  1. bed rest 3+ days
  2. edema
  3. non-varicose superficial veins
  4. cancer (active)
  5. history of DVT

3 CM LARGER ON AFFECTED LEG

Paralysis
Tenderness
Swollen

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17
Q

PEACE is for when?

A

immediately after post-op

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18
Q

LOVE is for when?

A

subsequent care after post op

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19
Q

grade 1 mm strain

A

mild damage, minimal loss of strength/motion

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20
Q

grade 2 mm strain

A

no rupture but significant LOSS OF STRENGTH/MOTION
*weak/painful

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21
Q

grade 3 mm strain

A

defect that you can feel
need sx probably
weak, PAINLESS SOMETIMES

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22
Q

grade 1 ligament sprain

A

stretched but keeps joint stable
*does NOT LIMIT MOTION

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23
Q

grade 2 ligament sprain

A

joint LOOSE (partial tear)

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24
Q

grade 3 ligament sprain

A

SPLIT INTO 2 PIECES, joint unstable (complete tear)

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25
Q

What is the max protection phase post op?

A

days –6 weeks
*inflammation/pain phase
*precautions!
*PROM or AAROM depending

26
Q

what is the post op mod protection phase?

A

less inflammation, more mobility
4-12 weeks long
FULL, PAIN FREE AROM
*want to restore joint motion, gradually strengthen, improve neuro-msk control/stability

27
Q

post op min protection phase

A

6 weeks-12 months
*very little protection
*restore strength, patient education!

28
Q

case! A 17 year old patient has non op PCL/MCL tear! according to guidelines, he can jog at 8 weeks. But he didn’t get PT until 5-6 weeks and lacks full ROM, strong quad activation.
Can he safely run?

A

NO
*consider the individual and not just the timeline
*ROM has a window of time
*can’t regain motion after few months of healing

29
Q

if you have a stress fx, will it show on imaging?

A

imaging may appear negative!
*may not be seen for 1 wk to several months

30
Q

ottawa knee rules

A
  1. age over 55
  2. can’t take 4 steps
  3. tenderness patella
  4. tender at fib head
  5. can’t flex to 90 degrees
31
Q

Ottawa anke/foot rules

A
  1. pain at ankle OR midfoot AND
    tender at lateral or medial mal
    tender at base of 5th met or navicular
    OR CAN’T WEIGHT BEAR 4 STEPS
32
Q

primary bone healing requires

A

absolute stability
*STRESS SHIELDING

33
Q

secondary bone healing is known as

A

fracture repaired without surgery
*cast or sling (indirect healing)

34
Q

what is stress shielding?

A

PATIENT IS NON WB
PLATES*
fragments held by compression, takes slower for bone to heal
*absolute stability/no motion at fracture site

35
Q

what is stress sharing?

A

lets secondary callus formation
-partial load transmission across fx site
-casts, pins, screws, external fixators, ETC…

*forces of WB distributed btwn bone and device
*EARLY WB IS GOOD

36
Q

early WB with what types of devices

A

cast, rod and external fixator (secondary healing)

37
Q

late WB with what devices

A

PLATE (unless bridged)
*delayed WB with pin, screw, wire

38
Q

exercise post-ORIF MAX PROTECTION PHASE

A

first 6-8 weeks
ankle pumps, deep breathing
resistive ex to everything except sx leg
submax mm setting:
-glutes
-abd
-add
-quads
-hams
supine vs standing ex:
-flex, abd, ext, SLR

39
Q

posterolateral THA

A

cut the glutes
*no flex 90
*no add
*no IR
abduction pillow, transfer to non op side

40
Q

direct anterior approach THA

A

cut the TFL/sartorius (abductors are weak!)
*no ext
*no ER, NO ABD
avoid frog leg! turn towards bad leg, use abduction pillow

41
Q

what kinds of exercises are for day 1-3 post op?

A

ankle pumps,
gait training, transfers
functional training with movement and WB restrictions
*ISOMETRICS

42
Q

what kinds of exercises for phase 2 post op?

A

week 1-6 MOTION IS LOTION
endurance, CARDIO, proprioception, nmes, ROM*

43
Q

full ROM and full WB should happen for patellar post op when

A

6-12 weeks
12 weeks on no more ext brace

44
Q

tibial plateau post op guidelines for ROM week 1-2

A

AAROM: 90 degrees of flexion
NO WB
isotonic ankle/glutes

45
Q

tibial plateau post op guidelines for ROM week 2-8

A

FULL ROM, quad sets isometric
NO WEIGHT BEARING AT 2 MONTHS

46
Q

when do you weight bear for tib plateau post op?

A

PROGRESS TO full ROM, BEGIN AT END OF 3 MONTHS
*gentle resistive

47
Q

WEEK 12-16 for tib plateau post op

A

full AROM progressive resistance WBAT

48
Q

when is ACL ligament reconstruction weakest?

A

at 6-12 weeks!
most likely torn at 12 weeks

48
Q

criteria for full ambulation

A

need 0 degrees ext, 90 deg knee flex
30 SLR without lag
min pain, swelling
symmetric gait with no limp
MD/PT approval

49
Q

ACL STRENGTH AND JOGGING PHASE

A

6-12 weeks
criteria: 2 degrees of normal knee ext, 120 flex
quad/hams 60% normal
*can do 1 min of single leg squats
pain below 3

50
Q

ACL REHAB
agility and power phase

A

12-20 weeks post op
strength, weight training
plyometrics and light agility

51
Q

ACL RETURN TO PLAY POST OP

A

20+ weeks
need pain less than 2/10
need quad/hams 90%, 60% HQ ratio for women
90% SLH test

52
Q

PCL management

A

Closed chain immediately!
NOT HAMS UNTIL 6-12 WEEKS

53
Q

MCL AND LCL POST OP

A

for 6 weeks avoid valg/varus, rotation
QUAD STRENGTH, NORMAL ROM

54
Q

WB OR ROM RESTRICTION TO MCL/LCL?

A

no

55
Q

MCL and LCL grade 1 tear should heal

A

few days to two weeks
(2: 2-4 weeks)
(3: 4-8 wks)

56
Q

quad/patellar tendon rupture protocol for first 12 weeks

A

NO RESISTED OPEN CHAIN STRENGTH
*WBAT locked in ext

57
Q

quad/patellar tendon gets full ROM when

A

8 weeks

58
Q

what mm are activated during quiet stance

A

gastroc/soleus
tib ant
glute med
TFL
iliopsoas
erector spinae

59
Q

what happens when post displacement of COG but weak quads

A

fall-no ankle

60
Q
A
61
Q
A

becky: THER EX (11 decks)

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