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454 Cards in this Set
- Front
- Back
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At what temp F does tissue damage begin?
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113F
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What is the increase (in %) of metabolic demand for each 10 degrees increase in skin temperature?
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100%
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What is a contraindication to heat therapy that can result in ischemic necrosis?
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scar tissue
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Heat therapy to scar tissue can result in what complication?
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ischemic necrosis
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What is the mechanism for heat transfer in deep heating modalities?
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conversion
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Hot water, parrafin bath, hot packs, heating pads transfer heat through what mechanism?
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conduction
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Fluidotherapy, contrast bathe, hydrotherapy transfer heat through what mechanism?
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convection
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Radiant heat, ultrasound and diathermy transfer heat through what mechanism?
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conversion
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Heat transfer through conversion of electromagnetic radiation is called what?
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conversion
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What is the maximum penetration of superficial heat in cm?
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2cm
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What is the peak temp of a heating pad in F?
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125F
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What is the ratio of parrafin wax:mineral oil?
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7:1
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What is the max temp F of parrafin therapy?
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130
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What are 3 indication for parrafin baths?
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RA
scleroderma contractures |
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What is the peak temp for fluidotherapy?
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120
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What type of tank is used to total body immersion?
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Hubbard tank
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What is the peak temp for Hubbard tank?
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102.2
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Use of a Hubbard tank is limited to those with a vital capacity greater than what?
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>1L
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What are 3 contraindications to contrast baths?
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small vessel disease from DM
Burger's disease arteriosclerotic endarteritis |
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What is the max/min temp of contrast baths?
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111/50
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What is the distance from the infrared lamp to the skin (range in inches)?
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18-24 inches
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An infrared lamp's effectiveness decreases by what formula?
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the square of their distance from the body
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An infrared lamp treatment is best for which patients?
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those who cannot tolerate the weight of hot packs
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What are three examples of deep heat (conversion) modalities?
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ultrasound
short wave diathermy microwave diathermy |
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Ultrasound frequencies above what Hz produce thermal effects?
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>20,000 Hz
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What two mechanisms produce heat in tissues undergoing ultrasound?
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beam attenuation
absorption |
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Ultrasound heating is more pronounced at what tissue levels?
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tissue interfaces
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Beam attenuation and absorption is most pronounced in what order of 5 tissues types (i.e. tendon, fat, bone, skin, and muscle)?
|
bone, tendon, skin, muscle, and fat
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What type of bone produces the highest termperature?
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cancellous bone
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Where is absorption the greatest?
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bone-muscle interface
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What is unidirectional movement of compressible material or medium due to pressure assymetries caused by ultrasound waves?
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acoustic streaming
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What two ultrasound effects are associated with wound contraction and protein synthesis?
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acoustic streaming and acoustic cavitation
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What is gas bubbles produced within the sound field due to turbulence, which, by their forced oscillation and bursting, are capable of disrupting tissue.
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acoustic cavitation
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What are two effects of ultrasound standing waves?
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elevated pressure and rarefaction
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Do standing waves have physiological benefits?
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no
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What the main indication for ultrasound?
|
OA
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What are two primary contraindications to ultrasound?
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near pacemakers or
tumors |
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What two types of total knee or hip replacement are an ultrasound contraindication?
|
total hip or knee with methylmethacrylate or polyethelyne
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What particular characteristic of methylmethacrylate or polyethylene make them susceptible to ultrasound effects?"
|
high coeffecient of absorption
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Why should children not receive ultrasound?
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skeletal immaturity; open epiphysis can be affected with decreased growth due to thermal injury
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Over what organ in women is ultrasound contraindicated?
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gravid uterus
menstruating uterus |
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US should be avoided over what intensity (in W/cm2)
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>3 W/cm2
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What is the frequency range for US (in MHz)?
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0.8-1.1 MHz
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What is the unit of ultrasound intensity?
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MHz
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US can be used under water, but only if it has undergone what process?
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degassed overnight
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What is the WHO suggested maximum US intensity?
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3 W/cm2
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Power output/effective radiating area are = ?
|
spatial average intensity
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What is the average intensity range (W/cm2) for tendonitis/bursitis?
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1.2-1.8 W/cm2
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At 1.2-1.8 W/cm2 what is the maximal tissue temperature generated (F)?
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114.8F
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What is the duration for US?
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5-10 minutes per site
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Is US deep heating superior to shortwave or microwave diathermy?
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Yes
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At what depth (cm)will tissue be heated to 113F for 2 minutes?
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8cm
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What is the most common US technique direct or indirect?
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direct
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What body parts are placed in degassed water for US treatment?
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hands and feet (uneven surfaces)
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What is the frequency range (MHz) for phonopheresis?
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1-2 MHz
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What are the intensity (W/cm2) and time (minutes) ranges for phonpheresis?
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1-3 W/cm2 for 5-7 minutes
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What deep heating technique converts radiowave electromagnetic energy into thermal energy?
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shortwave diathermy
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What is the most commonly used diathermy frequency?
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27.12 MHz
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What is the maximum depth (cm) for shortwave diathermy?
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5 cm
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What technique is preferred for heating of superficial muscles?
|
shortwave diathermy
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What shortwave diathermy method produces high tempertatures in water-poor tissues?
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condensor method
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What shortwave diathermy method is used for deep joints such as the hip?
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condensor method diathermy
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What patient feedback is used to dose shortwave diathermy?
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pain perception of heat
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What is the subcutaneous fat temperature in shortwave diathermy (C)?
|
15 C
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What patient reaction can cause severe local heating, and why?
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sweating/sweat is highly conductive
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What are 4 indications for shortwave diathermy?
|
chronic prostatitis
Pelvic inflammatory disease myalgia back spasm |
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What is a unique shortwave diathermy contraindication (that differs from US contraindications)?
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metal
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What are the two frequencies for microwave diathermy (MHz)?
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915Hz and 2456 MHz
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915 MHz and 2456 MHz are frequencies for what modalities?
|
microwave diathermy
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What is least penetrating? US, shortwave diathermy, or microwave diathermy?
|
microwave diathermy
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What is the best modality for chronic prostatitis?
|
shortwave diathermy
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What is the best modality for refractory pelvic inflammatory disease?
|
shortwave diathermy
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What are two unique indications for microwave diathermy?
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resolution of hematomas
local hyperthermia in cancer patients |
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What is the best modality for resolution of hematomas?
|
microwave diathermy
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What is the best modality for back spasm?
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shortwave diathermy
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What is the best modality for local hyperthermia in cancer patients?
|
microwave diathermy
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What is a risk of microwave diathermy to therapists?
|
cataracts
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What structures does microwave diathermy preferentially heat?
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fluid-filled cavities
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What is the average temperature at 1-3 cm with microwave diathermy?
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105.8
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What is the depth range of microwave diathermy(cm)?
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1-4 cm
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What are three forms of diathermy?
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ultrasound
shortwave microwave |
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What is the depth range of shotwave (cm)?
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4-5 cm
|
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What is the depth of ultrasound (cm)?
|
8cm
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What diathermy technique is best for contractures?
|
US
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Near what type of surgery should US not be used?
|
laminectomy
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The contraindication of fluid-filled cavities, such as eyes, blisters, moist skin, and edematous tissues, applies to what modality?
|
microwave diathermy
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Use over contacts lenses is contraindicated in what two modalities?
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US and shortwave
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Use near heart or reproductive organs is contraindicated in what modality?
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US
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Use near brain and spinal cord are contraindications of what diathermy?
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US
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What is a contraindication that applies to all diathermies?
|
skeletal immaturity
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Cold therapy decreases firing rate of what two types of afferent muscle fibers?
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Ia and II afferent fibers
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What is a primary effect of cold on muscle?
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decreases spasticity
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What transient effect does cold therapy have on systolic and diastolic blood pressure?
|
increases both transiently
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What disease is a contraindication to cold?
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Raynaud's disease/phenomenon
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What are two examples of cold treatment conduction?
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cold packs
ice massage |
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Cold packs and ice massage transfer cold by what mechanism?
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conduction
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Cold baths transfer cold by what mechanism?
|
convection
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What is an example of cold convection?
|
cold baths
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Vapocoolant spray uses what mechanism to transfer cold?
|
evaporation
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What is an example of evaporation to transfer cold?
|
vapocoolant spray
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By how many degrees C is muscle cooled at a depth of 2cm afer 20 minutes of hydocollator pack?
|
5 C
|
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What is the water temp range in C of cold baths?
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4-10C
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What is the indication for cold baths?
|
localized burns
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What is an indication for vapocoolant?
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myofascial pain (spray and stretch technique)
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What is the temp (F) and pressure (mmHg) of cold compression units?
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45F/60mmHg
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What is the indication for cold compression units?
|
acute musculoskeletal injury
|
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What is the wavelength range (A) for UV?
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2000-4000A
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What is the bacteriocidal wavelenght of UV (A)
|
2537A
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What molecule can be altered with UV?
|
DNA
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What are two sources of UV lamps?
|
mercury
cold quartz |
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What vitamin is produced by UV?
|
Vitamin D
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What is the primary wound effect of UV?
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vascularization of wound margins
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What is the primary indication for UV?
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psoriasis
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What is Goeckerman's technique?
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coal tar ointment application prior to UV
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What is the technique of coal tar ointment prior to UV treatment?
|
Goeckerman's technique
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What are two skin related precautions for UV?
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scars and atrophic skin
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What is an infectious precaution for UV?
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active tuberculosis
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What is are two endocrine precautions for UV?
|
severe DM and hyperthyroidism
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What is a vitamin deficiency contraindication of UV?
|
pellagra
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What are three dermatological contraindications or UV?
|
active psoriasis
eczema xeroderma pigmentosum |
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What is an oral/genital ulcer contraindication of UV?
|
herpes simplex
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Minimal exposure time of UV is determined by erythema on what limb surface?
|
volar surface of the forearm
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How long (hours) does it take for the minimal erythema dosage to subside?
|
24 hours
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What is the initial prescription range in MED of UV treatment?
|
1-2 MED
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4th degree MED erythema with superficial blister is what MED dose?
|
10
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What is the MED dose that produces 3rd degree erthyema in 2-4 hours with local pain and edema and local desquamation?
|
5 MED
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What MED dosage produces a 2nd degree erythema in 4-6 hours with pain and subsides in 2-4 days followed by local desquamation?
|
2.5 MED
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Electrotherapy stimulates what type of nerve fibers?
|
large myelinated Type A
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What is a ROM effect of electrotherapy?
|
increases ROM
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What is a muscle strength effect of ET?
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increases muscle strenght
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What 3 polypeptides are released by ET?
|
B-endorphins, enkephalins,
vasoactive intestinal peptide |
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What 2 neurotransmitters are released by ET?
|
dopamine and serotonin
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What are 2 circulatory contraindications of ET?
|
thrombosis
thrombophlebitis |
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Over what 2 structure is ET contraindicated?
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carotid sinus and heart
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What neurological condition is a contraindication to ET?
|
seizure disorder
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What is the placebo effect percentage range of TENS?
|
30-35%
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TENS is based of what theory by whom?
|
Gate control by Melzack and Wall
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What nerve fibers does TENS stimulate?
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large, myelinated Type IA afferent
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What structure in the spinal cord is stimulated by TENS?
|
substantia gelatinosa (by Type IA myelinated fibers)
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TENS pain relief at 4 Hz stim is blocked by what drug?
|
naloxone
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Naloxone does not block TENS pain relief at what frequency?
|
200 Hz
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What type of TENS is the most effective? (frequency high or low; stimulation high or low)
|
high frequency low intensity
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Where in the spinal cord is the substantia gelatinosa?
|
dorsal horn
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What afferent fibers to the thalamus are blocked by TENS?
|
type C fibers
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What is the frequency range(Hz) of a conventional TENS stimulator?
|
50-100 Hz
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What is the prescription of ET using acupuncture needles? (high or low frequency; high or low sitmulation?
|
low frequency; high intensity stimulation
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What TENS method stimulates C-fibers causing counterirritation?
|
hyperstimulation TENS
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Neuromuscular electical stim requires what neuron to be intact?
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alpha motor neuron
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NMES applies what level stim?
|
above the threshold to cause muscle contraction
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NMES are most commonly internal or external?
|
external
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What is the frequency range (Hz) of external NMES electrodes?
|
10-50 Hz
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The most common functional neuromuscular stimulation utilizes an open or closed loop?
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closed loop
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Manual feedback is the hallmark of open or closed loop FES?
|
open
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What is the primary indication for neuromuscular stimulation?
|
strengthens and maintains muscle mass after immobilization
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Strengthening and maintaining muscle mass after immobilization are indications for what modality?
|
neuromuscular electrical stimulation
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Neuromuscular stim helps prevent what 3 common complication of immobility?
|
DVT, atrophy, osteoporosis
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Neuromuscular electrical stimulation systems are used for what SCI condtions?
|
phrenic nerve pacing
urinary incontinence |
|
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Neuromuscular electrical stimulation to antagonist muscles in spasticiy management provokes what phenomenon?
|
reflex inhibition
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Neuromuscular electrical stimulation is used on what joint in a hemiplegic limb?
|
shoulder
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What is the cardiac effect of neuromuscular electrical stimulation ?
|
cardiovascular conditioning
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What is monitored during FES exercise of lower extremities in SCI?
|
BP
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What is an indication of iontophoresis?
|
plantar fasciitis
|
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What is a transdermal electrical delivery system that propels a charged substance across the skin?
|
iontophoresis
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What is a neurocirculatory effect of massage?
|
reflex vasodilation
|
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What technique is kneading to increase circulation?
|
petrissage
|
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What is petrissage?
|
kneading to increase circulation and reduce edema
|
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What is effleurage?
|
gliding movement of the skin without deep muscle movement; used for muscle relaxation
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What is gliding movement of the skin without deep muscle movement?
|
effleurage
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What massage technique is used for chest therapy to remove secretions?
|
tapotement
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What is tapotement?
|
percussion massage technique to clear secretions
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What massage technique prevents adhesions in acute injuries?
|
friction massage
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An acute injury is an indication for what type of massage?
|
friction massage
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What is friction massage?
|
a massage technique to prevent adhesions in an acute injury and breaks adhesion in subacute and chronic injuries
|
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What are the two directions of friction massage on the muscles?
|
transverse or perpindicular
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What massage technique is used for reduction of contractures?
|
soft-tissue mobilization
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Soft tissue mobilization is done with the fascia/muscle in a relaxed or stretched position?
|
stretched
|
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Is myofascial release light or heavy pressure on muscle?
|
prolonged light pressure
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What is the distance (cm) range of cervical elongation during traction? using how much weight?
|
2-20mm/25 lbs
|
|
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What are 4 congenital contraindications to cervical traction?
|
Downs
Marfans achondroplastic dwarfism Ehlers-Danlos syndrome |
|
|
What is one rheumatoid contraindication to cervical traction?
|
rheumatoid arthritis
|
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What is a spinal instability contraindication to cervical traction?
|
atlanto-axial subluxation with cord compromise
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What is a vascular contraindication to cervical traction?
|
vertibrobasilar insufficiency
|
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What is a pulmonary contraindication to lumbar traction?
|
restrictive lung disease
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What is a GI contraindication to lumbar traction?
|
active peptic ulcer disease
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What is a circulatory contraindication to lumbar traction?
|
aortic aneurysm
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What degree range of cervical flexion is used in cervical traction for nerve root decompression?
|
20-30 degrees
|
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|
For lumbar traction, to what degree are the hips and knees flexed with the patient supine?
|
knees and hips are flexed to 90 degrees
|
|
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For cervical traction how much weight is used?
|
25 lbs
|
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How much weight is needed for posterior lumbar distraction?
|
>50lbs
|
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How much weight is needed for anterior lumbar distraction?
|
>100 lbs
|
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How much weight is needed overcome friction in traction in relation to the weight of the body part being treated?
|
1/2 weight of the body part being treated.
|
|
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What is the percentage of total body weight is the lumbar spine?
|
25%
|
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What provides a greater pull intermittent or continuous traction?
|
intermittent
|
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What is the functional unit of contraction?
|
sarcomere
|
|
|
Is myosin thin or thick?
|
thick
|
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Is actin thin or thick
|
thin
|
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What attaches to the outer margins of the z line?
|
actin
|
|
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How the sarcomere measured?
|
from Z-line to Z-line
|
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|
What is the zone in the A band (myosin) that does not overlap
|
H zone (at center)
|
|
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Does the I band (actin) overlap?
|
no
|
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What shrinks during muscle contraction?
|
H and I zones
|
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What muscle type is high in oxidative enzymes?
|
type I
|
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Type I muscle is high in what enzymes?
|
oxidative
|
|
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What fiber type is used for low intensity, long duration activities?
|
type I
|
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What muscle type has high levels of glycogen and phosphoylase
|
Type II
|
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What is the fast fatiguable subtype?
|
IIb
|
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What are the fast-twitch, glycolytic fibers?
|
IIb
|
|
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What are the fatigue resistant fiber subtype?
|
IIa
|
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What is the description of IIa fibers (i.e. fast-twitch, slow-twitch, glycolytic, oxidative)
|
fast-twitch, glycolytic/oxidative
|
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What is the description of IIb fibers (i.e. fast-twitch, slow-twitch, glycolytic, oxidative)
|
fast-twitch/gylcolytic
|
|
|
What has a better capillary supply IIa or IIb?
|
IIa
|
|
|
What is the muscle diameter of type II fibers, large or small?
|
thick
|
|
|
Visible joint movement is a hallmark ow what type of exercise?
|
isotonic
|
|
|
Progressive resistance exercises is an example of what type of exercise?
|
isotonic
|
|
|
Weightlifting is an example of what type of exercise?
|
isotonic
|
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|
Give an example of isotonic exercise?
|
weightlifting
|
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Variable speed is a characteristic of what type of exercise?
|
isotonic
|
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Constant speed is a characteristic of what type of exercise?
|
isokinetic
|
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Isokinetic exercise has constant or variable speed?
|
constant
|
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Isotonic exercise has constant or variable speed?
|
variable
|
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Isotonic has constant or variable external resistance?
|
constant
|
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Constant external resistance is a hallmark of what type of exercise?
|
isotonic
|
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Visible joint movement is apparent in what two types of exercise?
|
isotonic
isokinetic |
|
|
Variable external resistance is a feature of what type of exercise?
|
isokinetic
|
|
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Isokinetic exercise has constant or variable external resistance?
|
variable
|
|
|
What are two examples of devices using isokinetic exercise?
|
cybex, nautilus
|
|
|
What is an exercise type that has no visible joint movement?
|
isometric
|
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|
What is the joint movement in isometric exercise?
|
none
|
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|
What is an exertion against an immoveable object?
|
isometric
|
|
|
How many reps are required in progressive resistance exercises (PRE)?
|
10
|
|
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What is the ROM requirement for PREs?
|
full ROM
|
|
|
What two types of exercise can be eccentric or concentric?
|
isokinetic or isotonic
|
|
|
Isokinetic or isotonic exercises contract muscle in what way? eccentric or concentric?
|
eccentric or concentric
|
|
|
What is the repetition schedule of progressive resistance exercises?
|
50%/75%/100%
|
|
|
What contraction is a lengthening contraction?
|
eccentric
|
|
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What contraction resists a stretching force?
|
eccentric
|
|
|
What contractions generate the greatest amount of force?
|
fast eccentric
|
|
|
What contractions cause more tissue destruction?
|
eccentric
|
|
|
How is muscle soreness in eccentric contractions relieved? rest or mild exercise?
|
mild exercise
|
|
|
What is more metabolically efficient eccentric or concentric?
|
eccentric
|
|
|
What is muscle shortening against resistance?
|
concentric contractions
|
|
|
What is the hallmark of concentric contractions?
|
muscle shortening against resistance
|
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|
What contraction develops little force?
|
concentric
|
|
|
What is the metabolic cost of concentric contractions? high or low?
|
high
|
|
|
What contractions produce the least force?
|
fast concentric contractions
|
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|
What contractions produce the most force?
|
fast eccentric contractions
|
|
|
What is more powerful slow eccentric or isometric contractions?
|
slow eccentric
|
|
|
What produces more force fast or slow eccentric?
|
fast eccentric
|
|
|
What produces more force slow or fast concentric?
|
slow concentric
|
|
|
What produces more force slow concentric or isometric contractions?
|
isometric contractions
|
|
|
What two contractions produce the least force?
|
slow and fast concentric (fast concentric being the least forceful)
|
|
|
What is the recommended percentage range of VO2 max for exercise
|
50-85% of VO2 max
|
|
|
What is the recommended percentage range of HR reserve max for exercise?
|
50-85%
|
|
|
How long (minutes) does the glycolytic system work during exercise?
|
2 minutes
|
|
|
What CV conditioning parameter increases during maximal exercise?
|
stroke volume
|
|
|
What consumption is reduced during rest and submaximal exercise as a result of CV conditioning?
|
myocardial O2
|
|
|
What CV parameter is reduced during rest and submaximal exercise as a result of CV conditioning?
|
BP
|
|
|
During maximal exercise what CV parameter is increaesed with CV conditioning?
|
BP is increased during maximal exercise
|
|
|
What is the effect of isometric on HR?
|
none
|
|
|
What is the effect of isometric on VO2 max?
|
none
|
|
|
What is the effect of isometric on systolic BP?
|
increases SBP
|
|
|
What is the effect of isometric on diastolic BP?
|
increases DBP
|
|
|
What is the effect of isometric on max vital capacity?
|
none
|
|
|
What is the effect of isotonic on HR?
|
increases HR
|
|
|
What is the effect of isotonic on VO2 max?
|
none
|
|
|
What is the effect of isotonic on systolic blood pressure?
|
increases SBP
|
|
|
What is the effect of isotonic on diastolic BP?
|
no change
|
|
|
What is the effect of isotonic on max vital capacity?
|
no change
|
|
|
What is shoulder flexion?
|
158
|
|
|
What is shoulder extension?
|
53
|
|
|
What is shoulder abduction?
|
170
|
|
|
What is shoulder adduction?
|
50
|
|
|
What is shoulder horizontal flexion?
|
135
|
|
|
What is shoulder internal rotation?
|
70
|
|
|
What is shoulder external rotation?
|
90
|
|
|
What is elbow flexion
|
70
|
|
|
What is elbow hyperextension?
|
90
|
|
|
What is arm pronation?
|
70
|
|
|
What is arm supination?
|
85
|
|
|
What is thumb abduction?
|
60
|
|
|
What is thumb IP flexion?
|
80
|
|
|
What is thumb MP flexion?
|
50
|
|
|
What is thumb MC flexion?
|
15
|
|
|
What is thumb IP extension?
|
20
|
|
|
What is thumb MP extension?
|
10
|
|
|
What is thumb MC extension?
|
20
|
|
|
What is finger DP flexion?
|
80
|
|
|
What is finger PIP flexion?
|
100
|
|
|
What is finger MCP flexion?
|
90
|
|
|
What is finger DIP extension?
|
0
|
|
|
What is finger PIP extension?
|
0
|
|
|
What is finger MCP extension?
|
45
|
|
|
What is hindfoot inversion?
|
5
|
|
|
What is hindfoot eversion?
|
5
|
|
|
what is hip flexion?
|
115
|
|
|
what is hip extension?
|
30
|
|
|
What is hip abduction?
|
50
|
|
|
What is hip adduction?
|
30
|
|
|
What is hip horizontal flexion?
|
60
|
|
|
What is hip internal rotation with hip in flexion?
|
45
|
|
|
What is hip external rotation with hip in flexion?
|
45
|
|
|
What is hip internal rotation with hip in extension?
|
35
|
|
|
What is hip external rotation with hip in extension?
|
50
|
|
|
What is knee flexion?
|
135
|
|
|
What is knee extension?
|
10
|
|
|
What is ankle plantar flexion?
|
50
|
|
|
What is ankle dorisflexion?
|
20
|
|
|
What is wrist extension?
|
70
|
|
|
What is wrist flexion?
|
75
|
|
|
What is wrist ulnar deviation?
|
35
|
|
|
What is wrist radial deviation?
|
20
|
|
|
What is forefoot inversion?
|
35
|
|
|
What is forefoot eversion?
|
20
|
|
|
What is great toe IP flexion?
|
60
|
|
|
What is great toe IP extension?
|
0
|
|
|
What is great toe MTP flexion?
|
40
|
|
|
What is great toe MTP extension?
|
65
|
|
|
What is 2-5 toes DIP flexion?
|
55
|
|
|
What is 2-5 toes PIP flexion?
|
40
|
|
|
What is 2-5 toes MTP flexion?
|
35
|
|
|
What is 2-5 toes extension?
|
40
|
|
|
What is cervical flexion?
|
40
|
|
|
What is cervical extension?
|
40
|
|
|
What is cervical lateral bending?
|
45
|
|
|
What is cervical rotation?
|
45
|
|
|
What is lumbar flexion?
|
85
|
|
|
What is lumbar extension?
|
30
|
|
|
What is lumbar lateral bending?
|
30
|
|
|
What is lumbar rotation?
|
40
|
|
|
What is static stretching with contraction of the antagonist muscle?
|
reciprocol inhibition
|
|
|
What is joint moved to end of ROM and held for 5-60 seconds?
|
static stretching
|
|
|
What stretching technique has a high risk of injury?
|
ballistic stretching
|
|
|
What type of injuries can arise from ballistic stretching?
|
bone avulsion
tendon tears |
|
|
What is 2-5 toes PIP flexion?
|
40
|
|
|
What is 2-5 toes MTP flexion?
|
35
|
|
|
What is 2-5 toes extension?
|
40
|
|
|
What is cervical flexion?
|
40
|
|
|
What is cervical extension?
|
40
|
|
|
By what daily percentage range does immobilization decrease muscle strength?
|
1-1.5% per day
|
|
|
How much (% range) does strength decrease in 7-10 days of immobiliztion, in month of immobilization?
|
20-30%/50%
|
|
|
What is the plateau (% range)of muscle strength retained after prolonged immobilization?
|
25-40% of original strength
|
|
|
One contraction per day at what strength (%) is necessary to prevent the effect of immobilization?
|
50% of maximal strength
|
|
|
What is the percentage range of muscle mass lost per week with immobilization?
|
5-10%
|
|
|
With immobilization there is a decrease in the diameter and percentage of what fiber type?
|
type I
|
|
|
What parameter of type I fibers decreases with immobilization?
|
diameter of type I
|
|
|
What bone condition develops with immobilization?
|
osteopenia
|
|
|
What develops as a result of immobilization osteopenia?
|
hypercalcemia
|
|
|
How many days after immobilization does calcium start being excreted in urine and feces?
|
2-3 days
|
|
|
When (week range) do calcium levels in urine and feces peak?
|
3-7 weeks
|
|
|
After activity is resumed when do calcium levels return to normal (week range)?
|
5-6 weeks
|
|
|
What improves last in urine, calcium, nitrogen, or protein?
|
calcium
|
|
|
What is nitrogen loss per day with immobilization? (g/day)
|
2 g/day
|
|
|
When (day range) does nitrogen loss begin in immobilization?
|
5-6 days
|
|
|
When(week number) does nitrogen loss peak in immobilization?
|
second week
|
|
|
For how long (days) does nitrogen loss continue after activity has resumed?
|
7 days
|
|
|
What muscle condition can be caused by calcium and phosphorous excretion?
|
muscle atrophy
|
|
|
What is the nutritional supply of cartilage?
|
synovial fluid
|
|
|
How is the synovial fluid nutrition delivered to the cartilage?
|
loading and unloading of joints
|
|
|
What circulatory parameters decrease with immobilization?
|
decrease in blood and plasma volumes
|
|
|
What sympathetic activity in increased with immobilization?
|
B-adrenergic activity is increased
|
|
|
What two CV parameter increases with immobilization?
|
increased resting HR
|
|
|
What CV parameter decreases with immobilization?
|
decreased stroke volume
|
|
|
By how many beats/min/day does HR increase with immobilization?
|
by 0.5 beats/min/day
|
|
|
By how much (%) does stroke volume decrease with 2 weeks of bedrest?
|
15%
|
|
|
What pulmonary parameter decreases with immobilization?
|
VO2 max
|
|
|
What blood characteristic increases with immobilization?
|
coagulability
|
|
|
What lung infection can develop with immobilization?
|
hypostatic pneumonia
|
|
|
What 3 pulmonary parameter decrease with immobilization?
|
decreased tidal volume, minute volume and vital capacity
|
|
|
What are two GI complications of immobilization?
|
constipation and loss of appetite
|
|
|
Immobilization leads to an increased risk of what two urinary conditions?
|
urolithiasis and UTI
|
|
|
Immobilization leasd to what skin complications?
|
skin atrophy and pressure ulcers
|
|
|
Paraplegia is an impairment, disability, or handicap?
|
impairment
|
|
|
Inability to ambulate because of paraplegia is an impairment, disability, or handicap?
|
disability
|
|
|
Inability to walk upstairs in a building without an elevataor is an impairment, disability, or handicap?
|
handicap
|
|
|
What is an inability to perform a particular activity or function.
|
disability
|
|
|
What is a physical or psychological abnormality?
|
impairment
|
|
|
What is an inability to perform a usual role/life activity as a result of an impairment?
|
handicap
|
|
|
What two parameters does the FIM score?
|
severity of disability
outcomes of rehabilitation |
|
|
How many items and categories are there in the FIM?
|
18 items in 6 categories
|
|
|
What type of scale is the FIM?
|
ordinal
|
|
|
What are the 6 categories of FIM?
|
self care
sphincter control mobility locomotion communication social cognition |
|
|
What is the grade range of FIM?
|
1-7
|
|
|
What score is total independence?
|
7
|
|
|
What are the 6 items under self care?
|
eating
grooming bathing upper body dressing lower body dressing toileting |
|
|
What are the 2 items under sphincter control?
|
bowel and bladder function
|
|
|
What are the 4 items under mobility?
|
bed, chair, wheelchair, tub or shower, and toilet transfers
|
|
|
What are the 3 items under mobility?
|
ambulation
wheelchair mobility stair management |
|
|
What are the 2 items under communication?
|
comprehension
expression |
|
|
What are the 3 items under social cognition?
|
interaction
problem solving memory |
|
|
What is a FIM score of 2?
|
max assist (subject =25%+)
|
|
|
What is a FIM score of 3?
|
mod assist (subject=50%+)
|
|
|
What is a FIM score of 4?
|
min assist (subject =75%+)
|
|
|
What is a FIM score of 5?
|
supervision (subject =100%+)
|
|
|
What is a FIM score of 6?
|
modified independence (device)
|
|
|
Maximal heart rate declines or increases with aging?
|
declines
|
|
|
Exercise ejection fraction increases or decreases with aging?
|
decreases
|
|
|
Left ventricle end systolic volume increases or decreases with aging?
|
increases
|
|
|
With aging, cardiac output during exercise depends more on what cardiac function? using what mechanism?
|
increaseed stroke volume/Frank-Starling mechanism
|
|
|
Cardiac output increases or decreases with aging?
|
decreases
|
|
|
Rate of diastolic early filling is increased or decreased with age?
|
deceased
|
|
|
With aging what is diastolic filling more dependent on?
|
late filling through atrial contracton
|
|
|
With aging increases in diastolic and systolic BPs are due to what factor?
|
decreased arterial elasticity
|
|
|
With aging baroreceptor sensitivty is increased or decreased?
|
decreased
|
|
|
VO2 max increases or decreases regardless of activity level?
|
decreases
|
|
|
Cough and micturation syncope syndromes are linked to a decrease in what sensitivity?
|
decrease in baroreceptor sensitivity
|
|
|
With aging VC increases or decreases?
|
decreases
|
|
|
With aging PO2 increases or decreases?
|
decreases
|
|
|
With aging PCO2 increases or decreases?
|
No change
|
|
|
With aging pH increases or decreases?
|
no change
|
|
|
FEV1 increases or decreases iwth aging? By how much (ml) per year does FEV1 decrease?
|
decreases/33ml/yr
|
|
|
Maximum minute ventilation increases or decreases with aging?
|
decreases
|
|
|
Residual volumes increases or decreases with age?
|
increases
|
|
|
Functional residual capacity increases or decreases with aging?
|
increases
|
|
|
Total lung capacity increases or decreases with aging?
|
no change
|
|
|
Number of motor units increases or decreases with age?
|
decreases
|
|
|
Number of myofibrils increases or decreases with age?
|
decreases
|
|
|
By age 80 fat increases by how much (%)
|
30%
|
|
|
With aging type IIA fibers increase or decrease?
|
increase
|
|
|
With aging type IIB fibers increase or decrease?
|
decrease
|
|
|
Type I fibers increase or decrease with aging?
|
no change
|
|
|
With aging base of stance is increased or decreased?
|
increased
|
|
|
Ratio of chontroitin-4-sulfate to chondroitin-6-sulfate increases or decreases with age?
|
decreases
|
|
|
Peak bone mineral density decrease starts at what age range?:
|
mid-30s
|
|
|
What brain neurons decrease with aging?
|
nigrostriatal neurons
|
|
|
What declines more, math or language skills with aging?
|
math skills
|
|
|
What percent of elderly with urinary incontience have detrusor instability?
|
70%
|
|
|
Glomular filtration rate increases or decreases with age?
|
decreases
|
|
|
Renal tubular cell mass increases or decreases with age?
|
decreases
|
|
|
Digitalis toxicity in the elderly is usually due to what impairment?
|
impaired renal function
|
|
|
What are three signs and symptoms of digitalis toxicity?
|
cardiac dysrhythmias
anorexia nauseau |
|
|
What is the most common finding of NSAID toxicity in the elderly?
|
prerenal azotemia
|
|
|
When renal blood flow is dependent on vasodilating prostaglandins, NSAID use can precipitate what condition?
|
acute renal failure
|
|
|
Acute renal failure can be precipitated by use of what agent when renal blood is dependant on vasodilating prostaglandins?
|
NSAIDs
|
|
|
In states of prostaglandin inhibition, NSAID use can precipitate what condition?
|
hyporeninemic hypoaldosteronism
|
|
|
Aging increases or decreases the amplitude of esophogeal peristaltic contractions?
|
decreases
|
|
|
Aging decreases the amplitude of what esophogeal function?
|
peristaltic contractions
|
|
|
Diarrhea can be caused by what cardiac medication?
|
digitalis
|
|
|
Falls is the community are secondary most commonly to what three factors?
|
decreased static balance
decreased leg strength decrease hip/ankle flexibility |
|
|
Falls in a nursing home are secondary most commonly to what two factors?
|
decreased knee strength
decreased ankle strength |
|
|
In the elderly, resting heart rate decreases by what beats/minute range with submaximal exercise?
|
9-20 beats per min
|
|
|
In the elderly stroke volume increases by what percentage with submaximal exercise?
|
8%
|
|
|
In the elderly with maximal exercise stroke volume increases by what percentage range?
|
6-8%
|
|
|
In the elderly with maximal exercise cardiac output increases by what percentage?
|
34%
|
|
|
What two cardiac parameters increase with maximal exercise in the elderly?
|
Stroke volume
cardiac output |
|
|
In the elderly, what two blood parameters increase with exercise?
|
total hemoglobin
blood volume |
|
|
By what percentage range does systemic vascular resistance decrease during submaximal exercise?
|
5-18%
|
|
|
In the elderly what muscle fibers increase in diameter with exercise?
|
Type I and Type II
|
|
|
What is the percentage range of the rate of major depression in the elderly?
|
16-30%
|
|
|
What is the increased risk of depression in the elderly with a disability?
|
3X
|
|
|
What is the preferred tricyclic in the elderly? Why?
|
nortriptyline. Less anticholinergic effect
|
|
|
TCAs cause orthostatic hypotension by blocking what?
|
alpha-1
|
|
|
What is the preferred medication for agitation in the elderly? Why?
|
amitriptyline. Not fat soluble
|
|
|
Is diazepam fat or water soluble?
|
fat soluble
|
|
|
What type of soluble meds accumulate in the elderly fat or water soluble?
|
fat soluble
|
