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NPTE Prep > Virtual Class topics 11-20 > Flashcards

Virtual Class topics 11-20 Flashcards

1
Q

Describe UMN disease presentation

In terms of:
Tone
Reflexes
Sensation
Involuntary
Voluntary

A

Spasticity
Hyperreflexia
Decreased sensation
Muscle spasms
Synergistic movement patterns

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2
Q

Describe LMN disease presentation

In terms of:
Tone
Reflexes
Sensation
Involuntary
Voluntary

A

Hypotonia
Hyporeflexia
Decreased sensation
Fasciculations
Weak movements

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3
Q

Describe basil ganglia disorder presentation

In terms of:
Tone
Reflexes
Sensation
Involuntary
Voluntary

A

Rigidity
Decreased or normal reflexes
Normal sensation
Resting tremors
Bradykinesia

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4
Q

Describe cerebellar disorder presentation

Tone
Reflexes
Sensation
Involuntary
Voluntary

In terms of:

A

Decreased or normal tone
Decreased or normal rexlexes
Normal sensation
No involuntary movements
Ataxia, intention tremor, dysdidochokinesia, dysmetria

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5
Q

Describe the patho of parkinsons

A

Progressive neurological disorder, degeneration of substantia nigra in midbrain, decrease in dopamine

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6
Q

What are the cardinal signs of parkinsons

A

TRAP
Tremor at rest
Rigidity
Akinesia / bradykinesia
Postural instability

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7
Q

Describe the Honen and Yahr classification system for parkinsons

A

Stage 1
Minimal symptoms
Unilateral if present

Stage 2
Bilateral symptoms
Balance not impaired

Stage 3
Impaired righting reflexes
Balance impaired
Some activities impaired

Stage 4
Ambulation only possible with assistance

Stage 5
Bed / wheelchair bound

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8
Q

Describe freezing and festinating gait

A

Freezing gait
Sudden inability to initiate movement
Walking and then stops
Happens in response to cognitive load
Visual cues to help correct

Festinating gait
Short stride, shuffling, anteropulsion
Correct by adding toe wedge, helps to bring COM backwards and prevents forward leaning

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9
Q

Describe the patho of MS, what demographic group is most at risk

A

Autoimmune disease.
Immune system attacks the myelin on nerves producing progressive demyelination in the CNS.
Common in women 20-40

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10
Q

What are some unique MS symptoms

A

Lhermitte’s sign
Neck flexion sends electric shock down spine

Uthoff’s phenomenon
Intolerance to heat

Charcot’s triad - SIN
(Cerebellar symptoms)
Scanning speech
Intentional tremor
Nystagmus

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11
Q

What is marcus gunn pupil

A

Pupils dilate in response to light rather than constrict, seen in MS

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12
Q

What are the 4 types of MS

A

Relapse remitting
Attacks with remission
Most common type

Primary progressive
No attacks, constant increase in symptoms

Secondary progressive
Relapse remitting turning into primary progressive

Progressive relapsing
Attacks with constant increase in symptoms

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13
Q

What are some intervention considerations for MS

A

Do not over fatigue
Manage temperature
Energy conservation
Exercise in best in the morning
Include coordination and balance training

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14
Q

Describe ALS patho and what is its other name

A

Progressive neurological disorder that damages nerve cells and causes disability.
Involves death of motor neurons.
Lou Gehrig’s disease

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15
Q

Describe ALS presentation in terms of motor, sensory, cognitive, respiratory , and common fatality

A

UMN and LMN presentation
Normal sensations
Only motor neurons affected
Dementia, cognitive deficits, pseudobulbar affect
Muscles, cervical spine extensor weakness is common
Respiratory muscle weakness which can lead to death

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16
Q

Describe GB
Cause, presentation, prognosis

A

Autoimmune disorder causing demyelination in the LMN

Occurs after respiratory or gastrointestinal infection
Full recovery possible

Progressive loss of distal to proximal paralysis (ascending paralysis)
Glove and stocking pattern

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17
Q

Describe ACA stroke presentation

A

ABCD = baby = what do kids do
Hemiparesis LE
Hemisensory loss LE
Urinary incontinence
Problems with imitation, bimanual tasks, apraxia
Slowness, delay, motor inaction
Contralateral grasp reflex, sucking reflex

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18
Q

Describe MCA stroke presentation

A

MPH, mouth, perception, HH
Hemiparesis UE and face
Hemisensory loss UE and face
Language issues
Visual perceptual deficits
Contralateral HH

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19
Q

Describe PCA stroke presentation

A

Contralateral HH
Visual agnosia - PROSOPagnosia, Inability to recognize people.
Dyslexia w/o agraphia, color discrimination.
Memory deficits.
Topographical disorientation.

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20
Q

Describe L sided stroke presentation

A

“OLd”
R hemiparesis and hemisensory
Language impairments
Slow, cautious
Highly distractible
Difficulty with positive emotions

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21
Q

Describe R sided stroke

A

“Rambunctious”
L hemiparesis and hemisensory loss
Visual perceptual deficits
Quick, impulsive
Rigid thought
Difficulty with negative emotions

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22
Q

Desceibe the brunnstrom stages of motor recovery

A

1
No active limb movements, flaccid

2
Minimal voluntary movement
Inside synergy, increased tone

3
Voluntary control of movement synergy
Spasticity at peak
Peak tone

4
Movement outside of synergy
Decreased tone

5
Increased independence from synergies

6
Individual joint ,povement
Coordinated movement

7
Normal

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23
Q

Describe the parameters for hot pack administration

A

158-167 F
20-30 mins
6-8 layers of toweling
Burns likely to happen within 5 minutes

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24
Q

Describe the parameters for parafin bath

A

125-127 F
15- 20 mins
Used on hands and feet with irregular distal areas

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25
Q

Describe the application and parameters for contrast baths

A

Immerse in hot and cold water in alternating fashion
Hot water 100-111 F for 4 min
Cold water 55-65 F for 1 mins
Always end with cold

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26
Q

What are the negative anions used during iniontophoresis and what do they do

A

ISAD
Iodine - Sclerotic scars
Salicylate - Analgesia
Acetate - Calcium deposits
Dexamethasone - Reduce MSK infmallation

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27
Q

What are the positive cations used in iontophoresis and what do they do

A

WHaCC LiZ
Water - hyperhidrosis
Zinc - dermal ulcers
Lidocaine / xylocaine - analgesia
Copper - fungal infections
Hyaluronidase - edema reduction
Calcium / magnesium - muscle spasms

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28
Q

What are the E-STIM parameters for muscle strengthening

A

35-50 pps

150-200 micro seconds for small muscles, 200-350 for larger muscles

> 10% to 50% MVIC

6-10 seconds on, 50-120 seconds off, 1:5 normally

2 second ramp time

10-20 min treatment time

Every 2-3 hours when awake

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29
Q

What are the parameters for high voltage pulsed valvanic current for wound healing, in terms of PPS, microseconds, Amplitude, duration and waveform

A

60-125 pps
40-100 microseconds
Comfortable tingling
45-60 mins
HPVC waveform

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30
Q

When administering high voltage pulsed galvonic current when should a positive or negative electrode be used

A

Negative electrode - Inflamed or infected wound
Positive electrode - Wounds without inflammation

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31
Q

Describe high rate tens and what is it’s other name

in terms of
Goal
Wave
PPS
pulse duration
amps
tx time

A

I - When there is acute pain use high rate
G - Goal is sensory stimulation
W - Mono or biphasic pulsed
PPS - 100 pps
PD -50-100 µs
A - Comfortable tingling
T - 20-30 mins, useful when there is pain during functional activities

Conventional tens

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32
Q

Describe low rate tens and what is it’s other name

in terms of
Goal
Wave
PPS
pulse duration
amps
tx time

A

G - Motor stimulation
W - Mono or biphasic pulsed
PPS - < 10 pps
PD - > 150 µs
A - Visible twitch
T - 20-45 mins
Acupuncture tens

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33
Q

Describe breif intense tens

in terms of
Goal
Wave
PPS
pulse duration
amps
tx time

A

G - Motor stimulation
W - Mono or biphasic pulsed
PPS - 100 pps
PD - >150 µs
A - Strong muscle contraction
T < 15 mins

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34
Q

Describe noxious tens and what are its use cases

in terms of
Goal
Wave
PPS
pulse duration
amps
tx time

A

G - Hyperstim
W - DC or monophasic
PPS - 100 PPS or 1-5 PPS
PD - >250 µs up to 1 sec
A - Highest tolerance
T - 30-60 sec per area
Trigger point release

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35
Q

Describe the US decision making tree for chronic pain

A

Thermal
100% duty cycle
5 - 10 mins
Depth:
- 1-2cm = 3MHz = .5 W/cm2
- 3-5cm = 1MHz = 1.5-2 W/cm2

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36
Q

Describe the US decision making tree for acute pain

A

Nonthermal
20% duty
5-10 mins
Depth
- 1-2cm = 3MHz = 0.5-1 W/cm2
- 3-5cm = 1MHz = 0.5-1 W/cm2

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37
Q

Describe traction parameters

A

Prone
- posterior disk herniation

Supine
- Intervertebral joints, facet joints, muscle elongation
- L3-L4: 75-90 hip flexion
- L5-S1: 45-60 hip flexion
- 25% body weight: Disc protrusion, spasm, elongation
- 50lb or 50% bodyweight: Joint distraction

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38
Q

Describe the parameters for EMG biofeedback

A

Relaxing muscles
- Low sensitivity
- Electrodes placed close together

Re-educating muscles
- High sensitivity
- Electrodes placed far apart

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39
Q

What are the diagnostic criteria for metabolic disorder

A

3 or more of the fallowing:
- Waist circumference > 40 in men, > 35 in women
- HDL < 40 in men, < 50 in women
- Triglycerides > 150
- BP - > 130/85
- Fasting glucose > 100

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40
Q

What fasting glucose level suggests diabetes

A

fasting glucose greater than 126

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41
Q

What hormones are secreted by the anterior pituitary and what do they do

A

ACTH - Adrenal cortex - cortisol, aldosterone
TSH - thyroid gland - T3, T4
FSH and LH - ovaries and testes - estrogen, progesterone, testosterone
GH - Bones and tissues - growth and metabolism
Prolactin - milk production in breasts

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42
Q

What hormones are secreted by the posterior pituitary and what do they do

A

ADH / vasopressin - Regulates water and mineral balance, water retention
Oxytocin - stimulates uterine contraction during birth

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43
Q

Describe addison’s disease

A

Decreased cortisol and aldosterone
Caused by infections, neoplasm, hemorrhage, autoimmune process.

(Cort)
Decreased BP
Decreased glucose.
Stress, anxiety, depression.

(Ald)
Hyperkalemia.
Dehydration.

Bronze pigmented skin.
Weight loss, anorexia, GI issues.
Generalized weakness.
Cold intolerance

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44
Q

Describe cushing’s disease

A

Elevated cortisol and aldosterone.
Caused by pituitary tumor.

(Cort)
Increased BP, water retention.
Increased glucose.

(Ald)
Hypokalemia.
water retention.

Ruddy appearance.
Weight gain, obesity, round moon face.
Proximal muscle weakness and atrophy.
Increased susceptibility to infection, osteoporosis, poor wound healing.

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45
Q

Describe hyperthryoidism

HR, BP, BMR, temp tolerance, glucose, energy, GI, lbs, DTR, appearance

A

Hyperthyroidism - Hype man (all metabolic processes increase).
Increased T3 and T4.
Increased HR.
High BMR.
Heat intolerance. (already running hot)
Increased glucose absorption.
Restlessness, insomnia.
Diarrhea.
Silky hair, moist palm.
Weight loss and increased appetite.
Increased perspiration.
Hyperreflexia.
Exophthalmos (bulging eyes), graves disease.

46
Q

Describe hypothyroidism

HR, BP, BMR, temp tolerance, glucose, energy, GI, lbs, DTR, appearance

A

Hypothyroidism - laying on couch all day (all metabolic processes decrease).
Decreased T3 and T4.
Decreased HR, increased BP.
Low BMR.
Cold intolerance. (already running cold)
Decreased glucose absorption.
Sleepiness, tired, proximal muscle weakness
Constipation.
Brittle nails, dry skin and hair.
Weight gain and decreased appetite.
Decreased perspiration.
Prolonged tendon reflexes.
Myxedema (swelling of hands, feet, face), hashimoto’s disease.

47
Q

Describe hyperparathyroidism

A

Elevated calcium and decreased phosphate in blood

Bones - Osteopenia, gout, arthralgia
Stones - Kidney, renal insuficiency
Groans - Peptic ulcer
Moans - Proximal muscle weakness, fatigue, drowsiness, depression
Sensory - Glove/stocking sensory loss

48
Q

Describe hypoparathyroidism

A

Low calcium and high phosphate in blood

CATS are NUMB
- Convulsions
- Arrhythmias
- Tetany, twitching
- Spasms, cramps
- Numbness in fingertips and mouth area
- Also fatigue and weakness

49
Q

Describe hypoglycemia

A

Cold and clammy requieres candy
< 70 blood glucose
Tachycardia and palpitations
Excessive hunger
Dizziness, fainting
Pale, sweating

Shakiness
Poor coordination and unsteady gait

Slurred speech, drowsiness, confusion
Loss of consciousness and coma - call 911

50
Q

Describe hyperglycemia

A

> 300 blood glucose
Deep and rapid respirations
Frequent, scant urination
Excessive thirst
Weakness
Dry mouth
Dull senses, confusion, diminished reflexes

Fruity odor breath
Hyperglycemic coma - 911

51
Q

How does insulin injectiion affect when to exercise

A

Avoid exercise 2-4 hours after injection

52
Q

Describe blood glucose levels and safety for exercise

A

100-250 = safe
70-100 = carb snack
250-300 w/o DKA = caution
250-300 w/ DKA = stop exercise
< 70 or > 300 = stop exercise

53
Q

What is normal HBA1C and when is insulin therapy needed

A

Normal = 4-6%
Immediate insulin therapy needed at >10%

54
Q

What is the FITT for diabetes and exercise

A

3-7 days
11-13 RPE
150 mins a week
Moderate intensity aerobic exercise involving large muscle groups

55
Q

Describe the different types of urinary incontinance

A

Stress - physical stress - strengthen pelvic floor muscles

Urge - hyperreflexive bladder - treat infections, voiding schedule

Overflow - too much, dribbling present - behavioral modification like double voiding, catheter, medication

Functional - bladder functioning normally but other reason why pt cannot void properly, clear environment, improve accessibility, promote voiding

56
Q

What are some physiological changes associated with pregnancy

A

20-30 lb weight gain
Forwared head posture, increased lordosis, anterior pelvic tilt
BP low in first 2 trimersters, high in last
HR increases

57
Q

Describe preeclampsia

A

Pregnancy induced acute hypertension after the 20th week of pregnancy
BP higher than 140/90 sustained for 4 hours

Also common: Increase protein in urine, hyperreflexia, edema, headache and sudden weight gain

Call 911 this is an emergency

58
Q

Describe eclampsia

A

Seizures occuring after the mother gives birth

59
Q

Describe diastasis recti

A

Splitting of the rectus abdominus away from the linea alba.
Common in post partum women

60
Q

Describe treatment for diastasis recti

A

> 2 cm - bracing or stabilizing
3-4 - bracing + head life, progressing to posterior pelvic tilt
4 cm - bracing + breathing

61
Q

Describe GERD and symptoms

A

Reflux of gastric content into the esophagus
Caused by lower esophageal sphincter pathology
Heart burn 30 mins after eating

Sour taste in mouth, dysphagia, hoarse voice, atypical pain of the head and neck

62
Q

What are some treatment stretegies for GERD

A

Positioning:
Maintain upright position, avoid supine, sleep on L side

Diet and exercise:
Eat meals 3-4 hours before sleep
Exercise before eating or 2-3 hours after
Avoid spicy, chocolate, fatty foods

Drugs:
Antacids, H2 receptor blockers, proton pump inhibitors

63
Q

What visceral structures refer pain to the mid back

A

Esophagus
Stomach
Pancreas
Gallbladder

64
Q

What visceral structures refer pain to the left shoulder

A

Heart
Diapgragm
Spleen
Tail of pancreas

65
Q

What visceral structures refer pain to the right shoulder

A

Gallbladder
Liver
Head of pancreas

66
Q

What visceral structures refer pain to the pelvis/low back/sacrum

A

Colon
Appendix
Pelvic viscera

67
Q

What pathologies can refer pain to the RUQ

A

Peptic ulcers
Gallbladder pathology
Head of the pancreas

68
Q

What pathologies can refer pain to the LUQ

A

Tail of pancreas
Spleen pathology

69
Q

What pathologies can refer pain to the RLQ

A

Appendix
Crohn’s disease

70
Q

What pathologies can refer pain to the LLQ

A

Diverticulitis
Ulcerative colitis
IBS

71
Q

Describe the different types of hernias and their pain refferal pattern

A

Hiatal hernia
Hernia of stomach up through the diaphragm
Causes shoulder pain

Femoral hernia
Lateral pelvic wall pain and groin pain

Inguinal hernia
Groin pain

Umbilical hernia
Causes pain around the umbilical ring in the mid to lower abdomen

72
Q

Describe cholecystitis

A

Blockage of gallstones in the cystic duct resulting in inflammation of the gallbladder
Pain in RUQ, right shoulder and right scapula
Nausea, vomiting, low grade fever
Pain increases with ingestion of fatty food

Test: Murphy sign - Pain w/ palpation and inhilation on R constal margin

73
Q

Describe the types of peptic ulcers

A

Gastric ulcer
Lesions in the stomach, caused by chronic NSAID use, stress, anxiety, infections
Pain when food present due to acid secretion, pain after eating
Pain relieved with antacids, medically treating infections

Duodenal ulcers
Ulcerative lesions in the duodenum
Pain when no food present, early in morning, between meals
Pain relieved by medically treating infection

Both:
Burning, cramping in epigastric area, can refer to R shoulder
Coffee ground emesis and dark tarry stools are characteristic

74
Q

Describe the two types of IBD

A

Ulcerative colitis - LLQ
Only large intestine and rectum affected
Continuous lesion
Rectal pain, bleeding, bloody diarrhea with mucus / pus, fecal urgency, weight loss, LBP
LLQ pain

Crohn’s disease - RLQ
Anywhere in GI tract
Skip lesions
Pain relieved by passing gas, abdominal pain, weight loss, joint arthritis
RLQ

75
Q

Describe IBS

A

Spastic, nervous or irritable colon
Caused by Emotional stress, anxiety, high fat, lactose foods

LLQ pain
Pain relieved by defecation
Ribbon like stools

Sharp cramps in the morning or after eating
Symptoms disappear while sleeping

76
Q

Describe appendicitis

A

Inflammation of the vermiform appendix
Pain in RLQ, comes in waves
Anorexia, elevated temperature, leukocytosis, fever
Tests:
- Tender at McBurney’s point
- rebound tenderness (bloomberg sign)
- Psoas sign
- Obturator sign
- Single leg hop test
- Merkel sign - landing on heels from toes

Immediate medical attention required if confirmed

77
Q

Describe where the spinal cord ends

A

Ends at T12
Conus medularis at L1
Cauda equina L2 and down

78
Q

Describe the DCML

A

Dorsal column medial lemnicus
Ascends ipsilateral
Proprioception
Vibration
fine touch
Graphesthesia
Bargognosis
Sterognosis

79
Q

Describe the ALS tract

A

Anterior spinothalamic tract
Ascends contralateral
Pain
Temperature
Crude touch

80
Q

Describe posterior cord syndrome

A

Loss of bilateral DCML
Caused most commonly by iatrogenic means

81
Q

Describe anterior cord syndrome

A

Loss of ALS and corticospinal tract bilaterally
Commonly caused by hyperflexion injury

82
Q

Describe brown sequard syndrome

A

Ipsilateral loss of CST and DCML
Contralateral loss of ALS
Commonly caused by knife wounds, GSW

83
Q

Describe central cord syndrome

A

Small lesions: bilateral ALS loss
Large lesions: All lost bilaterally, LE spared somewhat, ambulaton possible
Commonly caused by hyperextension injuries

84
Q

Describe conus medularis and caudaequina syndrome

A

Conus
LMN+UMN symptoms
Bilateral symptoms in perineum and thighs
Saddle anesthesia, bilateral symmetric
Symmetric motor loss

Cauda equina
LMN sign
Unilateral and asymmetric symptoms in perineum, thighs, leg and back
Saddle anesthesia, unilateral, asymmetric

85
Q

Describe the ASIA muscle groups

A

C5 - elbow flexors
C6 - Wrist extensors
C7 - Elbow extensors
C8 - finger flexors
T1 - fifth finger abductors
L2 - hip flexors
L3 - Knee extensors
L4 - Ankle dorsiflexors
L5 - Long toe extensors
S1 - Ankle plantar flexors

86
Q

Describe how to identify the lowest motor and sensory level during an ASIA exam

A

Motor level
Lowest level that has 3/5 AND everything above has to be 5/5

Sensory level
Lowest level where score is 2/2 AND everything else above is 2/2

87
Q

Describe the NLI

A

Most caudal level with motor AND sensory function intact

88
Q

Describe the ASIA impairment scale

A

A
Complete
No motor or sensory at S4-S5 level

B
Sensory incomplete
Sensory but no motor below NLI and S4-S5

C
Motor incomplete
Most muscles below NLI have below 3/5 strength

D
Motor incomplete
Most muscles below NLI have above 3/5 strength

E
Motor and sensory normal

89
Q

What are some complications related to SCI

A

Orthostatic hypotension
Tone
Respiratory dysfunction
Autonomic dysreflexia

90
Q

Describe the preserved respiratory muscles for the various SCI levels and how to manage respiratory functon

A

C1-C2 - SCM, upper traps - treat with phrenic nerve stimulator and ventilator

C3-C4 - Partial diaphragm, scalene - treat with ventilator, glossopharyngeal breathing

C5-C8 - Diaphragm - Weak cough

91
Q

Describe spastic and flaccid bladders

A

UMN spastic bladder
Seen above S2 spinal level, T12 vertebral
Intermittent catheterization every 3-6 hours
Suprapubic tapping - helps the pt void

LMN flaccid bladder
Seen in S2 spinal level or below, L1 vertebral
Require intermittent catheterization every 3-6 hours
Valsalva or crede’s maneuver
Crede (Pushing on abdomen)

92
Q

Describe the functional capacity of a C1-C4 level SCI

A

Dependent for everything
Mechanical ventilation

Mobility:
Mechanical lift transfer
Powered WC, head, shin and mouth control

93
Q

Describe the functional capacity of a C5-C6 level SCI

A

Modified independence
Can be independent but modifications and equipment required

Mobility
C5 - dependent slide board
C6 - independent slide board
Both - Manual WC, plastic coated handrims

94
Q

Describe the functional capacity of a C7-C8 level SCI

A

Beginning of independence

Mobility
IND w/o device for even transfers
Dep w/ SB for uneven transfers
C8 - may be able to do floor to WC transfer

Manual WC, plastic coated handrims
Independent on even surfaces, not on ramps
C8 - independent on ramps and surfaces

95
Q

Describe what transferes are posible at various thoracic SCI levels, when is stand pivot possible

A

T1
Floor to WC transfer
Independent w/ WC

T4
Sitting pivot transfer
Independent w/ WC

L3
Standing pivot transfer
Independent w/ WC

96
Q

Describe ambulation expectations regarding various SCI level injuries

A

T level 1-12
Standing w/ HKAFO and crutches

L1-L3
Bilateral KAFO and crutches

L4-S2
Bilateral AFO and crutches or cane

97
Q

Describe RLA SCI levels 1-3

A

1 - No response
Coma

2 - Generalized response
Whole body responds to stimulus

3 - Localized response
Local response, inconsistent
Follows simple commands, open close eyes

98
Q

Describe RLA SCI levels 4-6

A

4 -Confused agitated
Heightened activity, aggressive, does not cooperate, verbalization is incoherent, confabulous
No selective attention
No-long term and short term memory

5 - Confused inappropriate
Consistent response to simple commands
Confabulations
Inconsistent response to complex commands
Able to socialize for short periods of time
Memory impaired

6 - Confused appropriate
Follow simple commands consistently
Memory begins to improve
Goal oriented behavior

99
Q

Describe RLA SCI levels 7-8

A

7 - Automatic appropriate
Oriented
Daily routine is robot like
Judgment impaired
Social interaction improved

8 - Purposeful appropriate
Learning possible
Impaired judgment in emergency situations
Return to previous level of function

100
Q

Describe which nerve endings perform what function

Regarding:
Meissner
Merkle
Krause
Ruffini
Pacinian
GTO

A

Meissner Corpuscles - Fine touch
Merkle disks - Crude touch
Krause end bulbs - Cold sensation
Ruffini endings - Hot sensation
Pacinian corpuscles - Pressure
Golgi tendon organs - Stretch reflex

101
Q

Describe venous wounds

A

Proximal to medial malleolus
Irregular, shallow
Flaking, brownish discoloration - hemosiderin staining
Mild to moderate pain
Elevation decreases pain

102
Q

Describe arterial wounds

A

Lower ⅓ of leg, toe, lateral malleolus
Smooth edges, well defined, deep
Thin and shiny, hair loss, yellow nails
Severe pain - due to lack of blood
Elevation increases pain

103
Q

Describe herpes zoster

A

Initial symptoms of pain and paresthesia localized to the affected dermatomes
Present as rash
Mostly unilateral
Raised to palpation
Pink with silvery white appearance

104
Q

Describe herpes simplex

A

Type 1
Cold sores above the belt and around the mouth

Type 2
Cold sores below the belt

105
Q

Describe the following terms

Blster
Vesicles
Wheals
Pustules

A

Blisters:
Common Blister

Vesicles:
Lesion that is filled with fluid 0.5 or less, Bullae if more

Wheals:
Like hives
Irregular, edematous, itchy

Pustules:
Inflamed, puss filled

106
Q

Describe which types of derssings to use for increasingly exudative wounds

A

No to scant exudate - transparent films
Minimal exudate - hydrogel, hydrocolloid
Moderate exudate - foam
Heavy exudate - calcium alginate, hydrofiber

107
Q

Describe some selective and nonselective debridement strategies and when to use them

A

Selective - used when leess than 50% necrosis
Sharp
Enzymatic
Autolytic debridement

Nonselective
Wet to dry dressings
Wound irrigation - moves necrotic tissue from wound bed uring pressurized wound
Hydrotherapy - use of whirlpool with agitation directed toward a wound requiring debridement

108
Q

Describe the uses of the following

Sterile normal saline
Povidone
Zinc oxide
Nitrofurazone

A

Sterile normal saline
Useful initial agent to clean wounds

Povidone - iodine solution
Surgical

Zinc oxide
Dental

Nitrofurazone
Infected burns and skin

109
Q

Describe the types of scars

A

Normal - flat and similar to skin color
Hypertrophic scar - healed wound with thick fibrous tissue that remains within original wound border
Keloid - excessive scar tissue grown outside of the original margins of the wound

110
Q

Describe the rule of nines and how it is adated to kids

A

Adults
Head - 4.5%
Torso - 18%
Arms 4.5%
Legs 9%
Perinium 1%

Kids
Head - 8.5%
Torso - 18%
Arms 4.5%
Legs 6.5%
Perinium 1%

NPTE Prep (6 decks)

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