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526 Cards in this Set

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Faber/Patrick'sJansen's/Figure Four
Tests: Hip, Anterior S/I ligament, Iliopsoas Contracture, obturator nerve
+ Inability to lower leg parallel to straight leg, pain, neurological symptoms
how can a virus hide from a hosts immune system?
by embedding viral buds into hosts cell membrane
what is hypertonicity?
increased muscle tonus
Thomas test
test hip flexion contracture
positive: decreases ROM at hip (45 degrees expected)
viral DNA can insert itself into the host's DNA. What is the result of mutating host cells?
malignant cells
what is a muscle spasm?
involuntary, convulsive contraction of an entire muscle or segment within a muscle
Obers test
tests length of TFL and ITB contracture
positive: foot of tested leg does not drop below table
antibiotics interfere with what five bacteria functions?
cell wall synthesis
DNA replication
protein synthesis
energy production / metabolism
membrane function
what is muscle tone?
partial, steady contraction of a muscle at rest
Ely's test
Indication: Rectus Femoris Contracture, femoral nerve (via stretch)
Positive - Ipsilateral hip flexes (some say look at unaffected hip), neurological symptoms
why do antibiotics not interfere with the host's cells?
because the host is a eukaryote and the bacteria is a prokaryote (no nucleus or organelles)
what is edema?
accumulation of fluid in the interstitial spaces
Straight Leg Raise
indication: Hamstring Contracture, tests sciatic nerve via stretch
Positive: client is unable to achieve minimum of 70 degrees of knee extension, neurological symptoms
what are the signs and symptoms of local bacterial infection?
erythemia
swelling
pain
exudates
what are adhesions?
uniting of two tissue surfaces that are normally separate
double hibbs
indication: piriformis contracture, compression of sciatic nerve
Positive: lever of the lower leg is less than 45 degrees, neurological symptoms
what are the signs of systemic bacterial infection?
fever
leukocytosis
fatigue / weakness
headaches
myalgia
arthralgia
what is fibrosis?
replacement of functional tissue with fibrous connective tissue
Gillet / SI Joint Motion Palpation
tests SI Joint movement (nutation / counter nutation)
Positive: PSIS moves superiorly or not at all
how are bacterial infections spread from person to person?
secretions
blood
urine
fecal matter
what is contracture?
fibrosis of connective tissue in skin, fascia, muscle or joint
Quadrant Kemp's
Indication: lumbar facet pathology, lumbar nerve compression
positive: pain, neurological symptoms
what is the hallmark of bacterial infection?
release of toxins to host tissues
what is a trigger point?
hyperirritable spot palpable in a taut band of skeletal muscle or fascia
anterior draw (ankle)
tests anterior talofibular ligament
positive: pain and/or laxity
what are the two categories of bacterial toxins?
exotoxins
endotoxins
what is atrophy?
a decrease in the size of an organ or body tissue as a result of a decrease in the size of tissue cells
Hibb's / prone gapping
Indication: Posterior Sacroiliac Ligament Pathology, or Piriformis Contracture, sciatic nerve compression
+ Pain at S/I or reduced mobility at the S/I joint, neurological symptoms
what makes up bacterial exotoxins?
proteins/enzymes
what is paralysis?
loss of voluntary movement through injury
talar tilt
tests: lateral ligaments and medial / deltoid ligament of the ankle (talofibular being the most often sprained)
positive: pain and/or laxity
what happens when bacteria release exotoxins?
key cellular components in the host's cells are deactivated
leads to cell dysfunction and possible death
Adson Test
Tests for subclavian artery compression
+ pulse diminishes with arm extended
what makes up endotoxins?
complex glycolipids
Cozen Test
Tests for lateral epicondylitis
+ if pain in lateral elbow
when are endotoxins released?
upon lysis
Finklestein test
tests for tenosynovitis at the wrist (DeQuarvains)
+ if pain in the area of the thumb/wrist
what is endotoxemia?
blood poisoning
Golfer's Elbow test
tests for medial epicondylitis by placing stretch on the tendons
+ if pain at medial elbow
release of endotoxins lead to what activity in the host?
blood clotting
bleeding
hypotension
inflammation
Mills test
tests for lateral epicondylitis by stretching the tendons of the extensor muscles
+ if pain at lateral elbow
what do endotoxins do to host cells?
change or destroy normal functions
Nobels test
tests for ITB dysfunction at the lateral femoral condyle
+ if pain and/or crepitus at lateral femoral condyle
what kinds of parasites are rickettsiae and chlamydiae
obligate intracellular parasites
Patellar glide test
tests for crepitus at the patella
+ if pain and/or crepitus felt at patella
in what ways are rickettsiae and chlamydiae like viruses?
obligate intracellular parasites
they can not reproduce independent of host cell
Speeds Test
test for tenosynovitis at the long head of biceps
+ if pain felt at shoulder where tendon passes through the intertubecular sulcus
in what way are rickettsiae and chlamydiae like bacteria?
produce a rigid cell wall
reproduce asexually
contain DNA and RNA
trandellenburg test
tests for strength of hip abductors
+ if hip of standing leg rises and non-weight bearing hip drops
what is the vector of rickettsia?
arthropods (ticks, fleas, lice)
what is the myotome for C1-C2?
c/s flexion
what is the relationship between the vector and rickettsiae?
symbiotic
what is the myotome for C3
c/s lateral flexion
what does chlamydiae affect?
affects ATP productions
what is the myotome for C4
shoulder elevation
how is chlamydiae transmitted?
directly from one host to another
no vector required
what is the myotome for C5
GH abduction
what do spirochetes most resemble?
similar to bacteria, they are a specialized type of bacteria
what is the myotome for C6?
elbow flexion
wrist extension
what are mycoplasms?
a genus of micro-organisms that as a whole do not produce disease
what is the myotome for C7?
elbow extension
wrist flexion
describe fungi based on their cellular make up, how they obtain food and their relationship to other organisms
eukaryotic
saprophytic
parasitic
what is the myotome for C8?
ulnar deviation
thumb extension
what are the two categories of fungi?
yeasts
molds
Which SC segment is tested with the triceps reflex test?
C7 / C8
which of the fungi are uni-cellular? How do they reproduce?
yeasts. They reproduce via budding
Which SC segment is tested with the biceps reflex test?
C5 / C6
which of the fungi are multi-cellular? How do they reproduce?
molds. They reproduce sexually and asexually
Which SC segment is tested with the brachioradialis reflex test?
C5 / C6
what is myselium?
a thin thread produced by mold that acts as an anchor
Describe the steps in a cervical scan test
1. AF at c/s with overpressure
2. AF at GH joint abduction and scaption ; elbow ; wrist
3. upper limb dermatomes, myotomes and deep tendon reflexes
describe myostatic contractures
adaptive shortening of fascia due to disuse, immobilization or faulty postures
fungi are opportunistic. What does this mean?
They usually don't cause any problems, but will infect humans when immunity is low
what is the capsular pattern of restriction at the cervical spine?
side flexion and rotation (equally)
extension
what are the three categories of parasites?
protozoa
worms
arthropods
what is the capsular pattern of restriction at the glenohumeral joint?
external rotation
abduction
internal rotation
describe protozoa based on their cellular make up and how they obtain food.
eukaryotic
saprophytes
what is the capsular pattern of restriction at the lumbar spine?
side flexion and rotation equally
extension
how are protozoa transmitted?
directly between hosts.
Body fluids, food, water
what is the capsular pattern of restriction at the hip?
flexion, abduction, internal rotation
(order may vary)
how are worms transmitted?
ingestion of fertilized eggs (via food or water)
skin penetration by larvae
what is the capsular pattern of restriction at the knee?
flexion
extension
what are ectoparasites and give an example
parasites that infest the surface of the skin
arthropods such as fleas, lice, ticks
what is the capsular pattern at the ulnohumeral joint?
flexion
extension
which body secretions transmit pathogens?
nasal secretions
saliva
urine
blood
feces
semen/vaginal secretions
What is the capsular pattern of restriction at the radiohumeral joint?
flexion
extension
what is the definition of infectious disease?
state in which the host sustains injury or pathological tissue change
what is the industry standard ROM for cervical spine flexion?
80 - 90
what are the two main ports of entry for pathogens?
open passageways
lesion sites
what is the industry standard ROM for cervical spine extension?
70
what are the three open passage ways of the body?
GI tracts
respiratory tract
genitourinary tract
what is the industry standard ROM for cervical spine lateral flexion?
20 - 45
what are the four modes of transmission available to pathogens?
penetration
direct contact between hosts
ingestion
inhalation
what is the industry standard ROM for cervical spine rotation?
70 - 90
what are the defences for penetration by pathogens?
inflammatory defence
what is the resting position of the cervical spine?
slight extension
what are the defences for direct contact transmission by pathogens?
immune system
inflammation
what is the close packed position of the cervical spine?
full extension
what are the defences for ingestion of pathogens?
intestinal microflora
mucous lining of the GI tracts
gastric acid
what is the resting position of the GH joint?
40 - 55 degrees of abduction
what are the defences for inhalation of pathogens?
cilia
mucous
coughing
antimicrobial secretions
phagocytes
what is close packed position of the GH joint?
full abduction, lateral rotation
how is a congenital infection contracted?
in untero (vertical transmission)
what is the industry standard ROM for GH abduction?
170 - 180
describe the course of pathogen infection
invade
colonize tissue
multiply
harm host tissue
released from host
infect a new host
what is the industry standard ROM for GH flexion?
160 - 180
what factos affect the spread of disease?
virulence
host immunity
sanity factors
what is the industry standard ROM for GH adduction?
50 - 75
opportunistic microflora infections are a type of what source of infection?
endogenous
what is the industry standard ROM for GH extension?
50 - 60
infections acquired from an external source are a type of what source of infection?
external
what is the industry standard ROM for GH internal rotation?
60 - 100
what are the three types of exogenous infections?
zoonoses
nosocomial
community acquired
what is the industry standard ROM for GH external rotation?
80 - 90
an infection passed from animals to humans
zoonoses
what is the resting position of the ulnohumeral joint?
70 degrees elbow flexion, 10 degrees supination
an infection developed in hospital patients
nosocomial
what is the close-packed position of the ulnohumeral joint?
extension with supination
an infection acquired from a public place
community acquired
what is the resting position of the radiohumeral joint?
full extension and full supination
what is an iatrogenic infection?
an infection acquired from surgery
What is the close packed position of the radiohumeral joint?
90 degrees elbow flexion, 5 degrees supination
list the five stages of disease
incubation
prodromal
acute
convalescent
resolution
what is the resting position of the radiocarpal joint?
neutral with slight ulnar deviation
which stage of disease is when the pathogen replicates and the host shows no signs or symptoms?
incubation
what is the close packed position of the radiocarpal joint?
extension
describe the prodromal stage of disease
initial appearance of symptoms
what is the resting position of the lumbar spine?
midway between flexion and extension
that stage of disease when symptoms are most pronounced and specific
acute stage
what is the close packed position of the lumbar spine?
extension
describe the convalescent stage of disease
infection is contained
number of pathogens decreases
damaged tissue is repaired
what is the resting position of the hip?
30 degrees flexion
30 degrees abduction
slight external rotation
during which stage of disease does immunity occur via memory cells?
the resolution stage
what is the close packed position of the hip?
extension, internal rotation, abduction
during which stage of disease is the pathogen eliminated from the body?
the resolution stage
what is the industry standard ROM for hip flexion?
110 - 120
if the body's immunute system is not able to contain the infection what are the two possible outcomes?
septicemia
chronic infection
what is the industry standard ROM for hip extension?
10 - 15
what is the definition of a chronic infection
mild symptoms that are destructive over time
what is the industry standard ROM for hip abduction?
30 - 50
do all skin lesions or changes signifiy disease?
no
what is the industry standard ROM for hip adduction?
30
what are the three manifestations of skin disorders?
rashes
lesions
pruritis
what is the industry standard ROM for hip external rotation?
40 - 60
what is pruritis?
itching
what is the industry standard ROM for hip internal rotation ?
30 - 40
what are skin excoriations?
destruction of small pieces of skin surface or mucus membranes, chafing or abrasions
what is the resting position of the tibiofemoral joint?
25 degrees of flexion
what are the three lesions that occur due to mechanical processes?
blister
callus
corn
what is the close packed position of the tibiofemoral joint?
full extension, external rotation of tibia
what is hyperkeratosis?
increased skin production
what is the resting position of the ankle joint?
10 degrees of plantar flexion
describe the shape of a corn
conical (apex is deep)
what is the close packed position of of the ankle joint?
maximum dorsiflexion
where do primary skin lesions form?
on normal skin
what is the myotome for T1?
digital (hand) abduction and adduction
where do secondary skin lesions form?
on primary lesions
Phaelen test
tests for carpal tunnel syndrome by compressing the median nerve
+ tingling burning or numb sensation in the hand
name the two flat, non-palpable skin changes / lesions
macule
patch
Reverse Phaelen
tests for carpal tunnel by stretching the median nerve
+ is numbness, tingling etc.
which is larger, a macule or a patch?
a patch
yergesen's test
tests for biceps tendinitis/tenosynovitis
+ is pain at the shoulder in biceps tendon
a freckle is an example of what type of skin colour change?
macule
Froment test
tests ulnar nerve / adductor pollicis
+ is weakness
what type of skin lesion is larger than 1 cm, made up of white areas surrounded by normal skin?
patch
Pinch Test
tests median nerve / flexor pollicis and flexor digitorum
+ is weaknes
what is the only difference between a macule and a patch?
size
Painful Arc
tests for supraspinatus tendinitis, subacromial bursitis
+ pain at 40 to 60 degrees - 120 degrees is GH impingement; local pain in the last 10 degrees is AC joint pathology
list the five palpable, elevated solid skin masses
papule
plaque
nodule
tumour
wheal
Appley's Scratch Test
tests for shoulder pathology, past dislocation, tendon impingement under the acromion, bursitis
+ is pain or decreased ROM
size of a papule?
up to half a centimeter
Apprehension test
Indicates previous GH joint dislocation
+ Look of apprehension from the client
describe a plaque
elevated surface greater than 0.5 cm
a fusion of papules
AC Shear
indicates A/C Joint Pathology
+ Pain or excessive mobility in A/C joint.
what type of skin lesion is 0.5 cm and up to 1 or 2 cm and deeper and firmer than a papule
nodule
Hawkins-Kennedy
indicates: Supraspinatus Tendinitis
+ Pain in the shoulder
describe a tumour
larger than 1-2 cm
abnormal mass of cells
describe the upper limb tension test for the radial nerve
c/s lateral flexion (away from affected side)
wrist flexion
GH internal rotation and extension
describe a wheal (4)
irregular
transient
superficial area of local skin edema
due to inflammatory response
describe the upper limb tension test for the median nerve
c/s lateral flexion
wrist extension
GH extension and abduction
list the three palpable, elevated, fluid filled masses
vesicle
bulla
pustule
describe the upper limb tension test for the ulnar nerve
c/s lateral flexion
GH abduction, external rotation
(looks a little like appley's scratch)
what is the size of a vesicle?
up to 0.5 cm
what is the myotome for L2?
hip flexion
which fluid filled masses contain serous fluid?
bulla and a vesicle
what is the myotome for L3?
knee extension
what would you find in a pustule?
pus
what is the myotome for L4?
ankle dorsiflexion
define lesion
wound, injury or pathological change in tissue
what is the myotome for L5?
big toe extension
define rash / eruptions
scattered outbreak on skin surface
usually raised
fluid filled vesicles
may be covered with scales / crusts
what is the myotome for S1?
ankle plantar flexion/eversion
what can cause skin excoriations?
excessive scratching
trauma
chemicals
what is the myotome for S2?
knee flexion
what are some treatments for excoriations?
cold therapy
topical creams and lotions
what is tested with the jaw reflex?
trigeminal nerve
list four types of infectious skin disorders
viral
bacterial
fungal
parasitic
what is tested with the patellar reflex test?
spinal segments of L3-L4
list five types of non infectious skin disorders
burns
inflammation
neoplasms
allergic
mechanical
what is tested with the achilles tendon reflex test?
spinal segments of S1
what type of fungal infection involves the epidermis and dermis and sometimes the subcutaneous layers?
deep fungal infections
Braggarts Test
Indication: sciatic nerve pathology ; hamstring length
+ nerve pain / symptoms (usually appear once the leg is past 30 degrees) ; decreased ROM
what are the two main culprits in superficial fungal infections?
candiasis
tinea
kernig brudzinski
Indication: Sciatic nerve pathology ; hamstring length
+ nerve pain / symptoms ; decreased ROM
what type of fungus causes tinea infections?
mould
Slump Test
Indication: sciatic nerve pathology
+ nerve pain / symptom recreation
what is the site of infection of Tinea Corporis?
the body
Yeoman's Test
Indication: femoral nerve pathology; rectus femoris length ; psoas major length ; SI Joint pathology
+ nerve pain / symptoms ; decreased ROM / length ; pain
what is the site of infection of Tinea Capitis?
the head
Gaenslen's Test
Indication: femoral nerve pathology ; rectus femoris length ; psoas major length ; SI joint pathology
+ nerve pain ; decreased ROM ; pain
what is the site of infection of Tinea pedis
the foot
athlete's foot
Morton's Test
Indication: distal tibial nerve pathology ; Morton's neuroma
+ nerve pain or pain in the metatarsal area of the foot
what is the site of infection of Tinea unguium?
nails
chvostek test (type of Tinnel's test)
Indication: abnormal reaction to the stimulation of the facial nerve
+ facial muscles on the same side of the face will contract momentarily
what is the site of infection of Tinea manus?
the hands
Spurling's Test
Indication: cervical nerve root compression ; facet joint irritation
+ nerve pain / symptoms ; local pain
what is the site of infection of Tinea cruris?
thigh
jock itch
Compression Test
Indication: cervical spine nerve compression ; disc pathology
+ nerve pain, neurological symptoms, local pain
what are the signs and symptoms of a tinea infection?
scaling or vesicles
itching
red-grey patches
brittle hair
Distraction Test
Indication: cervical spine nerve compression ; cervical ligament sprain
+ relief of neurological symptoms ; local pain
tinea capitis mostly affects which population?
children
ages 3 - 8
Jackson's Test
Indication: cervical spine nerve compression
+ nerve pain, neurological symptoms
how can tinea pedis be avoided?
hygiene!
feet clean and dry
change socks often
wear open footwear
what are the signs and symptoms of tinea unguium?
thick opaque white/yellow/brown nails
brittle nails
cracks
nail plates separate from the bed
define candiasis
yeast infections caused by candida albicans which is part of the the microflora of the mouth, GI and vagina
what are the signs and symptoms of candiasis?
itching, burning
red, swollen mucous membranes
thick, whitish discharge
painful urination
what are some factors that predispose one to candiasis infections?
diabetes
antibiotics
birth control
malnutrition
immunosuppression
what type of infection is impetigo?
a superficial, contagious, bacterial infection
what are the common sites for impetigo?
around the mouth
nostrils
what are the signs and symptoms of impetigo?
thin walled vesicles, bulla, pustules
clusters
contain yellowish fluid / crust
what is the target population for impetigo?
infants and young children
what are decubitus ulcers?
bed sores
what type of infection are decubitus ulcers?
non contagious deep tissue infection
what is the target population for decubitus ulcers?
bed ridden patients
wheel chair users
which cranial nerves are tested with the finger movement test?
III - occulomotor
IV - trochlear
VI - abducens
what are common sites of decubitus ulcers?
sacrum
heel
ischial area
greater trochanter
lateral malleoli
Which tests can you use to test CN V (trigeminal)?
sensory testing for the face
jaw elevation test
jaw reflex
knuckle test
what are the two contributing factors to decubitus ulcers?
external pressure, ischemia, hypoxia
friction / shearing when shifting in bed or in a chair
what is tested with the fascial expressions test?
CN VII - Fascial
where would you find the most painful part of a decubitus ulcer?
the edges of the lesion
the center has degraded past the area where nocicepters are found
the Romberg balance test is used to test which Cranial Nerve?
VIII - Vestibulocochlear
if untreated, decubitus ulcers can lead to what?
gangrene
amputation
death
how can one test cranial nerve IX?
swallow test
when was penicillin discovered?
1928
what is assessed with the tongue movement test?
CN XII - hypoglossal
what global event spurred the commercial development of antibiotics?
WWII
Lhermittes test
tests: sciatic nerve ; entire spinal cord and meninges
+ is neurological symptoms
what are natural microflora?
microbes that inhabit different body areas and do not cause disease (if body is in homeostatic balance)
Brachial Plexus Compression Test
tests: brachial plexus
+ is recreation of neurological or vascular symptoms
when are microflora established?
shortly after birth
piriformis test
tests: length of piriformis ; piriformis syndrome
+ is decreased ROM / length ; neurological symptoms
what is the predominant microflora bacteria?
serratia
lumbar compression test
tests: lumbar nerve roots ; lumbar discs
+ is neurological symptoms ; pain
what are the common viral microflora?
Herpes simplex, varicella, Epstein Barre
valsalva test
tests: entire spinal column ; disc pathology / herniation
+ is pain ' neurological symptoms
what are the common fungal microflora?
candida
pronator teres test
tests: pronator teres syndrome
+ is neurological symptoms ; weakness
what is the role of microflora?
protection
thoracic expansion test
tests: movement of costovertebral, costotransverse joints as well as general ease of rib cage movement
+ less than 2 inches of expansion
viruses require a host, meaning they are what kind of parasite?
obligate intracellular
shoulder depression test
tests: brachial plexus
+ is pain and neurological symptoms and possibly vascular symptoms
what are two common skin infections in humans that are viral in nature?
warts and herpes
vertebral artery compression tests
tests: vertebral artery for occlusion
+ is dizziness ; nauseous ; eyes flicker
what type of herpes is a cold sore?
HSV1
hautant test
test: vertebral artery compression
+ is dizziness ; nauseous ; eyes flicker ; unable to hold arms up
Herpes simplex virus 2 is what kind of herpes?
genital herpes
naffzigger test
tests: drainage of the jugular veins
+ is pain in head or neck with coughing
** positive result = refer
what type of herpes virus are chicken pox and shingles?
varicella zoster or simplex 3
Allen's maneuver
tests: TOS due to scalenes or possibly pec minor
+ is diminished or loss of palpated pulse
herpes simplex 4 is also known as what group?
lymphotrophic beta group
Wrights test
tests: TOS due to pec minor compression
+ is diminished or loss of palpated pulse
what is herpes simplex virus 8?
Koposi's sarcoma
costoclavicular test
tests: TOS due to compression between first rib and clavicle
+ is diminished or loss of palpated pulse
which virus causes warts?
human papilloma virus (HPV)
digital blood flow test
tests: capillary refill in nail bed
+ is if nail bed does not refill within a few seconds
are warts contagious?
yes
Buerger test
tests: blood flow to lower extremities
+ is if refill is slow (may become bright red also before returning to normal)
** this test may also be performed by palpating a lower extremity pulse and feeling for loss or diminishment.
describe the appearance of warts
elevated mass of cells
irregular thickening of stratum spinosum
increased thickening of stratum corneum
Homan test
tests: presence of DVT
+ is pain deep and local in the calf
an eruption of vesicles related to overexposure to the sun, stress and reduced immunity describes what?
Herpes simplex 1
allen's test
tests: radial and ulnar artery and refill to the hand
+ refill is slow
describe the appearance of herpes simplex 1
thin walled vesicles
tend to recur at same site
appear at the junction of skin and mucous membranes
shoulder elevation test
tests: for clavicular syndrome
+ is relief of symptoms
describe the 10 step pathogenesis of herpes simplex 1
virus enters the cell
replication of viral particles
cell lysis and release of virons
infection spreads
necrosis and vesicle eruption
wound healing
virus moves along nerve
colonizes ganglionic cells
latency
recurrence
Kleiger Test
Tests: deltoid ligament
+ is pain or laxity
what are the signs and symptoms of HSV1? (7)
pruritis
burning sensation
soreness
tenderness
erythema
erupted vesicles
vesicles rupute
Homan Test
Tests: DVT in lower extremity
+ is pain deep in calf area

* no longer considered clinically reliable
what does herpes zoster cause?
post herpetic neuralgia / shingles
Thompson Test
Tests: achilles tendon integrity
+ is no motion of foot. Achilles tendon rupture
what is described as an acute inflammatory condition of spinal or cranial nerves?
herpes zoster / HSV3
Gapping Test
Tests: anterior S/I ligaments
+ is pain in low back area
what are the common sites of infection of herpes zoster?
trigeminal nerve
lumbar nerves
Anterior Drawer
Test: anterior cruciate ligament
+ is pain or laxity
describe the pathogenesis of shingles
childhood viral infection
lies latent for years
unilateral cutaneous eruption
vesicles subside after a few weeks
Appley's Distraction Test
Tests: ligamentous structures
+ is pain. Relief of pain may indicate meniscal damage
severe pain and neuralgia and paraesthesia are signs and symptoms of what kind of infection?
herpes zoster
Appley's Compression / Grind
Tests: menisci
+ is pain
what is the treatment for herpes zoster?
corticosteroids, antiviral drugs, pain relievers
Approximation test
Tests: posterior SIJ ligaments
+ is increased feeling of pressure or pain
what is the causative agent of scabies?
a mite that burrows into the epidermis
SI Rocking / Sacrotuberous stress
tests: sacrotuberous ligament
+ is pain
what are the common sites of scabies infections?
between fingers
wrists
axillae
genitalia
inner thigh
Squish Test
Tests: posterior SIJ ligaments
+ is pain
papules, vesicles, pustules, itching, excoriations are signs and symptoms of what?
scabies
Clarke's Test
Tests for patellofemoral dysfunction
+ is retropatellar pain, inability to complete or maintain contraction without pain
pediculus humanus is the causative agent for what infection?
lice infestation
what body areas are infected by lice?
body
head
pubic area
Halstead Test
tests: TOS due to scalene syndrome
+ is diminished pulse
what are the signs and symptoms of lice?
pruritis
skin irritation
eczematous patches
Lachman Test
Tests: anterior cruciate ligament
+ is mushy or soft end feel
what diseases are associated with ticks?
Rocky Mountain Spotted Fever
Lyme Disease
McMurray Test
Tests: menisci
+ is pain or clicking or snapping
what are the signs and symptoms of a tick carried virus in humans?
high fevers
rashes
malaise
Nachlas Test
Tests: L2 and L3 nerve root ; femoral nerve ; quadriceps
+ is neurological pain in the ipselateral lumbar area, buttock. Neurological symptoms in anterior thigh ; decreased ROM
why do antibiotics work against tick infections?
because the viruses have characteristics or bacteria
Posterior Drawer
Tests: posterior cruciate ligament
+ is pain or laxity
inflammatory, allergic, burns and neoplasms are examples of what kind of skin disorders?
non-infectious
Posterior Drawer
Tests: posterior cruciate ligament
+ is pain or laxity
burns can have what four serious consequences due to skin damage?
compromise the integrity of the skin
loss of protective function lead to infection
reduced thermoregulation
loss of fluids
ROOS test
tests: TOS
+ is unable to keep arms in starting position, ischemic pain, heaviness, profound weakness, numbness, tingling
what kinds of skin disorders should an RMT look for and possibly refer a client to a heath care professional? (6)
bruises
fissures
moles
athlete's foot
dry skin
odours
Sag Test
Tests: posterior cruciate ligament
+ is sulcus at the tibial plateau ; the tibia will 'sag' posteriorly
what are examples of heavy skin scaling?
dandruff
psoriasis
eczema
Toe Stand
Tests: tricep surae strength, tibial nerve, plantar faciitis
+ weakness, numbness / tingling, pain in the foot
what glands secrete sebum and what kind of structure are they?
sebaceous glands. They are an epithelial structure
What does sebum contain?
a mixture of fatty substances
what is a holocrine process?
cells produce a secretion and then release it by bursting
how is sebum released?
via a holocrine process
what stimulates sebaceous cell proliferation and sebum production?
hormones
pubescent acne is related the increase of which sex hormone?
the male sex hormone androgen
what are the four types of lesions associated with acne?
comedones
papules
pustules
cysts
what is the laypersons name of comedones?
whiteheads
blackheads
what causes a comedone?
obstructed ducts of accumulated sebum
what do blackheads contain?
melanin from broken down melanocytes
the inflammation of acne is cause by what?
irritating effects of some of the fatty acids in sebum
what are the three forms of acne?
acne vulgaris
acne conglobata
acne rosacea
what type of acne is common at puberty?
acne vulgaris
when does acne conglobata normally occur?
in adulthood
which type of acne is more common in the elderly?
acne rosacea
what is the cause of acne vulgaris?
idiopathic / unknown
hormonal activity, keratinisation of epithelial cells and increased sebum are contributing factors to what non-infectious skin condition?
acne vulgaris
what is the prevention and treatment of acne vulgaris?
keep skin clean
balanced diet
avoid stress
topical creams
what are the three most common lesion site for acne conglobata?
back
buttocks
chest
how does acne conglobata manifest?
comedomes
postules
abscesses
cysts
scars
keloid scarring due to abnormal remodeling is related to what type of acne?
acne conglobata
what is a raised pink or red firm mass of cells due to excess collagen deposition?
keloid
what are the systemic manifestations of acne conglobata?
anaemia, increased white blood cell count, increased neutrophil counts
describe the onset of acne rosacea
insidious
begins with red patches over the nose and cheek that spread to chin and forehead
what is telangiectasia and what type of skin disorder is it associated with?
it is dilation of capillaries and it is seen in acne rosacea
how can one best manage acne rosacea?
avoid vascular stimulants
what are the lesion types seen in acne rosacea?
red patches (erythema)
telangiectasia
spider lesions
pustules may or may not be present
what is the etiology of psoriasis?
unknown
what can exacerbate psoriasis?
stress
what are common lesion sites of psoriasis?
elbows
knees
scalp
what kinds of lesions are seen with psoriasis?
papules
plaques
thick, silvery scales
erythema
what is hyperkeratosis?
rapid proliferation and migration of keratinocytes from the basal layer to the corneum
photochemotherapy, sunbathing, mud treatments and methotrexate are treatment options for which skin condition?
psoriasis
what is the pathology of psoriasis?
hyperkeratosis
what are some possible treatments for psoriasis?
photochemotherapy
sunbathing
methotrexate
natural remedies
what type of white blood cells release histamine?
basophils
what are mast cells?
specialized basophils found in connective tissue
what types of white blood cells are phagocytic?
neutrophils and monocytes
what do lymphocytes do?
produce specific antibodies
what are the two types of lymphocytes?
B-lymphocytes
T-lymphocytes
what types of white blood cells are responsible for circulating antibodies and mediating blood/humoral immunity?
B-lymphocytes
what type of white blood cells are responsible for cell mediated immunity and play a role in allergic reactions?
T-lymphocytes
which white blood cells are granulocytes?
neutrophils
eosinophils
basophils
which white blood cells are agranulocytes?
lymphocytes
monocytes
what is an allergy?
an acquired abnormal immune response to a substance that does not normally elicit a reaction
what are the two classifications of allergies?
immediate / type I
delayed / type IV
what type of cell is involved in type I allergic reactions?
mast cells
what do mast cells release when they bind with an allergen?
histamine
what three things happen at first exposure to an allergen that will eventually cause a Type I reaction?
no symptoms
the mast cells become sensitized
an IgE is produced and attaches to the mast cells
What happens at subsequent exposure to an allergen in a Type I allergic response?
the allergen binds to the IgE
mast cells release histamine
localized inflammatory response
symptoms appear
what is the most severe form of a Type I allergic reaction?
anaphylaxis
what type of vascular response does histamine produce?
vasodilation
what is the consequence of vasodilation in an allergic response (anaphylaxis)?
blood pressure drops drastically which leads to edema in the lungs and airway constriction
what category of allergic response is eczema?
Type I
what is the appearance of eczema lesions in infants?
oozing vesicles
crusty scales
excoriations
what is the appearance of eczema lesions in adults?
dry, leathery
hyper or hypopigmentation
pruritis
weeping / oozing (if severe)
how is eczema treated?
avoid extreme temperatures
avoid stress
moisturize skine
what two things are reacting in Type IV hypersensitivity?
allergen and T-lymphocytes
Type IV hypersensitivity is mediated by what?
cells
what happens at first exposure in a Type IV hypersensitivity?
the T-lymphocytes become sensitized
what happens at subsequent exposure in a Type IV hypersensitivity?
allergen binds to T-lymphocytes
synthesis of lymphokines and cytokines
circulating and fixed macrophages are recruited
T-lymphocytes proliferate
local inflammation
tissue damage
dermatitis is what type of hypersensitivity?
Type IV
what are the types of dermatitis?
irritant contact
allergic contact
what causes the inflammation in irritant contact dermatitis?
chemical irritation
how long does it take for lesions to appear due to allergic contact dermatitis?
24 - 48 hours
what are the signs of contact dermatitis?
erythema
edema
vesicles or bulla
excoriation
pruritis
how is dermatitis treated?
avoid irritant
wash affected area
dress area loosely
topical ointment for itch
corticosteroids
what is a burn?
tissue injury due to excessive heat, chemicals, electricity or radiation
what are the two systemic effects of burns?
primary shock
secondary shock
which type of shock due to burns has an insidious onset and follows severe burns?
secondary shock
what are the three classifications of burns?
first degree
second degree
third degree
what degree of burn is also called superficial?
first
which degree of burn is also called partial thickness?
second degree
which degree of burn is also called full thickness?
third degree
a first degree burn results in damage to which structure?
the epidermis
a second degree burn results in damage to which structure?
epidermis and dermis
a third degree burn results in damage to which structure?
skin and subcutaneous layer
what are six possible burn complications?
shock
secondary infection
rigor muscles
vomiting
convulsions
fever
what type of cell is an undifferentiated cell?
a stem cell
a stem cell can divide into which two different types of cells?
another stem cell
a progenitor cell
a progenitor cell will go on to become what?
a specialized cell
what are the four types of labile cells?
epithelial
endothelial
bone
fibrous connective tissue
what are the two types of permanent cells?
cardiac muscle
neurons
what are the four types of stabile cells
smooth muscle
dense regular connective tissue
skeletal muscle
cartilage
which of the stabile cells are very limited with regeneration?
skeletal muscle
cartilage
what are the three ways that cells can adapt?
change size
change shape
change in number
what are the two types of adaptation?
physiological
pathological
what is a physiological adaptation?
a response to appropriate stimuli and the adaptation stops when the stimuli is removed
what are the two types of pathological adaptation?
trophic changes
plastic changes
what is a pathological adaptation
abnormal adaptation and response to inappropriate stimuli
what is a trophic change?
change in cell size due to change in nourishment and demand on cells
what is a plastic change?
change in number, type and appearance of cells
what is atrophy?
decrease in cell size
which type of atrophy is irreversible?
atrophy due to denervation
what are some causes of atrophy? (4)
disuse
decreased hormone stimulation
malnutrition
ischemia
what is hypertrophy?
increase in cell size
what are the types of hypertrophy?
physiological
pathological
what causes physiological hypertrophy?
increased workload or metabolic demands
what are the types of pathological hypertrophy?
adaptive
compensatory
what is adaptive hypertrophy?
a response to chronic pathological conditions
what is compensatory hypertrophy?
enlargement due to tissue or organ loss
can hypertrophy go on forever?
no, it is limited
what are the three types of plastic changes in cells?
hyperplasia
metaplasia
dysplasia
what is hyperplasia?
increase in the number of cells
what types of cells are capable of physiological hyperplasia?
cells capable of mitosis - labile and stable cells
what is pathological hyperplasia?
excessive reproduction of cells due to viral infections or excessive hormonal stimulation
which trophic and plastic changes can occur at the same time when stimulated by the same factor?
hypertrophy and hyperplasia
what is metaplasia?
replacement of one cell type by another within the boundaries of a primary tissue
what is dysplasia?
a deranged line of cells
which one is a normal adaptation, metaplasia or dysplasia?
metaplasia
what are the cell adaptations that result in a change in cell size or cell number?
hyperplasia
hypertrophy
atrophy
what are the cell adaptations that result in a change in cell type?
metaplasia
dysplasia
is reabsorption of water and other substances from the nephron tubules done passively or active?
both
a high protein meal stimulates...
gastric and intestinal activity
what happens if small proteins squeeze through the glomerular membrane?
they are reabsorbed via endocytosis
degraded in the epithelial cells by enzymes into amino acids and returned to the amino acid pool in the blood
a high fibre diet enhances...
gastric motility
what is tubular secretion?
reverse absorption
removes substances from peritubular capillaries to the tubule to join urine
what regulates the contractile rhythm of the stomach?
pacemaker cells in the muscularis
what is the function of tubular secretion?
maintain blood pH
maintain plasma K+ ion levels
remove urea and uric acid that was reabsorbed
remove drugs
how soon after a meal does gastric emptying occur?
about four hours
urine combines substances collected from which two areas?
bowmans capsule / glomerulus
peritubular capillaries / distal convoluted tubules
what is acute gastritis?
transient inflammation of the gastric mucosa due to local irritants. Usually reversible within a few days
what is mieturition?
urination
what irritants might predispose someone to gastritis?
endotoxins
coffee
cigarette smoke
heavy alcohol consumption
asprin
excess bile salt
what is uremia?
waste products in the urine (usually nitrogen type waste)
what is the treatment for acute gastritis?
avoidance of irritants
antacids
antibiotics (bacterial infections)
what is hematuria?
blood in the urine
what is chronic gastritis?
progressive and irreversible atrophy of the epithelium of the stomach. Inflammation leads to mucosal degeneration, metaplasia and dysplasia
what is the purpose of renal autoregulation of filtration rate?
to maintain filtration rate in kidneys regardless of changes in systemic blood pressure
what are the two forms of chronic gastritis?
simple atrophic gastritis
autoimmune atrophic gastritis
what do juxtaglomerula cells detect?
pressure
what is simple atrophic gastritis?
disorder involving impaired secretion of acid and pepsinogen
what do maculadensa cells do and where would you find them?
detect filtrate concentration
found in the distal convoluted tubule
what is autoimmune atrophic gastritis?
severe impairment of acid and pepsinogen secretions with disturbances in protein digestion and malnutrition
what do maculadensa cells to when the GFR goes up?
they sense increased filtrate concentration and release local vasoconstrictors that cause constriction of the afferent arterioles
what causes autoimmune atrophic gastritis?
antibodies that destroy gastric mucosa cells
what triggers the angiotensin mechanism?
low systemic blood pressure
autoimmune atrophic gastritis predisposes to which three other disorders?
pernicious anemia
gastric ulcers
gastric carcinoma
which two regions are common for peptic ulcers?
stomach
duodenum
what are the two scenarios that lead to peptic ulcers?
normal aggression / decreased defense
increased aggression / normal defense
when is the pain of a peptic ulcer most likely?
when the stomach is empty
what relieves the pain of peptic ulcers?
food
antacids
what is a stress ulcer?
ulcer is response to major physical stress or trauma such as burns, surgery, long tern steroid use, liver failure
what are two types of gastric neoplasms?
polyps
malignant
what is a gastric polyp?
benign nodules of masses projecting above the surface of the mucosa
which cells are affected in gastric carcinoma?
secretory cells
which structures are the start and end of the small intestine?
pyloric sphincter
ileocecal valve
which two ducts drain into the duodenum?
bile duct
pancreatic duct
what lines the surface of the intestinal mucosa and what is its function?
villi
increase surface area for absorption
which four types of cells are found in the villi of the intestine?
absorptive cells / brush border
goblet cells
enteroendocrine cells
paneth cells
is intestinal juice alkaline or acidic?
alkaline
what makes up intestinal juice?
water
mucus
electrolytes
some enzymes
where would you find most intestinal enzymes?
bound to the brush border
what are the four categories of disorders that affect the intestines?
inflammatory
malabsorption
diverticular
neoplasms
what is enteritis?
inflammation of the mucosa of the small intestine leading to temporary atrophy of villi
what is peritonitis?
inflammation of the peritoneum
which side is the appendix on?
the right
what is irritable bowel syndrome?
a functional disorder of the GI tract manifested by various recurrent symptoms that have no apparent structural or biomechanical cause
how is IBS managed?
relaxation / stress reduction
avoidance of irritants
what is crohn's disease?
inflammation of ileum that ranges from mild to debilitating
progressive and chronic
fistulas form which lead to malabsorption
which intestinal disorder is characterized by 'skip lesions'?
crohn's disease
what is the treatment for crohn's disease?
corticosteroids
immunosuppressive therapy
surgery
what are the two main functions of the large intestine?
absorb remaining water
store and eliminate waste
name the regions of the large intestine (5)
cecum
appendix
colon
rectum
anal canal
name the two sphincters of the anal canal and are the voluntary or involuntary?
internal anal sphincter (involuntary)
external anal sphincter (voluntary)
what are the two movements in colon?
haustral churning
mass movements
what is haustral churning and what is the purpose?
segmentation movement
exposes all fecal matter to the intestinal surface for absorption of water and electrolytes
what are mass movements?
contraction of large segments of the colon which moves fecal matter along as a until
which area of the spinal cord contains the defecation reflex?
sacral
how do the walls of the large intestine differ from the small?
thicker
gutted by crypts lined with goblet cells
what are the health benefits of fibre?
- retain water making feces bulkier and softer
- reduces risk of cancer
- binds lipids forming cholesterol
what is constipation?
infrequent and/or painful elimination of feces
what are some factors that predispose someone to constipation?
low fiber diet
dehydration
bad bathroom habits
emotional states
lack of exercise
what is ulcerative colitis?
a progressive, chronic inflammatory disorder which affects the colon and rectum
what are the two types of colitis?
acute fulminating
chronic intermittent
describe the pathogenesis of colitis
ulceration begins in rectum
spreads proximal
affects muscosa and submucosa
fissure lesions form and merge
what is colonic diverticular disease?
mucosa of the colon herniates and bulges through the muscularis
what is the etiology of colonic diverticular disease?
scant colon content leading to increased interluminal pressure due to increased force of contraction
what is the most common site of colonic diverticular disease?
sigmoid colon
name two types of carcinomas of the colon
fulminating
ulcerative
describe fulminating carcinoma (colon)
cauliflower shape bulging into the lumen
describe ulcerative carcinoma (colon)
large irregular ulcer penetrating the muscularis
presence of abundant scar tissue
which other GI disorder can predispose to colorectal cancer?
ulcerative colitis
what is celiac disease?
intolerance to gluten leading to inflammation and progressive atrophy of small intestine villi
how many lobes make up the liver?
four
which organ would you find under the liver?
the gall bladder
which system/structure delivers nutrients from the intestinal region to the liver?
portal circulation
what four cell types make up the lobules of the liver?
hepatocytes
Kupffer's cells
bile canniculi
sinusoids
what are kupffer's cells?
macrophages in the liver responsible for phagocytosis of bacteria carried up from the intestine
which structure carries bile from the liver into the gall bladder?
bile canniculi
what is the role of the liver sinusoids?
carry nutrients from the intestines, oxygen from the heart/lungs
what four functions are affected when injury to the liver damages hepatocytes?
vascular function
metabolism
secretory and excretory functions
storage and defense
explain what it means that the liver is a blood reservoir?
in times of need up to 10% of total blood volume in the body can be diverted from the liver to other areas in the body
what can cause sirrhosis of the liver?
alcohol abuse
poisons
viral infections
hepatitis
infection of bile ducts
what is ascites?
excessive lymph exudation to the abdominal cavity
what is portal hypertension?
increased pressure in the portal vein due to blood obstruction through the liver
what are two possible causes of portal hypertension?
right chronic congestive heart failure
liver cirrhosis
why does right CCHF lead to portal hypertension?
congestion of right atrium leads to abnormal venous flow into the heart. This causes peripheral congestion including that of the liver
why does cirrhosis of the liver lead to portal hypertension?
inflammation and fibrosis obstruct blood flow
what is the role of the liver in carbohydrate metabolism?
-production and storage of glycogen
-convert galactose and fructose to glucose
- gluconeogenesis
what is the role of the liver in protein metabolism?
-conversion of amino acids to fatty acids or glucose
-synthesis of plasma proteins
conversion of ammonia to urea
what is the role of the liver in lipid metabolism?
-conversion of fatty acids for beta oxidation
-packaging of lipoproteins
synthesis of cholesterol and phospholipids
-conversion of CHO and proteins to fat