Flashcards in exam 3 Deck (89):
T/F: A submax GXT can be administered before hospital discharge for a post-acute MI.
true, as long as it's 4-6 days post MI and doesn't go above 70% instensity
At what times are APGAR tests taken?
1, 5, 10 minutes
- scored 2 points for each section (5 sections)
- HR. respiration, muscle tone, reflex irritability, color
What trunk motion will stress a pars defect and should be avoided?
extension and rotation
What compensations might you see from a forefoot varus when it hits the ground?
PF'ed first ray
excessive tibia/hip/pelvic IR
What exudate would be expected through use of panafil for a wound?
green/yellow exudate is expected
- foul smell is NOT to be expected
What is the most common cause of falls in the elderly?
turning around and sitting into a chair
What is a typical early clinical manifestation of CF?
excessive appetite and weight loss
What exocrine glands does CF affect?
glands of the hepatic, digestive, and respiratory systems
- hence the appetite/weight loss early clinical symptoms
NOT REALLY AN ENDOCRINE DISEASE
T/F: For patients with CF, it's typical to see both obstructive and restrictive disease components.
What would indicate an integrated ATNR reflex?
turning the head to the side and able to bring that hand to mouth on that side
- ATRN: extended arm on face side
What does a hypertrophic scar look like as compared to an atrophic scar?
hypertrophic = thick and pink
atrophic = thin and white
What type of TENS provides rapid-onset, short term pain relief during painful procedures?
brief intense TENS
What does modulated TENS do?
prevents accomodation, does not provide relief of pain
- aka not really a setting
T/F: Conventional TENS is high-rate.
- not as high of intensity as brief intense tens, and it has a longer application
If a patient has poor posture, what should you first look to correct?
see if they have a stable base: fix the pelvis first, as that often corrects a lot
Working at 60-90% of max HR is equivalent to working at what percentage of VO2 max?
If your patient experiences chest pain during acute cardiac rehab, what do you do?
angina during exercise is an indication to rest
- should improve following rest; closely monitor
What symptoms do patients with scleroderma incur?
symmetrical skin thickening and visceral involvement of GI tract, lungs, heart, and kidneys
- hypersensitivity to touch also
T/F: Multivitamins and calcium can increase fall risk.
- not multivitamins, but calcium can increase fall risk
T/F: thyroid meds commonly cause falls in the elderly.
What neural tension testing position biases the tibial nerve?
SLR with dorsiflexion and eversion
What neural tension testing position biases the sural nerve?
SLR with DF and inversion
What neural tension testing position biases the fibular nerve?
SLR with PF and inversion
T/F: Muscle wasting is a common manifestation of COPD.
At what stage of COPD is it common to see patients with supplemental oxygen?
T/F: Weight loss is common in patients with progressing COPD.
T/F: Patients with stage 3 COPD will demonstrate a decreased subcostal angle.
false: air trapped in so will have increased angle
Is the knee extended an a modified Ober or typical Ober test?
modified = knee extended
- to slack rectus femoris
What are wet to dry dressings used for?
to remove necrotic tissue
When is calcium alginate used for a dressing?
in the presence of heavy exudate
What does hydrogel do for a wound?
keeps wound moist
protects granulation buds
At what pressure level is considered low for wound irrigation?
under 15 psi
What is spondylosis?
pain d/t degeneration of the discs
T/F: Opioids may produce pulmonary hypertension.
false, produce orthostatic hypotension
What medication can cause Raynaud's symptoms to occur?
What is GBS?
inflammation and demyelination of the motor and sensory fibers of PNS
- so will have sensation issues, but often early on motor is the bigger problem
T/F: Post polio syndrome is a LMN disease with no sensory paresthesias.
- no sensory paresthesias, typically asymmetrical
T/F: MS in an LMN disease.
false: UMN with spasticity, hyperreflexia
Why is the valsalva maneuver bad for pts with cardiac disease?
when the breath holding is released, blood rushes to the heart and this can overload the cardiac system
What physiological responses occur with the valsalva maneuver?
decreased return of blood to heart
increased venous/intrathoracic pressure
DOES NOT affect heart rate
What is the rubor of dependency test and what does it identify?
rubor of dependency = for arterial insufficiency
- pallor when LE is elevated
- hyperemia when leg is dependent and hanging
What score on the functional reach test indicates a fall risk?
What is the tinetti scored out of? What indicates fall risk
out of 28 points
- <19 indicates high risk of falls
- 19-24 = moderate risk for falls
What times on a TUG test indicate fall risk?
<20s indicates low fall risk (yay, good)
>30s indicates increased risk
What is Murphy's sign?
pain with percussion over costovertebral RUQ
- for acute cholecystitis
Where would appendix pain occur?
- from rebound
What does peritoneal inflammation present like?
abdominal pain with coughing and light percussion; also rebound tenderness
What is acute cholecystitis?
acute gallbladder inflammation
How do you differentiate a grade II from grade III sprain?
grade III is so torn that there's no pain
When filling out an incident report, what pieces are necessary to include?
names of those involved
What type of wrap (short stretch or long stretch) are used for initial lymphedema management?
short stretch: have high working pressure but low resting pressure
- opposite of ace wrap, which is the long stretch
If a patient has facial involvement in a stroke, what is save to assume about the location of the stroke?
it is above the brainstem
- recall that brainstem is midbrain, pons, medulla
What is allodynia?
perception of an ordinarily painless stimulus as painful
What are the 5 things that would make you terminate an exercise session for a patient in cardiac rehab?
1) onset of angina or other indications of exertional intolerance
2) systolic >240, diastolic >110
3) >1mm ST segment depression, horizontal or downsloping
4) increased frequency of ventricular arrhythmias
5) 2nd or 3rd degree AV block
What should your frequency and duration prescription be for patients beginning a walking program for claudication?
What does a stage-2 pressure ulcer look like?
intact or ruptured serum-filled blister
If fascia, muscle, tendons, or ligaments are seen in a pressure ulcer, what stage is it?
What does a stage 3 pressure ulcer look like?
granulation tissue present, as well as adipose
- slough or eschar may be present
What does a stage 1 pressure ulcer look like?
T/F: Stage II pressure ulcer involves partial-thickness skin loss.
What is a closing restriction in the spine?
lack of extension of one vertebrae on the other
- provide central PA force at inferior vertebrae, stabilize superiorly
What is vestibular neuritis?
inflammation of vestibular nerve caused by a virus
- symptoms of dysequilibrium, nystagmus, nausea, severe vertigo
What is meniere's disease?
felling of fullness in the ears associated with abnormal fluid buildup
- tinnitus, vertigo, nausea, hearing loss are common symptoms
What lab value might be high with polycythemia vera?
- this is when there's proliferation of all bone marrow cells with in increase in number of RBCs and hemoglobin concentration
What types of exercises should patients with osteoporosis avoid?
flexion/rotation, as that can result in compression fracture
What are the two options of current for wound healing?
1) high volt pulsed current
2) low-intensity continuous low volt direct current
When would you use the prone position for lumbar traction?
for herniated disc
When would you use the hook lying position for lumbar traction?
for separation of the facets, elongating muscles, open up the intervertebral foramen
What are the positions of synergy for a stroke, both flexion and extension patterns? (UE)
flexion: shoulder abducted, elbow flexed, forearm supinated
extension: shoulder adducted and IR, elbow extended, forearm pronated
What CN is responsible for constriction of the pupils?
What are signs that you should absolutely stop a GXT on a patient? (7)
- drop in systolic <10mmHg with increasing workload
- reaching levels of BP over 260/115
- CNS signs (ataxia, vertigo, visual/gait problems, confusion)
- serious arrhythmias
- moderate to severe angina (some is expected but not to this level)
- signs of exertional tolerance (clammy, severe SOB)
- ST segment depression/elevation >2mm
T/F: Calcium alginate dressings do NOT allow rapid evaporation.
What dressing provides semirigid support for the limb while maintaining a sterile field?
What kind of environment should be avoided for patients on antipsychotic/depressant meds?
What is the capular pattern for TMJ?
limitation on opening, lateral devation greater to the uninvolved side, and deviation on opening to the involved side
If the L lateral pterygoid was weak, what direction would deviation be with mouth protrusion?
deviation to the R
- remember that lateral pterygoids assist with mouth opening (the only one of those muscles)
- so it'll deviate to the opposite side of weakness
What does a capsular pattern of the c-spine look like?
side bend and rotation equally limited
What are the hallmark findings of Horner's syndrome? (3)
miosis (pupillary constriction)
anhydrosis (lack of sweating)
**all on same side of face and ipsilateral to lesion
What is myasthenia gravis?
a auto immune disorder of the NM junction in which muscle weakness results, especially with repeated contractions
- ptosis is common
What is a pneumothorax?
air getting into the pleural cavity and putting pressure on the lung, often resulting in lung collapse
What is nonfluent aphasia?
Broca's motor or expressive aphasia
- slow hesitant speech with limited vocab/articulation
- think of Danny
Compare symptoms of L vs R ventricular heart failure.
Left heart failure
- S3 heart gallop
- dyspnea with mild activities
- persistent spasmotic cough
- paroxysmal nocturnal dyspnea, orthopnea
- signs/symptoms of pulmonary edema (marked dyspnea, pallor, cyanosis, diaphoresis, tachy, anxiety, agitation)
R heart failure
- dependent ankle edema, weight gain
- fatigue, RUQ pain, anorexia, nausea
- cyanosis of nail beds
- decreased urin output
What are signs of pulmonary edema?
**excess fluid in lungs, caused by L heart failure (back up into pulmonary veins)... results in:
What are potential long term effects of corticosteroids?
atrophy, osteoporosis, joint pain, fractures
How quickly will a partial-thickness wound heal if it doesn't get infected?
T/F: Partial thickness wounds are without sensation d/t nerve endings getting fried.
false, full thickness are without sensation
T/F: Risk of keloid and hypertrophic scars is high with deep partial thickness and full thickness burns.
With a posterolateral incision for a hip replacement, what motions are contraindicated?
hip flexion past 90