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NPTE Prep > Virtual class topics 21-30 > Flashcards

Virtual class topics 21-30 Flashcards

1
Q

What happens to lung volumes in obstructive diseases

A

TV increases
RV increases
FRC increases
TLC increases

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2
Q

Describe ankle ABI scoring

A

Falsely elevated >1.2 = arterial disease and diabetes
Normal - 1.19-.95
Mild - .94-.75
Moderate - .74-.50
Severe <.50

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3
Q

Describe arterial and venous insufficiency presentation

In terms of:
Cause
Location
Appearance
Pain
Ulcer
Complications

A

Arterial insufficiency
- Inadequate blood flow
- Lateral malleolus
- Pale wound, well defined edges
- Intense, worse with elevation
- Minimal exudate, dry, shiny skin, hair loss
- Gangrene, amputation risk

Venous insufficiency
- Poor blood return due to damaged veins
- Medial malleolus
- Pink, red, irregular shape, shallow edges, hemosiderin staining
- Minimal pain, relieved by leg elevation
- Moderate/heavy exudate, swelling, skin discoloration
- Cellulitis, venous stasis dermatitis

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4
Q

Describe the claudication grading scale

A

Grade 1
Initial discomfort, minimal pain

Grade 2
Moderate discomfort, attention can be diverted

Grade 3 - stop exercise, resume once pain subsides
Intense pain, attention cannot be diverted

Grade 4 - stop activity, refer to physician if pain persists
Excruciating pain, unbearable

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5
Q

Hello

A

Good bye

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6
Q

What are some intervention strateges for obstructive lung pathologies

A

Activity pacing
Pursed lip breathing
Promote huffing
Inhalation of corticosteroids, bronchodilators

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7
Q

What are some intervention strateges for restrictive lung pathologies

A

Ventilatory support
Respiratory muscle training / chest expansion exercises
Managing medications and their side effects

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8
Q

Describe fremitus, assessment and interpretation

A

Vibratiry tremors that can be felt through the chest by palpation
Assess by saying 99 and palpating the chest

Decreased fremitus
Indicates more air in the lungs

Increased fremitus
Indicates increased fluid in lungs

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9
Q

Describe chest percussion, assessment and interpretation

A

Tapping of pt chest walls

Hyperresonant to percussion (louder) - indicates more air in that area

Dullness to percussion - indicates increased secretions

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10
Q

Describe the difference between pneumothorax and atelactasis

A

Pneumothorax
Collection of air outside the lungs but in pleural cavity
Pushes trachea to opposite side

Atelectasis
lung collapse caused by blockage of air
Attracts trachea to affected side

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11
Q

Briefly describe Asthma, emphysema and hemothorax

A

Asthma
Acute narrowing of airways
Wheezing present

Emphysema
Permanent alveolar damage
Air trapped in lungs, more than in chronic bronchitis

Hemothorax
Blood in the pleural space

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12
Q

Describe L and R sided heart failure presentation

A

R sided
Peripheral edema
Enlarged liver - hepatomegaly
Abdominal discomfort
Jugular vein distention
Fluid retention

L sided
SOB
Fatigue and weakness
Orthopnea - SOB in supine
Paroxysmal nocturnal dyspnea
Cough, pink, frothy sputum

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13
Q

What level of table elevation will taget the middle and lower lobed during postural drainage

A

Middle lobe - Foot elevation of 12 inches
Lower lobe - foot elevation of 18 inches

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14
Q

Describe the cardic rehab phases

A

Phase 1
Medically stable patient after MI, CABG, PTCA, valve repair, heart transplant
FITT
F - 2-3 per day
I - 50-70% HR max
T - 10-15 mins, (30 mins phase 2)
T - ADLs, supervised ambulation

Phase 2
24 hours after discharge, lasts up to 6 weeks

Phase 3
Begins at end of phase 2 and extends indefinitely
Resistance training begins
FITT
2-3 sessions per week
70-85%
30-60 mins
Walking, treadmill, cycle

Resistance training can begin this phase
1-3 lbs of elastic bands and light hand weights
8-10 reps, progress to 12-15
Avoid upper extremity resistance as soft tissue is still healing

Phase 4
Exercising in community
50-85% functional capacity
3-4 times per week
45 mins or more
Discharge from supervision in 6-12 months

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15
Q

Describe weight reduction exercise guidelines

A

F - 5-7 days per week
I - 40-60% VO2
T - 45 - 60 mins per session, 250-300 mins per week
T - Aerobic and resistance exercise

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16
Q

List and describe the types of studies by strength of evidence in descending order

A

Meta analysis
Synthesis of huge body of evidence
Statistics performed to determine outcomes

Systematic review
Summary of many papers
No statistical review

RCT
Used to determine the efficacy of an intervention

Cohort studies
Observe two different groups of people over time and compare outcomes

Case control studies
Compares a group of individuals with a specific condition with a group of people without the same condition

Cross sectional analysis
Observational study where the investigator measured outcome and exposure in the participants at the same time

Case series / case reports
Document clinical case of a single patient or a series of patients

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17
Q

Describe qualitative data and its types

A

Qualitative
Analysis of non-numerical data
Statistical analysis not performed
Interested in emotional or subjective experiences

Nominal - names
Data that can be organized into mutually exclusive groups with no overlap
EX: Gender, blood type, hair color

Ordinal
Data organized by ranking system, spaces between categories in system not meaningful, rank itself only important
EX: MMT grades, level of assistance, joint laxity grades

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18
Q

Describe quantitative data and its types

A

Quantitative
Collecting and analyzing numerical data
Analysis of quantifiable outcome measures
Statistical analysis performed

Interval
Data that is ordered in ranking system and space between rankings meaningful
No true 0
EX: temperature

Ratio
Data organized in ordered ranking system, meaningful space between rankings with a true 0, negative values not possible
EX: Height

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19
Q

Describe validity

In terms of:
Content
Construct
Concurrent
Face

A

Construct validity
Does the test measure the thing (construct) you want to measure

Content validity
Does the test measure all relevant parts of the construct

Concurrent validity
Comparing the new measure to the current gold standard

Face validity
Does an outcome measure appears like it measures what it should

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20
Q

Describe the types of error

A

Type 1
False positives
Incorrect rejection a true null hypothesis

Type 2
False negative
Failing to reject a false null hypothesis

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21
Q

Describe speceficity and sensitivity

A

Sensitivity
Ability of a test to identify true disease
Snout

Specificity
Ability of a test to correctly identify absence of a disease
Spin

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22
Q

Describe the peripheral nerve sensation to the hand

A

Radial
- Lateral 3.5 fingers, dorsal side, not tips
- Lateral part of dorsal hand
- Wraps around base of thumb, most lateral postion of thenar eminance on volar surface

Median
- Lateral 3.5 fingers, volar side, tips of fingers dorsal side
- Thenar eminence, lateral palm

Ulnar
- Medial 1.5 fingers, dorsal and volar surfaces
- Medial part of volar and dorsal hand

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23
Q

Describe peripheral nerve sensation to the lower leg and foot

A

Tibial
-Heel of foot

Deep peroneal
-1st web space

Superficial peroneal
-Dorsum of foot (except first web space)
- Anterolateral part of lower leg

Sural
-Posterolateral leg

Saphenous
-Medial lower leg

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24
Q

What are some peripheral vestibular pathologies

A

BPPV
Vestibular neuritis
Labyrinthitis
Acoustic neuroma

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25
Describe BPPV and what are its causes
When the otolith crystals get stuck in the semicircular canals Infection, head trauma, Vestibular weakness, advancing age
26
Describe the dix halpike test and its interpretation | Duration of symptoms?
Turn pt head 45 degrees to side you wish to test Move pt into supine position with head extended Upbeating torsional nystagmus - posterior canal Down Beating torsional nystagmus - anterior canal Canalithiasis Symptoms last a short duration, less than 1 minute Cupulolathiasi Symptoms last longer than 1 minute
27
Describe the supine roll test and its interpretation
Pt in supine, 30 degrees flexion Rotate head toward testing side and assess for symptoms Geotropic - beats toward ground - canal - stronger = affected Ageotropic - beats away from ground - cupulo - weaker = affected
28
Describe epley's manuever
Used to treat BPPV in the posterior canal - Turn head to affected side - Lay pt in supine with head 20-30 extended - Turn head 45 opposite way - Roll onto shoulder head is facing, maintain nose down - Sit pt up
29
Describe the treatment strategy for cupulolithiasis
Semont maneuver / liberatory maneuver Turn head 45 degrees opposite of affected side Lay in side lying on side pt is not looking, remain here for 1 min Quickly move pt 180 degrees to side lying on opposite side Return to sitting after 1 min
30
Describe the brandt darroff exercise
Alternating side lying while looking toward the ceiling Used when pt cannot tolerate epley / semont
31
Describe treatment for horizontal canal BPPV
Supine, 20 degrees cervical flexion Turn head 90 degrees to affected side Turn head back to neutral Turn head to unaffected side Roll towards unaffected side into prone At each step wait for symptoms to resolve
32
What is the name of the treatment used for horizontal canal cupulolithiasis
Gufoni manuever
33
What are the central vestibular pathology tests
Smooth pursuit -H test Saccade - Look quickly between 2 target If impairments present, this is a problem
34
Describe how to test the VOR
Head impulse test Turn head quickly, look for lag, present on side with ipsilateral impairment
35
Describe signs of central vestibular pathology
Intense ataxia Abnormal smooth pursuits / saccades Diplopia, drop attacks, dysphagia Pendular nystagmus
36
Describe labyrinthitis
Inflammation of labyrinth **Hearing loss, tinnitus** Sudden onset of vertigo, nausea, vomiting Positive head impulse test Lasts days to weeks
37
Describe Vestibular neuritis
Inflammation of vestibular postion of CN VIII **No hearing loss** Sudden onset of vertigo, nausea, vomiting Positive head impulse test Lasts days to weeks
38
Describe Meniere's disease
Overproduction of fluid within the inner ear increased pressure in inner ear increase in pressure leads to vertigo Vertigo, hearing loss, tinnitus, fullness in ear
39
Describe Acoustin neuroma
Slow growing tumor that develops from the CN VIII Hearing loss, **tinnitus**, loss of balance, vertigo, **facial numbness and weakness** or loss of movement (CNV)
40
Describe treatment of Unilateral bilateral vestibular hypofunction
Unilateral Gaze stability exercises X1 and X2 Postural stability and balance Habituation Bilateral Gaze stability, X1 but not X2, unless asymmetrical involvement Imaginary targets Walking
41
Describe the muscles that move the mouth
Mouth opening - 35-55 - lateral pterygoid Mouth closing - Temporalis, masseter, medial pterygoid Protrusion of mandible - 7mm - Medial and lateral pterygoid Retraction of mandible - 3-4 - temporalis Lateral deviation of mandible - 10-15 - Contralateral pterygoids
42
Describe the presentation of various TMJ disorders
Hypomobility Jaw deviation to ipsilateral side, limited opening, no pain Disc displacement Clicking Synovitis No deviation, pain Capsulitis Jaw deviation to ipsilateral side, limited opening, pain
43
Describe Legg-calve-perthes disease
Deformity / flattening of femoral head due to loss of blood supply, causes femoral head necrosis Age 2-13 Short stature, males **Limited extension, abduction and IR** Pain worsens with activity Limping Stiffness Treat with bracing, surgery
44
Describe slipped capital femoral epiphysis and treatment
Displacement of femoral head due to slippage from the growth plate Age 10-17 Overweight Flexion, abduction and IR limited Pain worsens with activity Limping Stiffness Surgical treatment to stabilize
45
Describe spondylosis In terms of: Age Pain location Agg Easing SLR Imaging
Degeneration of intervertebral disc space Age: >50 Pain location: Back Agg: Extension Easing: Flexion SLR: negative Imaging: radiograph positive
46
Describe spondylolysis Age Pain location Agg Easing SLR Imaging | In terms of:
Defect in pars interarticularis of vertebral arch Age: 15-20 Pain location: Back Agg: extension Easing: Flexion SLR: Negative Imaging: radiograph positive
47
Describe spondylolesthesis Age Pain location Agg Easing SLR Imaging | In terms of:
Forward slip of vertebrae Age: 20 Pain location: Back Agg: Extension Easing: Flexion SLR: negative Imaging: Radiograph positive
48
Describe disc herniation Age Pain location Agg Easing SLR Imaging | In terms of:
Age: 30-50 Pain location: Back, leg Agg: Flexion Easing: Extension SLR: Positive Imaging: MRI, CT
49
Describe spinal stenosis Age Pain location Agg Easing SLR Imaging | In terms of:
Age: >60 Pain location: Back, Leg Agg: extension Easing: Flexion SLR: Positive Imaging: MRI, CT, radiograph
50
Describe scoliosis presentation
Convex side - Direction of vertebral rotation - Long and weak muscles - Posterior rib deviation - Same side shoulder high Concave side - Direction of spinous prcess deviation - Short and tight muscles - Anterior rib deviation - decreased lung volumes - Same side pelvis high
51
Derscribe the S3 and S4 heart sounds
S3 - early diastole - CHF S4 - Late diastole - MI, hypertension,
52
Describe the types of AV blocks
1st degree Lengthened PR interval > 1 large box Continue exercise 2nd degree Type 1 - Wenckebach - length, length, length drop Disease of AV node Monitor, lower intensity Type 2 Mobitz - random drop in QRS complex Stop exercise Refer this individual to physician 3rd degree No correlation between P and QRS complex Stop exercise Call 911
53
Describe how to interpret ST segment changes
Depression more than 2 small boxes - Myocardial ischemia Elevation more than 1 small box- Myocardial infarction - call 911
54
Describe atrial tachycardia, flutter and fibrillation
Atrial tachycardia 150-250 beats per minute Fast atrial contraction, QRS for each PVC Atrial flutter Saw toothed pattern Multiple atrial contractions per ventricular Stop exercise Atrial fibrillation No clear P waves, quivering of atria Stop exercise
55
Describe bigemony, trigemony, multifocal PVC's and Couplet's
Bigeminy 1 normal beat followed by 1 PVC Trigeminy 2 normal beats followed by 1 PVC Multifocal PVC 2 different looking QRS complexes Call 911 Couplet 2 PVCs in a row, stop exercise 3 or more in a row considered V-tach - stop exercise
56
Describe the expected developmental milestones at months 2-3
Prone on elbows Lift head in prone
57
Describe the expevcted developmental milestones at months 3-4
Supine to sidelying
58
Describe the expected developmental milestones at months 4-5
Feet to mouth Prone to supine Pull to sit without head lag Sitting with UE support
59
Describe the expected developmental milestones at months 6-7
Supine to prone Quadruped and sitting from quadruped Independent sitting Trunk rotation in sitting
60
Describe the expected developmental milestones at months 8-9
Creeping Cruises on furniture Can stand alone Improved grasping
61
Describe the expevcted developmental milestones at months 10-15
Unassisted walking Squatting Pincer grasp Stacking objects Floor to stand
62
Describe which reflexes are integrated at months 1-2
Flexor withdrawl - Noxious stimulus to sole of foot - Toes extend, foot dorsiflexes, LE flexes uncontrollably Crosed extension - Noxious stimulus on ball of foot - Opposite LE flexes, then abducts and extends
63
Describe which reflexes are integrated at month 3
Rooting - Stroking the side of the baby’s cheek - Head turns toward stimulus, mouth opens
64
Describe which reflexes are integrated at months 2-5
Traction - Grasp forearm and pull up from supine into sitting - Flexion of the UE to prevent pulling
65
Describe which reflexes are integrated at month 6
Palmar grasp - Pressure on palm of hand - Maintained gripping ATNR - Rotation of the head to one side - Bow and arrow posture Moro - Drop baby backward from sitting position - Extension, abduction of UEs, hand opening and crying, followed by flexion and protection tone TLR - Prone or supine - Prone - increased flexor tone of all limbs - Supine - increased extensor tone of all limbs Positive support - Contact ball of foot in upright standing - Rigid extension, co-contraction of LEs
66
Describe which reflexes are integrated at month 9
Plantar grasp - Maintained pressure to ball of foot under toes - Maintained toe flexion
67
Describe which reflexes are integrated at month 12
Babinski STNR - Flexion or extension of the head - Head flexion - flexion of UE, LE extension - Head extension - extension of UEs, flexion of LEs
68
Describe the APGAR test
Appearance - Blue, blue extremities, pink Pulse - absent, <100, 100-140 Grimace - No reponse, grimace, cry or withdrawl Activity - flaccid, some flexion, active motion extremities Respiration - absent, weak cry or hypoventilation, strong cry 8-10 = normal 5-7 = blow by oxygen 3-4 = mask ventilation
69
Describe the different types of age
Gestational age - weeks in gestation + weeks of life Chronilogical age - Age in weeks since birth Corrected age - chronilogical age minus premature weeks
70
Describe CP and its types
Spastic Velocity dependent resistance of a muscle to stretch Synergy patterns, contractures, crouched gait, toe walking Ataxia Disorder of coordination, force, timing and associated with cerebellar involvement Floppy baby, low tone, poor balance, wide BOS, nystagmus Hypotonic / dyskinetic Disorder of basal ganglia, characterized by athetoid writhing Poor stability intention tremor, fluctuating tone
71
Describe gross motor classification of CP
Level 1 Walk without restrictions Advanced motor skills limited Level 2 Walk without assisted device Outdoor walking limited Level 3 Walk with assisted device Limitations outdoors AD > WC Level 4 Chair mobility WC > AD Level 5 Chair mobility
72
Describe plagiocephaly
Result from prolonged asymmetrical pressure on the premature skull Creates parallelogram shape Named for side of flat spot Presentation - Occipital parietal flattening, contralateral occipital bossing - Anterior bossing ipsilateral to flat spot
73
Describe downsyndrome patients
Extra copy of trisomy 21 Forceful neck flexion and rotation activities should be limited due to ligamentous laxity Encourage motor function and avoid hyperextension of the elbows and knees during weight bearing activities
74
Describe autism spectrum disorder patients
Social communication skill limitations, especially non-verbal skills Hypo-reactive or hyper-reactive to sensory input - Hypo - sensory seeking - Hyper - sensory avoiding - most
75
Describe muscular dystrophy
X linked recessive, inherited by boys Dystrophen gene missing Causes pseudo hypertrophy Maintain mobility as long as possible Do not over fatigue
76
Describe Scheuermann disease
Wedge shaped vertebrae Increased thoracic kyphosis SS Schmorl nodes Pain with extension and rotation Treatment Schroth method Pec stretches
77
Describe ERB and Klumpke palsy
ERB - C5-C6 Stretching of head downward Loss of abduction and ER Waiter's tip deformity Klumpke C8-T1 Stretching or arm overhead Paralysis of the intrinsic hand Claw hand
78
What is parametric and non-parametric data
Parametric Ratio and interval data - quantitative data Bell shaped curve, normal distribution Randomized of sample More powerful Non-parametric Nominal and ordinal data - qualitative data Unequal distribution Non randomized sample Less powerful
79
Describe a T test, paired T test, 1 and 2 tailed T test. What kind of data?
T-Test 2 independent groups Equal distribution Paired T-test 2 dependent groups Equal distribution One tailed T test T-test with assumption of outcome 2 tailed T-test T-test with no assumption of outcome Parametric data
80
Describe the one way anova, two way anova and repeated measures anova tests
One way anova 3 or more independent groups Equal distribution 1 variable Two way anova 3 or more independent groups Equal distribution 2 variables Repeated measure anova 3 or more dependent groups Equal distribution Same individuals meausred continuously over time
81
Describe the Chi square, Mann whiteny U and Kruskal wallis tests
Chi square test 2 Independent unequal groups Nominal data only Mann whiteny U 2 independent unequal groups Ordinal data only Kruskal Wallis test 3 independent unequal groups Ordinal data only
82
What are the ottowa ankle rules
X-ray of foot if any one of following: Pain on lateral or medial malleolus Inability to bear weight for at least 4 steps
83
What are the foot radiograph rules
Seek x-ray if: Bone tenderness at navicular bone Bone tenderness at base of 5th metatarsal
84

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