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Flashcards in exam 3 Deck (89):
1

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

2

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

3

What trunk motion will stress a pars defect and should be avoided?

extension and rotation

4

What compensations might you see from a forefoot varus when it hits the ground?

PF'ed first ray
pronation
excessive tibia/hip/pelvic IR

5

What exudate would be expected through use of panafil for a wound?

green/yellow exudate is expected
- foul smell is NOT to be expected

6

What is the most common cause of falls in the elderly?

turning around and sitting into a chair

7

What is a typical early clinical manifestation of CF?

excessive appetite and weight loss

8

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

9

T/F: For patients with CF, it's typical to see both obstructive and restrictive disease components.

true

10

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

11

What does a hypertrophic scar look like as compared to an atrophic scar?

hypertrophic = thick and pink
atrophic = thin and white

12

What type of TENS provides rapid-onset, short term pain relief during painful procedures?

brief intense TENS

13

What does modulated TENS do?

prevents accomodation, does not provide relief of pain
- aka not really a setting

14

T/F: Conventional TENS is high-rate.

true
- not as high of intensity as brief intense tens, and it has a longer application

15

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

16

Working at 60-90% of max HR is equivalent to working at what percentage of VO2 max?

50-85% VO2max

17

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

18

What symptoms do patients with scleroderma incur?

symmetrical skin thickening and visceral involvement of GI tract, lungs, heart, and kidneys
- hypersensitivity to touch also

19

T/F: Multivitamins and calcium can increase fall risk.

half false
- not multivitamins, but calcium can increase fall risk

20

T/F: thyroid meds commonly cause falls in the elderly.

false

21

What neural tension testing position biases the tibial nerve?

SLR with dorsiflexion and eversion

22

What neural tension testing position biases the sural nerve?

SLR with DF and inversion

23

What neural tension testing position biases the fibular nerve?

SLR with PF and inversion

24

T/F: Muscle wasting is a common manifestation of COPD.

true

25

At what stage of COPD is it common to see patients with supplemental oxygen?

stage IV

26

T/F: Weight loss is common in patients with progressing COPD.

true

27

T/F: Patients with stage 3 COPD will demonstrate a decreased subcostal angle.

false: air trapped in so will have increased angle

28

Is the knee extended an a modified Ober or typical Ober test?

modified = knee extended
- to slack rectus femoris

29

What are wet to dry dressings used for?

to remove necrotic tissue

30

When is calcium alginate used for a dressing?

in the presence of heavy exudate

31

What does hydrogel do for a wound?

nonadherent
keeps wound moist
protects granulation buds

32

At what pressure level is considered low for wound irrigation?

under 15 psi

33

What is spondylosis?

pain d/t degeneration of the discs

34

T/F: Opioids may produce pulmonary hypertension.

false, produce orthostatic hypotension

35

What medication can cause Raynaud's symptoms to occur?

aspirin

36

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

37

T/F: Post polio syndrome is a LMN disease with no sensory paresthesias.

true
- no sensory paresthesias, typically asymmetrical

38

T/F: MS in an LMN disease.

false: UMN with spasticity, hyperreflexia

39

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

40

What physiological responses occur with the valsalva maneuver?

slows pulse
decreased return of blood to heart
increased venous/intrathoracic pressure

DOES NOT affect heart rate

41

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

42

What score on the functional reach test indicates a fall risk?

<10in

43

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

44

What times on a TUG test indicate fall risk?

<20s indicates low fall risk (yay, good)

>30s indicates increased risk

45

What is Murphy's sign?

pain with percussion over costovertebral RUQ
- for acute cholecystitis

46

Where would appendix pain occur?

RLQ
- from rebound

47

What does peritoneal inflammation present like?

abdominal pain with coughing and light percussion; also rebound tenderness

48

What is acute cholecystitis?

acute gallbladder inflammation

49

How do you differentiate a grade II from grade III sprain?

grade III is so torn that there's no pain

50

When filling out an incident report, what pieces are necessary to include?

when/where/what occured
witnesses
names of those involved

51

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

52

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

53

What is allodynia?

perception of an ordinarily painless stimulus as painful

54

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

55

What should your frequency and duration prescription be for patients beginning a walking program for claudication?

2-3x/day, 3-5days/wk

56

What does a stage-2 pressure ulcer look like?

intact or ruptured serum-filled blister

57

If fascia, muscle, tendons, or ligaments are seen in a pressure ulcer, what stage is it?

stage IV

58

What does a stage 3 pressure ulcer look like?

granulation tissue present, as well as adipose
- slough or eschar may be present

59

What does a stage 1 pressure ulcer look like?

unblanchable redness

60

T/F: Stage II pressure ulcer involves partial-thickness skin loss.

true

61

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

62

What is vestibular neuritis?

inflammation of vestibular nerve caused by a virus
- symptoms of dysequilibrium, nystagmus, nausea, severe vertigo

63

What is meniere's disease?

felling of fullness in the ears associated with abnormal fluid buildup
- tinnitus, vertigo, nausea, hearing loss are common symptoms

64

What lab value might be high with polycythemia vera?

hematocrit
- this is when there's proliferation of all bone marrow cells with in increase in number of RBCs and hemoglobin concentration

65

What types of exercises should patients with osteoporosis avoid?

flexion/rotation, as that can result in compression fracture

66

What are the two options of current for wound healing?

1) high volt pulsed current
2) low-intensity continuous low volt direct current

67

When would you use the prone position for lumbar traction?

for herniated disc

68

When would you use the hook lying position for lumbar traction?

for separation of the facets, elongating muscles, open up the intervertebral foramen

69

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

70

What CN is responsible for constriction of the pupils?

III

71

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

72

T/F: Calcium alginate dressings do NOT allow rapid evaporation.

true

73

What dressing provides semirigid support for the limb while maintaining a sterile field?

unna boot

74

What kind of environment should be avoided for patients on antipsychotic/depressant meds?

hot environment

75

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

76

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

77

What does a capsular pattern of the c-spine look like?

side bend and rotation equally limited

78

What are the hallmark findings of Horner's syndrome? (3)

ptosis
miosis (pupillary constriction)
anhydrosis (lack of sweating)

**all on same side of face and ipsilateral to lesion

79

What is myasthenia gravis?

a auto immune disorder of the NM junction in which muscle weakness results, especially with repeated contractions
- ptosis is common

80

What is a pneumothorax?

air getting into the pleural cavity and putting pressure on the lung, often resulting in lung collapse

81

What is nonfluent aphasia?

Broca's motor or expressive aphasia
- slow hesitant speech with limited vocab/articulation
- think of Danny

82

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

83

What are signs of pulmonary edema?

**excess fluid in lungs, caused by L heart failure (back up into pulmonary veins)... results in:

marked dyspnea
pallor, cyanosis
diaphoresis
tachypnea
anxiety, agitation

84

What are potential long term effects of corticosteroids?

atrophy, osteoporosis, joint pain, fractures

85

How quickly will a partial-thickness wound heal if it doesn't get infected?

3-5 wks

86

T/F: Partial thickness wounds are without sensation d/t nerve endings getting fried.

false, full thickness are without sensation

87

T/F: Risk of keloid and hypertrophic scars is high with deep partial thickness and full thickness burns.

true

88

With a posterolateral incision for a hip replacement, what motions are contraindicated?

hip flexion past 90
IR
add

89

What is prosopagnosia?

inability to recall faces