Subjective Flashcards

(41 cards)

1
Q

subjective portion checklist

A

chief complaint
health history
pyschosocial
screening tools
outcome measures
RAPPORT

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2
Q

what is the difference between an “orange” and “red” level of concern

A

orange - further investigation by physician

red - ER

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3
Q

what are some screening tools for chronic pain

A

Orebro
STarT Back

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4
Q

what are screening tools for pain catastrophizing? significant score?

A

PCS
>30

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5
Q

what is a screening tool for kinesiophobia? significant score?

A

TSK-11
11-44 (higher more avoidant)

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6
Q

what is a screening tool for fear avoidance? significant score?

A

FABQ
>15 for physical activity
>34 for work

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7
Q

major difference between an orange and red on yellow flag screening

A

orange - referral due to mental illness symptoms

red - referral to ER for emergency care response due to severe mental illness (ie suicide)

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8
Q

how is therapeutic alliance formed in subjective? what is it an indicator of

A

explains flow of visit to patient by setting expectations

the outcome of patient

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9
Q

what do we need to understand about the chief complaint

A

history
location/behavior of symptoms
previous treatments

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10
Q

what external factors could affect one’s chief complaint

A

functional status in roles / demands upon the patient

patient’s goals/expectations

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11
Q

what do we use to evaluate symptom behavior

A

SINSS

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12
Q
A
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13
Q

what does SINSS stand for

A

Severity
Irritability
Nature
Stage
Stability

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14
Q

health history includes

A

review of systems (red flag screen)
surgeries
allergies
illnesses
health habits
history of abuse
pertinent family med hx

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15
Q

local factors that affect MSK tissue healing

A

tissue perfusion
infection
implants/foreign matter

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16
Q

what affects healing of MSK tissue

A

local
systemic
synergistic

factors

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17
Q

how does tissue perfusion and oxygenation affect tissue healing

A

initial hypoxia stimulates healing, but prolonged can lead to chronic inflammation

18
Q

what systemic factors affect tissue perfusion

19
Q

when is infection most relevant

A

after surgical procedures or open injuries

20
Q

how does infection affect healing

A

prolonged inflammation
increased bacteria (oxidative stress)
biofilms
matrix metalloproteinases

21
Q

what danger do foreign matter and implants pose

A

trigger immune response via macrophages
inflammation
inhibit cell differentiation
increase osteolysis

22
Q

what danger do bioabsorbable materials pose

A

prolonged joint effusion

23
Q

how does age affect healing

A

slows rate of nerve regeneration, tendon healing, muscle recovery

24
Q

what inflammation stages are affected by aging

A

hemostasis, inflammation, proliferation and remodeling are affected

aka ALL of them

25
how do estrogen and androgens affect healing
estro - improved andro - delay, but essential for muscle and nerve regeneration
26
what medications affect tendon healing
NSAIDS glucocorticoids
27
what are age associated traits that can be caused by smoking
increased: muscle atrophy strength loss oxidative stress on tissues
28
what happens initially after stopping cigarette smoking
blood flow increase oxygenation glucose and lactate levels return to normal levels
29
what happens 4 weeks after cessation of cigarettes
endothelial function are back to level of non-smoker
30
what happens 2 weeks after cessation of cigarettes
platelet aggregation effects are reverse
31
what happens 20 years after cessation of cigarettes
c-reactive protein fibrinogen white blood cell count levels of hemostasis
32
what does diabetes affect
vascular function angiogenesis increased oxidative stress
33
what does obesity cause the body to be in
a pro-inflammatory state
34
how does obesity affect wound closure
delay healing due to relative avascularity of subcutaneous adipose tissue skin folds around incision can allow for bacterial growth
35
protein recommendations for each life stage
younger adults - 0.8g/kg older adults - 1g/kg chronic wounds - 1.25-1.5g/kg
36
step ranges and associated benefits
2200 = lower mortality and CVD risk 9000-10500 = lowest mortality
37
the patient's perception of the chief complaint allows for the PT to
bridge gap between patient expectation and possible outcomes
38
understanding the patient's: family social personal circumstances environmental barriers allows the PT to understand
contextual factors and how they can link to prognosis
39
compare patient recovery expectations and treatment expectations
Patient recovery expectations are commonly associated with patient outcomes Patient treatment expectations were less clear with patient outcomes
40
what are the major variables that determine recovery expectations
pain progress performance treatment
41
how has MSK patient care changed?
framework associated with - providing a plan - management focused around patient education, centered care, healthy lifestyle x Empathy x Honesty x Empowerment --> last slide graphic.... probably not important but oh well.