Rehab Orientation Day

Front 1

Immobility effect on orthostasis?

Back 1

decreased orthostatic tolerance. can be reduced by sitting up daily

Front 2

Immobility effect on plasma volume

Back 2

lose 5% of plasma volume within 24 hours; 20% loss after 2 weeks!

Front 3

Why the decrease in plasma volume with too much bed rest?

Back 3

Increased diuresis because of increased renal blood flow because when supine, 500mL fluid shifts from lower body to upper body (which apparently includes kidneys)

Front 4

Disuse atrophy--lose what percentage of muscle strength per day?

Back 4

1-3% muscles strength lost per day

Front 5

When is muscle wasting the most?

Back 5

first 10 days of bedrest. this is result of reduced protein synthesis.

Front 6

Effect of training on disuse atrophy on gene expression level?

Back 6

certain gene expression upregulated with disuse atrophy after 2 weeks immobitility; one day of exercise decreased expression back to normal

Front 7

Common effect of immobility on:
1) neck
2) shoulders
3) forearms
4) fingers

Back 7

1) neck flexion
2) shoulders internally roated
3) forearms pronated
4) fingers flexied

Front 8

Common effect of immobility on (position):
1) hips
2) kness
3) ankles

Back 8

1) hips flexed
2) knees flexed
3) ankles plantar flexed

Front 9

What is a PRAFO?

Back 9

passive range ankle foot orthosis.

keeps ankles in neutral position

Front 10

What is Wolff's law?

Back 10

The density of bone is directly proportional to the stress placed on the bone (ergo: my weight baring bones must be very dense!)

Front 11

Effect of immobility GU system?

Back 11

hypecalciuria (bone loss); incomplete voiding and urine stagnation (esp in men with BPH!)

Front 12

Efect of immobility on GI system?

Back 12

acid reflux (LES is relaxed longer); constipation (decreased peristalsis, gravity ain't there to help if supine)

Front 13

Why do rehabbists like the commode for bedridden patients?

Back 13

improves bladder empyting efficiency, decreases constipation; helps with orthostatic tolerance, weight bearing, use of leg muscles

Front 14

Effect of immobility on insulin and blood sugar levels

Back 14

immobility--> decreased lean muscle mass--> increased fat %. fat is less sensitive to insulin so need more insulin for managing blood sugar

Front 15

Effect of immobility on nerves?

Back 15

Usually bedresting with legs in external rotation with puts pressure on fibular head--> peroneal nerve--> foot drop

Front 16

Effect of immobility on immune system?

Back 16

not much known but thought that there is decreased in lymphocyte responsiveness and number of natural killer cells

Front 17

Impairment vs disability

Back 17

impairment=abnormality of body part or funciton; disability= unable to perform self care or social roles; impairments often lead to disability (but not necessarily!)

Front 18

minimal assistance =?

Back 18

patient does 75% of the work

Front 19

moderate assistance=?

Back 19

patient does 50% of the work

Front 20

max assist=?

Back 20

patient does 25% ofthe activity

Front 21

6 major categories of impairment that are important to a physiatrist?

Back 21

pain; weakness; deformity; sensation; incoordination; mind/brain