Virtual Class Topics 1-10 Flashcards
What muscles does the ulnar nerve innervate and what are the nerve roots
MAFIA
Medial lumbercles
Actions of pinky, not ext
FDP, FCU
Interossei
AdPol, FPolBrev
C7-T1
What muscles does the radial nerve innervate and what is the nerve root
BEAST
Brachioradialis
Extensors
AbPolLong, anconeus
Supinator
Triceps
C5-T1
What muscles does the median nerve innervate and what are the nerve roots
LOAF
Lumbercles 1,2
O - ProQ, ProT, PLong
Actions of thumb FPL, FPB, AbPB, OpP
F - FCR, FDS, FDP
C5-T1
As a general rule do you want to stretch or strengthen first
Stretch
Describe the arthrokinematics of the CMC joint
Flex / Ext = Same
Abd / Add = Opposite
Describe the rule 6-6 weeks, 12 weeks and 6 months
Refers to post opperative goals
First six weeks - protective
Second 6 weeks - active/ mild protective
3 months to 6 months - ADL based activities
In open chain, which direction will the tibia rotate to lock
Tibia in Open chain will Laterally rotate to Lock the knee
TOLL
Describe the difference between active and passive insuficiency
Active - inability of two joint muscle to shorten simultaneously at both joints - muscle does not want to contract - same as intended motion (when a muscle is trying to do its thing but cannot)
Passive - the inability of a two joint muscle to lengthen simultaneously at both joints - muscle does not want to lengthen - opposite of intended motion (when a muscle is unable to limit a motion)
Describe femoral anteverion / retroversion and what is considered normal
Normal 8-14 anteversion
> 14, excessive anteverion, causes toe in
< 8, retroversion, causes toe out
What are the BP guidelines
Normal - 120/80
Elevated - 120-129 and still less than 80
Stage 1 - 130-139 or 80-89
Stage 2 - 140 or 90
Hypertensive crisis: Systolic over 180, Diastolic over 120
How does the nervous system regulate the heart
Parasympathetic system - decreases heart rate: Vagus nerve
Sympathetic system - increases heart rate: Sympathetic trunks
What is rate pressure product and what does it measure
HR x SBP
Oxygen demand of the heart
How does altitude affect HR, BP, CO and SV initially and then after 3 weeks
HR - Increases, Increases (remains elevated)
BP - Increases, Normal (returns to normal)
CO - Increases, Normal (returns to normal)
SV - no change, Decreases
How does aquatic therapy affect cardiovascular markers
HR - Decreased
BP - Decreased
VC - Decreased
Weight bearing - Decreased
Edema - Decreases
SV - Increased
CO - Increased
Work to breath Increased
What happens if the frontal lobe is damaged
A Brilliant CEO
A - apraxia
B - broca aphasia
C - control of movement impaired
E - emotion
O - olfaction
What happends when there is damage to the occcipotal lobe
Oc-see-pital lobe
Visual defecits
What happens if there is damage to the parietal lobe
Perceptual disorders (neglect)
What happens if there is damage to the temporal lobe
WHaT
Wernicke aphasia
Hearing loss
Temporal lobe
Name the cranial nerves
Olfactory
Optic
Occulomotor
Trochlear
Trigemonal
Abducens
Facial
Vestibulochochlear
Glossopjaryngeal
Vagus
Spinal acessory
Hypoglossal
Describe CN 1
Olfactory
Type: sensory
Function: Sense of smell
Affected: Anosmia
Describe CN 2
Type: Sensory
Function: Vision, color, acuity, peripheral vision
Affected: Blindness, myopia (short sightedness), presbyopia (farsightedness)
Describe the pupillary light reflex
Reflex to protect the eyes from noxious light stimulus
Normal: Both pupils will constrict via CN3
Sensory component - CN2, sends signal
Motor component - CN3, constricts pupils
Describe CN 3
Occulomotor
Type: Motor
Function: Moves eyeballs, opens eyelids, constricts pupils
(Eyes up, down, in, and up and in)
Affected: Lateral strabismus, ptosis (drooping eyelid), dilation of pupils
Which CN opens eyes and wihich cranial nerve closes them
CN 3: Opens
CN7: Closes
The restaurant “opens” at 3 “closes” at 7
Describe CN 4
Trochlear
Type: Motor
Function: Look down and in
Affected: Inability to look down and in
Describe CN 5
Trigemonal
Type: Mixed
Function: Sensation to face, Muscles of mastication, Corneal reflex - afferent, Sensation to anterior tongue, Dampens sounds
Describe the corneal reflex
Closes eyelid when cornea touched
CN 5: Afferent
CN 7: Efferent
Describe CN 6
Abducens
Type: Motor
Function: Abduct the eyes, look laterally
Affected: Medial strabismus
Describe CN 7
Facial
Type: Mixed
Function: Muscles of the face, Corneal reflex - efferent, Closes eye lid, Taste to anterior 2/3 tongue, Dampens sounds
Describe CN 8
Vestibulochochlear
Type: Sensory
Function: Balance, Hearing
Affected: Conductive hearing loss (External structures), Sensorineural hearing loss (Inner ear affected)
Describe CN 8 testing
Rinne test - determines type of hearing loss
Tuning fork placed on mastoid process wait until pt can no longer hear ir
Then place in front of ear
If sound is heard: AC>BC = SN loss
If sound is not heard: BC>AC = Con loss
Weber - determines side of hearing loss
Tuning fork placed on sagittal suture
Normal - equally loud on each side
If SN loss, loud side = normal side
If Con loss, loud side = affected side
CANS
Describe CN 9
Glossopharyngeal
Type: Mixed
Function: Posterior tongue sensation and taste
Gag reflex - afferent
Initiates gag reflex
Describe CN 10
Vagus
Type: Mixed
Function: Gag reflex - efferent
Moves uvula
Nerve pulls uvula to ipsilateral side
Desdcribe CN 11
Spinal Accessory
Uper traps
Describe CN 12
Hypoglossal
Tongue movements
Lick your Lesion”
Tongue will deviate toward damaged CN 12
Describe the motor and sensory supply to the tongue
Ant 2/3
Taste: 7
Sensation: 5
Posterior 1/3
Taste and sensation: 9
Motor function: 12
What is needed to share medical information
POA
Writen consent
What are the core values of PT
Altruism
Patient autonomy
Professional judgement
Beneficence
How many ML is tidal volume
roughly 500
How much larger should IRV, ERV and RV be compared to TV
IRV: 5-6 times
ERV: 2-3 times
RV: 2-3 times
How do obstructive lung diseases affect lung volumes
TV, RV, FRC, TLC increase
Everything else decreases
How do restrictive lung diseases affect lung volumes
Everything decreases
Name some obstructive lung diseases
ABCbCfE
Asthma
Bronchiectasis
Chronic bronchitis
Cystic fibrosis
Emphysema
What is the most common restrictive lung disease
Idiopathic lung fibrosis
Describe normal breath sounds
Vesicular, most of lungs
Bronchiovesicular
Bronchial, manubrium
Tracheal, trachea in neck
Louder, higher pitch, less difuse
Describe Rhonchi
Resembles snoring
Describe wheeze
High pitched whistling
Caused by obstruction
Describe Crackles
Poping sounds
Common with edema and CHF
Describe pleural rub
Sounds like sandpaper rubing together
Indicates pleural inflammation
Describe Bronchophony, egophony and whispered pectriloqy
Bronchophony: Increased vocal resonance with greater clarity than normal, Say 99
Egophony: Type of bronchophony in which the spoken E sound changes to an A sound
Whispered pectoriloquy: Increased loudness of whispering
What are some relevant quality control agencies you should be aware of
JHAKO - hospitals
CARF - rehab facilities
CMS - determines reimbursement
OSHA - Worker safety
Describe airborn infection PPE and what are some diseases
N-95 mask
Gown and gloves if severe
MTV
Measles
TB
Varicella
What is contact precaution PPE
Gloves and gown
What is droplet precaution PPE
Mask
What are some CPR guidelines
100-120 compressions per minute
Compress chest to 2 inches
Minimize pauses between chest compressions
What is the correct way to don / doff PPE
Doffing PPE
Doff in alphabetical order
Gloves, goggles, gown, mask
Donning PPE
From down up, gloves last
Gown, mask, goggles gloves
Describe a hickman catheter
Hickman catheter
Provides antibiotics, nutrition, and blood samples
What is a swan ganz catheter
Device that is inserted through the internal jugular vein or femoral vein into the pulmonary artery to monitor blood flow and the function of the heart
What is a central venous presure catheter
Central venous pressure catheter
Measures blood pressure in right atria and superior vena cava
What is a chest drainage tube
Chest drainage tubes
Removes air, blood, and other drainage from chest cavity
How does muscle tightness and weakness affect gait
Tightness will cause a decrease in ROM in opposite motion
Weakness will cause decrease in ROM in the same direction
How do tight hip flexors affect gait
Smaller opposite step length
Anterior pelvic tilt
Terminal stance decreased on ipsilateral side
Early toe off
Lumbar lordosis
How do weak hip flexors affect gait
Step length on same side shorter
Circumduction
Hip hike
Describe trunk lean and gait
The trunk will lean toward weak muscles when in stance phase
The trunk will lean away from the weak muscles when in swing
How does prosthetic socket depth affect gait
Socket too shallow:
Presents like weak muscles
Low anterior wall mimics weak quads
Socket too deep:
Similar to tight muscles
High anterior wall mimics tight hip flexors
What are the pressure tolerant areas around the knee
Patellar tendon
Medial tibial plateau
Tibial and fibular shafts
Distal limb
What are the pressure intolerant areas around the knee
Anterior tibia
Anterior tibial crest
Fibular head and neck
Fibular nerve
What drains into the R and L lymphatic ducts
R: R of face and neck, R arm, R of torso
L: Everything else
Describe primary vs secondary lymphedema
Primary
Congenital deformity
Secondary
Damage or dysfunction of the lymphatic system
Describe edema grading
1+ Mild: < ¼ inch
2+ Moderate: .25-.5 inch, Less than 15 seconds
3+ Severe: .5-1 inch, 15-30 seconds
4+ Very severe: More than 1 inch, More than 30 sec
Describe lipedema
Bilateral condition swelling affecting the lower extremities
Pathological fat accumulation
No specific cause, congenital
Ankel and feet spared
Painful to touch
Stemmer sign negative
Describe the decongestive therapy stages for lipedema
Phase 1
MLD
Multi Layer compression bandages, day and night, low stretch bandages in phase 1
Skin and nail care
Exercise
Phase 2
Self MLD by pt
Compression therapy: Compression garments during the day, multi layer bandages in the evening
Skin and nail care
Exercise: AROM, ROM, Gentle stretching, aerobic exercise, proximal to distal exercises
Describe how the hip extensors and flexors can affect step length
Hip flexor tightness / hip extensor weakness
Opposite step length decreases
Hip extensor tightness / hip flexor weakness
Same side step length decreases
