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NMt200 exam > wk 9 > Flashcards

wk 9 Flashcards

1
Q

pelvic joint

A
  • 1 Pubic Joint
  • 2 Sacroiliac Joints

minimal movement

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2
Q

SI joint mvoement

A

anterior and posterior rotation

symphysis pubis- gliding in inferior/superior direction

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3
Q

risks of SI mobilize/manip

A

minimal risk, hyper mobile SI joint (should strengthen muscles)

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4
Q

contraindications for SI manip/mobilize

A
  • Ankylosing Spondylitis * InflammatoryArthrides * Osteoporosis
  • Lumbar spine fracture * Skeletal metastases
  • Cauda equina syndrome
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5
Q

low back pain in 20-30% of patients is from

A

dysfunctional SI joint mechanics

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6
Q

SI manip/mobilization indications

A
  • Low Back Pain in 20-30% of all patients is a result of dysfunctional SI Joint mechanics
  • Hypo-mobile SI Joints
  • Hip Pain
  • Elevated or Lowered ASIS
  • Functional Leg Length Discrepancy
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7
Q

widely accepted evidence based benefit of manip

A

reduce pain

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8
Q

benefits of SI manip/mobilize

A
  • Reduce Pain (widely accepted evidence-based)
  • Restore optimal ROM of segment
  • Restore quality of movement
  • Improve proprioceptive function (Via vibratory nature of
    oscillation activating sensory mechanoreceptors)
  • Segment specific via contacts placed on or close to segment
    being mobilized vs Manipulation (Grade 5) tends to have
    collateral effects.
  • Improve kinetic chain function
  • Reduce muscle guarding
  • Compensatory mechanical stress on adjacent structures
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9
Q

key actions for hypothryoid botnaical

A

adaptogen, alterative

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10
Q

herbs for hypothryoids

A

Withania somnifera (Ashwagandha)
Panax ginseng (Korean red ginseng)
Fucus vesiculosus (Bladderwrack)
Iris versicolor (Blue flag)
Rhodiola rosea (Rhodiola)
Rumex crispus (Yellow dock) Eleutherococcus senticosus (Siberian ginseng)

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11
Q

ashwaganada CI

A

can increase androgens and lead to acne and increased libido, avoid in PCOS

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12
Q

how much of communication is nonverbal

A

80%

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13
Q

door openers/ encouragers

A

invitation to talk i.e. tell me more

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14
Q

3 P of insomnia

A

predisposing, precipitating, and perpetuating factors

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15
Q

non pharm for insomnia

A

-stimulis control
-progressive muscle relaxation
-sleep hygiene

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16
Q

insomnia severity index

A

> 10 is insomnia

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17
Q

Pittsburg sleep quality index

A

> 5 is poor sleep

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18
Q

Hepworth sleepiness scale

A

> 10 is sleepy

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19
Q

STOP BANG

A

> 3-4 is intermediate risk of OSA
5-8= high risk

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20
Q

polysomnogrpahya
actigraphy

A

poly- OSA, movement disorder

actigraphy- circadian rhythm problems

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21
Q

first line treatment for insomnia

A

CBT I or non pharmolgocial

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22
Q

get out of bed if cant fall asleep in

A

20 mins

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23
Q

x

A
  • Tx
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24
Q

impact intensity to hydro

A

temp, duration, wetness, pressure, freq3euncy, permeability

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25
Q

extreme temp + short duration

neutral temp + long duration

wet material

more friction and pressure

A

both more intense

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26
Q

increased area covered by heart

A

stronger derivative effect

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27
Q

smaller area covered by cold

A

stronger revulsive (depletion)/ retrostatic effect

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28
Q

reflexive vs direct

reflexive useful when

A

limited access to the area

local hot or cold is containdicatred

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29
Q

what carries temeprature well

A

water

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30
Q

closed body system in hydro

A

skin > nerves > vessels

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31
Q

direct what flow

A

blood and lymph

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32
Q

derivation

A

heat
-blood and lymph flow towards heat

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33
Q

depletion (revulsive/retrostatic)

A

-cold
-blood and lymph flow away from cold

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34
Q

alternating/ contrast

A

-combine heat and cold= pumping action
-decongestive

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35
Q

arterial trunk reflex

A

-apply over arterial trunk has same effect on arterila branches (superficial and deep artery)

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36
Q

collateral circulation

A

-relationship between superficial and deep branches of a vessel
-oppsite effect between branches

i.e. if put heat on superficial artery to vasodilate then the deep artery will constrict

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37
Q

sodium is not salt

A

1 gram of salt (sodium chloride) = 387 mg of sodium (approximately 40% sodium by weight)

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38
Q

loss of sodium via

A

sweat

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39
Q

upper limit of sodium intak

A

2.5 g

adequate intake= 1500mg

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40
Q

potassium sources

A

avocado, legumes, seafood, greens, dairy, banana

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41
Q

vitamin C for

A

cholesterol metabolismv

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42
Q

vitamin K for

A

vascular health and calcium homeostasisv

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43
Q

vitamin E for

A

reduce lipid peroxidation and platelet aggregation

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44
Q

CVD diet

A

-increase monounsaturated and omega 3 FA
-increase fiber
-increase Vitamin E, A, B6, B12, folate
-plant > animal protein (meditteranean)

45
Q

cholesterol

A

only 20% from diet, 80% made in body

46
Q

to reduce LDL whats best fat

A

replace saturated with mono and polyunsaturated fats

saturated= solid at room temp (butter, lard, coconut oil), meats

47
Q

fiber reduces

A

LDL cholesterol

48
Q

fiber amount

A

17-30 g (total fiber)
7-13 g (soluble fiber)

49
Q

20 - 50% of people are salt sensitive (genetic)

A

increases in blood pressure are directly observed with salt consumption

50
Q

DASH diet for hypertension

A

<2300mg of sodium (lower version of 1500mg)

27% fat, 18% protein, 55% carb

2100 calorie day: potassium intake of 4700 mg per day, calcium 1250 mg, magnesium 500 mg, fibre 30 g, cholesterol intake limit of 150 mg per day

51
Q

daily servings in a dash diet (2100 cal)

A

Grains: 6 – 8
Vegetables: 4 – 5
Fruits: 4 – 5
Fat-free or low-fat dairy: 2 – 3 Lean meat, poultry, fish: 6 or less
Fats and oils: 2 - 3
Sweets/added sugars: 5 or less per week
Nuts, seeds, legumes: 4 – 5 per week

52
Q

study for whole grinds: 10 gram increase in intake is associated with

A

4% reduction in CVD mortality

(compare to lowest intake group, highest group had 13% lower risk of mortality)

53
Q

10 gram increase of red and processed meat in a day is associated with

A

1.8% risk of CVD mortality

highest intakes have 23% increased CVD risk

54
Q

dairy on CVD

A

no effect

55
Q

nuts on CVD

A

27% lower risk in highest vs lowest consumption groups

56
Q

legumes

A

no associated with CVD mortality

10g increase causes 0.5% reduction

57
Q

fruit and veg and CVD risk

A

28% lower risk in fruit and veg

36% reduction if higher fruit

plateau after 5 servings

58
Q

Which of the following serving recommendations is consistent with a 2100 calorie/d DASH diet?
A. 2 – 3 servings of full-fat dairy per day
B. 6 – 8 servings of whole grains per day
C. 4 – 5 servings of nuts and seeds per week
D. 5 servings or less of added sugar per week

A

B, C , D

** not A because recommend 2-3 servings of low fat or fat free dairy

59
Q

stages of behaviour change

A

pre contemplation (dont want to change, build awareness)
contemplation
preparation
action
maintenance

60
Q

ROM in Atlanta occipital joint C0-C1

A

15 degrees
flex, ext, lateral flex

61
Q

atlantoaxial joint C1-C2

A

45 degree rotation

62
Q

risks of cervical manip/mobil

A

high risk bc vascular and nervous tissue

disc herniation, cervical artery dissection, dislocate or fracture, vertebral artery dissection

63
Q

warning signs or risk factors of cervical artery disection

A
  1. sudden pain in side of neck or head
  2. dizzy, unsteady, vertigo
  3. age < 45
  4. migraine
  5. connective tissue disaese
  6. recent infection (URTI)
64
Q

signs of vertebrobasilar ishcemia

A

5 Ds and 3 Ns
-dizzy (vertigo)
-drop attack (lose conscious)
-diplopia (vision)
-dysarthria
-dysphagia
-ataxia of gait,
-N/V
-unilaternal numbeness
-nystagmus

carotid artery ischemia:
-confusion, dysphasia, headache, hemianesthesia, hemiparesis

65
Q

contraidincations for cervical manip

A

tumor
infection
diplopia
nasuea
tinnitus
dysphagia
RA
vascular disease
ankylosing spondylitis
etc

66
Q

indications for cervical mobilizations

A

-headahce
-TMJ
-nonspecific neck pain

67
Q

headaches and vitamin deficney

A

IDA

low ferritin

68
Q

forms of iron

A

-hemoglobin and myoglobin (majority of iron)

-storage iron (ferritin in liver, spleen, marrow) (excess is hemosiderin)

-transport iron (bound to transferrin)

69
Q

iron absorption

A

heme vs non heme
fe3+ vs fe2+

fe2 (fe3+ has to be reduced to Fe2+) and heme better

70
Q

most of diet iron is

A

non heme (all plant and 60% of animals)

71
Q

17% of non heme and 25% of heme

A

absorbed

72
Q

iron deficiency enhances absorption of

A

heme, but not non-heme iron

73
Q

absorb iron in

A

upper SI

74
Q

amount of iron absorbed determined by

A

ferritin already in intestinal mucosal cells

75
Q

when iron binds apoferritin or apotransferrin and forms ferritin and transferrin

A

when saturated these sites- halt iron absorption in SI

76
Q

vitamin C and acidic envo

A

increase iron absorption (via reduction of Fe3+ to 2+)

77
Q

animal protein

A
  • Heme iron improves absorption of nonheme iron eaten at the same meal via peptides released from meat and fish
78
Q

infection and iron absorption

A

decrease

79
Q

binding agents affecting iron absorption

A
  • Phosphates, phytates, and oxalates prevent absorption
  • Some vegetable proteins (like soy) decrease absorption
  • Polyphenols (tea and coffee) decrease nonheme iron absorption
80
Q

calcium and iron

A

inhibit iron absorption (in supplements)

81
Q

iron excretion

A

no system to actively excrete

filtered through kidneys and reabsorbed

blood loss

regulation occurs at absorption

82
Q

food triggers of headaches

A

caffeine, milk, cheese, citrus, processed meats, MSG, aspartame, and alcohol

fasting

low omega 3

83
Q

PICA

A

craving for non food item (i.e. ice, soil, hair, paint chips)

associated w iron deficiency

84
Q

iron supplementation

A

150-200mg elemental iron

not all iron salts yield same amount of elemental iron

ferrous glyconate= 12%
ferrous fumarate = 33%

85
Q

best iron salt (non heme)

A

ferrous fumarate

86
Q

heme iron supplements vs non heme (iron salts) when to talk

A

heme with meals

non heme iron salts on empty stomach

87
Q

what to avoid when supplementing with iron

A

other minerals (magnesium, calcium, zinc)

antacids

88
Q

side effect of iron supplementation

A

constipation

89
Q

diet for migraine

A

low glycemic index

low fat

ketogenic

DASH

IgG food sensitivity test

90
Q

How long should iron therapy be continued after hemoglobin levels normalize in a patient with a history of iron-deficiency anemia?
A. 1 week
B. 4 weeks
C. 8 weeks
D. 24 weeks

A

C. 8 weeks

91
Q

aspects of informed consent

A
  • Nature of the intervention (or assessment) and rationale
  • Expected outcomes and/or benefits
  • Material risks (including financial costs, significant harm or death) * Alternatives
  • Consequence of no treatment
  • Right to withdraw consent at any time
92
Q

cognition peaks at

A

30 yrs old and declines after

93
Q

risk factors for dementia

A

Type 2 diabetes
Hypertension
Obesity
Smoking
Depression
Insufficient mental activity Insufficient exercise

94
Q

muscle mass decrease with aging

A

Muscle mass decreases approximately 3 – 8% per decade after the age of 30 with the rate of decline higher after the age of 60

95
Q

GI and age related body changes

A

Loss of gastric acid interferes with the absorption of vitamin B12 and reduces uptake of thiamine, folate, calcium, and iron

Neural changes result in increased transit time (constipation) and early satiety

96
Q

macros in olders

A

high fiber- 45-65%
fat 20-35%

protein 0.8 g/kg body weight
or to reduce muscle loss do 1-1.25 g/kg body weight

97
Q

mineral and electrolytes in aging

A

Ca2+ (bone loss)

iron lower post menopause

K+ (if on diuretic)

Na+ < 2300mg (BP and fluid retention)

98
Q

vitamins in againg

A

folate (for preventing increased homocysteine and atherosclerosis)

b6 for muscle mass

b12 for gastric acid and absorption

vitamin D for calcium

99
Q

fluids in eledrs

A

less thirsty, kidneys not as good

1.2 L to 2 or 3 L depending on body size and activity levels

100
Q

neuroprotection

A

antioxidants

Pinocembrin (honey, propolis, ginger)
Naringenin (citrus)
Genistein (soy)
Orientin (tea)
Eriodictyol (citrus, peppermint)
Luteolin (radicchio, peppers) Apigenin (parsley, celery)

polyphenols

Curcuminoids
Taurine (meat, dairy, fish)
Harpagoside
Alpha lipoic acid (spinach, broccoli, tomato, organ meats)
Allicin (garlic)

101
Q

diet for alzihmers

A

Mediterranean and Japanese and DASH

Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)

102
Q

Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)

A

3+ servings a day of whole grains
1+ servings a day of vegetables (other than green leafy)
6+ servings a week of green leafy vegetables
5+ servings a week of nuts
4+ meals a week of beans
2+ servings a week of berries
2+ meals a week of poultry
1+ meals a week of fish
Mainly olive oil if added fat is used

Less than 5 servings a week of pastries and sweets
Less than 4 servings a week of red meat (including beef, pork, lamb, and products made from these meats)
Less than one serving a week of cheese and fried foods
Less than 1 tablespoon a day of butter/stick margarine

103
Q

MIND diet and alzhimers

A

53% lower rate in high engagement

104
Q

feeding assistance in dmentia

A

i.e. hard to eat

105
Q

diet in elders

A

nutrient density if early satiety

omega 3

potassium fro muscle mass

fruit and veg for antioxidants

106
Q

The MIND diet is a combination of what two therapeutic diets?
A. Low GI diet and Mediterranean diet
B. Mediterranean diet and DASH diet
C. DASH diet and ketogenic diet
D. Ketogenic diet and low GI diet

A

B. Mediterranean diet and DASH diet

107
Q

burnout from

A

chronic workplace stress

108
Q

compassion fatigue

A

cost of caring for others to relieve their suffering

in helping professions

NMt200 exam (6 decks)

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