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88 Cards in this Set
- Front
- Back
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What is infection? |
The process in which an organism establishes a parasitic relationship with its host. This invasion and multiplication of microorganisms produces an immune response and subsequent signs and symptoms. |
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What are some different infection sites of nosocomial infections? (those that originate or occur in a hospital setting) |
-Central nervous system -Surgical site -Urinary tract -Respiratory tract -Bloodstream -Intestinal tract |
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Name the common signs and symptoms of infection. |
-Fevers, chills, malaise (fatigue) -Nausea, vomiting -Headache -Confusion -Tachycardia -Joint effusion and myalgia -Cough and sore throat |
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Define "contamination": |
A non-sterile environment, surface, area, or item that contains microorganisms. |
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What is sepsis? |
A systemic inflammatory response to infection in which there is fever, tachycardia, tachypnea, and evidence of inadequate blood flow to internal organs. It is a result of the combined effects of a virulent infection and the patient's immune system response to the infection. |
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What are the most common sites for sepsis to occur? |
In the lungs, abdomen, or urinary tract. |
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How many people in the US die from sepsis per year? |
200,000-400,000 deaths per year |
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True or False:
In physical therapy, medical *asepsis* includes procedures that protect the patient from infections |
True :)
The medical asepsis procedures practiced by PTs and PTAs provide physical therapy interventions free of pathogenic microorganisms, although nonpathogenic microorganisms may still be present |
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What is PPE? |
Personal protective equipment - items that are worn and used as barriers to protect someone who is assisting a patient with a potentially infectious disease. |
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What does PPE include? |
-Gloves -Gowns -Lab coats -Masks -Goggles -Face shields |
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How can clinicians help to prevent the transmission of nosocomial infections? |
By following procedures, standard precautions, and proper hand washing techniques, infection control, and isolation procedures. |
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What is a sterile field? |
A designated area that is considered void of all contaminants and microorganisms.
*Used to maintain surgical asepsis*
*There are standard and required protocols that must be followed in order to develop and maintain a sterile field* |
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What are Universal Precautions? |
-Wash hands before and after each pt contact -Clean treatment area -Use PPE as needed -Cover open wounds on yourself prior to pt contact -Place biohazard materials in appropriate disposal |
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What are Airborne Precautions? |
To reduce the risk of airborne transmission of infectious agents through evaporated droplet in air or dust particles containing infectious agents
-Examples: measles, varicella, TB |
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What do airborne precautions consist of for the patient? |
-Private room with monitored air pressure -6-12 air changes within the room daily -Room door should remain shut with the patient remaining in the room -Respiratory protection worn when entering room for visitors/staff -Limit patient's transport outside the room for only essential purposes -Patient should wear mask when outside of room |
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What are Droplet Precautions? |
To reduce the risk of droplet transmission of infectious agents through contact of the mucous membranes of the mouth and nose; contact through coughing, sneezing, talking, or suctioning
-This transmission requires close contact, 3 feet or less, to become contaminated
-Examples: meningitis, pneumonia, mumps, influenza |
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What do droplet precautions consist of for the patient? |
-Private room or shared with someone with same infection -Maintain at least 3 feet of contact with patient and wear mask if closer -Room door may be open -Limit patient's transport outside |
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What are Contact Precautions? |
To reduce the risk of transmission of infectious agents through direct or indirect contact.
-Examples: GI, respiratory, skin or wound infections, scabies, ebola, etc. |
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What do contact precautions consist of for the patient? |
-Private room or shared with another of the same infection -Staff uses gloves or gown as needed -Limit patient's outside transport from room -Do not share equipment with others and WASH HANDS!! |
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What do standard precautions consist of?
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1. hand washing
2. gloves 3. mask 4. gown 5. patient care equipment 6. occupational health and blood borne pathogens |
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What are the 3 Transmission-Based Precautions? |
1. Airborne precautions 2. Droplet precautions 3. Contact precautions |
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What is the order of application of sterile protective equipment? |
Gown -> Sterile gloves -> Cap and mask -> Sterile field guidlelines |
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What are the legal and ethical considerations of first aid? |
1. Duty to act 2. Need for consent, if person is conscious 3. Legal concerns - Good Samaritan Law |
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What is the Good Samaritan Law? |
Act that gives legal protection to lay rescuers who act in good faith with no expectation of remuneration and are not guilty of gross negligence or willful misconduct. The type of rescuer covered and the scope of protection may vary from state to state. |
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What are some different conditions in which you MAY be required or feel obligated to perform first aid? |
-Anaphylaxis -Bleeding -Blisters -Burns -Chest pain -Diabetic emergencies -Dislocation -Fainting -Fractures -Frostbite -Head trauma -Heat cramps -Heat exhaustion -Heart attack -Seizure -Sprains/strains |
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I did NOT include first aid treatment methods because we were already tested on it! :) |
If you feel that you need to re-familiarize yourself with these, refer back to PowerPoint or check the lovely note card set that Lauren made for the 110 practical. :)
Search for: PTA 110 Practical First Aide If you don't already have them |
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What are "Vital Signs"? |
1. Blood pressure (BP) 2. Pulse rate (heart rate) 3. Body temperature 4. Respiratory rate |
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What units are used to measure blood pressure? |
millimeters of mercury |
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What do you use to take someone's BP? |
sphygmomanometer and stethoscope |
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What is considered to be normal range for blood pressure?
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90/60 - 120/80
HTN Kills more than 37, 000 Americans each year |
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What can potentially happen if HTN (hypertension or high BP) goes and remains untreated? |
-Can lead to increased sized heart causing heart failure -Narrow blood vessels in the kidneys leading to kidney failure -Brain aneurisms causing stroke |
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What is orthostatic HTN? |
-An inability to compensate quickly for changes in BP
-When a person stands quickly, gravity tends to cause the blood to pool in the veins in the legs. As a result, the amount of blood return to the heart is reduced and the BP falls. |
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What are the most common sites for checking and taking pulse? |
Radial, brachial, and corotid |
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Normal heart rates for all ages: |
-Newborns/infants: 130-150 -Toddlers: 100-120 -Older children: 90-110 -Adolescents: 80-100 -Adults: 50-80
*If the person's heart rate is regular, measure for 15 seconds and then x4. If irregular, measure for entire 60 seconds. |
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What is the normal range for body temperature? |
97.8-99.1 deg F (avg. = 98.6)
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Which of the following can affect the normal range of body temp?
-Menstrual cycle -Pregnancy -Physical activity |
All three! |
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What are variables that affect temperature in general? |
-Age -Weather -Time of the day -Emotions -Site temp is taken - oral, rectal, axillary, or ear |
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Normal readings for rectal, oral, axillary: |
Rectal: 99.6 Oral: 98.6 Axillary: 97.6 |
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What factors would cause and elevation in body temperature > 100 deg F? |
-Systemic infection or inflammation -Hyperthermia - overheating of the body |
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What is normal range for a person's respiratory rate?
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12-20 breaths per minute
Variates with age |
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What factors can affect a person's respiratory rate? |
-Positional changes -Exercise -Heat -Cold |
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What are anthropometrical characteristics? |
A set of non-invasive, quantitative techniques for determining an individual's body fat composition by measuring, recording, and analyzing specific dimensions of the body, such as height, weight, skinfold thickness, and bodily circumference at the waist, hip, and chest. |
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What is a key indicator of nutritional status for children? |
-Mid upper arm circumference (MUAC) |
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True or False:
1. The MUAC predicts death in children better than other anthropometrical indicators. |
True |
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True or False:
The MUAC is an indicator of malnutrition in adults. |
True |
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What are the average MUAC measurements for males and females? |
Males: normal - 26-29mm; < 26mm - malnutrition
Females: normal - 26-28.5mm; < 20mm - malnutrition |
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What instrument is used to measure skinfolds? |
A caliper |
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Which side of the body should you measure skin folds? |
Right |
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What is BMI? |
-Body mass index
-An estimate of body fat |
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Is the BMI calculation an accurate way to measure an individual's fat percentage? |
NO |
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What is an "android" body type? |
*Person is shaped like an apple*
-fat is accumulated mostly around the abdomen -more common in men -Health risks: highest risk for Metabolic Syndrome (associated with insulin resistance and type 2 diabetes mellitus), HTN, increased intra-abdominal pressure, sleep apnea, increased risk for several types of cancer, problems with pregnancy |
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What is a "gynoid" body type? |
*Person is shaped like a pear*
-fat is accumulated in butt and thighs; more common in women -Health risks: DJD, venous stasis in the LEs |
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What is the formula for calculating BMI, and what are the NIH classifications?
**KNOW THIS ENTIRE CARD** |
weight in lbs x 703 / height in inches x height in inches
weight in kg / height^2 in m
<18.5 = underweight 18.5-24.9 = normal 25-29.9 = overweight 30-34.9 = obesity I 35-39.9 = obesity II >40 = extreme obesity |
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What is the percentage of body fat with the least health risks? |
women - 18-25%
men - 13-18%
*In general, percentage of body fat is greater in women than men and typically increases with age |
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What is the most accurate way of measuring body fat percentage? Why? |
Hydrostatic - called the "Gold Standard" for measuring body fat %
- Because fat floats. Therefore, a large amount of fat mass will make the body lighter in the water and have a higher percent of body fat. |
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What are the 3 different body types? |
1. Ectomorph - slim, long limbs and phalanges, lack of muscle mass, sharp facial features, great body type for endurance activities and cardio training
2. Mesomorph - muscular, hour glass shape (women) and rectangular in men, mature muscle mass, thick skin and large bones, poor flexibility, energetic and capable of a lot of activity
3. Endomorph - round, curvy, soft body. Mass concentrated in abdominal area, short arms and legs, high waits, small hands and feet, inclined to obesity, small-medium bones, lack of musculature |
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What are the two levels of consciousness? |
1. Arousal - the general state of readiness to respond to the environment; necessary for selective attention and purposeful responses. -Function of the reticular activating system (RAS); disruption of the RAS can reduce the level of consciousness and lead to coma
2. Coma - prolonged period of unconsciousness, sleep-like state, no speech, no response commands -may have reflexes in response to touch or pain -Absence of awareness of self and the environment |
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What is the standard measure of coma in the acute phase? |
Glasgow coma scale
-measures of depth of coma based on: motor response, eye opening, vocal response |
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Other scales:
(See handouts attached to toggle 6) |
Ranchos Los Amigos Scale (RLAS) - used as a pt improves or stabilizes
*Disability Rating Scale (DRS) - most popular, reliable, and valid because of ease of scoring. Has the ability to track the pt across a wide span of recovery from coma to communtiy. Address all 3 WHO categories: impairment, disability, and handicap
Coma/Near Coma Scale - developed to measure small changes in pts with severe brain injuries with very low functional levels of near-vegetative and vegetative states. Reliable and easy. Indicates severity of sensory, perceptual and primitive response deficits |
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What is a normal pain response? |
-Noxious stimulus caused by high intensity mechanical, thermal, or chemical stimulus -A chemical stimulus may be released as a result of damage to the tissue, including ischemia and inflammation -Psychological as well as physical factors guide the brain's interpretation of painful sensations |
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How is pain produced? |
*Peripheral Mechanism*
-Pain can be transmitted by many different nerve endings; skin, muscle, bone and other tissues have thousands of nerve endings within a single millimeter -When stimulated, these nerves generate electrical signals (action potentials) which travel at various speeds (milliseconds to seconds) along the afferent nerve fibers to the spinal cord and brain |
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Describe the pain pathway: |
1. Pain receptors (nociceptors) in the skin are activated by tissue damage 2. A signal travels up the peripheral nerve to the spinal cord 3. Within the spinal cord, neurotransmitters are released. These activate other nerves that pass signals to the brain 4. The thalamus relays the signals on to the somatosensory cortex (sensation), frontal cortex (thinking), and limbic system (emotional response) |
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What are Nociceptors? |
The pain specific nerve endings in the periphery.
-Fire response to potential tissue damage; abundant in skin and musculoskeletal systems
-Consist of free nerve endings: *A-delta fibers: respong to mechanical and thermal stimulation and elecit the first localized sharp pain; produce the withdrawal reflex and are short duration *C-fibers: respond to chemical, thermal, and mechanical stimulation and produce the secondary aching or burning pain and are long duration
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What is the "Gate Control Theory"? |
The theory that there is a "gating system" in the central nervous system that opens and closes to let pain messages through to the brain or to block them. |
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What are endorphins? |
-Endogenous opiates, a class of neurotransmitters normally produced in the human brain that mediate a sense of well being as well as pain and anxiety relief. -When released, lower BP, boost immune system, slow down the aging process, reduce symptoms associated with eating disorders, and regulate the production of sex hormones
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What workouts are most likely to release endorphins? |
weightlifting, biking, running, aerobics, football, or soccer |
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What is the most widely accepted trigger of endorphin release? |
Pain |
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What are some other ways to trigger an endorphin release? |
-Laughing, chocolate, and capsaicin (the active chemical in chili peppers) |
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True or False:
Patient self-report provides the most valid measure of the pain experience. |
True |
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Visual pain scale: |
Happy face - crying sad face
No pain: 0 Worst pain: 10 |
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What is the numeric pain rating scale? |
Identical to visual pain scale without the faces
0-10 pain rating scale |
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What is the McGill pain questionnare? |
-Consists of 3 portions: 1. Body diagram (pt is instructed to mark the body diagram where they are having pain) 2. Pain intensity rating 3. List of words a pt is asked to choose from in describing their pain; circle one word that describes pain, but not more than one word in a group
Advantages: reliable and can be used to establish a baseline Disadvantages: time consuming (15-20 minutes), may be culturally inappropriate. |
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What is the Onwestry Low Back Pain Disability Questionnaire? |
-Specific to pts with low back pain -consists of 10 items addressing various aspects of function -each item is scored from 0-5, with higher values representing greater disabilities -total score is manipulated by 2 and expressed as a % |
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What are body mechanics? |
The way we position our bodies during tasks
-Affects the efficiency of our movements and the stress that is placed on the tissues of the body. |
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What are the 5 Ls of lifting? |
1. Load 2. Lever 3. Lordosis 4. Legs 5. Lungs |
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Name some general principles of lifting and using proper body mechanics. |
-Wide base of support -Center of gravity close to body -Minimize bending and twisting -If turning, pivot feet -Push heavy objects onto a cart -Make several trips of smaller loads -Be aware of posture during daily activities -Plan ahead, a clear pathway -Lift smoothly, lower smoothly |
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How can one achieve good sitting posture? |
-Shoulders and hips facing the same direction -Back against the back of the chair -Feet flat on floor -May have small lumbar pillow -If wheelchair, must fit properly
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What are two good exercises to improve sitting posture? |
1. Neck protraction and retraction
2. Scapula retraction (squeezing shoulder blades together as if making wings) |
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How can one achieve good standing posture? |
-Wear comfortable shoes with arch support -Avoid high heels or platform for long periods -DO NOT lock knees -Stand with feet shoulder width apart -Align head with shoulders -Visualize a plumb line hanging from the ear lobe through the shoulder and ankle |
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What does "dynamic trunk stabilization" refer to? |
An element of protection against injury during mobility activities |
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What are two different types of dynamic trunk stabilization? |
-Static Stability: maintaining and controlling the body's orientation in space, usually by keeping the line of gravity within the base of support (BoS); no observable movement
-Dynamic Trunk Stability: aka dynamic lumbar stabilization or core stabilization; maintaining core stabilization of the trunk, and the lumbar spine in particular, within a safe range of movement through activation of core musculature |
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What is the goal of dynamic trunk stabilization? |
To maintain the lumbopelvic complex in a relatively neutral spine position between flexion and extension; this stabilization is achieved by the contraction of multiple muscles of the trunk acting in all the planes of movement |
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What is one of the most important muscle used for dynamic trunk stabilization? |
Transverse abdominus muscle which wraps around the lower abdomen like a corset.
-You can activate this muscle by gently bringing the belly button toward your spine without pushing out the lower abdomen. |
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Guidelines for proper lifting body mechanics: |
-Plan ahead: know the load when possible and clear a path for travel -Position yourself close to the load: stay close to your pt -Maintain a wide base of support: feet shoulder width apart -Maintain normal spinal curvature whenever possible: slight lordotic curve of lower back prevents strain -Bend hips and knees -Hold objects close: reduces amount of force needed to get the job done -"Set" the trunk muscles prior to lifting: stabilize trunk -Use larger muscles to perform the heavier work -Exhale during exertion -Avoid twisting at the trunk, particularly when the trunk is flexed: pivot feet -Push rather than pull -Get help if you need it |
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What can potentially happen if proper body mechanics are not used and maintained while lifting heavy objects? |
*Herniated disc
-Also called: bulging disc, compressed disc, herniated intervertebral disc, herniated nucleus pulposus, prolapsed disc, ruptured disc, slipped disc. |
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What are symptoms of a herniated disc? |
-Back pain that spreads to the butt and legs, when the disc is in lower back -Neck pain that spreads to the shoulders and upper arms when the disc is in the upper back -Tingling or numbness -Muscle spasms or weakness |
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How is a herniated disc treated? |
Rest, pain and NSAIDs, other medications, PT, and sometimes (in severe cases) surgery |
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To review pictures of good lifting techniques: |
Review power points :) |
