vasc/lymph/integ
what is primary (first) intention for wound closure?
-patellar ligament
-anterior compartment
-medial flare of tibia
-distal end
-shaft of fibula
-gastroc
-popliteal fossa
what are pressure tolerant areas?
-slow contractile response
-high oxidative capacity,low anaerobic capacity
-LOW INTENSITY, ENDURANCE ACTIVITIES
-"_____ = long run"
what are type 1 muscle fibers?
-no lifting, pushing, or pulling more than 5 lbs.
-hold pillow during transfers, coughing and sneezing
-no UE during transfers
-no reaching back w/ B UE
what are traditional sternal precautions?
amount of blood pumped in 1 heartbeat/1 contraction of heart (myocardial contraction)
what is stroke volume?
-partial thickness skin loss with exposed dermis
-wound bed is viable, pink or red, moist and may also present as intact or ruptured serum-filled blister
-adipose and deeper tissues not visible, granulation tissue, slough, and exchar are not present
what is a stage 2 pressure injury?
-anterior distal tibia
-fibular head
-peroneal nerve
-crest of tibia
-distal cut fibula
-lateral tibial condyle
what are pressure sensitive areas?
-fast contractile response
-high glycolytic capacity
-POWER activities
-"_______ = big dude"
what are type 2 muscle fibers?
-excessive fatigue, lightheadedness, dizziness, confusion, ataxia, pallor, cyanosis, SOB, nausea
-chest pain onset w/ exercise
-hypotension (20+ drop in SBP), hypertension (SBP > 190, DBP > 110)
-profuse sweating, drop in HR 10+ w/ increase/no change in workload
what are cardiac precautions?
amount of blood in ventricle at end of diastole (more = more SV)
what is preload?
used for wounds with heavy exudate; used for dry wounds with minimal drainage
what is alginates and hydrogels?
-prosthetic causes: too long (swinging around to clear limb), no knee flexion/DF
-pt. causes: weak hip flexors, possible glute med. contracture, pain, scared to fall
what are possible reasons for circumduction?
The ability of the body to transport and use oxygen during physical and aerobic activities is an indicator of physical fitness and is measured most commonly using which unit of measure?
what is maximum oxygen consumption? (VO2max)
-avoid moving arm of surgery side, don't lay on that side for 24 hrs
-no pushing, pulling, or twisting with arm, no raising arm above shoulder
-call cardiologist if any redness, swelling, or drainage, frequent hiccups, dizziness, lightheadedness, or blackouts occur
-wait 7-10 days to shower
what are pacemaker precautions?
force L ventricle must do to overcome aortic pressure and push blood out
what is afterload?
complete decongestive therapy (CDT - gold standard; compression, MLD, compression garments, skin/nail care, etc.), pneumatic compression pumps, surgery, and medications
what are possible treatments for lymphedema?
-prosthetic causes: too short (leaning over), medial border too long (pressure on groin, leaning away)
-pt. causes: pain due to improper fit, possible glute med. weakness and Trendelenburg compensation
what are possible reasons for a lateral bend/trunk lean?
method of training that is characterized by a period of exercise followed by a brief period of relief
what is interval training?
-severe CV and pulmonary problems, dementia/cognitive impairments making use of prosthesis unsafe, unmotivated (may delay prosthesis until pt. is "ready")
-neuropathy, arthritis, lack of skin integrity, contracture, weakness
-other factors to consider: size (children, obese pt.), cost
what are contraindications and precautions for prosthetics?
amount of blood pumped in 1 min, SVxHR
what is cardiac output (CO)?
state the rules of 9s
-front of torso=18%
-back of torso=18%
-head=9% (4.5 front/back)
-arm=9% (4.5 front/back)
-leg=18% (9 front/back)
name the components of a prosthetic
shrinker (before prosthetic), then prosthetic includes gel liner, sock/sock ply if needed, socket, and suspension sleeve (optional, to reduce rotation if needed)
-HR max declines
-CO and SV decrease
-dec. aerobic capacity and VO2 max
-increased BP
-increased RR and dec. vital capacity
-strength decline due to reduced mm. mass and lack of PA
what are effects of age on body/endurance/exercise tolerance?
uncontrolled HTN, intracranial pressure > 20 mmHg, unstable head/neck injury, rib fx., distended abdomen, pulmonary embolism
what are contraindications/precautions to postural drainage?
name what the p-wave, QRS complex, and T-wave represent on an EKG
-p-wave = atrial depolarization
-QRS complex = ventricular depolarization
-t-wave = ventricular repolarization