Level 1

Front 1

achilles tendon rupture

Back 1

• typically occurs 1-2 inches above tendonous insertions to calc
• typically 30-50yo without incidence of calf or heel pain
• typically unable to stand on toes and have a positve thompson sign

Front 2

adhesive capsulitis

Back 2

• occurs more in middle age, females
• arthrogram can diagnose by looking at volume of fluid in joint capsule
• ROM restriction in capsular pattern ( ER, abd, IR)

Front 3

alzheimer's disease

Back 3

• progressive neurological disorder that results in deterioration and irreversible damage in cerebral cortex and subcortical areas of the brain
• initially noted by change in higher coritical function shcaraterized as subtle changes in memory, impaired concentration and difficulty with new learing
• lasts 7-11 years with death from dehydration or infection

Front 4

amotrophic lateral scleorsis

Back 4

• typically men, 40-70
• can include UMN and LMN involvement with weakness occurring in a distal to proximal progression
• lasts 5yr, 20-30% patients survive longer

Front 5

ankylosing spondylitis

Back 5

• systemic condition characterized by inflammation of the spine and larger peripheral joints
• men, 20-40yo
• clinical presentation- recurrent and insidious back pain, morning stiffness and impaired spinal extension, lumbar curve eventually flattens
• high impact and flexion therex is contraindicated

Front 6

ACL sprain grade III

Back 6

• occurs with hyperflexion, rapid deceleration, hyper-extension or landing bad
• more likely women
• 2/3 have associated meniscal tear

Front 7

arterial insufficiency ulcer

Back 7

• narrow arterial vessels can't get blood to tissue, lateral and distal leg
• linked with PAD; risk factords, atherosclerosis, HTN, DM, and smoking
• typically heal by secondary intention with adequate blood supply and wound healing interventions

Front 8

bicipital tendonitis

Back 8

• inc incidence with baseball pitching, gymnastics, swimming, rowing and tennis
• ache directly on top and in front of shoulder made worse with overhead activities or lifting
• + speeds or yergason

Front 9

breast cancer

Back 9

• may spread to lymphatic system and commonly metastisises to brain, lungs, bones adrenals and liver
• 30% of all femal cancer and seonds leading cause of death for women in USA
• survivial: 85% stage 1, 66% stage 2, 36% stage 3, 7% stage 4

Front 10

carpal tunnel syndrome

Back 10

• 35-55 yo women
• muscle atropy in Abductor pollicis brevis and later in thenar muscles
• EMG studies, tinel's sign, phalens

Front 11

central cord syndrome

Back 11

• incompletes SC lesion often results from hyperextension injury
• motor loss upper>lower
• most common incomplete SC lesion accounting for 30% of incomplete forms of terapelgia

Front 12

cerebral palsy

Back 12

• spastic CP is UMN, athetoid CP involves damage to the BG
• clinical presentation: motor delays, abnormal tone and motor control, reflex abnormalities, poor postural control and balance impairment
• mental retardation & epilepsy in 50-60% kids with CP

Front 13

CVA

Back 13

• ischemic stroke (thromus, embolus, lacunar) and hemorhaggic stroke (intracerebral, subdural, subarachnoid)
• L CVA: weakness/paralysis R, impaired processing, heightened frustration , aphasia, dysphagia and motor apraxia
• R CVA: weakness/paralysis L, poor attn span, impaired awareness and judgement, spatial deficits, memory deficits, emotional lability and impulsive behavior

Front 14

congenital torticullis

Back 14

• cause neck to involuntarily contract to one side 2* to SCM contracture
• lat flex I/L SCM, chin faces C/L and there may be facial assymeteries 85-90% of patients with congenital toritcullis respond to conservative tx and passive stretching within 1st year of life

Front 15

congestive Heart failure

Back 15

• contributing etiologies: arrhythmia, PE, HTN, valvular heart disease, myocarditis, unstable angina, renal failure and severe anemia
• L side associated with pulmonary venous congestion. R side associated with signs of systemic venous congestion
• diminished cardiac output causes compensatory changes inc inc blood volume, cardiac filling pressure, HR and cardiac muscle mass

Front 16

cystic fibrosis

Back 16

• causes the exocrine glands to overproduce thick mucus which causes obstruction
• autosomal recessive on long arm of chromosome 7
• common cause of death is respiratory failure

Front 17

degenerative spondylolithesis

Back 17

• caused by weakening of joints that allowd for fwd slippage of a verterbral segment due to degenerative changes
• often at L4-5
• william's flex exercises to strengthen abs and reduce lumbar lordosis

Front 18

DM type 1

Back 18

• beta cells of pancrease are destroyed and therefore no insulin
• starts in children age 4+, peak incidence early adolescence and puberty
• common sx: polyuria, polydipsia, polyphagia, nausea, weight loss, fatigue, blurred vision and dehydration

Front 19

down syndrome

Back 19

• hypotonia flattened nasal bridge simian crease, epicanthal folds, enlargement of tongue an developmental delay
• detected in 60-70% in utero
• exercise!

Front 20

duchene muscular dystrophy

Back 20

• x-linked ressive (only boys)
• waddling gait, calf pseudohypertropy, gowers sign, proximal muscle weakness, toe walking, difficulty climbing stairs
• rapid progerssion, inability to ambulate by 10-12yo with death as teenager or less likely in 20s

Front 21

emphysema

Back 21

• results from a long history of chronic bronchitis, recurrent alveolar inflammation or genetic predisposition for alpha 1 antutrypsin deficiency
• barrel chest, increased subcoastral angle, rounded shoulders 2* to tight pecs, rosy skin
• sx worsen as disease progresses persistnet cough, wheeze, difficulty breathing particularly expiration and increased respiration rate

Front 22

erbs palsy

Back 22

• muscles affected C5-6 nerve root, include rot cuff, delts, brachiallis, coracobrachiallis and biceps brachii
• typically due to birth trauma
• flacid paralysis - waiter's tip deformity, lost shoulder function , loss of elbow flex, forearm supination and the hand positioned in pinch grip manner

Front 23

fibromyalgia syndrom

Back 23

• non-articular rheumatic condition with pain caused by tender points within muscles, tendons and ligs
• more women, no particular age
• widespread hx of pain in all four quadrants of the body (above and below waist), axial pain is present and there is pain in 11/18 recognized tender points

Front 24

full thickness burn

Back 24

• burn causes immediate cellular and tissue death and subsequent vascular destruction
• eschar form from necrotic cells and creates a dry hard layer that required debridement
• absent sensation and pain as free nerve endings destroyed, may be pain from adjacent areas with partial thickness burns

Front 25

Guillain-Barre

Back 25

• motor weakness distal to proximal, sensory impairment and possible respiratory paralysis
• believed to be an autoimmune response for a previous respiratory infection, flu, immunization or surgery
• most fully recover, 20% neuro deficits, 3-5% dies from respiratory complications
  

Front 26

HIV

Back 26

• risk: unprotected sex, IV drugs or mom to fetus
• maybe sx free for 2yr or have flu like sx including fever and rash
• leading cause of death is kidney failure 2* to extended drug therapy

Front 27

huntington's disease

Back 27

• chronic progressive genetic disorder that is fatal 15-20 years post manifest
• characterized by degeneration of BG (particularly the striatum) and cerebral cortex
• enlarged ventricles 2* to atrophy of BG, mental deterioration, speech disturbance and ataxic gait

Front 28

juvenile rhumatoid arthritis

Back 28

• autoimmune disorder <16yo that occurs when the immune cells begin to attack joints and organs causing local and systemic effects throughout the body
• girls, often diagnosed as toddlers or early adolescence
• persistant joint, swelling, pain or stiffness

Front 29

lateral epicondylitis

Back 29

• inflammation or degnerative changes of the common extensor tendon
• repeaed overuse of wrist extensors, particularly the extensor carpi rad brevis can produce tensile stress that results in mircotears and damage
• difficulty holding or gripping objects, insuffcient forearm functional strength
• cozens, mills, lat epi

Front 30

lymphedema post masectomy

Back 30

• too much lymph or inadequate transport 2* to loss of homeostasis
• often due to damage/removal of axillary lymph nodes
• interventions should focus on manual lymph drainage, short stretch compression bandages, retrograde massage, exercise, compression therapy and use of a mechanical pump

Front 31

Medial collateral lig sprain - grade II

Back 31

• tearing of lig fibers results in joint laxity when lig is stretched
• typically blow to outside of knee causes excessive force at medial joint
• return to previous functional level in 4-8 wk if no other damage

Front 32

MS

Back 32

• demylination of nerves in brain and spinal cord resulting in plaque development, dec nerve conduction velocity and eventual failure of impulse transmission
• vision problems, paresthesias, sensory changes, clumsiness, weakness, ataxia, balnce dysfunction and fatigue
• intervention includes regulation of activity, relaxation and energy conservation texhniques, normalization of tone, balance activities, gait training and core stab

Front 33

myocardial infarction

Back 33

• occurs with poor coronary artery profusion, ischemia and subsequent necoriss of cadiac tissue usually due to thrombus, arterial blockage and atherosclerosis
• risk factors: family hx of heart disease, smoking, no PA, stress, HTN, hyperlipdemia, DM, obesity
• deep pain or pressure in the substernal area w/ or w/o pain radiating into jaw or L arm/back

Front 34

neuropathic ulcer

Back 34

• often referred to as diabetic ulcer
• areas at risk are those subj to pressure with normal weight bearing atypical stress due to structural changes of improperly fitting footwear
• often heal with secondary intention with appropriate wound healing intervention and absense of compications

Front 35

osteoarthritis

Back 35

• degenerative process involving articular cartilage resulting from excessive loading of healthy joint or normal loading of abnormal joint
• diag with x-ray and clinical findings
• women, 80-90%of indiv 65+ have some evidence of OA

Front 36

osteogenesis imperfecta

Back 36

• 4 types with a wide range of clincal presentations ranging from normal appearance w/ mild symptoms to severe involvement which can be fatal during infancy
• done densiometry can be used to guess fracture sites
• kids with this disease often have delayed developmental milestones 2* to ongoing fractures with immobilization, hypermobility of joints and poorly developed muscles

Front 37

osteoporosis

Back 37

• metabolic disorder where the rate of bone resorption accel while the rate of bone formation slows
• patients may complain of low thoracic or lumbar pain and experience compression fractures of the vertebrae
• bone mineral density test account for 70% bone strength, easiest diag.

Front 38

parkinson's disease

Back 38

• degen disorder characterized by dec of dopamine within the corpus striatum of the BG
• hypokinesisa, difficulty initiating and stopping movement destinating and shuffling gait, bradykinesia, poor posture and cogwheel rigidity
• medical mgt includes dopamine replacement therapy which is designed to minimize bradykinesia, rigidity and tremor
• 3-5 year on levadopa can result in SE of dyskinesia

Front 39

partial thickness burn

Back 39

• superficial partial thickness burns involve the epidermis and upper portion of the dermis; deep partial get most of the thickness of the dermis and structures in the dermis
• superficial have a red color that blanches, deep partial is red, but won't blanche
• typically heals without deficits sans complications

Front 40

patellofemoral syndrome

Back 40

• damage to articular cartilage of patella
• extremely common during adolescence, women>males, direct association with activity level
• mgt imcludes controlling edema, stretching, strengthening, inc ROM and activity modification

Front 41

peripheral vascular disease

Back 41

• narrowing of the lumen of BV causing a reduction in circulation secondary to atherosclerosis
• risk factors: phlebitis, injury/surgery, autoimmune disease, DM, smoking, HLD, inactivity, + family history, inc age, obesity
• pt edu important concerning disease process, limb protection, foot/skin care, risk factor reduction (stop smoking, no cold exposure)

Front 42

plantar fasciattis

Back 42

• chronic over use condition 2* to repetive stretching of the plantar fasica thru excessive foot pronation during the loading phase of gait
• severe pain in the heel when first standing in the morning,
• ice massage, deep friction massage, heel insert, orthotic prescription, activity mod, & gentle stretching program of achilles and plantar fasica

Front 43

pressure ulcer

Back 43

• unrelieved pressure causes ischemia in tissues, leading to cell death and necrosis
• high risk areas are occiput, heels, spinous process, greater troch, ischeal tubes, sacrum and epicondyles of elbow
• impaired cognition, poor nutrition, altered sensation, incontinence, dec lean body mass and infection contribute

Front 44

reflex sympathetic dystrophy

Back 44

• increased sympathetic activity causes a release of norepinephrine in the periphery and subsequent vasoconstriction resulting in P! and an increase in sensitivity to peripheral stimulation
• women, 35 - 60
• experience intense burning and chronic pain in affected extremity that eventually spreads in proximal direction

Front 45

restricitve lung disease

Back 45

• pulmonary or extrapulmonary restriction which produces impairment in lung expansion & reduction in pulmonary ventilation
• can be caused by tumor, interstitial pulmonary fibrosis, scarring of the lungs, pleural effusion, chest wall stiffness, structural abnormality and respiratory muscle weakness

Front 46

RA

Back 46

• symmetric auto immune disorder of connective tissue that is characterized by chronic inflammation of synovial membranes, tendo sheaths and articular cartilage
• 3x > incidence women, 30-50
• blood work detects rheumatoid factor, WBC ceount, erythocyte sedimentation rate, hemoglobin and hematacrit values

Front 47

rotator cuff tear

Back 47

• can be due to accute trauma or chronic degenerative pathology of supraspinatus tendon
• drop arm and empty can
• failure to tx can result in significant activity mod, additional surgical mgt, adhesive capsulitis or degenerative changes

Front 48

rotator cuff tendonitis

Back 48

• inability of weak supraspinatus to adequately depress head of humerus in glenoid fossa during elevation of the arm
• appears with excessive overhead component: swimming, tennis, baseball, painting or manual labor
• weakness, painful arc btwn 60-120

Front 49

sciatica secondary to herniated disk

Back 49

• low back and gluteal pain that typically radiates down the back of thigh along sciatic nerve distribution
• pain inc with sitting or lifting, fwd bend or twist

Front 50

scoliosis

Back 50

• curvature in thoracic or lumbar vertebrae may be associated with kyphosis or lordosis
• 25-40 requires orthosis and PT for posture, flexibility strengthening respiratory function and orthosis wear
• typically does not continue after bone growth is complete if curvature remains below 40 at time of skeletal maturity

Front 51

spina bifida-Myelomenigocele

Back 51

• occulta- incomplete fusion of the vertebral arch with no neural tissue protrussion; meningocele same as prior w/ neural tissue meniges protruding outside neural arch; myleoleningocele same as prior but with spinal cord and meninges protruding
• 75% defects in lumbar region, L5-S1
• prenatal testing of alphafetoprotein (AFP) are elevated indicated probable neural tube defect at 16wk gest

Front 52

spinal cord injury- complete C7 tetrapelgia

Back 52

• impaired cough and inability to clear secretions, alt breathing pattern, & poor endurance
• Independence with feeding, grooming, dressing, self ROM, manual WC mobility, transfers, driving with fancy car
• triceps, extensor pollicis L & B, extrinsic finger extensors & flexor carpi radiallis are lowest innervated muscles

Front 53

spinal cord injury- complete L3 tetrapelgia

Back 53

• partial innervation of gracillis, iliopsoas, QL, rectus femoris, and satorious - full UE
• may have sexual dysfx, non-reflexive bladder, need for bowel program, UTI, muscle contracture, pressure sores
• should be able to live independently

Front 54

systematic lupus erythematosus

Back 54

• CT tissue disorder caused by autoimmune rxn
  
• 15-4-, >women
• red butterfly rash across cheeks and nose, red rash over light exposed areas, arthralgias, alopecia, pleurisy, kidney involvement, seizure depression

Front 55

TMJ dysfx

Back 55

• > women, 20-40
• P! (persistant or recurring), muscle spasm, abnormal or limited opening, head ache tinnitus
• pt edu, TENS, posture retraining, moist heat, biofeedback, ultrasound, massage

Front 56

TOS

Back 56

• compression/damage to brachial plexus nerve trunks, subclavian vascular supply, and/or axillary artery
• contributing factors, presence of a cervical rib, abnormal 1st rib, postural deviations, spasm/hypertrophy of scalenes, elongated cervical transverse process
• 30-40, >women

Front 57

total hip arthroplasty

Back 57

• >55 yo, constant P! not relieved by conservative measures which limits functional mobility
• posterolateral approach leaves muscles intact, but higher incidence of post op instab as posterior capsule disrupted
• cemented allows for weight bearing initially, non-cemented toe touch for upto 6wk

Front 58

total hip precautions

Back 58

• anterolateral: btwn TFL and glute med no ext, flex >90, Lrot, add
• direct lateral: spares some med, TFL and vastus lateralis; o ext, flex >90, Lrot, add
• posterolatero: split glute max; no ext, flex >90, IR

Front 59

TKA

Back 59

• articular cartilage destroyed 2* to OA
• post op care may be knee immobilizer, limb elevation, cryo, CPM, initiation of knee protocol exercise
• pt edu: avoid excessive stress to the knee, squatting, quick pivot, using pillows under knee in bed and low seats

Front 60

Total shoulder arthroplasty

Back 60

• surg candidates have irreparable damage, deterioration and destruction to humeral head and glenoid fossa
• surgical complications: mechanical loosening of the prosthesis, instability, RTC tear, implant failure, heterotropic ossification and intraoperative fracture

Front 61

trans femoral amputation due to osteosarcoma

Back 61

• cancer begins in medullary cavity of bone and leads to formation of a mass
• post amputation: fatigue, loss of balance, phantom limb p!, hypersensitivity of residual limb and psych issues
• lying in prone reduces risk of hip contracture

Front 62

transtibial amputation due to ateriosclerosis obliterans

Back 62

• ateriosclerosis obliterans results in ischemia and subsequent ulceration of tissues
• post amputation decreased CV status depending on frequency of intermittent claudication experienced prior to amputation
  
• preprosthetic intervention: strength, ROM, functional mobility, use of assistive devices, desensitization and edu on residual limb care

Front 63

TBI

Back 63

• open injury with penetration to skull or closed head injury where brain makes contact with skull
• may include swelling, axonal injury, hypoxia, hematoma, hemorrhage and changes in intercranial pressure
• >risk males, 0-4, 15-19, and >65

Front 64

Uriniary stress incontinence

Back 64

• occurs with an increase in abdominal pressure due to straining, sneezing, coughing lifting
• risk factores: pregnancy, vaginal delivery, epistomy, prostate or pelvic surg, DM, aging, CNS dysfx, recurrent UTI
• 50-60% of all incontinence cases and is manifested solelu by the inovoluntary loss of urine with any for of exertion or increased abdominal pressure

Front 65

venous insufficiency ulcer

Back 65

• venous hypertension presents idiopathically, secondary to valve incompetence or peripheral impedance
• typically mild and relieved with elevation/compression garments
• tx of ulcer and underlying pathology should allow for a normal course of recovery

Front 66

vestibular disorders

Back 66

• disruption of sensory info processed by inner ear and brain with respect to the body's control of balance and eye movements
• maybe peripheral or central with most cases being peripheral
• effects can range from permanent disability to spontaneous recovery

Front 67

lateral ankle sprain

Front 68

pelvic floor dysfunction

Back 68

• Wide range of problems that occurs when muscles of pelvic floor are weak, tight, or there is an impairment of the SI joint, low back, coccyx, and/or hip. Tissues surrounding the pelvic organs may have increased or decreased sensitivity/and or irritation resulting in pelvic pain.
  

Front 69

asthma

Back 69

• Airway hypersensitivity to various stimuli
• wheezing, chest tightness, and slight shortness of breath
• PT: caregiver edu, airway clearance, breathing exercises, relaxation, and endurance/strength training. Ultimately, , pharmacological mgt &reduced exposure to triggers will most influence outcome.

Front 70

chronic bronchitis

Back 70

Bronchitis is a condition where the airways become inflamed due to an infection or certain irritants, such as tobacco smoke, fumes, dust, or air pollution. Prolonged exposure to these irritants may permanently damage the airways and result in chronic bronchitis. Signs and symptoms of bronchitis include coughing, wheezing, mucus production and shortness of breath. Acute bronchitis is treated with acetaminophen or aspirin for fever, cough medicine, a humidifier, and antibiotics if applicable. Chronic bronchitis with subsequent COPD may require the use of supplemental oxygen, bronchodilators, and corticosteroids. Taking a thorough history can help differentiate between bronchitis and asthma.