Midterm 2/13/21 Red Flags &TherEx
the American Cancer Society (ACS) and the Skin Cancer Foundation used the following method A. B. C. D. E. to assess skin lesions for cancer detection
A-Asymmetry, B-Border, C-Color, D-Diameter, and E-Evolving
F. I. T. T. stands for
Frequency, intensity, time, and type of exercise
Muscles of the hip performing hip extension
Gluteus maximus
Hip muscles that perform internal rotation
Gluteus medius and minimus and the TFL
Hip muscles that perform hip abduction
Gluteus medius, minimus and Sartorius
In resistance training, dosage includes
Intensity, volume, frequency, and duration of exercise
Hip muscles that perform hip adduction
Pectineus, gracilis, adductor longus, brevis, and magnus
Which of the following interventions are contraindicated during the active inflammatory period of rheumatoid arthritis?
Stretching
Dynamic balance tests are
The five times sit to stand test
What is NOT a symptom of severe dehydration?
Thirst
Which of the following is a contraindication to PROM exercises?
When movement of a body segment is disruptive to the healing process
Maximum oxygen consumption (VO2 max) is a measure of the body's capacity to use
oxygen.
Medications such as beta blockers and calcium channel blockers can prevent the normal rise in pulse rate. If patient is taking these medications the
PTA must monitor rates of perceived exertion (RPE) instead of pulse rate.
Which of the following is a true statement about the components of the patient management model described in the guide physical therapist practice
Patient education is the one intervention that should be included for every patient throughout the entire episode of care
It is not uncommon for older adults to experience a change in mental status or go through a stage of confusion about 24 hours after hospitalization for a serious illness or trauma, including surgery under a general anesthetic.
Physicians may refer to this as iatrogenic delirium, anesthesia-induced dementia, or postoperative delirium. It is usually temporary but can last several hours to several weeks.
All of the following could contribute to falls in the elderly population except?
Poor taste buds
Hip muscle that perform hip flexion
Psoas major, iliacus, sartorius, and TFL
When observing the respirations of a COPD patient, you note changes in all the following
Rate, Sound and Pattern, Use of accessory muscles, and Excursion
This is the feature of the individual's medical history and clinical examination thought to be associated with a high risk of serious disorders.
Red flag
The normal SaO2 range at rest and during exercise is 95% to 100%.
Referral for further evaluation is advised when resting saturation levels fall below 90%.
Pain perceived in an area other than the site of the stimuli is the definition what term?
Referred pain
The difference between the systolic and diastolic pressure readings (SBP - DBP) is called pulse pressure normally around 40 mm Hg. Pulse pressure is an index of vascular aging.
Resting pulse pressure consistently greater than 60 to 80 mm Hg is a yellow (caution) flag and is a risk factor for new onset of atrial fibrillation
Anterior superior iliac spine (ASIS)
Round bony prominence at the anterior end of the iliac crest.
What do we always need to be aware of with performing exercises or any intervention with patients?
Safety
When someone is having a heart attack they may experience pain where else than the chest?
Shoulder, Neck, Jaw, and Arm
A ________can be easily seen, heard, smelled, measured, photographed, or shown to someone else.
Sign
Using the concept of direct pressure and shared pathways, the type of pain generally described as bumping your knee, biting your lip, or burning your hand is called?
Somatic pain
Which of the following terms associated with aspects of physical function is used to describe the ability of the neuromuscular system to statically are genetically hold proximal or distal body segments in appropriate positions using the sinner just muscle action
Stability
The PTA is encouraged to become accustomed to using the word"_" instead of "pain" when talking with the patient/client.
Symptom
_________ pain tends to be relieved minimally, relieved only temporarily, or unrelieved by change in position or by rest.
Systemic
Static balance tests are
The Rhomberg test, the sharpened Romberg, the single leg balance test, and the stork stand test
Anticipatory postural control tests are
The functional reach test and the star excursion balance test
The mode of exercise and a resistance exercise program or first the form of exercise, the type of muscle contraction that occurs, and
The manner in which the exercise is carried out
Symptoms of any kind that present bilaterally always raise a red flag for concern and further investigation.
True
Safety during balance training
Use a gait belt and stand slightly behind and to the side of patient with one arm holding near the gate belt and the other arm on the trunk, close to the shoulder
Painful symptoms that start 3 to 5 minutes after initiating activity and then go away when the client stops suggest pain from what structures?
Vascular
If the blood glucose level is less than 100 mg/dL
a 10- to 15-g carbohydrate snack should be given and the glucose retested in 15 minutes to ensure an appropriate level.
The need or demand for oxygen is determined by the heart rate (HR), sys- temic blood pressure, myocardial contractility, and
afterload.
In an acute care or trauma setting, the PTA may be using vital signs and the A.B. C. D. E. method of quick assessment which stands for
airway, breathing, circulation, disability, and exposure
A common strategy for history taking in the trauma unit is the mnemonic AMPLE:
allergies, medications, past medical history, last meal, and events of injury.
Fast-twitch fibers (type IIB) are characterized by a fast contractile response,
and are recruited for activities requiring power.
Fast-twitch fibers (type IIA) have characteristics of both type I and type IIB fibers
and are recruited for both anaerobic and aerobic activities.
Slow-twitch fibers (type I) are characterized by a slow contractile response,
and are used preferentially in low-intensity exercise.
Modified versions of the Timed Up-and-Go Test with secondary cognitive and motor tasks can be used by clinicians to
assess the influence of divided attention on balance control.
The normal resporation rate is
between 12 and 20 breaths per minute.
With insufficient rest intervals during a resistance exercise program, a patient's performance plateaus and/or
deteriorates
Posterior superior iliac spine (PSIS) bony prominence at the posterior end of the iliac crest,
felt subcutaneously at the bottom of the dimples on the proximal aspect of the buttocks; the spines are at the level of the spinous process of S2.
Muscle performance is the capacity of a muscle to do work
force x distance
Muscle strength is a broad term that refers to the extent that the contractile elements of muscle produce
force.
the hip joint may be flexed and extended in the sagittal plane, with movement occuring around a
frontal axis
Backward body sway results in activation first of the paraspinals followed by the
hamstrings.
With the hip positioned in 90° of flexion, hip internal and external rotation occurs
in the frontal plane around a sagittal axis
Movements at the hip joint
includes flexion, extension, abduction, adduction, and internal and external rotation.
Myocardial oxygen consumption is a measure of the oxygen consumed by the
myocardial muscle.
Dyspnea when the person is lying down is called
orthopnea
In response to a forward body sway, muscles are typically activated in a proximal to distal sequence: Abdominals beginning about 90 to 100 ms after perturbation onset followed by activation of the
quadriceps.
Studies over several decades have demonstrated that if light exercise is performed during the recovery period (active re- covery),
recovery from exercise occurs more rapidly than with total rest (passive recovery). Faster recovery with light exercise is probably the result of neural as well as circulatory influences.
Endurance (a measure of fitness) is the ability to work for prolonged periods of time and the ability to
resist fatigue.
The three elements of muscle performance-strength, power, and endurance-can all be enhanced by
resistance exercise.
Hip abduction and adduction occur in the frontal plane around a
sagittal axis
The rate of fiber growth (increase in cross-sectional area) is relatively consistent from birth to puberty. Change in fiber type distribution is relatively complete by the age of 1,
shifting from a predominance of type II fibers to a more balanced distribution of type I and type II fibers.
A pulse increase with activity of more than 20 bpm lasting for more than 3 minutes after rest or changing position
should be reported.
the upper border of the ilium; the top of the iliac crest is level with the
space between the spinous processes of L4 and L5.
The Romberg Test
tests the patient's ability to stand with the feet parallel and together with the eyes open and then closed for 30 seconds.
Most healthy individuals use combinations of strategies to maintain balance depending on the
the control demands.
Training is dependent on exercise of sufficient frequency, intensity, and
time.
Divided attention is when a person is doing
two tasks simultaneously
Hip rotation can be performed in the anatomical position, with movement occurring in the transverse plane around a
vertical axis.
The cardiovascular system and the muscles used adapt to the training stimulus over time. Significant changes can be measured in as little as
10 to 12 weeks.
According to the American Heart Association Stage 1 High BP, the systolic and diastolic figures are in what range?
130-139/80-89
Recovery from acute exercise, in which the force-producing capacity of muscle returns to 90% to 95% of the pre-exercise capacity, usually takes
3 to 4 minutes, with the greatest proportion of recovery occurring in the first minute.
The resting pulse may be higher than normal with fever, anemia, infections, some medications, hyperthyroidism, anxiety, or pain.
A low pulse rate below 60 bpm is not uncommon among trained athletes.
Pain of a visceral source is usually accompanied by which of the following?
Abnormal change in blood pressure, Change in skin pallor, and Diaphoresis
Ms. L is a 78-year-old who underwent surgery for internal fixation of an intertrochanteric fracture of the (L) hip 3 days ago. For the next few weeks she must remain non weight-bearing on the operated side and has begun to use a walker for ambulation. She is to standing. According to the ICF able to walk for short distances around her hospital bed but is not yet able to rise from a chair model, the inability to stand from a sitting position is classified as a(n):
Activity limitation.
An 85-year-old female presents to the clinic with hip pain that has developed quickly without any known injury. What are the two red flags in this scenario?
Age/insidious onset
When working with patients with advanced dementia, it is important to remember that untreated pain may be manifested as which of the following?
Agitation
Visceral diseases of the abdomen and pelvis are likely to refer pain where?
Back
The body systems react, adapt, and develop in response to forces and physical stresses placed on them. All of the following stresses help the body to develop and maintain a functional level of strength except:
Bed rest.
When is a good time to check vital signs in a CHF patient on oxygen?
Before initiating exercise, During gait if symptoms are present and After treatment intervention
When surveying or observing a patient, the PTA should be looking at many changes in the patient. What is not commonly used by PTA's to assess, report and document?
Cardiac Arrhythmias
Which of the following terms is synonymous with cardiopulmonary fitness and is associated with the aspects of physical function that can be modified by therapeutic exercise?
Cardiopulmonary endurance
Non-communicable chronic diseases are the primary cause of death and illness in the United States (US). The top four chronic conditions in the US in terms of mortality include all of the following.
Chronic respiratory disease, Cancer, Cardiovascular disease, and Diabetes
Your patient is performing pelvic tilt exercises for the first time and needs verbal and tactile cues to perform exercises correctly. This represents which stage of motor learning
Cognitive
Patients that have more than 1 condition that they are affected by on a daily basis is called?
Comorbidities
Which of the following components of the ICF model is defined by the individuals lifestyle, education, and social and environmental backgrounds
Contextual factors
Cardiopulmonary fatigue is related to the body's ability to use oxygen efficiently. Cardiopulmonary fatigue associated with endurance training is probably caused by a combination of the following factors:
Decreased blood sugar (glucose) levels, Decreased glycogen stores in muscle and liver, and Depletion of potassium, especially in the elderly patient
A PTA is working with a client who complains that her pain occurs after walking a block with her dog. The client further describes the pain as sharp and that it relieves after 5 minutes of rest. What is the most appropriate follow-up method for the PTA?
Document and report the symptoms to the PT, while educating the client to keep a more detailed log of her symptoms with activity and rest until her next appointment.
The chest and gut are formed from the same tissue in utero. This explains symptoms of intrathoracic organ pathology frequently being referred to the abdomen. These statements describe which theory of developing pain patterns?
Embryological
Blood glucose levels of 300 mg/dl or higher indicate the blood sugar level is too high to exercise safely, putting the client at risk for ketoacidosis
Exercise should be postponed until the blood glucose level drops to a safe pre-exercise range between 100 and 250 mg/dL
What is the leading cause of death among those 65 and older, and a primary symptom of Parkinson's Disease?
Falls
Tobacco use, poor nutrition and alcohol abuse are not preventable or manageable behaviors.
False
All of the following are Red Flag symptoms of a visceral source and are usually accompanied by an Autonomic Nervous system (ANS) response.
Fever, Pallor, Fatigue and Nausea/Vomiting
Muscle power is related to the strength and speed of movement and is defined as the work (force x distance) produced by a muscle per unit of time (force x distance/time)
In other words, power is the rate of performing work.
When assessing pain and gathering information from the client, the PTA must be prepared to listen to information regarding _______.
Location and Frequency
Which of the following is a contraindication or precaution to therapy?
Marked dyspnea, Irregular pulse with symptoms of dizziness, nausea, or shortness of breath or loss of palpable pulse, and Postoperative posterior calf pain
Adductor tubercle
Medial projection at the distal end of the femur at the proximal aspect of the medial epicondyle.
Muscles of the hip performing hip external rotation
Obturator internus and externus, gemellus superior and inferior, quadratus femoris, piriformis (deep six) and a little of the sartorius
According to the definition of therapeutic exercise and the goal of designing an individualized program therapeutic exercise, the physical therapist might develop a therapeutic exercise program in order to
Optimize overall health status, fitness, or sense of well-being.
