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87 Cards in this Set

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What are the cardinal vital signs?
Temperature
Pulse Rate
Respiration
Blood Pressure
Oximetry
What is the purpose of vital signs?
Check body’s physiological status
Reflects function of internal organs
Helps plan treatment, POC, reasoning, judgment, determine progress
What are influencing variables with vital signs?
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
What are characteristics of peripheral thermoreceptors?
Skin—free nerve endings
Rapid change sensitivity
Abdominal organs
Nervous system
What are charcteristics of central thermoreceptors?
In hypothalamus
Sensitive to changes in blood temp
What are effector organs that deal with body temperature?
Vascular
Metabolic
Skeletal muscles (shivering)
Sweat glands
What are characteristics of effector organs during decrease temperature?
Vascular—vasoconstriction
Metabolic—hormonal regulation, NE, E
Skeletal muscles—shivering to increase metabolism
Sweat glands—abolished
What are ways in which the body reacts to increased temperature?
Dissipation of body heat
Radiation
Conduction—Salt River Tubing
Convection
Evaporation
Vasodilation, decreased metabolism, increased sweat
What is pyrexia?
At what termperature?
Fever, 106 F
What factors influence body temperature?
Time of day—circadian rythym
Age
Emotions/stress
Exercise
What are the 5 major locations for peripheral pulses?
Radial
Carotid
Popliteal
Brachial
Pedal
What determines the quality of a pulse?
Amplitude
Volume
What is the normal feeling of a blood vessel?
Smooth
Elastic
Soft
Flexible
Straight
What is the abnormal feeling of a blood vessel?
Sclerotic
Twisted
Hard
Cord-like
Decrease Elasticity
What is normal pulse oximetry?
96-100%
What is internal respiration?
Exchange of O2 between organs and cells in the body
What area of the brain controls respiration?
Pons/medulla
In respiration, what does the CNS chemoreceptors monitor?
PNS?
CO2, H+
PaO2 (plasma only)
What is blood pressure?
The force the blood exerts on wall of artery
Finish the equations:

CO= HR x _____

BP= CO x _____
CO= HR x SV

BP = CO x R
What structure in the brain regulates BP?
Pons/medulla
What should a patient history consist of?
Medical Chart

Patient Interview

Family Interview

Consultations
What should a systems review consist of?
Communication
Cardiopulmonary
Integumentary
Musculoskeletal
Neuromuscular
What should the examination consist of?
Functional Tests
Structure/Observation
Movement Testing – Active, Passive, Resisted
Neurovascular
Palpation
Special Tests
What should a prognosis consist of?
Level of improved function
Time needed
Plan of Care
Goals
Outcomes
Interventions
Time frame
What does the medial model focus on?
Diagnosis and treating the disease
What does the disablement model focus on?
Focuses on the impact of the condition on function
What is the purpose of the PT differential diagnosis?
Diagnose and manage movement dysfunction and enhance physical and functional abilities.

Change the movement to improve function
What is defined as Problems in body function or structure as a significant deviation or loss.
Impairment
When determining the quality of symptoms, what factors are considered?
Severity
Type of pain
Numbness, tingling
Ache
Weakness
When determining the behavior of symptoms, what questions should be asked?
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?
When evaluating posture, what are the anterior landmarks?
Eyes
Acromion processes
ASIS
Crests (iliac)
Greater trochanters
Patellae
Malleoli
When evaluating posture, what are the lateral landmarks?
Plumb line
Ear
Acromion
Trochanter
Just posterior to patella (anterior moment)
2 inches anterior to lateral malleolus
Spinal curves
When evaluating posture, what are the posterior landmarks?
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
Size and contour, skin color/texture, pallor, erythema, and scars are all important when examining what?
Soft Tissue
A key point of stability is that the center of mass falls within what?
The base of support
What are the 4 faulty postures focused on in this class?
Lordotic
Slouched (Swayback)
Flat low back
Flat upper back
What type of posture is A?
Kypholordotic
What type of posture is B?
Relaxed/Slouched/Swayback
What type of posture is C?
Flat Low Back
What type of posture is D?
Flat Upper Back
Blood flow is dependent on what?
The heart
What are characteristics of venous return?
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
What are characteristics of arterial blood flow?
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
What are two functions of the lymphatic system?
1) immune protection from infection. 2) movement of fluid between interstitial and vessel
What is lymph?
Interstitial fluid
What controlls lymphangions?
ANS and pressure of adjacent arteries
What are characteristics of the integumentary?
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
Which layer of skin is not part of integument?
Hypodermis
What are the 3 stages of a wound?
Inflammation
Proliferation
Maturation
What are characteristics of inflammation?
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?
What are characteristics of proliferation?
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
What are characteristics of maturation?
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
What affect does O2 have in wound healing?
Antibiotic
What affect does moisture have in wound healing?
Allow gaseous exchange
What is usually red or pink that elevates in order for the healing to proceed?
Granulation
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
What are characteristics of contractions?
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
What are specialized epithelial cells involved in re-epithelialization?
Keratinocytes
What are factors affecting closure by secondary intention?
Wound Shape
Wound Depth
Wound Location
Wound Etiology
Lost tissue not replaced
What is defined as being caused by medical professionals?
Iatrogenic
What are complications of chronicity?
Functional impairments
Decreased activity
Placement in extended care facilities
Perceptions of loss
Depression
Infection
Limb loss
Death
What are characteristics of arterial insufficiency?
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
What are treatment interventions for arterial insufficiency?
Restore
Compression is contraindicated
Don’t debride
No good for skin grafts, antibiotics
May need bypass graft, or amputation
What are interventions of lymphedema?
Compression, but only with expertise
Splinting
Aseptic precautions are taken to avoid which types of transmissions?
Body fluids
Secretions
Excretions
Nosocomial Pathogens
What is an example of a nosocomial pathogen?
MRSA
What are different ways to clean?
Alcohol-based hand rub
Soap
Anti-microbial
Aseptic
Antiseptic agents: alcohols, etc.
Aseptic technique
Cleanliness: Cleaning, Disinfection, Sterilization
When dealing with an isolation rationale, what can be a source of transmission?
Patient
Personnel
Visitor
When dealing with an isolation rationale, what can be a factor of hosting a transmission?
Age
Weakness
Medication
Irradiation
Breaks in first line defense
What are the 5 routes of transmission of a disease?
Contact: direct vs. indirect
Droplet: cough/sneeze
Airborne: nuclei < 5 micrometers
Common vehicle: food, H2O, meds, devices
Vectorborne: rodents, flies, mosquitoes
What are the 2 Tiers of Isolation Protocol?
Standard Precautions
Transmission-based
What are the standard precautions used with all patients?
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.
What are 8 requirements of a sterile field?
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
What are the levels of transfers?
Independent
Assisted
Dependent
What are the levels of assistance?
Stand-by
Close guarding
Contact guarding
Minimal (>75%), moderate (>50%), maximum (<25%)
What are the types of assistance?
Verbal cuing
Balance control
Physical assistance
What are the key points to body mechanics when transferring?
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
When is the transfer complete?
When the patient is secure and safe in the new position?
What is long sitting?
Legs out straight, body upright
What are goals for proper positioning?
Patient comfort
Maintain integument
Maintain musculoskeletal integrity
Maintain cardiopulmonary integrity
Access to environment
Positioning for interventions
What is the general rule for time in a position?
2 hours
What is the rule for the time in a first time position?
5-10 minutes
What are general procedures to lower risk of harm when positioning a patient?
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
What are types of ROM?
Passive
Active Assistive
Active
What are types of end feel?
Bony
Firm
Soft
What are parameters of ROM?
Reps
Frequency