DPT 5000 Quiz 1

Question 1

Elements of the Patient/Client Management Model

Answer 1

Examination  --> gather data
Evaluation --> analyze the date
Diagnosis --> PT DIAGNOSIS
Prognosis/ Plan of Care --> determine pt's potential goals
Intervention -->
Outcomes --> Results/ Discharge pt

Question 2

Functions of Bone

Answer 2

1. Support
2. Protection of Vital Organs
3. Mechanical Leverage
4. Storage for Minerals (calcium)
5. New blood cell formation - bone marrow

Question 3

Cortical Bone; % of skeleton; Constructed with what two structures?

Answer 3

(Compact or Dense Bone)
80% of Skeleton
Lamellae w/ Haversion canal
Canaliculi (Volkmann's)
Thicker in the middle of long bones for added strength

Question 4

Lamellae

Answer 4

Collagen fibers forming concentric rings

Question 5

Haversion canal

Answer 5

Core center of lamellae, contain blood vessels and nerves (need to know for healing) –> allows for circulation

Question 6

Canaliculi (Volkmann’s)

Answer 6

Tiny canals within lamellae for diffusion of nutrients and waste to and from haversian canals

Question 7

Cortical Bone- X-ray Images

Treatments (Cortical Screws)

Answer 7

X-ray shows more dense white–> representing thicker bone

Orthopaedic surgeons try to anchor screws to cortical bone (cortical screws). Goes through both side of hard bone.

When bone is broken and treated with rod implant –> bone is weight bearing!

Question 8

Medullary Canal

Answer 8

• Manufacturing of RBCs in children, contains yellow fatty marrow in adults.
• Ream out and place metal rods for fixation of fxs & amp; joint replacement stems
• X-ray examples: femur fx, tibia fx, Total Hip Replac, THA w/ fx from inserting stem

Question 9

Periosteum

Answer 9

Fibrous membranes that cover bones, (pain) nerves, and blood vessels pass thru.

• Contains pain nerves so trauma to bone is very painful.
• This is what you palpate (tibia, elbow, skull, malleoli)
• Fx through periosteum very painful. Thicker in children, so fractures are sometimes less serious than adults.

Question 10

Cancellous (spongy) Bone; % skeleton; Structure

Answer 10

20% of skeleton
Lamallae deposited in parallel (vs concentric rings)–> called Trabeculae- irregular arranged w/ lattice work or woven mesh.
Bone marrow contained between layers of mesh. Thin layers, but show layers of bone stress (hip x-ray)

Question 11

Where is cancellous bone located and what areas have the highest density.

Answer 11

Found @ end of long bones, near joint.
Highest Density: Proximal femur, distal radius, vertebral body.

These are often the sites of osteoporosis fracture

Question 12

Cancellous bone fractures

Answer 12

Bone becomes compacted w/ fxs and can be more difficult to manage.
Impaction or compression fxs.
X-ray examples: tibial plateau fx, femoral neck fx, thoracic vertebrae compression fx, humeral head dislocation

Question 13

Compression Fractures

Answer 13

Cancellous bone is susceptible to these. (Rather than snapping fractures)

• WAY more difficult to manage
• long time b4 weight bearing

Question 14

Osteoarthritis Breaks

most common where?

Answer 14

Hip, Wrist, Spine

Question 15

Use of Medullary Canal for treating fractures

Answer 15

• Ream out and place metal rods for fixation of fxs & joint replacement stems
• Old method of fx management: traction & bedrest for 3mo.
• New method: rod fixation and discharge in 2-3 days.

Question 16

Bone Parts

Answer 16

1. Diaphysis
2. Epiphysis
3. Epiphyseal Plate

Question 17

Diaphysis

Answer 17

Long axis of bone. Compact bone surrounding medullary canal.
In adults, canal contains marrow and yellow fat which can break off and enter the veins in the form of globules.
–> which lodges in arteries of lung forming a pulmonary emboli (fat vs blood clot)

Question 18

Epiphysis

Answer 18

• bone ends. Thin layer of compact bone surrounding interior of spongy bone.

Question 19

Epiphyseal Plate

Answer 19

Growth plate.

AKA Salter-Harris plate

Question 20

Bone Growth

Answer 20

Diaphysis= primary development growth

Epiphyseal plate= secondary growth centers that fuse @ end of puberty and represents end of growing

Question 21

Epiphyseal Plate fractures vs. non-fracture

Answer 21

X-ray of open epiphysis can be mistaken for fractures

Salter-Harris fracture- through growth plate must be managed properly or it will stunt growth of that bone

Question 22

Articular Cartilage

And what disease involves this cartilage?

Answer 22

Cushions bone ends and absorbs stress @ joints.

Degenerative joint disease (DJD) is wearing away of cartilage.

Question 23

What is a PTA

Answer 23

Physical THERAPIST assistant

Question 24

Components of preferred PT-PTA team that promote efficient, high faulty patient/cline care.

Answer 24

1. Pt needs suppressed team needs
2. Ea. professional being knowledgeable of rules that apply to one’s own role and the other’s role within the team.
3. Ability to recognize when the team isn’t working.
4. Acknowledging tendencies, preferences and pet peeves.

Question 25

PT/ PTA Relationship Roles

Answer 25

-PT directs PTA to perform selected interventions -PT provides ongoing supervision as needed and mandated by law -PTA performs tasks w/ patient PTA documents performance/ response PT- retains ultimate responsibility Both responsible for following state and APTA regulations

Question 26

What should be considered when determine PT/PTA involvement?

Answer 26

1. Predictability of consequences 2. Stability of situation 3. Observability of basic indicators 4. Ambiguity of basic indicators 5. Criticality of results 6. Purpose of dimension Instrumental or Expressive functions of tasks? 7. Locale dimension

Question 27

Explain the purpose of the Guide to Physical Therapist Practice

Answer 27

- It describes the PT practice (who PTs are and what their role is in healthcare) - Explains the settings in which we work - Standardizes Terminology - It reviews our education

Question 28

Define the primary components of the ICF Model

Answer 28

"Health Condition" (Disorder/Disease/Pathology/Condition) Diabetes, pregnancy, fracture, etc. "Functioning and Disability" Body Functions and Structures Impairments Activities Limitations Participation Restrictions "Contextual Factors" Personal Factors Environmental Factors

Question 29

Global purpose(s) for using ICF model terminology in PT practice?

Answer 29

It standardizes the terminology that we use so that it is clear and understandable across disciplines.

Question 30

Elements of the Patient/Client Management Model

Answer 30

PT Examination- Pt history, previous notes, gather data via pt interview/tests Evaluation- analyze data PT diagnosis- impairments, activity limitations Prognosis/ Plan of Care- identify patient's potential goals Intervention- Outcomes- Results/ Discharge patient

Question 31

Data to be gathered during a Patient History

Answer 31

``` Activities and Participation Current Condition(s) Family Hx General Demographics General Health Status Growth and Development Living Environment Medical/Surgical Hx Medications Other clinical tests? Review of Systems Social/Health Habits Social History ```

Question 32

Primary Care

Answer 32

1st line of care (sees patient 1st) | Family Physician, Family Dentist

Question 33

Secondary Care

Answer 33

Referred care | Pharmacist (who is referred to)

Question 34

Tertiary Care

Answer 34

Specialized Team | Burn-unit team, transplant team

Question 35

Primary Prevention

Answer 35

Screenings; blood pressure, weight, scoliosis

Question 36

Secondary Prevention

Answer 36

Preventing further injury when a patient already has a health issue (splinting a fx, providing medication for strep throat)

Question 37

Tertiary Prevention

Answer 37

``` optimizes what the patient can do, environment/equipment modifications- modify living Slow progression (ex. Cerebral Palsy) ```

Question 38

What is included in the Guide to Physical Therapist Practice

Answer 38

- What is a PT and what is their role in healthcare - The general accepted elements of patient/client management provided by PTs - Types of tests and measures used by PTs as part of examination for specific client/patient diagnostic groups - Types of interventions provided by PTs, and what the anticipated goals are of these interventions - What the desired outcome is of patient/client management provided by PTs

Question 39

Trabeculae

Answer 39

Irregular arranged w/ lattice work or woven mesh.