Final Exam Flashcards
1
Q
Biopsychosocial Model
A
Biology: how does their body work
Psychology: current mindset
Social: what do they do, what is around them, who is around them
1
Q
Open-Ended questions
A
-use at the beginning
-use when difficulty opening up
-use when clarifying any missing information
2
Q
Close-Ended questions
A
-clarify questions
-get specific answers
3
Q
Graded-Response questions
A
-quantify experience with a range
-clarify vague answers
-use for goal setting
4
Q
Multiple-Option Questions
A
-often visual
-use for patients with difficulty describing
-identify patterns
5
Q
Pre-Interview
A
-review chart and Hx
-observe patient’s posture, demeanor, company, movements
-establish first impression
6
Q
Chief Complaint
A
-Onset
-Location
-Description/Duration
-Intensity
-Behavior
7
Q
Injury Descriptions: Aching
A
Muscular
8
Q
Injury Descriptions: Burning
A
Muscular or neural
9
Q
Injury Descriptions: Shooting, lightning, electrical
A
Nerve root irritation
10
Q
Injury Descriptions: Coldness
A
Blood flow issues
11
Q
Injury Descriptions: Hotness
A
inflammation or infection
12
Q
Injury Descriptions: Clicking, snapping, popping
A
ligament or tendon dysfunction
13
Q
Injury Descriptions: Joint locking
A
Cartilage tear, looseness, misalignment
14
Q
Injury Descriptions: Global weakness or fatigue
A
Cardio or pulmonary dysfunction
15
Q
Injury Descriptions: Whole body pain
A
-central somatization: chronic pain
16
Q
Injury Onset: Acute
A
-quick
17
Q
Injury Onset: Subacute
A
-has no timeline, but not chronic
18
Q
Injury Onset: Chronic
A
-long term
19
Q
Injury Onset: Episodic
A
-Chronic with recent exacerbation
20
Q
Injury Onset: Insidious
A
- no plausible explanation
21
Q
Injury Location
A
-show location
-describe any movement
22
Q
Injury Intensity
A
-pain tools/scales
-numbers
23
Q
Injury Behaviors
A
-exacerbating factors
-Alleviating factors
-changes in 24h
24
24h Pain Pattern
-"Over the course of 24h how does your pain change?"
-joint and back pain
-how does it effect sleep
-how often do you think about your pain
25
Jt pain worse in AM
-inflammatory
-Ex: RA
26
Jt pain worse with movement
-degenerative
-OA
27
Back pain worse in AM and then again in late PM
Disc
28
Red Flag for Malignancy
Constant intense pain, worse PM, awakes from sleep without relief
29
Red Flags Requiring Immediate Attention
-anginal pain no relieved in 10-20min
-angina with sweating, nausea, vomiting
-Diabetic client that is confused or lethargic
-onset of incontinence or saddle anesthesia
-anaphylactic shock
30
Yellow Flags
-proceed with caution
-psychological
31
ABCs of Radiographs
A: alignment or structures
B: Bone density and textures
C: Cartilage
S: soft tissues
32
Patient History
-Determine understanding of condition
-determine current interventions from other clinicians (current and other conditions)
-prior level of function
-health habits/risks
-Medications
-past PT experiences
-Family Hx
33
Patient Environment
-Physical environment
-Living environment/Assistance
-Work/recreation/social/school/sport
34
Mental Orientation Assessment
-AOx3
-Name, location, current date
35
Nominal Measures
-categorized
-one or the other
36
Ordinal Measures
-order/rank is important
37
Interval Measures
-real numbers that can be manipulated
-have no real 0
ex: ankle circumference
38
Ratio Measures
-real numbers that can be manipulated
-real 0
ex: goniometer reading, pain scale
39
Test-Restest Reliability
-reliable accurately and consistently
-stability over time
40
Intra-Rater Reliability
-reliable accurately and consistently
-same for the same person
41
Inter-Rater Reliability
-reliable accurately and consistently
-Same for all raters
42
Face Validity
-does it measure what it claims to
-Does a scale measure weight?
43
Content Validity
-does it measure the full construct
-Does an ADL insttrument include all ADLs
44
BATTED
-ADLS: activities of daily living
-Bathing
-Ambulation
-Toileting
-Transfers
-Eating
-Dressing
45
MDC
-Minimal detectable change
-amount of change that must be achieved to reflect true statistical difference
46
MCID
-Minimal clinically important difference
-smallest difference in a measured variable that signifies and importance
47
Global Disability/QoL
-measures overall disability and quality of life
-patient perceptions of how conditions affects their role in society
-broad range of health
48
Ataxia
-lack of control of body movements
49
Dysmetria
-error in trajectory
-inability to touch target
50
Anesthesia
-complete loss of sensation
51
Hypoesthesia
-abnormally low sensitivity to sensation
52
Hyperesthesia
-abnormally high sensitivity to sensation
53
Hypalgesia
-diminished sensitivity to pain
54
Graphesthesia
-recognizing writing on skin
55
Hyperalgesia
-incrreased sensitivity to pain
56
Astereognosis
-inability to recognize familiar object by touch
57
Atopognosis
-inability to corrrectly locate sensation
58
Abaragnosis
-inability to distuingiush different weights
59
Paresthesia
-Abnormal sensation
60
Dysethesia
-impairment of any sensation
61
Paralysis
-loss of motor function
62
Hemiparaplegia
-paralysis of lover half of one side of body
63
Hemiparesis
-muscular weakness or partial paralysis on one side
64
Hemiparaesthesia
-pertaining to hemiparesis
65
Hemiplegia
-paralysis on one side of body
66
Paraparesis
-partial paralysis of LEs
67
Paraplegia
-paralysis of LEs
68
Tetraplegia
-paralysis of all extremities
69
Quadriplegia
-paralysis of all extremities
70
Triplegia
-paralysis of 3 extremities
71
Diplegia
-paralysis of either both UEs or LEs
72
AROM
-muscle strenth, coordination, willingness to move
-contractile tissue integrity
-if they can do AROM, no need for PROM
73
PROM
-integrity of joints, extensibility of CT, endfeels of joints
-diagnostic
-slightly > AROM
74
Capsule Pattern
-pattern/order of restriction involving most ROMs in a joint
75
Hip Capsular Pattern
-IR then Flexion
76
Elbow Capsular Pattern
-ER then flexion
77
Empty End Feel
-no resistance
-presence of pain
78
Shoulder Capsular Pattern
-ER, AB, IR
79
Injury Severity
Strong & Painless: intact
Strong & Painful: minor
Weak & Painful: Major
Weak & Painless: complete lesion or neuro deficit
80
Thomas Test
-LE flexibility
-edge of plinth
-bend both knees
-bend one, let other down and check for discrepancies
-flexed hip with knee 90: iliopsoas
-ext hip with >90 knee: rectus
-abducted: ITB
-flx hip and ER: short sartorius
81
Ely's Test
-short rectus fem
-prone, passive knee flexion
-check for hip rise
82
Craig's Test
-femoral retro/anteversion
-prone, knee flexed
-ER and IR until Greater troch is parallel with mat
-light reliable
83
Piriformis Flexibility Test
-hip flexed to 100, maximally ER
-slowly adduct to get stretch of piriformis
-stand on opp side
84
Testing Order For Class
1. Dermatome
2. Periperal N.
3. Opposite Tracts
4. Myotome
5. Reflexes
6. ROM Screen
7. ROM Testing
8. MMT
9. Outcome Measure
85
Neck Outcome Measures
OM: NDI
Screens: Posture, Sitting Posture
Implication Tests: SLE with Dural Stretch, Slump Test
Performance: TUG, Cervical Deep Flexor Endurance
86
Shoulder Outcome Measures
OM: quickDASH, DASH
Screens: Scapulohumoral Rhythm, Posture, Overhead Reach
Implication Tests: Apley Scratch Test/Cross Body
Performance: Hand Grip Dynamometry, UE Y-Balance Test
87
Elbow Outcome Measures
OM: qDASH, UEFS, Carpal Tunnel Syndrome, Michigan Hand Questionnaire
Screens: Arm Curl, Carying Angle
Implication Tests:
Performance: Hand Grip Dynamometry, UE CKC Stability
88
Wrist/Hand Outcome Measures
OM: DASH, UEFS, Michigan Hand Questionnaire
Screens: Hands at Rest and Fist, Tinel's Test, Phalen's Test
Implication Tests:
Performance: Hand Grip Dynamometry, UE CKC Stability
89
Back Outcome Measures
OM: Oswestry Low Back Disability Index, Neck Disability Index, STaRT Back Tool, Functional Lumbar Index (projected)
Screens: Posture, Sitting Posture, Gait
Implication Tests: Slump Test,
Performance: TUG, Cervical Deep Flexor, 5x Sit to Stand or 30s, Sorensen Endurance, Prone Plank, Side Plank
90
Hip Outcome Measures
OM: LEAP, LEFS, LEAS, Harris Hip Function Scale, HOOS
Screens: Half/Full Squat, Gait, Posture, SLR, Leg length discrepancy
Implication Tests: Ober's, Thomas, Ely's, Quadrant Test (w or w/o Scour), SI Tests, FADIR, FABER,
Performance: TUG, 6 MWT, Hop Test, Y-Balance, Vertical Jump Test, 12' Drop Jump Test
91
Knee Outcome Measures
OM: LEAP, LEFS, LEAS, KOOS,
Screens: Half/Full Squat, Gait, Posture
Implication Tests: Popliteal Angle, Ober, Thomas
Performance: TUG, Wall sit test, Hop Test, Y-Balance, Vertical Jump Test, 8' Step Down, 12' Drop Jump Test
92
Ankle/Foot Outcome Measures
OM: LEAP, LEFS, LEAS, FFI, FADI, FAOS, FAAM
Screens: Half/Full Squat, Gait, Foot Posture
Implication Tests: Feiss Line, Figure 8, Windlass Test
Performance: TUG, Vertical Jump, Hop Test, Y-Balance, 12' Drop Jump Test
93
Most Common Areas of Spine for Disc Pathology
-C6-C7
-L4-L5
-L5-S1
94
Common Spinal Hinge Points
-transititon areas that that a lot of pressure
95
Cervicogenic Headache
-starts a neck, migrates to head
-upper cervical dysfunction
Sinus: around nose and eyes
Cluster: behind eyes
Neck: top and back of head
Tension: forehead
Migrane: 1 side
TMJ: temples
Tests:
-AROM
-MMT
-Sensation
-Reflexes
Questions:
-screen time
-MOI
-areas of head/face
96
Whiplash
-muscle tightness, brain stem-like Sx
Tests
-JPSE laser
-ROM
-Reflexes
-Myotomes/Dermatomes
Outcome Measures
-NDI
-Kinesiophobia
-Grip test
-Flexor endurance
97
Lumbopelvic Rhythm
1st lumbosacral flexion, then anterior pelvis tilt, hip flexion
98
SIJ Hypermobility
-common with pregnancy
-unilateral activities
-pain radiating behind leg
-inability to stand or sit for a while
Tests
-MMT (trunk and hip)
-AROM
Outcome Measures
-Plank
-Sorensen
99
Cervical AROM Values
Flx: 40
Ex: 50-70
LSB: 22
Rot: 70-90
100
Thoracolumbar AROM Values
Flx: 60
Ex: 25
LSB: 35
Rot: 45
101
Lumbar AROM Values
Flx: 40-50
Ex: 15-20
LSB: 25
102
Impingement Syndrome
-compression and damage to soft tissue within the structure (MC: subacromial, supra, infra, bicep)
S/S: pain 60-120 deg, pop or click, anterolareral pain
Cause:
-acromion shape
-overhead reach
-foosh
-RTC weakness
OM: DASH, UEFI, Grip, Wall overhead reach
103
Rotator Cuff Tears
-SITS
I: Bursitis or tendonitis, pain
II: partial rotator cuff
III: full thickness, loss of ROM and strength
S/S: pain when ER/IR, , upper trap atrophy, Shrug Sign (shrug needed for flexion to compensate torn supra)
Cause: chronic and degenerative
Intrinsic: blood supply
Extrinsic: acromion morphology, acute injury
Better: out of aggravating position, retraction
Worse: recruitment of supra, protraction
-Surgical: immobilized, no AROM for 4-6w, limited PROM ER, Ab, IR
104
Shoulder Labral Tears
-SLAP (superior labrum ant to post): overhead throwing, hyperextension, pain with flx
-Bankheart: labral tear (2-6oclock, bicep tendon ass. anteriorinferior)
-Psterior Labral Lesions (internal impingement)
S/S: aching, instability, catching, popping, feels heavy
Cause: FOOSH, overhead mmt, traction, trauma, dislocation, impingement
Worse: overhead activity, liting, hands behind back, flexion
105
Adhesive Capsulitis
-inflamed and stiff shoulder capsule
S/S: loss of ROM, pain in deltoid, nocturnal pain hallmark
Phase 1: insidious, nocturnal pain
Phase 2: diminished pain, ROM loss
Phase 3: pain gone, ROM increases 12-24
Cause:
Primary: insidious
Secondary: response to trauma
-DM, hypothyrpidism, hypertriglyceridemia
OM: DASH, UEFI, hand grip, overhead reach
106
Shoulder ROM Values
Flexion: 180
Extension: 50-60
Abd: 180
Internal Rot: 70-80
External Rot: 90
107
Scapular Resting
-T2-T7
-3 in from SP
-slight upward rotation
108
AC Joint Sprain
-FOOSH, downward force on acromion
Sx: weakness with elevation, piano key sign (severe), pop, pain @90
109
Posture @ Rest
-clavicle elevated 20
-Shoulders elevated 20
-acromion under ear
-khyphosis
-elbow under humeral head
-scapular T2-T7
110
Elbow ROM Values
Flexion: 140-150
Extension: 0
Supination: 80
Pronation: 80
111
Wrist ROM Values
Flexion: 80
Extension: 70
Rad Dev: 20
Ulnar Dev: 30
112
Finger ROM Values
-MCP:
Flex/ext: 90/45
-PIP:
-Flx/Ext: 100/0
-DIP:
-Flx/Ext: 90/0
113
Elbow, wrist, hand Outcome Measures
-qDASH
-UEFS
-Carpal Tunnel Syndrome Instument
-Mischigan Hand
-Hand grip
-Jebsen test of hand function
-Arm curl
-hand grip
-lateral pinch
114
Normal Elbow Position
-8-15 degrees of Cubital Valgus
115
Median Nerve Entrapment
Pec minor, scalenes, 1st rib, humeral head, cubital tunnel, carpal tunnel
-thumb and fingers 2-3, tips of fingers
Phalen's Test: Stretch median nerve
Tinel's Test: tap nerve
116
Radial Nerve Entrapment
Scalenes, triangular space, lat epi, supinator
-back of hand
Tinel's Test
Resisted Supination
-thumbs up
117
Tennis Elbow
-Lateral Elbow Tendinopathy
-repetitive wrist extension and radial dev
-no inflammation
Grip Strength
-lateral pinch
118
Golfer's Elbow
-medial eppicondylalgia
-repetitive wrist flexion, twisting
Grip Strength
119
Telephone Elbow
-Cubital Tunnel
-ulnar nerve entrapment
Sx: ulnar side gripping
120
Osteochondritiis Dessicans
-Lesion on capitulum
-forceful valgus
-loss of extension, catching and locking
121
Ulnar Nerve Compromise
-crossing fingers
-intrinsic muscle atrophy
-last 2 finger and thumb adductors
122
UCL Sprain
-valgus force
-Snap and ain over medial elbow
123
LCL Sprain
-varus force
-chronic crutch user
-radial head sublux
-unstable feeling
-popping, clicking, catching
124
Post-Op Elbow Patient
-brace
-ORIF AROM only
-tendon PROM only
125
Postural Responses
Ankle: small disturbances, most common, distal to proximal
Hip: larger disturbances, proximql to distal
Stepping: COM is displaced beyond BOS
Reaching: moving to tocuh down
126
Gait Cycle
Stance:
-Initial contact (Preswing): heel contact, flexion hip (20)
-Loading response (initial swing): weightshift, flexed knee (15), DF (7 lack of will show)
-Midstance (Middle Swing): Neutral hip
-Terminal Stance (Terminal Swing): extended hip (20 backwards rotation of pelvis will show it flexors are tight), DF (10 at highest)
-Pre-Swing (Initial contact): full extension, flexion (40), PF (15 need toe extension for windlass)
Swing:
-Initial Swing (loading response): toe off, most knee flexion (60), pelvis rotates to catch up
-Middle Swing (Midstance): most flexion (25)
-Terminal Swing (Terminal Swimg): right before initial contact
127
Double Limb Support
-20%
128
Single Limb Support
-80%
-running is 100%
129
Pelvis MMT During Gait
-3deg ant/post
-2deg sup/inf
130
Step
-distance foot advances in relation to the other (heel to heel)
-18 inch norm
131
Stride Length
-distance from one foot back to the same foot
-Right heel to right heel
-3 ft norm
132
Step Width
-horizontal disrance between heels
-2-4 inches
133
Cadence
-number of steps per min
-117/min
134
Velocity
-speed of walking
-1.2-1.4 m/s
135
Circumduction Gait
-trunk and pelvis rotate anteriorly
-propels leg forward to avoid knee flx
136
Foot Drop
-toes drag with no DF
-cast or fibular fx can cause
137
Hemiplegic Gaitt
-one side of body is weak
-cerebral palsy, tbi, stroke
138
Antalgic Gait
-short stance on pain side
139
Ataxic Gait
-lack of coordination
140
Scissor Gait
-crossing over
-tightness of hib adductors
-cerebral palsy
141
Parkinsonian Gait
-shuffling feet with flexion placing weight on balls of feet
142
Steppage Gait
-excessive hip and knee flexion to clear limb
143
Vaulting Gait
-rapid ankle PF to clear limb
144
Plumb Line
-ant to mastoid
-anterior acromion
-post to hip
-anterior to knee
-anterior to malleolus
145
Crossed Syndrome
-anterior superior to posterior inferior= weak and stretched
-posterior superior to anterior inferior= tight and contracted
146
Postural Sway
-anterioposterior is 5-7mm
-mediolateral is 3-4mm
147
Pressure on Lumbar Discs
-sitting with flexion while carrying = 275lbs
-standing with flexion while carrying= 220lbs
-laying on back= 25lbs
148
Anterior Pelvic Tilt
-tight errectors and hip flexors
-weak glutes and abs
149
Posterior Pelvic Tilt
-weak errectors and hip flexors
-tight glutes and abs
150
Coxa Valga
-greater angle of inclination >125
-straighter
-longer limb
-increase dislocation
-genu varum
151
Coxa Varum
-lesser angle of inclination <125
-shorter limb
-improved congruence
-more stress on neck
-genu valgum
152
Anteversion
-greater torsion than normal >20
-head more anterior
-more IR, toe in
153
Retroversion
-lesser torsion than normal <10
-head more posterior
-more ER, toe out
154
ROM Needed to rise from sitting
-hip flexion 120
155
ROM needed to tie shoes
-hip flx 115
-ER 13
-abd 18
156
ROM needed to sit cross legged
-hip flx 85
-abd 35
-ER 45
157
Lateral Femoral Cutaneus Neuralgia
-brittany spears
-73-81%
-L2-L3 dermatomes
158
Hip Dysplasia
-acettablum doesnt cover femoral head
-babies
-groining pain, possible limp, unstable, LLD
159
Femoral Acetabular Impingement
-FAI
-bony overgrowth
-can lead to labral tears
CAM: head and neck, athletes
Pincer: pelvis and acetabulum, females
Mixed: both, more common
160
Hip Osteoarthritis
-coxa valga, hip dysplasia, trauma
-hip flx posture
-decreased extension
1. Squatting
2. Hip flx causing lat hip pain
3. Scour test
4. Extension lateral pain
5. Passive IR <25
3 or 4/5
161
Tibiofemoral Angle
-angle btwn femoral shaft and tibial shaft
-165-175
Valgum: <165
Varum: >174
162
Q Angle
-estimate of tibiofemoral angle
-10-15 normal, >20 malalignment
-asis, patella, tib tub
163
Knee ROM to Ride a bike
-115
164
Knee ROM to get up from a chair
-120
165
Knee ROM to descend stairs
-90
166
Knee ROM to climb stairs
-83
167
Knee ROM to walk
-60-70
168
Knee Capsular End Feel
-extension then flexion
169
ACL Sprain
-tear of ACL (85% of resistting ant. translation)
-females more likely
-athletic ppl
S/S: pop or tearing sensation, pain, knee giving out, decreased quad
Cause: violent twist w/o contact, joint laxity, medial blow to knee, weak hamstrings
Better: elevation
Worse: walking, pivoting, stairs, cutting
Treatment:
Surgery: Hamstring, quad, gastroc, patellar tendon grafts
-1-2 years
-necrosis, revascularization, cellerular proliferation, collagen formation
PT:
Stage 1: Inflammatory 0-14d
-ROM, inflammation
Stage 2: Reparative 15-21d
-ROM, full extension, swelling, flexibility, walking
Stage 3: Remodeling 22-60 60-360d
-pain free ROM, no limitations, return to sport
170
MCL Sprain
-tearing of MCL by valgus force at femoral attachment with tibal ER
-well vascularized and not under tension, can heal own on in 6w
S/S: tearing sensation, medial knee brusing, instability
171
LCL Sprain
-tearing of LCL by varus force at fibular attachment
-least common knee lig injury
S/S: pop sensation, lateral knee pain, instability, swelling, n/t from superficial fib
172
Meniscal Injury
-tearing of meniscus
-often with ACL
-Medial more common (less mobile)
S/S: popping, clicking, giving away, joint line tenderness, delayed swelling
Cause: degeneration, trauma (compressive twisting)
173
Patellofemoral Pain Syndrome
-pain around or behind patella
-above and below
S/S: pain descending stairs, pain during flexion and extension behind or around knee, swelling, pain with activity, grinding, clicking
Cause: overuse with force at patellofemoral with compression of knee, weak abd extensors and ERs
Better: avoidance of knee flexion
Worse: prolonged sitting, running, walking
Treatment:
-PT: contributing factors, avoid flexion based things, avoid last 30 of extension
174
Patellar Tendinopathy
-Tendinitis (jumper's knee): acute inflammation of the patella
-Tendinosis: chronic degeneration
-low metabolic rate
S/S: pain ascending stairs, localized pain ant patellar tendon, swelling, pain with activity, no referral
Cause: overuse activity (3-8%) of load applied, repetitive jumping and running, eccentric
Better: rest, bracing
Worse: squatting, running, squatting
Treatment:
-PT: correction of other factors, activity mod, flexibility, abnormalities
-Surgery: if PT fails after 6mon
175
ITB Syndrome
-lateral knee deviations
-tight TFL, weak glutes, Positive ober
176
PCL Tear
-dashboard injuries
-hyperextension injury
S/s: knee swelling, instability
177
Pronation MMts
-eversion, abduction, df
178
Supination MMTs
-inversion, adduction, PF
179
Hallux Valgus
-bunion
-lacking extension
-angle btwn metatarsal and phalanx >15 is abnormal
180
Hallux Rigidus
-great toe MTP is rigid
-inflammation
181
Functional Capacity Evaluation
-worker's comp
-residual capacity to perform work
-~4 hrs
-phychometric, physical and functional tests
-compares abilities to work description
182
Industrial PT
-promote wellness at worksites with early access
-ergonomics, prevention
183
Y-Balance Stats
-difference in legs with anterior position are most prredictive for non contact injuries
184
LESS
-12 inch box jump
185
Hop Test Stats
-differences in leg percentages <90% is bad
186
Functional Movement Screen
-hard one
-screens for mmts sharbed btwn sports
-7 tests, 3-1
-14/21 or > is goal
187
Selected Functional Movement Assessment
-easy one in hall way
-7 tests
- can w/o pain, can w/ pain, cant w/ pain, cant w/o pain
