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60 Cards in this Set
- Front
- Back
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Post partum sacral pain -pain increased w/ long walks, up/down stairs, rising from sit to stand TX |
-manual therapy to SI jt for relief of Sx's -ther ex to restore normal function |
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ligamentous laxity during pregnanacy d/t |
hormone relaxin -usually affects SI jt -continues 3 mos after pregnancy -leaves pelvic area vulnerable to injury -SI pain aggravated w/ prolonged WB & stairs -DO NOT mobilize bc it will stretch already lax jts |
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Fall on shoulder 3 wks ago -pain -(-) xrays -AROM 35 degrees -abduction with scapular elevation -PROM almost full w/mild pain & mm guarding at end of range -reisisted abd weak w/ pain in ant & lateral deltoid -no atrophy Dx? |
rotator cuff tear |
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RC tear would be provoked by |
resisted testing bc it's a contractile lesion -would not be able to raise arm over head bc of lack of force transmission secondary to tear -fall on shldr could cause tear |
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supraspinatus tendinitis -presentation |
-raise arm overhead w/ painful arc of motion at end range -typically caused by overuse |
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adhesive capsulitis presentation |
-a little more passive range than active bc tight capsule is restricting ROM |
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axillary nerve palsy caused by |
dislocation -marked atrophy of deltoid |
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Test for function of deep cervical flexors (mm function test that uses cranio cervical flexion test) -normal findings |
-during active chin tuck , the pressure in the stabilizer cuff increases to 22 & pt can hold position for 10 secs -(30 sec hold is endurance test, not flex test) -SCM should remain unactive -C spine should assume a flexed position so it loses its normal lordosis intentionally |
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elderly low vision best strategy for ambulation |
practice walking in areas of high illumination & low clutter -DO NOT look down at feet (safety hazard - restricts avoidance strategy of env objects) -color coded staris with strong colors & well lit can help |
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unstable angina in preinfarction state -signs |
angina of increasing intensity that is unresponsive to nitroglycerin & rest (typically decreases w/ most angina) -CONTRAINDICATED: exercise |
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are increasing atrial rhythms a sign of angina |
no |
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L CVA -R hemiparesis -strong dominant hemipelvic synergies actiivty to break these synergies |
bridging with pelvic elevation -bridging breaks up LE synergies (combines hip ext from ext synergy & knee flex from flex synergy) |
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stage III pressure ulcer -open wound with necrosis of subcutaneous tissue down to the fascia age does what to ulcer outcome |
decreased vascular & immune response resulting in impaired healing -in elderly scarring is less than in younger -elasticity & eccrine sweating decreased in elderly |
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Pt recovering from CVA -spastic hypertonia in involved UE there should be abnormal resistance to PROM in? |
shoulder adductors, forearm pronators, flexors of elbow, wrist & hand (antigravity muscles) |
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eldery -3 weeks post surgical resection of carcinoma of colon -weak -pt c/o pain in L shoulder aggrvated by WB when walking What should PT do? |
Notify physician immediately -risk of metastatic disease is present |
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L ankle sprain 4 days ago -4/10 pain -moderate swelling that's getting worse Best intervention |
cold/intermittent compression with limb elevation |
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L lateral epicondylitis -no resolution of Sx's after 2 wks of Tx -re-examination finds: L biceos reflex 1+ PT shold next complete exam of which area? |
mid cervical region -pt has sx's of possible L C5 nerve root compression -reflex change suggests nn root irritation or compression -lateral epicondylitis frequently involves the extensor carpi radialis brevis, innervated by nerves from mid-cervical region |
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which measure of aerobic activity is a reliable and valid functional capacity measure with reported min detected change scores in pts with HF |
6 min walk test |
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Bruce protocol Canadian Aerobic Fitness step Test LE ergometer test |
CANNOT report min detectable changes -have literature to support that they are reliable & valid |
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R THR 4 mos ago -shortened stride length on the R most likely has? |
contracted hip flexors -pts are less active after Sx & spend less time in standing and more time in sitting -iliopsoas becomes short with increased time in sitting -limits ability to extend the hip, which shortens stride length on affected side |
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contracted HS or weak quads cause what during gait |
decreased knee ext during stance & unstable knee |
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weak hip flexors produce what during gait |
decreased limb shortening during swing -typically compensated with circumduction |
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pt with CP -difficulty releasing food from hand to mouth -once food is brought to mouth what to do? |
slowly stroke finger extensors in prox to distal direction -Contraindicated: stimulation of spastic finger flexors (slow stroke, quick stretch) |
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nevi |
mole |
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mole exam |
assymetry border irregularities color diameter (>6mm) |
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not uncommon to have a group of moles, but when they transform what needs to be done? |
contact PCP |
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when lifting an object off the ground the most significant contributing factor for increasing L spine compression forces in addition to weight of load is |
distance of the load from the base of the spine -there are high L spine moments when load is not held close to the body -height of load from ground can decrease overall work, but not a key factor in reducing lumbar compression forces |
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Position of glide to move L UE overhead |
posterior & inferior translatory glides -inferior glide improves abduction & flex -posterior glide improves ER (exception to concave convex rule) |
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superior GH glides improve |
ext |
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based on the concave-convex rule anterior glides seem best to improve ER, but what direction of glides is best for this |
posteroinferior |
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elderly pts with memory impairments typically demonstrate? |
-intact immediate recall (can repeat words) -impaired memory for recent events (who came to see me yesterday) -long term memory ususally intact -hallucinations or delusions |
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Stage I dementia |
disease begins with mild memory loss |
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Stage II dementia |
agitation & wandering |
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Positive L dix hallpike |
when head turned to L, the change in position produces the pts symptoms |
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sharpened Romberg asseses |
standing balance with eyes closed & feet in tandem |
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associative stage of motor learning |
errors are decreasing & movements are becoming organized |
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how to progress pt in gait training when learning is going well, errors are decreasing, & endurance increasing |
walk in varying envs |
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continuous feedback improves what and delays what |
improves performance delays motor learning |
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what are inappropriate strategies for associative stage of learning |
practicing until errors are extinguished intervening early when errors appear |
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What devices are not appropriate devices for clearing secretions for a young child |
acapella, active cycle of breathing technique, autogenic drainage bc the child is too young and they rely on independent use and ability to monitor secretion clearance to know how long & often to perform the techniques |
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Stress Incontinence -loss of control w/ coughing, laughing, & exercising TX? |
Kegals several times/day |
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kegal exercises are |
pelvic floor exercises |
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Cerebral thrombosis -decreased pain & temp sensation of ipsilateral face -nystagmus -vertigo -nausea -dysphagia -ipslateral Horners synd. -contralateral loss of pain & temp sensation site of thrombosis |
post inf cerebral artery -this pt presents with lateral medullary (Wallenbergs) syndrome -clearly indicates branstem (CN) involvement |
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PICA is a branch of |
vertebral artery -involves descending tract & nucleus of CN V, IX, X, cuneate & gracile nuclei of spinothalamic tract |
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ant & post cerebral artery CVA -what's involved |
cortical involvement |
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Internal Carotid artery CVA -what's involved |
combines middle cerebral & ant cerebral artery strokes |
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e-stim for wound with infected & exudate -best choice of polarity & electrode placement |
cathode placed in wound to cover as much Tx area as possible -negative current repels bacteria & it attracts neutrophils to purge bacteria |
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e-stim for wound that is clean & uninfected |
anode is used to promote healing -place in wound |
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how to Tx pts with conversion disorder |
initiate functional training consistent with level of injury -it represents real loss of function for the pt -Pt should be empathetic, but not act as a counselor |
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10 wks post CABG -post op was complicated with atrial fib that has been controlled with meds prescribed by a cardiologist -during therapy vitals are: HR=90 in atrial fib, BP = 117/74, RR = 14, SpO2 = 99% on room air should proceed with symptom limited exercise test as planned? |
yes, HR is well controlled & cardiologist is aware of the arrythmia -it is safe to exercise a pt who is in A fib, but it's a concern if their HR >115 bpm (this is the point at which diastolic filling time is decreased, which places a person in A fib at risk of not maintaining thier CO with increased demand) |
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WHAT IS AN ABNORMAL FINDING DURING AN EXAM OF A NEWBORN INFANT |
continuous tremulousness (occasional is not abnormal) |
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normal findings in newborn |
symmetry in ROM response decrement to repetitive stimuli dramatic skin color changes with change of state |
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standard WC -sacral sitting -rounded, kyphotic upper back cause of posture |
excessive leg length from seat to foot plate -can result in sliding forward in WC to reach foot plate -this results in post tilt of pelvis and sacral sitting |
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how to collect sample from wound |
-collect exudate in the wound -has to be collected from wound site with little contamination from adjacent pics |
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arm exercise compared to leg exercise at a given workload what cardiac response to expect |
higher HR higher SBP & DBP -arm ergometry uses smaller mm mass than leg ergometry, with resulting lower maximal oxygen uptake |
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the most common infection transmitted to health care workers is |
hepatitis B -transmission through exposure to blood, blood products, infected body fluids |
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ataxia results from lesion where in brain |
cerebellum |
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damage to cerebellum results in |
difficulty with movement, postural control, eye movement disorders, muscle tone -ataxia is a common finding |
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aphasia -area of brain damaged |
L cerebral infarct |
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L sided unlateral neglect ususally d/t |
R cerebral injury |
