Intro to PT 600 > Final > Flashcards

Final Flashcards

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1
Q

What are the principles and goals of patient positioning in the acute care setting?

A
  • Prevent contractures
  • Prevent pressure injuries
  • Provide support and stability
  • Optimize treatment area exposure
  • Reduce edema
  • Optimize ventilation

Proper positioning helps maintain a patient’s neutral body alignment and prevents complications of immobility and injury.

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2
Q

What are common risk factors for contracture development in hospitalized patients?

A
  • Prolonged immobility
  • Amputation
  • Critical illness
  • Bed-bound status
  • High muscle tone
  • CVA
  • Cerebral Palsy
  • Scar tissue formation
  • Burns

These factors increase the likelihood of chronic loss of joint motion due to structural changes in non-bony tissues.

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3
Q

What are effective strategies for contracture prevention?

A
  • Use pillows, towel rolls, braces, and/or wedges
  • Encourage frequent movement (active or passive)
  • Implement turn schedules for gentle stretching

These strategies help maintain joint motion and prevent structural changes.

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4
Q

What is a pressure injury?

A

Wound caused by unrelieved pressure, usually at bony prominences

Also known as a decubitus ulcer or ‘bed sore’, it develops due to ischemia from sustained pressure.

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5
Q

What are the risk factors for pressure injury development?

A
  • Immobility
  • Lack of sensation
  • Poor nutritional status
  • Incontinence
  • Friction/shear forces
  • Advanced age
  • Extremes in weight

These factors contribute to the likelihood of developing pressure injuries.

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6
Q

How often should a patient be repositioned to prevent pressure injuries in bed?

A
  • Supine: every 2 hours
  • Seated: every 20 minutes for 2 minutes continuously

Regular repositioning is crucial to offload high-pressure areas and prevent skin breakdown.

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7
Q

What precautions should be taken during patient positioning?

A
  • Avoid clothing or linen folds beneath the patient
  • Observe skin color over bony prominences
  • Protect bony prominences from excessive pressure
  • Avoid positioning extremities beyond the support surface
  • Use caution with cognitively challenged or sedated patients

These precautions help prevent complications during patient positioning.

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8
Q

What are the functions of standard hospital room equipment?

A
  • Lock/Unlock wheels
  • Bed rails
  • CPR lever
  • HOB and knee adjustments
  • Fall alarm
  • Foley hook
  • Oxygen and suction cannister

Understanding these functions is essential for safe and effective physical therapy sessions.

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9
Q

Fill in the blank: A decubitus ulcer is also known as a __________.

A

pressure injury

It is caused by unrelieved pressure on bony prominences.

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10
Q

What should be done before assisting a patient during a treatment session?

A
  • Assess the patient’s vitals
  • Ensure safety equipment is in place
  • Confirm patient readiness for movement

These steps are crucial for patient safety and effective treatment.

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11
Q

What equipment is commonly used in a hospital setting for patient care?

A
  • Foley catheter
  • Nasal cannula
  • IV pole
  • Sequential Compression Device (SCD)
  • Gait belt

Familiarity with this equipment is important for effective patient management.

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12
Q

Differentiate between movement screening and standardized strength testing by identifying their respective purposes.

A
  • Movement screening: Quick tool to identify asymmetries impacting function
  • Standardized strength testing: Quantifiable test to measure severity of movement impairment

Movement screening is typically qualitative, while standardized testing can be retested over time.

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13
Q

What are the factors that influence muscle strength?

A
  • Age
  • Sex
  • Type of muscle contraction
  • Muscle size
  • Speed of contraction
  • Previous training effect
  • Joint position
  • Fatigue
  • Other factors (motivation, pain level, etc.)

These factors can significantly impact assessment findings.

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14
Q

What is the purpose of a strength screen?

A
  • General assessment of strength impairments
  • Identify areas needing further testing
  • Observe quality of movement and substitutions
  • Begin developing a PT hypothesis

This helps in identifying treatment plan areas.

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15
Q

True or false: Strength assessment is an endurance test.

A

FALSE

Strength assessment should avoid fatigue and focus on strength rather than endurance.

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16
Q

What are the patterns of weakness that can be verified and identified?

A
  • Localized weakness
  • Generalized weakness

Examples include weakness due to specific injuries or conditions like CVA or SCI.

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17
Q

What does RIM stand for in the context of muscle testing?

A

Resisted Isometric Testing

RIM is a quick strength screen of multiple muscle groups.

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18
Q

What is the grading scale for Manual Muscle Testing (MMT) based on evidence of contraction?

A
  • 0: No contraction
  • 1: Contraction without movement
  • 2: Movement with gravity eliminated
  • 3: Movement against gravity
  • 4: Movement against moderate resistance
  • 5: Movement against maximal resistance

This grading helps evaluate muscle function and strength.

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19
Q

What is the optimal angle of muscle pull for strength testing?

A

90º to the bony element

This angle maximizes torque during muscle testing.

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20
Q

What should be included in the documentation of muscle performance assessments?

A
  • Laterality
  • Motion assessed
  • Presence of pain
  • Quality of motion

Example: Shoulder flexion: R: WNL, L: Limited, painful with apprehension.

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21
Q

What is the sequence for conducting an objective exam in muscle strength assessment?

A
  • Start with UE or LE
  • Move proximal to distal
  • Test bilateral movements concurrently
  • Test painful joints last

This sequence helps in effective assessment and reduces overflow pain.

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22
Q

Fill in the blank: The movement system can be affected by _______ factors leading to weakness.

A

[pharmacologic, genetic, autoimmune, infection, inflammation, rheumatologic, neurologic, neuromuscular dysfunction, cardiometabolic, endocrine, metabolic, musculoskeletal, electrolyte imbalance, muscle fatigue, muscle power dysfunction, psychological]

Awareness of these factors is crucial in a direct access setting.

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23
Q

What additional information do we want to know related to PMH during a chart review?

A

Functional history, Social history, Patient’s goals

These elements help in understanding the patient’s background and needs.

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24
Q

During a chart review, how does the information gathered inform the structure of our exam?

A

UE vs LE, Seated vs supine, Sequence of joint assessment

This helps tailor the examination to the patient’s specific situation.

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25
What are the vital signs to be assessed in a patient during the **Patient Interview**?
* BP * HR * RR ## Footnote These vital signs provide essential information about the patient's health status.
26
What is the recommended patient position for taking **BP** during the assessment?
Back supported in chair, Legs uncrossed, UE supported on mat ## Footnote Proper positioning is crucial for accurate blood pressure readings.
27
What should be considered for **body mechanics** during the assessment?
Consider using a stool ## Footnote This helps maintain proper posture and reduces strain on the clinician's back.
28
What is the sequence of joint assessment during the **Movement Screen**?
* Hip * Knee * Ankle/foot ## Footnote This sequence ensures a systematic approach to joint evaluation.
29
What are the steps in the **sequencing of screenings** during the Movement Screen?
* AROM * RIM: NT if pain with AROM * PROM ## Footnote This sequence helps in assessing the range of motion and identifying issues.
30
What should be maintained during the **seated** position for a patient?
Patient’s feet on the ground with knees at 90* ## Footnote This position promotes stability and comfort during the assessment.
31
What is the purpose of the **AIDET** approach during the closing of the exam?
* Thank you for your time * Do you have any questions for me? * It was great to meet you, and I look forward to working with you again soon. ## Footnote AIDET is a communication framework to enhance patient experience.
32
What is the purpose of a **movement screen**?
Identify asymmetries resulting in functional movement deficiencies ## Footnote It is a quick and convenient tool typically described in binary terms.
33
What is the difference between a **movement screen** and a **test and measure**?
* Movement screen: Quick, qualitative assessment * Test and measure: Quantifiable, standardized clinical test ## Footnote Movement screens identify impairments, while tests measure severity over time.
34
What does **AROM** stand for?
Active Range of Motion ## Footnote It refers to the movement a joint can achieve using muscle activation without assistance.
35
What are the **limitations** that may affect AROM?
* Inert OR contractile tissue dysfunction * Pain * Fear of movement ## Footnote These factors can restrict a patient's willingness to move.
36
What does **PROM** stand for?
Passive Range of Motion ## Footnote It involves passive movement of the joint without contractile effort from the patient.
37
What are the **normal end-feels** in ROM assessment?
* Soft * Firm * Hard * Empty ## Footnote Each end-feel describes the quality of tissue resistance at the end of PROM.
38
What is **hypomobility**?
ROM substantially less than normal age/gender values for that joint ## Footnote It indicates a restriction in joint movement.
39
What are the **contraindications** to ROM assessment?
* Joint subluxation/dislocation * Unhealed or unstable fracture * Rupture of a tendon/ligament * Infectious or acute inflammatory process * Myositis ossificans or ectopic ossification * Osteoporosis or bone fragility ## Footnote These conditions may pose risks during assessment.
40
What is the **most likely body structure/function impairment** for a patient with limited AROM of R elbow extension (50%) and full PROM (100%) with a hard end feel?
Anterior articular capsule restriction at the R elbow ## Footnote This scenario suggests a specific restriction affecting the joint.
41
What should be observed during **AROM analysis**?
* Willingness to move * Onset of pain * Quality of movement * Observable restriction * Pattern of movement ## Footnote These observations help in assessing the patient's condition.
42
What is the **patient positioning** for upper extremity ROM screening?
* Supine * Seated ## Footnote Proper positioning is crucial for effective assessment.
43
What are the **components** of the upper extremity ROM screen?
* Shoulder: Flex/Ext, Abd/Add, IR/ER * Elbow: Flex/Ext * Wrist: Flex/Ext * Fingers: Flex/Ext, Abd/Add ## Footnote These components are assessed in both supine and seated positions.
44
What should be tested **last** during ROM screening?
Painful joints ## Footnote Testing painful joints last helps to minimize overflow pain to subsequent joints.
45
What is the **goal** of the ROM screen?
* General assessment of function and mobility * Determine willingness to move * Identify limitations for further evaluation ## Footnote The ROM screen aids in developing a treatment plan.
46
Define **body mechanics**.
The use of one’s body to produce motion that is safe, energy conserving, and anatomically and physiologically efficient, maintaining body balance and control. ## Footnote Proper body mechanics protect both the patient and the caregiver from injury.
47
List the **principles** of using correct body mechanics.
* Safety * Energy Conservation * Anatomically Efficient Movement * Physiologically Efficient Movement * Injury Prevention ## Footnote These principles apply to patient care and everyday activities for therapists, patients, and caregivers.
48
What is the **Center of Gravity (COG)**?
The point of a body where weight is evenly distributed in all directions, located slightly anterior to the S2 vertebra in standing anatomical position. ## Footnote The COG changes with limb and trunk position.
49
How does lowering the **COG** affect stability?
Lowering the COG increases stability. ## Footnote The COG must be positioned directly above the base of support to maintain balance.
50
Define **Base of Support (BOS)**.
The area under and between the parts of the body that are in contact with the ground. ## Footnote Increasing the BOS increases stability.
51
What is the **Line of Gravity (LOG)**?
An imaginary vertical line drawn through the COG and the center of the Earth. ## Footnote The system is stable when the LOG is within the BOS.
52
What is **mechanical advantage**?
The force-amplifying effectiveness of a simple machine, allowing a small force to turn into a large force or movement. ## Footnote Gaining mechanical advantage involves shortening the lever arm and increasing the BOS.
53
What does **friction** refer to in body mechanics?
The force opposing the movement of one object over the surface of another object. ## Footnote Understanding friction is essential for safe patient handling.
54
What is **inertia**?
A property of matter by which it remains at rest or in uniform motion unless acted upon by an external force. ## Footnote Inertia plays a role in patient handling and movement.
55
How can **energy conservation** be achieved in body mechanics?
By using proper body mechanics with every patient to decrease energy consumption. ## Footnote Work physically smart, not hard, and use large muscle groups when lifting.
56
What is the recommended maximum weight to lift without assistive equipment according to the National Institute for Occupational Safety and Health?
35 lbs ## Footnote This guideline helps prevent injuries among healthcare workers.
57
What should be assessed before mobilizing a patient?
* Environment * Equipment * Patient * Provider (or caregiver) ## Footnote Proper assessment ensures safety during patient handling.
58
What is the purpose of a **gait belt**?
To provide physical and legal protection to both the patient and the caregiver during mobility tasks. ## Footnote It should be placed snugly at the patient's waist.
59
What are the **levels of assistance** in patient mobility?
* Dependent/Total A: 0 - 24% of task * Maximal Assist (Max A): 25 - 49% of task * Moderate Assist (Mod A): 50 - 74% of task * Minimal Assist (Min A): 75-99% of task * Contact Guard Assist (CGA): 100% of task with PT hands-on * Supervision / Standby (SBA): 100% but PT close by for safety ## Footnote Levels of assistance are determined by how much work the patient does.
60
True or false: **Safety** in body mechanics is only about the patient.
FALSE ## Footnote Safety is about both the clinician and the patient.
61
What should be maintained during all activities to ensure proper body mechanics?
Lumbar lordosis ## Footnote This helps prevent injury and maintain proper posture.
62
What is the first step in the **lateral transfer** of a patient from the transport bed to the hospital bed?
Work with your rehab technician to perform the transfer ## Footnote Detailed verbal instruction is needed for the rehab tech to support both the clinician and the patient during the transfer.
63
What should be ensured about the **bed/mat** during the supine to/from sitting transfer?
Positioned at height to allow for patient to place feet on ground once upright ## Footnote This setup is crucial for the patient's ability to transition safely.
64
During the **patient handling** phase of the supine to/from sitting transfer, where should the clinician support the patient?
* Patient’s shoulder and spine * Knees under popliteal fossa ## Footnote Supporting these areas helps in safely moving the patient into a seated position.
65
What is the correct procedure for pivoting the patient into a seated position?
On count of 3, pivot trunk up and legs off of side of bed concurrently ## Footnote This method helps in maintaining balance and safety during the transfer.
66
What should be done to stabilize the patient once in a sitting position if they have poor sitting balance?
Stabilize patient’s shoulder and pelvis ## Footnote This is important to prevent falls and ensure safety.
67
What are the key components of **clinician safety** during patient transfers?
* Body mechanics * Proper hand placement * Inertia and energy conservation ## Footnote These practices help prevent injury to the clinician while assisting the patient.
68
What should be done to prepare for the **sit to/from standing** transfer?
* Non-slip footwear donned * Gait belt donned * Chair locked * RW placement ## Footnote These preparations ensure safety and stability during the transfer.
69
What is the phrase to remember for proper body mechanics during patient transfers?
Nose over toes ## Footnote This phrase helps clinicians maintain balance and proper posture.
70
What is the goal for the PT evaluation of the **82-year-old male** admitted with a urinary tract infection?
Provide minimal assist while the patient moves from supine in bed to the bedside chair using a walker ## Footnote The patient is globally weak and unsteady, requiring careful assistance.
71
What should be done to prepare the **patient's room** for a safe transfer to the chair?
Set up the room to ensure all relevant belongings are within reach ## Footnote A tidy environment is crucial for patient safety during transfers.
72
What is the definition of **posture**?
The disposition of the body at any one moment, a composite of the positions of the different joints of the body ## Footnote An active process involving muscles, joints, perception, emotions, and the environment.
73
True or false: There is evidence to suggest that **correct posture** prevents or reduces pain and disability.
FALSE ## Footnote No evidence supports posture or movement screening for primary prevention of pain in the workplace.
74
What should be assessed as part of the **PT Examination**?
* Postural assessment * Body structure/functional impairments * Functional movement activity limitations ## Footnote This assessment helps guide the PT hypothesis and further evaluation.
75
What are the two types of **posture**?
* Static Posture * Dynamic Posture ## Footnote Static posture refers to body position when stationary, while dynamic posture refers to body position during movement.
76
What is the **primary movement system** suspected to drive deficits in posture?
The primary movement system is the main focus of assessment ## Footnote Secondary movement systems may also be implicated.
77
What are some **contributors to postural deviations**?
* Injury * Obesity * Pregnancy * Weak or tight muscles * Work environment and duties ## Footnote These factors can significantly affect posture.
78
What is the **plumb line** used for in postural assessment?
An imaginary straight line extending from the top of the head to the floor, representing ideal posture ## Footnote It serves as a reference for assessing alignment.
79
What should be observed in **static postural assessment**?
* Musculature (tone, bulk) * Soft tissue contours * Bony & soft tissue landmarks * Skin * Joint Spaces ## Footnote Observations should begin at the head or feet and remain consistent.
80
What is the **ideal posture** represented by the plumb line in the anterior view?
* Tip of nose * Midline of chin * Sternum * Xiphoid Process * Umbilicus * Symphysis pubis * Midpoint between feet ## Footnote This alignment indicates proper posture in the anterior view.
81
What is the **clinical tip** regarding postural assessment?
Don’t tell the patient you’re assessing their posture ## Footnote Take mental notes about postural observations throughout the exam.
82
What should you encourage your patient to do regarding **postural preferences**?
Encourage your patient to alternate time between various comfortable postures/positions ## Footnote This helps in understanding individual postural preferences.
83
What are some **abnormal postural conditions** mentioned?
* Kyphosis * Lordosis * Sway-back * Flat-back * Pelvic Tilt Deviations ## Footnote These conditions can result from various factors, including muscle integrity and body habitus.
84
Fill in the blank: **Static posture** refers to the position of the body when __________.
stationary ## Footnote Examples include sitting, standing, lying, or kneeling.
85
Fill in the blank: **Dynamic posture** refers to the position of the body during __________.
movement patterns ## Footnote Examples include transfers, walking, reaching, and lifting.
86
What is **osteokinematics**?
Gross movement of the shafts of bony segments ## Footnote Understanding osteokinematics is essential when assessing range of motion (ROM).
87
What is the purpose of a **goniometer**?
Instrument used to measure joint position and motion in the clinical setting ## Footnote Goniometers are essential for assessing range of motion (ROM) accurately.
88
Define **Range of Motion (ROM)**.
The arc of motion that occurs at a joint or series of joints ## Footnote ROM is a critical concept in physical therapy and rehabilitation.
89
What are the **three types of measurements** on a goniometer?
* Inside (180 – 360*) * Middle (0 – 180*) * Outside (0 – 90*) ## Footnote Each scale serves a different purpose in measuring joint angles.
90
List the **planes of motion** and their corresponding axes.
* Sagittal Plane: Medial/Lateral * Frontal Plane: Anterior/Posterior * Transverse Plane: Vertical ## Footnote Understanding these planes is crucial for accurate joint movement assessment.
91
What is the **fulcrum** in goniometry?
Placed over approximate location of axis of rotation ## Footnote The fulcrum is a critical reference point for accurate measurements.
92
What is the **testing position** for measuring ankle dorsiflexion?
Sitting ## Footnote The position of the patient is important for accurate ROM measurement.
93
What is the **expected range** for ankle dorsiflexion?
15°-20° ## Footnote Knowing the expected ROM helps in assessing joint function.
94
What is the **end feel** for ankle dorsiflexion?
Firm ## Footnote The end feel provides information about the quality of the motion.
95
What should be documented when measuring ROM?
* Side of body * Joint * Motion measured * ROM and unit of measure (AROM vs. PROM) * Subjective info (e.g., Pain) * Objective findings (e.g., Spasm) * Abnormal end-feel * Deviations from standard testing position ## Footnote Proper documentation is essential for tracking patient progress and treatment effectiveness.
96
True or false: The **proximal arm** of the goniometer is aligned with the distal segment of the joint.
FALSE ## Footnote The proximal arm is aligned with the proximal segment of the joint.
97
What is the **reference zero** position for measuring ankle dorsiflexion?
Foot MUST be positioned in zero ## Footnote This ensures accurate measurement starting from a neutral position.
98
What is the **testing position** for measuring ankle plantarflexion?
Sitting with knee flexed to 90 degrees ## Footnote The position affects the measurement of ROM.
99
What is the **expected range** for ankle plantarflexion?
45°-55° ## Footnote Knowing the expected ROM assists in evaluating joint function.
100
What is the **stabilization** technique for measuring ankle dorsiflexion?
Tib/Fib to limit knee motion ## Footnote Stabilization is crucial for obtaining accurate measurements.
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