Chiro - PT Boards Flashcards
(78 cards)
1
Q
Heating modalities: Deepest to shallow
A
- Ultrasound
- Short wave diathermy
- microwave diathermy
- IR
- Ultraviolet
2
Q
Ice Modalities: Best to worst
Used in acute cases
A
- Ice
- Positive pole of Low Volt Galvanic
- Pulsed Ultrasound
- PRICE
3
Q
Subacute phase (eliminate edema) modalities
A
- Contrast therapy
- Pulsed ultrasound
- Interferential
4
Q
Subacute Exercise
A
- Stretching/passive/ROM
- Isometric exercise
5
Q
Chronic Rehab
A
Warm up/ use heat modality
6
Q
Target HR Equation
A
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
Q
Williams Exercises
A
- Sit ups and Crunches
- Pelvic Rocks/Tilt
- Knee to Chest
8
Q
Aerobic Exercise is in what range of Max HR?
A
60-90%
9
Q
Aerobic Exercise must be for at least how long?
A
15-20 minutes
10
Q
Aerobic Exercises
UBC = Upper Body Cycle –> used for people with what problems?
A
Lumbar Problems
11
Q
Williams Approach says that all activities should b geared towards ____ lumbar lordosis
A
Reducing/decreasing Lumbar Lordosis (Flexion)
12
Q
McKenzie Approach is a spinal assessment and therapy based on the behavior of pain and mechanical response to ____ loading
A
Dynamic and static loading
13
Q
Postural Pain Syndrome =
A
End range stress of normal structures
14
Q
Dysfunction pain syndrome =
A
end range stress leading to contracted of adherent structures
15
Q
Derangement Pain Syndromes=
A
anatomical disruption or displacement of structure “herniated disc”
16
Q
Plyometric Exercises -
A
- Box Drills
- Depth Jumps
- Jumps
- Hops
- Bounds
17
Q
Acute Care mngmt
-First 4 weeks
A
- Ice
- pole LVG
- Pulsed US
- Price
18
Q
Plyometrics based on concept of power
Equation for power?
A
Force x Speed = Power
19
Q
Chronic phase starts after ___ weeks
A
12
20
Q
Chronic phase therapy - >12weeks
Therapies:
A
-Strengthening
-Heat/warm-up
-Stretch the decreased ROM places
Mensuration and Wexler Scale for quantitative measurements
21
Q
Lower Crossed Syndrome:
MM involved and state they are in
A
Erector Spinae - Tight/Fascilitated
Iliopsoas - Tight/Fascilitated
Glut. Max - Weak/Inhibited
Abs - Weak/ inhibited
22
Q
Toe in or out for VMO during leg extensions?
A
Toe Out
23
Q
Upper Crossed Syndrome:
MM involved and their state
A
Deep neck Flexors/Longus Coli - Weak
Lower Trap/ Serratus Anterior - Weak
Pectoralis - Tight
Upper Trap/Levator Scap - Tight
24
Q
Usual Tight Mm:
A
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
