Blast from the Past
What is the function of CN IV?
Trochlear; turns eye in and down
Describe a Stage II pressure ulcer
Describe a Stage III pressure ulcer
Partial thickness tissue loss, shallow crater, pink wound bed, open blister. no slough
Full thickness tissue loss. Subcutaneous fat may be present but not bone, tendon or muscle. Non-obscuring slough, undermining and tunneling possible
Name an orthosis that would be indicated for spasticity
solid ankle foot orthosis (SAFO)/ posterior calf shell
What is the function of the lymphatic system?
Removes excess fluid, blood waste and protein molecules. Protects body form infection via immune response.
symptom of low hemoglobin and hematocrit
anemia
Describe the postural changes that occurs during pregnancy. Name 3
forward head, increased thoracic kyphosis, increased lumbar lordosis (anterior PT), rib cage flares
Name 2 dressings that promote autolytic debridement
What would be the LEAST functional LE amputation level?
Transpelvic < Transfemoral < Transtibial < transmetatarsal
Describe what a grade II distraction mobilization is
Slack of the capsule taken up (eliminates joint pain)
What effect will immunosuppressives have on white blood cell count?
Lower levels
How do you differentiate between RA and OA? Name 3 symptoms or hallmark features.
RA has systemic symptoms (weight loss, fever, malaise, inflammation, vascular and neuro involvement), a.m. stiffness that lasts longer than 1 hour. Bilateral and symmetrical involvement vs unilateral. Nodules vs osteophytes. Ulnar drift, radial drift.
Name 3 indications for alginates
wounds with large amount of exudate
wounds that require packing and absorption
Infected and noninfected wounds
wounds with combination of exudate and necorsis
What is the effect of an orthotic with a higher heel height?
Produces excessive stance phase knee flexion, more weight shifted onto forefoot and metatarsal heads
Name 3 joint mobilization indications
Pain
Decrease muscle guarding or spasm
Treat reversible hypomobility of capsular origin
Prednisone and cortisone are examples of what type of drug? What is the patient at risk for with long term use?
Glucocorticoids (corticosteroids); osteoporosis/ weakening and breakdown of supporting tissue
When should you terminate exercise during cardiac rehab? Name 5
Persistent dyspnea/ sudden onset dyspnea
Dizziness/ Confusion
Severe angina pain with other s/s of cardiac insufficiency
Severe leg claudication
N&V, ataxia, excessive fatigue and muscle pain
resting HR >130 bpm or <40 bpm
fall in systolic BP, rise in systolic BP above 250mmHg, diastolic >115 mmHg
A patient has long standing DM II, what type of ulcer is this patient most at risk for?
A patient is immobile and incontinent, what type of ulcer is this patient most at risk for?
Neuropathic
Pressure
Common contractured position for the transfemoral amputee and transtibial amputee
Transfemoral: hip flexion, ER, Abd
Transtibial: knee flexion
Name (4) signs and symptoms of lymphedema
feeling of heaviness/ pressure/ tightness
sensory disturbance
decreased mobility/ ROM
impaired wound healing
skin changes
+ Stemmer's sign
What is the action of ACE inhibitors?
What is the implication for PT?
produces vasodilation- decreases BP and afterload
Watch for orthostatic hypotension, fatigue
Describe Klumpke's Palsy. Nerves affected. Muscles affected, primary feature and characteristics.
C8-T1. Ulnar and median nerves. Intrinsic hand muscles. Claw hand: paralysis of lumbricals. Fingers become extended at MCP, flexed at IPs.
Describe the differences between arteria and venous ulcer: location, appearance, exudate, pain, pedal pulse, skin temp, tissue changes, what leg elevation causes
Dorsal foot, lateral malleolus vs medial malleolus
Smooth edges, deep vs irregular and shallow
exudate: minimal vs heavy
pain: severe vs mild
pedal pulse: diminished/absent vs present
skin temp: decreased vs normal
tissue: thin, shiny, hair loss, yellow nails vs flaky dry skin and brown
leg elevations increases pain vs lessens pain/ discomfort
If a patient is wearing a SAFO with a DF stop, what functional limitations may this patient experience?
Rising from a chair
Ascending ramps
Squatting
Descending steps using step over step
Name 3 indications for exercise that will help with lymphatic drainage. Give examples of 3 exercises.
Contraction of muscles pumps fluid/ strengthen muscle pump. Exercise reduces joint and tissue hypomobility that can contribute to static positioning. Exercise increases HR and arterial pulse to help encourage lymph flow.
What is exercise induced hypoglycemia and how do you counteract effects?
During intense exercise, plasma concentrations of insulin progressively decrease.
Individual may need to increase carbohydrate intake before or after exercise