Clinical Procedures Chapter 32: Rehabilitation and Therapeutic Modalities.

Standard Walker:

- Adjustable height, rubber tips and made of aluminum and is lightweight. - Use for patients who require maximum assistance with balance and coordination, because walkers provide stability and support when patients are standing or walking.

List six percautions that medical assistants must take when applying heat or cold madalities.

- Infants and patients who cannot report a burning sensation should be watched carefully.Infants and older adults partiulatly susceptible to burns. - Heat and cold sensitivitt varies with patients; check patients frequently and never leave them alone. - Always wrap appliances, whether warm or cold, with cloth before applying them to the skin.

The appropriate way to utilize a gait belt includes:

- Lifting the patient by grasping the belt from underneath - Lifting up

Walkers are used for patients who need _______?

- Maximum assistance - Assistance with poor balance - Stability

Axillary Crutches:

- Placed into the axilla area. Made for younger people not older. - Use primarily for individuals who need crutches temporarily while a lower extrmity heals.

Forearm ( lofstrand or canadian ) Crutches:

- Shorter than axillary crutches, and have a metal cuff worn around the forearm. - Use: the weight is borne almost exclusivly on the hand grip.

Quad Cane:

- single cane resting on a platform with four legs with rubber tips on the legs. - use for patients with more severe walking difficulties.

Standard Cane:

- single leg, curved handle. rubber tip. - use when a patient has one weak side and will need this assistive device for a longer period than crutches.

What is a KEY when using lifting techniques?

- use the largest muscles of the legs and arms to lift. - bend from the hips and knees, squat down, and push up with leg muscles. - get as close as possible to the patient

List six safety rules for transporting a patient in a wheelchair.

-Make sure equipment is stable and firm. Lock breaks. -Check that there are no obstructions to trip over when making the transfer. - Take small shuffling steps, and avoid crossing the feet. - Practive good body mechanics. - Ascertain beforehad whether assistance from other staff will be needed with the transfer.

Platform Crutches:

-Platform ism affixed to a crutch, patient bees weight on forearm. Use: recommended for patients who cannot grip the handles of other types of crutches or bear weight through their wrist or hands.

Temperature and time for : A Warm compress to assist with frainage from a patient's skin infection.

110 degrees F & limited time

Temperature and time for : Hot water bottle for an adult patient.

125 degrees F - adult no more than 20 minutes.

Temperature and time for : Faraffin wax bath for a patient with rheumatoid arthritis.

127 degrees F & 30 min or less.

Temperature and time for : Aquamatic K-Pad for an older adult patient.

95-100 degrees F & 30 minutes or less.

Motion away from the midline of the body is ________.

Abduction

Motion away from the midline of the body is ________?

Abduction

_______, which are self-directed and performed by the patient without assistance.

Active exercises

__________, which provide voluntary movement against various tyes of maual or mechnaical pressure to increase muscle strength.

Active resistance exercises

Name four types of exercise programs that are used for therapeutic or preventative purposes.

Active, Passive, Assistive, and Active-resistance

____________:Lenny Taylor, suffering the early stages of dementia from Alzheimer disease, works with an occupational therapist to practive methods of amking these everyday tasks easier to perform.

Activities of daily living

Motion toward the midline of the body is ________?

Adduction

Motion toward the midline of the body is __________.

Adduction

_________:When patient Linda Maier comes to Inner City Health Care discribing a sore back and several recent falls. Dr. Osborne asks clinical medical assistant Joe Guerrero, CMA (AAMA), to secure a gait belt around Linda's waist and have her walk across the room. With Joe staying a step behind her and slightly to the side, Dr. Osborne carefully observes Linda's progress when performing this tasks.

Ambulation

____________: Clinical medical assistant Joe Guerrero, CMA (AAMA), applies this practive of using certain key muscle groups together with correct body alignment to avoid injury when assisting patient Lenore McDonell in performing a transfer from her wheelchair to the examination table.

Body mechanics

Explain how to avoid internal damage to the patient when an ultrasound treatment is being performed.

Applicator must be kept moving to prevent any internal damage.

Temperature and time for : An ice pack for a patient with an ankle sprain.

As cold as patient can take and the colder the shorter... usually 20-30 min.

______, which help the patient voluntarily move weakened muscles with the use of assistive device, such as a therapy pool.

Assisted exercises

__________: Canes, walkers, and crutches are examples of walking aids.

Assistive devices

What is the most effective type of crutch that may be used temporarily while a lower extrimity is heals?

Axillary

Define rehabilitation medicine and what is its importance in patient care?

Branch of medicine concerned with evaluation and treatment of and coordination of care. Uses physcial and mechanical agents to diagnose treat and prevent mechanical injuries. It aid in restoring any body functions that have been effected by disease or injury.

Circular motion of a body part is ________?

Circumduction

Circular motion of a body part is _________.

Circumduction

Moving a body part outward is __________.

Eversion

Cryotherapy

Cold applications used to constrict blood vessels and slow or stop the flow of blood to an area.

___________:As a muscle atrophies, shrinking and losing its strength, joints become stiff and experience development of these deformities. Without constant exercise, the musculoskeletal systen deteriorates.

Contractures

What is a type of assistive device that does not require much upper body strenght but is not recommended for older adults?

Crutches

____________:Using extreme cold to destroy abnormal tissue is a treatment for abnormal cervical cells found with a Pap smear.

Cryotherapy

Straightening of a body part is ________?

Extension

Straightening of a body part is __________.

Extension

__________ shows how hard a muscle can work.

strength testing

Moving the foot upward at the ankle going is _______.

Dorsiflexion

Moving the foot upward at the ankle joint is ________?

Dorsiflexion

Heating pad is _______ and can be performed _______.

Dry Heat Therapy........ at home with a patient or a caregivr

Ice pack is _______ and can be performed ______.

Dry cold therapy.......at home.

In crutch-walking gaits, what is a point?

Each time a the patients foot or crutch touches the ground at the same time.

____________:Massage using circular motions with the palm of the hand taht may ese muscle tissue.

Effleurage

___________:In order to diagnose carpal tunnel disorder, a recording of the electrical activity of muscle and nerve tissue is obtained.

Electromyography

Moving a body part outward is ________?

Eversion

Bending of a body part is ________?

Flexion

Bending of a body part is __________.

Flexion

How many legs does a quad cane have?

Four

___________:Dr. Angie Osborne recommends that patient Linda Maier begin to use a walker at home to prevent further falls. Joe Guerrero secures this item inside Linda's waste and positions her inside the walker as he gives her verbal instructions to begin the procedures of learning to ambulate with a walker.

Gait Belt

___________:Margaret Thomas's neurologist uses this instrument to meausre the angle of her shoulder joint's ROM during a follow-up examination for Parkingson disease.

Goniometer

___________:A physical therapist uses the measurement of joint motion to help exaluate a patient's ROM.

Goniometry

A position of maximum extension, or extending a body part beyond its normal limits is ________?

Hyperextension

A position of maximum extensions, or extending a body part beyond its normal limits is ______.

Hyperextension

The medical term for paralysis on one side is ______?

Hemiplegia

___________:Older adult patient Abigail Johnson is afraid that because she has diabetes mellitus she is at increased risk for stroke. "I dont want to end up a vegetable and a burden to my family," she tells Dr. Mark King, "all paralyzed on one side like that."

Hemiplesia

Moving a body part inward is _______.

Inversion

Moving a body part inward is ________?

Inversion

Electromyography (EMG)

Is the instrument used to test the electrical activity of a muscle...

What is a safety rule to be followed when moving a patient in a wheelchair?

Make sure the patients feet are on the footrest prior to moving.

Who is authorized to perform ultrasound procedures on patients?

Medical assistants or other caregivers specially trained can perform ultrasound.

Cold compress is _______ and can be performed _______.

Moist Cold Therapy........at home.

Whirlpool bath is ________ and can be performed ______.

Moist Heat Therapy...... at home by a patient with a caregiver.

Total body immersion in Hubbard tank is _______ and can be performed ________.

Moist Heat Therapy...... can be administered at home by patient with a care giver.

Warm pack is _______ and can be performed_______.

Moist Heat Therapy...... with supervision of a health care professional in a clinical setting.

Paraffin wax bath is ________ and can be performed ______.

Moist Heat Therapy............by physical therapy department by a professional therapist.

Hot water bottle is _______ and can be performed ________.

Moist Heat Therapy.......at home.

Warm compress is ________ and can be performed________.

Moist Heat Therapy......at home.

Warm soak of one extremity is __________ and can be performed _________.

Moist Heat Therapy......with caregiver assistance.

________________ :When examining a new patient, a physical therapist must determine which of the physical agents, such as heat, cold, light, water, and electricity, will be most beneficial in treating the patient's condition.

Mordalities

What are the special concerns of ultrasound treatment?

Must be used carefully near bones, because their waves are capable of concentrationg in one area and causing damage.

Moving the foot downward at the ankle is _______.

Planter flexion

Moving the foot downward at the ankle is ________?

Planter flexion

_______, which are performed by another person with no voluntary participation from the patient.

Passive exercises

Describe the procedure for measuring a patient for axiflllary crutches.

Patient must stand tall. Measure with patient wearing good walking shoes. Adjust lnfht so that axillary rest 2-3 fingers breadths below the the patients axilla. Adjust hand fgrips so that elbows are bent at a 20 degree angle. Handgrips should be level of crease or wrist when arms hang relaxed at side. Adjust overal length of each crutch until tip rests 2 inches lateral and 6 inches anteriorly to foot when positioned appropriately related to axilla.

Moving the arm so the palm is down is ________.

Pronation

Moving the arm so the palm is down is ________?

Pronation

___________:When lying flat with arms at the side, the average person should be able to move from a 20-degree hyperextension of the elbow joint to a 150-degree flexion.

Range of motion

The use of activities to help restore independent fuctionning after an illness or injury is know as ________?

Rehabilitation medicine

Turning a body part around its axis is ________?

Rotation

Turning a body part around its axis is _________.

Rotation

Moving the arm so that the palm is up is __________.

Supination

Moving the arm so the palm is up is ________?

Supination

What is joint range of motion, how is it measured, and how is the measurement expressed?

The amount of movement that is present in a joint. It is measured with an instrument called a goniometer ad is alwaus expressed in degrees.

How long can an ultrasound be administered?

The treatment last anywhere from 5-15 minutes.

__________:Dr.Winston Lewis recommends this heat modality to help relieve Herb Fowler's chronic lower back pain, which is caused by strain on the back muscles created by the patient's overweight condition.

Thermotherapy

A method of using electric current to stimulate nerves is know as _________?

Transcutaneous electric nerve stimulation (TENS)

_____________: As Margaret Thomas, diagnosed with Parkinson disease, began to experience balance problems and difficulties in walking, her physical therapist prescribed the use of heigh-frequency sound waves to generate heat in the deep tissue of her right leg, producing a therapeutic effect.

Ultrasound

Describe how ultrasound works and identify the patient conditions for which it is an effective treatment.

Use hight-frequency sound waves that are converted to heat in the deeper tissues. Treatment for chronic pain or acute injuries such as sprains or strains.

____________:Cold applications may be used to constrict blood vessels to slow or stop the flow of blood in the area.

Vasoconstriction

________________Slows down the inflammatory process which can reduce or prevent swelling of inflamed tissues, reduce bleeding, numb the pain sensation by acting as a topical anesthetic, ad reduce frainage to an area.

Vasoconstriction

Temperature and time for : Warm soak of the arm and hand for a patient with osteoarthritis.

Water not hotter than 110 degrees F & no more than 15 minutes.

What type of patient would need forearm crutches?

a patient with upper body strenght, and will be using a long period of time or perminently.

Gait belt

a safety belt worn around the patient's waist, when transferrring a patient.

Range of motion (ROM)

amount of movement present in a joint

Thermotherapy

heat, causes vasodilation

Goniometer

how joint movement is measured

Electrode

is inserted through skin into the muscle and measurements of muscle strengh are made

________ heat penetrates better than _____ heat.

moist heat ............ dry heat

Contractures

occur when the body is in a nonmoving state.

A patient with sever arthritis or poor use of their hands could utilize what?

platform crutches

Assistive device

provide stability and support, whereas others require more coordination.

Passive (assisted motion)

someone is assisting

Active (Voluntary motion)

someone is doing it themselves

It is best to perform passive ROM with the patient in the relaxed _________ position.

supine

Ambulation

the activity of walking around.

Body mechanics

the practice of using certain key muscle groups together with good boy alignment and proper body positioning to reduce the rist for injury to both patient and caregiver.

How do ultrasound waves travel?

the waves best travel in tissue that has a high concentration or water.

__________ is a high-frequency acoustic vibration that is part of the elctromagnetic spectrum, and its frewuencies are beyond the perception of the human ear.

ultrasound