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Acute Care > Orthotics, Skin Issues & Positioning > Flashcards

Orthotics, Skin Issues & Positioning Flashcards

1
Q

philadelphia spinal orthotic

A

restricts flex/ext

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2
Q

aspen spinal orthotic

A

restricts in all 3 planes

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3
Q

miami spinal orthotic

A

restricts in all 3 planes

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4
Q

cervical collar

A

not alot of restriction
on at all times
may have to sleep in them

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5
Q

cervicothoracic spinal orthotic

A
  • lower cervical/thoracic

- upper back/cervical support

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6
Q

halo spinal orthotic

A

absolute restriction

actual spinal cord injuries

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7
Q

hyperextension orthoses

A

jewett
CASH
HE brace with neck support

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8
Q

TLSO spinal orthotic

A

support from thoracic down to lumbar spine

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9
Q

what should you do with pillows

A

float heels
elevate UE
use for sidelying
prevent hip ER in supine

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10
Q

what do you not do with pillows

A

place under knees

keep neck flexed

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11
Q

whats important to do with speciality beds

A

inflate maximally during mobility

return to proper setting at end of tx

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12
Q

what can you use to off load the pt

A

cushions in wheelchair

tilt WC

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13
Q

foam cushion

A

least amount of pressure

most stability

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14
Q

gel cushion

A

little more pressure relief

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15
Q

air cushion

A

best pressure relief

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16
Q

gold standard for off loading for diabetic ulcers

A

total contact cast

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17
Q

role of PT in wound care

A
  • promote wound healing
  • education
  • maximize pt mobility
  • minimize pain
  • recommendations for interdisciplinary care
  • recommendations for follow up care
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18
Q

what will you see with arterial insuffiency wounds

A
  • decreased pedal pulse
  • intermittent claudication
  • anteriolateral foot/ankle, toes
  • full thickness - well defined borders
  • pale, minimal drainage, often with eschar
  • shiny, anhydrous, pale to cyanotic
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19
Q

arterial insufficiency will create what kind of wounds

A

dry wounds

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20
Q

what will u see with venous insufficiency wounds

A
  • pedal pulse present
  • lower limg discomfort
  • edema worse in dependent position, less when LE raised
  • irregular shape, shallow wound on medial lower leg and malleolus
  • mod to copious drainage
  • hemosiderin staining and lipodermatosclerotic changes
21
Q

venous insufficiency will create what kind of wounds

A

wet wounds

22
Q

diabetic foot ulcer will look like what

A
  • pedal pulse often absent
  • ulcers painless with decreased temp
  • at pressure points
  • pale wound, nonviable tissue, minimal drainage
  • trophic changes
23
Q

pressure injury

A
  • pulses intact
  • on pressure areas
  • painful
  • varying depth
  • stages 1-4
24
Q

superficial wound stage

A
  • damage to epithelium

- heals rapidly through regeneration of epithelial cells

25
Q

partial thickness wound stage

A
  • dermal layer

- vessel damage

26
Q

full thinkness wound stage

A
  • subcutaneous fat and deep
  • longest time to heal
  • contraction
27
Q

stage 1 pressure injury

A

intact

reddened skin that does not lighten when palpated

28
Q

stage 2 pressure injury

A

partial thickness when exposed
viable dermis
no slough, eschar

29
Q

stage 3 pressure injury

A

full thickness with exposed subQ
may include epibole, tunneling, undermining
slough and eschar

30
Q

stage 4 pressure injury

A

full thickness exposed muscle, tendon, ligament, fascia, cartilage, bone
epibole, tunneling, undermining
slough, escar

31
Q

unstageable pressure injury

A

slough, escar covers full thickness wound

unable to detect depth

32
Q

deep tissue pressure injury

A

intact or nonintact skin appearing as non-blanchable red, maroon or purple in color

33
Q

phases of wound healing

A

hemostasis
inflammation
proliferation
remodeling

34
Q

hemostasis

A

begins immediately

minimize bleeding and create barrier form contamination

localized vasoconstriction, activation of platelets

35
Q

inflammation

A

10-15 min after injury

control bioburden, establish clean wound

localized vasodilation, inc tissue permeability bring exudate to wound

localized response in proportion to injury

36
Q

proliferation

A

2-5 days post injury

restoration of vascular integrity, formation of connnective tissue, wound contraction, reepitheliazation

fibroblasts –> granulation tissue

37
Q

remodeling

A

up to 2 yrs post injury

immature collagen organized into mature collagen
scar tissue only up to 80% or original tissue strength
lacks elastin, stiffer than original tissue

38
Q

acute wounds

A

known cause
moves through phases of healing in reasonable timeframe
achieves successful wound closure

39
Q

chronic wounds

A

underlying condition or from negative effect
delayed healing in one or more phases of healing
wound closure not sustained

40
Q

acute wounds last how long

chronic wounds last how long

A

4-6 weeks

longer 6 weeks

41
Q

examples of acute wounds

A 
surgical wounds
bites
burns
abrasions
traumatic wounds
42
Q

examples of chronic wounds

A

leg/foot ulcers

pressure sores

43
Q

treatment for acute wound
clean/minor:
severe and contaminated:

A
  • minimal intervention
  • surgical debridement
  • antimicrobial therapy
  • wound lavage
44
Q

chronic wound treatments

A 
wound dressing
antimicrobial agents
footwear
PT 
educational strategies
optimise tx for co-morbidities
45
Q

sharp debridement

A

using a scalpel cutting away non-viable tissue

46
Q

autolytic debridement

A

dressing placed and bodies enzymes heal it

47
Q

enzymatic debridement

A

certain enzymes added to the dressing that help heal it

48
Q

mechanical debridement

A

dressing placed on wound and when pulled off - it pulls all the skin off

49
Q

ideal wound bed

A

clean and moist

Acute Care (20 decks)

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