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Final Flashcards

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1
Q

Purpose of inflammatory aka acute phase

A
  • Defend against foreign intruders
  • remove damaged tissue and debris
  • immobilize area
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2
Q

Joint effusion

A

Contained by joint capsule and feels like a waterballon.

Moves when palpated then returns

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3
Q

Edema

A

Fluid in interstitial space and dents/pits when pushed

Circumference measurement is reasonably accurate

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4
Q

PRICES

A 
Protect
Rest
Ice
Compress
Elevate
Support
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5
Q

Compression

A

Decreases edema and bleeding and provides mechanical support

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6
Q

External compression procedure

A

Wrap distal to proximal

May add U or J shaped felt pad to increase

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7
Q

Internal compression

A

Compresses lymph vessels and veins

Done through muscle contractions, ROM, pumping ankles, writing alphabet and isometrics

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8
Q

Purpose of external compression

A
  • Pushes flood toward the heart (therapeutic and prophylactic for DVTs and VTE)
  • pushes arterial blood into extremity
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9
Q

Intermittent compression

A

Acute or chronic edema
Mechanical device used that inflates to compress part

Ex: intermittent sequential graded compression (3 parts) that’s repeated hours per day

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10
Q

Compression gradient in compression garments

A

Increasing compression as continues dismally

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11
Q

What can intermittent compression be combined with

A

Cooling

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12
Q

Effects of elevation

A
  • gravity augments (increases) lymph flow

- elevation above heart significantly reduces edema in 20 minutes

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13
Q

Forms of “support” in PRICES

A
  • nutritional
  • education
  • referral for emotional support
  • bracing, taping, crutches, canes etc
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14
Q

What is taping and bracing good for?

A

Acute support

Bracing may inhibit muscle action

Ex: hamstring inhibition with knee bracing

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15
Q

Ambulatory aids

A

Support/assist when patient cannot walk or put weight on one extremity

-still maintain partial weight bearing but gives local rest to a lower extremity

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16
Q

Fitting of crutches

Positions, arm brace, hand brace

A
  • 6 inches lateral to foot and 2 inches in front of shoe
  • arm brace 1-2” below anterior axillary fold
  • hand brace elbow flexed at 30 degrees
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17
Q

Improper use/fit of crutches may lead to what

A 
-abnormal stress causing:
Lumbar/pelvic subluxation
Low back strain
Hip strain
Crutch palsy (axillary N/vessels-numbness)
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18
Q

Walking with crutches: non-weight bearing vs. partial weight bearing

A

Non weight bearing: tripod gait

Partial weight bearing: tripod or four point gait

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19
Q

Tripod gait: non-weight bearing

A

Affected foot fully elevated

Tips move 12-15” in front and swing both legs between crutches and land on healthy foot

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20
Q

Tripod gait: swing-to gait vs. swing-through gait

A

Swing-to: easier and less coordination

Swing-through: faster, more coordination

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21
Q

Tripod gait: partial weight bearing

A

Aka four point gait

Affected leg and crutches move forward together

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22
Q

Up and down stairs gait options

A

Tripod gait and handrail gait

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23
Q

Handrail gait for up stairs

A

Safer
Both crutches under one arm opposite to the side of the railing and on the affected side if possible.

“The good go up the bad go down”

Unaffected leg steps up followed by the crutches and involved leg

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24
Q

Handrail gait down stairs

A

Crutches opposite of railing on affected side.

Crutches go down first, then affected leg, then unaffected leg

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25
Tripod stair gait up stairs
Without railing Step up with unaffected then crutches and affected leg
26
Tripod stair gait down stairs
Without railing Crutches and affected leg step first, then unaffected leg follows
27
Fitting of cane
Length at superior aspect of greater trochanter (of femur)
28
Use of cane
Cane is used on opposite side of involvement Moves WITH involved side
29
Braces for scoliosis
TLSO -thoracolumbosacral orthosis CTLSO -cervicothoracolumbosacral orthosis
30
Boston brace aka and for?
TLSO-thoracolumbosacral orthosis Aka under arm brace Scoliosis Worn under clothing at least 23 hours a day For thoracolumbar curves
31
Milwaukee brace aka and for what
CTLSO-cervicothoracolumbosacral orthosis For thoracic curves-scoliosis Includes a neck ring Worn 23 hours a day
32
What curves are the boston and Milwaukee braces used for?
Boston: thoraolumbar curves (TLSO) Milwaukee: thoracic curves (CTLS)
33
Charleston bending brace
Night brace only used when sleeping Molded to patient while they are in side flexion to give added pressure Scoliosis
34
Braces for spinal fractures
``` Jewett brace TLSO Extension Voigt-Bahler Knight-Taylor Williams Lennox-Hill ```
35
Trochanteric/SI Belts
Support SI joints and pelvis by forcing closure Used in pregnant/post-partum females with SI joint pain Causes gapping of SI joints if worn over trochanter
36
Lumbar supports-thoughtsn
Weak evidence that they prevent re-injury. Cause increased intrabdominal pressure leading to higher BP and HR. Requires screening for cardiac risk Should be considered temporary
37
Knee braces for ACL tears
- pt feels more stable even though not objectively more stable - doesn’t protect from injury - bracing slows hamstring reflexes while elastic taping increases - protects from lateral blows
38
Knee bracing-neoprene sleeve
- Keep muscles and joints warm - no injury prevention - improve proprioception in patients with deficits
39
Hamstring reflex in brace vs. elastic taping
Brace: decreases | Elastic taping: increases
40
Cho-Pat use at knee
So good schlatter’s
41
Cho-pat for elbow
Epicondylitis
42
Walking boot indications
Fracture Severe strain Post surgery
43
Description of walking boot
Full immobilization and weight bearing
44
Ankle stirrup inhibits/allows what Motion’s
Allows flexion/extension | No: inversion/version
45
Orthopedic (fracture) shoe
For fractured toes Protects from re-injury/aggrevation Has rigid sole
46
Plantar fasciitis supports
- thermoskin plantar FXT night splint - passive night splint - Strassburg sock
47
Brace for metatarsalgia
Use a almond shaped bad under the metatarsal heads
48
Cervical pillows
Little research - positive results on pain - mild traction of neck - should have firm support of curve and doesn’t force flexion or extension
49
Philadelphia collar
Rigid Prevent motion Stabilizes Some distraction (C-collar)
50
Soft cervical collar
Limits cervical motion No rotation Used post strain/sprain injuries
51
Wrist brace name and use?
Cock-up splint For sprain and CTS
52
Effects of massage
- increase blood flow and disperses waste - dilation of lymphatics - sedation - muscle relaxation - removal of lactic acid - loosens adhesions and soften scars
53
Indications for massage
- adhesions - circulatory stasis - congestion - edema/joint swelling - myalgia/trigger points - tension HA - postexertion fatigue/stiffness
54
Contraindications to massage
- arteriosclerosis - thrombus/embolism - varicosities - acute phlebitis - cellulitis - synovitis - abcess/skin infection - acute inflammatory conditions
55
Effleurage
Long stroking motions done with palm of hand or flats of fingers Parallel with fibers
56
Petrissage
Kneading muscle | Pulling tissue up with fingers: squeeze, pinch, rolling
57
Tapotement/percussion
``` Rapid blows Tapping: tips of fingers Hacking: ulnar boarder of hand Slapping: fingers Cupping: cupped hands ```
58
Manual vibration
Perpendicular to orientation of muscle fibers | -distal to proximal
59
Mechanical vibration
G5, genie rub, thumper
60
High frequency vibration uses
``` Analgesia Decrease trigger points Pre-exercise warm up Relax spasticity Superficial circulation ```
61
Low frequency vibration uses
- decrease congestion/edema/stasis - milk tissue - postural drainage
62
Times for vibration of: Trigger points: Muscle relaxation: Postural drainage: Body relaxation:
Trigger points: 1 min/spot Muscle relaxation: 10min Postural drainage: 15min Body relaxation: 5min
63
Cross friction massage
Over ligaments, tendons, muscles - loosen scar tissue/adhesions - aid in absorption of local edema/effusion - mobilize ligaments/tendons/scars - restore mobility/extensibility
64
Duration of cross-friction massage
7-10 minutes or until numb. No lotion
65
Trigger point therapy
Focus on hyerirratibility in muscle/fascia
66
Rope sign and twitch sign. What and indicate what type of massage
Indicate: trigger point needed Rope sign: taught band of fibers causing hyper-excitability in surrounding muscles (twitch sign)
67
Ischemic compression-trigger point
Digital pressure for one minute of series of 7-10seconds
68
Stripping-trigger point
Sliding along tissue with increasing pressure, pause over trigger point then continue
69
Spray and stretch (Travell)-trigger point
Vapocoolant spray combined with stretching
70
Myofascial release
Pressure to tendons, ligaments, fascia and nerve while actively pr passively moving the tissue
71
ART benefits
- restore strength, flexibility, motion to soft tissues - release entrapped nerves, circulatory and lymphatics Concentrates on tissue texture, tension, movement and function
72
Rolfing
“Balance body within a gravitational field” Alter a person’s posture and structure with deep massage
73
Instrument assisted soft tissue mobilization
Allow deeper pressure and less stress on doc’s hands ``` T-bar FAKTR Graston -localized inflammatory reaction to speed healing -break scars and loosen adhesions ```
74
IASTM
Graston technique Ligaments 43% stronger 4wks post MCL injury, but no difference at 12 weeks -ligaments had better collagen bundle formation and orientation
75
FAKTR-PM stand for?
Functional and kinetic treatment with rehab, provocation and motion F: treat during function, not just static K: assess and use entire kinetic chain T: soft-tissue techniques R: incorporate resistance and proprioceptive P: produce pain and treat M: treat with option if more painful
76
Indication for FAKTR: PM
1. Tendinopathies 2. Fascial syndromes (ITB, trigger finger) 3. Entrapment syndromes 4. Ligament pain (sprains) 5. Scar tissue/adhesions 6. Edema
77
FAKTR-PM. R examples
Rehab—incorporate resistance and proprioception Ex: oscillation/vibration and unstable surfaces
78
SASTM?
Sound assisted soft tissue mobilization
79
Traction types
Manual Positional Mechanical Inversion
80
Positional traction
- Knee to chest | - side lying on a roll to open an IVF
81
Inversion traction
NOT RECOMMENDED ``` Contraindicated for: Heart disease HTN Glaucoma Sinus infections Asthma Migraines Detached retina ```
82
Benefits of spinal traction
Spinal column elongation Enlarge IVF Increase diffusion of nutrient to disc Release pressure on NR
83
Indications for spinal traction
Neck and low back disorders - disc - NR impingement - joint hypomobility - arthritis of facets
84
Contraindications to traction
- infection/tumor - fracture - severe herniation - hypermobility - VBAI - spinal stenosis - osteoporosis - Aortic aneurysm - abdominal hernia - HTN - pregnancy-lumbar only
85
Risks of traction
-increase pain -history of spinal surgery -spondylosis/spondylistesis -HTN/respiratory disorders -dentures (C only) TMD (C-only)
86
Instructions of mechanical traction-lumbar
``` Pelvic and thoracic harnesses Hips/knees flexed Force= 30-60% body weight Angle pull= 0-30 degrees 10-30 minutes ```
87
Cervical traction
Over-the-door pulley system Mechanical Head/neck angle=0 degrees 10-30% body weight 10-30 mint
88
Injury taping with keywords: basket weave with stirrups and heel lock?
Ankle injury taping
89
Ankle injury taping key words
Closed basket weave with stirrups and heel lock
90
Key words for foot taping plantar fasciitis
1st metatarsals around calcaneous and anchoring
91
What are you taping for with taping 1st metatarsal through the 5th with anchoring
Plantar fasciitis
Passive Care
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