Exam 1 Flashcards
(125 cards)
1
Q
What are the key patient supervision skills?
A
-Teamwork
-Seek, understand, and relay information
-To the PT and Team
-Have a warm personality
2
Q
What are Cardiovascular red flags?
A
-Chest pain, L UE pain, or any symptoms of an MI
-Pulsating Pain
-Constant, severe LE pain
3
Q
What are the red flags for cancer?
A
-Chronic night pain
-Constant pain unrelieved by position/activity
4
Q
What are the Gastrointestinal red flags?
A
Frequent or severe abdominal pain
5
Q
What are the Neurological red flags?
A
Frequent or severe headaches
6
Q
What are the cardinal signs of inflammation?
A
-Pain
-Redness
-Heat
-Swelling
-Decrease in ROM
7
Q
What type of surgery have a high risk (40-70%) of the pt. developing a DVT if not given prophylaxis?
A
LE Joint Replacement
8
Q
Which test can indicate a DVT?
A
Homan’s Sign
9
Q
What are the risk factors for a DVT?
A
-Immobility
-Trauma: fx, surgery
-Hx, DM obese, hormone change
-Hypercoagulation
10
Q
What is used to calculate the risk score interpretation for DVTs?
A
Wells Prediction Rule
11
Q
What are the signs and symptoms for a DVT?
A
-Peripheral edema
-Warmth
-Skin discoloration
-Prominent superficial veins
-Leg pain
-Tenderness
12
Q
How can a PTA decrease the risk of a DVT in a pt.?
A
Get them moving
13
Q
Is Brawny (hard/chronic) edema normal?
A
Yes
14
Q
Is pitting in the edema site normal?
A
Yes
15
Q
Is bilateral edema normal?
A
No
16
Q
What is Compartment Syndrome, and where is it most commonly found?
A
It is a dangerous type of edema most commonly found in the anterior compartment of the calf.
-Pt. typically loses sensation in web space between 1st and 2nd toe
17
Q
Definition: Creating a situation by using probing questions and appropriate communication skills, accountability, listening, and responsibility, so that active responses occur rather than simply reacting once something happens
A
Proactive
18
Q
Empathy vs. Sympathy
A
-Empathy is actively trying to understand the person’s point of view
-Sympathy is more of just acknowledging that the person has certain feelings without truly trying to put yourself in their shoes and find a solution
19
Q
Does the PTA have the ultimate responsibility for the physical therapy interventions provided?
A
Yes
20
Q
What are the 5 components of patient supervision?
A
-Gather relevant information and data
-Fully understand the POC
-Assist in the management of the pt.
-Establish rapport, trust, and confidence with the pt.
-Create an environment where the pt. can feel comfortable voicing concerns about their problem
21
Q
Appropriate medical language used with the patient and their family helps to convey…
A
Understanding, sensitivity, warmth, and reassurance
22
Q
Definition: An effective communication tool that demonstrates interest and concern for the patient and their individual needs.
A
Listening
23
Q
A professional relationship with the patient should be based on…
A
Trust and respect
24
Q
Blood in urine would indicate which type of red flag?
A
Gastrointestinal
25
Symptoms
-Palpable cord (vein is hardened along its length)
-Redness
-Subcutaneous vein distension
-Warmth
Superficial Vein Thrombosis
26
Symptoms
-Discoloration or cyanosis
-Pain or tenderness of affected area
-Pain with placement of blood pressure cuff around calf inflated to 160-180
-Positive Homan's sign
-Unilateral tenderness or leg pain usually in calf
-Unilateral swelling
-Warmth of skin
Deep Vein Thrombosis
27
Symptoms
-Edema of an entire extremity (usually unilateral)
-Pain may or may not be present
-Paresthesias (tingling or prickling sensation)
-Skin is taut and shiny
-Stemmer sign (taut skin on dorsum of foot)
-Worse with dependent positions
Lymphedema
28
Type of Lymphedema where accumulation of protein-enriched fluids may be secondary to a developmental disorder of the lymphatic system.
Primary Lymphedema
29
Type of Lymphedema that is the result of obstruction or damage to the lymphatic system (nodes, vessels, and organs). Most common type.
Secondary Lymphedema
30
What is the most abundant material of Connective Tissue?
Collagen
31
What are the types of Connective Tissue?
-Bone
-Ligament
-Tendon
-Muscle
-Cartilage
-Neurovascular
32
Which type of collagen is most common; seen in tendons/ligaments, bones, mature scars, meniscus/disk): thick bundle/very strong?
Type I
33
Which type of collagen is thin supporting filaments; 1/2 life of 3 months; seen in hyaline and elastic cartilage?
Type II
34
Which type of collagen is thin filaments; strong but supple and elastic; seen in fresh scars, blood vessels prevalent in newborns)?
Type III
35
Which type of collagen is not assembled into fibers; with other fibers it forms the base membrane?
Type IV
36
What type of connective tissue is found in capsules?
Dense irregular
37
What type of connective tissue is found in ligaments?
Dense regular
38
What type of connective tissue is found in tendons?
Dense regular
39
What are the Phases of Healing?
1. Inflammatory response (acute stage)
2. Repair Sequence/ Fibroplastic (subacute stage)
3. Remodeling/ Connective tissue formation (chronic stage)
40
What is Autolytic wound debridement, and which phase of healing is it found in?
-When good cells come in to clean the area
-Inflammatory response phase
41
Exudate vs. Effusion
-Exudate is increased protein and phagocytic cells (pus)
-Effusion is fluid escaping into a compartment (knee joint)
42
When does the Repair/Fibroplastic phase of healing occur?
Approximately 5-21 days post injury
43
Characteristics of which phase of healing?
-Purpose: new tissue to integrate into the area
-Granulation tissue visible
-Angiogenesis: new blood supply to area
-Proliferation of new collagen, elastin, and proteins
-Low tensile strength of tissue at 20%; causing risk of reinjury
Phase 2: Repair/Fibroplastic
44
When does the Remodeling phase of healing occur?
2-3 weeks post injury
45
Characteristics of which phase of healing?
-Connective tissue formation
-Tissue is aligning
-Increased fibrous formation
-Maturation of scar
Phase 3: Remodeling
46
The medical term for the cardinal sign of pain is...
Dolar
47
Exudate flows into the area in which phase of healing?
Inflammation
48
Which type of cartilage is found on joint surfaces, ribs, and fetal skeletons?
Articular (Hyaline) Cartilage
49
Which type of cartilage are found at tendon/ligament insertions, and is the meniscus and disks made out of
Fibrocartilage
50
What type of cartilage is found in the external ear and trachea?
Elastic
51
Characteristics of which type of Cartilage?
-Avascular (poor healing)
-2-4 mm thick
-Frictionless
-Force distributor
-Permeable (allows gasses or liquids to pass through it)
-Type II collagen
-Nourished by synovial fluid
Articular (Hyaline) Cartilage
52
What does OATS stand for?
Autologous Chondrocyte Transplant
53
Characteristics of which type of Cartilage?
-Vascular along rims
-Mechanoreceptors
-Shock absorbing
-Contributes to joint stability
-Ex. meniscus, disk, labrum
-Type I collagen
Fibrocartilage
54
Which type of collagen is found in articular (hyaline) cartilage?
Type II
55
Which type of collagen is found in fibrocartilage?
Type I
56
Which part of the meniscus is vascularized?
The outer 10-30%
57
What do surgeons do to an injured outer 10-30% of the meniscus?
Surgical repair via arthroscopy
58
What do surgeons do to an injured inner area of the meniscus?
Partial or total meniscectomy
59
What are the Post-op precautions for a surgical repair of the meniscus?
-NWB to FWB later
-Limit flexion ROM
-Slower progression to full flexion ROM
60
What are the Post-op precautions for a meniscectomy?
-FWB early
-Progressive AROM
-Prog. Strengthening
61
What type of collagen is found in ligaments?
Type I
62
Do you sprain or strain a ligament?
Sprain
63
Do you sprain or strain a muscle?
Strain
64
Which grade of sprain?
-Microscopic tearing
-No joint laxity
-No/minimal swelling
-Local tenderness
-(-) joint stress test
Grade I
65
Which grade of sprain?
-Incomplete tearing
-Moderate joint laxity
-Localized swelling
-Pain with WB
-Ecchymosis (bleeding)
-Mild (+) stress test
Grade II
66
Which grade of sprain?
-Complete tear/rupture
-Profound joint laxity and instability
-Unable to WB
-Significant pain and swelling/ecchymosis
-Mod/severe joint stress test
Grade III
67
Do extra- or intra-articular ligaments have..
-predictable and structured healing pattern
-healing of various rates and degrees
-ultimate healed tensile strength of 50-70%
Extra-articular ligaments
68
Do extra- or intra-articular ligaments have..
-decreased spontaneous healing process
-because synovial fluid interferes with the healing process
Intra-articular ligaments
69
How long does it generally take Grade III sprains to heal?
>40 weeks
70
When do surgeons decide to surgically repair a sprained ligament?
When there is functional instability
71
Functional movement of the human body is performed by the interaction of how many skeletal muscles?
Over 600
72
What is the structure of a muscle?
Muscle > Fascicle > Myofiber > Myofibril/Sarcomere
73
What is the basic contractile unit of a muscle?
Myofibril
74
Characteristics of which type of muscle fiber..
-Red fibers
-Adapted for aerobic activity
-Fatigue resistant
Slow twitch- Type I
75
Characteristics of which type of muscle fiber..
-White fibers
-Designed for anaerobic activity
-Fatigues easily
Fast twitch- Type II
76
Which part of the muscle is strained the most?
The musculotendinous junction
77
During which type of contraction do muscle strains most typically occur?
Eccentric contraction/loading
78
What is the fastest healing of all the connective tissues?
Muscle
79
In what order are connective tissues from fastest healing to slowest healing?
Muscle > Bone > Tendon/Ligament
80
What are the goals for Muscle rehabilitation at the Acute stage?
Facilitate healing and decrease inflammation and pain
-RICE, modalities
-Controlled movement using PROM, AAROM
81
What are the goals for Muscle rehabilitation at the Subacute stage?
Restore full ROM and initiate strengthening
-Progress to AROM and stretching
82
What are the goals for Muscle rehabilitation ate the Chronic stage?
Remodeling of collagen
-Functional exercise, endurance training
-Plyometrics when pain free
83
What is tendon avulsion?
When a small chunk of bone attached to a tendon gets pulled away from the main part of the bone
84
What is Mallet Finger and how does it happen?
When the tendon of a finger is avulsed at the DIP. It happens when the DIP is suddenly and forcefully flexed
85
What is common during Tendon healing?
Adhesion formation due to vascularity from surrounding tissue
86
When is a tendon repair at it's weakest?
7-10 days post op
87
What is Tendonitis?
Inflammatory response to tendon due to injury
88
What is Tendinosis?
Degeneration of a tendon without inflammatory process
89
What is Tenosynovitis
Inflammation of a tendon's synovial membrain
90
Your patient is a 24 YO soccer player who sustained a 2nd degree strain on her gastrocnemius muscle. At what stage of rehabilitation would you expect to begin low load and high repetition strengthening?
Subacute Stage (1-3 weeks)
91
______ migrate to the injury site directly after trauma and release specific growth factors and chemical mediators, which stimulate homeostasis and initiate the repair process.
Platelets
92
What is the neovascular budding that helps reestablish oxygen-rich and growth factor-rich blood to new, fragile healing tissue?
Angiogenesis
93
The connective tissue membrane surrounding the entire muscle is called ________.
Epimysium
94
T or F: There are essentially three types of collagen found in musculoskeletal tissue.
True
95
Which phase of ligament repair occurs as the ligament retracts and looks highly disorganized?
Phase I
96
What is Ligamentization?
Tendon repair to ligament-like tissue
97
T or F: Ligaments lose up to 20% of their weight after 8 weeks of immobilization
True
98
To orient collagen fibers and promote a functional scar, _____ must be applied.
Progressive controlled stress
99
After injury or surgery to a ligament, protection against ________ must be strictly enforced.
Unwanted forces
100
What are the canals and the surrounding lamellae of bone called?
The Haversian System
101
What are Bone forming cells called?
Osteoblasts
102
What are Bone maintaining cells called?
Osteocytes
103
What are Bone matrix dissolving cells called?
Osteoclasts
104
Where is the Haversian System located?
In Cortical/Compact bone
105
How porous is Coritcal/Compact bone?
30%
106
How porous is Cancellous bone?
50-90%
107
What is the longitudinal growth of bone called?
Endochondral Ossification
108
What is the latitudinal growth of bone called?
Intramembranous Ossification
109
What is in the Medullary canal of long bones, and what happens there?
Bone marrow, and it is the cite of bone cell production.
110
What is very rich in nerve supply, and probably where we feel pain the most when we break a bone.
Endosteum and Periosteum
111
Which law states: Load intermittently applied to bone stimulates growth
Wolff's Law
112
What is the method used to grade fractures that occur in children and involve the growth plate?
The Salter-Harris Classification System
113
Which is the most common Salter-Harris fracture and what is the worry with this type of fracture?
Type II (fracture through the growth plate and metaphysis). The worry is that the bone may not grow to normal length.
114
Which is the worst prognosis of the Salter-Harris Classification System?
Type V (compression fracture through the growth plate)
115
T or F: Bone is very brittle and can tolerate small deformation.
True
116
Which form of cell is a giant cell multinucleated bone resorption cell?
Osteoclast
117
What are the two distinct forms of microscopic organization and classification of bone tissue?
-Normal, mature lamellar bone
-Weak, fragile, immature woven bone
118
Which type of bone is more commonly seen in embryos and newborns but can also be seen in adults in fracture repair callus, bone tumors, and various bon pathologies?
Woven Bone
119
T or F: Intermittent physiologic loads create osteoblastic activity.
True
120
Which law states that compression forces limit bone growth, whereas tensile stress stimulates growth?
Hueter-Volkman
121
Mature bone begins formation at about age __________, and comprises most of the skeleton by age _______.
-1 month after birth
-4 years
122
The three distinct complications of bone healing are ______.
Delayed union, nonunion, and malunion
123
T or F: Compact bone heals faster than cancellous bone
False
124
T or F: Collagen constitutes about 50% of the dry weight of bone, whereas lipids and proteins constitute the remaining 50%
False
125
Collagen makes up what percent of bone?
90%
