Review Set 8

अब Quizwiz के साथ अपने होमवर्क और परीक्षाओं को एस करें!

What is apoptosis?

"programmed cell death" -controlled by genetics -cells self destruct, undergo phagocytosis -occurs when cell # is excessive or when cells are injured

How do we get chronic pain?

"wear and tear" stressors to the nervous system similar to how stressors to the musculoskeletal system can lead to arthritis

What does pirenzepine do?

-Inhibits gastric acid secretion (at doses below those needed to affect the CNS) -relaxes the lower esophageal sphincter, making mvt of food into lower GI tract easier

Examples of "good" bacteria that can prevent diarrhea:

-Lactobacillus acidophilus -Lactobacillus bulgaris (often called Intestinex or Lactinex)

Emphysema: -what are the symptoms?

-S: dyspnea, minimal wheezing, barrel chest, prolonged expiration

What types of exercise activities should people with osteoporosis participate in?

-WB activities -resistance training -balance training

What do "bulk forming" laxatives do?

-absorb water and swell within the lower GI tract -stretch the bowel and stimulate peristalsis

What is secondary osteoporosis?

-acceleration of bone loss due to *chronic illness* or medication -Ex: glucocorticoids, hyperthyroidism

Early mobilization s/p amputation helps with what 2 random things?

1. wound healing 2. shaping residual limb

What gait speed is required to safely cross an urban street?

1.0 - 1.2 m/s

What is the "average" gait speed?

1.37 meters/sec (~3 mph)

What is the loose packed position of the radiocarpal joint?

10 deg of wrist flexion w/ slight ulnar deviation

How many molecules of ATP are produced from 1 molecule of palmitate (C16) in the TCA cycle?

106

What is the average cadence for gait?

110 steps/min (spm) (up to 120 spm)

How many items are on the Berg Balance Test?

14

How long does the Berg Balance test take to administer?

15-20 min

What is the cutoff score for Dynamic Gait Index (DGI)?

19

If a person uses an assistive device, it drops their DGI score to a:

19, limits the use of this test (floor effect)

How long is one cell of DNA?

2 meters long

How many vertical sine waves occur during one full gait cycle? How many "side-to-side" sine waves occur during one full gait cycle?

2 vertical 1 side-to-side

How often are RRD worn s/p amputation?

24/7

How often should ACE wraps be worn for an amputee?

24/7

What lab value helps to guide the dosage of vitamin D supplementation?

25 OH D

Up to how many mL of fluid can the bladder have before the internal urethral sphincter opens?

250 mL

For osteoporosis, the goal should be ____ minutes of activity ____ days of the week

30 min most days

What is the oldest dressing technique that is still frequently used s/p amputation?

ACE wrap

Lapar

Abdomen; Example: Laparoscopy

Macr

Abnormal largeness; Example: Marcroblast; Abnormally large, nucleated red blood cell

What ligaments hold the AC joint together?

Acromioclavicular lig Coracoclavicular lig

What are the different bases that could be found in DNA? How do they normally pair?

Adenine Thymine Cytosine Guanine AT or CG (energy efficient)

At what joint does circumduction of the digits occur?

CMC and MCP joints

How are kidney stones/renal calculi removed?

Can be dislodged by increased fluid intake, invasively, ultrasound, or muscle smooth muscle relaxants

What are the 2 openings in the nasopharynx?

Choanae: post. openings of nasa cavities Auditory tube: pharyngeal openings on lateral walls

What muscles control the external urethral sphincter in a male?

Compressor urethra M Sphincter urethrae M

What muscles control the external urethral sphincter in a female?

Compressor urethra M Sphincter urethrae M Urethrovaginal sphincter M

Esis

Condition

Ia

Condition of diseased or abnormal state Example: Amyluria; Excess of starch in the urine

What type of joint is the wrist joint (radiocarpal joint)?

Condyloid (synovial)

What type of joints are metacarpophalangeal joints?

Condyloid (synovial)

Kerat

Cornea; Example: Keratotomy; Incision of the cornea

What is the clinical gold standard to measure BMD?

DEXA (dual x-ray absorbiometry) measures BMD at multiple sites

What are the two types of nucleic acid?

DNA RNA

What is the smooth muscle of the wall of the bladder?

Detrusor muscle

Where is the bladder by puberty?

Empty bladder lies in the true pelvis

Megaly

Enlargement; Example: Cardiomegaly; Enlargement of the heart

Olig

Few, scanty; Example: Oligogalactia; Deficient secretion of milk

What is the anular ligament?

Forms a ring around the head of the radius to the radial notch of the ulna

Where is the bladder at 6 years of age?

Greater pelvis

What is important for signal transduction to work correctly?

Has to be tightly regulated

What conditions can interferons be used to treat?

Hepatitis B and C, and Kaposi's Sarcoma associated with HIV

What type of joint is the elbow?

Hinge (synovial)

Ischi

Hip joint; Ischium

Patient compliance is mandatory with which type of post-op dressing?

IPOP, not eligible to use this if they aren't compliant

What happens to the IRV of someone with a chest wall restriction?

IRV: decreases

If a drug is detroyed by stomach acid, how might it be administered?

IV or coated tablet form

What is unique about the joint capsule of the proximal radioulnar joint?

It is continuous with the elbow joint capsule

What canal does the ulnar nerve run through at the wrist?

It is superficial to the flexor retinaculum and runs through the ulnar canal/canal of guyon. This is a groove between pisiform and hook of hamate.

What is the function of the subscapular bursa?

It protects the tendon of subscapularis and communicates with the glenohumeral joint cavity

Does the clavicle fracture or dislocate more often?

It rarely dislocated due to the strong ligaments, it is more likely to fracture

Laryng

Larynx; Example: Laryngitis; Inflammation of the larynx

What is the close packed position for the MCP? IP?

MCP: full flexion IP: full extension

Mania

Madness

Kinesi

Movement; Example: Kinesiology; The study of movement

Myos (my)

Muscle; Example: Myocarditis; Heart muscle inflammation

What may be used in the medical management of CTS?

NSAIDs corticosteroids surgery (CT release)

Noct

Night; Example: Nocturia; Excessive urination at night

Nyctal

Night; Example: Nyctalopia; Night blindness

Nyct

Night; Example: Nycterine; Occurring at night

Papill

Nipple; Example: Dermal papilla; Small elevations that indent the inner surface of the epidermis

Oophor

Ovary; Example: Oophorostomy; Incision of an ovarian cyst

What type of incontinence is almost exclusively male?

Overflow/outflow incontinence

Ox(ia)

Oxygen; Example: Hypoxia; Insufficient oxygen

Are PPIs or H2 blockers more expensive?

PPIs

Patell

Patella (kneecap); Example: Patellectomy; Surgical removal of the patella

Where does the common iliac A split into external and internal iliac AA?

Pelvic brim

Iatry

Physician, treatment; Example: Psychiatry

Iatr

Physician; Example: Iatrogenic; Caused by a physician

Which meningeal layer is considered the vascular layer?

Pia mater vasculature runs within arachnoid mater on the pia surface

Which cranial fossa contains the occipital lobes, tentorium cerebelli, cerebellum, pons, medulla, and occipital bone?

Posterior

Which 3 arteries make up the posterior circulation of the brain?

Posterior cerebral Basiliar Vertebral **

Gravid

Pregnancy; Example: Gravidocardiac; Pertaining to heart disease in pregnancy

What is an additional function of the internal urethral sphincter in males?

Prevention of retroejaculation

Which muscles are in layer 4 of the anterior forearm?

Pronator quadratus

Which muscles are in layer 1 of the anterior forearm?

Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris (pass, fail, pass, fail)

Prost

Prostate gland; Example: Prostatolith; A calculus (stone) of the prostate gland

What is in the pudendal/Alcock's canal?

Pudendal N Internal pudendal A/V

How is one gait cycle defined?

R foot initial contact to R foot initial contact

Where is the subarachnoid space?

REAL space filled with CSF

In which type of dressing (soft, RRD, rigid) can simulated WB *start* to occur s/p amputation?

RRD (picture of pt holding towel looped under distal residual limb and pulling towards them to apply pressure)

What are the contents of the anatomical snuff box?

Radial artery, radial styloid process, scaphoid, trapezium, and 1st CMC joint

What is a patent urachus?

Rare condition where the urachus re-canalizes or remains open leading to dribbling of urine from umbilicus

Actin

Rays; Example: Actinogen; Any radioactive substance

What are examples of endogenous chemical agents?

Reactive oxygen species or free radicals

In what order does G-Protein coupled receptor signaling occur? Where are all the components found?

Receptor G protein complex Effector molecule all within the plasma membrane

Gram

Record; Example: Sonogram; Sound record

Is the bladder intra- or retro- peritoneal?

Retroperitoneal

What is the function of arachnoid villi?

Returns CSF to venous blood at the superior sagittal sinus

What type of joint is the sternoclavicular joint?

Saddle joint (synovial)

What is an automatic reflex bladder?

Same response found in an infant

Hom

Same; Example: Homogeneous; Same components

Ictal

Seizure, attack; Example: Peri-ictal; Events aroung the time of the seizure

Lepsy

Seizure; Example: Narcolepsy; Recurrent uncontrollable desire for sleep

Acu

Sharp; Acupuncture

What is the insertion of all of the elevators of the pharynx?

Side of pharynx

Later

Side; Example: Lateropulsion; The involuntary tendency to fall to one's side

Myelo

Soft, pith; Example: Myelopathy; A pathological change in the spinal cord

What 2 tendons form the anatomical snuff box?

The EPL and EPB tendons

What is the carrying angle of the elbow?

The angle appears when the elbow is fully extended and forearm supinated. The angle is about 10-15 degrees, with women having a slightly larger angle

What articulates with what in the intermetacarpal joints?

The bases of adjacent medial four metacarpals Thumb just articulates with trapezium

What is a common problem with antacids?

The body gets feedback that acid in the stomach is too low, so it produces more acid to accommodate.

How does the radius move around the ulna during pronation and supination?

The distal radius moves around the distal ulna medially and anteriorly

What is urge incontinence? (also known as an overactive bladder)

The need to urinate more than 7 times per day or 2 times at night

How does pronation and supination happen?

The radial head rotates within the annular ligament against the ulna

Why is joint cartilage important?

The thicker the joint cartilage the better because it functions to absorb shock

Why doesn't the ulna participate in the wrist joint?

Their is an articular disc located at the distal end of the ulna

What is the main artery of the posterior compartment of the forearm?

There is none

How do ACh M1 Receptor Antagonists work?

They block the M1 subtype of ACh muscarinic receptors

What are the transverse metacarpal ligaments?

They connect the heads of the medial 4 metacarpal together

Where do the sigmoid sinuses drain?

They drain the transverse sinuses into the jugular foramina & jugular VV

How are antacids used to treat ulcers?

They relieve gastric pain and facilitate ulcer healing

Hist

Tissue; Example: Histoblast; A tissue forming cell

Gloss

Tongue; Example: Glossitis; Inflammation of the tongue

What are sulfonamides usually prescribed for?

UTI (urinary tract infection)

What does the ureter carry and what does it carry it to and from?

Urine From renal pelvis to bladder

What do hyperosmotic laxatives do?

Use osmotically active substances to produce a gradient that draws water into the bowel and small intestines (to inc. fluid content and stimulate excretion)

Uvula deviation indicated a lesion in which CN? Which way does the uvula deviate?

Vagus uvula deviates toward the unaffected side

What are the 3 general types of headaches?

Vascular Muscular Traction/inflammatory

Where does the ureter enter the pelvis?

When it crosses the pelvic brim

When do elbow dislocations usually occur?

When the coronoid process of the ulna is chipped away

Leuk

White; Example: Leukocytes; White cells

Where is the pharynx widest and narrowest?

Wide: at hyoid Narrow: jxn w/ esophagus

Where is the golgi complex normally located?

Within the cell, attached to the ER

Gyn(gynec)

Women; Example: Gynecologist; Physician who specialized in diseases of women

Ergo

Work; Example: Ergostat; A machine to be worked for muscular exercise

Rhytid

Wrinkles; Example: Rhytidoplasty; The elimination of facial wrinkles by plastic surgery

What are the results of a radial nerve injury?

Wrist drop, inability to extend thumb and MCPs. You can test for this by having patient resist against you pushing against the dorsum of their hand

What imaging could you utilize to confirm/disconfirm that a patient has a scaphoid-lunate dislocation?

X-ray

Does the AC joint have an articular disc?

Yes, it is wedge-shaped and in between the fibrocartilage covered articular surfaces of the acromian and clavicle

Which articulations are the "yes" and "no" joints?

Yes: atlas & occipital No: atlas & axis

What is the ROM of the glenohumeral joint like?

Zhang said to just know it has a large ROM

A transtibial bi-valved RRD would extend to:

above the knee

What are interleukins and erythropotein?

cytokines

What are examples of tyrosine kinase-linked receptors?

cytokines or interferons

What properties of the intracellular environment may influence protein folding?

molecular chaperones pH ions temperature

Does a person lose consciousness in a simple, partial seizure?

no, memory and consciousness remain although awareness may be reduced

During a complex, partial seizure, is a person responsive?

no, person is unresponsive to people or activities

What causes Absence (of breath sounds)?

nonaeration or collapse of a lung

What does strong and painless mean when MMT?

normal finding

What can PTs do for treatment of Raynaud's disease?

not much education on smoking effects, use of medications, and wearing gloves in cold

Side effects of stool softeners include:

stomach cramps

Which 2 ligaments stabilize the atlantooccipital joint?

Anterior and posterior atlanto-occipital membrane/ligaments

What are the parts of the bladder (3)?

Apex Fundus Neck

What is the result of hypertrophy of the arachnoid villi?

Arachnoid granulations: form pits in inner table of cranial bones

Melan

Black; Example: Melanonychia; Blackening of the nails by melanin pigmentation

What type of incontinence results if parasympathetic efferents & afferents are disrupted?

Bladder can't contract and overflow incontinence is developed

Which muscles are in layer 3 of the anterior forearm?

Flexor digitorum profundus Flexor pollicis longus

Genu

Knee; Genurecurvatum

Where do the first 2 muscle layers of the anterior forearm originate from?

Medial epicondyle of humerus (flexors and pronators)

What is the O, I, N, F of flexor carpi ulnaris?

O: medial epicondyle I: pisiform N: ulnar nerve F: flexes and adducts (ulnar deviates) the hand

What is the O, I, N, F of pronator teres?

O: medial epicondyle and coronoid process of ulna I: lateral surface of radius N: median nerve F: pronate the elbow

What is the O, I, N, F of flexor digitorum superficialis?

O: medial epicondyle and parts of the ulna and radius I: body of middle phalanges N: median nerve F: flexes PIP, MCP, and the wrist joints

What is the O, I, N, F of abductor pollicis longus?

O: posterior surface of ulna & radius I: base of 1st metacarpal N: radial nerve F: abducts & extends thumb at CMC joint

A Berg Balance score in the range of 41-56 means:

-low fall risk -independent

What are intervention options for a Boxer's fracture?

-surgical -conservative w/ brace depends on the extent of injury

What is primary osteoporosis?

-associated w/ *aging* and dec gonadal function -unrelated to chronic illness

A Berg Balance score in the range of 0-20 means:

-high fall risk -wheel chair bound

What should tracheal breath sounds normally sound like?

-high-pitched, loud & hollow sounding -like wind rushing through a pipe -expiration is louder and might be more coarse

What are a lot of thing that can cause a restrictive lung disease? (read)

-hypoxemia -hyperventilation -kyphosis -extertional dyspnea -dry cough -hemoptysis -idiopathic lung fibrosis -asbestos -radiation fibrosis -obesity -neuromuscular impairment

What population is overflow/outflow incontinence common in?

Diabetic patients who lost ANS innervation to bladder Males who have BPH

Flav Yellow

Example: Flavin; One of a group of water soluble yellow pigments

Where do the lymphatics of the testes drain to?

Aortic/caval nodes

Which arteries and veins supply the rectum & anal canal?

Superior, middle, inferior rectal arteries and veins

What is the function of lysosomes?

To break down other molecues that are no longer needed (also foreign bodies) serve as a "clearing station"

What is the function of the nucleus in a cell? What is the boundary of the nuclear envelope made up of?

To contain genetic information, made of a phospho lipid bi-layer

Cyanosis

bluish discoloration of skin due to poor circulation or oxygenation

What is step length?

distance measured from heel strike of other foot to heel strike of measured foot Ex: distance from L heel strike to R heel strike

Do penicillins treat gram-positive or gram-negative bacteria?

gram-positive

Does vancomycin treat gram-positive or gram-negative bacteria?

gram-positive

If percussion over an area produces pain, it could indicate ______________

infection or tumor

Meningitis, brain abscess, encephalitis, rabies, tetanus (lockjaw) and poliomyelitis (infantile paralysis) are all caused by:

infections

Which muscles of the anterior forearm have a synovial sheath around their tendons?

FDS and FDP share a flexor synovial sheath, FPL has its own synovial sheath

_____________ care is critical to positive outcomes after an amputation

post-op

What muscles does the median nerve run between?

FDS and FDP, but it becomes superficial at the distal forearm and is in between the FDS and flexor carpi radialis tendons

What would be included in a patient's past history for someone suspected to have Kienbock's disease?

FOOSH compression fracture

What is the MOI for a scaphoid fracture?

FOOSH with wrist extension and radial deviation

What tool can be used to help establish the *need* to treat previously untreated patients for poor BMD?

FRAX- a website used to calculate 10 year risk for hip fracture or other major osteoporotic fracture

FYI: if something is suspicious from medical history questionnaire, you should probs ask more about it

FYI

FYI: loss of IADLs or ADLs can impact a person's identity

FYI

FYI: some clinicians may not differentiate b/w tracheal and bronchial sounds, calling them tracheobronchial

FYI

FYI: when a person has a seizure, you should update their medical history to include changes in precipitating factors (triggers) and the type of seizure

FYI

FYI: you should investigate any TIA immediately

FYI

What do interleukins do?

stimulate immune system cells

Adipo

Fat; Example: Adipogenic; Producing fat

With NMES used for edema, what level of muscle contractions do you want?

strong, visible, comfortable contraction

What are microtubules and microfilaments?

structures that make up the cytoskeleton in a cell

Paroxysmal Nocturnal Dyspnea

sudden acute dyspnea

What is sometimes referred to as the 6th vital sign?

walking speed

What portion of the ANS mediates bladder contraction?

Parasympathetic

What portion of the ANS is involved in the cavernous N?

Parasympathetic vasodilation of deep A of penis

Which portion of the ANS mediates the detrusor muscle of the bladder?

Parasympathetic pelvic splanchnic nn "rest & digest"

Where is ureter pain referred to?

Ipsilateral lower quadrant of abdomen, especially to groin & external genitalia (scrotum & labia majora) GVA: general visceral afferent

Where do (most of) the posterior compartment muscles of the forearm originate?

Lateral epicondyle of humerus (extensors and supinators) only ECRB, ED, EDM, ECU

Levo

Left; Example: Levoduction; Movement of an eye to the left

What are the names of the tonsils in the oropharynx?

Lingual tonsil (1) Palatine tonsils (2)

Mening

Lining of the brain and spinal cord; Example: Meningitis; Inflammation of the meninges

Tuberculosis: -what are the symptoms? -how is it diagnosed?

-S: can be vague: fever, weight loss, lethargy, loss of appetite -D: sputum sample

Pneumonia: -what are the symptoms? -how is it diagnosed?

-S: fever, chest pain, productive cough -D: sputum sample, chest x-ray or CT scan

Bronchitis: -what are the symptoms? -how is it diagnosed?

-S: might have barrel-chest & cyanosis -D: chest x-ray or CT, sputum sample

According to Cyriax, what are 5 abnormal end feels?

-capsular (early in range) -bone-to-bone (early in range) -spasm (abrupt end) -springy block -empty

What are some outcome goals that you would use NMES for?

-muscle re-education -edema reduction -contracture management -muscle strengthening -atrophy prevention??

Side effects of anti-spasmodic drugs:

-nausea -ab pain/distention -dry mouth -constipation -drowsiness/fatigue -dizziness

What are prodromal signs in a tonic-clonic seizure? When do these signs take place?

-nausea -irritability -depression -muscle twitching this happens hours before the seizure

Why is a telomere lost during replication?

-piece of DNA serving enzymes replicating having a place to occupy

3 types of anti-diarrhea agents: (review)

-stool thickeners -bulking drugs -anti-spasmodic drugs

When is the post-op protector applied after an amputation?

0-4 wks depends on surgeon

What is the cutoff score for a gait speed test?

0.56 m/s (roughly 10 sec to walk 6 m)

What type of muscle contraction do the following pps ranges result in? 1 pps 10 pps 25 - 30 pps

1 = twitch 10 = summation 25-30 = tetanus (most fibers will reach tetany by 50 pps)

During gait, the pelvis tilts laterally about ___ inches on the swing side

1 inch (mid-stance on right leg = left leg swinging = left side of pelvis drops ~1 in)

In the MMSE, for every correct response you get ____ points

1 point they are also scored by the # of times it takes them to get the right answer

In the mid-stance phase of gait, the GRF is _____ (anterior/posterior) to the ankle, which makes the ankle want to move into _______(PF/DF)

anterior DF

In the pre-swing phase of gait, the GRF is _____ (anterior/posterior) to the ankle, which makes the ankle want to move into _______(PF/DF)

anterior DF

In the terminal stance phase of gait, the GRF is _____ (anterior/posterior) to the ankle, which makes the ankle want to move into _______(PF/DF)

anterior DF

In the initial contact phase of gait, the GRF is ________ (anterior/posterior) to the knee, which makes the knee want to move into _______ (flexion/extension)

anterior extension (a.k.a. knee extension moment)

Kussmaul respirations, labored respirations, wheezing and stridor are all examples of _________________ patterns.

breathing

Cephalosporins and carbapenem attack an infection how?

by compromising cell wall synthesis

What are the 4 types of transport?

diffusion osmosis facilitated diffusion active transport

What is the MOI for mallet finger?

direct force causing forced DIP flexion

Laxatives are prescribed to promote:

elimination from the bowel and defecation

Initial contact happens when the foot hits the ______. What happens right after initial contact?

ground shock absorption

What happens to cells at high temperatures?

inactivation of enzymes protein misfolding protein coagulation damage to organelles disruption of cell membrane

What is cellular hypertrophy? What may cause it?

increase in cell size -training -hypertension (cardiac) -increased hormonal stimulation

What is the main indication for NMES used for contracture management?

increased ROM with prolonged stretching

What is the main indication for NMES used for muscle strengthening?

increased force production

What causes a myasthenic crisis?

increased stress: infection, trauma or alcohol intake

If palpation of a lymph node is swollen & painful it may mean _____________

infection

What are the terms Matt prefers to use over temporary and permanent prosthesis?

initial & definitive

Break down of time spent in stance phase for the following: -initial contact -loading response -mid-stance -terminal stance -pre-swing

initial contact + loading response = ~10% mid-stance = ~20% Terminal stance = ~20% Pre-swing = ~10% Total ~60%

Which phase of gait is also called the acceleration phase?

initial swing

Break down of time spent in swing phase for the following: -initial swing -mid-swing -terminal swing

initial swing = ~13% Mid-swing = ~14% Terminal Swing = ~13% Total ~40%

What is the difference between intrinsic muscles and extrinsic muscles?

initrinsic - originate and insert distally to the wrist (within the hand) extrinsic - originate at elbow or in forearm and cross the wrist to insert in the hand

How does a simple, partial seizure affect a person's vision or hearing?

it causes auditory and visual experiences such as ringing in the ears or sensation of light

What are sleep apnea and snoring? What causes it? How is it treated?

Abnormal breathing during sleep Cause: may be dropping of tongue, enlarged tonsils, or soft palate into oral pharynx Treat: weight loss, palatouvuloplasty (shorten soft palate)

How do receptor channels work?

Acetylcholine binds to a receptor, causes the channel to open, ion travels into the cell and causes a nerve impules

What is an example of ion channel receptors?

Acetylcholine receptor

Why should tetracycline not be prescribed to children or pregnant women?

it will deposit in bones or teeth of developing children and cause deformities

In a stroke, occlusion of ___________ arteries can cause severe effects such as:

large arteries coma, loss of consciousness or death *almost immediately*

On a gait speed test, a lower number indicates more or less distance covered per second?

less

What components make up the plasma membrane of a cell?

lipid bi-layer embedded proteins

Should penicillins be taken with or without food?

most without food because it will bind to the food and make it ineffective, exception is amoxicillin

What component of a physical exam is often overlooked and can prevent us from overlooking the obvious?

observation

What causes stridor?

obstruction in larynx or trachea

Where does the energy from G proteins come from?

phosphate bonds

Where do you measure bronchovesicular breath sounds?

place stethoscope over anterior wall over sternum at angle of Louis and along the costosternal borders of the sternum

Where do you measure tracheal breath sounds?

place stethoscope over trachea and larynx

With a FOOSH where the wrist was extended <35 deg (less than), what bone is likely to fracture?

radius fx

With a FOOSH where the wrist was flexed, what bone is likely to fracture?

radius or ulna

What is the objective of performing muscle re-education NMES?

re-establish motor control

Why is it called a G-Protein?

receives energy from a GTP molecule

What are the 4 ways that cells communicate?

receptors channels adhesion molecules signal transduction

Overuse injury for hand/wrist likely involves what?

repetitive tasks or tendinopathies/neuropathies

If glenohumeral motion was to happen in a closed chain setting, the roll and glide would be in the _________ (same/opposite) direction

same (glenoid moving on humerus)

What determines the fate of pyruvic acid?

the presence or absence of O2

What is the definition of ADLs?

the self care, communication, and mobility skills required for independence in everyday living

What is active transport? Does it use energy?

the transfer of molecules from low concentration to high concentration, does use ATP for energy

What about viral replication makes it difficult to treat in a viral infection?

they use the host cell to replicate

Rhonchi was formerly known as:

wheezing

Is estrogen replacement used to treat osteoporosis?

yes, although the evidence is unclear

Can RRD's control edema & protect limbs?

yes, they all do

Can vitamin D supplements be taken without food?

yes, they can be taken with or without food

What muscles contribute to adduction and abduction of the wrist joint?

The flexor and extensor on the same side create a deviation toward one side Ex: flexor carpi radialis and extensor carpi radialis longus and brevis contribute to abduction

Where is the weak point of the glenohumeral joint?

The inferior border, this is where dislocations always happen

Nat

Birth; Example: Natality; The birth rate

What are the results of an epidural hemorrhage?

Blood accumulates and compresses the brain which can lead to herniation or death if not treated

Hem

Blood; Example: Hematocrit

Myel

Bone marrow, spinal cord; Example: Myelitis; Inflammation of the bone marrow or spinal cord

Os(te)

Bone; Example: Osteolysis; Dissolution of bone

What do the meningeal AA mainly supply blood to?

Bones of the cranial cavity (poorly named)

Genic

Cause, form; Example: Carcinogenic; Cancer causing

Which dural sinus is located on each side of the sella turcica and body of the sphenoid?

Cavernous sinuses

What is cellular dysplasia? What may cause it?

Cells that vary in size and shape within a tissue -chronic irritation -DNA mutations -pre-cancerous cells

What is the innervation of longissimus capitis and cervicis?

Cervical SN

What is the innervation of semispinalis?

Cervical SN

What is the innervation of splenius capitis and cervicis?

Cervical SN

Which ligament hold the atlas to the dens of the axis?

Cruciform ligament

What happens to the ERV and FEV of someone with COPD?

ERV: decreases FEV: decreases

What happens to the residual volume (RV) as a person gets older?

ERV: decreases RV: increases

T/F: discs degenerate slowly, so their injuries take time to develop

False, discs degenerate very quickly

Which dural fold is below the tentorium cerebelli and projects between cerebellar hemispheres?

Falx cerebelli

Opt

Vision; Example: Opticokinetic; Pertaining to movement of the eyes

What is the function of the lateral venous lacuna?

Way to increase area of the superior sagittal sinus to allow more CSF to return to venous blood via arachnoid villi

After the ictal stage of tonic-clonic seizure, why does the person typically let out a cry?

abdomen and thoracic muscles contract which causes the cry the jaw is clenched and respiration ceases

In the load response phase of gait, the GRF is _________(anterior/posterior) to the hip, this makes the hip want to move into _________ (flexion/extension)

anterior flexion (a.k.a hip flexion moment)

In initial contact, the GRF is _______ (anterior/posterior) to the hip, this makes the hip want to move into _______ (flexion/extension)

anterior flexion (a.k.a. hip flexion moment)

Residual Volume (RV)

amt of air left in the lungs after a forced expiration

Expiratory Reserve Volume (ERV)

amt of air that can be expired past tidal volume (normal)

Inspiratory Reserve Volume (IRV)

amt of air that can be inspired above the tidal volume (normal)

Tidal Volume (TV)

amt of air that passes in/out of lungs during resting breathing

What separates the two bony attachments for the sternoclavicular joint?

an articular fibrocartilaginous disc (separates into medial and lateral compartments)

Osmotic laxatives are best given to people with:

an urgent need to empty the bowels

What are the most common side effects of sulfonamides that may be an indication of toxicity?

anemia and leukopenia

How is step angle measured?

angle measured between: -middle of heel to second toe -parallel to direction of gait

In the mid-stance phase of gait, the GRF is ______ (anterior/posterior) to the knee, which makes the knee want to move into _______ (flexion/extension)

anterior extension (a.k.a. knee extension moment)

In the terminal stance phase of gait, the GRF is ______ (anterior/posterior) to the knee, which makes the knee want to move into ______ (flexion/extension)

anterior extension (a.k.a. knee extension moment)

PPIs are thought to have ____________ properties that can help kill _____________

anti-bacterial; H, pylori (bacteria that causes stomach ulcers)

PPIs may also have an _________ action that helps decrease __________

anti-inflam; gastric irritation

What type of drug discovered in the 1900s is arguably one of the most important discoveries in medical breakthroughs?

antimicrobial drugs

According to Kaltenborn, what is an abnormal end feel?

any end feel that occurs at another place or is of another quality than is characteristic for the joint being tested

Lip

Fat; Example: Lipoma; A fatty tumor

Myc

Fungus; Example: Mycostasis; Stopping the growth of fungus

What should you focus on in the mobility and gait training portions of amputee rehab?

Fxn Mob: bed mobility & transfers Gait: crutches & non-WB gait

What are the different intracellular signaling molecules?

G proteins Effector Proteins Second Messenger target proteins

What are the classes of cell surface receptors?

G-protein coupled receptors (GPCR) Enzyme linked receptors ion channel receptors

What are the cavernous sinuses connected by?

Intercavernous sinuses

What ligaments of the clavicle make it hard to dislocate?

Interclavicular lig Costoclavicular lig

Which artery runs through the cavernous sinus?

Internal carotid A

Where are most arteries of the pelvis from?

Internal iliac AA some from abdominal aorta: Superior rectal A Median sacral A Ovarian/testicular AA

What is the common synovial sheath?

It contains the tendons of the extendsor digitorum and extensor indicis. It is deep to the extensor retinaculum

What is the function of the glenoid labrum?

It deepens the glenoid cavity. It is a ring-like fibrocartilaginous structure. This makes it so that 1/3 of the humeral head surface is into the glenoid cavity

What is unique about the way the ureter enters the bladder?

It enters it obliquely which forms a natural one way valve

What happens to joint cartilage with age?

It gets worn down and joint problems are developed

What stabilizes the glenohumeral joint?

Lots of ligaments and muscles

Where does the brachial artery split and what does it split into?

Lower cubital fossa Ulnar and radial arteries

What are the names of the tonsils in the nasopharynx?

Pharyngeal/adenoid tonsil (1) Tubular tonsils (2)

What nerves does the superior gluteal N pass between?

Lumbosacral trunk S1

What is Waldeyer's tonsillar ring?

Lymphatic ring of the 4 tonsils in the nasal and oral pharynx

Onych

Nail; Example: Onchyomalacia; Softening of the fingernail

Which portion of the pharynx connects to the middle ear?

Nasopharynx

Neur

Nerve; Example: Neuranagenesis; Regeneration of nerve tissue

Are pathologies detected by tracheal breath sounds common?

No

Does the soft palate form a perfect seal to keep fluids out of the nasopharynx?

No

Does the wrist share a joint capsule with the intercarpal joints?

No

Does brachioradialis work in the anatomical position?

No, because the elbow does not bend laterally. If you bend the elbow it is able to flex the elbow

Does the internal iliac A normally have a middle division as well as an anterior and posterior division?

No, only has it 20% of the time

Do the venous sinuses of the dura contain valves?

No, there is no direct pathway for blood to flow through

What is the drug of choice for treating ulcers and GERD?

PPIs

Are PPIs or H2 blockers more effective in reducing acid?

PPIs (can reduce acid up to 90%)

What is a safe dosage for you to tell a pt to supplement vitamin D with? What dosage can a pharmacist prescribe?

PT- up to 2,000 IU Pharm- up to 10,000 IU per day for 8-12 weeks

Algo

Pain, cold; Example: Algor; Chill or rigor, coldness

Palat

Palate; Example: Palatoplegia; Paralysis of the palate

What is the N of palato-, salpingo-, and stylo- pharyngeus?

Palato: CN X Salpingo: CN X Stylo: CN IX

What is the O of palatopharyngeus, salpingopharyngeus, and stylopharyngeus?

Palato: hard & soft palate Salpingo: auditory tube (cart) Stylo: styloid process

What muscles form the palatopharyngeal arch?

Palatoglossus m Palatopharyngeal m

Pancreat

Pancreas; Example: Pancreatalgia; Pain in the pancreas

What is the most common risk factor for cancer?

Stacia: previous history of cancer Irina: age

Which forearm extensors attach to the supraepicondylar ridge and which attach to the lateral epicondyle?

Supraepicondylar ridge: BR, ECRL Lateral epicondyle: ECRB, ED, EDM, ECU

What vessels supply blood to the MCP and IP joints?

Superficial palmar arch branches

Where is the epidrual space?

Superficial to dura mater

What drains the cavernous sinuses?

Superior & inferior petrosal sinuses

What makes up the hypogastric plexus?

Superior hypogastric plexus gives rise to R/L hypogastric NN which connect to a R/L inferior hypogastric plexus which gives rise to multiple pelvic organ plexuses

What runs in the superior border of the falx cerebri?

Superior sagittal sinus

Which arteries supply blood to the bladder?

Superior vesicle AA M: inf vesicle AA F: vaginal AA

What is the O of superior, middle & inferior constrictor mm?

Superior: pterygoid hamulus Middle: stylohyoid lig, hyoid Inferior: thyroid cartilage

Where does the glenohumeral joint get its blood supply from?

Suprascapular A Ant/Post circumflex humeral AA (branches of subclavian and axillary arteries)

What nerves innervate the glenohumeral joint?

Suprascapular N Axillary N Lateral Pectoral N

What is an example of a fibrous joint?

Sutures in the skull

What is the Marshall-Marchetti-Krantz procedure to treat stress incontinence?

Suturing vagina to neck of bladder

Hidr

Sweat; Example: Hidropoiesis; The formation of sweat

Gluc

Sweetness, sugar; Example: Glucometer; Glucose meter

What portion of the ANS mediates bladder retention?

Sympathetic

What may inhibit the ability of a male to urinate in a public restroom?

Sympathetic discharge can't open internal urethral sphincter

How is osteoporosis defined in terms of BMD T scores? How is oteopenia described in terms of BMD T scores?

T score of -2.5 or less T score of -1.0 to -2.5

What happens to a person's total lung capacity (TLC) if they are obese?

TLC decreases

What happens to a person's total lung capacity (TLC) if they have a neuromuscular disease?

TLC decreases

How does the total lung capacity differ between early and severe emphysema?

TLC severe > TLC early

What is the most common blood vessel that is torn to cause a subdural hemorrhage?

Tear of bridging veins b/w brain surface and dural sinus Cerebral veins as the enter the superior sagittal sinus

Lacrim

Tear, duct; Lacrimal gland

Many people with Guillain-Barre syndrome develop _______________ nervous system involvement

autonomic (cardiac arrhythmias, fluctuating BP, loss of ability to sweat)

How can surgical techniques reduce post-op complications?

by reconstructing a residual limb designed for prosthetic use

Which calcium supplement can be taken with or without food and has a risk of causing constipation?

calcium citrate should limit to 500 mg in a dose

Is Guillain-Barre syndrome usually develop insidiously or rapidly?

can be either (few hours to several days- exam question made it seem v acute onset)

Where do you measure vesicular breath sounds?

can be heard across most of the chest including anterior, lateral & posterior chest walls (w/ exception of the area of bronchial sounds)

At what age does asthma occur?

can occur at any age, but is common in kids

Do simple or complex partial seizures involve the temporal lobe or have psychomotor involvement?

complex, partial seizure

Total Lung Capacity (equation)

comprised of all 4 values *TLC* = TV + IRV + ERV + RV

At the SC joint, the manubrium is ________ (concave/convex) on its longitudinal diameter and ________ (convex/concave) on its transverse diameter

concave on longitudinal convex on transverse

Kussmaul's Respiration

deep, regular sighing respirations with an inc in respiratory rate

What would be your main clue in an objective exam to determine if a patient has a mallet finger injury?

deformity of the DIP

A seizure involves sudden, spontaneous, uncontrolled:

depolarization of neurons

In what plane and around what axis do clavicular motions take place in?

elevation/depression -frontal plane/sagittal axis protraction/retraction -sagittal plane/frontal axis rotation -transverse plane, longitudinal axis

Lyme disease can lead to what condition?

encephalitis

Reye's syndrome may start out as what condition initially?

encephalopathy (w/ symptoms like lethargy, headaches & vomiting)

What are interferons?

endogenous proteins that are inserted into the membrane of a cell after viral infection to make that cell appear as though it has already been infected by the virus

What is cellular respiration?

energy production through oxidation of fuel molecules

External moments influence which muscles need to ________

engage

What do lysosomes contain?

enzymes that break down other molecules (protease)

Asthma occurs in ________________

episodes

How does the capsular pattern of restriction present in the wrist?

equal limitation of flexion and extension

Describe the CPR of the MCP/IP joints

equal restriction in flexion/extension

Outcome measures support ____________________ practice

evidence-based

If PAM is unrestricted, it can be either normal or ________?

excessive (instability or joint laxity)

Antacids only treat the symptoms of:

excessive stomach acid

What is the difference between exogenous and endogenous chemical agents?

exogenous: from environment Endogenous: from inside the body

What is the MOI for a Colles' fracture?

extension + compression (FOOSH with wrist extended)

What is the close packed position of the radiocarpal joint?

extension w/ radial deviation

As you flex your fingers, which way do they rotate slightly?

externally (away from the body)

What is the MOI for a scaphoid-lunate dislocation?

fall or trauma to wrist

Orthostatic hypotension that occurs with Parkinson's disease can lead to an inreased risk of what?

falls

T/F: intermittent vs constant pain gives you a good idea of the origin of the pain (musculoskeletal vs visceral)

false

T/F: electrical stimulation can help with nerve regeneration

false it has no effect on nerve regeneration

T/F: only select patients should receive non-pharmacologic treatment for osteoporosis

false, ALL patients should

T/F: You should not use physical modalities to treat central sensitization pain

false, but they should never be used alone and always be incorporated as a part of the larger plan of care

T/F: tubular elastic dressings are always applied in a double layer of material

false, it can be double or single layering of material

T/F: FRAX can be used to determine the need for *pharmacologic* treatment in previously treated patients

false, it is usually for previously untreated patients

T/F: there is good evidence for the effectiveness of conservative treatment of CTS

false, limited evidence for efficacy of conservative treatment

T/F: there is no surgical repair option for a TFCC disc injury

false, there is a surgical repair option

T/F: The ulna directly articulates with the carpals

false, there is no direct articulation because of the TFCC

T/F: people with arthritis lose the loose packed position of the CMC of the thumb

false, they loose the close packed position (full opposition)

T/F: if a person has eaten recently, the gurgling bowel sounds will take place less often

false, will happen more often

What happens during circulation in lipid oxidation?

fatty acids exit adipocytes fatty acids circulate bound to albumin

What is the function of the costoclavicular ligament at the SC joint?

fibers "criss-cross" to stabilize and limit protraction, retranction and elevation of the clavicle

What is the MOI for a Smith's fracture?

flexion + compression (FOOSH with wrist flexed)

What motions are possible at the glenohumeral joint? What plane and axis does each take place in?

flexion/extension: sagittal plane, frontal axis abduction/adduction: frontal plane, sagittal axis horizontal ab/adduction: transverse plane, vertical axis internal/external rotation: transverse plane, vertical axis

What is the close packed position of the CMC of the thumb?

full opposition

Sneezing, coughing, sputum and breathing patterns are all ____________________ of the respiratory system.

general characteristics

What is in a patient profile?

general info: age, sex, ethnic group

Partial (focal) seizures lead to ____________ seizures

generalized

What is the most important stretch to get a transfemoral amputee to do?

hip flexor stretch to prevent contracture often done by laying in prone and pressing up

During pre-swing, since the GRF is posterior to the hip, causing it to want to extend, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

hip flexors *concentric contraction* attempting to *begin hip flexion*

During mid-stance, since the GRF is posterior to the hip, causing it to want to extend, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

hip flexors eccentric contraction controlling hip extension (glut med isometric to prevent hip drop during single support)

When testing PAM or joint glides, what are 3 possible classifications for joint movement description?

hypermobie normal hypomobile

How do kanamycin and neomycin work?

inhibit protein synthesis by binding directly to a ribosome to inhibit its function

How do macrolides work?

inhibit protein synthesis in bacteria

How does gentamicin work? How is it administered?

inhibit protein synthesis; intramuscular or IV

How do Didanosine and lamivudine (videx and epivir) work to treat HIV?

inhibit reverse transcriptase

How do tetracyclines work?

inhibiting protein synthesis on ribosomes

How does indinavir (Crixivan) work to help treat HIV?

inhibitor of protease specific to HIV-1

How does acyclovir work?

inhibits DNA synthesis and does not harm the host because it requires a viral protein to activate it

How does flucytosine work?

inhibits both DNA and RNA synthesis

What is vitamin E's role in preventing damage from free radicals?

inhibits production of free radicals by reacting with them to return to its reduced state (prevent oxidative phosphorylation)

Is the onset of a brain abscess rapid or insidious?

insidious

What are examples of tyrosine kinase receptors?

insulin or other growth factors (intrinsic enzymatic activity)

As you extend your fingers, which way do they rotate slightly?

internally (towards the body)

What is the primary side effect of the bacteria that prevent diarrhea?

intestinal gas

What are the drugs of choice when normal bowel movements have been impaired?

laxatives

In the mid-stance phase of gait, the GRF is ______ (medial/lateral) to the subtalar joint, which makes this joint want to move into ______ (pronation/supination)

medial pronation

What is the loose packed position of the CMC of the thumb?

midrange between abd/add and flex/ext (natural resting position)

What does MMSE stand for?

mini-mental status examination

What are antacids often used to treat?

minor GI discomfort after overeating or eating foods not appropriate for a person

What does strong and painful mean when MMT?

minor injury

What is the main indication for muscle re-education NMES?

muscle inhibition after surgery or injury (only if neuromuscular mechanisms are intact)

What happens in the clonic stage of a tonic-clonic seizure?

muscles alternately contract and relax (jerky movements) bowel & bladder incontinence may occur

What types of tissues serve as stabilizers for the hand and wrist?

muscles and ligaments

What are some common side effects of AZT?

myelosupression, GI issues and headaches (ocasionally myopathies)

Does flucytosine have a broad or narrow spectrum of anti-viral activity?

narrow

What are the 4 types of cell macromolecules?

nucleic acid proteins lipids carbohydrates

How many nitrogen are present in one AA?

one

What does each tRNA carry?

one amino acid sequence

How does exercise impact BMD in older men?

one study showed 2% net gain in *femoral neck* BMD

What serves as an explanation to why mRNA ends up a lot smaller than its DNA counterpart? Why is this actually a good thing?

only about 5% of the DNA chain contains information to make proteins, this way the mRNA can be transported through the nuclear envelope

For abduction/adduction of the CMC of the thumb, roll and glide are in the _________ direction

opposite

For the proximal radioulnar joint, roll and glide happen in the ______ direction

opposite

How are antacids ingested?

orally

How are acyclovirs administered?

orally, IV or topically

Where does the TFCC attach?

originates of the ulnar notch on the radius and attaches to the ulnar styloid process

What is Kienbock's disease?

osteonecrosis/ avascular necrosis of the lunate following a fracture

What is a major cause of the development of drug-resistant microorganisms?

overuse and inappropriate administration of antimicrobials

What are stressors that may cause cellular adaptations?

oxygenation temperature electrolytes molecular toxins

What is the function of the Golgi complex?

package synthesized proteins into vesicles to be delivered to other sites either inside or outside of the cell

In the pre-swing phase of gait, the GRF is _______(anterior/posterior) to the hip, which makes the hip want to move into _________(flexion/extension)

posterior extension (a.k.a. hip extension moment)

Walking speed can reflect underyling:

physiological processes

1 generic name of ACh M1 Receptor Antagonists:

pirenzepine

What is the most common ACh receptor antagonist prescribed for GI problems?

pirenzepine

What type of joint are the radioulnar joints?

pivot (held together by interosseous ligament)

What is an example of a lung expansion disease?

pleural effusion (build up of excess fluid b/w the layers of the pleura)

A classic sign of __________________ is when a person stops breathing at the point of pain (splinting), so their breath pattern is halting rather than smooth & continuous

pleural friction rub

What conditions might cause a pleural friction rub?

pleural inflammation due to lobar pneumonia or lung infarction

What is an attribute of vancomycin that determines how it can be administered?

poorly absorbed in GI tract

Since people don't live in the hospital, many acute care outcome measures are validated with other:

populations (Ex: community ambulators) this is still useful if used to make judgements related to discharge into community setting

What is Brudzinski's Sign?

positive: indicates meningitis neck flexion causes flexion of hips and knees

What is Kernig's Sign?

positive: indicates meningitis pt resists leg extension when lying with their hip flexed

FYI: in a subjective examination, you might ask the patient if they smoke, and if so how many packs per day

possible answers: - 0 - 1/2 - 1/2 - 1 - 1 -2 - 2+

In the initial contact phase of gait, the GRF is ________ (anterior/posterior) to the ankle, which makes the ankle want to move into ________ (PF/DF)

posterior PF

In the load response phase of gait, the GRF is _____ (anterior/posterior) to the ankle, which makes the ankle want to move into _______(PF/DF)

posterior PF

In the mid-stance phase of gait, the GRF is ________ (anterior/posterior) to the hip, this makes the hip want to move into _______ (flexion/extension)

posterior extension (a.k.a hip extension moment)

What is the loose-packed position for the SC joint?

shoulder in anatomically neutral position

Are limb shrinkers (shrinker socks) or silicone liners tighter on the limb?

silicone liners by a long shot

For which type of post-amputation dressing is the use of non-fragrants soaps around the residual limb very important? Why?

silicone liners, b/c they trap moisture & when the user sweats the moisture mixes with the fragrance and is trapped on their skin and can cause irritation

Tonic-clonic (grand mal) generalized seizures may occur spontaneously or after:

simple seizures

What type of seizure is a Jacksonian seizure?

simple, partial (focal) seizure

Do simple or complex partial seizures have motor, sensory, autonomic and/or psychic involvement?

simple, partial seizure

Mid-stance is a phase of _________ support

single

Terminal stance is a phase of _________ support

single

_______________ support is when only one limb is in contact with the ground

single

Simple partial (focal) seizure usually stem from a ____________ area of damage in the ____________

single cortex

Someone's center of mass exhibits a _________ curve during gait

sinusoidal (happens in both vertical pattern and side-to-side pattern)

What does SBAR stand for?

situation background assessment recommendation

What non-bony structure increases the surface area for the articulation between the glenoid fossa and the head of the humerus? How much does this structure deepen the glenoid fossa?

the glenoid labrum deepens by up to 50%

What are indications of toxicity with vancomycins?

supression of adrenal system and hypercorticism (cushing's syndrome)

Is surgical or conservative intervention more likely after a Smith's/Colles' fracture?

surgical

Who is responsible for fall costs s/p amputation?

the hospital, if the pt is insured by Medicare

In a plaster or fiberglass cast RRD, compression is provided by which part of the dressing?

the layers of socks, the rigid part just protects the limb

What is a result of the accumulation of lactic acid?

the lowering of pH and creation of an acidic environment

Why is positioning s/p amputation important for the patient and family to have knowledge about?

to prevent contractures Note: never want a transfemoral amputee in abduction

T/F: osteoporosis is a chronic, progressive disease

true

T/F: surgical treatment of CTS has fairly good success rates at about 70-90%

true

T/F: treatment needs for osteoporosis should be continuously re-evaluated

true

T/F: you are unable to palpate lymph nodes unless they are swollen

true

T/F: a medical history may be helpful when determining if a pt has a brain abscess

true (abscess from ear, throat, lung or sinus infection inc pt's risk)

T/F: donning a shrinker sock after a recent amputation may require assist x2

true used once suture line has healed sufficiently, need to apply it carefully to avoid wound tension

T/F: you may have to gradually increase the amount of time the amputee wears the silicone liner when they are first using one

true want to progress from 2 hrs 2x/day, to 5 hrs 2x/day to eventually full day use

T/F: the prosthetic foot on an IPOP can be removed

true, can unscrew it so they don't have to have the weight of it in bed or something

T/F: nerve glides may help with symptoms of CTS

true, some effect, but not large effects

Different shrinker socks can vary in what ways from each other?

various lengths, widths & grades of compression

TIA's, strokes and cerebral aneurysms are examples of ______________ disorders

vascular

When are vancomycins used?

when penicillins are ineffective/contraindicated or with severe staphylococcal infections

When might tobramycin be prescribed?

when penicillins aren't effective

What is translation?

when the genetic information carried by mRNA is translated into a sequence of amino acids

When does the pre-swing phase of gait start and end?

when the opposite limb contacts the ground; ends just prior to lift off (includes toe off)

After an amputation, when do patients often forget they are missing part of their limb?

when they first wake up and go to get out of bed use precautions, such as placing a chair at EOB, to remind them before they fall & end up in the E.R.

Are chloramphenicols narrow or wide spectrum? What does this mean?

wide spectrum, act against anaerobic and aerobic gram-positive and gram-negative bacteria and rickettsiae

Do tetracyclines have a narrow or wide spectrum of activity? What does this mean?

wide spectrum, they inhibit gram-positive and gram-negative bacteria

What are the two categories of enzyme linked receptors?

with intrinsic enzymatic activity lack intrinsic enzymatic activity, but bind to and activate cytosolic tyrosine kinase

How quickly after an amputation can someone accomplish touch down WB with an IPOP?

within 24 hours

Where can molecules be transported?

within the cell inside to outside the cell outside to inside the cell

Where does aerobic oxidation take place within the cell? What is the name of the cycle it goes through?

within the mitochondria TCA/Krebs/Citric Acid Cycle

What AD may help with CTS?

wrist splint

If a person score in the range of 21-23 on the MMSE, do they have a cognitive impairment?

yes

When doing a gait speed test, is use of an assistive device permitted?

yes

Can a non-removable rigid dressing be used for WB?

yes w/ prosthetic components attached for ambulation

Can non-removable rigid dressings control edema or protect the limb?

yes, they control edema, pain & provide protection

How many seconds is one full gait cycle typically? How much of that time is spent in stance or swing phase?

~1 second stance: 0.6 seconds (60%) swing: 0.4 seconds (40%)

How much does the pelvis shift laterally during gait?

~1-2 inches towards weight-bearing side

What is the average stride length?

~144 cm or 56 in (double the average step length)

When are the sutures removed and limb shaping begins after an amputation?

~4 wks

What is the sensitivity/specificity level of Watson's test?

~70%

What is the average step length?

~72 cm or 28 in (half of the average stride length)

NMES is also called what?

EMS Electric Muscle Stimulation

Cubit

Elbow; Cubital fossa

Normal FEV1/FVC%

greater than 80%

What does erythropotein do?

stimulates RBC production

2 generic names of stool thickeners:

-kaolin -pectin (KP)

Eupnea

-rhythm is smooth -expiration is longer than inspiration

What does a pleural friction rub sound like?

"grating or clicking sound paper is rubbed together"

What are external moments created by?

GRF

Vital Capacity (equation)

*VC* = IRV + TV + ERV

If a person exhibits any of the 5 warning signs of a stroke, what should you do?

*Emergency First Aid for Stroke:* 1. call 911 & say pt has symptoms of a stroke 2. pt should be transported to hospital ASAP with record of common drugs used & medical conditions being treated 3. time between onset of stroke & treatment is directly related to the severity of the damage to the brain, *minutes count!*

Since the glenohumeral joint consists of the ________ (convex/concave) humeral head moving on the _________ (convex/concave) glenoid fossa, the roll and glide happen in the _________ (same/opposite) direction

*convex* humeral head *concave* glenoid fossa *opposite* direction

How are bi-valved RRD's made?

*custom made* from a cast or a pre-fabricated shell

What are some possible symptoms of a TIA?

*depends on location of ischemia* -muscle weakness in arm/leg -visual disturbances -numbness & paresthesia in face -transient aphasia or confusion

What sensory deficits may occur with a neurological disorder?

*loss of:* -touch -pain -temperature -position -sense of vision -hearing -taste -smell

When is velocity the lowest during gait?

*mid-stance* (middle of weight-bearing support on one limb, leg is vertical)

Which conditions is the drug Teriparatide contraindicated for?

*osteosarcoma*!! -Paget's Disease -inc bone alkaline phosphatase -open epiphyses -prior external beam radiation treatment -prior implant radiation (these are all risk factors for developing osteosarcoma)

What category of post-op dressing is an IPOP?

*rigid dressing* w/ a pylon & foot stands for immediate post-operative prosthesis

When does heel rise happen during gait?

*terminal stance* just before lifting the rear leg off of the ground to initiate swing

T/F: lifestyle factors impact your peak bone mass

*true* everybody has an individual full genetic potential for peak bone mass, but lifestyle factors determine if you will reach it

What are some examples of orders for PT for someone with osteoporosis? (read)

-"gait evaluation" -"safe walking program" -"LE strengthening program"

Describe a complex, partial seizure:

-*aura* may be present -*bizarre behavior*: repetitive & purposeful, but inappropriate movements such as waving or clapping -frequent visual or auditory *hallucinations* -feelings of deja vu

What are symptoms of Reye's syndrome?

-*disorientation* -hyperreflexia -hyperventilation -seizures -*stupor or coma* can follow quickly

Describe the progression of symptoms of Lyme disease over time.

-*early*: sore throat, dry cough, fever, headache -*later*: cardiac arrhythmias, neurologic abnormalities (facial N paralysis) -*very late*: pain & swelling in large joints --lyme disease leads to encephalitis--

What are symptoms of a brain tumor?

-*headaches in the AM* -headaches that inc in severity & frequency -vomiting -lethargy -irritability -personality & behavioral changes

What are some symptoms of a cerebral aneurysm? (5)

-*loss of visual field* -other visual disturbances -*photophobia* (inc sensitivity to light, occurs w/ small leak) -intermittent periods of dysfunction (confusion, slurred speech, weakness) -*nuchal rigidity* (stiff/exteneded neck due to muscle contractions)

Cheyne-Stokes Respiration

-*periodic breathing* associated with periods of *apnea* alternating regularly with a series of respiratory cycles -respiratory cycles gradually increase then decrease in rate & depth

What stimuli might trigger a seizure? (precipitating factors)

-*physical stimuli*: loud noises, bright lights -*biochemical stimuli*: stress, excessive premenstrual fluid retention, hypoglycemia, change in medication, hyperventilation

What is the difference between primary and secondary seizures?

-*primary*: idiopathic -*secondary*: acquired due to an identified cause like post-traumatic syndrome

What are the side effects of bisphosphonates?

-*upper GI irritation* -osteonecrosis of jaw -severe musculoskeletal pain -hypocalcemia -uveitis/scleritis -possible risk of atypical femur fractures

With a stroke, functional deficits increase during the first _____ hours as ______________ develops

-48 hours -inflammation

What qualifies as acute vs chronic bronchitis (time frame)?

-A: symptoms lasting 2-3 weeks -C: productive cough lasting more than 3 months

What are some everyday activities that could be aggravating factors for a patient's hand/wrist symptoms?

-ADLs -lifting/pushing/pulling -opening a door -writing

When reassessing motion with goniometry in an objective exam, what are the 3 different types of movement you should assess?

-AROM -PROM -flexibility

When testing PROM in objective exam, what are 3 things you should take note of?

-AROM not easily reached -gently apply overpressure -end feel

What are some things that are important to document for e-stim?

-Dx or description of condition being treated -documentation of intact nerve supply -POC description -description of therapy program -attended/unattended code

What are a couple examples for an acute injury/trauma that could result in hand/wrist symptoms?

-FOOSH -radius, ulna or carpal fx

According to Cyriax, what are 3 normal end feels?

-capsular -bone-to-bone -tissue approximation

What are some things you can do to live a bone healthy lifestyle?

-adequate Ca++ intake -optimal vitamin D levels -WB exercise -avoid tobacco and excessive alcohol use

What are some examples of weight bearing activities?

-aerobics -circuit training -jogging -jumping -volleyball -walking

What factors related to patient profile are helpful in a subjective exam for the hand/wrist?

-age -occupation (often associated w/ symptoms) -recreation -psychosocial factors

What could the popping sound be caused by that is associated with rales?

-alveoli suddenly opening up -when air passes through mucus plugs

Briefly describe ankle motion during gait starting from heel strike: (read)

-ankle in neutral at heel strike -quickly plantarflexes due to gravity acting on forefoot -slowly moves back towards neutral and into dorsiflexion during mid-stance -reaches determinant of gait just before heel rise (10 deg DF) -moves back towards neutral as heel rises and as foot lifts off ground

Adventitious Sounds -what are they? -what do they indicate?

-any sound that occurs along with normal breath sounds -typically indicates turbulence of air flow

In general, where are the joints located in the intercarpals?

-articulation between proximal and distal rows -articulation between individual carpals

What are some symptoms of Guillain-Barre syndrome?

-ascending flaccid paralysis -paresthesia -pain -muscle aching -vision & speech impairments

FYI: in a subjective examination, you might ask the patient if they have ever had any of the following:

-asthma -emphysema -cancer -TB -shortness of breath -difficulty breathing

How (generally) do antimicrobials work in targeting an infection? (3)

-bacterial or fungal cell wall synthesis -bacterial ribosomes for protein synthesis -enzymes in DNA replication

What in the objective exam may help determine if a patient has Raynaud's?

-blanching of fingers -+ Allen's test (blocking of U and R arteries) -skin color changes

Appearance of sputum due to hemoptysis. (hemoptysis: coughing up of blood) What condition is this usually a sign of?

-blood-tinged (bright red) -frothy (EW) -sign of pulmonary edema

What are some symptoms of multiple sclerosis? (8)

-blurred vision, diplopia (double vision), scotoma (spots in vision) -weakness in legs -progressive weakness & paralysis extending to upper limbs -paresthesia, areas of numbness, burning, tingling -dysarthria (trouble speaking) -loss of coordination -bladder, bowel & sexual dysfunction -chronic fatigue

What may be done in a surgical intervention for Kienbock's disease?

-bone graph or prosthetic lunate

The 4 types of laxatives: (review)

-bulk forming -stimulant -hyperosmotic -lubricants/stool softeners

How do you diagnose a pulmonary embolism?

-can be difficult to diagnose b/c initial symptoms are vague -take history: recent surgery, inactivity? -chest x-ray and CT scans are helpful

How does exercise impact BMD in post-menopausal women?

-can inc *lumbar spine* BMD by 1-2% -hip data somewhat contradictory

What are contraindications for NMES?

-cardiac pacemakers -Hx of cardiac arrthmias -phrenic or urinary bladder stimulators -deep brain stimulators -carotid sinus (scalene triangle) -temporal lobe -eyes -larynx locations -malignancy -thrombophlebitis -pelvic region in pregnant females -*increased pain during/ following treatment* -anxiety

What should you be sure to R/O before determining if someone has CTS?

-cervical -shoulder -elbow involvement -DD of pronator teres and anterior interosseous syndromes

4 generic names of H2 receptor antagonists:

-cimetidine -famotidine -nizatidine -ranitidine

Describe the middle stages of Alzheimer's disease: (5)

-cognitive function, memory & language continue to decline -problem-solving, mathematical ability and judgement & judgement are poor -apathy, indifference & confusion -difficulty with ADL's -wandering due to confusion and getting lost

In middle stages of Alzheimer's disease, what 3 skills continue to decline?

-cognitve function -memory -language skills

People with which conditions can't take more fiber into their diet and therefore should take bulk laxatives?

-colostomies -ileostomy bags -IBS -anal fissures

What are some other measures that could be taken to help diagnose osteoporosis? (read)

-comprehensive metabolic panel -CBC -24 hr urine for Ca++, creatine, sodium -25-Hydroxy vitamin D -TSH -SPEP/UPEP if anemic -PTH -fall risk assessment

For home assessment, what might you consider with patient mobility?

-consider dynamic interaction between personal factors and prognosis to respond to PT -interaction between environmental factors and activity level or risk (support patient at their worst when they are at home)

What symptoms occur due to an occlusion of the anterior cerebral artery (frontal lobe)?

-contralateral muscle weakness or paralysis -sensory loss in leg -confusion -loss of problem-solving skills -personality changes

What symptoms occur due to an occlusion of the middle cerebral artery (cerebral hemisphere)?

-contralateral paralysis and sensory loss (mostly upper body or arm) -aphasia (when dominant hemisphere is affected) -spatial relationships affected if R side is damaged

Brain stem or cerebellar tumors may affect several ___________ and possibly cause __________ paralysis or ____________ problems

-cranial nerves -unilateral facial paralysis -visual problems

What information should you get with a medical history?

-current & past illness -family history

Things to observe about the integument (7)

-cyanosis -jaundice -pallor -streaks on skin -change in amt of hair -clubbing nails -pitting nails

What are the benefits of post-op amputation care in the hospital? (3)

-dec pain -dec LOS -dec time to prosthetic use

How does calcitonin treat osteoporosis?

-dec risk of vertebral fractures -(no data on hip fracture prevention) -taken as a nasal spray or injection

How does Raloxifen treat osteoporosis?

-dec risk of vertebral fractures -this is a type of SERM

What do rhonchi sound like?

-deeper & harsher breath sounds due to thicker mucus -can be high or low pitched

What are the general components of an objective exam? (5)

-determine structure involved -confirm/refute working hypothesis -establish objective baseline -identification of impairments -determine functional limitations, disabilities or changes in physical function

What are some early signs of Huntington's disease? (5)

-difficulty learning new info -loss of problem-solving skills -poor judgement -inability to concentrate -memory lapses

2 generic names of anti-spasmodic drugs:

-diphenoxylate -loperamide (keep it on the ~DL~ if you're taking anti-spasmodic drugs)

Diarrhea is often a temporary symptom of minor GI disorders, but can occur with serious conditions such as:

-dysentery -ulcerative colitis -cholera

Orthopnea How could you treat this?

-dyspnea that occurs when someone is lying down -to treat, raise upper part of body with pillows

What areas of the body do tremors affect in early vs late Parkinson's disease?

-early: hands (at rest) -late: hands, feet, face, tongue & lips

What components of the objective exam findings may indicate CTS?

-electrophysiology -ROM (deficit/painful?) -palpation (produce symptoms) -dec grip strength -positive phalens/reverse phalens/tinel's (special tests)

What are 3 components you can use to help assess a patient's felxibility?

-end feel -postural analysis -special tests (SLR, Thomas, Ober etc.)

5 generic names for PPIs:

-esomeprazole -lansoprazole -omeprazole -pantoprazole -rabeprazole *-prazole*

What are symptoms of COPD?

-extreme shortness of breath (work hard to take a breath) -always accompanied by wheezing

How does Parkinson's disease affect a person's face?

-face might resemble a mask -dec blinking -blank, staring face

What are some early signs of Parkinson's disease? (6)

-fatigue -muscle weakness/aching -dec flexibility -less spontaneous changes in facial expression -tremors in hands at rest -repetitive "pill-rolling" motions of hands

What are some symptoms of poliomyelitis? (6)

-fever -headache -vomiting *then....* -stiff neck -pain -flaccid paralysis

Initially ____________ paralysis is present in a CVA/stroke, ____________ paralysis develops several weeks later

-flaccid -spastic

Fine rales: -what do they indicate? -what do they sound like? -what conditions are they common with?

-fluid in terminal areas of the tracheobronchial tree -more of a "slurping" sound than a popping sound -more common with inflammation & congestion in the lungs

FEV1

-forced expiratory volume in the 1st second -measures the peak expiratory flow rate (PEFR)

Summary of important aspects of post-op amputation care: (read)

-fully evaluate each patient -select most appropriate device & protocol -team input & communication are critical -educate patient, family & rehab team -follow-up, follow-up, follow-up

Walking speed correlates with: (2)

-functional mobility -balance confidence

What are some examples of additional tests that can be performed in an objective exam that can give you more information? (read)

-functional tests (hop, double leg squat, max jump height) -gait analysis -balance tests (single leg stance, star test, timed up and go) -questionnaires

When looking at the ICF model's contextual factors, what are some examples of personal factors to consider when treating a patient and trying to help them establish their goals?

-gender and sex -age -other health conditions -coping style -social background -education -profession -past experience -character style

What are the risk factors for osteoporosis? (11)

-genetics -low Ca++ diet -low vitamin D stores -smoking -excess alcohol -hx of fracture -medications -malabsorption -excessive urinary Ca++ -hyperthyroidism -comorbid conditions

What should be included in your objective exam for patients who are post-op from either a Smith's or Colles' fracture? (3)

-girth measurement (edema) -PROM/AROM -functional tests (grip strength

People with which conditions should not take anti-diarrhea meds?

-glaucoma -prostate disease -kidney disease -liver disease

What are the 4 ligaments that serve to support the glenohumeral joint?

-glenohumeral ligaments (superior, middle, inferior) -coracohumeral ligament -transverse humeral ligament -coracoacromial ligament

4 generic names of hyperosmotic laxatives:

-glycerin -magnesium hydroxide -magnesium sulfate -sodium phosphate (MSG)

Describe the early stages of Alzheimer's disease: (3)

-gradual loss of memory and lack of concentration -impaired ability to reason and learn new info -behavioral changes: irritability, hostility, mood swings (Ellis Grey)

What are side effects of PPIs?

-headache -diarrhea -constipation -ab pain -nausea -rash

What are some symptoms of rabies? (6)

-headache -fever -nervous hyperirritability (sensitivity to touch) -seizures -difficulty swallowing -foaming at mouth

Side effects of H2 receptor antagonists:

-headaches -dizziness -mild/transient GI complaints such as nausea and diarrhea

What factors can influence our lung capacity? (4)

-height -gender -weight -age

The abdomen may sound __________ with air, but will sound ____________ with masses (organs).

-hollow with air -dull with organs

How often should someone get a bone density assessment done?

-if on treatment, every 1-2 years -if not on treatment but at risk, every 2 years

What are symptoms of a cerebral aneurysm that is a result of a massive rupture? What is the pt prognosis like?

-immediate, severe, blinding headache -vomiting -photophobia -seizures or loss of consciousness *death* may occur shortly after rupture

Hyperpnea

-inc depth of respiration -normal to inc rate -regular rhythm

What would someone's vital signs look like if they were experiencing inc intracranial pressure?

-inc systemic BP -dec HR

Describe a myasthenic crisis:

-inc weakness & fatigue -resp. impairment may develop

What are common post-op complications s/p amputation? (7)

-infection -slow healing -wound dehiscence -*contractures* -edema -fall trauma -pain: phantom & residual limb

What can cause someone to sneeze?

-inflammation -foreign material in nasal passages

What can cause pleural pain?

-inflammation -infection in parietal pleura

What is the MOA of Denosumab?

-inhibits osteoclast function -dec bone resorption

What phases of the gait cycle are categorized as part of the stance phase?

-initial contact -loading phase -mid-stance -terminal stance -pre-swing

What things may be included in rehabilitation of someone with Kienbock's disease?

-initial immobilization -thermal modality (to inc blood flow) -ROM/glides

What phases of the gait cycle are categorized as part of the swing phase?

-initial swing -mid-swing -terminal swing

What are some symptoms of amyotrophic lateral sclerosis?

-initial: UE weakness, muscle atrophy -stumbling, falls -muscle twitches, cramps -weakness, paralysis progress throughout the body -dysarthria -later: impaired swallowing and respiration

What are some symptoms of myasthenia gravis?

-initial: muscle weakness in face & eyes -muscles of arms & trunk affected next -impaired vision & speech (monotone) -difficulty chewing & swallowing -head droops (neck mm) -upper resp. infections -significant problems: dysphagia & aspiration

What are some potential problems that occur with O2 deficit in tissues?

-interferes w/ energy production -increase in lactic acid (acidity - issues w/ protein folding) -loss of Na++/K+ pump -Increased Ca++ into the cell

What can cause someone to cough?

-irritation from nasal discharge dripping into oropharynx -inflammation -foreign material in lower respiratory tract

What are some symptoms of tetanus (lockjaw)? (6)

-jaw stiffness -difficulty swallowing -stiff neck -headache -skeletal muscle spasm -respiratory failure

Describe the late stages of Alzheimer's disease: (3)

-lacks awareness or interest in environment -incontinent -unable to function in any way

Appearance of sputum due to bronchiectasis.

-large amt of purulent (pus) sputum -foul odor

When looking at a person's level of function as it pertains to ADLs and home assessment, what are other areas of activity and participation you should examine? (read)

-learning and applying knowledge -general tasks and demands -communication -*movement* -self care -domestic life areas -interpersonal interactions -major life areas -community, social and civic life

How can a person's level of consciousness be affected by a neurological disorder?

-lethargy -confusion -disorientation -memory loss -unresponsiveness -difficulty in arousal (one of early changes noted?)

In general, what do rales sound like?

-light, bubbly or crackling breath sounds w/ serous secretions -popping sound during inspiration

List some general effects of neurological dysfunction (read)

-local (focal) effects -supratentorial & infratentorial lesions -L & R hemispheres -level of consciousness -motor dysfunction -sensory deficits -visual loss- hemianopia -language disorders- aphasia -seizures -inc intracranial pressure

What would be indications in your objective exam that may lead you to believe that a patient has Kienbock's disease?

-local tenderness -swelling -limited wrist motion -pain with gripping

What do the following changes in skin temperature mean: -localized inc -general inc -general dec

-localized: inflammation -inc: hyperthyroidism -dec: hypothyroidism

Stridor: -what does it sound like? -when is it heard? -what pediatric condition does it sound similar to?

-loud, musical sound during inspiration -worsened condition leads to stridor during inspiration & expiration due to tracheal stenosis -this is the same sound that is heard in kids with croup

How does Parkinson's disease affect a person's mouth/throat?

-low voice -slow, monotonous speech -dysarthria (hard to articulate speech) -difficulty chewing & swallowing -prolonged eating time -recurrent drooling -*impaired communication*

Describe how you would apply tubular elastic?

-may have 2 people do this the 1st time -stretch the dressing and let it glide off your fingers as you move up the limb to avoid shear forces -never want layers to stop in the same spot -if there are 2 layers, the first one should be more proximal

List the aspects of a PT screen (2)

-medical screening questionnaire -medical history

A Berg Balance score in the range of 21-40 means:

-medium fall risk -assisted ambulation

What are some symptoms of vascular dementia? (3)

-memory loss -apathy -inability to manage daily routine

What are some symptoms of Creutzfeldt-Jakob disease? (4)

-memory loss -behavioral changes -motor dysfunction -progressive dementia

2 generic names of "bulk forming" laxatives:

-methylcellulose -psyllium

What are 4 of the most common antibiotics prescribed for peptic ulcers?

-metronidazole -clarithromycin -amoxicillin -tetracycline (M.C.A.T) <-- #blessed we didn't have to take that

What are some good dietary sources of calcium? (read)

-milk -yogurt -OJ w/ calcium -cheese -cottage cheese -soy milk -dark green leafy vegetables need 4 glasses of milk to reach your RDA of calcium (1200 mg/day)

What are some later symptoms of Huntington's disease?

-mood swings, personality changes -restlessness, choreiform/jerky movements in arms & face -rigidity, akinesia develop-- makes movement difficult

What should bronchial breath sounds normally sound like?

-more muffled than tracheal sounds due to more soft tissue -louder on expiration

What are potential conditions for which you could use NMES?

-muscle dysfunction due to CNS lesion (CVA, spinal cord, TBI) -post-op orthopedic -disuse atrophy -peripheral nerve injury -pain

What should you include in your PT intervention of someone with CTS under the exercises portion?

-nerve/tendon glides -posture education

The focal signs of a brain abscess indicate ______________ deficits and increased __________ develops

-neurologic -intracranial pressure

What are characteristics of anaerobic respiration?

-no O2 -cytoplasm -1 molecule of glucose -> 2 ATP molecules -results in pyruvic acid

What are some presentations you're looking for when screening the spine to rule involvement in/out?

-no history of trauma -radicular signs present -trauma with radicular signs -altered sensation in the limb -spinal cord signs -presents with abnormal patterns -suspected psychogenic pain

What are characteristics of a misfolded protein?

-non-functioning -unstable in solution -will precipitate -will be degraded to prevent harm

When are non-removable *rigid dressings* used s/p amputation? What are they made out of?

-not often due to advances in removable systems -they're applied in the operating room -usually a plaster or fiberglass cast

What conditions can lead to a chest wall restriction? (4)

-obesity -spinal kyphosis -ankylosing spondylitis -neurological disorders

What should be involved in your objective exam for someone with hand/wrist symptoms?

-observation (deformity, swelling, atrophy, color, scars) -ROM -strength -palpation -special tests -neuro/segmental exam -nerve mobility

What different assessments should you include in an objective exam? (9)

-observation/posture -scanning or screening of spine to rule it in/out -active movement -passive movement -joint play -MMT -special tests -palpation -functional tests

How can penicillin be administered?

-orally -intramuscularly -IV -intrathecal (subarachnoid space)

What are indications from the subjective exam that may help determine if a patient has a TFCC disc injury?

-pain along the ulnar aspect -crepitus (may also have difficulty with grip or weight bearing on the hand)

What clues will come up in the objective exam (mostly regarding pain) that will help you determine if a patient has a scaphoid fracture?

-pain in anatomical snuff box -*painful*/limited wrist movement -painful compression/load note: painful wrist motion more likely than limited wrist motion

When examining a patient for symptoms in the hand/wrist, what should you consider/ask questions about in the subjective?

-pain local or from elsewhere like the shoulder, forearm, or neck/thorax? -area of symptoms (palmar, dorsal, radial, ulnar) -description of the pain -N/T? pattern?

What in the objective exam would lead you to believe that a patient has a lunate dislocation?

-pain w/ palpation -limited/painful motion -positive X-ray -numbness/tingling in the median nerve distribution

What are some symptoms of herpes zoster (shingles)? (5)

-pain, paresthesia & vesicular rash develop in a line, unilaterally -pain and/or neuralgia may continue after the lesions disappear

What are things in the subjective exam that you would consider to be indications of CTS?

-pain/paresthesia -numbness -noctural pain -hand falling asleep -thenar atrophy

What would your objective exam reveal that may lead you to believe a patient may have a scaphoid-lunate dislocation?

-palpation abnormal -limited wrist motion -increased glide -positive Watson's test

Which 2 types of pain do you need to differentiate between early on in an evaluation?

-peripheral pain -central sensitization pain

Where do you measure bronchial breath sounds?

-place stethoscope over upper lobes of lungs, close to the sternum along the anterior midline of the thorax at the jugular notch of manubrium -can also hear them along the costosternal region

What causes the sound of a pleural friction rub?

-pleural membranes become inflamed which causes the lining to be rough and adherent -results in membranes rubbing against each other = pleural friction rub -cells are sticking together & causing pain

What are some common infections that penicillins are used to treat? (4)

-pneumonia -streptococcal infections -staphylococcal infections -prevention of rheumatic fever

What education should be provided to the patient and family after an amputation?

-positioning (prevent contracture) -skin inspection -family member assistance -hygiene -how to don/doff -sock management -TBI considerations

What are 3 components of the observation assessment in an objective exam?

-posture -movement limitation -caregiver support

What are 5 quick diagnostic tests you could perform to help determine if a patient has a scaphoid fracture?

-pressure in anatomical snuff box -compression of 1st metacarpal w/ axial load -pain with wrist extension -pain with resisted wrist pronation -pain when pt leans on palmar aspect of wrist (on a table) all of these will produce pain in scaphoid region

What are the theories of electrically stimulating denervated muscle?

-prevention of muscle atrophy -edema and venous stasis -decreased degeneration

When looking at the ICF model's contextual factors, what are some examples of environmental factors to consider when treating a patient and trying to help them establish their goals?

-products and technology -natural environment and human-made changes in the environment -services, systems and policies

What is the function of the coracoacromial ligament? (3)

-protect head of humerus -prevents superior dislocation of humerus -closes coracoacromial arch

What should you address with an amputee upon discharge? (read)

-protect: surgical wounds -educate: complications often develop w/out proper prosthetic care -selection of post-op device: driven by location & their access to follow-up appts

Components of a taking a history (read)

-pt profile -location of symptoms -symptom behavior -symptom history -medical history -review of symptoms

What are some visual signs someone might exhibit if they are experiencing inc intracranial pressure?

-pupil(s) fixed and dilated -ptosis: droopy eyelid -nystagmus

Tachypnea

-rapid, superficial breathing -regular or irregular rhythm

What are some things to consider in our interventions and matching those to the patient needs?

-reduce activity demands -ensure adequate supports -facilitate performance through use of environment -avoid further functional decline and excess disability caused by environmental factors (we won't be making changes but can recommend for patient benefit)

What should you do if your patient has stridor?

-refer them to a DR immediately -or send them to an ER if it comes on quickly

What are some things to consider when planning the objective exam? (read)

-reflection if you get everything -decide on peripheral or spinal exam -SINSS (identify precautions or indications) -extent of exam -predict movements/clinical tests that will confirm your hypothesis, sequence of tests and reassessment

Percussion can be done with what 2 objects?

-reflex hammer -tapping fingertips

What are risk factors for CTS?

-repetitive use of wrist and hand -diabetes -female -age -pregnancy -vitamin B deficiency

Side effects of stimulant laxatives:

-stomach pain/cramping -diarrhea

What should be focused on in post-op rehab after the repair of a Smith's/Colles' fracture?

-restore joint glides/motions -*scar massage* -soft tissue work -*edema management* -active exercises to promote circulation and nerve glides/movement *bold* are especially important in the hand because scar tissue can restrict motion, and there's not a lot of muscle to help pump out edema

What is the difference between smooth and rough ER?

-same general structure -rough has ribosomes which synthesize proteins -smooth participates in the production of lipids and cholesterol

What are some symptoms of meningitis? (8)

-severe headache -back pain -photophobia -nuchal rigidity -vomiting -irritability -lethargy progressing to stupor or seizure -fever & chills (infection)

With encephalitis, early signs of infection include: (6)

-severe headache -stiff neck -lethargy -vomiting -seizures -fever

What are *early signs* of someone experiencing increased intracranial pressure?

-severe headache -vomiting -papilledema-- swelling of the optic disc

What are symptoms of a pleural effusion?

-sharp chest pain, worse with cough or deep breaths -cough -fever -hiccups -tachypnea -SOB: shortness of breath (lol)

What are the different types of partial (focal) seizures?

-simple -complex

Bradypnea

-slow respiratory rate -deeper than usual -regular rhythm

What should vesicular breath sounds normally sound like?

-softer, almost muffled -lower sounds compared to others -sounds like listening through a pillow -inspiration is louder than expiration and may seem like it lasts much longer than expiration -no pause b/w end of expiration & beginning of inspiration

What does an abnormal vesicular breath sound sound like?

-softer, more difficult to hear -loss of strong vesicular sound could mean a lack of ventilation

What should bronchovesicular breath sounds normally sound like?

-sound like vesicular on inspiration and bronchial on expiration -means pitch changes b/w insp. & exp. (high pitched insp. and muffled exp.) -appears to be a pause b/w breaths -in kids under 13 yo, sound covers more of the chest

What can be done in the conservative treatment for TFCC disc injury? (3)

-steroid injection (for edema and pain) -PT (education, US, exercises) -splint or cast for 4-6 weeks

What are some examples of high risk medications someone with low bone mass might be on?

-steroids -aromatase inhibitors (treats breast cancer) -androgen deprivation therapy (treats prostate cancer)

3 side effects of hyperosmotic laxatives:

-stomach pain -gas -cramps

What should you focus on in the exercise program part of amputee rehab?

-stretching & ROM -strengthening: glutes, adductors, UE, core -balance

When MMT during an objective exam, what are 3 results that can happen?

-strong and painless -weak or painful contraction -strong and painful

What is the typical intervention for a lunate dislocation?

-surgical reduction -immobilization for 3-4 wks -limit wrist ext for ~2 mo. for healing

What characteristics in an objective exam might help you determine if a Boxer's fracture is present?

-swelling -pain w/ MMT

What are indications from the objective exam that may help determine if a patient has a TFCC disc injury?

-swelling -tenderness -weakness -possible instability -loading wrist into ulnar deviation & wrist extension (produce pain)

When testing AROM in the objective exam, what qualities of movement are you considering?

-symptoms reproduction -quantity of ROM -integrity of contractile and inert tissues -presence of muscle substitution -pattern of motion restriction (capsular or not) -full and pain free active ROM suggest normalcy

What are key point for objective exam (read)?

-tell pt what you are doing -test the normal side first -do active movements first, then passive, then restricted isometrics -do painful movements last -apply overpressure with care to test end feel -repeat movements or sustain certain postures or positions if history indicates -remember that with passive movements and ligamentous testing, both the degree and quality of opening are important -with ligamentous testing, repeat with increasing stress -with myotome testing make sure contractions are held for 5 seconds -warn the patient of possible exacerbations -maintain pt dignity -refer if needed

Stimulant laxatives should be taken if:

-the bowel is full but the person feels that they can't empty it -if bulk-forming laxatives aren't appropriate

What is symptom behavior?

-the way a person acts based on the symptoms -how does it change in 24 hrs Ex: sit to one side to alleviate pain

What should be done if bronchial sounds are heard in other areas? (Ex: bronchopulmonary segments, right middle lobes, or bilaterally in lower lobes)

-these are abnormal breath sounds and require immediate referral -could be indicative of fluid in lungs or compressed, consolidated lung

How do stool thickeners work?

-they have ingredients that carry pectins or clays that thicken the stool -they also have an effect on bacteria/toxins that might cause diarrhea

What should you know about post-op protocols s/p amputation? (5)

-they're *flexible* to meet pt needs & surgeon preference -should be *known by all staff* & initiated by surgical team -specific *instructions in pt chart* & bedside -*communicate* w/ prosthetist & PT -regular *staff training*

Appearance of sputum due to asthma or cystic fibrosis. If there is blood present, what does this mean?

-thick, sticky mucus -if there is blood present it could indicate a rupture of superficial capillaries or a sign of a tumor or TB

What are 3 special tests that test for CTS?

-tinel's -phalen's -reverse phalen's

What are the types of generalized seizures? (6)

-tonic-clonic (grand mal) -absence (petit mal) -myoclonic -infantile spasms -atonic (akinetic) -Lennox-Gastaut syndrome (febrile seizures)

Appearance of sputum due to a bacterial infection.

-yellowish-green -thick -cloudy

What are some later signs of Parkinson's disease? (7)

-tremors affects hands & feet, face, tongue and lips -inc muscle rigidity -difficulty initiating movements -slow movements -lack of associated involuntary movements (loss of arm swing when walking) -propulsive gait, stooped posture -complex activities become slow & difficult (ex: getting out of a chair)

What might cause secondary seizures? (7)

-tumor -infection -hemorrhage in brain -high fever in kids (febrile seizure) -renal failure -hypoglycemia -sudden withdrawal from sedatives, alcohol or drugs

When evaluating a patient's situation and how you might approach their therapy, what might be included in physical context and evaluation?

-understanding obstacles/barrier to participation -understand supports to participation -consider individual, groups and/or populations who use the physical space

What are side effects of ACh receptor antagonists?

-urinary retention -confusion -constipation -dry mouth

How does Parkinson's disease affect their autonomic function?

-urinary retention -constipation leads to UTI's and resp infections

Dyspnea

-use of accessory muscles for respiration (retraction of muscles b/w or above ribs) -accompanies at times by flaring of the nostrils

How does functional electrical stimulation work?

-uses multiple channel stimulators to recruit muscles in a sequence to facilitate functional movement through a microprocessor

What are the 2 types of vitamin D?

-vitamin D2 (ergocalciferol) -vitamin D3 (cholecalciferol)

What are 3 different intervention options for Mallet finger?

-volar splint -surgical fixation -exercises (after splinting or fixation)

What are the different ways rales can be described?

-wet or dry -fine, medium or coarse

What do wet rales indicate? What do dry rales indicate?

-wet: fluid is in the lungs & alveoli -dry: collapsed alveoli

FYI: if the patient answers yes to any of the history of resp conditions or smoking questions, what follow up questions should you ask?

-what do you do to keep your asthma under control? -when did you have cancer & what type was it?

How does exercise impact BMD in pre-menopausal women?

1-2% gains in BMD at *spine and hip* -resistance training > spine -high impact training > hip -menstrual status influenced these gains

What are 4 pharmacological treatments for osteoporosis?

1. *Bisphosphonates* 2. Teriparatide 3. Denusumab 4. SERM: selective estrogen receptor modulators

What are 3 good exercise interventions for patients with chronic pain? Which is the most effective? (bold)

1. *aerobic exercise that's dosed appropriately* 2. graded motor imagery (laterality training and mirror therapy) 3. functional movement/training

List the types of soft dressings & compression: (4)

1. ACE wrap 2. tubular elastic 3. shrinker socks 4. gel liners GAST

Where do kidney stones get stuck most often (3)?

1. Jxn of renal pelvis & ureter (ureteropelvic junction) 2. Where ureters cross pelvic brim 3. Jxn of ureters & bladder (ureterovesicle junction)

What are the 2 openings of the articular capsule of the glenohumeral joint?

1. Between the tubercles of humerus for the tendon of the long head of biceps 2. Ant & inf to coracoid to allow communications between synovial cavity of joint with subscapular bursa

What are 2 good education interventions for patients with chronic pain?

1. CBT (cognitive behavioral training) 2. TNE (therapeutic neuroscience education - subset of CBT)

When doing a gait speed test, what are the standardized cues for telling the patients how fast to walk?

1. CGS: comfortable gait speed, tell them to "walk at your usual speed" 2. FGS: fast gait speed, tell them to "walk as fast as you safely can"

What are the 3 regions of the pharynx?

1. Nasopharynx: post. to nasal cavities 2. Oropharynx: post. to oral cavity 3. Laryngopharynx: post. to larynx

What 2 layers can the dura mater be separated into?

1. Outer endosteal layer: periosteum of cranial bones 2. Inner/meningeal layer

List the 3 elevators of the pharynx.

1. Palatopharyngeus 2. Salpingopharyngeus 3. Stylopharyngeus

What are the 3 valves that help keep the pathways for food and air separate? What are their functions?

1. Soft palate: closes off naso- from oro- pharynx 2. Epiglottis: diverts food posteriorly to esophagus 3. Glottis: closes off vocal folds to keep food out of respiratory tract

List the 3 constrictors of the pharynx

1. Superior constrictor 2. Middle constrictor 3. Inferior constrictor

What are the 3 types of shoulder pain that Dr Zhang covered and how do you test for them?

1. Supraspinatus problem or bursitis, test with painful arc or shoulder drop test 2. Anterior pain, long head of bicep, tendonitis & bursitis, test with arm wrestle 3. Deep pain, subscapularis bursitis, test with IR

What are the 4 antivirals that we discussed?

1. acyclovir 2. AZT (azidothemidine) 3. indinavir 4. interferons

What are the 4 types of bisphosphonates? (read)

1. alendronate 2. risedronate 3. ibandronate 4. zolendronic acid (-dronate)

Who should receive medical treatment for osteoporosis?

1. anyone diagnosed w/ OP 2. those w/ low bone mass taking high risk medications 3. those w/ elevated FRAX risk scores

What are 2 types of calcium supplements?

1. calcium carbonate 2. calcium citrate

What emergency treatment should you provide for someone experiencing a seizure? (6)

1. clear space, gently place person on floor, position them on their side, cushion the head 2. clear potentially harmful objects from the area 3. don't force a specific position or restrain the person (lol #1) 4. don't put anything in their mouth 5. afterwards, offer reassurance & check breathing, orient pt to surroundings 6. if seizure continues or repeats, seek medical assistance

What are the 6 components of clinical problem solving which involves progress and reassessment?

1. collect data 2. evaluate data 3. develop treatment plan 4. apply treatment 5. reassess the results 6. progress the intervention

How can you work on improving an amputee's emotional well-being?

1. counseling 2. regular follow-ups w prosthetist & therapists 3. peer support: offer contact of someone who has gone through this, options of individual, group or online meetings

What are characteristics of a well-constructed residual limb? (6)

1. effective length 2. stable distal shape 3. good muscle coverage 4. proper skin coverage & tension 5. *closure in full extension & adduction for good ROM* 6. pre-op consultation w/ prosthetist

Summary of which post-op dressings provide protection from trauma: options: gauze/ACE wrap, shrinker sock, non-removable rigid, RRD, IPOP/rigid

1. gauze/ACE wraps: none 2. shrinker sock: minimal 3. non-removable rigid: excellent 4. RRD: very good 5. IPOP/rigid: very good

Summary of time to first prosthetic fitting with different post-op dressings: options: gauze/ACE wrap, shrinker sock, non-removable rigid, RRD, IPOP/rigid

1. gauze/ACE wraps: prolonged 2. shrinker sock: slightly shortened 3. non-removable rigid: shortened 4. RRD: shortened 5. IPOP/rigid: shortened

Summary of which post-op dressings allow/reduce edema and pain: options: gauze/ACE wrap, shrinker sock, non-removable rigid, RRD, IPOP/rigid

1. gauze/ACE wraps: significant amt present 2. shrinker sock: moderate 3. non-removable rigid: minimized 4. RRD: minimized if worn consistently 5. IPOP/rigid: minimized if worn consistently

Summary of which post-op dressings have what level of risk of allowing a knee flexion contracture to develop: options: gauze/ACE wrap, shrinker sock, non-removable rigid, RRD, IPOP/rigid

1. gauze/ACE wraps: very high 2. shrinker sock: very high 3. non-removable rigid: extremely low if thigh level cast, moderate if terminates under knee 4. RRD: extremely low 5. IPOP/rigid: low if worn consistently

What are some ways in which physical modalities can be helpful for patients with peripheral pain?

1. give pts a way to control their pain 2. give pts a window to perform exercises in 3. dec pain by inhibiting pain transmission at SC

Procedure to measure breath sounds

1. have pt cough a few times beforehand to clear tubes (if they have congestion) 2. place stethoscope at upper chest and move sideways & down across the chest 3. listen to a full inspiration/expiration prior to moving the stethoscope

What are goals of post-op treatment s/p amputation? (9)

1. heal wound 2. protect residual limb 3. dec pain 4. begin limb shaping 5. begin controlled WB 6. maintain or inc ROM & strength of entire body 7. teach pt to use mobility aids 8. accomplish fxnal activities 9. psych adjustments to limb loss

What are the 3 phases of rehabilitation after an amputation?

1. healing 2. maturation 3. definitive

What should you monitor in a physical exam about a person's respiratory system?

1. is breathing difficult or uneven? 2. are they using diaphragmatic breathing or the upper chest & accessory muscles? 3. can they talk comfortably while breathing or do they have to take a break before finishing sentences?

What 3 things are required in order for a joint to be classified as synovial?

1. joint capsule 2. joint cavity 3. joint cartilage

How are the following values affected by an obstructive lung disease? 1. forced expiratory volume (FEV1) 2. peak expiratory flow (PEF) 3. total lung capacity (TLC) 4. residual volume (RV)

1. lower 2. lower 3. normal or higher 4. higher

What are the 2 types of rigid dressings?

1. non-WB 2. WB

How are the following values affected by a restrictive lung disease? 1. forced expiratory volume (FEV1) 2. peak expiratory flow (PEF) 3. total lung capacity (TLC) 4. residual volume (RV)

1. normal or lower 2. normal or lower 3. lower 4. normal, lower or higher (lol)

Components of a physical exam (4)

1. observation 2. palpation 3. ausculatation 4. percussion

What are the 6 determinants of gait?

1. pelvic rotation in transverse plane 2. lateral pelvic tilt 3. lateral shift 4. knee flexion 5. ankle dorsiflexion 6. heel rise

What are the categories of antibacterial drugs we covered? (8)

1. penicillin 2. vancomycin 3. Tetracyclines 4. Chloramphenicol 5. Macrolides 6. aminoglycosides 7. sulfonamides 8. isoniazid

What are 4 aspects of the SC joint that make it more stable to be able to support the UE?

1. periarticular connective tissues surrounding 2. articular disc that provides shock absorption inside 3. uniquely shaped joint coupled with 4. tight interweaving of the costoclavicular joint fibers

List the types of rigid removable dressings: (3)

1. plaster or fiberglass cast 2. bi-valved design 3. AmpuShield by Hanger

What does the rehabilitation treatment plan of an amputee look like after they are discharged? (read)

1. post-op pain management: massage, tapping, desensitization 2. scar mobilization 3. emotional well-being 4. functional mobility 5. gait training 6. assessment of other injuries 7. exercise program: strength, stretch, balance 8. weekly follow-up 9. pt/family education 10. contracture prevention

Describe the pattern of a tonic-clonic seizure: (8)

1. prodromal signs 2. aura 3. loss of consciousness: person falls to the floor 4. *ictal stage*: strong tonic muscle contraction 5. cry as abdomen & thoracic mm contract 6. *clonic stage*: mm alternate contract & relax 7. contractions gradually subside spontaneously, leaving body limp and conscious 8. *postictal stage*: person is confused, fatigued with aching mm and falls into deep sleep

What are four ways in which antivirals could act?

1. requiring action of proteins specific to the virus 2. blocking reverse transcriptase 3. block proteases that are unique to the virus 4. using interferons to block entry into host cell

What are the 3 main types of dressings for a pt s/p amputation?

1. soft dressings & compression 2. removable rigid dressings (RRD) 3. rigid dressings

What are the 5 warning signs of a cerebrovascular accident (CVA/stroke)?

1. sudden, transient weakness, numbness or tingling in face, arm/leg, or on one side of body 2. temporary loss of speech, failure to comprehend or confusion 3. sudden loss of vision 4. sudden severe headache 5. unusual dizziness or unsteadiness

Where do you measure breath sounds?

1. tracheal 2. bronchial 3. vesicular 4. bronchovesicular (picture in slides)

What muscles make up the soft palate? (5) What innervates them?

1. uvula 2. tensor palati 3. levator palati 4. palatopharyngeus 5. palatoglossus all innervated by CN X, except tensor palati is innervated by CN V(3)

Which carpometacarpal joint has its own joint capsule?

1st CMC joint

What happens in beta oxidation?

2 carbon fragments are released in repeated cycles producing acetyl-co-A which then enters the TCA cycle

Stool thickeners should not be taken for more than:

2 days

When listening over the bowels, you would expect to hear gurgling every _______ minutes at the least

2-5

Dementia develops late in the course of Parkinson's disease in _____ % of affected individuals

20%

What % of LE amputees fall in the hospital? Of these, what % are bad enough to require revision surgery? What % of revision surgeries result in higher level amputations?

20% 3% 47%

What percent of the total gait cycle is spent in double support?

20% initial contact, loading response and pre-swing

The clavicle has ____ degrees of freedom. What motions does this encompass?

3 DOF -elevation/depression -protraction/retraction -rotation

How many base pairs of DNA are found in humans? How many genes?

3 billion; 20,000-25,000 genes

What muscles form the pharynx?

3 constrictor muscles 3 muscles that elevate the pharynx

Anti-spasmodic drugs shouldn't be taken for more than:

3 days

How many trials should you include in a gait speed test?

3 trials (don't include the time it takes them to turn around)

SC joint dislocations account for about what percentage of shoulder girdle injuries?

3%

If a person walks less than _________ meters during a 6 minute walk test, they have poor short-term and long-term survival rates

300

How many molecules of ATP does 1 molecule of glucose produce in the Kreb's Cycle?

34 ATP

About what percent of time during a full gait cycle is spent in the swing phase?

40%

What percent of the total gait cycle is spent in single support?

40% mid-stance, terminal-stance (initial swing, mid-swing and terminal swing don't count bc the foot you are looking at is in the air)

A clavicular fracture accounts for ~ ____ to _____% of all shoulder girdle injuries and most commonly happens in what population?

40-50% of injuries males under 30 y.o. (due to contact sports and traffic-related injuries)

How many arterial arches from the ulnar artery are in the distal forearm and hand?

4

There is about ____cm of displacement side-to-side of the center of mass during a gait cycle

4 cm

How long can the effects of PPIs can last?

4 weeks

When does a pt receive an initial prosthesis and begin prosthetic gait training after an amputation?

4-12 wks give them a broad range

When does ongoing therapy and prosthetic adjustments begin after an amputation?

4-6 months

When is the incision fully healed and a cast made for a prosthesis after an amputation?

4-8 wks

What is the cutoff score for the Berg Balance Test?

45

What are the branches of the radial artery?

5 Radial recurrent artery, palmar and dorsal carpal branches, and superficial and deep palmar branches

There is about ____cm of displacement vertically of the center of mass during a gait cycle

5 cm

What groups can the posterior forearm muscles be divided into in terms of dissection? Does Zhang like this?

5 groups: Zhang likes this 3 lateral side- BR, ECRL, ECRB 3 for thumb- APL, EPB, EPL 3 for other digits- ED, EDM, ECU 1 for index- EI 1 for supination- supinator

What groups can the posterior forearm muscles be divided into functionally? Does Zhang like this?

5 groups: Zhang thinks its okay but likes another way better Flex elbow Extend, abduct, adduct wrist Extend digits Extend, abduct thumb Supinate

How long do absence seizures last?

5-10 seconds

What is the average value for step angle?

5-7 degrees

How many types of joints are there?

6

How many tendon sheaths are there for the forearm extensors (posterior compartment)?

6 1. APL & EPB 2. ECRL & ECRB 3. EPL 4. ED & EI 5. EDM 6. ECU

With pelvic rotation in the transverse plane, there are about ____ to ____ degrees of total motion

6 - 10

Which test can estimate VO2 max via an equation?

6 minute walk test

Which test is the gold standard for an endurance test?

6 minute walk test

How long may immobilization be required after a carpal fracture to allow proper healing?

6 mo

When does a pt receive a definitive prosthesis after an amputation?

6 mo - 1 yr a pt's quality of fit will improve, plateau, & actually start to get worse-- this is when you need to refer them back to a prosthetist for a definitive prosthesis

How long does it take to administer the MMSE?

6-10 minutes

A vaccine for herpes zoster (shingles) is recommended for people over the age of:

60

What is the ROM of the sternoclavicular joint like?

60 degrees ant/post 25-30 degrees inferior (allows for wide ROM of UE)

About what percent of time during a full gait cycle is spent in the stance phase?

60%

How long is a non-removable rigid dressing left on an amputee s/p amputation?

7-15 days less if there are signs of complications

What age is at risk for vascular dementia?

70+

In developing countries, ___% of the population carries the bacteria that can cause ulcers

70-80%

In the gait speed test, older adults averaged ____ to ____ % slower than young adults

71-95%

How many branches does the ulnar artery have and what are they?

8 anterior and posterior ulnar recurrent, common interosseous, muscular branches, palmar and dorsal carpal branches, superficial and deep palmar branches

How many items are on the Dynamic Gait Index (DGI)?

8 includes dynamic component and stairclimbing

What is the average value for step width?

8-10 cm or 3-4 in

What is the average human walking speed?

80 m/min (or 1.3 m/sec)

London doctor said _____ % of the time, the pt will tell you what's wrong with them

80%

What is the posterior cutaneous nerve?

A branch from the radial nerve that supplies the skin on the posterior forearm

What is the anterior interosseous nerve?

A branch of the medial nerve, runs along the front of the interosseous membrane with the anterior interosseous artery of the ulnar artery.

What is the cause of ulnar nerve injuries?

A direct hit against a hard object or fracture or medial epicondyle. The ulnar nerve is less commonly injured at the canal of guyon

What joint is the coracohumeral ligament a part of? What part of the joint capsule does it reinforce?

A part of the glenohumeral joint capsule that reinforces the superior side

What joint is the coracoacromial ligament a part of and what part of the joint capsule does it reinforce?

A part of the glenohumeral joint capsule, runs from the acromion to the coracoid process. It prevents superior dislocation of the joint

What happens in an elbow dislocation?

A posterior dislocation may occur due to a fall, overextension of the elbow, or a direct blow. Might be associated with fractures of the radius or ulna and the ulnar nerve may be injured

What is a urachal sinus?

A remnant of the urachus that connects to the umbilicus

What do the stretch receptors in the bladder stimulate?

A spinal reflex arc Causes parasympathetic firing leading to contraction of detrusor M causing urination if its strong enough to open internal urethral sphincter

What are the advantages & disadvantages of rigid dressings?

A: -dec falls -early intro to ambulation & prosthetic use -inc acceptance of limb loss D: -bulky & heavy -*poor suspension* -might apply too much weight too soon -*must have compliant pt* -trained & diligent rehab team required -time consuming -no visual wound inspection -post-op pain may be mistakenly attributed to dressing

What are the advantages & disadvantages of ACE wrapping s/p amputation?

A: -cheap -readily available -minimal tension across suture D: -re-apply often, -*doesn't prevent knee flexion* -non-WB -uncertain amt of compression -min protection from accidental trauma -complications if incorrectly done -requires flexibility -hand strength & endurance for indep. donning

What are the advantages & disadvantages of the AmpuShield RRD by Hanger Clinic?

A: -custom fit or fabricated- scans or measurements -allows wound inspection, dressing changes & PT -light weight -easy to clean -*adjustable compression* D: not for WB (nude-color RRD w/ black straps he passed around in class)

What are some advantages and disadvantages of the silicone liners?

A: -excellent adhesion -*equalized compression* -compression & properties of gel can minimize scar tissue -easily cleaned -early pt opportunity to learn to use silicone liner D: -*traps heat & moisture* -skin can macerate -requires hand dexterity to don/doff -min protection against trauma -needs daily cleaning & follow-up

What are the advantages & disadvantages of shrinker socks & tubular elastic?

A: -many sizes readily available -can be more effective than ACE wrap in dec limb volume D: -difficult to don w/out assistance -apt to roll down transfemoral limbs -replaced as they stretch out or volume dec -may irritate bony prominences or sensitive areas

What are the advantages & disadvantages of RRDs in general?

A: -removable for inspection -protects & compresses limb -improves healing -dec LOS -AmpuShield designs can be washed -bi-valved & AmpuShield limit knee flexion -mimics partial WB -used w/ soft dressings D: -potentially removable by non-compliant patients -requires skilled team -shorter version of plaster or fiberglass cast doesn't limit knee flexion -not designed for ambulation -may need to be replaced w/ sig. volume loss

How does the quality of compression provided by an ACE wrap, tubular elastic and silicone liners compare to each other?

ACE: uncertain amt of compression TE: uniform compression SL: equalized compression

What is the difference between an acute or chronic subdural hemorrhage?

Acute: often times an artery was torn, high pressure vessel, blood leakage is quick and spreads over brain and compresses it Chronic: often times a vein was torn, low pressure vessel, blood leakage is slow, more common

Where do the constrictor muscles of the pharynx insert? What are they innervated by?

All 3 insert on the median raphe of the pharynx All 3 are innervated by pharyngeal plexus (CN X) via the pharyngeal branch of the vagus

Where does the superficial muscle group of the anterior forearm all originate from?

All 5 muscles originate form the medial epicondyle

What diseases may result from proteopathies? (misfolded proteins)

Alzheimer's Parkinson's Huntington's Diabetes Mellitus Mad Cow Creutzfeldt-Jakob disease Amyloidoses

Which RRD do you want off for a minimum of 30 min 2x/day and why? options: plaster or fiberglass cast, bi-valved or AmpuShield

AmpuShield b/c don't want moisture to build up

What divides the sternoclavicular joint into 2 compartments?

An articular disc which is fixed to the articular capsule and by the interclavicular ligament

What is the sacciform recess and what is its function?

An extension of the fibrous capsule that is kind of an L shape that runs from on top of the ulna to in between the ulna and radius. It is important for the distal radioulnar joint to function

What is pronator syndrome?

An injury to the median nerve due to compression from the heads of the pronator teres. Results in pain and tenderness in proximal anterior forearm

Which cranial fossa contains the frontal lobes, crista galli, cribiform plate, and orbital plates?

Anterior

What compartments is the forearm divided into?

Anterior (anteromedial) and posterior (posterolateral) compartments

Do aneurysms occur in the anterior or posterior circulation more often?

Anterior 85% of the time

Which 3 arteries make up the anterior circulation of the brain?

Anterior cerebral Internal carotid ** Middle cerebral

Which compartment are the radial and ulnar arteries in?

Anterior compartment of the forearm

What are the branches of the median nerve?

Anterior interosseous nerve, palmar cutaneous branch, and recurrent branch of median nerve

Is an anterior or posterior dislocation of the humeral head more common?

Anterior, its caused by obtaining a blow to the arm when your shoulder is abducted

List the 3 cranial fossae

Anterior, middle & posterior cranial fossae

What is anterior, posterior and inferior to the bladder?

Anterior: pubic sympysis Posterior: rectum in males, uterus in females Inferior: prostate in males, and pelvic diaphragm in females

Where does the joint capsule of the distal radioulnar joint thicken?

Anteriorly and posteriorly

How many muscles are in the arm vs the forearm?

Arm: 4 Forearm: 19

Where is a nucleus typically found within a cell?

Attached to the ER

How does exercise impact BMD in kids?

BMD inc over 6 months at *hip & spine* -1-6% gains before puberty -0.3-2% gains during adolescence

What 3 muscles in the posterior compartment of the forearm are literally on top of each other?

BR - ECRL - ECRB

What type of joint is the glenohumeral joint?

Ball and socket (synovial)

What are the building blocks of DNA?

Base Sugar Phosphate

Why are there more side effects with ACh M1 Receptor Antagonists?

Bc there are ACh receptors located all over the body (including the brain)

Part

Bear, give birth to; Example: Parturient; Concerning childbirth

Gon

Become, seed; Example: Glucagons; Glucose producing

Describe the pathway of the superior sagittal sinus

Begins at crista galli, runs with falx cerebri, ends at internal occipital protuberance where it joins with the confluence of the sinuses

Lord

Bent forward; Example: Lordosis; Forward curvature of the spine

What is the most widely used global measure of gait and balance performance?

Berg Balance Test

Which test is the preferred method for research especially in neuro patients?

Berg Balance Test

Where does blood acumulate in a subdural hemorrhage?

Between dura and arachnoid mater

Where is the subdural space?

Between dura and fluid impermeable layer of arachnoid mater

Where in the meninges are there tight intercellular junctions to contain CSF?

Between outermost layer of arachnoid mater and dura mater

Where are the venous sinuses of the head located?

Between the 2 layers of the dura

Where are the subacromial and subdeltoid bursae?

Between the acromian and supraspinatus tendon. Between joint capsule and deltoid

Where is the subscapular bursa?

Between the tendon of subscapularis and the neck of the scapula

The tendon of what muscle passes through the joint capsule of the glenohumeral joint between the tubercles of the humerus?

Biceps brachii (long head)

Halluc

Big toe; Hallux valgus

What muscles does the radial nerve travel between?

Brachialis and brachioradialis, then it divides into 2 branches

Which muscle is an exception to the posterior compartment of the forearm in terms of those muscles being extensors?

Brachioradialis, it flexes the elbow instead and also supinates it. It is actually located on the anterolateral aspect of the forearm

What foramen does the middle meningeal A travel through and what does it branch off of?

Branches off maxillary A and goes through foramen spinosum Then it gives off a frontal & parietal branch

Fract

Break into pieces; Fracture

What is a hangman's fracture?

Breakage of the posterior arch of the axis

Mamm

Breast; Example: Mammogram; A radiograph of the mammary gland

Mast

Breast; Example: Mastectomy; Removal of the breast

Which cranial nerves form the wall of the cavernous sinus?

CN III CN IV CN V (1) CN V (2) CN VI is in the sinus but doesn't form the lateral wall

Bronchitis, asthma and emphysema are examples of what kind of disorder?

COPD

What is produced in the choroid plexuses within the lateral, 3rd and 4th ventricles?

CSF

Repeated attacks of TIA are a warning sign of:

CVA (stroke)

What are two conditions to where there may be clinical application for functional e-stim?

CVA and SCI

Is the auditory tube normally open or closed to the nasopharynx?

Closed, it opens only when one swallows to equalize air pressure

Cleido

Collarbone; Sternocleidomastoid

What fracture results in a dinner fork deformity?

Colles' fracture

What is the most commonly occurring fracture in the wrist joint?

Colles' fracture

What is known as the "Central dogma of biology"?

DNA makes RNA makes Protein

Chorea

Dance; Chorea-form movements

Necr

Death; Example: Necrology; Statistics or records of death

Which osteoporosis drug is considered for patients with kidney dysfunction?

Denosumab

Which osteoporosis drug is a humanized monoclonal antibody against RANKL protein?

Denosumab FDA approved in 2010

Lytic

Destroy, reduce; Example: Electrolytic; Destroy with electricity

Heter

Different; Example: Heterogenous; Different components

What causes AC joint dislocation?

Direct impact to shoulder or outstretched arm which tears the coracoclavicular ligament resulting in a downward separation of UE, the AC joint capsule is also torn

Path

Disease; Example: Pathophysiology; The physiology of disease

Lysis

Dissolution, loosening; Example: Hemolysis; Blood destroying

What articulates with what in the wrist joint?

Distal end of radius with the first row of carpals (scaphoid, lunate, triquetrum) Not pisiform

What articulates with what in the carpometacarpal joints?

Distal row of carpals with base of metacarpals

What are the branches of the ulnar nerve in the anterior forearm?

Dorsal cutaneous branch, Palmar cutaneous branch, Superficial branch, Deep branch, muscular branches

Where does the kidney develop?

Down in the pelvis and migrates up, the opposite of the gonads

What are some other means that can cause cell damage besides lack of O2?

Drugs Microorganisms Abnormal metabolites Nutritional deficits Imbalance of fluid or electrolytes Extreme temperatures

Ambly

Dullness; Example: Amblyopia; Dimness of vision

The falx cerebri, tentorum cerebelli, falx cerebelli, and diaphragma sellae are folds of what tissue?

Dura mater

What is between the 2 dural layers?

Dural sinuses

Ot

Ear; Example: Otoscope; Device to view ear

Myring

Eardrum; Example: Myringitis; Inflammation of the tympanic membrane

Oo

Egg, ovum; Example: Oogenesis; The process of formation of ova

Ov

Egg; Example: Oviduct; Passage through which ova leave body

Fractures of the skull can lead to which type of hemorrhage?

Epidural hemorrhage

Bleeding from a torn meningeal vessel may lead to what type of hemorrhage?

Epidural/extradural

Is(o)

Equal, same; Example: Isometrics

Where does the pharynx extend to and from?

Extends from base of skull to esophagus (~C6)

Which urethral sphincter is under voluntary control?

External urethral sphincter

Ocul

Eye; Example: Oculogyric; Pertaining to or causing movement of the eyeballs

Ophthalm

Eye; Example: Ophthalmia; Inflammation of the eye

When are fine, medium & coarse rales heard?

F: at the beginning of inspiration when air first enters tree M: at any stage of inspiration C: at any stage of inspiration

What muscles does the ulnar nerve run between?

FDP and flexor carpi ulnaris (it innervates both of these)

T/F: all RRD's are non-weight bearing

False There was a slide in Matt's presentation titled WB RRD's, basically was a RRD w/ a prosthetic foot attached, but he skipped it. All the ones we learned about are non-WB, although you can begin to simulate WB

Lepto

Fine, thin, slender; Example: Leptocephalus; An abnormally tall, narrow skull

What fissure does the falx cerebri run within?

Fissure between 2 cerebral hemispheres

Which muscles are in layer 2 of the anterior forearm?

Flexor digitorum superficialis

What is the only muscle that flexes the IP joint of the thumb?

Flexor pollicis longus

Why should infants never be allowed to drink while laying on their backs?

Fluid in the oropharynx can reflux up into the nasopharynx. This increases the likelihood of fluids being pulled into the auditory tube leading to middle ear infections

What is the heimlich maneuver?

Food gets stuck at the narrowest part- jxn of esophagus and pharynx, this causes reflex closure of the glottis. Heimlich results in forced increased abdominal pressure to expel stuck food

Where is the radial collateral ligament?

From the lateral epicondyle to the anular ligament of the radius

Where is the ulnar collateral ligament?

From the medial epicondyle to the coronoid process & olecranon of the ulna

Which arteries supply the frontal, temporal, and occipital lobes?

Frontal: ant. cerebral A Temporal: mid. cerebral A and post. cerebral A Occipital: post. cerebral A

How do you find the superficial and palmar arches?

Fully extend your thumb, the superficial arch is at the same level as your thumb. The deep arch is about 1 cm proximal

Which ligaments surround the glenohumeral joint?

Glenohumeral ligaments Coracohumeral lig Transverse humeral lig Coracoacromial lig

Why is it important for transfemoral amputees to have good glute strength?

Glute max. controls the flexion moment that occurs w/ initial contact & allows them to extend in mid-stance

Gingiv

Gum; Example: Gingivitis; Inflammation of the gums

the NIH discovered that ulcers can be caused by:

H. pylori bacteria

Eating stimulates the stomach to produce:

HCl

How do you test for subscapular bursitis?

Have pt medially rotate and place their arm behind their back. This should produce a lot of pain if positive

What articulates with what in the proximal radioulnar joint?

Head of radius with radial notch of ulna

What articulates with what in the distal radioulnar joint?

Head of ulna with ulnar notch of radius

What type of joints are interphalangeal joints? (DIP, PIP, IP)

Hinge (synovial)

What is a major regulator of acid secretion in the stomach?

Histamine

What are the articulations of the elbow joint?

Humeroulnar Humeroradial Proximal Radioulnar

Kyph

Hump; Example: Kyphosis; Abnormal convexity in the thoracic spine

What is whiplash? What are the results?

Hyperextension of the neck due to sudden acceleration ALL and ant neck muscles are often damaged, also fracutres of C1 & C2, ruptured discs, and hangman's fractures can happen

What is the mixed autonomic/visceral plexus in the pelvis called?

Hypogastric plexus

What may lack of O2 lead to?

Hypoxia (low O2 in blood) Ischemia (low O2 in tissues) Infarction (cell death from low O2)

How does sympathetic discharge at ejaculation prevent retroejaculation?

It causes the internal urethral sphincter to close

What will happen as a result of an ulnar nerve injury?

If you ask the patient to make a fist, it will result in a "claw hand" DIP flx of digits 4-5 is lost Impaired adduction of digits Numbness & tingling in medial part of palm and digits 4 & 5

What will happen as a result of a median nerve injury?

If you ask the patient to make a fist, it will result in a "hand of benediction": PIP flx of digits 1-3 is lost, 4-5 is weakened. DIP and MCP flx of digits 2 & 3 is lost

How are the muscles of the anterior forearm organized?

In 2 groups and 4 layers: Superficial group: layers 1 and 2 Deep group: layers 3 and 4

Where are the muscles bellies of the forearm muscles located?

In the proximal part of the forearm, they become tendons as they continue into the wrist

What runs within the free edge of the falx cerebri?

Inferior sagittal sinus

What is the clinical importance of tendon sheaths?

Inflammation spreads within each sheath Make sure you inject into the right compartments

Itis

Inflammation; Example: Carditis; Inflamed heart

What is the insertion & innervation of all of the constrictor muscles of the pharynx?

Insertion: median raphe Innervation: CN X

Graph

Instrument to record; Example: Cardiograph; Heart recorder

Meter

Instrument used to measure; Example: Goniometer; Instrument to measure angles

What is an example of a cartilaginous joint?

Intervertebral discs Head with neck of femur

What happens to the tendon of supraspinatus after it becomes inflammed?

It also begins to calcify

Where does the median nerve run in relation to pronator teres?

It can run between the heads, through it, or underneath it. In certain cases this can cause the nerve to be impinged when the pronator teres contracts

What is the recurrent branch of the median nerve?

It is a branch of the median nerve that branches off after the flexor retinaculum and supplies the thenar eminence

What is the radial recurrent artery?

It is a branch off of the radial artery that comes off distal to the elbow and then goes back towards the lateral epicondyle

What is the pharynx?

It is a funnel-shaped muscular tube that is a common route for both food & air

What is the palmar cutaneous branch of the median nerve?

It is a small branch of the median nerve that does not travel through the carpal tunnel, so when patients have carpal tunnel, they will loose sensation in their fingertips but still have sensation in the palms of their hands due to this nerve

What is elbow tendonitis/lateral epicondylitis?

It is also called tennis elbow. Its caused by repetitive forceful flexion and extension of the wrist. This results in inflammation of the periosteum of the lat epicondyle and causes pain that starts here and radiates down the posterior forearm

What do we need to know about pelvic lymphatic drainage?

It is highly interconnected so drainage can pass in almost any direction to any pelvic or abdominal organ

Where can you palpate the abductor pollicis longus tendon?

Just lateral to the EPB tendon of the snuff box

What may help improve stress incontinence?

Kegel exercises Estrogen treatment in some post-menopausal women

Nephr

Kidney; Example: Nephroma; A tumor of kidney tissue

Gangl

Knot; Ganglion cyst

What nerve roots make up the lumbosacral trunk?

L4 and L5

What must be present for pyruvate to turn into lactic acid?

LDH (lactate dehydrogenase)

Phak

Lens of the eye; Example: Phakitis; Inflammation of the lens of the eye

What often causes a subluxation and dislocation of the radial head?

Lifting children by pulling their arms

Labi

Lips; Example: Labiogingival; Pertaining to the lips and gums

Artic

Little joint; Example: Articular; Pertaining to a joint

Hepat

Liver; Example: Hepatitis; Liver inflammation

Metry

Measurement; Example: Audiometry; Measurement of hearing

What is the function of CSF?

Mechanical & protective support for the brain, and serves as an ion sink

What does the joint capsule of the intermetacarpal and carpometacarpal joints include?

Medial 4 CMC and IMC joints have a common capsule 1st CMC has its own capsule

Where is the articular capsule of the glenohumeral joint strong?

Medially: attaches to glenoid cavity. Laterally: attaches to anatomical neck of humerus. Superiorly: attaches to scapula Inferiorly: capsule is loose

What does the bladder leave behind as it recedes into the pelvis?

Median umbilical fold over the urachus (urinary canal of fetus)

How many muscles do the median and ulnar nerves innervate in the forearm?

Median: 6.5 Ulnar: 1.5

Which cranial fossa contains the temporal lobes, dorsum sellae, posterior clinoid processes of sphenoid bone, and petros & squamous portions of temporal bones?

Middle

Galact

Milk; Example: Galactopyra; Milk fever

Lact

Milk; Example: Lactogen; A substance that stimulated mild production

Where does the obturator A normally come off and where does it come off sometimes?

Normal: internal iliac A Aberrant: inf epigastric A

Nas

Nose; Example: Nasogastric Tube; inserted in the nose to the stomach

What is the O, I, N, F of flexor pollicis longus?

O: anterior radius & interosseous membrane I: base of distal phalanx of 1st digit N: median nerve F: flexes IP, MCP CMC joints of the thumb, also flexes the wrist

What is the O, I, N, F of pronator quadratus?

O: distal anterior ulna I: distal anterior radius N: median nerve F: pronates forearm, also helps interosseous membrane hold the radius and ulna together

What is the O, I, N, F of extensor carpi radialis brevis?

O: lateral epicondyle I: base of 3rd metacarpal N: radial nerve F: extend and abduct the wrist, also steadies the wrist when making a fist

What is the O, I, N, F of extensor carpi ulnaris?

O: lateral epicondyle I: base of 5th metacarpal N: radial nerve F: extends and adducts wrist, and steadies it when making a fist (w/ ECRL and ECRB)

What is the O, I, N, F of extensor digiti minimi?

O: lateral epicondyle I: extensor expansion N: radial nerve F: extends DIP, PIP, MCP, and wrist joints It splits into 2 parts and the lateral tendon joints with the ED

What is the O, I, N, F of extensor digitorum?

O: lateral epicondyle I: extensor expansion N: radial nerve F: extends digits 2-5 at all joints

What is the O, I, N, F of supinator?

O: lateral epicondyle, radial collateral and annular ligaments I: lateral anterior/posterior surface of radius N: radial nerve F: supinates forearm along with biceps

What is the O, I, N, F of flexor carpi radialis? (and what does it lie just medial to?)

O: medial epicondyle I: 2nd metacarpal N: median nerve F: flex and abduct the wrist at the same time Lies just medial to the radial artery

What is the O, I, N, F of palmaris longus?

O: medial epicondyle I: flexor retinaculum & palmar aponeurosis N: median nerve F: protracts nails out we don't need this muscle anymore and about 16% of caucasians do not have it

What is the O, I, N, F of extensor pollicis brevis?

O: posterior radius I: base of proximal phalanx of thumb N: radial nerve F: extends thumb at MCP, CMC, and wrist, also abducts wrist

What is the O, I, N, F of extensor pollicis longus?

O: posterior radius (ulna according to google) I: base of distal phalanx of thumb N: radial nerve F: extends thumb at IP, MCP, CMC and wrist, also adducts thumb when extended

What is the O, I, N, F of extensor carpi radialis longus?

O: supraepicondylar ridge I: base of 2nd metacarpal N: radial nerve F: extends and abducts the wrist, also steadies the wrist when making a fist

What is the O, I, N, F of brachioradialis?

O: supraepicondylar ridge I: lateral surface of radius N: radial nerve F: flexes elbow, supinates forearm

What is the O, I, N, F of flexor digitorum profundus?

O: ulna & interosseous membrane I: base of distal phalanges N: digits 2 &3 median nerve, digits 4 & 5 ulnar nerve F: flex DIP, PIP, MCP and wrist joints

What is the O, I, N, F of extensor indicis?

O: ulna and interosseous membrane I: 2nd extensor expansion N: radial nerve F: extends the index finger at DIP and PIP independently, also helps extend wrist

What does the greater occipital N come out below?

Obliquus capitis inferior

What portions of the brain does the tentorium cerebelli separate?

Occipital lobes from the cerebellum

Which sinus runs in the junction of the falx cerebelli with the occipital bone?

Occipital sinus

Ger

Old age, aged; Example: Gerontologist; Physician who specialized in elderly adults

How do growth factor receptors work?

One kinase phosphorylates a protein that then becomes active, looks for its target and activates that by phosphorylation, activates another enzyme by phosphorylation, signal to move into the nucleus, causes another binding within the nucleus

Ician

One who; Example: Geriatrician

Mon

One; Example: Monospasm; Spasm of a single limb or part

Genesis

Origin, cause; Example: Pathogenesis; The development of disease

What does the deep branch of the radial nerve innervate?

Pierces the supinator and innervates all the extensor muscles (becomes the posterior interosseous nerve)

What does the diaphragma sellae cover?

Pituitary gland within the sella turcica

What type of joint is the distal radioulnar joint?

Pivot (synovial)

What type of joint is the proximal radioulnar joint?

Pivot (synovial)

What type of joint is the acromioclavicular joint?

Plane (synovial)

What type of joints are intermetacarpal joints?

Plane (synovial)

What type of joints are the intercarpal joints?

Plane (synovial) There is a small amount of gliding between carpal bones, they also often participate in wrist movement

What type of joints are carpometacarpal joints?

Plane (synovial) Except the 1st CMC joint is a saddle joint

What is the function of the 4 tonsils (8 total) in both the nasal and oral pharynx?

Protect the entrances to the respiratory & digestive tracts

What nerve innervates the posterior compartment of the forearm?

Radial nerve

Which muscles make up the suboccipital triangle?

Rectus capitis major Obliquus capitis superior Obliquus capitis inferior

Which 4 muscles are innervated by the subocciptal N?

Rectus capitis post. minor Rectus capitis post. major Obliquus capitis superior Obliquus capitis inferior

What motions cause inflammation of the supraspinatus tendon?

Repetitive use of the upper limb above the horizontal level or forceful throwing

What is the ROM of the AC joint like?

Rotation of the acromian is as much as 50 degrees under the clavicle

What keeps the humeral head in the glenoid cavity?

Rotator cuff muscles

What joint is the transverse humeral ligament a part of and what does it hold in place?

Runs from greater tubercle to lesser tubercle of humerus. It holds the long head tendon of the bicep in place. It is a part of the glenohumeral joint capsule.

What is the most common cause of a subarachnoid hemorrhage?

Rupture of an aneurysm as arteries pass within the subarachnoid space Results in severe headache, stiff neck, loss of consciousness

What nerves does the inferior gluteal N pass between?

S2 S3

What nerve roots make up the pudendal nerve?

S2, S3, S4 "keep poop, pee, & penis off the floor" Ext urethral & anal sphincters, motor & sensory to ext genitalia

What is the external urethral sphincter innervated by? What type of muscle is it?

Skeletal muscle somatic NS (Pudendal N)

What does the superficial branch of the radial nerve innervate?

Skin on dorsum of hand and some hand joints

Hypn

Sleep; Example: Hypnalgia; Pain during sleep

Gracile

Slender; Gracilis muscle

What is a urachal cyst?

Small fluid filled cyst above bladder and below umbilicus

What is the internal urethral sphincter innervated by? What type of muscle is it?

Smooth muscle Autonomic NS sympathetic: closed parasympathetic: open

Lei

Smooth; Example: Leiodermia; Dermatitis characterized by abnormal glossiness or smoothness of the skin

What actions cause involuntary leaking in stress incontinence?

Sneezing, coughing, laughing, or heavy lifting

What is an example of active transport that we discussed?

Sodium Potassium Pump -transports 3 sodium ions out of the cell and 2 potassium into the cell both are towards high concentration (maintains gradient from reversing)

What allows one to forcibly blow out one's mouth or nose?

Soft palate

What structure is also referred to as the velum?

Soft palate

Malacia

Softening; Example: Chondromalacia; Softening of the cartilage

What is the vallecula?

Space b/w base of tongue and epiglottis

Acanth

Spine, prickle; Example: Acanthocyte; A distorted erythrocyte with a thorny appearance

How are amyloid deposits formed?

Starts from proteins from AS, PD, TTR and other diseases Proteins misfolded and assemble into oligomers and fibers All aggregates share common amyloid fold

Ism

State of; Example: Dwarfism; State of being a dwarf

What are the joints of the pectoral girdle?

Sternocalvicular joint Acromioclavicular joint Scapulothoracic joint The last one is a conceptual joint and not a real joint

Lith

Stone; Example: Fecolith; Hardened stool

What is the function of the smooth ER in muscles?

Stores Ca++ in addition to its normal functions

Orth

Straight, correct,normal; Example: Orthopnea; Difficult breathing except in the upright position

What type of incontinence is almost exclusively female?

Stress incontinence especially common if they have given birth

Where is the joint capsule of the elbow strong and weak?

Strong: on each side Weak: anterior & posterior

Narc

Stupor; Example: Narcolepsy

Which type of hemorrhage results in a bloody spinal tap?

Subarachnoid hemorrhage

Are epidural or subdural hemorrhages very prominent in the elderly?

Subdural

Gen

Substance or agent that produces or causes ; Example: Pathogen Any disease-producing agent

What are the bursae of the elbow called and where are they located?

Subtendinous Olecranon Bursa: b/w olecranon and distal tricep tendon Intratendinous Olecranon Bursa: someimtes inside tricep tendon Subcutaneous Olecranon Bursa: in the subcutaneous CT over olecranon

Diadocho

Succeed, take over; Example: Diadochokinesia; Rapid, alternating movements

Gly(glycos)

Sugar; Example: Glycolysis

What groups can the posterior forearm muscles be divided into anatomically? Does Zhang like this?

Superficial and Deep groups Zhang doesn't like this

What 4 bones come together at the pterion?

Temporal Sphenoid Parietal Frontal

Which muscles help open the auditory tube when you swallow? (2)

Tensor palati m Salpingopharyngeus m

Which type of osteoporosis drug is an anabolic "bone building" agent?

Teriparatide taken daily as a subcutaneous injection

Orch (I, id)

Testis; Example: Ochiopathy; Any disease of the testis

What is a Z score (in terms of osteoporosis)?

The # of standard deviations from age matched mean density

What is a T score (in terms of osteoporosis)?

The # of standard deviations from the young adult mean BMD

What separates the 2 compartments of the forearm?

The 2 bones and the interosseous membrane

What branches off of the vertebral AA? (5)

The 2 vertebral AA come together to form the basilar A which then gives off.. Post. inf. cerebellar AA (PICA) Ant. inf. cerebellar AA (AICA) Sup. cerebellar AA Post. cerebral AA Post. communicating AA

What are the extensor expansions of the extensor digitorum?

The ED tendons flatten to form the extensor expansions that wrap around the back and sides of the head of the metacarpals and proximal phalanges. The proximal portion is called the hood. After the hood, the expansions divide into a central band that goes to the middle phalanges and 2 lateral bands that go to the distal phalanges

How are the tendons of FDS and FDP laid out?

The FDS tendons split in 2 and insert onto the middle phalanges, the FDP tendons run through this split to insert on the distal phalanges

What does the term leptomeninges mean?

The combination of pia and arachnoid meninges

What is the pudendal canal formed by?

The epimysium of the obturator internus muscle

What do we need to know about the ligaments in the wrist joint?

The joint capsule is strengthened on palmar, dorsal, medial, and lateral sides creating a whole bunch of ligaments Palmar & dorsal radiocarpal ligs Ulnar & radial collateral ligs

What does it mean when they say you can have either an anterior or posterior dislocation of the humeral head?

The long head triceps tendon is inferior to the joint, so the humeral head can either dislocate anterior or posterior to the tendon, but all dislocations are truly inferior dislocations

How do you test to see if the median nerve sensation is intact without also testing the ulnar nerve?

The median nerve innervates finger 1-3 and half of 4, the ulnar nerve innervates the other half of 4 and all of 5. So you would test sensation in one of the first 3 fingers

What is osmosis?

The movement of water from an area of low concentration of molecules to a high concentration of molecules (trying to achieve same ratio of water:molecules)

Why can the radial artery be used as a graft and the ulnar artery can't be?

The radial artery is connected to the ulnar artery by the arches, so blood supply will not be lost to those areas. The ulnar artery has additional branches that the radial artery does not connect to (common interosseous artery) so it cannot be used as a graft

Which of the olecranon bursae is the most problematic and why?

The subcutaneous bursa, when you rest your elbows on the table you are putting pressure on this bursa which can lead to bursitis of the elbow which is often called student's elbow

What forms the superficial and deep palmar arches?

The superficial and deep palmar branches of the ulnar artery anastomose with the superficial and deep palmar branches of the radial artery to form these arches.

What are intertendinous connections?

The tendons of the 4th and 5th digits and the 2nd and 3rd digits were initially fused. Their tendons are still connected in small segments

Which ligament of the elbow consists of 3 bands and what are the bands called?

The ulnar collateral ligament Anterior cordlike band Posterior fanlike band Oblique band

Where does a bladder in a newborn extend up to?

The umbilicus

What does the fibrous capsule of the intercarpal joints look like?

There is a Common Fibrous Articular Capsule that encloses all of the intercarpal joints

What are the anterior ulnar recurrent and posterior ulnar recurrent arteries?

They are 2 branches of the ulnar artery, they are called recurrent because they branch off of the ulnar artery below the elbow and then go back towards the medial epicondyle

Are the EI and EDM tendons medial or lateral to the ED tendon?

They are both medial to the digitorum

What is a synovial cyst of the wrist?

They are of unknown cause, often develop on dorsum of wrist and are fluid-filled. If it appears on the palmar hand it can compress the median nerve

What does it mean to say that the epidural and subdural spaces are potential spaces?

They are only present if a pathology occurs

What joint are the glenohumeral ligaments a part of and what part of the joint capsule do they reinforce?

They are part of the joint capsule of the glenohumeral joint. They reinforce the anterior aspect of the capsule

Where is the fibrous capsule of the MCP and IP joints strong?

They have collateral ligaments on the sides and a palmar ligament on the palmar side

How do anti-spasmodic drugs work?

They slow down the speed at which the bowel travels through the intestines, so that more water can be absorbed from the stool to produce fewer and firmer stools

How do lubricants/stool softeners work?

They use mineral oil to bring water into the fecal mass, thus softening the stool and permitting easier elimination

What is the function of the joints of the pectoral girdle?

They usually coordinate with each other to move the scapula

Pachy

Thick; Example: Pachyblepharon; Thickening of the eyelids

Where is the sternoclavicular joint capsule thickened to form ligaments?

Thickening of the fibrous joint capsule at the front and back

What is the common interosseous artery?

This is a short branch off of the ulnar artery that soon divides into the anterior and posterior interosseous arteries. These are the main arteries of the forearm and go in front of and behind the interosseous membrane

What forms the palmar and dorsal carpal arches?

This is the "bracelet" of arteries around the wrist. The palmar and dorsal carpal branches of the ulnar artery anastomose with the palmar and dorsal carpal branches of the radial artery to form these arches

The laryngo pharynx becomes the esophagus and the larynx becomes the what?

Trachea

What does CN XI innervate?

Trapezius SCM

What does TFCC stand for?

Triangular Fibrocartilage Complex

What is the main nerve of the meninges?

Trigeminal N is in all 3 cranial fossae. Vagus and C2-3 help in the posterior fossa.

What is the area of the bladder called without rugae?

Trigone Between ureters and internal urethral opening

Onc

Tumor; Example: Oncotropic; Having special affinity for tumor cells

When moving into radial and ulnar deviation of the wrist, ulnar deviation is accompanied by ________, whereas radial deviation is accompanied by ________

UD w/ flexion RD w/ extension

Which ligament of the elbow do baseball players often develop a problem with?

Ulnar collateral ligament

Omphal

Umbilicus, navel; Example: Omphalorrhagia; Hemorrgage from the umbilicus

What is the straight sinus formed by?

Union of inferior sagittal sinus with great cerebral V

What is the junction of the ureter with the bladder called?

Ureterovesical junction

How do the ureters run in relation to the vas deferens?

Ureters are posterior to vas deferens "water under the sperm"

What is significant about the process of making proteins in a cell? (costs)

Uses energy, arranged in a way that we must use energy to synthesize proteins because it is more important to protect the genetic material

What causes the lunate to dislocate?

Usually happens to a dorsiflexed wrist, the lunate is dislocated into the carpal tunnel on the palm side of the hand and presses into the median nerve

Hyster

Uterus; Example: Hysterectomy

Metr

Uterus; Example: Metritis; Inflammation of the uterus

What does the suboccipital triangle contain?

Vertebral A Suboccipital N (as they pierce the atlantooccipital membrane**)

What is a spinal tap leak?

When a pathology causes a greater pressure above the tentorium cerebelli which results in the brain herniating through the tentorial incisure and CSF may leak from the spinal canal

When might macrolides be prescribed?

When penicillins are not appropriate for treatment

What is a shoulder separation?

When the AC ligament and coracoclavicular ligament tear and the shoulder drops (most severe type)

What is overflow or outflow incontinence?

When the detrusor M no longer contracts properly, results in constantly full bladder and tend to dribble constantly

What is cubital tunnel syndrome?

When the ulnar nerve is compressed by the 2 head of flexor carpi ulnaris. It causes the same symptoms as an ulnar nerve injury

What is circular breathing?

Wind instrument players close oral cavity w/ soft palate, quickly pull air into lungs, contract buccinator to blow into instrument, reopen oral cavity quickly by raising soft palate while exhaling

What is a supratentorial lesion?

a lesion in the cerebral hemispheres

What is happening when you sublux or dislocate the radial head?

You are pulling the radial head out of the anular ligament, manual relocation is possible with a special maneuver

What is a brain abscess?

a collection of pus and other material in the brain

If the environmental press is too high what may result?

a fall

How long do TIA episodes last?

a few minutes or longer, but no more than 1-2 hours

What happens in a Jacksonian seizure?

a focal motor seizure with clonic contractions in a certain area that then spread progressively

What are cytokines?

a group of endogenous proteins that have regulatory capacities within the immune system

What is an infratentorial lesion? What affects might this cause?

a lesion in the brain stem may affect motor & sensory fibers, respiratory & circulatory function, & level of consciousness

Outcome measures are a quantifiable measure of:

a patient's abilities and progress

What is a telomere?

a piece of DNA that is at the end of a chromosome, portion is lost with each cell division

The diagnosis of osteoporosis is made either by a DEXA scan or:

a prior non-traumatic fracture

What is postpolio syndrome?

a progressive condition with symptoms such as: -debilitating fatigue -weakness -pain -muscle atrophy

What is a TIA?

a short episode of impaired function due to a period of ischemia

Define a weight bearing activity:

a structured, force-generating activity that provides loading to skeletal regions, *above* that provided by activities of daily living

Is manual therapy an effective treatment for patients with chronic pain?

a variety of MT interventions may be effective for pain modulation

What type of seizure involves a brief loss of consciousness and sometimes facial movements such as eyelid twitching or lip smacking?

absence (petit mal) generalized seizures

What do stimulant laxatives do?

activate peristalsis by an unknown mechanism (they might inc. fluid accumultion in the small intestines)

What does an increase flux of Ca++ into a cell cause?

activation of: -proteolytic enzymes -apoptotic enzymes *cause cell death*

Whether you're performing an objective exam on the spine or peripheral joints, what movements should you test?

active passive resisted isometric

Under the education part of the PT intervention for CTS, what should you include when working with the patient?

activity modification ergonomic posture

A positive effect according to the Lawton's Ecological Model will occur near the _________ level?

adaptation (includes zone of support or stimulation)

How do RBC support themselves starting out?

aerobic metabolism

What are the 2 possible destinations of pyruvic acid?

aerobic respiration (if O2 is present) or turns into lactic acid

How prevalent is osteoporosis in the U.S.?

affects 10 million

What does it mean to say summation of contractions occurs in muscle re-education NMES?

after the first stimulus, the membrane repolarizes; overlapping myofilaments contract resulting in further shortening

The norms for the 6 minute walk test are based on:

age

What is facilitated diffusion? Does it use energy?

aided diffusion due to molecular size or chemical make up, does not use energy because it is still following gradient of high to low

What is a Watson's test?

aka: scaphoid shift test -patient seated, elbow at 90 deg w/ arm pronated -passively move from UD to RD while stabilizing scaphoid -+ result is increased movement, pain or clunk in dorsal direction

What is the function of the glenohumeral ligaments?

all function to stabilize the joint anteriorly: -superior at 60 deg elevation -middle at 90 deg elevation -inferior at 120 deg elevation

What is the function of the scapulothoracic "joint"?

allows for maximum movement at end ranges

What do the 3 letter "codes" of letters represent in mRNA?

amino acids

What is a by-product of protein break down? How is it rid of?

ammonia, through urea

How does the person feel after a complex, partial seizure?

amnesic (forgetful) and drowsy

What are the 3 antifungals we talked about?

amphotericin B flucytosine azoles

What is the most common pulmonary problem in kids?

asthma

Where are areas of major lymph nodes?

at major joints -elbow, wrist, knee, ankle

Extension of the wrist occurs mostly (>50%) where in the carpals?

at the RC joint

What are the types of cellular adaptations that can occur?

atrophy hypertrophy hyperplasia metaplasia dysplasia anaplasia

How does amphotericin B work?

attacks the unique lipiids in fungi compromising the stability of the fungus

What do antacids do?

attempt to neutralize excess stomach acid in the case of heartburn or acid reflux

What is Mallet finger?

avulsion of extensor tendon from the DIP

Why is prolonged use of stool thickeners dangerous?

bacteria that are inhibited by the drugs are necessary for normal digestion

What does a score of 19 on the DGI indicate?

balance/gait impairment or fall risk

What is the difference between a base and a base pair?

base is one strand, base pair is two strands

Why is looking at posture/body mechanics so important in someone with CTS?

because even though CTS isn't a neck issue, they may have limitations in neck movement that contribute to bad posture and CTS symptoms

Why is chloramphenicol prescribed sparingly?

because it is fairly toxic

Why does Jason prefer his patients with osteoporosis to walk instead of do the elliptical?

because the elliptical takes a lot of the WB component out of it, walking has more axial loading which will encourage osteoblast activity

Why are the bases in DNA called nitrogenous bases?

because they have nitrogen in their structure

Why are lung infections common with emphysema?

because viral, bacterial or fungal particles can easily get into the enlarged acini

When is a stool softener usually taken?

before bedtime (with the anticipated result occurring in the morning)

R hemisphere damage could mean a lead to what problems?

behavioral problems and dec appreciation for art & music

How is fuel obtained from fatty acids (lipids) for cellular respiration?

beta-oxidation

How do azoles work?

bind to cytochrome P450 enzymes

What causes the initiation of signal transduction?

binding of the ligand to the receptor

How does chloramphenicol work?

binds to ribosomes responsible for protein production in bacteria and inhibits their activity

What type of current does NMES use?

biphasic current

What is the MOA of bisphosphonates?

bisphosphonates inactivate osteoclasts to allow the bone to regenerate

How do aminoglycosides work?

block protein synthesis

How do isoniazid antibacterials work?

block synthesis of cell wall and interfere with cellular metabolism

What do PPIs (proton pump inhibitors) do?

block the hydrogen pump responsible for secreting acid into the stomach lumen

What are some signs of toxicity for ioniazid antibacterials?

blurred vision, eye pain, difficulty breathing and seizures

What are signs of toxicity with polymyxin?

blurred vision, swelling in the face, stiff neck, muscle weakness and headaches

In the terminal stance phase of gait, what is happening? When does it start and end?

body is progressing past the forefoot from mid-stance to just prior to contact of opposite limb

What happens during the mid-stance phase of gait? When does it start and end?

body progresses over the foot starts when the contralateral foot leaves the ground, ends when body is directly over the supporting limb

In the ICF framework table, the disorder or disease is listed at the top. What categories of consideration branch off of this?

body structures/function activities participation

What are possible side effects of flucytosine?

bone marrow toxicity and anemia

In an AmpuShield RRD, which strap (top or bottom) do you want to be the tightest?

bottom strap should be as tight as possible b/c this is your suspension top strap should be snug

What is the MOI for a Boxer's fracture?

boxing or punching (via axial load on 5th MC)

What happens during lipolysis in fatty acid oxidation?

break down of triglycerides to fatty acids and glycerol

Why is it called beta oxidation?

breaking of the beta carbon bond

Do azoles have a broad or narrow spectrum of anti-viral activity?

broad

Does amphotericin B have a broad or narrow spectrum of anti-viral activity?

broad

Which breath sound is a combination of vesicular and bronchial sounds?

bronchovesicular

What is the best choice of drug for people with small, hard stools?

bulk forming laxatives

________________ are just high doses of fiber, so they are safe, even for kids

bulking drugs

What are 2 significant problems of myasthenia gravis?

dysphagia aspiration

What is the close and loose packed position of the glenohumeral joint?

c: maximum abduction and ER L: 60 deg abduction, 30 deg horizontal adduction

What is the most abundant second messenger?

cAMP

What are some *temporal variables* of gait? (read)

cadence stance time swing time single support double support average gait speed

Which calcium supplement is poorly absorbed if on a PPI?

calcium carbonate

Which calcium supplement requires stomach acid for absorption and must be taken with food?

calcium carbonate

What can serve as fuel molecules for cellular respiration?

carbohydrates (glucose) and lipids (fatty acids)

What are examples of exogenous chemical agents?

carbon monoxide tobacco smoke carbon tetrachloride

What manual therapy technique could be used to help treat CTS?

carpal bone mobilization

With a FOOSH where the wrist was extended >80 deg (greater than), what bone is likely to fracture?

carpal fx

What is CTS?

carpal tunnel syndrome (compression of the medial nerve)

What is the function of mRNA?

carries genetic information that has been copied from the DNA, serves as a "messenger"

What makes TB difficult to treat?

caused by mycobacteria which replicate slowly, develop drug resistance quickly, and thus do not respond well to traditional actibacterials

How does a simple, partial seizure affect a person's motor activity?

causes repeated motor activity such as jerking or turning the head or eye, jerky movements of the leg or by a sensation such as tingling that begins in one area and may spread

What prevents excessive growth with cellular reproduction?

cell cycle inhibitors

What is mitosis?

cell division (part of cell cycle)

What happens with cell reproduction?

cell growth controlled by growth factors goes through cell cycle until cannot reproduce

What are the stages of apoptosis?

cell shrinks membrane starts blebbing, organelles disintegrate nucleus and organelles collapse apoptotic bodies form macrophages phagocytose apoptotic bodies

Apnea

cessation of breathing

Absence (petit mal) generalized seizures are more common in what population?

children starting at age 5

What class of antibacterials causes "gray baby syndrome"?

chloramphenicol

What respiratory condition can cause clubbed fingers?

chronic hypoxia

Multiple sclerosis, Parkinson's disease, amyotrophic lateral sclerosis, myasthenia gravis, Huntington's disease, Alzheimer's disease, vascular dementia, Creutzfeldt-Jakob disease, and AIDS dementia are all types of __________________ disorders

chronic neurologic degenerative disorders

What information should you get with a symptom history?

chronological development, onset (MOI), changes, treatment

What aspects of a residual limb should be assessed weekly?

circumference & wound healing Notes: -measure BKA girth in full extension around the largest circumference -important to monitor wound healing bc keep in mind many people who have amputations were bc of diabetes, they may not realize they have a sore

At the SC joint, the ______ moves on the sternum. The purpose of this is what?

clavicle moves on the sternum purpose is to place the scapula in position to accept the head of the humerus

Impairment level measurements are __________________ as outcome measurements are _________________

clinical contextual (idk, but Carla said it was important in online lecture)

_____________ rales are a sign of involvement of the distal airway.

coarse

Which type of rales is almost always wet rales and almost always serious?

coarse rales

What is global aphasia?

combination of expressive and receptive aphasia

Lawton's Ecological Model relates what two variables?

competence and environmental press

Is surgical or conservative intervention more common after a scaphoid fracture?

conservative (w/ immobilization)

Morphine and other opiates are known to be ________

constipating (produce a general dec. in GI motility)

What is the most common side effect assoc. with *aluminum containing* antacids?

constipation

What is Raynaud's phenomenon?

constriction of small blood vessels of hands and toes (vasospasm)

When is a pleural friction rub heard?

continuous sound heard from the middle of inspiration to the beginning of expiration

At the sternal end, the clavicle is _______ (concave/convex) on its longitudinal diameter and ________ (convex/concave) on its transverse diameter

convex on longitudinal concave on transverse

What is a sign of toxicity with penicillins?

convulsions due to high levels in CSF

Define DNA replication

copying or doubling of DNA structures

Which ligament of the SC joint has two "bundles"?

costoclavicular anterior bundle runs superior and lateral posterior bundle runs superior and medial

What is the purpose of the Sodium Potassium Pump?

create membrane potential and maintain osmotic balance and stabilize cell volume

What occurs during an episode/attack of asthma?

dyspnea with significant wheezing

After an amputation, you want to return the pt to __________ at the highest level possible

daily life

Prolonged use of tobramycin may cause what?

damage to the optic nerve

What is cellular atrophy? What may cause it?

decrease in size of cells -reduced use -malnutrition -decreased hormonal stimulation -aging

What does the H2 receptor antagonist class of drugs work to do?

decrease the amount of acid in the stomach

What is a downfall of AZT?

develops resistance quickly, especially if not taken on a strict schedule

What can sulfonamides be used to treat in addition to bacterial infections?

diabetes mellitus, edema and gout

What is the most common side effect assoc. with *magnesium containing* antacids?

diarrhea

The sternoclavicular joint is a ________, saddle synovial joint

diarthrodial

What type of joint are the MCPs?

diarthrodial condyloid joint

What type of joint is the radiocarpal joint?

diarthrodial ellipsoid joint

The glenohumeral joint is what kind of joint (3 components)?

diarthrodial, synovial, ball-and-socket

What are symptoms of Raynaud's phenomenon?

diffuse pain cold numbness

Outcome measures capture function at ______________ level as opposed to the impairment level (strength/ROM)

disability

What causes necrosis?

disrupted cell metabolism lack of energy inflammation *membrane loses function, allows entry of enzyme that causes cell destruction, prevents Na++ from staying outside cell, causes swelling and bursting of cell

Where does Raynaud's phenomenon occur?

hands and feet

How is step width measured?

distance measured between two lines drawn between the midline of each foot during gait

What is stride length?

distance measured from heel strike to heel strike of the *same foot*

What is a common side effect of bulk forming laxatives?

distended and painful abdomen

If PAM is restricted, what are two tests that can be done to determine the source of the problem?

distraction and compression

What does weak or painful contraction during MMT mean?

disuse atrophy, inhibition, rupture, palsy or neuropathy

Adduction of the CMC of the thumb involves a _______ roll and a ______ glide

dorsal roll volar glide

Extension of the thumb involves a ______ roll and a ________ glide

dorsal/radial roll dorsal/radial glide

During load response, since the GRF is posterior to the ankle, causing it to want to PF, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

dorsiflexors eccentric contraction controlling PF of ankle

During initial contact, since the GRF is posterior to the ankle, causing it to want to PF, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

dorsiflexors eccentric contraction controlling plantarflexion

Initial contact is a phase of ______ support

double

Pre-swing is a phase of __________ support

double

__________________ support is when both limbs are in contact with the ground

double

Loading response is a phase of ___________ support

double support

When does the lowest point of a vertical sine wave occur during gait?

double support

Stool softeners work best if the person:

drinks a lot of water

What is the main indication of using NMES for edema?

duplicate regular muscle contractions to increase circulation through venous and lymphatics

What is differentiation?

each cell type differentiates (becomes specialized) to carry out particular functions

At what point during the gait cycle is knee flexion a determinant of gait? About how many degrees of flexion are in the knee at this point?

early in stance (loading response) 15-20 degrees --there is more knee flexion during the swing phase, but that is not part of the determinants of gait--

If compression: -eases pain -is painful What do each of these mean?

eases pain: joint capsule implication painful: joint surface implication

Which muscle group gives us most of our strength in the hand? Which is more stabilization focused?

flexors - strength extensors - stabilizers

What are the 4 boundaries of the carpal tunnel?

floor - carpal bones and palmar ligs roof - flexor retinaculum radial border - trapezium ulnar border - hook of hamate

A dull sound over a lung might indicate:

fluid or another space-occupying lesion

What is sometimes the first sign of a brain tumor?

focal or generalized seizures

What population uses BMD T scores?

for older adults to compare to the young adult mean density

What population uses BMD Z scores?

for pre-menopausal women and younger males to match them to a mean density

How does recruitment of fibers vary based on size for electrical-induced vs. voluntary muscle contraction?

for voluntary small slow twitch fatigue resistant fibers are recruited first, followed by large muscle fibers for electrical-induced large fast twitch fibers are recruited

What is the function of the cytoskeleton in a cell?

form cell structure and participate in cell movement and cell division

What is the direction of momentum during gait?

forward

For every standard deviation below the norm a person is in BMD, the ___________ risk doubles

fracture

The clavicle is more likely to ________ before the SC joint _______ (think injury)

fracture before it dislocates

What is a Boxer's fracture?

fracture in the neck of the 5th metacarpal

What is a Colles' Fracture?

fracture of the distal radius with dorsal displacement

What is a Smith's fracture?

fracture of the distal radius with volar displacement

When does pre-prosthetic training take place for someone who is having an amputation?

from pre-surgery to initial device before 0 wks

When does the mid-swing phase start and end?

from the max knee flexion to when tibia is vertical

When does the terminal swing phase start and end?

from when the tibia is vertical to just prior to initial contact (leg reaches to achieve step length)

Which type of seizure affect both hemispheres and includes loss of consciousness?

generalized seizure

Which type of seizures have multiple foci/origins in the deep structures of both cerebral hemispheres and the brain stem and cause loss of consciousness?

generalized seizure

Where do proteins go after they are synthesized?

get folded and packaged into golgi to be sent where needed

What is the main goal of interventions in someone with Kienbock's disease?

goal to restore blood supply/ revascularization

In the early stages of Alzheimer's disease there is a ____________ loss of memory and lack of ______________

gradual concentration

Gentamicin is used to treat what kind of bacterial infection?

gram-negative

During initial contact, since the GRF is anterior to the knee, causing it to want to extend, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

hamstrings eccentric contraction controlling knee extension

During terminal stance, since the GRF is anterior to the knee, causing it to want to extend, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

hamstrings eccentric contraction controlling knee extension

What population has the strongest hand intrinsic muscles? Feet intrinsic?

hand - climbers feet - barefoot runners

Why is asking about aggravating factors so important when examining a patient with hand/wrist symptoms?

hands/wrists are so involved with every day tasks and this can help determine the cause

Are ACh receptor antagonists easier or harder to take than PPIs or H2 blockers?

harder (that's why they are rarely used)

The ICF is a psychosocial model of what two things?

health and disability looks at what can be enabling

What are some side effects of tobramycin?

hearing loss, dizziness, muscle weakness and nausea

Why is it important for transfemoral amputees to have good UE strength?

helpful for assistive devices such as crutches and walkers

Walking speed can predict future events such as:

helps determine response to therapy

________________ strokes usually begin with a blinding headache and increasingly severe neuro deficits

hemorrhagic

What is acyclovir used to treat?

herpes simplex virus and varicella-zoster virus

One cranial nerve, or dermatome, on one side of the body is affected in which neurologic condition?

herpes zoster (shingles)

A 6 minute walk test is a measure for a higher or lower level of function?

higher

What type of joint are the IPs?

hinge

During initial contact, since the GRF is anterior to the hip, causing it to want to flex, which muscle group is active in trying to control this movement? What kind of contraction is that muscle engaging in?

hip extensors eccentric contraction controlling hip flexion

During load response, since the GRF is anterior (and medial) to the hip, causing it to want to flex (and adduct), which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

hip extensors and *hip abductors* eccentric contractions controlling hip flexion and adduction

During terminal stance, since the GRF is posterior to the hip, causing it to want to extend, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

hip flexors eccentric contraction controlling hip extension (glut med isometric to prevent hip drop during single support)

In the pre-swing phase of gait, what position are the hip, knee, ankle and MTP in?

hip: 0-10 degrees extension knee: 45 degrees flexion ankle: 20 degrees plantarflexion MTP: 70 degrees extension

In what position are the hip, knee and ankle in during the initial swing phase of gait?

hip: 15 degrees flexion knee: max flexion (~60 deg) ankle: 5 degrees plantarflexion

What position are the hip, knee and ankle in during the terminal stance phase of gait? Which is a determinant of gait? (answer in bold)

hip: 20 degrees extension knee: 0-5 degrees flexion *ankle: 10 degrees dorsiflexion*

In the loading response phase, what position are the hip, knee and ankle in? Which one is a determination of gait? (bold in answer)

hip: 20 degrees flexion *knee: 15 degrees flexion* ankle: 0-5 degrees plantarflexion

In what position are the hip, knee and ankle in during the terminal swing phase of gait?

hip: 20 degrees flexion knee: 5 degrees flexion ankle: neutral

In the initial contact phase, in what position are the hip, knee and ankle?

hip: 20-35 degrees of flexion knee: 0-5 degrees of flexion ankle: neutral

In the mid-swing phase of gait, what position are the hip, knee and ankle in?

hip: 25 degrees flexion knee: 25 degrees flexion to extension ankle: neutral

In what position are the hip, knee and ankle in during the mid-stance phase?

hip: neutral to extension (slight) knee: 0-5 degrees flexion ankle: 5 degrees dorsiflexion

What causes DNA to coil up? How does this process work?

histones through electrostatic interactions (have a positive charge)

If the optic tract or occipital lobe is damaged, what type of vision loss occurs?

homonymous hemianopia: -medial half of one eye -lateral half of other eye

What are 4 things that cell receptors are sensitive to?

hormones growth factors chemical transmitters drugs

Antacids usually contain a base such as:

hydroxide or carbonate/bicarbonate with aluminum, magnesium, calcium or sodium

People with vascular dementia usually have a past medical history of:

hypertension

You should use NMES for edema in conjuction with what other things?

ice and elevation

What are potential causes of Raynaud's phenomenon?

idiopathic trauma cold emotional stress

What is mutation?

if DNA in parent cell is altered and passed on, offspring cells will carry mutation

What special questions should you ask a patient with hand/wrist symptoms?

if they have RA/OA?

What are signs that you should discontinue WB with an IPOP?

if wound healing complications arise

What are possible interventions for a scaphoid-lunate dislocation?

immobilization modalities surgery depends on extent of injury

What populations would drugs that boost the immune system be indicated for?

immunosuppressed patients, people with chronic infections and cancer

What may cause a seizure? (3)

inflammation, hypoxia or bleeding in the brain

Where are fatty acids stored?

in adipocytes as triglycerides

Where is the beta2-adrenoceptor found?

in cardiomyocytes (cardiac tissue)

In which position do the IP joints have the most force?

in extension of the wrist (we extend our wrist when lifting something heavy)

Have interferons been successful?

in laboratory settings yes, in clinical settings their performance has been lackluster

When might penicillins induce seizures?

in people with renal failure

Where does translation take place within the cell? Why this location?

in the cytosol outside of the nucleus because the mRNA has to reach the ribosomes to make proteins

Where does transcription take place within the cell? Why this location?

in the nucleus where the genetic information is contained, the nuclear envelope serves as a protection for the genetic material from surrounding chemical reactions

What is aphasia in general? What are the 3 types called?

inability to comprehend or express language types: expressive, receptive, global

What is receptive aphasia?

inability to read or understand

What is expressive aphasia?

inability to speak or write

What is cellular hyperplasia? What may cause it?

increased number of cells -pregnancy -hormonal changes in puberty -liver regeneration -exposure to high altitudes

What happens to cells at low temperatures?

increased vasoconstriction reduced oxygen supply ice crystal formation

How does muscle re-education NMES affect the muscle tissue?

increases sensory input to the muscle

What is an alternate treatment for people with small, hard stools besides taking drugs?

increasing fiber in their diet

What is proliferation?

increasing number of cells

What are some examples of IADLs?

indoor home chores outdoor home chores/shopping driving, transportation work/school social interaciton

What do channels allow the passage of in cell communication?

ions

The symptoms of a TIA are related to the location of:

ischemia

Compression of the median nerve leads to what 4 things?

ischemia edema reduced nerve gliding fibrosis

For NMES used for muscle strengthening, resistance is applied to produce what type of contraction? What percent is your goal?

isometric 60% of MVIC is the goal

What type of antibacterial is the first line of defense in treating active TB?

isoniazid

What is the purpose of the 6 minute walk test?

it is a measure of exercise tolerance and endurance

How does AZT work?

it is a reverse transcriptase inhibitor

What is PQRST as it relates to symptom behavior?

it is key to ask these things with chief complaint: P: what provokes pain Q: quality of pain (sharp?) R: region of pain S: severity T: timing as it relates to other events

What is TNE?

it uses explanation of the physiology behind pain to tell the NS to lower the threat to the system itself (teach yourself that the "pain" isn't painful)

If PAM is restricted, what does this mean?

joint surface and/or surrounding tissues are implicated

Where is the COM during gait?

just anterior to S2 vertebra

When is velocity the highest during gait?

just before double support

At what point during the gait cycle is ankle dorsiflexion a determinant of gait? About how many degrees of dorsiflexion are in the ankle at this point?

just before heel rise 10 deg dorsiflexion

Polymyxin is an alternative drug for ______________?

kanamycin

What are some side effects of indinavir?

kidney problems and hyperbilirubinemia

What are some ways that gait can be analyzed? (3)

kinematics (limb movement) kinetics (GRF) electromyography (EMG studies)

Outcome measures provide a common ______________ among PTs across disciplines

language

In the initial contact phase of gait, the GRF is ______ (medial/lateral) to the subtalar joint, which makes this joint want to move into ______ (pronation/supination)

lateral pronation

In the pre-swing phase of gait, the GRF is ______ (medial/lateral) to the subtalar joint, which makes this joint want to move into ______ (pronation/supination)

lateral supination

In the terminal stance phase of gait, the GRF is ______ (medial/lateral) to the subtalar joint, which makes this joint want to move into ______ (pronation/supination)

lateral supination

Are ACh M1 Receptor Antagonists more or less effective than H2 blockers at reducing acid secretion?

less effective

FEV1/FVC% of an obstructive ventilation disorder (indicates asthma)

less than 70%

What are the general components of signal transduction?

ligand binds to receptor intracellular signaling molecules

When you initially see a pt after an amputation what do you expect their limb to look like? What are some things you should know about the pt?

limb: swollen, painful, hyper-sensitive, weak know: PMH, MOI, comorbidities, emotional well-being

What is the function of the interclavicular ligament at the SC joint?

limit depression and support weight of UE

Describe the CPR for the CMC of the thumb

limitation of abduction and slight limitation of extension

What is an empty end feel?

limitation without tissue resistance (pain)

If distraction: -is limited -is painful -eases pain What do each of these mean?

limited: contracture of connective tissues painful: tear of connective tissue eases pain: articular surfaces implicated

What is auscultation?

listening for body sounds

How does exercise impact BMD in young men?

little data, but likely beneficial

During mid-stance, since the GRF is anterior to the knee, causing it to want to extend, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

little muscle activity is needed here, so this is all N/A

What organ is affected the most with macrolides toxicity?

liver

What is an indication of toxicity with tetracyclines?

liver toxicity (in patients with renal impairment)

During which phase of gait is foot flat achieved?

loading response immediately after initial contact until the opposite extremity leaves the ground

What are symptoms of a scaphoid-lunate dislocation?

localized pain, swelling, clicking, pain with wrist extension

The ___________ of a brain tumor determines the focal signs

location

Describe apneusis

long, gasping inspiratory phase followed by a short, inadequate expiratory phase

Obstructed Breathing

long, ineffective expiratory phase with shallow, inc respirations

ACh M1 Receptor Antagonists are just as effective as H2 blockers at _________

long-term healing of ulcers

What happens to RBC when they reach maturity?

lose nucleus lose ER lose mitochondria

L hemisphere damage could cause a loss of what 2 functions?

loss of logical thinking and communication

Absence of tone is an indication of ________________ motor neuron damage

lower

What drugs are used on a short-term basis to relieve constipation?

lubricants/stool softeners

What is the most commonly dislocated carpal bone?

lunate

With a lunate dislocation, what wrist motion would be limited? Which motion should you limit during rehab?

lunate is dislocated volarly which would limit wrist flexion because the bone is dislocated volarly, you need to limit wrist extension to prevent further dislocation

What are the 3 types of RNA?

mRNA tRNA rRNA

What can be prescribed as an anti-constipation med?

magnesium-containing antacids

What is transcription?

making mRNA from its DNA template

If palpation of a lymph node is swollen & painless, and the node is immoveable it may mean _____________

malignancy

What is cellular metaplasia? What may cause it?

mature cell type is replaced by a different mature cell type, chronic irritation from GERD or chain smoking

What is the max score in MMSE? What is the cutoff for a normal score?

max: 30 cutoff: 24, everything below is considered abnormal

What is the CPR for the SC joint?

maximal shoulder elevation

What is the close-packed position for the SC joint?

maximal shoulder elevation

How long do seizures last?

may last a few seconds or minutes

What population do complex, partial seizures occur in?

may occur in children or adults

How frequently do absence seizures take place?

may occur many times a day

When doing a gait speed test, how far do the participants walk?

measure the time it takes them to walk 6 meters

In the load response phase of gait, the GRF is ______ (medial/lateral) to the subtalar joint, which makes this joint want to move into ______ (pronation/supination)

medial pronation

If there are no bowel sounds in a certain area, and it is an area associated with pain, it could be a ______________________

medical concern

Are medium or fine rales louder?

medium rales

AIDS dementia involves a gradual loss of what 2 things? It also involves impaired ____________ function

memory & cognitive ability motor (ataxia, weakness, & abnormal reflexes)

_________ is a common example of a bulking agent

metamucil

Define osteoporosis:

micro-architectural deterioration of bone tissue leading to loss of bone mass decreased peak bone mass coupled w/ accelerated bone loss

What can outcropping of cell membranes appear as?

microvili or cilia

Flexion of the wrist occurs mostly (> 50%) where in the carpals?

mid carpal joints

When does the highest point of a vertical sine wave occur during gait?

mid-stance

When does the greatest amount of deviation from mid-line occur during a side-to-side sine wave?

mid-stance on right or left

A seizure causes abnormal ______________ or ______________ activity and possibly loss of consciousness

motor or sensory

Failure of the defensive barrier in the stomach/duodenum leads to:

mucosal injury

In general, what are rales caused by?

mucus obstruction in distal airway or collapse of acini

What causes rhonchi?

narrowing of the pulmonary tree within the trachea, bronchi or bronchioles

What are bulking drugs made of?

natural fibers from seed that form a gelatin when inside the GI tract

What should you do if a non-removable rigid dressing starts to smell weird?

need to tell prosthetist or MD, needs to be cut off right away to inspect residual limb for infection

For NMES the active electrode should be ________

negative

Kanamycin and Neomycin are prescribed to treat gram-____________ bacterial infections?

negative (rods)

For NMES the negative electrode should be placed ________ and the positive electrode placed ________

negative - distal positive - proximal

What kind of charge is associated with DNA? What part of the DNA structure causes this?

negative charge comes from the phosphate molecule

What does NMES stand for?

neuromuscular electrical stimulation

What cells are considered to be "Terminally differentiated"?

neurons and cardiomyocytes

What is a neoplasm?

new growth, often a tumor

Do people who have experienced an absence seizure have memory of the epidosde?

no

Does the sternoclavicular joint have any active ROM?

no

If a patient has a lunate fracture, are they always at risk for developing Kienbock's disease? What may increase the risk?

no if the fracture is not treated or unsuspected, or in the case of a non-union fracture, these are all things that increase someone's risk of developing necrosis

Will taking a bulk-forming laxative help if there is a chance of blockage in the intestine?

no, it will make it worse

Do azoles have many side effects?

no, maybe some GI problems

Where are electrodes placed in relation to the contracture site for NMES used for contracture management?

on the antagonist muscle group (patient should NOT actively contract muscle group)

How often are PPIs taken?

once a day (or twice in severe cases) they have lasting effects, unlike H2 receptor blockers which are taken before each meal

When is it especially appropriate to use physical modalities to help alleviate pain by inhibiting pain transmission at the SC?

pain caused by conditions that can't be directly modified (Ex: cancer, fractures, or PNS pathology)

Which type of seizures have a single/focal origin and often are in the cerebral cortex and may not involve altered consciousness?

partial seizure

What does PAM stand for?

passive articular mobility

What is arguably the most important aspect of the PT's intervention after a scaphoid fracture?

patient education -encourage patient to comply with immobilization and wearing the brace to prevent necrosis of the bone

What is an aura in a tonic-clonic seizure? When does this take place?

peculiar visual or auditory sensation immediately before the loss of consciousness

With pelvic rotation in the transverse plane, how hoes the pelvis rotate in relation to the advancing limb?

pelvis on the side of the advancing limb moves *anteriorly* (right limb advancing = right ileum rotates anteriorly)

What category of antibacterials is the most widely prescribed and effective class?

penicillins

What populations are contraindicated for isoniazids?

people with acute liver disease, history of liver damage or acoholism

What populations are sulfonamides contraindicated for?

people with kidney damage/irritation pregnant or lactating women people with previous bone marrow depression

The over-the-counter version of H2 receptor antagonists are used to treat:

peptic ulcers

Ataxic Breathing

periods of apnea alternating irregularly with a series of shallow breaths of equal depth

Which type of pain are modalities more effective at treating?

peripherally sourced pain

During pre-swing, since the GRF is lateral to the subtalar joint, causing it to want to supinate, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

peroneals eccentric contraction controlling supination

During terminal stance, since the GRF is lateral to the subtalar joint, causing it to want to supinate, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

peroneals eccentric contraction controlling supination

What happens in the postictal stage of a tonic-clonic seizure?

person is confused, fatigued and has aching muscles falls into deep sleep

What are contextual facors listed in the ICF framework when considering a person's level of function?

personal environmental

How is an enzyme rendered inactive?

phosphytases remove the phosphate which renders it inactive

In the pre-swing phase of gait, the GRF is ______ (anterior/posterior) to the knee, which makes the knee want to move into _________ (flexion/extension)

posterior flexion (a.k.a knee flexion moment)

In the load response phase of gait, the GRF is ______ (anterior/posterior) to the knee, which makes the knee want to move into _______ (flexion/extension)

posterior flexion (a.k.a. knee flexion moment)

In the terminal stance phase of gait, the GRF is ________(anterior/posterior) to the hip, which makes the hip want to move into ________(flexion/extension)

posterior extension (a.k.a hip extension moment)

During mid-stance, since the GRF is medial to the subtalar joint, causing it to want to pronate, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

posterior tibialis *concentric* attempting to *supinate the foot*

During initial contact, since the GRF is lateral to the subtalar joint, causing it to want to pronate, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

posterior tibialis eccentric contraction controlling plantarflexion

During load response, since the GRF is medial to the subtalar joint, causing it to want to pronate, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

posterior tibialis eccentric contraction controlling pronation

During SC rotation, the clavicle rotates _______ (anteriorly/posteriorly) during shoulder abduction and flexion

posteriorly (clavicle spins on articular disc)

The more severe the original polio infection is, the more severe the effects of ______________ syndrome will be

postpolio syndrome

Outcome measures provide _____________ validity. For example: fall risk.

predictive

If a person's score on a gait speed test is below 0.56 m/s, what does this mean?

predictive of recurrent falls

What does anything under 45 on the Berg Balance Test indicate?

predictive of recurrent falls

How do H2 antagonists work?

prevent the histamine-activated release of acid under resting conditions and during stimulation with food

What is the function of the coracohumeral ligament?

prevents excessive ER and extension

What is signal transduction?

process by which a cell converts one kind of signal or stimulus (extracellular) into another (cellular responses) -uses sequence of events to communicate outside the cell to inside the cell

What is the main function of mitochondria?

produce ATP for cellular activities

What do anti-spasmodic opiates do?

produce a general dec. in GI motility

What happens to RBC as they mature?

produce hemoglobin have enlarged ER small golgi apparatus lose lysosomes

What is glycogenesis?

production of glycogen from glucose

What is gluconeogenesis?

production of new glucose from proteins and fat

What is Guillain-Barre syndrome?

progressive muscle weakness and areflexia/flaccid paralysis that starts in the legs

Describe the gait of a person with Parkinson's disease;

propulsive gait: short, shuffling steps with inc acceleration

What does Ritonavir (Norvir) do to treat HIV? What makes it less useful?

protease inhibitor, interacts with a lot of other drugs, and HIV needs to be treated with a combination of drugs

What process must happen once a protein is synthesized before it can be functional?

protein folding

Muscle contractions are described according to _________

pulse frequency

During load response, since the GRF is posterior to the knee, causing it to want to flex, which muscle group is active in trying to control the movement? What kind of contraction is that muscle group engaging in?

quadriceps eccentric contraction controlling flexion of the knee

During pre-swing, since the GRF is posterior to the knee, causing it to want to flex, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

quadriceps eccentric contraction controlling knee flexion

If a tumor grows rapidly, signs of inc intracranial pressure develop slowly or quickly? Rapidly growing tumors usually present with headaches at what time of day?

quickly morning

Is the onset of meningitis rapid or insidious?

rapid/sudden

What does status epilepticus mean?

recurrent or continuous seizures without recovery of consciousness (must be treated immediately)

What does a FEV1/FVC% measurement represent?

represents the proportion of a person's vital capacity that they are able to expire in the first second of forced expiration

The prescription version of H2 receptor antagonists are used to treat:

reflux disorders & peptic ulcers

What is the function of the posterior SC ligament at the sternoclavicular joint?

reinforce joint capsule and limit anterior movement of medial end of clavicle

What is the function of the anterior SC ligament at the sternoclavicular joint?

reinforce the capsule and limit posterior movement of medial end of clavicle

How can you reduce the risk of falls that lead to revision surgery s/p amputation?

removable rigid dressing (protects the residual limb in case they fall)

What is a side effect of gentamicin?

renal function impairment

What is a benefit of flucytosine?

resistance develops rarely

What has been a major issue in clinical settings with vancomycins recently?

resistance with enterococci

What type of responses to altered conditions can occur in cellular adaptation?

reversible (ceases when stressor removed) or irreversible (eventually results in death)

How are silicone liners applied?

rolled over limb (not stretched) can be removed for incision inspection

When screening the spine in an objective exam, what should you consider?

ruling out the possibility of referral symptoms especially from the spine (helps ensure correct diagnosis, shouldn't last more than 5-10 mins)

What type of joint is the CMC of the thumb?

saddle/sellar

External moments act in the _______ plane

sagittal

The interaction of an antacid + HCL produces:

salt + water

For flexion/extension of the CMC of the thumb, the roll and glide are in the _______ direction

same

For the distal radioulnar joint, roll and glide happen in the ________ direction

same

What is smooth ER called in muscles?

sarcoplasmic reticulum

With a FOOSH where the wrist was extended and radially deviated, what bone is likely to fracture?

scaphoid

What does Watson's test help confirm?

scaphoid-lunate dislocation

What does MMSE screen for?

screening tool for cognitive impairment

Which etiology of seizures occur after head injury or infection?

secondary/acquired

Children with congenital disorders, like cerebral palsy, may have _______________ resulting from brain damage

seizures (primary/idiopathic etiology)

What type of bacteria is tobramycin used to treat?

serious gram-negative bacteria and staphylococci (gram-positive)

What is the role of an enzyme? What is an enzyme made up of?

serve as a catalyst to a reaction, enzymes are proteins (not all proteins are enzymes)

What is the most common cause of COPD?

smoking

What are the two types of ER?

smooth and rough

According to Kaltenborn, what are 3 normal end feels?

soft firm hard

During mid-stance, since the GRF is anterior to the ankle, causing it to want to DF, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

soleus eccentric contraction control anterior tibial movement (DF)

During terminal stance, since the GRF is anterior to the ankle, causing it to want to DF, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

soleus eccentric contraction controlling anterior tibial movement (DF)

During pre-swing, since the GRF is anterior to the ankle, causing it to want to DF, which muscle group is active in trying to control this movement? What kind of contraction is that muscle group engaging in?

soleus and gastroc *concentric contraction* for pushoff

What are local (focal) effects in terms of neurological disorders?

specific effects based on the area of the brain or spinal cord that's affected

What is the function of the TFCC?

stabilizes the radioulnar joint and protects against compressive forces

Velocity changes during gait with each ______

step

The optimal balance between competence and environmental press that is optimal for patient improvement is called the level of _____?

stimulation if one variable is too high it can result in a negative effect

What is the typical standing posture of someone with Parkinson's disease like?

stooped, leaning forward

What are the key steps of lipid oxidation?

stored in adipocytes lipolysis circulation transport to mitochondria beta-oxidation

What is the function of the transverse humeral ligament?

strengthens shoulder capsule

What are 4 *distance variables* of gait? (read)

stride length step length step width step angle

Which breath sound can sometimes be heard without a stethoscope?

stridor

What happens in the ictal stage of a tonic-clonic seizure?

strong thoracic muscle contractions briefly in flexion, followed by extension of the limbs and rigidity in the trunk

For NMES used for muscle strengthening, what level of muscle contraction do you want to achieve?

strong, visible contraction

With NMES used for muscle re-education, you want what level of muscle contraction?

strong, visible muscle contraction

With NMES used for contracture management, what level of muscle contraction do you want to achieve?

strong, visible, comfortable contraction

After taking a _____________ , you should have a very good idea of what is going on. (subjective or objective)

subjective

Define gait:

successive episodes of losses and recoveries of balance

What is the backbone of DNA?

sugar and phosphate

How does high SPF sunscreen affect vitamin D production?

sunscreen protects you from developing skin cancer, but prevents you from getting enough vitamin D to prevent osteoporosis

The results from a 6 minute walk test are not validated to fall risk, but instead are validated to:

survival rates

What must happen before massage and tapping can take place in amputation rehab.? Why is massage & tapping a part of amputation rehab.? How often should it be done?

suture line must be fully healed to prevent skin breakdown w/ prosthetic use 2-5 min, 3-4x/day

What is the general function of ER?

synthesize macromolecules (proteins, fats, carbohydrates)

How can tetracyclines be administered?

tablets, capsules, topically or IV

How do vancomycins work?

target bacterial cell wall synthesis

How do penicillins work?

target bacterial cell wall synthesis by inhibiting peptidoglycan synthesis

What determines how many times a cell can reproduce?

telomeres

What is an acini?

the area of a lung that one terminal bronchus supplies (not the same thing as alveoli)

The manifestations of multiple sclerosis are determined by:

the areas of demyelination

What is glycogenolysis?

the breakdown of glycogen into glucose

What are instrumental ADLs (IADLs)?

the more complex skills - such as caring for dependents, maintaining a home, performing household chores and tardwork, shopping, and structured play that are important components for maintaining independent living

What is a significant sign that someone is in the late stages of Alzheimer's disease?

the person does not recognize his or her family

What is an H2 receptor?

the subtype of the histamine receptor in the stomach

What is diffusion?

the transportation of molecules from high to low concentration through a semi-permeable membrane Does NOT require energy

What is the problem with laxatives?

they are frequently abused

Where do brain tumors metastasize? What does this mean for their prognosis?

they do not metastasize outside of the CNS they will cause death before they are large enough to cause general effects

How do sulfonamides work?

they inhibit bacterial synthesis of folic acid that is needed for synthesis of nitrogenous bases (enzyme in DNA synthesis)

Why are penicillins so widely used?

they treat a broad spectrum of infectious agents

What happens to the LE when the initial swing phase occurs? When does the initial swing phase start and end?

thigh advances, foot clears the ground from when limb leaves the ground to maximum knee flexion

Why is asking about past history for a patient so important?

this can help determine their prognosis recurring issue = worse prognosis

Why is protein folding beneficial?

this form is thermodynamically efficient

Who should receive a referral to PT for osteoporosis?

those who have: -fall risk -unstable gait -noted weakness

How is fuel obtained from carbohydrates (glucose) for cellular respiration?

through glycolysis and aerobic respiration

What are some signs of toxicity for kanamycin and neomycin?

tinnitus, extreme vertigo, decreased renal clearance, increased level of blood urea nitrogen (BUN)

Why does the knee of the posterior limb flex slightly (~15-20 degrees) when the anterior limb makes initial contact?

to accept the weight of the body

What is the goal of diffusion?

to achieve equillibrium

What is the function of rRNA?

to associate with a set of proteins to form ribosomes, also they catalyze the formation of amino acids into protein chains

Why do RBC need enlarged ER?

to be more efficient and produce more hemoglobin

Why might it be important to ask a patient which is their dominant hand?

to compare if the dominant side symptoms are the same or different

What is the function of tRNA?

to decode the sequence delivered by the mRNA into a protein (transfers the information from mRNA to a place where proteins are made (ribosomes))

What is one theory for the purpose of the 6 determinants of gait?

to minimize energy expenditure by minimizing change in COM and to create an efficient movement pattern

T/F: a secondary evaluation of a patient with osteoporosis should include fall risk

true

Why is it important for transfemoral amputees to have good adductor strength?

to prevent the residual limb from going into abduction (Note: in a normal LE, the femur rests in adduction) if it goes into abduction, glute med. will no longer be on stretch and you won't have as much support when you go into SLS

How may tobramycins be administered?

topically, injections or inhalers

The pelvis shifts laterally ________(towards/away) the weight-bearing limb during gait

towards

What is the most likely limitation of amphotericin B?

toxicity causing renal impairment/failure (renal damage almost eminent in all patients)

What are some basic examples of ADLs?

transfers bathing grooming dressing feeding toileting

What are functions of a cell?

transport ingestion (endocytosis) secretion (exocytosis) respiration communication reproduction

What are the 2 bones that articulate to make the CMC joint of the thumb?

trapezium and 1st metacarpal

What is the MOI for a TFCC disc injury?

trauma (typically FOOSH) OR overuse injury from repetitive pronation & gripping with load through the wrist

What are the causes of CTS?

trauma or overuse of flexor muscles (posture of hands)

The MOI for hand/wrist symptoms is likely one of the two following:

trauma/acute overuse

Classification of clinical syndromes (read):

traumatic/FOOSH: -colles/smith fractures -scaphoid fx -Boxer's fx -mallet finger -lunate dislocation -scaphoid-lunate dislocation -Kienbock's disease -TFCC disc injury Overuse: -CTS Disease specific: -Raynaud's phenomenon -complex regional pain syndrome

The goal of rehabilitation with hand/wrist symptoms is to return to function, how should this influence your plan with therapeutic exercises?

try to relate them to functional tasks rather than performing mundane/flexion and extension exercises

Which soft dressing would be good for bulbous, sensitive limbs?

tubular elastic

H2 antagonists are used for both acute and long term management of _____

ulcers

The 3 general types of seizures include partial, generalized and __________________ seizures

unclassified

What is cellular anaplasia?

undifferentiated cells with variable nuclear and cell structures (characteristic of cancer)

PAM can be classified as restricted or _________?

unrestricted

Increased tone and hyperreflexia are indications of __________________ motor neuron damage

upper

How is desensitization done in amputation rehab? What should you make sure not to do while performing desensitization? How often should it be done?

use different textures over residual limb to make them less sensitive to touch never want to stretch the suture line during this 2-5 min, 1-2x/day

What should you do if no one is available to help you don a tubular elastic?

use one of those cylindrical applicators that are open on both ends to apply it

Do penicillins have any negative side effects?

usually no, except for in people with hypersensitivity reactions to the drug

An external moment depends on the GRF _______________'s relationship to the _____________ axes

vector joint

If symptoms don't change much with activity or body position, the origin is most likely musculoskeletal or visceral?

visceral

If there is no clear MOI, is the origin of pain likely visceral or musculoskeletal?

visceral

When pt describes the location of their pain, what should you keep in mind?

visceral referred pain -visceral pain is usually more dull and generalized -musculoskeletal pain is more sharp and focused

What symptoms occur due to an occlusion of the posterior cerebral artery (occipital lobe)?

visual loss

Abduction of the CMC of the thumb involves a _______ roll and a _______ glide

volar roll dorsal glide

Flexion of the thumb involves a _________ roll and a ________ glide

volar/ulnar roll volar/ulnar glide

In which direction is the lunate commonly dislocated?

volarly

How does fatigue vary with voluntary vs. electrical-induced muscle contraction?

voluntary has varied motor unit response = less fatigue electrical-induced the same motor units respond

How is the firing of neurons different with voluntary muscle contraction vs. electrical-induced muscle contraction?

voluntary is asynchronous whereas electrical-induced is synchronous

For voluntary muscle contractions, the movement is _______ depending on ________. Whereas for electrical-induced muscle contraction is a(n) __________ response, depending on _________

voluntary is graded depending on load electrical-induced is all or nothing depending on intensity

What may increase the amount of lateral pelvic tilt during gait?

weak gluteus medius (Trendelenburg if significant)


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