Final Exam Flashcards
(211 cards)
1
Q
Adolescence stages of development
A
11 yrs - 18 yrs
2
Q
Adolescence (erikson)
A
12-19 yrs / identity vs, role confusion
3
Q
Pre-adolescence
A
rapid physical growth and secondary sex characteristcs
Girls: 8-10
Boys: 9-11
4
Q
End of Puberty
A
Females: menses at 12-13
Males: production of sperm
5
Q
Characteristics of Puberty
A
- Primary sex characteristics
- secondary sec characteristics
- Rapid physical growth
- Change in body proportions
6
Q
Sex Characteristics
A
Primary: testes and ovaries
Secondary: physical appearance
7
Q
Adolescence Factors Affecting Timing of Puberty
A
Genetics, stress, socioeconomic status, environment, nutrition, fat on body, chronic illness
8
Q
Puberty in female athletes
A
-delayed
-ovulation occurs after period
-pubertal maturation issues
-ovulatory cycles don’t occur for months to years
9
Q
Pubertal maturation
A
establishment of cyclic ovarian function
10
Q
Puberty is second to ______ as most rapid growth
A
Prenatal period
11
Q
Adolescence Growth spurt order
A
Feet, legs, trunk
12
Q
Puberty Height increase
A
Male: 4-12 inches
Female: 2-8 inches
13
Q
Puberty Weight Increase
A
Male: 15-65lbs
Female: 15-65lbs
14
Q
Adolescence Height Increases
A
Girls: 13-15
Boys: 15-17
15
Q
Adolescence BMI Index for age
A
Underweight: <5%
Healthy: 5-85%
Overweight: 85-95&
Obese: 95%
16
Q
Puberty Changes in body proportions
A
-Nose reaches adult size first
-Hands and feet before arms and legs
-LE become longer than trunk
17
Q
Bone growth stops when?
A
Males: 21
Girls: 18
18
Q
Adolescence Bones
A
-Immature, porous with unstable growth plates
19
Q
Adolescence Muscles
A
-adult muscle diameter reached at 12
-strength increases related to age
-Girls: strength levels off at 15
-Boys: strength levels off 13-20
20
Q
Adolescence Cardiopulmonary System
A
-60-90bpm
-16-24 breaths per min
-increase in size of organs
-higher HR during exercise
-lower stroke volume
-higher cardiac output
-BP lower at rest
21
Q
Adolescence temperature regulation
A
-greater surface area to body mass
-produce more heat
-lower sweating capacity
-increased risk for temperature related injuries
22
Q
Adolescence Psychosocial development
A
-social antagonism: need for privacy and hate supervision, wish for independence
-self consciousness
-Search for identity
-emotion issues
23
Q
Psychosocial Development Young Teens
A
-13-14
-most self centered
-value peer’s opinions
24
Q
Psychosocial Development Middle Teens
A
-15-16
-better at compromising
-think more independently
-risk taking behaviors
25
Psychosocial Development Late Teens
-17-18
-develop seriousness
26
Cognitive development
-11-14
-increasingly capable of thinking hypothetically
-abstract concepts
-self relective
27
Adolescence Self Esteem
-small gains in second decade of life
Determined by:
attractiveness, peer acceptance, intelligence, athletics, support from peers and family
28
Adolescence Depression/Suicide
-3rd leading cause of death 15-24
-Masked by anxiety, ED, drugs, hyperactivity
29
Adolescence Destructive Behaviors
-Disordered eating (bulimia, anorexia, obesity
-Self harm
-substance abuse
30
Adolescence Sexuality
-48% of high schoolers have sex
-condom use is 57%
31
Adolescence Sport Injury Risks
-growth spurts
-increased training
-sport specialization
32
Relative energy deficiency in sport (RED-S)
-insufficient caloric intake or excessive expenditure
-decreased muscle strength
-chronic fatigue
-bone loss
-stress
33
female athlete triad
-low bone mass
-menstral disturbance
-energy deficient
34
Adolescence ACL injury
-can occur with growth plate fracture
-increased risk for osteoarthritis
35
Most common type of scoliosis
-right thoracic and left lumbar
36
Idiopathic adolescent scoliosis (AIS)
-most common spinal deformity with 3d rotation
37
AIS screening age
Girls: 10-12
Boys: 13-14
38
What bony landmarks are looked at for scoliosis?
-scapula (uneven), iliac crest (elevated), spinous process (body shift), arm gapping
39
Refferal for scoliosis
10+ degrees
40
Diagnosis of scoliosis
20+ degrees
41
Naming convention for scoliosis
Convex side and left or right
42
Orthotic intervention for scoliosis
25-45 degree curves
43
Surgical intervention for scoliosis
45-50 degree curves
44
ATNR Diminishing Age
3-9th months
45
STNR
-neck is flexed, UE flex nad LE extend
-neck is extended, UE extend and LE flex
-Emerges 6-9m
-Diminishes 9-11months
46
Middle age stages of development?
40-65 yrs
47
Middle adulthood (Erikson)
26-64yrs / generavity vs. Stagnation
48
Midlife crisis
-period of transition where you struggle with identity and self-confidence
-40-60s
49
Middle Adulthood Considerations
-role in society and functional needs
50
Middle Adulthood Vision
-Presbyopia: loss of accommodative ability of the lens
-reduced dim light vision
-increased glare sensitivity
-diminished color sensitivity
-increased risk of glaucoma
51
Middle Adulthood Hearing
-Presbycusis: age related hearing loss, begins with loss of high frequencies
-ability of to to distinguish sounds becomes harder
52
Middle Adulthood Muscle
-strength declines at 30
-each decade declines 5%
-increased occurrence of muscle strains
-LE strength reduced by 40% btwn 30-80
-increased fat deposits
53
Middle Adulthood Bone
-Osteoporosis=10% of adults over 50, risk increases 5 fold (7-35%) in women, risk increases 3 fold in men (3-11%)
54
Middle Adulthood Balance
-coordination declines in 30
55
Middle Adulthood Vestibular System
-begins to decline in 40s
-decreased sensory cells and nerve fibers 40%
-dizziness and vertigo past 50
-Increased threshold of excitation
56
Menopause
-absence of menses for 12 months
-average age 51
-ovaries begin to atrophy and decline of estrogen and progesterone
57
Perimenopause
-3-5 years before menopause
-estrogen and progesterone fluctuate
58
Post-menopause
-end of females reproductive years
-end of ovulation, produce small levels of estrogen and progesterone
-increased risk of heart disease and osteoporosis due to estrogen decrease
-symptoms galore
59
Andropause
-symptoms men have during decreased testosterone production (hypogonadism)
-increases risk of metabolic syndrome
-decrease erections, slowed ejaculation, decreased muscle mass, erectile dysfunction, hair loss, insomnia, bone loss
60
Middle Adulthood Cardiopulmonary Changes
-heart disease, 2nd most common cause of death 45-64
-25% of american deaths
-atherosclerosis: build up of plaque in arteries
-silent killers
-74-76bpm, BP 140/85, 10-20 respiratory rate
61
Middle Adulthood Cancer
-leading cause of death 45-64
-breast, prostate, lung, colon
62
Geriatrics Stages of Development
65+
63
Geriatrics Erikson
65+Ego integrity vs. dispair
64
For every 100 woman over 65-74 there are_____
86 men
65
15% of people 85+ live_____
in long term care facilites
66
Theories of Programmed Aging
-Hayflick Limit
-Neuroendocrine and Hormonal theory
-Caloric restriction theory
67
Neuroendocrine and Hormonal Therory
-aging decreases the promotion of hormones
68
Caloric restriction theory
-caloric restriction extends lifespan and slows aging
-reduces metabolic rate and oxidative stress
69
Theories of aging Stochastic
-Free radical
-error/catastrophe theory
-somatic mutation theory
-cross linking theory
70
Free Radical Theory
-free radicals damage cells
71
Error/catastrophe theory
-errors ini DNA accumulate and kill the cells
72
Somatic Mutation Theory
-genetic damage or mutation results from radiation
73
Cross linking theory
-cross-linking of proteins that slow normal cell processes
74
Successful Aging
-capacity to function across all domains
-physical, cognitive, active engagement, low risk of disease
75
Primary Aging
-inevitable and happens in all systems
76
Secondary Aging
-lifestyle, environment, disease
77
Typical aging
-gradual decline in function of most systems
78
Atypical Aging
-aging due to disease
-cognitive decline
79
Geriatric Musculoskeletal
-5-10% of muscle loss 20-50
-12-15 muscle loss each decade after 50
-peak bone density at 30
80
Geriatric Neuromuscular
-Decrease in brain, vascular supply
-increase risk for neuro diseases
81
Geriatric Neuro red flags
-loss of consciousness
-confusion
-seizures
-sudden incontinence
-sudden gait abnormalities
82
Geriatric Cardiopulmonary
-heart disease #1
-VO2 max decreases 10% every decade past 20
-decrease pacemaker cells
-heart cells thicken
83
Geriatric Visual
-Presbyopia: loss of accommodative ability of the lens
-reduced dim light vision
-diminished color sensitivity from yellowing of lens
-glaucoma, cataracts, macular degeneration, retinopathy
84
Cataracts
clouding of lens due to protein buildup
-70% of adults at 75
85
Glaucoma
-loss of peripheral vision
86
Macular degeneration
loss of central clarity
87
Retinopathy
damaged BV in eyes
88
Geriatric Integumentary
-largest organ, 15%
-less thick, less nerves/BV
-less thermoregulation
-less cell turnover
-longer healing
-less mast cells
-infection risk
-less collagen and elastic
89
Pressure Injuries
-can develop in 2 hours
-skin tears
90
Geriatric Cognition
-decreases everywhere
-long term memory and procedural are stable
-retention of new info stable but needs more cues
-visual recognition of objects are stable
91
Atypical Cognition Aging
-mood changes
-visual-spacial changes
-memory changes
-difficulty communicating
92
Mild cognitive impairment
-do not interfere with ADLS (unlike dementia and Alzheimer's)
-19% 65-75, 38% 85+
-gradual, opposite of learning
93
Dementia
-umbrella term for disorders of the brain
-affects thinking, behavior , and ADLs
2 or more to meet criteria
-memory
-reasoning and judgment
-communication
-focus issues
-visual perception
94
Delirium
-sudden change in mental function
-slurred speech, hallucination, agitation
Causes
-UTI, dehydration, hospitalization, drug interactions
95
Geriatric Depression
-most common mental health condition 65+ (11-16%), (30-44% in living communities)
-can mimic dementia
96
Geriatric Common conditions
-Hypertension, arthritis, heart disease, diabetes, frailty, cancer, stroke, UTIs, pneumonia
97
Geriatric Mortality conditions
-Heart diseases
-cancer
-Covid
98
Geriatric Cancer
-Breast, prostate, lung, colorectal
-spinal metastasis
Signs
-constant pain at night that doesnt change with movement
-weight loss
-back pain
-fatigue
99
Geriatric Diabetes Complications
-diabetic neuropathy
-retinopathy
-wound healing
-increased stroke risk and cancer risk
100
Frailty
-decreased physiologic reserve across multiple systems
-affects physical, cognitive, and psychological
-underweight, low energy, slowness, inactivity
Predictive of:
-falls
-hospitalization
-death
-disability
101
Fit (not frail)
-conditions well controlled or absent
-physically active
-gait of >1.2 m/s
-TUG <10s
102
Mild frailty (prefrail)
-slowing, may need help with IADLs
-beginning to restrict life
-gait of 0.8-1.2 m/s
-TUG 10-15s
103
Moderate frailty
-difficult outdoor mobility
-may need help with ADLS
-Restricted life
-gait of 0.5-0.8 m/s
-TUG 15-20s
104
Severe Frailty (end stage)
-dependent with ADLs
-dying (6-12m)
-gait of <0.5 m/s
-TUG >20s
105
Geriatric Stroke
-leading cause of long term disability
-reduce mobility
-FAST
Risk factors
-age
-high BP
-diabetes
106
Geriatric UTIs
-most common hospitalization for infection
-10% of women over 65
Signs
-change in mental function (mimics dementia)
-flank pain
-hematuria
107
Geriatric Pneumonia
-4x more likely in older adults, 5x more likely to be hospitalized
-decreased ability to clear airway (diaphragm and intercostals)
-2nd leading cause of hospital acquired infection (8-10% of admissions, 50% of sepsis, 33% mortality rate)
108
Ageism
-earlier death by 7.5 years
109
Polypharmacy
-excessive or inappropriate use of meds
-65+ purchase 30% of meds
-more likely to have adverse reactions, 50% take 1 unneeded drug
-average older adults take 5 meds, average nursing home 7 meds
Signs
-no reason, duplicate, interacting, contraindicated, dosage, treatment of reactions
110
Polypharmacy Pharmacokinetics: Absorption
Decreased
-gastric acid
-stomach emptying
-motility
111
Polypharmacy Pharmacokinetics: Distribution
Decreased
-h20
-plasma proteins
-lean body mass
Increased
-fat
112
Polypharmacy Pharmacokinetics: Metabolism
Decrease
-liver mass
-blood flow to liver
-enzyme activity
113
Polypharmacy Pharmacokinetics: Excretion
Decreased
-kidney mass
-blood flow to kidneys
-nephron function
114
Geriatric common meds
Laxatives, BP meds, diuretics, DM meds
NSAIDS: GI stress
Opioids: sedation
Antidepressants: confusion
Barbiturates/antihypertensives: depression
Antihypertensives: orthostatic hypotension
Diuretics/glucocorticoids: fatigue and weakness
115
Geriatric Falls
-29% of people 65+
-50 bil per year
-Gait speed 6th risk factor
-Cutoff for community @ 0.8m/s gait
-TUG: 13.5s (8.5s for falls)
-Sit to stand: 11.4s
-BERG: 45/56
Work on balance, somatosensory, vestibular, AD training, environment mods, CV endurance
116
Balance Outcome measure for Geriatric Patients
-Berg Balance
-Sharpened romberg: feet together, tandem, semi tandem witih eyes open and closed
-4 square step
-functional reach
-MiniBEST
117
Self-Report Outcome measure for Geriatric Patients
-MFES: modified falls
-Efficacy scale
-Fear of falling avoidance Q
118
Functional Outcome measure for Geriatric Patients
-Sit to stand
-TUG
-WT?
119
Endurance Outcome measure for Geriatric Patients
-6 min walk test
-step test
120
Disability
-4% visible
Types
-ambulation
-cognitive
-visual
-hearing
-medical
121
Medicare
-65+ or disability
Part A: IP, SNF, HH, Hospice
Part B: OP, DME
122
Medicaid
-low income, pregnant, responsible for minor, disabilities
123
Discharge Planning: Independent Living
-walk 400m (different terrains, obstacles)
-1.2 m/s gait
-carry 1 gallon/8lbs
124
Discharge Planning: Inpatient
-3 hrs per day of therapy
-high level of prior function
-not safe to go home
125
Discharge Planning: Skilled nursing facility (SNF)
-unable to do 3 hrs a day
-variable prior function
-moderate progress
126
Discharge Planning: Outpatient
-high level of function
-stable needs
-community travel
127
Discharge Planning: Home health
-limited ambulation
-safe at home
-good functional prognosis
128
Discharge Planning: Long term acute care
-high complexity
-poor prognosis
-less need for skilled therapy
129
Discharge Planning: palliative care
-chronic illness
-treat pain and suffering
-fix things other than physical
130
Discharge Planning: Hospice
-end of life care
-6 months or less
-manage pain and symptoms
131
Discharge Planning: Advanced Care Directives
-identify preferences for care
Living wills, DNR, medical orders for life sustaining care, power of attorney
132
Geriatric PT intervensions
-group exercise
-resistance exercise
-aquatic exercise
-balance training
-power training
-Home training/modifications
Sensory loss
-bright colors
-large print
-less background noise
-strong smells
-avoid temperature extremes
133
Leading Causes of Death in men
-heart disease
-cancer
-unintentional injuries
134
Heart Disease in Men
-50% of deaths 65+
-1/4 have CHD (CAD most common blood vessel disease 47%)
135
Coronary Artery Disease
-#1 killer of men
-plaque buildup
Symptoms
-chest pain
-arrhythmia
-heart attack
136
Risk Factors for Heart Disease in Men
-hypertension
-high cholesterol
-tobacco use
137
Coronary Angioplasty
-catheter and balloon in artery
138
Coronary Bypass Surgery
-take vein from other part of body and move it to heart
139
Cancer risk factors in Men
-smoking
-obesity
-inactivity
-genetic predisposition
140
Most common Cancers in Men
-Prostate (10m)
-Lung (7m)
-Colorectal (4.4)
141
Prostate
-produces fluid to make semen and controls urethral output
-grows 21x compared to birth weight (1.5g - 31g) due to decreasing testosterone
142
Benign Prostatic Hyperplasia
-enlargement of the prostate
-20% 50s, 60% 60s, 70% 70s
Lower Urinary tract Symptoms (LUTS)
-frequency, urgency, urge Incont., nocturia
143
Treatments for BPH
-lifestyle mods
-Surgery
-Medications
Alpha blockers: relax prostate and bladder neck
Alpha reductase inhibitors: reduce size
144
Prostate Cancer RF
-age
-family history
-Race
145
Prostate Cancer Symptoms
-pain with urination
-blood in urine
-back, hip or pelvic pain
-painful ejaculation
146
Prostate Cancer Screening
-Digital Rectal Exam
-Prostate Specific Antigen test
147
Prostate Cancer Treatment
-Surgery
-radiation
-hormone
-Chemo
148
St. Louis ADAM questionnarie
-Androgen Deficiency in Ageing Males
-depression can increase score
149
Causes of Andropause
-alcohol
-obesity
-smoking
-hight BP
-diet
-sedentary
150
Osteoporosis in Men
-25% of 50+
-testosterone deficiency
Primary Osteoporosis
-age
Secondary Osteoporosis
-lifestyle behaviors
Risk Factors
-alcohol
-caffeine
-immobilization
-meds (glucocorticoids)
151
Metabolic Syndrome
-25% of population
-need 3 or +
-deadly quartet
1.Diabetes
2. Obesity
3. Hypertension
4. Dylipidemia
152
Common Male injuries
-back injuries
-shoulder injuries (overuse and rotator cuff)
-fractures
4x more likely to drown, 50% alcohol
153
Male Depression
-6 million men
-more successful with suicide
154
Common Male Pelvic Floor Disorders
-Chronic Prostatitis: non infectious
-Neuralgias
-Anismus: spasm of anal region
-ED
155
Endometriosis
-endometrial tissue grows outside of uterus
-11% of women 15-44
-Most common 30-40
RF
-Nulliparous
-long periods and short cycles
-family hx
156
Interstitial Cystitis
-Painful bladder syndrome
-chronic pain of bladder, pelvis and genitals
-3-8mil women
Sym
-Pain, urinary frequency, pressure, dysuria, UTI
157
Primary Dysmenorrhea
-most common
-pain from contractions of uterus
RF
-early period (<11)
-bad periods
-smoking
-stress
158
Secondary Dysmenorrhea
-caused by associated medical conditions: endometriosis, fibroids, cysts
159
Anorexia
-restriction of calories and over exercising
Can cause:
-heart issues
-anemia
-osteoporosis
-kidney issues
-amenorrhea
160
Bulimia
-binging and purging to lose weight
-2% of women (15-29)
Sym
-tooth decay
-broken blood vessels
-dehydration
161
Binge Eating
-once a week for 3 months
-3% of women (early to mid 30s)
-dieting increasing risk 12x
162
Mental Health conditions that affect Women more than men
-Anxiety 2x
-depression 2x
-PTSD 2x
-BPD
-body dysmorphia
-Postpartum depression
163
Pregnancy MSK changes
-forward chin, eyes down
-shoulders forward and slouched
-anterior pelvic tilt, strained abs, butt out
-hyper extension of knees
-weight on inner borders of feet
164
Diastasis Recti
-stretching of linea aspera 2> inches
-33% at 21 weeks, 60% at 6 weeks post, 45% at 6 months post, 32% at 12 months postpartum
165
Pregnancy Related Pelvic Pain
-20% of pregnancies
-low back pain
Signs
-waddle gait, grinding in pubis area
166
Autoimmune Conditions
-75% women
-3x more than men
167
Heart Attack signs in Women
-pain in jaw, neck, throat
-nausea/vom
-indigestion
-heartburn
-tiredness
-dyspnea
168
Stroke in Women
-after 85, more likely than man
-2x more likely than 20-39yrs
-repeat strokes in 5 years
169
Breast Cancer
-peaks around 75-80
-very few before 45
170
Ovarian Cancer
-most common reproductive cancer
-1/78 chances
-older than 63
RF
-family hx
-genetic mutation BRCA or lynch syndrome
-other cancers (breast, uterine, colon)
-jewish
-endometriosis
-never given birth
171
Cervical Cancer
-hpv virus
-hispanic women have higher rates, black women die more
RF
-HIV
-smoking
-parity
-birth control
172
Osteoporosis
-1/4 women 65+
RF
-small frame
-post-menopausal
-family hx
173
Pelvic Floor Dysfunction
-PF disorders, weakening of the support structures
Ex
-prolapse
-incontinence
RF
-pregnancy/childbirth
-aging
-obesity
174
Pelvic Organ Prolapse
-1/3 women
175
Stress Incontinence
-1/3
-urethra support structures
176
Overactive bladder
-urge incontinence
-15% of women
-urge followed by leaking from triggers
177
Bowel Leakage
-6-15%
RF
-perineal tear
-forceps
-diabetes
-radiation
-constipation
178
Constipation
-slow transit, obstructed, dyssynergic
-women (19.7%) more than men (10%)
-1-8% of Americans
179
What age makes up the infancy stage of development?
0-1 year
180
Neonatal stage of development?
O - 2 weeks
181
Infant Stage of development
3 weeks - 1 year
182
Toddlerhood Stage of development
13m - 2y 11 M
183
Early childhood Stage of development
3 years - 10 years, 11 M
184
Preschool stages development Stage of development
3yrs - 5 yrs
185
Elementary school stages of development
5 yrs - 10yr, 11 m
186
Adolescence stages of development
11 yrs - 18 yrs
187
Young adulthood stages of development
18 - 22/25
188
Adulthood stages of development?
22-40yrs
189
Middle age stages of development?
40-65 yrs
190
Late adulthood pages of development?
65+ yrs
191
Infancy (erikson)
0-l yr / trust vs. Mistrust
192
Early childhood (erikson)
1-3 yrs / autonomy vs. shame
193
Preschool (erikson)
3-6 yrs/ Initiative vs. Guilt
194
School age (erikson)
6-12 yrs /industry vs. Inferiority
195
Adolescence (erikson)
12-19 yrs / identity vs, role confusion
196
Young adult (erikson)
20-25 yrs / intimacy vs. Isolation
197
Middle adulthood (Erikson)
26-64yrs / generavity vs. Stagnation
198
Maturity (erikson)
65+/ego integrity vs. Despair
199
Vertical line of body alignment
Mastoid process, anterior to shoulders, hip joints, anterior to knee joints, anterior to ankle joints
200
Newborn developmental changes
Large head, c curve of spine, flexion predominates
201
First 3 months developmental changes
Flexed posture, limb symmetry, increased spine extension, midline orientation, lift head
202
4 to 6 months developmental changes
Lumbar extension, head held up, hands knees position, sitting at 6 months
203
7 to 9 months developmental changes
Quadraped positions, creeping, sitting
204
10 to 12 month developmental changes
Vertical posture, pull to stand, walking
205
2 to 6 years developmental changes
Loss of body fat, gain more balance and flexibility
206
7 to 12 years developmental changes
Improved symmetry, adult skills refined, growth spurt, puberty
207
Adolescence developmental changes : posture control
11 years to 18 years. Ideal posture
208
Adulthood developmental changes: posture control
18 to 40 years. Reduced symmetry, ideal posture
209
Older Adulthood developmental changes
40 plus. Flexed posture, kyphosis, internal shoulder rot, cervical extension, issues with transition movements, less balance and strength
210
ACSM School-aged children Activity Recommendations
-60 min/day vigorous; aerobic: running, biking
-3x/week; strengthening: gymnastics, climbing, monkey bars, yoga
-3x/week; bone loading: jump rope, hopscotch, tennis, basketball
211
ACSM Healthy Adults Activity Recommendations
-30min/5 day moderate intensity (can talk) or 20min/3 day vigorous intensity (can't talk); aerobic
-Resistance 2x/wk
-Flexibility 2x/wk
