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52 Cards in this Set
- Front
- Back
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No sig. PMH -bacterial pneumonia R anterior base Exam findings? |
-crackles on inspiration only at R ant base -decreased SaO2 -productive cough x 3 days |
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Bacterial pneumonia presentation |
onset of days with productive cough -pneumonia interferes with transport of O2 from alveoli to pulm capillaries, the PaO2, and therefore SaO2 is lower -crackles in area of pneumonia unusual finding -wheezing may occur and resound in thorax -febrile -bronchial breath sound in specific area of lung |
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viral pneumonia onset |
abrupt dry cough |
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Theophylline |
-bronchodilator -used to reverse airway obstruction |
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Theophylline toxicity |
-irreg. HR -jittery -gastric upset -can cause arrythmias & seizures |
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Ventolin |
-bronchodilator -used for asthma or COPD |
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Amcort |
anti inflamm used for bronchial asthma |
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Down Syndrome -decreasing strength in extremities -neck pain -limited neck motion -UE DTRs 3+ |
Atlanto-axial subluxation with spinal cord impingement -other signs: clonus, + babinski |
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ligamentous laxity hallmark of |
Downs Syndrome -can lead to atlanto axial instability |
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What can cause subluxation & shoulder pain in hemiplegia |
traction with depressed, downwardly rotated scapula -spastic retraction also likely TX -PROM w/ normal scapulothoracic rhythm |
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tuning fork on mastoid process & then in front of ear and asked if bone conduction or air conduction is louder -test? |
Rinne's |
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Weber's test |
tuning fork on vertex of head -asked which ear is louder -it differentiates unimpaired ear from deaf ear |
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Caloric test |
place cool or warm water in the ear and observe pattern of nystagmus produced |
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Pressure ulcer on heel -dry eschar -no: edema, erythema, fluctuance, or drainage -afebrile TX |
AFO w/ heel pressure relief -to prevent PF contractures -heel pressure relief prevents further damage to promote healing -this ulcer is stable & needs to be monitored, not debrided |
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When to use arterial bypass graft with pressure ulcer |
when circulation compromised |
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test for ant talofibular lig |
ant drawer |
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talar tilt test |
calcaneofibular lig |
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Thompson's test |
achilles tendon |
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Morton's test |
stress fx or neuroma in forefoot |
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Postpartum pt w/ stress incontinence -best initial pelvic floor exercise |
sitting on toilet, stop & hold flow of urine for 5 secs during urination -repeat several times -sphinctor control in supine is more difficiult than practicing control during urination |
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Pt with CVA -early recovery with R UE -mod spasticity in biceps & finger flexors -voluntary movement in elbow flex and shldr abd (only 1/2 range) TX |
WB on extended R UE w/ wrist & fingers extended -early intervention should focus on stretching & positioning R UE in ext (wrist & fingers too) -this helps decrease increasing flex spasticity -WB on limb helps promote extensor activity in triceps & shldr stabilizers |
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Most important factor in ordering power WC for 3 yr old |
good head control & good fine motor control -kids as young as 18 mos can operate power WC -kids with mild cognitive impairments can operate power WC |
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osgood schlatter -TX |
-decrease loading of knee by quad femoris, but still maintain normal LE function -adolescents -DO NOT strengthen quad femoris bc it increases load on tendon |
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bulging disc at R L5-S1 -no nn root compression most likely impairment |
centralized gnawing pain with loss of postural control with lifting activities -no nn root compression = no radicular pain and/or decrease in specific muscle function beyond lumbar spine region |
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RLA Stage VII |
-often exhibit rote movements (robot syndrome) indicative of highly structured training used for pts in early stages of recovery |
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how to correct forward festinating gait in pt with PD |
use a toe wedge -to help displace COG backward |
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festinating gait |
abnormal & involuntary increase in speed of walking in an attempt to catch up with displaced COG d/t pts forward lean |
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strength training that focuses on improving fast twitch fiber function -exercise RX |
high intensity workload for short duration -fast contraction speed for < 20 reps help train the highly adaptable fast twitch IIa fibers |
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workloads at low intensity & slow contraction speeds challenge ------fibers |
slow twitch (type I) |
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stress fx signs |
-cross country runner -pain in prox 1/3rd of tibia -insidious onset 4 wks ago -pain intermittent -running exacerbates sx's -ligament testing & soft tissue exam of leg and knee unremarkable |
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Best initial imaging for stress fx |
radiograph & bone scan -stress fx may take 2-8 weeks before they can be seen on plain film -if plain film negative, then perform bone scan -if bone scan neg., then MRI |
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radiograph |
fx's & healing rates |
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bone scan |
stress fx bone bruising |
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MRI |
meniscal bone bruising soft tissue |
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CT scan |
small bony irregularities |
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5 yo -high Lumbar lesion (myelomeningocele, L2 level) -min cognitive impairment Functional therapy goal? |
household ambulation with reciprocating gait orthosis & loftstrand crutches -physiological benefits: improved cardiovasc & musculoskel functions -will not be a community ambulator (energy expenditure is too high) -possible to use KAFO's w/ reciprocal 2 or 4 point gait |
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Reciprocating gait orthosis |
hips joined by metal cables to prevent inadvertant hip flex |
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Test to ID integrity of C1/ C2 articulation |
transverse lig stress test -assesses integrity of transverse lig -it maintains position of the dens of C2 w/ ant arch of C1 |
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cervical compression test |
dysfunction of cervical facet joints |
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Hautant's test |
differentiates btwn vascular dysfunction in vertebrobasilar system & dysfunction of vestibular system |
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Contraindicated test for person with bony/joint cervical instability |
vertebral artery test cervical compression test |
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Arterial Blood Gas Analysis FiO2 = 0.21 PaO2 = 53 mmHg PaCO2 = 30 mmHg pH = 7.48 Bicarbonate = 24 mEq/L this indicates |
Respiratory Alkalosis -increased pH = alkalosis |
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When looking at arterial blood gas values |
CO2 can be seen as an acid -if CO2 level is low, then you have less acid, or a resulting alkalosis = respiratory alkalosis |
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blood pH higher than normal (7.35-7.45) indicates |
alkalosis |
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If increased pH is d/t metabolic disorder than what would be expected? |
high bicarbonate value |
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Pt has Type I DM -controlled w/ insulin injections 2x/day to decrease risk of hypoglycemic event during exercise the pt should |
avoid exercise during periods of peak insulin activity -monitor blood glucose levels when initiating exercise program and avoid exercise 2-4 hrs after insulin injection (peak insulin activity) -RPE in addition to HR to monitor exercise intensity |
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Exercise & DM Type 1 |
-carbs should be eaten before & during prolonged exercise bouts -blood glucose levels should be monitored frequently throughout the day -exercise should begin with daily sessions, 20 min 2x/day. NOT 40-50 min sessions |
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What to expect with Alzheimer's type dementia |
-will likely be resistent to activity training if unfamiliar activities are used -can't be trusted to safely perform IADL's or functional mobility skills -memory for past events may be retained initially, but eventually all memory becomes impaired |
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pt w/ SCI is having difficulty learning how to transfer from mat to WC. Can't coordinate the movement. Most effective use of feedback during early motor learning is? |
Focus on knowledge of results and visual inputs |
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During early stage of motor learning (cognitive stage), learners benefit from? |
seeing the whole task correctly performed -dependence on visual inputs is high -developing a reference of correctness (knowledge of results) is critical to ensure early skill acquisition (cognitive mapping) |
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Focus on proprioceptive inputs is important during which stage of motor learning |
middle (associative) stage |
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delayed feedback should be used during ------- learning |
later |
