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Flashcards in Chiro - PT Boards Deck (78):
1

Heating modalities: Deepest to shallow

-Ultrasound
-Short wave diathermy
-microwave diathermy
-IR
-Ultraviolet

2

Ice Modalities: Best to worst

Used in acute cases

-Ice
-Positive pole of Low Volt Galvanic
-Pulsed Ultrasound
-PRICE

3

Subacute phase (eliminate edema) modalities

-Contrast therapy
-Pulsed ultrasound
-Interferential

4

Subacute Exercise

-Stretching/passive/ROM
-Isometric exercise

5

Chronic Rehab

Warm up/ use heat modality

6

Target HR Equation

220-Age = Est. Max HR (EMHR)
EMHR - Resting Heart Rate (RHR) = Heart Rate Reserve (HRR)
HRR x 0.6 - 0.9 (epends on lifestyle) = Workout HR
Workout HR + RHR = Target HR

7

Williams Exercises

-Sit ups and Crunches
-Pelvic Rocks/Tilt
-Knee to Chest

8

Aerobic Exercise is in what range of Max HR?

60-90%

9

Aerobic Exercise must be for at least how long?

15-20 minutes

10

Aerobic Exercises
UBC = Upper Body Cycle --> used for people with what problems?

Lumbar Problems

11

Williams Approach says that all activities should b geared towards ____ lumbar lordosis

Reducing/decreasing Lumbar Lordosis (Flexion)

12

McKenzie Approach is a spinal assessment and therapy based on the behavior of pain and mechanical response to ____ loading

Dynamic and static loading

13

Postural Pain Syndrome =

End range stress of normal structures

14

Dysfunction pain syndrome =

end range stress leading to contracted of adherent structures

15

Derangement Pain Syndromes=

anatomical disruption or displacement of structure "herniated disc"

16

Plyometric Exercises -

*Box Drills
*Depth Jumps
-Jumps
- Hops
-Bounds

17

Acute Care mngmt
-First 4 weeks

1. Ice
2. + pole LVG
3. Pulsed US
4. Price

18

Plyometrics based on concept of power
Equation for power?

Force x Speed = Power

19

Chronic phase starts after ___ weeks

12

20

Chronic phase therapy - >12weeks
Therapies:

-Strengthening
-Heat/warm-up
-Stretch the decreased ROM places
Mensuration and Wexler Scale for quantitative measurements

21

Lower Crossed Syndrome:
MM involved and state they are in

Erector Spinae - Tight/Fascilitated
Iliopsoas - Tight/Fascilitated
Glut. Max - Weak/Inhibited
Abs - Weak/ inhibited

22

Toe in or out for VMO during leg extensions?

Toe Out

23

Upper Crossed Syndrome:
MM involved and their state

Deep neck Flexors/Longus Coli - Weak
Lower Trap/ Serratus Anterior - Weak
Pectoralis - Tight
Upper Trap/Levator Scap - Tight

24

Usual Tight Mm:

Iliopsoas
Rectus Femoris
TFL
Adductor Group
Errector Spinae
Gastroc / Soleus

25

Action of TFL

*Abducts
-Flexes and Medially Rotates the hip joint

26

Lower Cross Syndrome results in positioning of:
Pelvis into ___
Lumbar ___
Hip ___
Knees ___

Pelvis anterior rotation
Increased lumbar lordosis
Hip Flexion
Knees hyperextended

27

Adductor group mm.

Lower, magnus, longus/brevis

28

Errector Spinae Action

Ext. Vertebrae in thoracic region
Draws Ribs down

29

Usual Weak/inhibited mm.

Rectus Abd.
Obliques
Glut. Max and Med.
Hamstrings

Trendelenburg Test - Tests ABductor strength

30

Usual Upper Body Tight Mm.

Pec Major and minor
Levator Scap.
Teres Major
Upper Trap
Ant Delt.
Subscap
Lats
SCM, Scalenes, and rectus capitus

31

Usual upper Body Weak Mm.

Rhomboids
Lower Trap, Serratus ant.
Post Delt.
*Teres Minor, infrspinatous, Post. Delt
Longus Coli

32

Clayton's exercises

crawling exercises to mobilize the spine and exercise mm in scoliosis

33

Thoracolumbosacral Supports
-Milwaukee brace: for what? how long/day? When is it indicated?

Milwaukee brace
-scoliosis. worn 23 hours/day
-employ for scoliosis that are between 20-40 degrees

34

Extremity braces:
Types and their uses:

-Figure eight (Louisiana Strap): inversion ankle sprain
-Lennox-Hill (derotational Brace): Knee
-Cockup Splint: Wrist -Carpal Tunnel syndrome - Puts wrist into extension and opens tunnel

35

Frenkel's: Sx and treatment

Ataxic motion and to develop coordination (wobble board).

36

Lumbar/SI Supports: Types and indications

Sacroiliac Girdle (Trochanteric belt)
-Goes around Hip circumference and is for SI hypermobility.

37

Fitting Crutches 2-10-30 rule

-2" from axilla
-Tip of crutch 10" from malleolus
-Crutches should be at 30 degrees

38

Contraindications to all PT modalities:

HIM
-Hemorrhage (systemic)
-Infection w/suppuration (not inflammation) - Exception = UV superficially
-*Malignancy (most important) unless 100% benign.

39

Contraindications to ALL Electric Modalities :

-Pacemaker
-Low Back and abdomen during pregnancy
-Decrease sensation (LVG only)
-Brain = Transcerebral (Co-planar = ok)
-Eyes
-Heart = Transthoracic
-Carotid Sinus

40

DC Current PT Electric Modality

LVG
HV

41

AC Current PT Electric Modality

-Sine Wave
-Faradic
-IF

42

Systematic Approach for PT Modalities:
WAT DP PICS

-Wavelength and Frequency
-Action
-Types
-Dosage
-Penetration
-Physiological Affects
-Indications
-Contraindications
-Special Tests

43

Contraindications to ALL Heating Modalities:
DALED

-Decrease in heat sensation
-Active TB
-Low Back and abdomen during pregnancy
-Encapsulated Swellings (Herpes simplex and non draining sinusitis, uviitis, osteomyelitis)
-Diabetes Mellitus - Late stages

44

*What PT modality is in the medium frequency range?

Interferential

45

What is the deepest e- Modality

Interferential

46

Massage's action (mechanical) has the greatest affect on what system?

Vascular

47

Levator Scapula actions:
Origin Fixed:
Insertion Fixed:

Origin: Elevated scapula and assists in rotation so the glenoid cavity faces caudally
Insertion: Unilateral acts to laterally bend the cervical neck. Bilateral assists in extension of cervical spine

48

Anterior Deltoid actions:

Abduction of shoulder.
Ant. fibers flex and in supine position medially rotate shoulder joint.

49

Lattisimus Dorsi actions:
Origin Fixed:
Insertion Fixed:
Bilateral:

-Origin: Int. rotation, adducts, and extends shoulder. depresses shoulder girdle and assists in lateral flexion of trunk
-Insertion: Assists in tilting pelvis anterior and laterally
-Bilateral: hyperextending the spine, anteriorly tilting pelvis or flexing the spine, depending on axis.

May acts as accessory respiratory mm.

50

Cybex machine

Used for isokinetic movements
-good for rehabbing painful arc syndrome

51

Buerger-Allen Exercises

-For patients with Buerger's, Raynauds, Elderly, bedridden, or early stage DM.
-Administrated to patients with vascular disease. Done 6-7 reps and several times a day.
1. support legs in an elevated 60-90 degrees for 30-180 seconds or until blanching of extremities. Then actively dorsiflex and plantarflex the ankle throughout the rest of the procedure.
2. Allow feet to hang over the bed for 2-3 minutes or as long as it takes to produce hyperemia then add 1 min. The total time should not exceed 5 min.
3. Place legs in horizontal position for 3-5 minutes.

52

Extension type exercises for low back conditions and CAN be done during the acute phase:

McKenzie Exercises

53

Codman's Exercises AKA Pendular Exercises:
Goal:
Uses:

To strengthen the shoulder girdle while eliminating the use of the supraspinatus mm. - Finger wall walking for abduction of the shoulder

Uses: Frozen shoulder, and rotator cuff rehabilitation.

-works everything but internal and external rotation

54

DeLorme's Exercises:

Systematic approach to mm strength by increasing the resistance on the mm. Ex. Weight lifting.

Sets of 3 x 10 reps

55

Trigger points =

myofascitis

56

*Kegel exercises are for who?

Pregnant females and ppl with urinary incontinence.

57

Jacobson's exercises

Stress exercise to relax mm.

-Galvanic Skin Response (GSR)
-Mental Imagery

58

OA of the hip - which hand do you place the cane?

Opposite of OA

59

High (Heat) Frequency modalities- 100,000 Hz or higher

-UV
-IR
-SWD
-MWD
-US

60

**Medium Frequency modalities - 2K-10K Hz

-IF --> Deepest E-modality

61

Low Frequency modalities - 1 - 2K Hz
Used to tetanize or exercise a mm.

-LVG
-HV
-SW
-Faradic
-TENS
-IF

62

Ultra Low Frequency Modalities - below 1 Hz

-Micro-current:
Primary Action:Incr. ATP and AA
Secondary Action: Decrease Pn

63

Micro-current:
Primary and secondary actions:

Primary Action:Incr. ATP and AA
Secondary Action: Decrease Pn

64

Electrokinetic action:

Contracting a mm electrically

65

Massage:
Physiological Effects:

-Increases:
Blood and lymph flow,
HR,
BP,
Breaks adhesions (Transverse Friction Massage-TFM),
Removes Lactic Acid
-Decreases:
Edema
Congestion
Nerve activity (sedation effect)

66

Massage:
Indications:

Strains/Sprains, Bruises, Bursitis, Tendonitis

67

Massage:
Contraindications:

*Key = Vascular problems
Phlebitis, Thrombosis, Varicosities, Ulcerations, Local acute conditions

68

Types of Massage:

-Effleurage - stroking
-Petrissage - deep kneading for mm tissue
-Tapotment - percussion:
1 Flat hand slapping
2. fist pounding
3. finger tips tapping for young kids
4. ulnar side hacking
5. cupping for cystic fibrosis
-Friction - deep rubbing (Powder)(TFM)
-Vibration - shaking (extremities only), genie rub, G5, and thumper
-Deep Pressure - Nimmo acupressure

69

Transverse Friction Massage - TFM:
Actions:
Indications:

-Breaks adhesions in mm., ligaments, and joint capsules
-Decreases chemical cross linking

Indications: Sprain/strain, tendonitis, bursitis
***-not recommended fro calcific tendonitis or bursitis (will inflame the tissue even more)

70

Traction:
Action:
Types:
Physiological Effects:

Action: mechanical
Types: Constant and intermittent (pumping, gliding, *disc problems)
Phys. Effects: Decrease intradiscal pressure, increase IVF space, break adhesions (intermittent), straightens curves (continuous), breaks mm spasms (intermittent), gliding of facet joints

71

Traction:
Indications:

-Disc syndromes
-Foraminal encroachment
-hyperlordosis
-chronic mm spasms
-fibrotic adhesions

72

Traction:
Contraindications

-Bone weakening conditions (osteoporosis, rickets, osteomalacia)
-Pregnancy *Not at any time - relaxin*
-Rheumatoid arthritis (transverse ligament laxity, Down's syndrome) unless flx and ext. views are taken
-Acute mm spasms
-Fx (even healed compression fx)
-Hypertensive disorders

73

Traction:
Dosage for cervical:
Position:

-Cervical: begin at 5% of BW and increase a max of 2lb/treatment to a max of 50lbs never exceeding patient tolerance
-Position: C2-C7 Flx. 25-28 degrees. C0-C1 neutral or 0 degrees

*it takes 10lbs to overcome weight of the skull. So min = 10lbs*

74

***Traction:
Dosage for lumbar:
Position:

-Dosage: Begin = 25% of BW. Increase a max of 5lbs/treatment to a max of 150 or 50% of BW whichever comes first. Never exceed patient tolerance.

**-Position: Supine with legs flexed and knees flexed AKA: 90/90 Traction or Goucher's position (Relaxes mm, flattens lumbar curve)**

75

**Cryotherapy:
Action:

Hypothermal - removes heat and reduces tissue temp.

Uses: Life-threatening fever.

*avoid BP Problems*

76

Cryotherapy:
Physiological Effect: Local and Systematic

Local:
-Vasoconstriction (followed by vasodilation **Hunting-Lewis Reaction**)
-Decrease capillary pressure
-Edema reduction
-decreased nerve metabolism
-anesthetic to the nervous system

Systemic:
-incr. BP
-Decr. Blood flow

77

***Cryotherapy:
Contraindications:

-Circulatory compromise (Raynauds, Beurgers)
-Patient hypersensitive to cold (elderly)
-Frostbite
-Chillblains - after Fb (use + pole galvanize)
-HBP

78

Cryotherapy:
Types:

-ice packs (1 towel layer for 20 min.)
-Blue Ice (1 towel layer for 20 min)
-Ice immersion - 10-15 minutes**
-Vapocoolant sprays flouromethane (ethyl chloride) flexible keep 14-18" away from patient
-Cryokinetics -ice massage for 5 min. and ROM or movements