Exam 2 Flashcards
(143 cards)
1
Q
What is a Burn Injury?
A
Heat exposure for a prolonged time damages the skin: thermal, electrical, radiation, and chemical.
Includes destruction of the different layers of the skin and structures within the skin.
2
Q
What are the four degrees of burn injury?
A
- First Degree
- Second Degree
- Third Degree
- Fourth Degree
Each degree varies in depth and severity of damage.
3
Q
What are the characteristics of a 1st Degree Burn?
A
Superficial, flash burn/sunburn, pain & tenderness, redness, heals in +7 days.
This type of burn affects only the outer layer of skin.
4
Q
What are the characteristics of a 2nd Degree Burn?
A
Partial thickness: superficial or deep, exquisitely tender, blisters, slow capillary refill, heals in 14-21 days.
This type of burn affects both the outer layer and part of the underlying layer of skin.
5
Q
What defines a 3rd Degree Burn?
A
Full thickness, anesthetic, white or leathery, clotted vessels.
This type of burn destroys both the outer layer and underlying layers of skin.
6
Q
What is a 4th Degree Burn?
A
Structural involvement, causes are similar to 3rd degree injuries, anesthetic, charred or skeletonized.
This burn extends into muscle and bone.
7
Q
What is included in the medical treatment during the emergent phase of a burn injury?
A
- Gentle cleansing
- Debridement
- Fluids
- Tetanus update
- Transfer to specialized burn center
- Wound closure efforts
These interventions are critical for managing severe burn injuries.
8
Q
What are common assessment tools used after thermal injury?
A
Assessment concerns include:
* Biomechanical frame of reference
* Evaluation with wounds exposed
* Consideration of etiology, depth, & TBSA involvement.
Associated injuries or trauma must also be identified.
9
Q
What is Total Body Surface Area (TBSA) involvement?
A
Percentage of body that is injured.
TBSA is crucial for assessing the severity of burns.
10
Q
What are the psychological concerns associated with burn injuries?
A
- Pain
- Fear & anxiety
- Grief & depression
- Anger & irritability
- Sleep changes
- Intrusive memories
Psychological effects can significantly impact recovery.
11
Q
What are some common interventions used after thermal injury?
A
- Positioning needs
- Orthotic devices
- Pain management
- Therapeutic exercises
- Functional mobility retraining
- Scar management
These interventions aim to improve recovery and function.
12
Q
What is the average time for scar maturation after a burn?
A
6 months to 2 years.
Immature scars are red, raised, and rigid; mature scars are pale, smooth, and pliable.
13
Q
What are the characteristics of Rheumatoid Arthritis (RA)?
A
- Systemic
- Symmetrical, polyarticular joint pain
- Persists more than 60 days
- Typically involves at least 3 joints.
Commonly affected joints include MCPs, PIPs, wrists, knees, and elbows.
14
Q
What are the classifications for Rheumatoid Arthritis?
A
- Type I: Acute inflammatory process that resolves
- Type II: Persistent disease without long-term consequences
- Type III: Progressive with radiologic changes.
Disability classifications also exist, ranging from full occupation performance to limited abilities.
15
Q
What are the signs and symptoms of Rheumatoid Arthritis?
A
- Fatigue
- Generalized weakness
- Weight loss
- Vague musculoskeletal symptoms.
Onset may be sudden and vary among individuals.
16
Q
What is Osteoarthritis (OA)?
A
Degenerative joint disease (DJD), prevalence correlates with age, affects axial and peripheral joints.
Risk factors include heredity, obesity, joint abnormalities, and overuse.
17
Q
What are common interventions for arthritic conditions?
A
- Medications (pharmacological and non-pharmacological)
- Self-care/ADLs
- Range of motion exercises
- Strengthening exercises
- Orthotic devices.
Education on self-management and joint protection is also crucial.
18
Q
What are the benefits of pressure therapy in scar management?
A
- Accelerates scar maturation
- Flattens scar
- Increases scar pliability
- Decreases blood flow
- Decreases edema.
Pressure therapy should be worn for 22-23 hours/day.
19
Q
What is the goal of using orthotic devices?
A
Reduce inflammation, provide support/reduce pain, prevent unwanted motion, increase ROM or prevent deformity, position joints for function or occupations, restrictive devices for deformities.
Examples include finger splints, figure-of-8, ulnar drift, and thumb CMC and spica splints.
20
Q
What are some methods included in the treatment of arthritis?
A
Education, environmental modifications, assistive devices, physical agent modalities.
Education includes energy conservation and joint protection principles.
21
Q
What is osteoporosis?
A
A metabolic bone disorder characterized by accelerated bone resorption and slowed bone formation, leading to loss of bone mass and increased fracture risk.
22
Q
Approximately how many Americans are affected by osteoporosis?
A
About 30 million Americans.
23
Q
What are the common causes of osteoporosis?
A
Age-related factors, inadequate calcium intake, estrogen deficiency, inactivity, medications, and hormonal imbalances.
Medications include corticosteroids, anti-seizure drugs, and anti-coagulants.
24
Q
Who is most frequently affected by osteoporosis?
A
Caucasian women 50 years or older who are post-menopausal with inadequate dietary calcium intake.
25
What are some symptoms of osteoporosis?
Typically no early symptoms; may include bone pain, spinal compression fractures, loss of height, and fractures with little or no trauma.
26
What are some therapeutic exercises recommended for osteoporosis?
Weight-bearing exercises, strength training, balance exercises, and endurance building activities.
## Footnote
Examples include walking, dancing, Tai Chi, or yoga.
27
What is a common complication after amputation?
Infection, delayed healing, hypersensitivity, limited range of motion, neuroma, scar adherence.
## Footnote
Alienation of the residual limb is also a concern.
28
What is meant by 'phantom limb sensation'?
The perception of the presence of an amputated limb, most common in traumatic amputations.
29
What is the purpose of prosthetic programs?
Provide emotional support, instruct in limb hygiene, maximize limb shrinkage, desensitize the residual limb, and retrain ADLs.
30
What are the four phases of rehabilitation for limb loss?
Phase 1: Perioperative, Phase 2: Pre-Prosthetic, Phase 3: Prosthetic Training, Phase 4: Advanced Training and Lifelong Care.
31
What is a 'body-powered prosthesis'?
A prosthesis controlled by body power, using a system of cables and harness.
32
What are the levels of upper limb loss?
Upper limb loss is less prevalent than lower limb loss, with specific types including transradial and transhumeral prostheses.
33
Fill in the blank: Osteoporosis leads to _______ of bone mass.
loss
34
True or False: Osteoporosis affects men and women equally.
False
35
What are some anticipated problems for individuals with limb loss?
Loss of motion, strength, coordination, dexterity, sensory loss, phantom pain, cognitive difficulties, and intrapersonal issues like frustration and depression.
36
What types of assessments are used for individuals with limb loss?
Muscle strength, range of motion, gross/fine motor skills, pain assessment, self-concept, and ADLs/IADLs.
37
What is the significance of weight-bearing exercises for osteoporosis?
They are essential for maintaining bone mass and reducing fracture risk.
38
What are some fall prevention strategies for individuals with osteoporosis?
Use of adaptive equipment, home modifications, pain medications with caution, and regular vision checks.
39
What is the difference between initial and definitive prosthesis?
Initial prosthesis is temporary and accommodates changes; definitive prosthesis is final for a mature residual limb.
40
What are the components of therapeutic exercises?
Positioning, Wound care & dressings, Limb shaping, Don/doff prosthesis, Prosthetic operation, Bimanual training, Posture
41
What are key aspects of wound care and scar management?
Protect wounds & areas of skin coverage, Edema control, Compression dressings or garments, Massage
42
What is the purpose of range of motion exercises after amputation?
To proximal uninvolved joints, To residual joints around level of amputation, Monitor and correct poorly executed substitutions, Orthotic devices
43
List methods of pain management.
* Medications
* Modalities
* Graded motor imagery
* Alternative treatments
44
What initial techniques are used for desensitization in pain management?
* Gentle tapping
* Massage
* Skin/scar mobilization
* Lubrication
45
What are medical interventions for phantom limb pain?
* Analgesics
* Nerve blocks
* Neurectomies
46
What rehabilitation methods can help with phantom limb pain?
* Mirror therapy
* Thermal modalities
* Limb percussion
* Ultrasound
* Acupuncture
* Psychotherapy
* Hypnotherapy
* Relaxation techniques
47
What factors are assessed in a functional assessment?
* Home tasks and environment
* Work duties and environment
* Community mobility and integration
* Recreational interests
48
What psychological issues may arise after amputation?
* Post-traumatic stress disorder (PTSD)
* Anxiety
* Depression
* Grieving and adjustment to disability
* Fear of community engagement
* Substance abuse issues
* Perceived quality of life
49
What are the intrapersonal and interpersonal aspects of psychological support?
* Intrapersonal: Adjust to disability, Learning new ways of task completion
* Interpersonal: Social engagement, Support group attendance
50
What are key components of the pre-prosthetic phase?
* Wound closure
* Scar control
* Ongoing education
* Ongoing physical interventions
* Continued psychological support
* Myoelectric site testing and training
* Prosthetic options
51
What factors are considered when prescribing a prosthesis?
* Residual limb factors
* Preference for cosmesis & function
* Hand dominance
* ADL/IADL/work/play/leisure needs
* Motivation & attitude
* Financial concerns
* Cognitive status
* Fitting upper limb within one month
52
What is the ideal pediatric timeline for congenital limb absence?
* 6 months: evaluation and passive device
* 18 months: electrically powered options
* 3 years: activity-specific and/or body-powered
53
List key aspects of prosthetic education.
* Proper terminology
* Proper operation
* Control strategy
* Device limitations
* Precautions
* Appropriate care of device
54
What are basic skills and ADLs that need to be retrained?
* Donning/doffing
* Wear schedule
* Control training
* Repetitive drills
* Functional training
55
What self-care skills are important for work and leisure?
* ADL/IADL retraining
* Modifications and alternative methods
* Functional skills with prosthesis
* Assistive devices and/or orthotics as needed
* Work simulation
* Modified tools
* Explore options
* Explore interests
* Practice skills
* Adaptations or modifications
56
What are the goals of advanced training in rehabilitation?
* IADL engagement
* Leisure skills
* Social engagement
* Return to work (or school)
* Routine follow-up X 6 months
* Continuing education
* Lifelong care
57
What indicators show discharge readiness?
* Normal muscle strength
* Proficiency in care of residual limb
* Knowledge of prosthetic function
* Independent don/doff of device
* Independent operation of device for function
* Safe use of prosthesis
* Improved self-care skills & home management
* Participation in work & leisure (school & play)
58
What resources are available for amputees?
* Amputee Coalition: www.amputee-coalition.org
* Arm Dynamics: www.armdynamics.com
* Handwriting for Heroes: www.handwritingforheroes.com
59
List resources for sports and athletics for amputees.
* Challenged Athletes Foundation: www.challengedathletes.org
* Crossroads Adaptive Athletic Alliance: www.crossroadsalliance.org
* NubAbility Athletics: www.nubability.org
* Move United: www.moveunitedsport.org
60
What are the common orthopedic spinal diagnoses?
* Cervical Strain
* Low Back Pain
* Spinal Stenosis
* Herniated Nucleus Pulposus
* Cauda Equina Syndrome
* Cervical Spondylosis
* Degenerative Disc Disease
* Spinal Radiculopathy
61
What are symptoms of cervical strain?
* Cervical pain
* Decreased motion
* Muscle spasm
* Muscle tenderness
* Normal neuro exam
62
What causes low back pain?
* Strain
* Sprains
* Inflammation
* Degeneration
63
What are red flags associated with low back pain?
* Fever/chills
* Radiculopathy
* Abnormal neurological exam
64
What is spinal stenosis?
Narrowing of spinal canal resulting in cord/nerve root compression
65
What are symptoms of herniated nucleus pulposus?
* Neck/back pain
* +/- extremity pain
* Paresthesia
* Segmental weakness
* Decreased motion
* Spinal tenderness
66
What is cauda equina syndrome?
Compression due to large disc herniation causing lower extremity numbness, weakness, and bowel/bladder dysfunction
67
What are common procedures for spinal conditions?
* Spinal Decompression
* Discectomy
* Kyphoplasty
* Scoliosis Correction
* Spinal fusion
* Spinal Osteotomy
68
What are the signs of spinal radiculopathy?
* Pain
* Numbness and/or tingling in extremities
* Localized neck or back pain
* Weakness in the muscles controlled by the affected nerves
69
What are the cognitive impairments related to spinal conditions?
* Need to comprehend and apply back precautions and body mechanics
* Pain may hinder thinking and problem-solving
70
What interventions are recommended for spinal conditions?
* Rest
* Resolve edema and inflammation
* Pain management
* Targeted exercises
* Bracing
* Activity modification
* Adaptive equipment
* Weight control
* Education
71
What are spinal precautions to be followed?
* Bed mobility: log rolling in/out of bed
* Pushing or pulling
* Lifting >10 pounds
* Twisting the spine
* Bending the spine
* Crossing legs
* Sitting for hours
* Abdominal crunches
72
What is Degenerative Disc Disease?
Decreased mechanical properties of spinal structures.
## Footnote
Ligaments and facets carry greater load, resulting in back pain without radiculopathy.
73
What are common symptoms of Spinal Radiculopathy?
* Pain
* Numbness and/or tingling in extremities
* Localized neck or back pain
* Hypersensitivity to light touch
* Weakness in the muscles controlled by the affected nerves
## Footnote
Indicative of nerve irritation or damage.
74
What is Cervical Radiculopathy?
Cervical spine involvement with irritation/damage to nerves at spinal exit impacting upper limb function.
## Footnote
Symptoms include neck pain with activity, weakness, and sensory loss.
75
What is Lumbar Radiculopathy?
Lumbar spine involvement with irritation/damage to nerves at exit from spine impacting lower extremity function.
## Footnote
Symptoms include localized compression site pain, possible radiation down the leg, weakness, and loss of sensation.
76
What is Sciatica?
Compression due to multiple different causes leading to constant pain in buttock or posterior leg, especially when sitting.
## Footnote
Symptoms include burning or tingling down the leg, numbness, weakness, and shooting pain when standing.
77
What is Spondylolysis?
Defect or fracture of pars interarticularis, common in hyperextension sports, especially in pediatrics.
## Footnote
L5 is the most common site with insidious onset LBP and pain worsening with activity.
78
What is Spondylolisthesis?
Slippage of vertebra on adjacent vertebrae, common in children due to defective vertebra or trauma.
## Footnote
Risk factors include family history and repetitive spinal hyperextension.
79
What are the symptoms of Spondylolisthesis?
* Insidious onset of LBP
* Pain worsens with activity & spinal hyperextension
* Tightness of the hamstrings
* Decreased range of motion of the lower back
* +/- radicular symptoms
* Loss of control of bowel or bladder function
## Footnote
May indicate cauda equina syndrome.
80
What is Scoliosis?
Lateral bending and/or rotation of the spine leading to gross or subtle spinal deformity.
## Footnote
Symptoms may include asymmetry of the back and +/- pain.
81
What imaging studies are commonly used in spinal assessments?
* Computed tomography (CT) scans
* Magnetic resonance imaging (MRI)
* Nerve conduction studies (NCVs)
* Radiographs/X-rays
* Myelogram
* Selective nerve root block
* Electromyography (EMG)
## Footnote
These studies help in diagnosing spinal conditions.
82
What is the purpose of Spinal Decompression procedures?
Release of entrapped nerve through procedures like laminectomy, laminotomy, foraminotomy, and laminaplasty.
## Footnote
These may require fusion or hardware.
83
What are common interventions for spinal conditions?
* Rest
* Resolve edema and inflammation
* Pain management
* Targeted exercises
* Bracing
* Activity modification
* Adaptive equipment
* Weight control
* Education
## Footnote
These interventions aim to improve function and reduce pain.
84
What is the significance of Body Mechanics in spinal health?
Good body mechanics are needed long-term to maintain proper spinal alignment and avoid injury.
## Footnote
Techniques include positioning the body close to the task and using hip flexors/extensors.
85
What are the common bones that make up the Shoulder Complex?
* Humerus
* Clavicle
* Scapula
## Footnote
These bones form the three joints: GH, AC, and SC.
86
What is the GH Joint?
A ball-and-socket joint formed by the glenoid of the scapula and the humeral head, contributing most to shoulder movement.
## Footnote
Full motion is not possible without rotator cuff muscles.
87
What is the Scapulohumeral Rhythm?
Kinematic interaction between scapula and humerus where arm movement to scapular movement is 2:1.
## Footnote
This rhythm helps prevent impingement between humerus and acromion.
88
What are the assessment components for the shoulder?
* Patient History
* Physical Examination
* Range of Motion
* Strength assessments
* Neurovascular checks
## Footnote
History includes age, occupation, sport/hobby, handedness, and pain assessment.
89
What are common shoulder injuries?
* Clavicle Fracture
* Scapula Fracture
* Proximal Humerus Fracture
## Footnote
Each injury has specific signs, symptoms, and treatment strategies.
90
What is the common treatment for a Clavicle Fracture?
Closed reduction for simple injuries followed by immobilization for 6-8 weeks and progressive rehabilitation.
## Footnote
Severe injuries may require ORIF.
91
What is the immobilization period for scapula fractures?
X 6-8 weeks
## Footnote
Followed by progressive rehabilitation & sling for 2-4 weeks
92
What is a common cause of proximal humerus fractures?
Direct trauma or FOOSH
## Footnote
Common in elderly & those with osteoporosis
93
What are the signs and symptoms of a scapula fracture?
* Swelling
* Tenderness
* Decreased motion
## Footnote
Risks of neurovascular injuries or non-union
94
What risk factors are associated with proximal humerus fractures?
* Stiffness
* Avascular necrosis
* Brachial plexus injury
* Axillary nerve damage
* Non-union of fracture site
95
What is the common treatment for humerus shaft fractures?
Conservative treatment = casting/bracing
96
What signs indicate sternoclavicular injuries?
* Anterior dislocation
* Joint laxity or deformity
* Loss of motion
* Neurovascular changes
97
What is the treatment duration for acromioclavicular injuries?
X 1-4 weeks
## Footnote
Treatment includes ice, sling, and/or taping
98
What are the signs and symptoms of a glenohumeral sprain?
* Pain/tenderness
* Limited ROM at end ranges
* Laxity
99
What is a Bankart Lesion?
Complete detachment of anterior labrum associated with anterior glenohumeral dislocation
100
What are the signs and symptoms of a bicep rupture?
* 'Snap' & intense pain
* 'Popeye' sign
* Weak elbow flexion & supination
101
What is a common treatment for shoulder bursitis?
* Rest
* Ice
* Ultrasound
* NSAIDs
* Strengthening when pain-free
102
What characterizes adhesive capsulitis?
Reversible contracture of joint capsule
103
What are some risk factors for rotator cuff pathology?
* Repetitive overhead activities
* Anatomical variants
* Poor posture
* Older age
104
What is the primary function of the elbow?
To position the hand in space
105
What are the three main ligaments of the elbow?
* Medial collateral ligament (MCL)
* Lateral collateral ligament (LCL)
* Annular ligament
106
What is the purpose of elbow bursae?
Facilitate movement & reduce friction
107
How does the elbow stabilize dynamically?
Muscles crossing elbow joint (Anconeus, Brachialis, Triceps)
108
What are the muscles responsible for elbow flexion?
* Biceps brachii
* Brachialis
* Brachioradialis
* Pronator teres
109
What is the positive test for Cozen's Test?
Pain over lateral epicondyle or in extensor compartment
110
What injuries can occur from a fall on the elbow with it flexed?
Olecranon fracture
111
What is the treatment for radial head fractures?
* Non-operative: Sling X 3 days
* Progressive elbow motion
* Strengthening
112
What is the common name for lateral elbow tendinopathy?
Tennis elbow
113
What is cubital tunnel syndrome?
Ulnar nerve compression at cubital tunnel
114
What is the treatment for olecranon bursitis?
* Rest
* Reduce trauma
* Monitor motion and strength
115
What are common fracture types?
* Transverse
* Spiral
* Oblique
* Comminuted
* Segmental
116
What is the difference between open and closed fractures?
Open fractures involve bony penetration of the skin
117
What is the treatment for distal humerus fractures?
* Closed reduction & cast immobilization
* Pain management
* Progressive motion & strengthening
118
What are the signs and symptoms of medial elbow tendinopathy?
* Pain over medial epicondyle
* Weakness in wrist flexors
119
What is a prerequisite to hand therapy?
Stability
## Footnote
Stability is essential for effective rehabilitation following injuries.
120
Name three types of concomitant soft tissue injuries.
* Peripheral nerve injury
* Joint or ligamentous injury
* Aggravation of pre-existing conditions
121
List the types of fractures.
* Transverse
* Spiral
* Oblique
* Comminuted
* Segmental
* Impacted
* Avulsion
122
What is the difference between open and closed fractures?
Open fractures involve bony penetration of the skin; closed fractures do not.
123
Define closed reduction.
No opening of soft tissues; manipulation and application of a device to maintain fracture reduction.
124
What is the purpose of open reduction?
Used for severe injuries or when closed techniques fail.
125
What is required for fracture healing?
Blood supply and structural stability.
126
Describe the three-phase process of fracture healing.
* Inflammatory Phase: Immediate cellular and vascular responses, formation of hematoma
* Repair Phase: Removal of damaged cells, replacement with callus, conversion of callus to bone tissue
* Remodeling Phase: Replacement and reorganization of repaired tissue
127
What factors affect fracture healing?
* Vascularity of bone
* Fracture characteristics
* Presence of disease
* Volume/width of defect
* Age
128
What is the healing time for a distal radius (non-displaced) fracture?
4 weeks
129
What indicates clinical healing at a fracture site?
No pain or tenderness over the fracture site.
130
What are the goals of treatment after a fracture?
* Maintain fracture stability
* Prevent edema, joint stiffness, tendon adhesions, and loss of function
131
What are the methods for edema control?
* Elevation
* Gentle active motion
* Retrograde massage
* Cold modalities
* Continuous, light, and even compression
132
What is the purpose of maintaining motion after a fracture?
To prevent stiffness, edema, and decreased functional use.
133
What is a Galeazzi fracture?
Distal 1/3 of radius with distal radio-ulnar joint (DRUJ) dislocation.
134
What are the symptoms of a scaphoid fracture?
* Pain
* Swelling
* 'Snuffbox' tenderness
* Decreased motion
135
What are the symptoms of a Grade III sprain?
Complete tear; gross joint laxity, unstable joint.
136
What is skier's thumb?
Ulnar collateral ligament (UCL) injury caused by forced radial deviation of the extended thumb.
137
What distinguishes a dislocation from a subluxation?
Dislocation is a complete separation of bones in a joint; subluxation is a partial dislocation.
138
What are the symptoms of dislocations?
* Visible deformity
* Swelling
* Discoloration
* Intense pain
* Immobility
* Tingling or numbness
139
What is the treatment for dislocations?
* Rest the joint
* Apply ice followed by heat
* Pain relief
* Gentle exercises to maintain ROM and strength
140
What are the three phases of fracture management?
* Phase I: Edema control, pain management, active motion of uninvolved joints
* Phase II: Active motion of involved structures, light functional activities
* Phase III: Corrective contracture management, active/passive exercises to restore motion
141
What are the common complications of radius fractures?
* Carpal tunnel syndrome
* Malunion
* DRUJ dysfunction
* Osteoarthritis
* EPL tendon rupture
* Stiffness
* Contractures from prolonged edema
* Complex Regional Pain Syndrome (CRPS)
142
What is meant by delayed union in fracture healing?
May occur due to poor bone quality, displaced fractures, or open reductions.
143
Complete the statement: Healing timelines, soft tissue tolerances, client-related factors, and ______ dictate interventions.
[functional goals]
