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87 Cards in this Set
- Front
- Back
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What are the cardinal vital signs?
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Temperature
Pulse Rate Respiration Blood Pressure Oximetry |
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What is the purpose of vital signs?
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Check body’s physiological status
Reflects function of internal organs Helps plan treatment, POC, reasoning, judgment, determine progress |
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What are influencing variables with vital signs?
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Lifestyle patterns:
Caffeine, tobacco, diet, stress, ETOH, obesity, activity, meds, illegal drugs, hormone status, age, gender, family hx, time of day/month, pain Culture, ethnicity |
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What are characteristics of peripheral thermoreceptors?
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Skin—free nerve endings
Rapid change sensitivity Abdominal organs Nervous system |
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What are charcteristics of central thermoreceptors?
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In hypothalamus
Sensitive to changes in blood temp |
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What are effector organs that deal with body temperature?
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Vascular
Metabolic Skeletal muscles (shivering) Sweat glands |
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What are characteristics of effector organs during decrease temperature?
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Vascular—vasoconstriction
Metabolic—hormonal regulation, NE, E Skeletal muscles—shivering to increase metabolism Sweat glands—abolished |
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What are ways in which the body reacts to increased temperature?
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Dissipation of body heat
Radiation Conduction—Salt River Tubing Convection Evaporation Vasodilation, decreased metabolism, increased sweat |
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What is pyrexia?
At what termperature? |
Fever, 106 F
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What factors influence body temperature?
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Time of day—circadian rythym
Age Emotions/stress Exercise |
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What are the 5 major locations for peripheral pulses?
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Radial
Carotid Popliteal Brachial Pedal |
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What determines the quality of a pulse?
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Amplitude
Volume |
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What is the normal feeling of a blood vessel?
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Smooth
Elastic Soft Flexible Straight |
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What is the abnormal feeling of a blood vessel?
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Sclerotic
Twisted Hard Cord-like Decrease Elasticity |
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What is normal pulse oximetry?
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96-100%
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What is internal respiration?
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Exchange of O2 between organs and cells in the body
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What area of the brain controls respiration?
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Pons/medulla
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In respiration, what does the CNS chemoreceptors monitor?
PNS? |
CO2, H+
PaO2 (plasma only) |
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What is blood pressure?
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The force the blood exerts on wall of artery
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Finish the equations:
CO= HR x _____ BP= CO x _____ |
CO= HR x SV
BP = CO x R |
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What structure in the brain regulates BP?
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Pons/medulla
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What should a patient history consist of?
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Medical Chart
Patient Interview Family Interview Consultations |
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What should a systems review consist of?
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Communication
Cardiopulmonary Integumentary Musculoskeletal Neuromuscular |
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What should the examination consist of?
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Functional Tests
Structure/Observation Movement Testing – Active, Passive, Resisted Neurovascular Palpation Special Tests |
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What should a prognosis consist of?
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Level of improved function
Time needed Plan of Care Goals Outcomes Interventions Time frame |
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What does the medial model focus on?
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Diagnosis and treating the disease
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What does the disablement model focus on?
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Focuses on the impact of the condition on function
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What is the purpose of the PT differential diagnosis?
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Diagnose and manage movement dysfunction and enhance physical and functional abilities.
Change the movement to improve function |
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What is defined as Problems in body function or structure as a significant deviation or loss.
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Impairment
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When determining the quality of symptoms, what factors are considered?
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Severity
Type of pain Numbness, tingling Ache Weakness |
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When determining the behavior of symptoms, what questions should be asked?
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What makes it better/worse?
What happens with different activity If no change in symptoms with activity change, may consider other medical problem What has happened over the last 48 hours? What previous care was received and how did it help? |
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When evaluating posture, what are the anterior landmarks?
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Eyes
Acromion processes ASIS Crests (iliac) Greater trochanters Patellae Malleoli |
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When evaluating posture, what are the lateral landmarks?
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Plumb line
Ear Acromion Trochanter Just posterior to patella (anterior moment) 2 inches anterior to lateral malleolus Spinal curves |
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When evaluating posture, what are the posterior landmarks?
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Earlobes
Acromion Scapulae—inferior angles, depression, elevation Crests PSIS Trochanters Buttock and knee creases Malleoli Spine in frontal plane Scapulae from spine Genu Varum/Valgum |
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Size and contour, skin color/texture, pallor, erythema, and scars are all important when examining what?
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Soft Tissue
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A key point of stability is that the center of mass falls within what?
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The base of support
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What are the 4 faulty postures focused on in this class?
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Lordotic
Slouched (Swayback) Flat low back Flat upper back |
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What type of posture is A?
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Kypholordotic
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What type of posture is B?
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Relaxed/Slouched/Swayback
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What type of posture is C?
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Flat Low Back
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What type of posture is D?
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Flat Upper Back
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Blood flow is dependent on what?
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The heart
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What are characteristics of venous return?
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Capillaries to venules to veins to vena cava
Also 3-layered Very thin, can’t hold shape under stress Blood pressure is very low Need outside help to move blood Valves—one way Weakened veins, valves don’t work, pooled blood, distention, varicose veins, venous reflux |
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What are characteristics of arterial blood flow?
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3-layered walls for strength and flexibility
Keep their shape Can change diameter—constriction, dilation Via amount of blood flow Via ANS Blood flow is dependent on the heart No need for valves |
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What are two functions of the lymphatic system?
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1) immune protection from infection. 2) movement of fluid between interstitial and vessel
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What is lymph?
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Interstitial fluid
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What controlls lymphangions?
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ANS and pressure of adjacent arteries
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What are characteristics of the integumentary?
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Is an organ
Touched by PT’s Dependent on normal circulatory and lymphatic dynamics Epidermis is avascular, H2O resistant, protection, regenerates rapidly Dermis is 20-30 times thicker Contains blood vessels, lymphatics, follicles, sweat glands, sebacious glands, nerves and endings, cooagen, elastin, ground substance |
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Which layer of skin is not part of integument?
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Hypodermis
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What are the 3 stages of a wound?
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Inflammation
Proliferation Maturation |
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What are characteristics of inflammation?
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A normal immune system reaction
Temporary repair: coagulation, decreased blood flow, necrosis Slows pathogen spread Attacks debris and bacteria (foreign) Periwound edema, erythema, drainage, pus Increased blood flow to deliver oxygen, nutrients Time frame—day 0-10 Rate: affecting variables? |
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What are characteristics of proliferation?
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New tissue from fibroblasts—scarring (collagen secretion, matrix)
Re-epithelialization/contraction Angiogenesis: from endothelial cells come new buds of capillary growth called granulation tissue (bumpy) Early scar tissue from epithelial cell differentiation to type I collagen—fragile—trauma can lead to return to inflammatory stage |
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What are characteristics of maturation?
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Begins while granulating from proliferative stage
Epithelial differentiation continues to Type I collagen Only 15% skin tensile strength of new skin Scar tissue only achieves 80% tensile strength of the normal tissue Random architecture—remodels according to movement and direction |
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What affect does O2 have in wound healing?
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Antibiotic
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What affect does moisture have in wound healing?
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Allow gaseous exchange
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What is usually red or pink that elevates in order for the healing to proceed?
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Granulation
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What is primary intention of wound care?
Secondary? Tertiary? |
Surgical closing using sutures, staples, etc.
Left to heal on its own Partial healing by secondary, then finished with primary |
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What are characteristics of contractions?
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Existing tissue migrates—pulls toward center
No new tissue formed Growth factors trigger myofibroblasts to pull inward Affected by O2, nutrition, mechanical forces (compression, over-stretch) If too fast: disfiguring scars (keloid), impaired tissue function |
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What are specialized epithelial cells involved in re-epithelialization?
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Keratinocytes
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What are factors affecting closure by secondary intention?
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Wound Shape
Wound Depth Wound Location Wound Etiology Lost tissue not replaced |
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What is defined as being caused by medical professionals?
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Iatrogenic
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What are complications of chronicity?
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Functional impairments
Decreased activity Placement in extended care facilities Perceptions of loss Depression Infection Limb loss Death |
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What are characteristics of arterial insufficiency?
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Necrosis—black, no granulation, gangrenous
pulse Pale with elevation, red with dependent Intermittent claudication Resting night pain No blood to fight infection Hypertension is likely |
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What are treatment interventions for arterial insufficiency?
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Restore
Compression is contraindicated Don’t debride No good for skin grafts, antibiotics May need bypass graft, or amputation |
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What are interventions of lymphedema?
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Compression, but only with expertise
Splinting |
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Aseptic precautions are taken to avoid which types of transmissions?
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Body fluids
Secretions Excretions Nosocomial Pathogens |
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What is an example of a nosocomial pathogen?
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MRSA
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What are different ways to clean?
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Alcohol-based hand rub
Soap Anti-microbial Aseptic Antiseptic agents: alcohols, etc. Aseptic technique Cleanliness: Cleaning, Disinfection, Sterilization |
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When dealing with an isolation rationale, what can be a source of transmission?
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Patient
Personnel Visitor |
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When dealing with an isolation rationale, what can be a factor of hosting a transmission?
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Age
Weakness Medication Irradiation Breaks in first line defense |
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What are the 5 routes of transmission of a disease?
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Contact: direct vs. indirect
Droplet: cough/sneeze Airborne: nuclei < 5 micrometers Common vehicle: food, H2O, meds, devices Vectorborne: rodents, flies, mosquitoes |
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What are the 2 Tiers of Isolation Protocol?
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Standard Precautions
Transmission-based |
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What are the standard precautions used with all patients?
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Consider all patient contacts as transmission capable when dealing with secretions (except sweat), body fluids, mucosa, non-intact skin.
Determined by the nature of the patient/health care worker interaction and contact potential. |
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What are 8 requirements of a sterile field?
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1. All instruments must be sterile—shelf life
2. Edges of field are not sterile 3. Sterile only in front from shoulder to table top. 4. Only the table top is sterile 5. Only the sterile field is sterile 6. Don’t render the sterile area non-sterile—lean against wall. Point out mistakes. 7. Penetration of the sterile cloths by air or H2O or fluids makes the field non-sterile. 8. Don’t prepare the area too soon before use |
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What are the levels of transfers?
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Independent
Assisted Dependent |
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What are the levels of assistance?
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Stand-by
Close guarding Contact guarding Minimal (>75%), moderate (>50%), maximum (<25%) |
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What are the types of assistance?
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Verbal cuing
Balance control Physical assistance |
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What are the key points to body mechanics when transferring?
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Keep patient close to the base of support, and between bases
Lift with large muscle groups Keep trunk erect: set muscles, neutral spine Do not twist Test the weight |
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When is the transfer complete?
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When the patient is secure and safe in the new position?
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What is long sitting?
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Legs out straight, body upright
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What are goals for proper positioning?
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Patient comfort
Maintain integument Maintain musculoskeletal integrity Maintain cardiopulmonary integrity Access to environment Positioning for interventions |
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What is the general rule for time in a position?
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2 hours
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What is the rule for the time in a first time position?
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5-10 minutes
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What are general procedures to lower risk of harm when positioning a patient?
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Smooth all sheets, towels, and clothing
Support body parts Clear the environment Have supplies at hand Adequate number of assistants Draping for modesty and warmth Patient as active participant |
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What are types of ROM?
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Passive
Active Assistive Active |
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What are types of end feel?
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Bony
Firm Soft |
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What are parameters of ROM?
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Reps
Frequency |
