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159 Cards in this Set
- Front
- Back
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what type of model is represented with pathlogy, impairment, functional limitation, and disability |
disablement model (NAGI) |
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In the Nagi model, what does the impairment refer to? |
ROM loss, mm weakness, anatomy, etc |
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In the Nagi model, what does disability refer to? |
a social functional role (basketball) |
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what type of model is the ICF? |
enablement model |
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ICF includes all of the following except: body impairments, activity, personal factors, health condition and pathology |
pathology |
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A PTA does all of the following except: examination, evaluation, diagnosis, prognosis, and intervention |
evaluation, diagnosis, prognosis |
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diseases that are present at birth but may not be apparent at birth |
Congenital |
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transmission of genetic characteristics from parents to offspring |
Hereditary |
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Not all congenital diseases are ______, BUT |
Hereditary |
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caused by external force |
trauma |
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Signs of _________ include: redness, heat, swelling, pain, loss of motion/function |
inflammation |
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Infection involves the presence of ___________microorganisms |
pathogenic |
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Overgrowth of cells (same type of cells) that occurs in response to a stimulus |
Hyperplasia |
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New type of cells form with uncontrolled growth patterns. |
Neoplasms |
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Overconsumption of calories/starts at BMI of 30 |
obesity |
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substance that causes the body harm and sets off a reaction |
antigen |
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proteins that react to an antigen and neutralize it so that it is harmless |
antibodies |
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body’s first line of defense |
skin |
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Factors that affect how we age |
Heredity Lifestyle Stress Diet environment |
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↓ blood flow; cell without O2 cannot produce needed energy and will die |
ischimia |
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obstruction of an artery- cuts off blood supply. Can cause ischemia or necrosis |
Infarct |
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Immune System Defense: 4 Physical or Surface Barriers- The Front Lines |
Skin Sebaceous glands (oil secreting) Odoriferous (perspiration secreting) Mucous membranes |
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Purpose of inflammatory response: |
–Isolate –Destroy –Clean up –Promote healing |
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Signs of Inflammation
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Redness (rubor) Warmth (calor) Pain (dolor) Edema (swelling) loss of function |
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Inflammatory Process
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Tissue Injury- damage occurs and starts the process, triggering: Release of chemicals Leukocyte Migration(swelling) Lymphocyte Invasion (7-10 days) |
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Acute Inflammation |
Not an exact time span Days to 2 weeks |
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Chronic Inflammation |
Lasts 2 weeks or longer Larger number of macrophages Fewer neutrophils |
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fluid that seeps out of tissue or capillaries as a result of injury or inflammation |
exudate |
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Inflammatory Exudate 3 types: |
Serous exudate |
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Clear Serum-like fluid Acute injury, less degree of injury Ex: blister
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Serous Exudate |
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Large amount of fibrin- filamentous protein formed as last part of blood clotting Occurs with more severe injury Ex: scab over superficial skin abrasion |
Fibrinous Exudate |
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Dead and dying neutrophils, tissue debris, bacteria Pus |
Purulent Exudate |
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Walled, contained formation around a bacteria |
Abscess |
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Crater-like lesion in skin or mucous membrane Tissue can become necrotic or slough off |
Ulcer |
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Wide, diffuse inflammation Usually of skin or subcutaneous tissue |
Cellulitis |
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Present in final stage of inflammatory process –Clean up –Produce growth factor → promote healing |
Macrophages |
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Regeneration type of Tissue Repair |
–Mitotic cell division –Damaged tissue replaced by healthy tissue |
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damaged tissue replaced by fibrous tissue |
Fibrous connective tissue repair |
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Fibrous connective tissue repair Creates bridge between normal tissue and wound |
scar |
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Primary Intention Wound Healing |
Approximation of wound edges (stitches, sutures, steristrips, adhesives, etc- to bring edges together)
Minimal scarring and usually heal quickly without complications |
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Secondary Union or Secondary Intention |
Larger wounds or contaminated wounds Same body tissue response but wound is not closed by approximation as deeper tissues have to repair and helps avoid infection |
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necrotic tissue that is hard, black or brown, leathery |
Eschar |
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Delay in Wound Healing |
Age Size Location Nutrition/diet Immobility Circulation/vascular supply Organism virulence Corticosteroid use Past medical history |
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separation of tissue margins after surgery to approximate them- insufficient |
Dehiscence |
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excessive collagen formation → hard, raised scar |
Keloid formation |
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invasion of microorganisms causing cell or tissue injury and leading to inflammatory process |
Infection |
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protective immune response and can occur without bacterial invasion |
Inflammation |
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normal bacteria that exist around us but do not cause illness |
Normal flora |
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microorganisms that produce disease |
Pathogenic |
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normal flora that become pathogenic because they take the opportunity to cause infection in the host |
Opportunistic infection |
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use vectors (insects or other arthropods usually) to transmit the bacteria |
Rickettsiae |
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PPE |
Gloves- protect hands Mask/goggles/face shield Gown- protects skin and/or clothing |
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Transmission-based Precautions |
•Airborne precautions •Droplet precautions •Contact precautions |
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Evaporated droplets in air or dust particles Respiratory protection worn when enter rm (if anticipate substantial spraying of respiratory fluids, use gloves, gown and goggles or face shield. Ie if pt is coughing a lot or sneezing) measles, varicella, TB |
Airborne Precautions |
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Transmission through mucous membranes Maintain 3-5 ft between pt and others Wear facemask when working within 3-5 ft influenza, meningitis, pneumonia, sepsis, rubella |
Droplet Precautions |
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Transmission through direct touching contact Wear gloves and remove prior to leaving rm Wear gown and remove prior to leaving rm GI, respiratory, skin or wound infections, Hepatits A, Diptheria, herpes simplex virus |
Contact Precautions |
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What methods will prevent the spread of Hepatitis B? |
–Standard precautions with every pt –Clean up blood spill per protocol in facility –Get Hep B vaccination series |
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An organism (insect, spider, etc) that transmit the disease from the host to another organism is a vector |
vector |
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Invader Molecule recognized by the immune system –Gives each cell a special identity |
Antigen |
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Produced in response to antigens Proteins used by the immune system to identify and neutralize foreign molecules Found in blood or body fluids Specific to the particular antigen |
Antibody |
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Primary Organs of Immune System |
Thymus gland Bone marrow |
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Secondary Organs of Immune Defense |
Lymph nodes spleen Liver Tonsils |
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4 types of Leukocytes: |
(1) Polymorphonuclear (2) Monocytes (3) Macrophages (4) Lymphocytes |
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Become phagocytes in presence of pathogens and foreign substances |
monocytes |
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Become phagocytes in presence of pathogens and foreign substances |
macrophages |
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Major cells of immune system type of white blood cells |
Lymphocytes |
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T cells B cells Plasma cells |
Types of Lymphocytes |
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Special cell receptors: act locally have specialized cell receptors that allow them to recognize antigens Destroy microorganisms most common |
T cells (type of lymphocyte) |
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Work through circulatory system Formed in bone marrow Make antibodies against antigens: act on distant tissue They remember the antigen |
Lymphocytes – B cells |
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Originate from bone marrow from divided B cells Secrete specific antibodies into blood and lymph |
Lymphocytes – Plasma cells |
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Allergic Rhinitis
Reaction to allergen in mucous membranes of nose or upper respiratory tract |
hay fever |
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Description: chronic recurrent inflammation of airway |
asthma |
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Description: hives, nettle rash
Sx: lesions that are red or pale and raised, itching |
uticaria |
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severe allergic reaction |
Anaphylaxis |
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Hypersensitivity to own tissue Body fails to recognize its own antigens so turns on itself and destroys it’s own tissues Cause: idiopathic Diagnostic testing may include ANA- antinuclear antibody titer |
Autoimmune Diseases |
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Inflammatory disease that can affect the heart, joints, skin Etiology: Strep |
Rheumatic Fever |
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chronic inflammation of the connective tissue, primarily joint tissue |
Rheumatoid Arthritis |
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Neuromuscular junction disorder – antibodies block acetylcholine receptors so message does not get to muscles well. Sx: mm weakness and fatigue, especially at end of day |
Myasthenia Gravis |
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Treated with insulin injected, orally or with implanted pump Alters body’s carbohydrate and sugar metabolism Body fails to produce insulin |
DM Type I(IDDM) |
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Chronic disease with exaccerbation and remissions Sx: persistent, red, facial butterfly; fever, joint pain, weight loss, arthritis,kidney and heart involvement |
Lupus Erythematosus |
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Chronic; hardening, thickening, shrinking of connective tissue, including skin; remissions and exaccerbations Fingers get very tight and don’t function, face can be involved and limit opening of mouth, other joints in limbs as well |
Scleroderma |
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Unexplained persistent (6 months or more) or relapsing chronic fatigue that is of the following –Not result of ongoing exertion –Not alleviated with rest –Decline in funtion –Sore throat –Tender lymph nodes –Muscle pain |
CFS |
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Linked to biochemical, endocrine and physiological abdnormalities Systemic Widespread multiple tender points 11 of 18 specific points for diagnosis |
Fibromyalgia Syndrome |
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one or few trigger points in localized area |
myofascial pain |
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Hypersensitivity of one person to another’s tissues |
Isoimmune Disorders |
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Blood types: A, B, AB, O universal donor: universal recipient |
O:AB |
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HIV attacks T lymphocytes Dx: Drop in t cell count below 200 Acquired, immune system is suppressed |
Acquired Immunodeficiency Syndrome (AIDS) |
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HIV and AIDS Transmission |
Spread by: –Sexual intercourse: exchange of bodily fluids –Sharing hypodermic needles –In utero from infected mother to unborn child |
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Vaccination |
Antigen introduced to body po or injection –Dead antigen –Very weak antigen –Synthetic compound mimicking antigen |
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exposure to antigen causes the immune system to produce antibodies to that antigen |
Active Immunity: Natural immunity/Vaccine-induced (or artificial) immunity |
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person given antibodies to a disease rather than producing them by own immune system- newborns get this through mom’s from placenta |
Passive Immunity |
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What the pt reports as the problem How the pt describes the problem SUBJECTIVE INFO |
symptoms |
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What a physician, PT or PTA observes Observable or measurable OBJECTIVE INFO |
signs |
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state of being diseased |
Morbidity |
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the presence of one or more additional pathologies (diseases/conditions) that coexist with the primary diagnosis |
Comorbidity |
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percentage of people who die with the disease. Identified with diseases that can lead to death |
Mortality Rate: |
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Percentage of people who live with the disease for a set period of time. |
Survival Rate: |
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how often a disease occurs in a population |
Prevalence |
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Treatment must be patient-centered ie focused on the pt and the pt’s goals T or F? |
True |
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BEST DEFENSE against spread of infection |
hand washing |
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Includes hand washing and PPE Use these any time you anticipate contact with bodily fluids |
standard precautions |
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Layers of the Skin |
•Epidermis •Dermis •Subcutaneous |
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produce melanin for pigmentation |
Melanocytes |
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Composed of connective tissue Contains: –Fat cells –Blood vessels |
Subcutaneous Layer |
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Cold sores and fever blisters
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Herpes Simplex
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Shingles Dermatomal pattern Pt may have pain before rash appears, so come to PT and eval may not be conclusive. |
Herpes Zoster |
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Warts |
Verrucae |
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Localized collection of pus in any tissue Caused by staph aureus Sx: erythema, edema, pain |
Abscess |
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Diffuse inflammation of dermal and subcutaneous tissue Caused by an infection Sx: erythema, edema, extreme tenderness to palpation |
Cellulitis |
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Bacteria transmitted by a tick bite → bull’s eye reddened circle |
Lyme disease |
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Bacteria resistant to many antibiotics which can present with skin lesions Pts with MRSA may be isolated depending on location of infection |
Methicillin-resistant staphylococcus Aureus MRSA |
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Ringworm Group highly contagious fungal infections Growth facilitated by warm, moist areas Includes athlete’s foot, nail fungus, jock itch |
Tinea |
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Thrush Yeast infection |
Candidiasis |
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Infestation of lice |
Pediculosis |
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Infestation of the itch mite Causes a skin infection Can occur in nursing homes, child care centers |
Scabies |
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Inflammation of sebaceous glands and hair follicles |
Acne |
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Closed sac of oily, cheese-like material located under the skin |
Sebaceous Cyst |
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Inflammation of skin Noninfectious skin lesion Generic term |
Eczema |
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Red, raised lesions with distinct borders and silvery scales Chronic, autoimmune Hereditary Not infectious or contagious |
Psoriasis |
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Chronic inflammation of the skin of the forehead, nose, cheeks and chin |
Rosacea |
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Tan, brown or black growths on the skin Overgrowth of epethelial cells |
Seborrheic keratosis |
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Small blood vessels forming reddish or purple birthmarks Congenital |
Hemangioma |
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Slow growing tumor that does not metastasize Non healing lesion that bleeds easily |
Basal Cell Carcinoma |
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Grows more rapidly Firm, red nodule with crusts Can metastasize |
Squamous Cell Carcinoma |
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Metastasizes Tan, brown or dark in color Arises in a mole then changes in size and color Irregular borders |
Malignant melanoma |
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Occurs with AIDS Malignant vascular skin tumor that is bluish-red |
Kaposi sarcoma |
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Excessive hair growth in women |
Hirsutism |
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Partial or complete hair loss |
Alopecia |
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Scrape |
Abrasion |
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Cut in the skin |
Laceration |
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Skin or appendage is torn away Degloving injury |
Avulsion |
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Cause: lack of O 2 to tissue including skin, muscle and other tissue Arterial Insufficiency Can lead to gangrene Night pain in feet Eschar is thick and black Slow to heal or fail to heal |
Ischemic Ulcer |
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Produce exudate Eschar is yellow, white or gray Most respond to treatment and heal completely High risk of reoccurence Intact LE pulses Often develop cellulitis with lymphatic involvement → edema |
Venous Stasis Ulcer |
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Nonblanchable, erythema of intact skin Observable pressure Changes in one or more of the following: skin temperature, tissue consistency (firm or boggy feel) and/or sensation (pain, itching) |
Wound: Stage I |
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Superficial Partial thickness Involving epidermis, dermis, or both Presents as an abrasion, blister, or shallow crater |
Wound: Stage II |
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Full thickness Involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia Presents as a deep crater with or without undermining of adjacent tissue |
Wound: Stage III |
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Full thickness Extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures (e.g., tendon, joint capsule) May involve undermining and sinus tracts |
Wound: Stage IV |
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Sx: feel weak, nauseated, muscles cramp, but normal body temp
Excessive activity in hot environment |
Heat Exhaustion |
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Temperature regulating system cannot cope with excessive heat Body temp rises to 105ºF Sx: skin is red, hot and dry without perspiration |
Heat Stroke |
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Percentage of body burned and severity |
Exceeding 9% of body - serious 25-30% - extremely serious 60% or greater – usually fatal |
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Rule of Nines - Burns adult |
head 9% Anterior trunk 18% (upper trunk 9% + lower trunk 9%) Posterior trunk 18% (upper trunk 9% + lower trunk 9%) Each leg 18% (anterior 9% + posterior leg 9%) Each arm 9% (anterior 4.5% + posterior 4.5%) Perineum 1% |
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Rule of Nines - Child |
Anterior head 9%(textbook says 8.5%) Posterior head 9% (textbook says 8.5%) Anterior torso 18% Posterior torso 18% Anterior leg, each6.5% Posterior leg, each 6.5% Anterior arm, each 4.5% Posterior arm, each 4.5% Genitalia/perineum 1% |
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Only affects epidermis Erythema (redness) with minimal edema Usually resolves within few days No scarring sunburn |
Superficial Burns first degree burn |
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Destroys epidermis and damage to dermal layers Blanching with pressure with fast return of pink coloration (blood vessels intact) Blister formation Pain 2° damage to nerve endings Usually heals within 10 days Minimal scarring |
Superficial Partial-Thickness Burn second degree burn |
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Destroys epidermis, damage of dermal layer is deeper Damage of hair follicles and sweat glands Skin may appeared charred, translucent white with coagulated vessels visible below the skin Usually heal within 3-5 weeks |
Deep Partial-Thickness Burns third degree burn
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Destroys epidermis and dermis; often fat tissue involved Distinguishing characteristic: Eschar No sensation No hair follicles preserved High risk for infection Require skin grafting to heal |
Full-Thickness Burns fourth degree burn |
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Destroys epidermis, dermis, all underlying fat, muscle and sometimes bone Usual cause: flame or electrical shock Require surgery (ex: grafting, amputation) |
Subdermal Burn
fourth degree burn ? |
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With electrical contact, what is one aspect of the heart that is at particular risk of insult? |
Electrical circuitry of the heart: AV node, SA node, electrical pulses, heart rhythm, natural pacemaker |
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Washing, cutting necrotic tissue to allowing healing |
Debridement |
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Purpose of Dressings |
Protect the wound Prevent contamination Prevent spread of infection from the wound Promote healing |
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Types of Dressings |
Dry to dry Damp to damp Damp to dry Occlusive Rigid |
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Dry to Dry Dressing |
Dry absorbent or nonabsorbent dressing over the wound |
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Damp to Damp Dressing |
Gauze moistened with a solution (usually normal saline solution) placed over wound Prevents dressing drying out and embedding in eschar prior to removal |
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Moistened gauze is placed over wound and allowed to dry prior to removal Dried dressing embeds in eschar and debrides during removal |
Damp to Dry Dressing |
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Semipermeable barrier to air and moisture |
Occlusive Dressings |
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Provide physical protection to wound and adjacent area |
Rigid Dressings |
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Wet Wounds |
Facilitate moisture absorption (want "moist" environment- not "wet" Alginate dressing (seaweed) •Alginate becomes a gel when it gets wet •Easily remove gel without damaging granulation dry to dry dressing |
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Dry Wounds |
Hydrocolloid dressing –Categories •Occlusive •Semi-occlusive –Waterproof so keep moisture in Wet to dry dressing |
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Removing a Dressing |
Wear clean gloves and gown or mask if need Use bandaging scissors Flat tip closest to pt Cut superficial dressing layers first Try not to allow scissors to contact skin Cut in an area away from wound, no contact between scissors and skin |
