Clinical Skills Final

Front 1

Diathermy

Back 1

heats deeper than hot packs, and heats larger area

Front 2

when we compress

Back 2

we facilitate muscles to fire

Front 3

GTO

Back 3

static stretch

Front 4

don't do intermittent traction: in what stage?

Back 4

in acute stage

Front 5

static traction can be used

Back 5

in acute stage

Front 6

5 Classic Western massage techniques

Back 6

1- Effleurage
2- Petrissage
3- Friction
4- Tapotement
5- Vibration

Front 7

Endangerment Sites
for massage

Back 7

anterior neck, vertebral column, thoracic cage, axilla, elbow, umbilicus, kidney area, inguinal area, popliteal fossa, eyes, and major veins in the extremities.

Front 8

Contraindications and Cautions for massage

Back 8

Severe distress, acute inflammation, skin problems, osteoporosis, decreased or increased sensation, compromised immunity.
Bleeding and bruising, some types of edema, cardiovascular disorders, diseases spread by circulation, loss of structural integrity.
Contact lenses and hearing aids.

Front 9

Categories of Physical Agents:

Back 9

-Thermal
-Mechanical
-Electromagnetic

Front 10

Thermal....types and clin. examp.

Back 10

Deep heating agents (Ultrasound, diathermy)
Superficial heating agents (Hot pack)
Cooling agents (Ice pack)

Front 11

Mechanical.....types and clin. examp.

Back 11

Traction (Mechanical traction)
Compression (Elastic bandage, stockings)
Water (Whirlpool)
Sound (Ultrasound)

Front 12

Electromagnetic....types and clin. examp.

Back 12

Electromagnetic fields (Ultraviolet, laser)
Electric currents (TENS)

Front 13

4 Effects of Physical Agents

Back 13

-Tissue Healing (p.9 Table 1-2)
-Treatment of Pain (p. 11 Table 1-3)
-Motion Restrictions (p.13 Table 1-4)
-Tone Abnormalities (p. 14 Table 1-5)

Front 14

For pain in Acute stage

Back 14

ice
non thermal Ultrasound (if over 18)
E-stem

Front 15

5 signs of inflammation

Back 15

-heat
-redness
-swelling
-pain
-loss of function

Front 16

4 Inflammatory Phase Responses

(p.33 Table 2-3)

Back 16

-Vascular
-Hemostatic
-Cellular
-Immune

Front 17

C fibers

aka group IV afferents

Back 17

small, unmyelinated nerve fibers that transmit action potentials
quite slowly.

Front 18

A-delta fibers

aka group III afferents

Back 18

small-diameter fibers; transmit more rapidly

Front 19

Mechanical trauma usually activates

Back 19

both C and A-delta fibers.

Front 20

initial sharp pain transmitted by

Back 20

A-delta fibers.
produced in response to high-intensity mechanical stimulation of the nociceptors as a result of impact (ex from book, brick falling of foot)

Front 21

later, deep ache is transmitted by

Back 21

C fibers.
produced in response to stimulation by chemical mediators of inflammation released by the tissue after the initial injury.

Front 22

Several mechanism have been proposed to explain pain control and modulation:

Back 22

Gate control theory
theory of endogenous opiates
psychological central control mechanisms

Front 23

***Gate Control Theory

Back 23

pain is modulated at the spinal cord level by inhibitory effects of innocuous afferent input

severity of pain sensation is determined by the balance of excitatory and inhibitory inputs to the T cells in the spinal cord.

Front 24

Theory of endogenous opiates

Back 24

pain is modulated at the peripheral, spinal cord, and cortical levels by endogenous neurotransmitters that have same effects as opiates.

Front 25

Psychological central control mechanisms

Back 25

are thought to effect pain perception and control

Front 26

Muscle tone

Back 26

Lower muscle tone is not abnormal unless an individual can't increase it sufficiently to prepare for movement or holding.

Front 27

Muscle tone

Back 27

Higher muscle tone is not abnormal unless an individual can't alter it at will, or unless it produces muscle spasms or cramps.

Front 28

Normal Muscle tone

Back 28

is not a particular amount of passive resistance to stretch but rather a controllable range of tension that supports normal movement and posture.

Front 29

Input to Alpha Motor Neurons (Sources)

Back 29

-Peripheral Receptors
-Spinal
-Supraspinal

Front 30

Input to Alpha Motor Neurons from Peripheral Receptors

Back 30

Muscle spindles via 1a sensory neurons
GTOs via 1b sensory neurons
Cutaneous receptors via other sensory neurons

Front 31

Input to Alpha Motor Neurons from Spinal Sources

Back 31

Propriospinal Interneurons

Front 32

Input to Alpha Motor Neurons from Supraspinal Sources

Back 32

Cortex, basal ganglia via corticospinal tract
Cerebellum, red nucleus via rubrospinal tract
Vestibular system, cerebellum via vestibulospinal tracts
Lumbric system, autonomic nervous system via reticulospinal tracts

Front 33

Crossover

Back 33

Ex. - a person flexes the elbow forcefully against resistance, propriospinal pathways assist in the commun. b/w neurons at multiple spinal levels. The result is coordinated recruitment of synergistic muscles that add force to movement. That same resisted arm movement also facilitates flexor muscle activity in the opposite arm via the propriospinal pathways. Used in ther. Ex. to increase tone and force output from muscles in persons with neurological dysfunction.

Front 34

Interventions for Low muscle tone

Back 34

-hydrotherapy
-quick ice
-electrical stim. (when muscle fibers are innervated)
-biofeedback
-light touch
-tapping
-resisted exercises
-range-of-motion exercises
-therapeutic exercises
-functional training
-orthotics

Front 35

Manual Traction

Back 35

you hang off a bar with your feet off the floor, it causes your thoracic and lumbar spine to EXTEND (more lordosis)

Front 36

Cryotherapy:
Sequence of sensations

Back 36

1. intense cold
2.burning
3. aching
4. analgesia
5. numbness