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326 Cards in this Set
- Front
- Back
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What is the difference btw a pt and client?
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Pt = individual w/ impairments & functional limitations dx by a PT
client = individual w/o diagnosed dysfunction |
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What 2 factors does the ICF model have that the Nagi model doesn't?
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1. Environmental
2. Personal Factors |
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Red flags for:
1. Cancer 2. Cardiovascular 3. GI/genitourinary 4. Neurological |
1. Night pain, unexplained wt loss, lumps, fatigue...
2. SOB, dizziness, chest pain, discoloration... 3. Abdominal pain, N/V, heartburn, menstrual... 4. HAs, swallowing, speech, hearing, vision... |
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What is the functional unit w/in each muscle fiber?
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sarcomere (actin + myosin)
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DOMS is more severe w/ eccentric or concentric exercises?
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eccentric
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arthrokinematics:
1. convex on concave = 2. concave on convex = |
1. opposite
2. same |
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is the roll or glide usually lost with motion?
how do we tx this? |
1. glide
2. jt mobs |
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COM is located at what level?
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S2
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Define stability?
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COM w/in BOS
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method of vector composition?
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1. tip to tail method
2. parallelogram |
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most common type of lever in our bodies?
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Type 3
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Define fibroplasia
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active scar formation
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Name 4 stage of healing...
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1. acute
2. repair 3. remodeling 4. chronic inflammation |
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MRI...
T1 is for... T2 is for... |
T1 = ST anatomy
T2 = fluid & pathology |
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Which tissue has the best healing capacity?
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bone
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Define Wolf's law...
What is Davis' law? |
Bone remodels based on loads and stresses its subjected to
Davis' = same as above but for CT |
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Define Paget's
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excessive bony turnover
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1. which vertebrae have transverse foramina?
2. whats its purpose |
1. Cervical
2. transmit vertebral a. |
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what is the only ligament to prevent hyperextension of the vertebral column?
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ALL
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which ligament limits IV disc herniation?
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PLL
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True/False:
Fibula is a part of the knee jt |
False
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what is the medial ligament of the ankle known as?
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deltoid
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what is the #1 force of mandible depression?
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gravity
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only ADDuctor to cross the knee?
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gracilis
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which HS muscle is used for graph ACL reconstruction?
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semitendinosis
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what is the order of structures in the femoral triangle?
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V.A.N. (medial -> lateral)
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What is the ratio for scapulohumeral rhythm?
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2:1
2 = GH 1 = scapulothoracic |
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at the elbow jt which band of the UCL is the strongest?
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anterior
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what muscles do hip ER?
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quadratus femoris
glute max piriformis |
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True/False:
Brachioradialis crossed the wrist? |
false
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which muscle is the primary supinator?
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Bicep Brachii
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With a musculotaneous n. injury are flexion and supination still possible?
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yes - b/c brachioradialis, pronator teres, and supinator
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at what stage of healing of a fx does a clinical union occur?
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stage 3 = hard callus
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what is clinical healing?
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absence of pain at the site, no pain on WB and return of normal limb function
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what fiber type are postural mm.
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Type 1 = endurance mm.
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Name 4 structures that make up the Barrel of the Core
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1. TrA
2. multifidus 3. Diaphragm 4. Pelvic Floor |
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whats the difference btw structural and functional scoliosis?
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Structural = rotational bony changes of the vertebrae
functional = tight concave muscles and weak convex muscles; can be caused by LLD |
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_________ scale for hypermobility
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Beighton
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End feels:
1. Boggy 2. Springy 3. Bony 4. Empty 5. Muscle Spasm |
1. d/t swelling
2. rebound felt at end of range; suggest torn meniscus or cartilage 3. osteophyte or bone fragment w/in jt 4. limited d/t pain 5. prolonged muscle contraction |
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Capsular Patterns:
1. GH jt 2. ulnohumeral 3. hip |
1. ER, ABD, IR
2. flexion, extension 3. flexion, ABD, IR |
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define atrophy
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loss of sarcomeres secondary to disuse or immobilization
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Name functional tests for LE
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1. SL balance
2. DL squat 3. SL squat 4. step up/down 5. hopping |
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Vascular lesions causing impaired sensations:
1. UE = ________ 2. LE = ________ |
1. opera glove
2. stocking |
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grading for DTRs
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0 = absent
1 = hypo 2 = normal 3 = hyper 4 = clonus |
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what NR are the following DTRs testing:
1. patellar tendon 2. achilles 3. bicep brachii 4. triceps |
1. L3-L4
2. S1-S2 3. C5-C6 4. C7 |
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1. pathological reflexes are indicative of what?
2. list some... |
1. CNS lesion
2. clonus, babinski, hoffman's chaddock's |
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CRPS:
-stage 1 = -stage 2 = -stage 3 = |
1. hyperalgesia/allodynia, edema, increased warmth, skin dry, redness
2. pain almost always present, edema hard, jt stiffness, neither warm/cold, skin thin glossy, osteoporotic changes 3. pain spreads proximally, edema harders, SNS regulation decreases, skin thin shiny, bony demineralization leads to atrophic fingers/toes |
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which bacterial infection has thick yellow crust "honey" in appearance?
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impetigo
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viral infections reside in the ____1___
2. how do they present? |
1. DRG
2. clear vesicles along dermatomal patterns |
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ABCDs of Melanoma
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A = asymmetry
B = Border irregularity C = color D = diameter (> pencil eraser) |
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Is OA or RA an inflammatory autoimmune disease?
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RA
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Clinical criteria for OA
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joint pain +
1. age > 50 2. stiffness < 30 min 3. crepitus 4. Bony tenderness 5. Bony enlargement 6. No palpable warmth **at least 3: sensitivity = 95% specificity = 69% at least 4: sensitivity = 84% specificity = 89% |
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Fibromyalgia = + pain in ____1____ out of ___2___ tender points
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1. 11
2. 18 |
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Contraindications for RA pts
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1. vigorous C-spine extension, stretching, or traction
2. prolonged heat, stretching, or manipulation across swollen jts |
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what are reasons for revision arthroplasty?
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1. remove old implant d/t loosening
2. after fx or infection |
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when is a reverse TSA indicated?
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with irreparable RTC damage
**deltoid becomes the primary shoulder elevator |
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what are 2 goals of ST mobs?
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1. relax tissue, decrease spasm
2. tissue mobs (cross friction) |
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cross friction massage aligns ____1____ fibers along lines of ___2___
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1. collagen
2. stress **want to get rid of adhesions |
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what is the difference btw a mobilization and manipulation?
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mobilization = increase mobility and/or decrease pain
manipulation = increasing jt mobility; HVLA |
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name 3 effects of jt mobs
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1. neurophysiological (GTOs = relax m.spindles = contract)
2. nutritional 3. mechanical |
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if your pt has limited DF, what functional task do you have them do?
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walk down stairs
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Loose packed vs closed packed
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loose packed = position of jt where there is max jt space
open packed = jt space is congruent |
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with jt mobs, the ___1___ is always in the tx plane
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1. elbow
**direction of movement is parallel (glide) or perpendicular (distraction) |
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Maitland Grades I-IV
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I = small amplitude
II = large amplitude at midrange III = large amplitude at end range IV = small amplitude at end range V = HVLA |
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1. which maitland grades are for pain relief?
2. which are for mobility? |
1. all of them (1 & 2 for acute more so)
2. 3-5 |
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which direction would you mob?
1. GH ABD 2. GH ER 3. NWB knee ext 4. WB knee ext 5. NWB ankle DF 6. WB ankle DF |
1. humerus inferiorly
2. humerus anterior 3. tibia anterior 4. femur posterior 5. talus posterior 6. tibia anterior |
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CPR for spinal manipulation
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1. hypermobile L-spine segment
2. pain < 16 days 3. radicular/referred pain not past the knee 4. hip IR at least 35˚, at least one hip 5. low score of FBAQ (< 19) |
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when do hyper- and hypomobile pts become unstable?
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when they lose neuromuscular control
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Muscle spindles:
-sensitive to ___1___ and ___2___ stretch -___3___ muscle when activated GTOs: -sensitive to ___4___ -___5___ muscle when activated |
1. rate
2. tonic 3. contracts 4. tension 5. inhibits |
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Stress strain curve:
-toe region = -elastic region = -plastic region = |
-toe region = taking up slack
-elastic region = tissue will return to original size -plastic region = permanent deformation |
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hold relax = ______
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reflexive inhibition = use the GTO to turn off contractile tissue
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Overload Principle
when do you reach this stage? |
To improve strength, muscle must be worked at a level higher than it is accustomed to
when the pt breas form |
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at what ages do men and women muscle mass peak?
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women = 16-20
men = 12-25 |
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how long does it take for hypertrophy of fibers?
how long does it take for increased cross sectional area? |
4 wks
8 wks |
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what is the rationale for isometric exercise?
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activation
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Compare the intensity of exercises for young athletes, healthy adults, and older adults
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young athletes = low intensity (12-15 reps)
increase reps instead of load healthy adults = 8-15 rep max w/ 1-3 sets older adults = low resistance and low reps |
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cardiovascular response to exercise
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1. vasoconstriction to non-exercising muscles (viscera)
2. linear effect on HR |
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what is the intensity requirements for aerobic training?
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20-30 min @ 60-70% HRmax
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PARQ
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Physical Activity Readiness Scale
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what is the #1 predictor of injury?
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previous injury
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range limiting muscles are ________
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antagonist
**the muscles getting stretched |
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what are some balance strategies?
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1. ankle strategy (AP plane)
2. wt. shift (lateral) 3. suspension 4. hip strategy 5. stepping strategy |
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why do you have to be extra careful with aquatic therapy with MS and post-polio pts?
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compromised thermoregulation
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water level vs. BW %
1. C7 2. xiphoid process 3. ASIS |
1. 10%
2. 30 % 3. 50% |
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_______ = direct transfer of E btw 2 objects in physical contact w/ each other
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Conduction
i.e. - ice packs, moist heat packs, paraffin |
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_______ = mediums move across body causing variations
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convection
i.e. - whirlpool, fluidotherapy |
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______ = changes other E forms into heat
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conversion
i.e. - US, microwave |
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______ = heat is absorbed by liquid on the skins surface and cools the skin as it turns into a gaseous state
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evaporation
i.e. - vapocoolant sprays, alcohol |
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law of grotthus draper
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inverse relationship btw absorption and penetration
** > E that is absorbed by superficial tissue, < remains to be transmitted deeper |
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"gate control" theory of pain modulation
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Block pain impulse with ascending A-beta input
**occurs in SC i.e. - pinching yourself during a shot |
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Cryotherapy:
what should you consider w/ ice vs flex-i-cold pack |
flex-i-cold doesn't under go a phase change, therefore, warms up faster
Flex-i-cold can get beyond freezing, therefore, needs a towel btw it and skin. **ice doesn't need a towel btw. use 20-30 min **use a towel w/ ice if >30 min |
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When do you use cryo- vs thermotherapy?
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Cryotherapy:
-acute inflammation -pain control Thermotherapy: -decrease m. spasm -increase blood flow/metabolic effects -pain w/o inflammation |
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Direct Current (DC) vs Alternating Current (AC)
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DC = continuous unidirectional flow (i.e. = iontophoresis)
AC = continuous bidirectional flow (i.e. = sine wave for e-stim) |
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How are electrically elicited contractions different that voluntary contractions?
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large (type II) to small (type I) recruitment
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What information does and EMG provide?
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feedback info about skeletal m. activity and voluntary control. **Does not quantify a contraction
EMG = electromyography |
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what is the orientation of the Head of Humerus in the GH jt?
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medially
superiorly (130-150˚ = angle of inclination) posteriorly (30˚ = retrotorsion) **scapular plane |
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Arthrokinematics:
1. GH ER w/ arm at side 2. GH ER in ABD |
1. convex on concave
2. spin |
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1. Name the ligaments of the GH jt?
2. Name the stabilizing mm. of the GH jt. |
1. Superior GHL, middle GHL, inferior GHL (anterior and posterior bands, and axillary pouch), coracohumeral
2. supraspinatus, infraspinatus, teres minor, subscapular |
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GH: ST
what is the setting phase? |
rotation for the first 30˚ is primarily GH as the scapula "sets" itself to perform functions
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ST motion is a combination of _____ and _____
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AC and SC motion
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what mm. are working during arm elevation?
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Deltoid + supraspinatus = conc. elevation
"ITS" = humeral head depression, compression, ER Long head of Biceps = humeral head depression upper trap = clavicle elevation and retraction middle trap = stabilizes ST jt lower strap = scapula upward rotation, stabilize ST jt SA = scapula upward rotation, posterior tilt, ER rhomboids = stabilize ST jt ecc. (prevent protraction) |
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Open Pack Position for shoulder
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55˚ ABD
30˚ Flexion neutral IR/ER |
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RTC tendinopathy:
-intrinsic -primary extrinsic -secondary extrinsic -internal extrinsic |
intrinsic = degeneration, hypovascularity, hypervascularity
primary extrinsic = inflammation (RTC, bursa, AC), anatomy (acromion shape, osteophytes, AC hypertrophy, size mismatch), biomechanics (scap dyskinesia, GH arthokinematics) secondary extrinsics = impingement 2˚ instability internal extrinsics = GIRD |
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GIRD
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Glenohumeral IR Deficit
-tight posterior capsule w/ lax anterior capsule |
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Traumatic subluxation or dislocation is usually in what direction?
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anterior 95% = ABD + ER
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1. Bankart lesion
2. Hills Sachs lesion 3. Reverse Hills Sachs lesion 4. SLAP lesion |
1. anterior labrum (subscapularis) detachment w/ osseous defect on anterioinferior glenoid rim; assoc w/ ant. dislocation
2. posterior lateral humeral head compression fx; assoc. w/ ant. dislocation 3. anterior lateral humeral head compression fx; assoc. w/ post. dislocation 4. Superior Labrum Anterior Posterior (LHB) |
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AC Separation:
-Type I -Type II -Type III |
1. sprain of AC ligaments
2. Ruptured AC ligaments + sprain of coracoclavicular ligament 3. Rupture of Both sets of ligaments **acromion displaced inferiorly |
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3 most common locations of compression of Thoracic Outlet Syndrome?
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1. interscalene triangle (Adson)
2. costoclavicular space (Allen & Roos) 3. subpectoral triangle |
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Compare TSA vs RTSA
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TSA:
-Convex humeral head -Concave glenoid RTSA: -Concave humeral head -Convex glenoid -more stable & less risks -≤ 90˚ elevation |
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Describe the ligaments of the vertebrae:
1. Supraspinous 2. Ligamentum Flavum 3. Anterior Longitudinal (ALL) 4. Posterior Longitudinal (PLL) 5. capsular ligaments |
1. btw SPs
**Ligamentum Nuchae = excessively developed in c-spine 2. btw pedicles 3. anterior to vertebral body = restricts ext 4. posterior to vertebral body = restricts flexion 5. around apophyseal jts |
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describe the orientation of the apophyseal jts at cervical, thoracic, and lumbar levels
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C-spine = tilted 45˚ in frontal plane "rise"
T-spine = frontal plane "bow your heads" L-spine = sagittal plane "pray" |
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Describe the ligaments of the AA jt:
1. transverse ligament 2. tectorial membrane 3. Alar ligaments |
1. posterior to dens - keeps dens from moving onto SC
2. Covers the dens and the ligaments 3. "check" ligaments - 2 ligaments, 1 on either side of the dens, respectively resisting axial rotation |
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In what spinal region do we get the most osteokinematic motion?
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C-spine
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C-spine:
RE: the foraminal space, does flexion open/close it? what about extension? |
flexion = opens the space
extension = closes the space **foraminal space = where NR exit |
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Describe the osteokinematics of protraction and retraction of the head in terms of upper and lower c-spine
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Protraction = upper ext + lower flexion
Retraction = upper flexion + lower ext **lower c-spine follows the head |
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Re: IVD failure, what is the creep effect?
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-injury d/t not allowing the tissue to return to normal btw loads
-may have a safe load, but a load sustained over time can create structural changes and increase the potential for injury |
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Describe the following types of herniated disc...
1. bulging/protruding 2. prolapsed/ruptured 3. extrusions |
1. AF intact but failing
2. AF ruptured and NP protruding 3. segment of NP separated from core 2˚ AF closing off and trying to heal |
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At what level do most cervical IVD herniations occur?
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#1 C6-C7
#2 C5-C7 |
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CPR for cervical radiculopathy
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1. ULTT A (median n. @ 110˚)
2. Spurling (rot toward affected side + compress) 3. distraction 4. cervical rotation < 60˚ **f/u with a dermatome/myotome exam **need 3 out of 4 2+ = 56% Specificity 3+ = 94% Specificity 4+ = 99% Specificity |
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What are the C-spine Clearing Tests?
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1. VAI insufficiency
2. sharp-purser 3. transverse ligament stress test 4. alar ligament test |
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Define the following terms:
1. spondylolisthesis 2. myelopathy 3. stenosis |
1. superior vertebrae slipping anterior on and inferior
2. SC encroachment (b/b symptoms, spasticity, Bilat sensory/motor deficits) 3. narrowing on spinal canal |
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Describe the difference btw opening and closing patterns of Facet Impingement
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opening = decreased rot to R w/ pain on L
closing = decreased rot to R w/ pain on R |
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Symptoms of VAI/VBI:
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tinnitus
dizziness nystagmus nausea throbbing confusion **test in supine + cervical ext + lat flex + rot |
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what principle guide MDT and the McKenzie approach to LBP
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-centralization and peripheralization of pain/symptoms
**measure ROM before and after Tx to indicate if the Tx is correct |
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What are the 3 MDT classifications
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1. Derrangement (reducible and irreducible)
-flexion increases pain and decreases ROM -extension decreases pain and increases ROM 2. Dysfunction -symptoms present 6-8 wks -repeated movements have no lasting effects -pain intermittent, at end range, local 3. Postural -no underlying pathology -younger pts |
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Treatment for...
1. Derrangement 2. Dysfunction 3. Postural |
1. reduction, maintenance, recovery prevention
2. stretching to lengthen tissues 3. postural correction and education |
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For any screening tool you want to have high _________
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sensitivity = if its negative r/o
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What tool do you use to tell you if radiographs are indicated w/ cervical pain?
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Canadian C-sine Rule:
1. high risk factors that mandate radiograph? (yes) 2. low risk factors that allow safe assessment? (no) 3. AROM ≥ 45˚? (no) **f/u with instability exam if exam is cleared |
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Neck Pain Classification System
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1. Mobility
2. Centralization 3. Conditioning & Increase Exercise Tolerance 4. Pain Control 5. Reduce HA **has not been validated YET! |
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what is the on:off for traction
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3:1 usually 30 sec: 10 sec
**by 7 sec you should have max separation |
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Name the 3 portions of the MCL of the elbow and their purpose
Name the 2 portions of the UCL of the elbow and their purpose |
MCL:
1. anterior - taut in extension (strongest) 2. posterior - taut in flexion 3. transverse/oblique UCL: 1. radial collateral - blends w/ annular ligament for rotation stability 2. ulnar collateral - taut in flexion |
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what is the best way to improve arthokinematics at the elbow?
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distraction b/c of the bony block anteriorly and posteriorly
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How do you distinguish btw pathology at the humeroulnar jt vs radiohumeral jt.
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HU:
-pain w/ extension more comfortable w/ flexion -open pack = 70˚ flex + 10˚ supination RH: -pain w/ flexion more comfortable w/ ext -open pack = extension + supination |
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Compare the Proximal vs Distal RU jts.
1. radius 2. ulna 3. glide for pronation 4. glide for supination |
1. Prox = convex Distal = concave
2. Prox = concave Distal = convex 3. Prox = posterior Distal = anterior 4. Prox = anterior Distal = posterior |
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What structure compose the TFCC
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TFCC = triangular fibrocartilage complex
1. UCL 2. Ulnar carpal ligament 3. articular disc **primary stabilizer of the distal RU jt |
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Law of Parsimony
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Body wants to use the least amount of Energy for movement, therefore, it recruits the smallest mm. first
i.e. - aconeus -> triceps |
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order of recruitment for wrist extension
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ECRB -> ECU -> ECRL
**ECRB is most involved w/ lateral epicondylitis = why we test resistance of 3rd digit when Dx |
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stabilize the wrist is _______ extension for stronger grip
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35˚
**want to limit active insufficiency |
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Elbow/shoulder Relationship:
OKC or NWB -pronation = ___1___ -supination = ___2___ CKC or WB -pronation = ___3___ -supination = ___4___ |
1. IR
2. ER 3. ER 4. IR **Supination = distal radius/ulna parallel Pronation = distal radius/ulna twisted |
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What is the difference btw wartenberg's sign and wartenberg's syndrome
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Wartenberg's Sign = inability to ADD 5th digit from an ABD position d/t ulnar n. entrapment @ Guyon's Canal
Wartenberg's Syndrome = entrapment of superficial radial n. (sensory) @ 1st dorsal wrist compartment = EPB + APL |
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re: nerve entrapment, "interosseous" involvement indicates what?
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motor involvement only!!
-posterior interosseous = weak finger ext -anterior interosseous = weak finger flexors + pronation |
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Which UCL test has he best sensitivity and specificity
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Moving Valgus Stress Test
-Sensitivity = 75% -Specificity = 100% **valgus stress t/o ROM |
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Lateral Epicondylitis/algia Tests
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1. resisted wrist extension
2. stretch = elbow ext + wrist flexion 3. resisted extension of 3rd digit |
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What is Tommy John Surgery for
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UCL repair
-use palmaris longs or HS -return to sports ~ 6-12 months -need 5/5 strength and full functional ROM before initiation of throwing progression **common in throwing athlete's d/t UCL instability -> medial elbow pain during cocking and acceleration phases of throwing |
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What is the biggest precaution s/p Total Elbow Arthroplasty (TEA)?
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No WB 6-8 wks b/c triceps are taken off to place the prosthesis
Hols isolated triceps 10-12 wks!! |
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What is the best treatment approach for lateral epicondylitis?
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Combined tx approach (deep friction, US, and exercise)
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describe double v tension in the wrist?
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ulnar deviation:
-lateral leg of Palmar Intercarpal pulls proximal row -Palmar ulnocarpal stabilizes distal row radia deviation: -medial leg of Palmar Intercarpal pulls proximal row -Palmar radiocarpal stabilizes distal row |
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List the mm. in the thenar evidence that are impaired w/ CTS
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-APB
-FPB -Opponens Pollicis |
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1. Name 2 Extrinsic Palmar ligaments
2. Name 3 Extrinsic Dorsal ligaments |
1. Palmar Ulnocarpal - taut w/ ext + ulnar deviation
Palmar Radiocarpal - taut w/ ext 2. Dorsal Radiocarpal - taut in flexion Radial Collateral ligament - taut w/ ulnar deviation Ulnar Collateral ligament - TFCC |
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wrist swelling is best viewed from which views?
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dorsal and radial
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which part of the scaphoid takes the longest to heal?
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proximal
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1. colles fx
2. smith's fx 3. ganglion cyst |
1. wrist/hand displaced dorsally
2. wrist/hand displaced anteriorly 3. mechanical fault over tendon |
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what movement agitates VISI?
DISI? |
VISI = extension
DISI = flexion **lunate dislocated dorsally |
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1. Reagan's test
2. Murphy's Sign 3. Piano Keys Test |
1. stabilize triquetrum and move lunate anterior/posterior
2. 3rd MC even with 4th and 5th 2˚ lunate dislocation 3. Dorsal spring on distal ulna (TFCC instability) |
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Klenbock's disease
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AVN of necrosis of carpals
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describe wrist involvement 2˚ RA
|
-radial deviation of wrist
-ulnar deviation of MCPs d/t ulnar pull of tendons |
|
|
1. What is DeQuervain's Syndrome
2. How do you test for it? |
1. tenosynovitis of dorsal wrist (EPB + AbdPL)
2. Finkelstein Test |
|
|
Which Special test has the highest specificity for CTS?
|
Direct Compression Test
|
|
|
CMC:
2nd + 3rd = _______ 4th + 5th = _______ |
stable
mobile |
|
|
4th and 5th MC _____ to increase grip strength
|
drop
|
|
|
How do you facilitate 1st CMC flexion/extension?
ABD/ADD? |
flexion = medial/ulnar
extension = lateral/radial ABD = Dorsal ADD = Palmar |
|
|
describe the motion of 1st CMC opposition
|
1 = ABD
2 = flexion + medial rotation |
|
|
What is the purpose of Palmer (volar) plates
|
-block hyperextension
-MCP, PIP, DIP **1st MCP has 2 sesamoid bones **check rein ligaments (only PIP reinforce plates |
|
|
Explain the Extensor Mechanism:
1. EDC 2. Central band 3. Lateral Bands 4. Dorsal Hood |
1. distal attachment, splits before PIP into central + 2 lateral bands, extends MCP
2. attaches to middle phalanx, extends PIP 3. attaches to distal phalanx, extends DIP 4. stablizes intrinsics to extrinsics = transfers force from lumbricals + interossei to extend PIP and DID |
|
|
Lumbricals
|
-PIP and DIP extension (pulls on lateral bands on extensor hood)
-MCP flexion 2-3 = median n. 4-5 = ulnar n. |
|
|
Interossei
|
-PAD
-DAB -flex MCP |
|
|
What do the following indicate:
1. clubbing of nails 2. spoon nails |
1. COPD, nutritional deficiencies
2. anemia, iron deficiency |
|
|
1. Z deformity
2. Ape Hand 3. Bishop's Deformity 4. Sweater Finger |
1. MCP flexion + IP ext
2. Thenar wasting d/t median n. injury 3. hypothenar wasting d/t ulnar n. palsy 4. FDP rupture **ring finger |
|
|
1. Swan Neck deformity
2. Boutonniere deformity 3. trigger finger 4. mallet finger |
1. hyperext PIP (volar plate rupture) + flex DIP
**also common w/ RA 2. Flexed PIP (extensor hood) + ext DIP 3. finger gets stuck in flexion d/t stenosis of flexor sheath causing FDP/FDS to get stuck 4. DIP flexion d/t rupture of lateral band |
|
|
when can you no longer do a direct repair for tendon laceration of the hand?
|
> 3wks after injury, must use a graft
**surgical repair when flexor > 60% and extensor > 50% torn |
|
|
Kehr's Sign
McBernie's Point |
-Spleen referring pain to L tip of shoulder
-btw umbilicis and ASIS = appendicitis |
|
|
gallbladder can refer pain where?
|
LBP
|
|
|
Waddell's Sign
|
**at least 3 of the following
1. Tenderness 2. Simulation Tests (axial loading & acetabular rotation) 3. Distraction Tests (sitting SL ext & dbl leg raise) 4. regional disturbances (weakness & sensory) 5. overreaction |
|
|
Lumbosacral angle
|
angle btw L5-S1
increases w/ APT = increases sheer forces decreases w/ PPT |
|
|
1. Spinal Stenosis
2. Cauda Equina 3. ankylosing spondylitis |
1. Narrowing of spinal canal
**pts are flexion biased 2. urinary retention, saddle paresthesia, loss b/b, great toe flexion weakness 3. LBP, tender SI, chronic inflammatory disease |
|
|
Low Back CPR
|
1. Pain < 16 days
2. hip IR > 35˚ 3. no radicular symptoms past knee 4. FABQ < 19 5. hypomobility of spine **≥ 4 + = 95% success ≥ 3 + = 68% success |
|
|
stay < _______ N of disc compression w/ exercises for minimal risk of injury
|
< 3,500 N
-Quadruped + SL extension = < 2500 -Quadruped + SL ext + arm ext = > 3000 -prone Bilat UE + LE raise = 4000-6000!! -side plank = 2500 **QL important lateral stabilizer |
|
|
SI joint:
-counternutation -nutation |
counternutation = sacral ext =ilium ant + sacral base post
nutation = sacral flex = ilium post + sacral base ant |
|
|
Anterior Pelvic Tilt:
-L-spine = ____ -sacrum = ____ -hip = _____ |
-L-spine = extended
-sacrum = flexed -hip = flexed |
|
|
Posterior Pelvic Tilt:
-L-spine = ____ -sacrum = ____ -hip = _____ |
-L-spine = flexed
-sacrum = extended -hip =extended |
|
|
when does flexion and extension of the sacrum occur?
|
end range b/c ligaments are becoming taut
|
|
|
Right on Right Sacral Torsion
Left on Right Sacral Torsion |
R on R = Sacrum faces to the R on a R OA
L on R = Sacrum faces to the L on a R OA |
|
|
Pelvic Fx:
Type A Type B Type C |
Type A = ilium fx
Type B = separation of pubic symphysis "open book" Type C = SI articulation disrupted |
|
|
Muscle Energy:
1. Anterior Rotation of Ilium 2. Posterior Rotation of Ilium 3. Inflare 4. Outflare 5. R on R OA |
1. resisted hip ext
2. resisted hip flex 3. FABER + resisted ADD 4. FADIR + resisted ABD 5. Resisted R ER of hip in prone |
|
|
increased anteversion will result in decreased ___1___
decreased anterversion will result in decreased ___2___ 3. what test do you use to assess ante version? |
1. ER
2. IR 3. Craig's test |
|
|
All 3 ligaments of the hip limit what motion?
|
extension
1. Iliofemoral (inverted Y) -restricts ext -superior = restricts ADD -inferior = restrictis ABD 2. pubofemoral -restricts ext and ABD 3. ishciofemoral -restricts ext and IR |
|
|
Lumbo-Pelvic Rhythm
|
pelvis will move ipsilateral to the L-spine if the head moves out of neutral
**flexion Pelvis will move contralateral to L-spine if head stays in neutral **APT |
|
|
________ group can function as hip flexors and extensors
|
ADDuctors
**tweak alert!! |
|
|
Early ambulation decreases what 3 complications?
|
1. pneumonia
2. decubiti 3. delirium |
|
|
Why do OA pts lean to the painful side when ambulating?
|
to decrease the JRF
|
|
|
1.Which THA approach is most common?
2. what are some assoc. precautions? |
1. Posteriolateral
2. Flexion > 90˚, ADD (crossing ankles), dont bend over to pick something up from the floor **12 wk minimum |
|
|
Hip pathology: anterior
1. Snapping hip 2. Bursitis 3. FAI: Cam and Pincer 4. labral tear |
1. pain 45˚ -> ext; FADER to EADIR
2. pain with ext 3. Cam = femoral neck bump Pincer = femoral retroversion = pain with FADIR 4. audible click with thomas test and FABER to EADIR |
|
|
Hip Pathology: lateral
Bursitis Tendinitis Snapping Hip |
Tendinitis vs Bursitis = resisted ABD (active contraction)
External Snapping Hip = ITB over GT; occurs near full ext |
|
|
Hip Pathology: posterior
Labrum Piriformis Syndrome |
Labrum - use scours test
Piriformis Syndrome -weak resisted ER -buttock pain, radicular pain |
|
|
1. What tests should you always do with a hip exam?
2. What mm. with you likely focus on for strengthening? |
1. step downs and lunges
2. ER and glutes |
|
|
lateral column of foot = _______
medial column of foot = ______ |
lateral = stable
medial = mobile |
|
|
1.Supination of foot
2. Pronation of foot |
1. supination = inv + ADD + PF
2. pronation = ev + ABD + DF |
|
|
Which ligament in the ankle is sprained most often?
|
Anterior Talofibular Ligament
PF + inversion |
|
|
which joint unlocks the subtalar joint?
|
calcaneocuboid jt.
-very stable -keystone of the foot |
|
|
Transversetarsal Joint:
TTJ + STJ movements are the ___1___ in WB TTJ + STJ movements are the ___2___ in NWB |
1. same (inv + inv)
2. opposite (inv + eversion) |
|
|
Lizfranc jt
Lizfranc injury |
Lizfranc jt = tarsometatarsal jt
Lizfranc injury = midfoot injury, fx/dislocation to TMJ |
|
|
First Ray Mobility:
Early MSt = ______ Late St = _______ |
Early MSt = DF
Late St = PF (helps raise medial arch -> rigid lever) **need mobility here!! |
|
|
Compartments of Lower Leg:
1. anterior 2. lateral 3. posterior |
1. TA, EDL, EHL (deep fibular n.)
2. FL, FB (superficial fibular n.) 3. superficial = gastroc, soleus, plantaris deep = posterior tib, FDL, FHL (all tibial n.) |
|
|
Ottawa Ankle Rules
|
1. tender at medial/lateral malleolus
2. inability to bear weight 3. tenderness at navicular/base of 5th metatarsal |
|
|
Jones fx
|
styloid process of 5th
|
|
|
Stress tests:
inversion + PF = ___1___ inversion + neutral = ___2___ Inversion + DF = ___3___ Kleiger = ___4___ |
1. ATF
2. calcaneofibular 3. posterior talofibular 4. deltoid ligament |
|
|
what 3 things should you consider with Chronic Ankle Instability (CAI)
|
1. cuboid subluxation
2. anterior lateral fibular subluxation 3. osteochondral lesion |
|
|
Syndesmotic Ankle Sprain
|
High Ankle Sprain
-distal tibiofibular ligaments + interosseous membrane |
|
|
Achilles Rupture:
1. what do you want to emphasize at the end stages of rehab? |
1. end range PF
|
|
|
1. Tarsal Tunnel Syndrome
2. Morton's Neuroma |
1. entrapment of posterior tibial n.
2. small ball of nn. typically btw digits 3-4 (met pad placement to off load neuroma) |
|
|
Screwhome Mechanism:
what is the m. action of the popliteus? |
last 10˚ ext = ~10˚ ER of tibia on femur to lock the knee
-ER of tibia in NWB -IR of femur in WB unlocks the knee -NWB = tibia IR -WB = femur ER |
|
|
Knee jt rotation is named for the relationship of ___1___ with ___2___
|
1. distal femur
2. tibial tuberosity **OKC: -tibia IR = knee IR -tibia ER = knee ER CKC -femur IR = knee ER -femur ER = knee IR |
|
|
Meniscal ligaments:
-coronary -transverse -posterior meniscofemoral |
1. coronary = attaches medial mensicus to tibia
2. transverse = btw medial and lateral meniscus 3. posterior meniscofemoral = lateral meniscus to femur |
|
|
which part of the meniscus has a potential for healing?
|
outer 1/3 b/c it has a blood supply
|
|
|
attachments of ACL? PCL?
|
ACL = medial side of lateral epicondyle of femur to anterior medial surface of tibia
PCL = lateral side of medial condyle of femur to posterior lateral aspect of tibia |
|
|
Which ligaments prevent lateral rotation? medial?
|
lateral = MCL and LCL
medial = ACL and PCL |
|
|
if the ____1____ restraint is injured you will feel pathologic motion
if the ___2___ restraint is injured you won't feel pathologic motion |
1. primary
2. secondary |
|
|
which test is preferred for ACL integrity?
|
Lachman's b/c with anterior drawer Hams are at a mechanical advantage
|
|
|
whats the difference btw laxity and instability
|
laxity = objective
instability = subjective |
|
|
s/p ACL surg, what is the safe range for OKC and CKC activity?
|
OKC = 45-90˚
CKC = 0-45˚ |
|
|
what are priorities in early stages of rehab?
|
-restore extension ASAP
-QF activation -edema -pain |
|
|
Patellar Contact:
135˚ 90-60˚ 0-20˚ |
135˚ = lateral and odd facet in contact
90-60˚ = 30% of total surface area in contact = max % = increased comfort 0-20˚ = inferior pole engaged @ 20˚ |
|
|
WHy is the patella important?
which activity has the highest JRF in the knee? |
increases mechanical advantage of QF
squat - patella force increase with increased knee flexion |
|
|
what direction does the patella dislocate most often?
|
laterally
-concerned with medial patellofemoral ligament |
|
|
What % of gait cycle is in Stance?
Swing? |
stance = 60%
swing = 40% |
|
|
Name the 3 rockers and the phased they occur in
|
1st rocker = heel rocker - LR
2nd rocker = ankle rocker - MSt 3rd rocker = forefoot rocker - TSt |
|
|
what happens if you do not have goo gastric-soleus control during 2nd rocker?
|
you have uncontrolled tibial advancement.
use QF to help control this |
|
|
When running, landing on the _______ decreases the amount of force going through the LE
|
midfoot
|
|
|
running uphill or downhill created more force up the chain?
|
Downhill b/c of the braking impulse
**start out flat > uphill > downhill |
|
|
What are 6 main contributors to injuries in runners
|
1. h/o injury
2. increase in weekly mileage 3. LE movement patterns 4. Q angle 5. impact forces 6. high BMI |
|
|
______= embryo has isolated arm & leg movements
______= alt leg movement observed, mother may feel fetus |
9 wks
16 wks |
|
|
Primitive reflexes
|
1. Rooting - touch peri oral area -> infarct turns toward stimulus for sucking
2. ATNR - head rotation -> ipsi arm ext + contra arm flex 3. Moro - head drop bwd -> UE ABD and ext + finger splaying (startle) |
|
|
What it's the main focus of preschool
|
Social development
|
|
|
Which developmental theory has become the theoretical framework for most of pediatric PT?
|
Dynamic Systems Theory
-movement is directed by many dynamic and interacting systems (internal milieu, external environment, task) |
|
|
In uterine breech position increases the risk of _________
|
Hip dysplasia
-shallow acetabulum |
|
|
Physiological flexion has no WB on ________
|
Pelvis
|
|
|
Is a movement more or less mature with a chin tuck?
|
More
|
|
|
When assessing the quality of a child's movement what are 3 things to include in your assessment?
|
1. WB surfaces
2. AG movements 3. Symmetrical or asymmetrical |
|
|
Infant stepping has a _______ trajectory
|
u- shaped
Appearance > disappearance > reappearance Neural maturation: reflex > inhibited by maturation > cortical control dynamic systems: individual (chubby legs), environment, and task constraints |
|
|
Will a baby without a stepping response step in water?
|
YES!!!
|
|
|
AIMS =
|
AIMS = 0-18 months
|
|
|
What are the 4 subscales of the AIMS
|
Prone
Supine Sitting Standing |
|
|
Describe how you score the AIMS
|
Identify the least mature and most mature observed item
+1 for everything below the least mature observed +1 for everything observed within the window |
|
|
________ approach has become the standard with pediatric PT
|
Top-down approach
Determining desired outcomes and goals before performing the examination. Use the exam to identify strengths |
|
|
Apgar scores
|
Assess physiological function (1 and 5 min, and 10 if needed)
8-10 = normal 0-3 = resuscitation needed |
|
|
How many wks of gestation are considered premature?
|
37
|
|
|
TRUE/FALSE:
Premature infants do not have flexor tone |
TRUE
|
|
|
How is strength evaluated in peds
|
Observing AG movements
|
|
|
_____ is one of the earliest skills we develop at ______ months
|
Reaching
3-6 months |
|
|
Kicking:
Frequency _______ over the first year |
Decreases
**with a brain injury frequency stays the same or increases **at 4 months the more intralimb coupling the later walking is attained |
|
|
How long do you use gestational age?
|
2 years from birth date
|
|
|
_____= preterm
_____= very preterm _____=extremely preterm |
<37 wks
< 32 wks < 28 wks |
|
|
______= low birth wt
______=very low birth weight ______= extremely low birth wt What is small for gestational age |
2500g
<1500g 1000g Less than 10th percentile for gestational age |
|
|
What is the main reasons fetus cannot survive outside the womb?
|
Poor lung development
-surfactant decreases surfaces tension and prevents alveolar collapse -must be intimated to receive surfactant therapy |
|
|
________ the amount of stimulation babies < 32 wks receive
|
Decrease
-clustered care -one stimulant at a time |
|
|
What is a large role of PT in the beginning at the NICU
|
Positioning
-physiological flexion -hands near face |
|
|
T/F: when there has been adequate prenatal care, the mother-infant system has been evaled
|
True
|
|
|
Mobile paradigm
|
Baseline - 3 min
Acquisition - 9 min Extinction - 3 min Learn in 15 minutes and remember for 1 wk **3-4 month old -High risk preterm NEVER learned the paradigm -Low risk and DS needed +1 days if learning |
|
|
_____ = type 2 alveolar cells form
_____ = surfactant present _____ = amt of surfactant increases ensuring adequate lung inflation at birth |
23 wks
28 wks 32 wks |
|
|
Foramen Ovale
Ductus Arteriosus |
Foramen Ovale = opening btw RA -> LA
Ductus Arteriosus = opening btw pulmonary a -> aorta **typically close w/in a few days of life |
|
|
Fetal Heart formation:
____ days = single heart tube ____ days = cardiac cells begin intrinsic beating ____ days = circulation begins ____ wks = fetal heart sounds can be detected |
21 days
22 days 24 days 8-10 wks |
|
|
what is the most common birth defect?
|
Congenital Heart Disease
**VSD has highest incidence |
|
|
Left to Right Shunts
-Oxygenated blood flows back into the lungs |
1. Patent Ductus Arteriosus (PDA)
2. Atrial Septal Defect (ASD) -persistent foramen ovale 3. Ventricular Septal Defect (VSD) -requires OHS -no activity limitations once fixed 4. atrioventricular septal defect (AVSD) -frequent in pts w/ DS |
|
|
Obstructive Lesions
|
1. Pulmonary Valve Stenosis
-can cause RV to hypertrophy increasing stenosis -blood flows from RA -> LA d/t increased pressure 2. Aortic Stenosis -decreased CO -Ross Procedure = replace aortic valve 3. Coarctation of Aorta -constriction of aorta |
|
|
Right to Left Shunts
unoxygenated blood gets to system! |
1. Transposition of the Great Arteries (TGA)
-aorta arise from RV + pulmonary aa. from LV -embryonic rotation did not take place!! -ductus arteriosus and foramen ovale need to stay open for survival 2. Tetralogy of Fallot (TOF) -VSD + overriding aorta + RV hypertrophy + pulmonary stenosis 3. Hypoplastic Left Heart Syndrome -left side is underdeveloped -not combatible w/ life -Norwood Procedure = 3 stage procedure over 1st 3 yrs of life |
|
|
Respiratory Distress Syndrome (RDS)
|
-not enough surfactant in the lungs
-risk inversely related to gestational age -BPD is a sequelae s/s = tachypnea, retractions, grunting, nasal flaring |
|
|
Bronchopulmonary Disease (BPD)
|
-Sequelae of RDS
-Dx if required mechanical ventilation > 28 days |
|
|
Athetosis
|
Fluctuating tone
|
|
|
Nueral tube deficits:
-enchephalocele -anencephaly -hydraenchephaly -spina bifida -hydrocephalus |
-enchephalocele: occipital region, usually focal
-anencephaly: absence of most of the brain -hydraenchephaly: absence of the cerebral cortex; skill and meninges intact -spina bifida: caudal defect -hydrocephalus: fluid in the ventricles |
|
|
Stages of Grief
|
Denial
Anger Depression Bargaining Acceptance |
|
|
When is W sitting atypical
|
When it is the only sitting position
|
|
|
Describe a crouched posture
|
Atypical standing posture
-child stands on toes -leads to decreased DF and tight gastrocnemius -IR and ADD |
|
|
Peabody:
1. age range? 2. subscales? 3. scoring? |
1. 0-5 y.o.a.
2. 6 subscales: reflexes (0-12mths), stationary, locomotor, object manipulation, grasping, visual-motor **2 = mastered skill 1 = resemblance of skill 0 = cannot perform 3. GMQ + FMQ = TMQ **perform w/in a 5 day period |
|
|
How do you know where to start testing with the Peabody?
|
Begin where 75% of a normative sample passed
**want child to be successful basal level = three 2s in a row ceiling level = three 0s in a row |
|
|
sensory integration emphasizes what 3 things?
|
1. vestibular
2. proprioceptive 3. tactile |
|
|
Gravitational Instability is a problem with the ____1___ system
|
1. vestibular
**changes in head position **fear of moving backwards in space!! |
|
|
What is dyspraxia?
|
Problem with motor planning
**difficulty learning a sequenced action **difficulty w/ Bilat coordination |
|
|
Spasticity = ________ dependent to passive stretch
|
velocity
|
|
|
what is the etiology of a majority of CP cases?
|
Prenatal events
-#1 perinatal asphyxia = lack of oxygen -antenatal CVA (MCA) or infection -perinatal = obstructed labor, antepartum hemorrhage, cord prolapse -postneonatal = metabolic encephalopathy, infection, injuries |
|
|
what is the national campaign against prematurity?
|
March of Dimes
**OH is a grade C |
|
|
its hard to Dx CP before what age?
|
2 y.o.a.
|
|
|
what is the most common type of CP?
|
Spastic = 65%
Athetosis or dyskinetic = 15% Ataxic or hypotonic = 10% |
|
|
Describe the levels of the Modified Ashworth (MAS)
0= 1= 1+= 2= 3= 4= |
0 = no increase
1 = slight increase in tone, manifested by catch and release 1+ = slight increase, manifest by catch and then resistance 2 = increased tone, but still easily movable 3 = difficult to move 4 = rigid |
|
|
Name 3 musculoskeletal characteristics of CP
|
1. Reduced breath support
2. Bilat rib flaring 3. Tight RA **makes extension difficult |
|
|
pts with CP typically have a ____1____ gate/posture
2. how do they compensate |
1. crouched
-hip and knee flexion -ADD and IR 2. APT + L-spine lordosis + gastroc spasticity |
|
|
what can be the 1st clinical sign of CP?
|
hip dislocation 2˚ muscle imbalances
**Test w/ Barlow and Ortioni |
|
|
what is the typical hand position of someone w/ CP?
|
flexed, pronated, and ulnarly deviated
|
|
|
GMFCS is validated in what population?
|
CP
**Gross Motor Function Classification System **used for goal setting, collaboration/communication, intervention planning, LT planning |
|
|
T/F: children tend to remain in the same GMFCS level over time?
|
true
|
|
|
GMFCS:
-Level 1 -Level 2 -Level 3 -Level 4 -Level 5 |
-Level 1 = walks w/o limitations
-Level 2 = walks w/ limitations -Level 3 = walks w/ a HH AD -Level 4 = self mobility w/ limitations, may use power mobility -Level 5 = transported in a MWC or PWC |
|
|
What population(s) is the GMFM validated in?
|
GMFM-88 = CP + DS
**use for young children (lying/rolling) **can test impact of aids/orthoses GMFM-66 = CP **not validated w/ orthoses |
|
|
How do you score GMFM
|
0 = not initiated
1 = initiated 2 = partially completes 3 = completes |
|
|
Can GMFM show change over time?
|
yes!!
GMFM-66 = no overlap in 95% CI is a significant change |
|
|
Why is NDT controversial?
|
it shows that the pt has the ability to perform the skill but it has limited/no carryover
|
|
|
As PTs when can we have the biggest affect in changing behavior?
|
unstable state
|
|
|
LE orthoses:
1. SMO 2. SAFO 3. Hinged-AFO 4. anti-crouch AFO 5. PF resist orthosis 6. DF assist (posterior spring leaf) |
1. SMO = controls HF, MF, FF; limited PF/DF restriction
2. SAFO = controls HF, MF, FF; Blocks PF/DF 3. Hinged AFO = controls HF, MF, FF; Blocks PF, free DF 4. anti-crouch AFO = blocks DF 5. resist PF 6. assist DF |
|
|
when is a helmet most affective for a child w/ plagiocephaly?
|
w/in the first 6 months b/c the sutures fuse btw 1-2 y.o.a.
**assoc. w/ torticollis |
|
|
when will a child have surgery for scoliosis?
|
when the cobb angle is < 40˚
3:1 (female:male) |
|
|
what brace are children put in with DHD?
|
pavlick harness = hip flexion and ABD
|
|
|
OI = genetic disorder of ____1___ structure or amt
|
1. collagen
|
|
|
1. Systemic Onset JIA
2. Oligoarthritis 3. Polyarticular |
1. Systemic Onset JIA = most painful, fever, symm, > 4 jts
2. Oligoarthritis = most common, asym, < 4 its, females 4x more likely 3. Polyarticular = sym, ≥ 5 jts |
|
|
how do you decrease pain w/ JIA pts
|
fitness and low impact activity
|
|
|
hemophilia is _________-linked
|
x-linked
|
|
|
w/ CP pts how many hours do you need to stretch the gastric?
|
6 hours
|
|
|
Muscular dystrophy:
- ___1___ linked -pt's will have ___2___ pseudohypertrophy - ___3___ weakness 4. what drug helps these pts |
1. x
2. calf **muscle replaced w/ fat and scar tissue 3. proximal 4. prednisone (steroids) |
|
|
T/F:
you use a AFO with MD pts |
FALSE
-AFO prevents the anterior shift of COM therefore these pts would collapse when walking |
|
|
T/F:
wt trng is indicated with MD pts? |
FALSE
if you damage the mm. they cannot repair themselves |
|
|
SMA:
-chromosome ___1___ recessive |
5q
-sym weakness -proximal > distal weakness -absent reflexes |
|
|
Torticollis:
1. Congenital Muscular Toricollis 2. Ocular Torticollis 3. Sandifer's Syndrome 4. Benign Paroxysmal Torticollis |
1. shortening of unilateral SCM
2. abnormal positioning to maintain binocular vision 3. reflux/GI disorder causing posturing 4. alternating torticollis |
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Spasticity:
-loss of ___1___ inhibition of the ___2___ reflex arc |
1. UMN
2. LMN **contralateral side affected |
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When do you use medications to treat spasticity?
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when it cannot be controlled with ROM and splinting
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List oral medications for spasticity?
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-Diazepam (valium)
-Baclofen -Dantrolene (dantrium) -Tizanidine **start low and increase slowly |
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injectable medications for spasticity?
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1. Botox
-injected into muscle 2. intrathecal Baclofen -injected into SC |
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What is a combined approach for spasticity?
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PT + botox
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Surgical interventions for spasticity?
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1. tenotomy
2. dorsal rhizotomy |
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Epilepsy
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reoccurring UNPROVOKED seizures
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_____1_____ is a cartilaginous structure weaker than bone
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1. epiphyseal plate
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what is the rule of thumb if a child has tenderness over a epiphysis and x-rays appear negative?
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splint and have a child f/u with sports med physician or orthopedist
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1. Sever's Disease
2. Osgood Schlatter's 3. Sinding Larsen Johanson 4. Little League Elbow |
1. osteochondrosis of heel
2. apophysitis of tibial tubercle 3. apophysitis of inferior pole 4. apophysitis of medial epicondyle |
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Rule of Thumb:
Back pain in children < 18 y.o.a. always ________ until proven otherwise |
pathologic
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Describe the Positioning Hierarchy pertaining to w/c positioning
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start at the pelvis > trunk > shoulders > neck > head
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What is considered the most affective airway clearance technique for pts with CF?
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huffing
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1. What is the name of OH's Early Intervention (EI)?
2. what part of IDEA is EI? 3. How do you become eligible for EI? 4. What is the Plan assoc w/ EI? |
1. Help Me Grow
**Birth-3 y.o.a. 2. Part C 3. Medical Dx or Developmental Delay 4. IFSP = Individualized Family Service Plan |
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what plan is used to identify the needs of a child t/o school?
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IEP = individualized education plan
**IDEA Part B |
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when must and IEP be in place?
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By the child's 3rd b-day
**IEP must address how interventions will affect life after HS, in OH this starts at 14 y.o.a in comparison to 16 y.o.a. |
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are students covered under IDEA for services in college?
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NO
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