Psychosocial & Subjective
When should psychologically-informed PT be inplemented?
Signs of yellow and/or orange flags.
Describe a grade 2 joint sprain.
Moderate tearing of fibers, painful w/ stress testing, mild-moderate instability/laxity present.
Name 3 contraindications for manual therapy.
- poor integrity of bony/ligamentous structures: unstable fx, tumor, osteomyelitis, infection
- Upper cervical instability, VBI, Upper motor neuron lesion, unremitting night pain, multilevel nerve root pathology
Arthritis/Arthrosis falls under which IBH?
Mobility Deficits
Improving performance and learning from being punished is an example of:
Behaviorism
Your patient presents with a moderately severe cervical osteoarthritis. They state, "This pain just won't go away, I feel like it will never go away, I can barely turn my head without awful pain, I need surgery". What psychological process are they demonstrating?
Catastrophization
Describe what is occurring at the cellular level during the remodeling phase?
Collagen type III (immature) of the initial ECM of the repair callus is replaced by collagen type I (mature).
Describe a grade 3 mobilization.
Large amplitude, middle to end range, into tissue resistance
Benefit?
What level of the nervous system is most directly responsible for the psychological effects of manual therapy
Cortical
A student struggles to perform manual skills well d/t limited practice, despite studying the didactic material diligently. What learning theory reflects this?
Constructivism
Who should receive SDoH screening?
All patients, regardless of population.
Describe how you would progress loading during the inflammatory, proliferative, & remodeling phase during healing from a ligament sprain.
Inflammatory: RICE, avoid stressing involved tissues. PROM/AAROM with tolerable range.
Proliferative: AAROM/AROM in safe ranges, isometrics.
Remodeling: return to unrestricted ROM & fxn activities.
What ICF domain does difficulty feeding & showering fall under?
Activity Limitations
What type of dysfunction is treated with neuromuscular reeducation & is typically caused by laxity?
Movement Coordination Impairments
You catch your coworker falsifying his documentation for additional units. Reporting him would get him fired, but he is the sole provider in a household of 5, and the lack of income would impact his whole family. What moral process are you using when analyzing this situation?
Moral judgement
Making sense of a patient's story through cultural values, beliefs, & experiences is what type of reasoning?
What is the primary protector against nerve compression? If nerve compression occurs, what is this injury called?
Epineurium; Neuropraxia
Sulcus Sign has a 97% specificity for superior GH capsule laxity. If a patient has a (+) sulcus sign, what can you interpret from this?
It is likely a true positive; as tests with high specificity have few false positives.
A patient presents with 3/10 neck pain currently, which gets up to a 7 after looking over her shoulder or looking up. The pain takes around a week to go back down to a 3 once aggravated. Severity & Irritability?
Severity: Mod
Irritability: High
Describe the difference between common good lens & justice lens.
Justice = equal distribution of burdens, equal treatment, fairness.
Common Good = values dictate ethical decision making; vulnerable parties might receive unequal treatment to uphold community values.
Communicative detective
Describe what happens during the inflammatory phase of healing (at the cellular level)
hemostasis; mobilization of cells to injury site to stimulate coagulation, control hemorrhage, & initiate fibrocartilaginous scaffolding
If the physical examination reveals aberrant motions during ROM testing, hypermobility of selected joints, and poor coordination of movement during activity performance what type of exercises would be the most appropriate intervention?
Neuro-muscular Re-education
Name 3 subjective/objective findings for mobility deficits.
- Stiffness w/ inactivity, improve w/ movement
- Loss of A/PROM
- Limited Accessory Motion
- Pain w/ loading structures
Define moral sensitivity.
Being able to identify situations with ethical implications.