Selected Topics Final
septic bursitis
- Infection can occur in the absence of trauma due to • Skin breakdown • Poor blood supply - S&S • Area hot and tender to touch; swelling • Restricted ROM • Individual shows traditional signs of infection (e.g. malaise , fever) - Management • Physician referral
myositis
- Inflammation of muscle tissue (e.g., shin splints)
fasciitis
- Inflammation of the fascia (e.g., plantar fasciitis)
epiphyseal fracture
- Little league shoulder - proximal humerus; due to repetitive medial rotation & adduction - S&S • Acute shoulder pain with throwing hard • Pain with deep palpation in axilla - Management • Cold; sling & swathe; immediate referral to a physician or emergency care facility
Posterior SC sprain
- MOI • Blow to the posterolateral aspect of the shoulder with the arm adducted and flexed - Concern: structures involved (heart, esophagus, trachea, aorta) • Unable to perform shoulder protraction • Numbness & weakness of upper extremity • Difficulty swallowing • Diminished pulse - Management: activate EMS
avulsion fracture of the shoulder
- MOI • Coracoid process due to forceful throwing • Greater and lesser tubercles: associated with dislocation - S&S: pain with deep palpation at site - Management: • Cold; sling & swathe; immediate referral to a physician or emergency care facility
Sternoclavicular (SC) Joint Sprain
- MOI • Indirect force through humerus • Blow to the clavicle - Displacement: superior and anterior and medial signs and symptoms include • 2°: unable to horizontally adduct; holds arm forward and close to body • 3°: prominent displacement of proximal clavicle • Management: cold; sling; physician referral
bicipital tendinitis
- MOI • Repetitive overhead activities involving excessive elbow flexion and supination; tendon passes back and forth in groove • Direct blow • Subsequent to impingement syndrome • Pain and tenderness at bicipital groove with internal and external shoulder rotation • Pain with passive stretch in extreme shoulder extension with elbow extended and forearm pronated - Management: do not permit to continue activity until seen by a physician - Prolonged tendinitis makes tendon vulnerable - MOI: forceful flexion against resistance - S&S • Hear and feel a snap • Intense pain • Visible palpable defect in muscle belly during flexion; "Popeye" appearance if mass moves distally •Weakness: flexion and supination of forearm - Management: cold; sling; immediate referral to a physician or emergency care facility
subacromial bursa
- MOI: impinged during overhead motion - S&S • Sudden shoulder pain: initiation and acceleration phase of throwing • Point tenderness on anterior & lateral edges of acromion process • Painful arc during passive abduction • Pain sleeping on involved side - Management: do not permit to continue activity until seen by a physician
• Acromioclavicular (AC) Joint Sprain
- MOI=direct blow • Fall on point of shoulder • Fall on outstretched arm -diagnose with cross arm test
metacarpal fracture (typical)
- Mechanism: axial compression - S&S: • ↑ pain and palpable - palm, directly over involved metacarpal • ↑ pain with percussion and compression - Management: immobilize in position of function; ice without compression; immediate physician referral
distal radius/ulna fracture
- Mechanism: axial loading; fall on outstretched hand - Monteggia's • Distal ulna with associated dislocation of radial head - Galeazzi's • Distal radius with associated dislocation or subluxation of distal radioulnar joint - S&S • Intense pain, swelling, deformity, and a false joint • Possible • Circulatory impairment • Median nerve may be damaged as it passes through the forearm. -Complication: Volkmann's contracture • S&S: hand is cold, white, & numb; severe pain with passive extension of fingers - Management: immobilization; immediate physician referral
phalangeal fracture
- Mechanism: compression; hyperextension - S&S: • ↑ pain with circulative compression of phalanx • ↑ pain with percussion and compression (long axis) - Management: immobilize in position of function; ice without compression; immediate physician referral
chromosomal abnormalities
- Nondisjunction ● Deletion ● Translocation are these
spasm
- Reflex action caused by: • Biochemical imbalance or • Mechanical blow to nerve or muscle -short duration
chronic injury
- Repeated forces - Characterized by becoming more problematic over time (Gradual onset over time) - Forces = microtrauma overwhelms the tissue - 30 - 50% are due to overuse -bursitis, tendonitis, etc.
acute injury
- Single force - Characterized by a definitive moment of onset - Force = macrotrauma
SC joint
- Superior sternum with the proximal clavicle • Joint capsule and ligaments • Ball-and-socket joint
gamekeepers thumb
- Tear of the ulnar collateral ligament at MCP joint - MOI: forceful abduction of the thumb when the MCP of the thumb is near full extension - S&S • Palmar aspect of joint is painful and swollen; possible ecchymosis • Instability - Management: • Standard acute; physician referral
bone
- grows longitudinal • Continues until epiphysis closes - Diameter • Continues to grow throughout life - New bone formed via the periosteum; bone is resorbed around the medullary cavity • Osteoblasts: form new bone • Osteoclasts: resorb bone
Shaken Baby Syndrome
- majority are < 1 yo & most are 6 - 8 wks old ◦ SDH ◦ Retinal Hemorrhages ◦ No signs of external trauma ◦ B/L rib fractures ◦ Other intracerebral injuries ◦ Small "chip" fractures major joints of extremities (shaking) ◦ Poor feeding, altered mental status, seizures ◦ 1/3 die; 1/3 severe lifelong disabilities including blindness, paralysis, mental problems, developmental problems and seizure disorders
congenital limb deficiencies
- small number born with or acquiring a limb deficiency -vast majority have no known etiology -child's changing developmental capabilities continuously alter the team treatment plan - must keep the doors open for long-term goals and yet provide for optimal functioning - successful outcome depends on treatment of the whole family - very pleasant clients which usually do very well in a healthy family unit
Stages of Motor Control
1. mobility 2. stability 3. controlled mobility 4. skill
edentulous
40% of the elderly are this.
stress
= Force x Surface area affected • Same force over a large area vs. a small area can have very different results
22
A BMI under this number indicated the patient is high risk
18
A Q angle greater than how many degrees can predispose the individual to patellar injuries
24
A TUG test greater than this number predicts falls within 6 months after hip fracture
Quadriplegia
A classification of Cerebral Palsy that involves ALL four limbs is called:
Hemiplegia
A classification of Cerebral Palsy that involves impairment of Upper and Lower limbs of one side of the body is called:
An intensive strengthening program
A patient with cerebral palsy has undergone Selective Dorsal Rhizotomy (SDR) with the goal of maintaining ambulation. After surgery, when ambulation is the goal, an appropriate entry in the physical therapy plan of care includes:
dementia
A progressive decline in cognitive function due to damage or disease of the brain and affecting two or more areas of cognitive function and interfering with day to day function.
serious mental injury
A psychological condition caused by an act or failure to act ◦Child becomes: ◦ Severely anxious, agitated, depressed, socially withdrawn, psychotic, or in reasonable fear that life or safety is threatened ◦ Seriously interferes with a child's ability to accomplish age-appropriate developmental and social tasks
motor control
A stimulus produces a reflexive motor response in infants, and provides feedback accuracy, and reinforces maintenance of developmental postures. Intrinsic and extrinsic feedback important
Moro reflex
A sudden extension of neck results in flexion, abduction of shoulders, extension of elbows and the enxtension, abductionof shoulders, flexion of elbows. Usually results in crying. What is this reflex called?
30
A tug score greater than this is predictive of requiring assistive device for ambulation and being dependent in ADLS.
type 3
A type of AC sprain involving rupture of the AC ligament and coracoclavicular ligament
dopamine
Aging
cortical dementias
Alzheimers disease, vascular dementia, dementia with Lewy Bodies, Alcohol Induced persisting dementia (Korsakoff's and Wernickes encephalopathy), and frontotemporal lobar degenerations are examples of these
Supported side-lying while doing visual (use black, white, and red objects 9 inches away), and auditory tracking and reaching, midline position of head
An appropriate PT intervention/activities to teach parents are play activities and positioning to facilitate shoulder protraction, adduction such as:
Level 3 (An infant at Level 3 will be able to maintain floor sitting when the low back is supported and can roll and creep forward on the stomach_
An infant who maintains floor sitting when the low back is supported and can roll and creep forward on the stomach should be classified at what level, according to the Gross Motor Functional Classification System?
posterior displacement of the clavicle
An injury after receiving a blow to the sternum, an individual has difficulty swallowing and breathing and a diminished pulse.
muscle spasm
An involuntary contraction of short duration caused by reflex action that can be biochemically derived or initiated by a mechanical blow to a nerve or muscle
cortical dementias
Arise from a disorder affecting the cerebral cortex which play a primary role in cognitive process such as memory and language.
reflexes
As we mature, our brain inhibits these
PIP dislocation
Because digital nerves and vessels run along the sides of the fingers and thumb, they could become damaged during a dislocation of this or the reduction of the dislocation. AS such, the coach should not attempt to reduce this Immediate treatment for this involves immobilization in a finger splint, application of cold, and referral to a physician.
tensile force
Both sprains and strains are what MOI?
Hypoxic-Ischemic Encephalopathy
Care of the preterm infant with HIE includes: • First and foremost - prevent hypoxemia • Careful monitoring by neurological assessments • Maintain adequate oxygenation • Administer anti-seizure drugs • Control brain swelling • Assessment of structural status of brain with CT scan, ultrasound, MRI, EEG or Evoked Potential Tests (Brainstem Auditory Evoked Response - click in ear and study brain waves on monitor)
aging
Characteristics of this include: ■ cellular and physiologic deterioration ■ increased mortality with age following maturation ■ increased vulnerability to disease ■ decreased ability to adapt to stress • impaired homeostasis
Spina bifida
Congenital incomplete closure of the vertabrae
coracoclavicular joint
Coracoid process of scapula with the inferior surface of clavicle • Coracoclavicular ligament - Minimal movement permitted
Office of Special Education Programs (OSEP)
Drafts regulations for implementing the IDEA Conducts activities under Part D Monitors and enforces the law Provides technical assistance to states
normalizing
During the process of aging, this helps individuals understand what to expect.
WW1
During this time, rehabilitation was provided by the reconstruction aides which were started by the surgeon general
upper brachial plexus injurt
Erb's palsy is what?
3 months
For a child with an upper extremity limb deficiency, how early does prosthetic wear occur?
Cerebral palsy (CP)
Group of conditions caused by a non-progressive lesion on the brain most often it has its origin before birth, at birth, or after birth and is caused by an interruption of oxygen to the brain of the fetus or new born.
cephalocaudal development
Head control is developed before trunk control • Begins with neck movements, followed by head control, and then trunk control but there is overlap • Tonic motor control • Maintained responses (small ROM)directed towards stimuli • Upper extremity function is mastered before lower extremity skills
motor learning
How an individual learns modifies a motor task. Learning that occurs over hours, days, or weeks.
kinesio taping
Improves joint alignment generally through balancing agonist and antagonist muscles. Enhances kinesthetic awareness
APTA's Section on Pediatrics
In 1973, Bud DeHaven lead the establishment of this, which is now called the Academy of Pediatric PT
polio vaccine
In the 1950's, this was developed. PT intervention for CP was beginning.
mallet finger
Inability to fully extend the DIP joint of the index finger with the forearm pronated?
bursitis
Inflammation of bursa • Acute or chronic • MOI: - Compression • S&S: - Localized swelling - Point tenderness - Warm to touch
direct service
Instruction or service by a single special education provider designed to support, bridge and strengthen student skills. - Opportunity to provide specific skill instruction, reteach, pre-teach, and scaffold instruction to support student goals and objectives and to access the curriculum.
extra capsular
Intertrochanteric and subtrochanteric fractures are these type of hip fractures
cystic fibrosis
Intervention of this includes: -chest PT -postural drainage -exercise
muscle strength
Interventions to include this should occur 2 days/week at 10 RM
cramp
Involuntary muscle contraction - Biochemical imbalance (dehydration) associated with muscle fatigue - Painful
chronic
Is achilles tendonitis chronic or acute injury?
Galant
It is a sharp stoke along paravertebral line from scapula to top of iliac crest results in lateral trunk flexion toward stimulated side. What is this reflex called?
Decreases superficial lymphatic flow for edema reduction.
Kinesio Taping has the following physiologic effects except: Enhances nervous system connections through the skin. Decreases pressure and inflammation Enhances kinesthetic awareness. Correct! Decreases superficial lymphatic flow for edema reduction.
lower brachial plexus injury
Klumpke's Palsy is what?
rigidity
Lead pipe and cog wheel, occurs in trunk and extremities
American Academy of Cerebal Palsy and developmental medicine
Mary Trainor, B Crothers, and Dr. W Phelps completed work to establish this
Functional reach test
Measures how FAR the person can reach forward without losing balance
motor development
Milestones of the developmental sequenced the kinesiology components of movement. Motor abilities that develop over months, years and decades.
Cystic fibrosis (CF)
Most common inherited chronic pulmonary disease among white children, characterized by production of thick mucous with progressive lung damage
muscle weakness
Most common side effect of meds
Germinal Matrix-Intraventricular Hemorrhage (GM-IVH)
Most common type of neonatal intracranial hemorrhage especially in premature infants less than 32 weeks of gestational age and weighing less than 1500 grams (<3.5 lbs.) • 18% of those < 32 weeks & 1500 g. will get this ) • Most will occur within the first 2 days - 1 week after birth • Diagnosed most commonly with ultrasound (no radiation) but sometimes with CT scan • Graded I to IV scale depending extent of hemorrhage
Developmental coordination disorder (DCD)
Motor condition in children with dysfunctions and motor coordination problems such as: awkward running, frequent falling, slow reaction times, immature balance reactions, poor handwriting, difficulty with AILDs
Dynamical systems theory
Movement emerges from the interaction of multiple body systems.
1. mobility 2. stability 3. controlled mobility 4. skill
Name the 4 stages of motor control
Neonatal neck righting
Neck righting on body, NOB. Turn head when infant is is supine, body logs roll towards same side. What is this reflex called?
premature
Need a highly controlled environment - Radiant warmer - Incubator - Hybrid bed (Giraffe)
Positive Gower's sign
Occurs in patients with diagnose with Duchenne's Muscular Dystrophy, and because of weak quadriceps and gluteal muscles, child must use upper extremities to "walk up legs" to rise from prone to standing. This is called:
bicipital tendinitis
Pain and tenderness over the bicipital groove when the shoulder is internally and externally rotated may be indicative of
Gamekeeper's thumb
Pain with stressing the MCP joint of thumb in flexion?
foot deformities
Patients with myelodysplasia at the low lumbar level typically experience what type of musculoskeletal problems?
maturation
Physical changes due to preprogrammed internal body processes
Parkinsons
Pill-rolling and tremors, shuffling, festinating gait describes what?
constant practice
Practice of a given task under a uniform condition
Palmar grasp
Pressure stimulus against palm results in grasping of objects with slow release (0-4 months). This reflex is called?
Plantar grasp
Pressure stimulus to sole or lowering of feet to floor results in curling of toes. (must be integrated before walking occurs). This reflex is called?
adaptation
Process by which environmental influences guide growth and development
Duchenne muscular dystrophy (DMD)
Progressive pelvic muscle weakness and waisting in a male child, combined with enlarged yet weak thigh muscles and tight heel chords Prognosis:Death in 20's from respiratory or cardiac failure
Americans with Disabilities Act
Protects rights of all individuals with disabilities
Traction pull to sit
Pull infant to sit from supine: upper extremities will flex and there will be head lag until 4 - 5 months. This reflex is called?
Rehabilitation Act
Requires provision of reasonable accommodations, including PT, for persons with disabilities
Cerebral palsy
Selective dorsal rhizotomy (SDR) is a surgical transection of electromyography (EMG)- selected dorsal sensory rootlets with the goals of facilitating or maintain ambulation or improving ease of care. This procedure will be most likely performed in patients with:
IFSP
Service plan utilized with children from infancy thru 2 years to support the child and family to enhance development. Broad in scope. Family makes decisions. Happens at home.
Hypoxic-Ischemic Encephalopathy
Signs of this include: • Apneic episodes (stop breathing) • Seizures • Abnormal state of consciousness • Abnormal muscle tone • Disturbed suck, gag, swallow, and tongue movements • Loss of autonomic functions
Hypoxic-Ischemic Encephalopathy
Stages of this include: • Stage 1 - less than 24 hours - Hyperalertness - Decreased Moro and stretch reflexes - Normal muscle tone • Stage 2 - approximately 5 days - Lethargy - Mild hypotonia (low muscle tone) - Strong tonic neck reflex when turning head - Seizures • Stage 3 - lasts a few hours to 4 weeks - Stupor - Very low muscle tone - Absent reflexes - Response only to strong noxious stimuli
congenital limb deficiencies
The environmental etiology of these include: -Precise origin unknown -Speculate Vascular/Thromboembolism -Mechanical: Amniotic Bands -Maternal causes -Pharmaceutical: ● Thalidomide only proven drug ● Others suspected, no convincing evidence
premature birth
The fetal factors for this include - Chromosomal Abnormalities - Intrauterine Infection - Anatomic abnormalities - In utero substance exposure
False
The injury sustained by the 38 year old male,a second degree groin strain of the right adductor muscles, is a hard tissue injury. True or False?
Tension
The mechanism of injury for medial epicondylitis is what?
compression
The most common mechanism of injury that produces a SC joint sprain involving an anterior displacement is what?
special education
The purpose of an initial eligibility evaluation for this is to determine whether a child has a disability and the nature and extent of the special education and related services that the child needs • This evaluation may or may not include an physical therapy assessment, depending on the areas of concern.
dementia
The sequence of this includes deterioration of the brain due to disease • Cognitive deficits result from impaired brain function • Cognitive decline results in decreased functional abilities • Cognitive and functional deficits can lead to behavioral problems
GDS
The seven stages of this include: • Stage 1 - Normal: No Cognitive Deficits • Stage 2 - Very Mild Cognitive Decline (Forgetfulness) • Stage 3 - Mild Cognitive Decline (Early Confusional) • Stage 4 - Moderate Cognitive Decline (Late Confusional) • Stage 5 - Moderately Severe Cognitive Decline (Early Dementia) • Stage 6 - Severe Cognitive Decline • Stage 7 - Very Severe Cognitive Decline
vitamins and herbs
These are highly present among older adults, and are generally not reported to the physician.
athletic training
These individuals study - Acute care of injury and illness - Assessment and evaluation - General medical conditions and disabilities - Health care administration - Nutritional aspects of injury and illnesses - Pathology of illness and injuries - Pharmacological aspects of injury and illnesses - Professional development and responsibility - Psychosocial intervention and referral - Risk management and injury prevention - Therapeutic exercise - Therapeutic modalities
C7-T1
These nerve levels innervate the intrinsic muscles of the hand.
Polio Epidemic
This began in 1917. It involved inflammation of the grey matter of the spinal cord. 27,000 affected and 7,000 deaths. -Robert Lovett, MD and W Wright in Boston used muscle testing, their technique was primary treatment for polio into the 1940's.
vascular dementia
This causes loss of attention, with changes in other congition and motor function occuring based on location of lesions.
Lewy Body Dementia
This causes psychiatric changes and motor loss, as well as fluctuations in mental status
Erb's palsy
This characteristic in arm postion is seen in which brachial plexus injury? - UE is in adduction, internal rotation of shoulder with extension of elbow, pronation of forearm and flexion of the wrist
Respiratory Distress Syndrome
This condition is due to atelectasis (collapse of lungs) caused by insufficient surfactant in premature lungs, which may lead to acute respiratory failure and death
path deviation
This could be indicative of peripheral neuropathy or CVD.
pharmacodynamics
This describes what the medication does to the body
memory
This domain of cognition includes - Multiple memory processes - Semantic, episodic, procedural, sensory - In SDAT, encoding of new memory declines first - Retrieval of memory deteriorates until end stage disease - Sensory and procedural memory are relatively stable until later in disease
visuospatial
This domain of cognition includes: - Deficits develop relatively early in disease, but are subtle - With deterioration, function is impacted - Ability to judge self in relation to space is impaired - Affects ability to navigate, purposeful movement, judgment of distance • Electric wheelchair, wandering, finding own room
language
This domain of cognition includes: - Naming deficits occur in all after age 30 - Expressive deficits typically occur first - Receptive deficits noted in mid-disease - Environment, content of communication and individual factors affect this function - Increased comprehension enhanced in controlled circumstances
posttraumatic headache
This is a localized area of blindness that may follow the appearance of brilliantly colored shimmering lights
dislocation
This is a traumatic injury that occurs when the bones that comprise a joint are forced beyond their normal position, resulting in the displacement of one joint surface on another. The resultant damage includes rupturing of the joint capsule and ligaments as well as potential tearing of surrounding muscle-tendon units. Because this results in extensive damage and stretching of the connective tissues surrounding a joint, there is increased susceptibility for chronic or recurrent dislocations. Less force is required to sustain a recurrent dislocation.
aricept
This is an anit-Alzheimers agent. It is used to help memory functions.
Remerson
This is an anti-depressant
Coumadin
This is an anticoagulant used for blood clots
coumadin
This is an anticoagulant used to treat or prevent blood clots.
Zoloft
This is an antidepressant. Used for depression or OCD
NET
This is an innovative approach to effectively provide therapy services to individuals with cognitive loss and dementia.
best friends approach
This is approaching the person as if they were your best friend • Recognize the importance of the moment for the person with dementia • Familiarity, warmth, knowledge of life history and positive emotional tone all serve to facilitate interactions
thrombectomy
This is direct aspiration by a large catheter at the site of a thrombus, there is rapid and painless clot extraction, and the intact clot extraction may reduce distal emboli
antalgic gait
This is due to pain
intra-arterial
This is effective for large vessel occlusions
aging
This is influenced by genetics, physiology, lifestyle and socioeconomics
little league elbow
This is is a condition that affects the medial humeral apophyseal growth plate, an area particularly vulnerable to injury in the adolescent athlete. The injury occurs as a result of tension stress from valgus forces that are associated with the acceleration phase of throwing. Swelling, ecchymosis, and point tenderness develop directly over the humeroulnar joint, or on the medial epicondyle. Pain is usually severe and aggravated by resisted wrist flexion and pronation and by a valgus stress. If the ulnar nerve is involved, tingling and numbness may radiate into the forearm and hand, particularly the fourth and fifth fingers.
focal brain injury
This is localized brain damage. Can be epidural, subdural or intracerebral hematomas
absorption
This is moving from the site of administration to the bloodstream
aging
This is not a disease, it occurs at different rates among individuals and within individuals. Does not generally cause symptoms
depression
This is often a precursor to dementia. Exacerbates functional deficits functional deficits. Behavioral challenges may be more prevalent. Meds may be helpful to treat mood and behavior
nociceptive pain
This is pain from tissue damage
6 years
This is the age when children: ● Stand on one foot for 10 seconds ● Developing sports skills
carbohydrates
This is the best fuel for muscles
plantar flexion and inversion
This is the common MOI for a lateral ankle sprain
excretion
This is the elimination of metabolites of medications
preclinical stage
This is the stage of AD is defined as stage in which pathophysiological findings are present, but observable syndromes are not
dexa scan
This is used to diagnose osteopenia and osteoporosis
APGAR
This test developed for full term newborn, infant and child as part of the pediatric examination. It is a screening test administered to newborns at 1 minute, 5 minutes, and 10 minutes after birth. It includes five items such as: - Heart rate, respiration, reflex irritability, muscle tone and color. Each item is scored 0,1 or 2. A score of ≥ 7 is considered to be good. This test is called?
neuronal group selection theory
This theory of motor development states that motor skills result from the interaction of developing body dynamics and the structure /functions of the brain
Seroquel
This treats schizophrenia and bipolar disorder
sexual abuse
This type of abuse is classified by Laceration or bruising of labia, penis, scrotum or perineum ◦ Laboratory findings of sexually transmitted infection ◦ Children involved in sexual activities that they cannot understand, are not developmentally prepared for, they cannot give informed consent for, or violate societal taboos.
vitamin E
This vitamin can work against cholesterol and warfarin
Sucking
Touch to lips, tongue, palate results in automatic sucking. This is an important feeding reflex. What is this reflex called?
intraventricular and periventricular hemorrhages
Treatment for these include: • Maintain arterial blood pressure to support cerebral perfusion • O2 support • Limit noxious handling of infant • Medications - Phenobarbital (anti-seizure) - Pancuronium - Trade name is Pavulon -a strong muscle relaxant - Ethamsylate - reduces capillary bleeding • Monitor ventricle size with ultrasounds • Monitor intracranial pressure • May need ventriculostomy or shunting for hydrocephalus (tube in ventricle to remove extra cerebral spinous fluid)
neonatal seizures
Treatment of these includes: • Monitor with electroencephalograph (EEG) • Anticonvulsants - such as phenobarbital, phenytoin, and diazepam to control the seizures and intravenous glucose if cause is hypoglycemia • Oxygen
osteoporosis
Treatment of this includes biophosphonates, Vitamin D, Calcium supplementation, hormone replacement and possibly exercise
True
True or False. The prevention of injuries to the pelvis, hip, and thigh should include strengthening exercises for both the hip and knee.
False
True or False: An individual with a mild quadriceps contusion will walk with a limp but will have only mild pain and swelling.
skill
Walking requires this. Fine dextrous movements and manipulation. Distal, voluntary phasic while proximal involuntary controls
Vitamin K
Warfarin works against this vitamin
popeye appearance
a classic sign associated with a biceps tendon rupture
Down syndrome
a condition of intellectual disability and associated physical disorders caused by an extra copy of chromosome 21.
adolescence
age of onset is ~11-12 in females and ~12-13 in males; lasts until the onset of adulthood (usually 18-21 years of age); begins with the physical changes that begin puberty and ends when physical growth ceases
CNS
aging causes a decrease in nerve cell number here.
IDEA
all children ages birth to 21 are eligible for: early intervention or special education and related services
protective reactions
are required to prevent injury if the equilibrium reactions are unable to restore balance. Protective reactions emerge first to the front, then the side and then backwards.
these are caused by brain acceleration, from shear, tensile and compressive forces
cerebral injuires
APGAR 7-10
child is in good condition
Individuals with disabilities education act (IDEA)
children from birth till age 5. are able to go to school and you are required to give them the least restrictive environment
contrecoup injury
damage to the brain on the side opposite the point of a blow as a result of the brain's hitting the skull
U. S. Department of Education
ensures states comply with IDEA provisions; states ensure local school districts comply with IDEA provision
speech language pathologist
expressive and receptive language skills
upper extremity
full-term neonate movement here is that hands are fisted much of the time; arms are held snug to the body; Strong elicited grasp, gross isolated finger movements
0.8-1.2 m/sec
gait speed of a community ambulator
0.4-0.8 m/sec
gait speed of a limited community ambulator
acute care
goals of PT will be to avoid problems related to the illness such as contractures or weakness, and to help the child gain the functional skills needed to return home; will usually have acute medical needs
audiologist
hearing
APTA
in 1921, this organization was formed to regulate and facilitate the growth of the profession
proximal radial head dislocation
in adolescents this is often associated with an immature annular ligament. - Due to: longitudinal traction of an extended and pronated upper extremity - Inability to pronate and supinate pain free warrants immediate physician referral
1970's
in this era, there was a shift from orthopedic approach to intervention
APGAR 0-3
indicates severe asphyxia and may indicate the need for intubation and cardiac massage
prematurity
infant is born before 37 weeks of gestation; considered more at risk with development
whole body
infants begin rolling this at once as in rolling
brachial plexus
is comprised of a group of nerves arising form the nerve roots C5-T1.
glenohumeral dislocation
it is a problem if these are chronic because less force is needed, less spasm, pain and swelling, sensation of arm going dead -signs and symptoms include pain with crepitus and clicking after reduction
hypotonia
low muscle tone
glenohumeral dislocation
management of this includes • Immobilize in comfortable position • Apply cold • Immediate physician referral • If deficits with pulse or sensation, activate emergency plan, including EMS
APGAR 4-6
may indicate a need for less intense resuscitation such as vigorous stimulation and administration of supplemental oxygen
medical model
multidisciplinary and interdisciplinary
valium and botox
name 2 medication used in the management of CP
pattern of growth
occurs in a cephalocaudal direction in the fetus and then head control before trunk and limbs functionally in the infant
head righting
orient the head vertically in space keeping eyes and mouth horizontal even when the body is tilted or rotated. Help the infant to develop head control
education of all handicapped children act (EHCA)
passed in 1975, was that all children age 6 to 21 years of age regardless of disability are entitled to free and appropriate public education
variable practice
practice of a given task under differing conditions
subcutaneous fat
premature babies look this way because they lack this
moro reflex
retention of this reflex could include -hypersensitivity/reactive -poor impulse control -vestibular related problems such as motion sickness, poor coordination (noticeable in ball games) -physically timid -visual and oculomotor problems -poor pupillary control -poor auditory discrimination -dislike of change or surprise
neglect
should consider this if: ◦ Failure to thrive ◦Medical problems are not addressed ◦Delay in seeking care ◦Special health care needs are not addressed ◦Extreme lack of cleanliness ◦ Inappropriate clothing for environment ◦ Injury without a medical explanation
social worker
social support and counseling, making referrals, explaining programs and resources, transportation, etc
transdisciplinary
team members commit to work and learn across disciplinary boundaries. Families are integral parts of the team, and goals are based on the family's priorities and concerns in concert with the service provider's concerns. Equal participation in the team process by family members and service providers • Consensus decision making in determining priorities for goals and objectives • Consensus decision making about the type and amount of intervention • All skills, including motor and communication skills, embedded throughout the intervention program • Infusion of knowledge and skills from different disciplines into the design and application of intervention • Role release to enable team members to develop the confidence and competence necessary to facilitate the child's learning
physical therapy
these services are intended to target specific areas of weaknesses related to educational access. They are not necessarily intended to be ongoing services for the duration of the child's academic career.
greenstick fracture
these types of fractures are more common in children because the bones of children contain relatively larger amounts of collagen than adult bones, they are more flexible and more resistant to fracture under day-to-day loading than adult bones. Consequently, these fractures, or incomplete fractures, are more common in children than adults.
type 1
this AC sprain includes mild stretching of ligaments • Minimal swelling & pain over the joint line • Discomfort on abduction >90° -managed with cold, a sling and physician referral
4 month
this age is when babies ● Head to 90 degrees in prone ● Hand to midline
6 months
this is the age when ● Righting reactions ● Transitional movements
7 months
this is the age when ● Unsupported sitting ● Lateral protective reactions
9 months
this is the age when babies do quadraped position and cruising
half-life
this is the amount of time it takes to reduce the drug's blood concentration by half. It can be seconds to days. -Liver metabolism and renal clearance can slow the half life and impair excretion
metabolism
this is the biotransformation of medications in the body
motor learning theory
this theory states that no action can be performed without resulting perception, and nothing can be perceived without action. Thus movement plays a central role in what we know and can perceive
greenstick
this type of fracture is when a bone breaks incompletely
avulsion
this type of fracture is when a bone fragment is pulled off by an attached tendon or ligament
compound
this type of fracture is when a bone penetrates the skin
spiral
this type of fracture is when jagged bone ends are S-shaped when excessive torsion is applied to fixed bone
DMD
treatment implications of this include: ● Proximal weakness ● Maintain range of motion (ROM) to prevent contractures ● Waddling gait ● Surgical and orthotic management ● Adaptive equipment ● Respiratory function
brachial plexus injury
treatment of this may be: •Exploration •Neurolysis •Excision of scar tissue •Nerve grafting (local end to end anastomosis or remote nerve transplant) •Surgical plication in case of diaphragmatic involvement Special considerations in post surgical care: Edema of neck and compromise of airway Injury to vagal and laryngeal nerves Risk for meningitis
child abuse
triggers for this include Crying infant ◦Misbehaving child ◦ Toileting accidents ◦Arguments/family conflict ◦ Frustrated parent
random practice
variation in the order of practice; tasks are intermingled or continuously rotated
Becker muscular dystrophy
very similar to, but less severe than, Duchenne muscular dystrophy Prognosis: live through 30's - 40's
polypharmacy
word meaning many drugs
Klumpke's palsy
• Much rarer than UBPIs and Erb's Palsy • Loss of C8 & T1 results in major motor deficits in the muscles working the hand: "claw hand" • Loss of sensation to medial aspect of UE • Sometimes ptosis or full Horner's syndrome • Much rarer (1%) but poorer prognosis absent grasp reflex of the hand
1-1.4 m/sec
At this walking speed, an individual is less likely to be independent in ADLs and less likely to be hospitalized
0-0.6 m/sec
At this walking speed, an individual is more likely to be dependent in IADLs and be hospitalized
0-1 m/sec
At this walking speed, you need to intervene to reduce fall risk
6-8 months
At what age does sitting typically develop for infants?
Meningocele
Benign herniation of meninges manifesting as a soft tissue cyst or lump surrounding a normal spinal cord and producing no neurologic deficits
second trimester
By the end of this, the fetus is ingesting and absorbing amniotic fluid through the gastrointestinal tract, and the kidneys are excreting urine -most of the peripheral neurological reflexes are present in the fetus during this trimester
third trimester
By this trimester, (28 weeks of gestation) the fetus weighs about 2.5 lbs. The eyes open and close, and the fetus has regular breathing movements. A fetus can survive premature birth at this stage but would need aggressive medical intervention and the risk of developmental problems is high.
prematue
CNS problems that these babies can have include: • Neonatal Seizures • Germinal Matrix- Intraventricular Hemorrhage (GM-IVH) • Periventricular Hemorrhage • Hypoxic-Ischemic Encephalopathy • Selective Neuronal Necrosis • Periventricular Leukomalacia
Down Syndrome
Challenges of this include: • Poor language development and use • Vision and hearing problems • Cognitive (ie, thinking, decision making) difficulties • Obesity • Degenerative joint disease • Poor cardiovascular health (ie, hypertension) • Thyroid dysfunction • Diabetes • Skin disorders • Lower bone density • Digestive problems • Leukemia • Sleep apnea • Depression (approximately 30% of cases) • Early onset of dementia
delirium
Common causes of this include UTI and pnuemonia, and medications.
cystic fibrosis
Condition where there is a high rate of sodium absorption and low rate of chloride secretion reducing salt and water content in mucus making mucus clearing in the lungs difficult
Down syndrome
Congenital developmental disability caused by a defect of chromosome 21 (trisomy 21)
Spina bifida aculta
Congenital incomplete closure of a vertebrae (separation of the spinous process) that is not associated with disability
strains
Damage to muscle or tendon - Key factor: magnitude of force and structure's cross-sectional area • MOI: - Abnormally high tensile force • Most common site for tears: near the musculotendinous junction
Myelodysplagia/Spina bifida
Defined as a neural tube defect resulting in vertebral and/or spinal cord malformation
Family centered approach
Defined as a type of approach that begins with child's and family's strengths,need, hopes, and results in a service plan which responds to the needs of the whole family. Role of PT is to support, encourage, and enhance competence of parents or caretakers in their role as caregivers. This approach is called?
Spina bifida occulta
Defined as no spinal cord involvement, may be indicated by a tuff of hair, dimple or sinus
Protective extension
Defined as quick displacement of trunk in a downward direction while held or while sitting in a forward, sideward, or backward direction will result in extension of legs in downward and extension of arms in the sitting position to catch weight. These reactions persists throughout life.
Tilting reactions
Defined as slow shifting of BOS or slow displacement of body in space that will result in lateral flexion of spine toward elevated side, and sometimes trunk rotation toward the elevated side this reactions persists throughout life.
ventricles
Dementia causes these in the brain to enlarge
equilibrium reactions
Develop after righting reactions and protective responses - Body adapts to slow changes in the relationship of the center of gravity with the base of support - Lateral weight shifts - trunk rotates in opposite direction - Developmental timetable
neurocognitive engagement therapy
Developed to address problems in traditional Therapy practices - Therapists have a difficult time providing effective treatment sessions to patients with cognitive impairment • Lack of comfort • Lack of training, clinical practice, and mentoring through the education process • Patients with cognitive impairment do not respond as well to traditional therapy techniques - Care provided to patients with cognitive impairment may be withdrawn due to poor engagement in therapy sessions
motor program model of motor control
Developed to directly challenge the notion that all movements were generated through chaining or reflexes because even slow movements occur too fast for sensory input to influence them. ● Refers to a specific neural circuit called a central pattern generator (CPG)
10-15 months
Developmental Sequence Summary at what month(s)? - begins to walk unassisted - begins self-feeding - reaches with supination, neat pincer grasp, can release, build a tower of 2 cubes - searches for hidden toys - suspicious of strangers
8-9 months
Developmental Sequence Summary at what month(s)? - belly crawls - quadruped creeping - moves quadruped to sitting - pulls to stand through kneeling - cruises sideways, can stand alone - reaches with: closest arm - can trasnfer objects from one hand to the other
7 months
Developmental Sequence Summary at what month(s)? - can maintain quadruped - pivots on belly. Infant in prove moves body in a circle - pivot prone (prone extension) position - assumes sitting from quadruped - trunk rotation in sitting - may show fear of strangers
4 years
Developmental Sequence Summary at what month(s)? - hops on one foot several times - stands on tiptoes - throws ball overhand
3 months
Developmental Sequence Summary at what month(s)? - prone on elbows, weight bearing on forearms - elbows in line with shoulders, head elevated to 90° - head in midline in supine - increased back extension with scapular adduction in supported sitting - takes some weight with toes curled in supported standing - coos, chuckles
6 months
Developmental Sequence Summary at what month(s)? - prone on hands with elbows extended, weight shifting from hand to hand - rolls supine to prone - independent sitting - pulls to stand, bounces
3 years
Developmental Sequence Summary at what month(s)? - rides tricycle - stands on one foot briefly - jumps with two feet
2 years
Developmental Sequence Summary at what month(s)? - runs well - can go up stairs foot over foot (reciprocal stair climbing)
5 years
Developmental Sequence Summary at what month(s)? - skips - kicks ball well - dresses self
Gower's sign
Difficulty rising to standing position; has to walk up legs using hands; occurs in Muscular dystrophy
Alzheimer's Disease
Disorder characterized by memory loss, language losses and executive function.
executive function
Domain of cognition: Managed by frontal lobe function Higher order skill affected by other functions Planning, organization and self control
third trimester
During this last trimester of pregnancy, the fetus gains the most weight, and the fatty tissue myelin is laid down in the CNS to help speed messages through the nervous system. The myelination of the CNS is not yet complete unitl one year after birth. 32 weeks- subcutaneous fat is present and fingernails and toenails have developed 36 weeks- the fetus weighs about 4.5 lbs
Brachial Plexus Injury
Dx of this at birth will recover from neurologic deficit. Those who do not recover during 3-6month period will Require surgical intervention. 1-2 week rest of affected limb Early referral to upper extremity clinic and PT Caregivers should be instructed on how to handle baby: No traction of affected arm, no pressure under axilla. Baby to be carried in football hold
transdisciplinary interdisciplinary
Early intervention models are this model(s) of team interaction
transdisciplinary
Early intervention protocols and school settings encourage the use of what type of delivery service?
IEP
Education plan developed for children ages 3-21 to focus on special education and services in the schools. IEP team can override parents. Happens at school
bedrest
Effects of this include: • loss of muscle mass; highest effect on LE muscles • loss of strength and power • increased muscle insulin resistance • increased bone loss • decreased pulmonary function and exercise capacity
Primary standing reaction
Hold infant in supported standing and infant supports some weight and extends lower extremities. if this reflex persists, it will interfere with walking by causing extension of all joints of the lower extremity and not allowing disassociation of flexion and extension. What is this reflex called?
LE strengthening
If an older person has difficulty rising from a chair, what would a good PT intervention be?
orthostasis
If an older person reports dizziness or staggering upon rising, what could this be indicative of?
Down Syndrome
Impairments and intervention for this to improve independence with daily activities and quality of life • improve muscle strength, • balance, coordination, • movement skills. determine child's motor development such as sitting, crawling, kneeling, pulling up from sitting to standing, walking, and more advanced skills like running, jumping, or kicking and throwing a ball.
educational
In 1975-1980, work was completed to describe PT practice in these settings
Pediatric Physical Therapy
In 1986-1990 this journal was launched
International Classification of Functioning
In 2001, WHO launched this, which provided a standard language and framework to health and related states
ICF Child and Youth version
In 2007, WHO launched this which expanded the ICF to address infancy, childhood and adolescence; this model provides foundation for examination, evaluation, intervention and outcome assessment
plaques and tangles
In Alzheimer's disease these form in the learning area (temporal lobe) and memory (hippocampus) regions, kind of like a spider web and kill the brain
Achilles tendon, hamstrings, iliopsoas, hip adductors
In the orthopedic management of CP lengthening procedures of muscles/tendons are performed to correct deformity or weak muscle(s) to prevent hip subluxation/dislocation. Which muscles/tendons are most often lengthened?
hip adductor transferred to hip abductor
In the orthopedic management of CP muscle transfers are performed to move/change the direction of force to increase function and decrease spascity. Which muscle transfer is most often done?
moderate
In this stage of AD, • Damage has spread to areas of the cerebral cortex that control language, reasoning, sensory processing, and conscious thought • More intensive supervision becomes necessary •Increasing memory loss and confusion •Shortened attention span •Inappropriate outbursts of anger •Problems recognizing friends and family members •Difficulty with language and problems reading, writing, and working with numbers •Difficulty organizing thoughts and thinking logically •Changes in visual fields •Restlessness, agitation, anxiety, tearfulness, wandering - especially in late afternoon or night •Repetitive statements or movement, occasional muscle twitches
severe
In this stage of AD, • Tangles are widespread, and most areas of the brain have shrunk • Can no longer recognize family or loved ones or communicate in any way • Completely dependent on others for care • Most frequent cause of death is aspiration pneumonia
timed up and go
In this test, the patient is timed while s/he rises from the chair, walks three meters, turns around, walks back to the chair, and sits back down. Postural stability, gait, stride length, sway, and steppage should be observed.
glomerular filtration rate
In those who are aging, this decreased by 30-46%
multidisciplinary and interdisciplinary
In which model types are family members left out of the team?
jersey finger
Inability to flex the DIP joint of the 4th finger against resistance?
Developmental milestone
Movement pattern that appears at a certain stage of growth and development
cerebral palsy
PT intervention in the first 3 years of a childs life that has this includes: ● Role of the family ● Role of the physical therapist assistant (PTA) ● Handling and positioning ● Feeding and respiration ● Therapeutic exercise ● Motor skill acquisition ● Constraint Induced Movement Therapy (CIMT) ● Functional postures ● Independent mobility ● Ambulation predictors ● Body-Weight-Supported Treadmill Training (BWSTT) ● Power mobility
multidisciplinary
PT will conduct an evaluation of the child, then make the written report available in a central location so that other team members are aware of each other's assessments and plans. Meetings are held to present each member's findings. Therapy is conducted without direct input from other disciplines. Common in acute care hospitals and some outpatient facilities
heel cords, tensor facia latae and lumbar lordosis and kyphoscoliosis
Patients with Duchenne's Muscular Dystrophy develop contractions and deformities due to muscle imbalances. What areas are common for contractures and deformities
household or community ambulators
Patients with myelodysplasia at the low lumbar level typically have what functional prognosis in terms of ability to ambulate with/without assistive devices such as wheelchairs, orthoses etc..?
Reciprocating gait orthosis (RGO)
Patients with myelodysplegia at high lumbar levels exhibit paralysis or weakness of hip flexors. what type of orthotic is the only one that makes ambulation possible?
post-concussion syndrome
Persistent headache, blurred vision, vertigo, memory loss, irritability, and inability to concentrate are characteristics of what?
Posterior rollator walkers
Rollator walkers are often used as part of orthoses in the treatment of CP. What type of rollator walker would be appropriate to help a child maintain upright position and arm position to decrease extensor tone?
anterior GH dislocation
S&S - intense pain - tingling and numbness down arm - arm held in slight abduction & external rotation; stabilized against body by opposite hand - deformity- sharp contour rather than smooth outline of deltoid - ind. will not allow the arm to be brought across the chest Management -assess axillary nerve and artery - deficits warrant activation of EMS -immediate physician referral (potentially activation of EMS) -immobilize arm in a comfortable position; prevent unnecessary movement of the humerus by placing a rolled towel or thin pillow between the thoracic wall and humerus prior to applying a sling. -apply ice
Timed Up and Down Stairs (TUDS)
Starting position: Student wears shoes but no orthotics. Student stands 1 foot from the bottom of one flight of stairs (14 steps). Directions: Instruct child to "Quickly, but safely go up the stairs, turn around on the top step (landing) & come all the way down until both feet land on the bottom step (landing)." Mean: 8.1 sec (range 6.3-12.6 sec), age 8-14 yrs. or 0.58 sec per step Correlates to: gait speed, stride length, fall risk, flexibility (ankle), fitness
geriatric disease process
Symptoms of this include: Sleep apnea, depression; hypothyroidism; gait disorder; cognitive impairment.
elbow strains
The MOI for these is excessive overload against resistance -overstretching -often occurs simultaneously with sprain - S&S: • Flexors (brachialis, biceps brachii, and brachioradialis) • Pain with resisted elbow flexion • Extensor (triceps) - pain with resisted elbow extension • Wrist flexors - pain with resisted wrist flexion • Wrist extensors - pain with resisted wrist extension - Management: • Grade 1 - standard acute; if symptoms persist > 2-3 days, physician referral • Grade 2 or 3 - cold; sling; immediate physician referral
muscle contusions
The MOI for this is compression • Can be both deep and superficial • Must be cautious and aware of more severe injuries associated with repeated blows (compartment syndrome- treat with fasciotomy) - Onset - acute - Ecchymosis: if superficial - Hematoma - Restrictions in ROM - Pain - localized - Swelling - Associated nerve compression
6 minute walk test
The SCAT3 is a standardized tool for evaluating injured athletes for concussion. I has all of the following components except: -Balance Assessment: Modified Balance Error Scoring System (BESS) -Glasgow coma scale (GCS) -Cognitive Assessment:Standardized Assessment of Concussion (SAC) -6 Minute Walk Test -Symptom Evaluation
the impairment of joint ROM
The basis for rating the severity of a contusion is what?
mild
The clinical diagnosis of AD is generally made at this stage
child abuse
Risk factors for this include: Premature Birth ◦ Infant with prolonged crying ◦"Difficult" child - emotional or behavioral difficulties ◦Child with physical disabilities ◦Developmentally delayed child ◦Chronic illness
Babinsky reflex
Stroke the lateral aspect of the plantar surface of foot and get extension and faning of toes. What is this reflex called?
Rooting
Stroking of perioral region results in head turning to that side with mouth opening. This is an important feeding reflex. What is this reflex called?
myositis and fasciitis
The MOI for these includes repeated movements irritate the tissues
motor control
The ability to maintain and change posture and movement as a result of a complex set of neurologic and mechanical processes. The process takes milliseconds.
pediatric physical therapy
The goal of this is to help children reach their maximal functional level of independence
aerobic activity
The guidelines for this in elders includes: Moderate intensity aerobic activity for minimum of 30 minutes, 5x/wk Or vigorous activity for a minimum of 20 minutes, 3x/wk • Moderate intensity would be enough to note a change in HR and breathing; on a Borg Scale of 10 = to 5 to 6 • Vigorous intensity on a Borg Scale of 10 = 7to 8
aerobic activity
The guidelines for this include moderate intensity aerobic activity for minimum of 30 minutes, 5x/wk Or vigorous activity for a minimum of 20 minutes, 3x/wk
Optical and labyrinthine righting
The head orients to a vertical position when the body is tilted. Labyrinthine righting is tested with the eyes blind-folded (1 month-throughout life). This is called?
summoning EMS
The immediate management for a SC joint sprain involving a posterior displacement includes what?
school physical therapists
The individuals are involved in Prevention and pre-referral activities (RtI2) • Assessments and student program planning for individuals with exceptional needs • Teacher, staff and parent training sessions • Treatment • Collaboration with all service providers
selective neuronal necrosis
The long-term effects of this includes: • Depend on the site of necrosis • Mental retardation • Spasticity - abnormal high muscle tone • Quadriparesis - weakness in all four extremities • Quadriplegia - paralysis of all 4 extremities • Hemiparesis - weakness of ½ of body • Hemiplegia - paralysis of ½ of body • Long term seizure disorder • Ataxia - loss of controlled body movements including ambulation • Hyperactivity • Impaired attention • Speech problems • This is cerebral palsy
SC sprains
The majority of injuries result from compression related to a direct blow, as when a supine individual is landed on by another participant, or more commonly, by indirect forces transmitted from a blow to the shoulder or a fall on an outstretched arm. The disruption typically drives the proximal clavicle superior, medial, and anterior.
number of drugs being taken
The most consistent risk factor for adverse drug reactions is what?
systems model of motor control
The neural control of posture and movement is distributed, that is, which areas of the nervous system that control posture or movement depend on the complexity of the task to be performed. ● Feedback is a third fundamental characteristic of the systems models of motor control
epigenetic
The normal growth process is this, which means it goes from a simple to complex progression
subcortical dementias
Examples of these include: Subcortical dementias - Result from dysfunction in parts of the brain that are beneath the cortex with primary symptoms being changes in personality and attention span, with slowed thinking.1 - Huntington's disease - Hypothyroidism - Parkinson's disease - Vitamin B1 deficiency - Vitamin B12 deficiency - Folate Deficiency - Syphilis - Subdural hematoma - Hypercalcemia - Hypoglycemia - General medical condition
modifiable causes
Exposures (UV, noise), psychological well being (social isolation), cognition (mental activity), nutrition (cholesterol, sodium, calcium) and exercise are these in relation to aging.
weakness and flaccid limbs
From 1916 to 1955, PT's treated what primarily. Dorothy Voss characterizes this period as the "era of flaccidity"
1.2 m/sec and above
Gait speed of someone who is able to cross the street safely
presbycusis
High frequency hearing loss
Hip Hemiarthroplasty
Hip precautions following this include no internal rotation, no hip flexion beyond 90, no adduction past midline
38-42 weeks
How many weeks are considered to be a normal gestational period?
Early Intervention Programs (EIPs)
Identify by the following description the type of pediatric program Mandated by public law - to provide comprehensive, multipdisciplinary early intervention programs - For infants and childrens from birth to 3 years - Multidisciplinary assessment - Individual Family Service Plan (IFSP) developed - Family is a member of the team
Tonic labyrinthine reflex
Identify the following reflex - Prone position results in maximal flexor tone - Supine position results in maximal extensor tone if persists and is strong, may block rolling from supine due to increased extensor tone
Newborn Individualized Developmental Care and Assessment of Progress (NIDCAP)
Identify the following test A systematic behavioral observation of preterm of full-term infant in nursery or home during environmental input, care-taking and treatments. note what stresses, consoles infant
Spastic diplegia
If a Patient with cerebral palsy has increased tone, and the lesion is in the motor cortex and it involves both lower extremities, this condition is called:
Spasticity
If a patient with cerebral palsy has increased tone, lesion of motor cortex or projections from motor cortex. This type of impairment will be called:
Ataxia
If a patient with cerebral palsy has instability of movement, lesion of cerebellum. This type of impairment will be called:
four-point position (quadriped)
In a normally developing infant, the Symmetrical Tonic Neck Reflex (STNR) has the potential to assist in attaining what functional position?
physical therapist's
In a school, these individuals address environmental factors, a child's physical and sensory motor needs, as well as activities that support participation and access to the child's curriculum. • The areas addressed by school-based physical therapists must directly relate to the child's performance within their school setting (campus, classroom, playground, cafeteria, bathroom and library).
Physical therapist
In a school, this person assesses the child's strengths and needs (foundational components) that support or limit his participation in school and access to the curriculum - Analyzes the environment, the curriculum and tasks, in order to determine if the child is able to successfully participate in his/her educational program
the more significant the motor delay
In patients with down syndrome, prognosis may be correlated with tone in terms of motor delay. the lower the tone a patient has the:?
ear
In premature babies, the cartilage of this is poorly developed, and this folds easily
skin
In premature infants, this is bright pink, smooth, shiny, often, translucent, with small blood vessels clearly visiblw
posture
In premature infants, this is relaxed with more extended limbs
scarf sign
In premature infants, this is when elbow may be brought across the chest with little or no resistance vs. term infant resists attempts to cross midline
unidirectional
In tendons, the collagen being arranged this way helps in resisting high unidirectional tension loads from the attached muscle
1900's
In the early parts of this century, services were given to those with musculoskeletal disorders. Children with severe TBI's did not survive.
Exercise
In the elderly, the benefits of this include: Weight loss; Decrease central adiposity;Increase lean body mass;Blood pressure decline;Aerobic capacity increase;Increase bone mass;Increase muscle strength
weight loss
In the elderly, this is caused by depression, swallowing or chewing problems, inadequate intake, or feeding dependence
cerebral palsy
In the preschool period of a child who has this they may have: ● Independent mobility ● Gait ● Orthoses ● Assistive devices ● Power mobility
physical therapy
In the public schools, this is used to enhance the student's ability to function within the educational environment. • Physical therapists use techniques that correct, facilitate or adapt the child's functional performance in motor control and coordination, posture and balance, functional mobility, activities of daily living and use of adaptive equipment.
multidirectional
In the skin, the collagen is arranged this way, which enables resistance of multidirectional forces like compression, tension, shear, etc.
second degree
In this degree of sprains, there is a 5-10 mm distraction with stress tests
PNS
In this region, there is decreased vibratory sensation
mild
In this stage of AD, there is • Memory Loss • Confusion about the location of familiar places (getting lost) • Taking longer than normal to accomplish normal daily tasks • Poor judgment leading to bad decisions • Loss of spontaneity and sense of initiative • Mood and personality changes, increased anxiety, depression and/ or irritability
Brachial Plexus Injury
Incidence of this is reported to affect 0.5 to 1.9 per 1000 live births (Bar et al 2001) 90% Erb palsy Most common on the right side because the most common delivery presentation is left occiput anterior vertex. Associated with: pre and gestational diabetes older maternal age increased BW, LGA Newborns with BP injuries have a higher incidence of low Apgar scores of less than 7 at 1 and 5 mins and of asphyxia than matched controls
Possible normal pressure hydrocephalus (would cause urinary incontinence and memory issues)
Increased sway or magnetic gait could mean what?
Meningomyelocele
Open congenital spinal cord region with minimal to no skin protection covering the deeper nerve roots most severe of these cases results in loss of motor function and sensation of the lower part of the body
Side effects: sedation, weakness, drowsiness, dry mouth
Oral medications such as: presynaptic inhibition of acetylcholine release, benzodiazepines, diazepam (valium), Baclofen (lioresal) are used in the managment of spasticity in patients diagnose with cerebral palsy, what are the side effects of these medications?
Brachial Plexus Injury
PROGNOSIS of this is outlined in a Study by Noetzel et al (2001) followed 80 patients with BP injury who did not recover by 2 weeks of age. Used the BMRC scales for evaluating muscle strength and found: Complete recovery in 66% Mild impairment in 11% Moderate weakness was seen in 9% Severe weakness in 14% When associated with phrenic nerve palsy and diaphragmatic paralysis, there is more likelihood of need for surgery for recovery
intradisciplinary
PT conducts an evaluation of the child, plans an intervention, and carries it out. The PTA may help collect data for the evaluation and carry out the intervention. Common in private practice and outpatient facilities
myelomeningocele
PT intervention for this includes ● Postoperative positioning ● Prone positioning ● Effects of gravity ● Orthoses for Lower Extremity (LE) positioning ● Prevention of skin breakdown ● Sensory precautions ● Range of motion to prevent contractures ● Promotion of age-appropriate sensorimotor development ● Development of head control ● Development of righting and equilibrium reactions ● Development of trunk control in sitting ● Acclimation to upright and weight bearing ● Mat mobility ● Standing frames
community ambulators
Patients with myelodysplasia at the lumbosacral level typically have what functional prognosis in terms of ability to ambulate with/without assistive devices such as wheelchairs, orthoses etc..?
hip dislocation, subluxation
Patients with myelodysplasia at the mid lumbar level typically experience what type of musculoskeletal problems?
wheelchair for community, orthoses for household ambulation
Patients with myelodysplasia at the mid lumbar level typically have what functional prognosis in terms of ability to ambulate with/without assistive devices such as wheelchairs, orthoses etc..?
Spinal deformity and decubiti
Patients with myelodysplasia at the thoracic level typically experience what type of musculoskeletal problems?
wheelchair
Patients with myelodysplasia at the thoracic level typically have what functional prognosis in terms of ability to ambulate with/without assistive devices such as wheelchairs, orthoses etc..?
hip flexion contractures
Patients with myelodysplasia at the upper lumbar level typically experience what type of musculoskeletal problems?
wheelchair, possible household or therapeutic ambulation, standing transfers
Patients with myelodysplasia at the upper lumbar level typically have what functional prognosis in terms of ability to ambulate with/without assistive devices such as wheelchairs, orthoses etc..?
Congenital muscular torticolis (CMT)
(Twisted neck) the muscle extending down the side of the neck is tight and shortened. An infant holds his or her head to one side and has difficulties turning the head
occupational therapist
ADLs and fine motor skills
C5-6
Brachial plexus injury called Erb's Palsy which cord segments involves?
ACL
Deceleration combined with a cutting motion is a common MOI for what?
sarcopenia
Degenerative loss of skeletal muscle mass.
Timed Up and Go (TUG)
Equipment: Stopwatch, chair Starting Position: Student is barefoot, sits with knees and hips bent 90o On "go" student stands up and walks 3 meters (9 ft 10 in) to a designated mark, turns around, walks back and sits on the chair
Shuttle Run
Equipment: Stopwatch, tape measure, 2 cones, 2 blocks Starting Point: Mark off 30 ft with 2 pieces of tape & cones; place 2 blocks at the line opposite to the starting line. At "go" student runs from starting line to the opposite line, picks up a block, runs back to the starting line, placing the block behind the line. The student repeats this for the 2nd block. Measure time to complete task
Developmental delay
Failure to obtain predictable movement patterns or behaviors associated with children of a similar chronological age
Athetosis
If a patient with cerebral palsy has fluctuating muscle tone (can be rigid, can be flaccid), lesion of basal ganglia. This type of impairment will be called:
osteoporosis
In aging women, this results from decreased activity, dietary calcium and estrogen withdrawal
foot pressure sores
Patients with myelodysplasia at the lumbosacral level typically experience what type of musculoskeletal problems?
cerebral palsy
Tendon lengthening , Selective dorsal rhizotomy (SDR) Baclofen pump and SEML (Single Event Multilevel) are surgeries that a child with what might have?
False
Tension on anchors or ends of tape should be 100% when Kinesio Taping. True or False?
Confusion Assessment Method (CAM)
Tests for delirium
proximal lower extremity weakness
The Gower Sign is indicative of what impairment?
finger sprains and dislocations
The MOI for these are varus or valgus stresses or hyperextension volar plate=hyperextension - S&S • Painful, swollen finger • Dislocation • Most common PIP • Obvious deformity may or may not be present • Immobilization; cold; immediate physician referral • Coach should not attempt to reduce a dislocation • Should not assume injury is a "jammed finger"
endodermal cells
These cells form most major organs
mesodermal cells
These cells will develop into muscles, bones, heart, blood vessels, excretory system, etc.
maintained
These responses are what? first head control then trunk prone on elbows-maintained responses directed stimuli small ROM
sucking reflex
This reflex begins at 28 weeks gestation. Integrated from 2-5 mos. Touch to lips, tongue, palate results in automatic sucking. This is an important feeding reflex. Persistence of this reflex may inhibit voluntary sucking
person centered care
Use of life history to inform care and life review to enrich communication.
crawling
When a child does this action, phasic and tonic systems are integrated
STNR
retention of this reflex can include poor posture -tendency to "slump" when sitting at desk/table -Simian (ape like) walk -poor hand-eye coordination -inability to sit still and concentrate
Landau reflex
retention of this reflex effects the development of balance and muscle tone in rapidly changing conditions -runs with stiff awkward movement -find hopping skipping and jumping difficult
interdisciplinary team
team members share responsibility for service delivery. Child assessments occur separately by discipline; however, results are shared between providers. Goals are discipline-specific but are shared with other team members to form a single plan of intervention.
premature birth
the maternal factors for this include - Malnutrition - Chronic Disease - heart, renal, diabetes
early childhood
the period from 18 months until 5 years of age
abrasion injury
the primary concern with this is the scraping away of skin tissue results in exposure of blood vessels. If dirt and foreign matter penetrates the exposed blood vessels there is a risk for infection
legislation
the types of disability and public opinion has effecting this when directing services to children
distribution
this is the movement of medication from bloodstream to body
ecological theory
this theory of motor learning states that how we plan movements based on our understanding of spatial configurations in our world and the medium in which we move.
rehabilitation setting
will need intensive PT to learn or relearn basic functional skills such as moving in bed, standing, walking, and playing--inpatient
intradisciplinary team
working with a single discipline
epiphyseal injuries
• Classifications - Injury to growth plate could result in alteration in normal growth - Acute injury • Types I-V
specific gene defects
● Autosomal dominant trait ● Autosomal recessive trait ● Sex-linked trait are these
myelomeningocele
● Etiology ● No definitive cause ● Use of folic acid in pregnancy to prevent myelomeningocele (MMC) ● Prenatal diagnosis ● Alpha-fetoprotein ● Possible fetal surgery
exceptions
◦Environmental factors beyond the control of the parent ◦Seriously held religious beliefs (bona fide religion) ◦Parents' right to discipline
skin bruises
- Accumulation of blood within skin - Results from compression sustained during a blow
cyclist's palsy
- Due to leaning on handlebar for extended period; leads to swelling in hypothenar area - Symptoms mimic ulnar nerve entrapment syndrome, but disappear rapidly after end of ride - Key: proper padding; varying hand position
Boutonniere deformity
- Rupture of central slip of extensor mechanism and damage to volar plate - MOI: • Blunt trauma to dorsal aspect of PIP • Rapid, forceful flexion of PIP against resistance - S&S • Deformity not apparent immediately, develops over 2-3 weeks (hyperextension MCP jt, flexion PIP jt, & hyperextension DIP jt ) • Swelling at PIP Lack of extension at PIP
jersey finger
- Rupture of flexor digitorum profundus tendon - MOI: rapid extension of finger (e.g., gripping opponent's jersey ... opponent turns & twists to get away ... jerking action) - S&S • Tendon palpable at proximal finger. • Unable to flex the DIP joint against resistance - Management: • Standard acute • Immediate physician referral
schaphoid fracture
- S&S • History of falling on an outstretched hand • Point tenderness in anatomic snuff box • Pain with inward pressure along long axis • ↑ pain with wrist extension and radial deviation - Management: standard acute; splint; physician referral - Concern: aseptic necrosis
FAST
1 No difficulties, either subjectively or objectively. 2 Complains of forgetting location of objects; subjective word finding difficulties only. 3 Decreased job functioning evident to coworkers; difficulty in traveling to new locations. 4 Decreased ability to perform complex tasks (e.g., planning dinner for guests; handling finances; marketing). 5 Requires assistance in choosing proper clothing for the season or occasion. 6a Difficulty putting clothing on properly without assistance 6b Unable to bathe properly; may develop fear of bathing. Will usually require assistance adjusting bath water temperature. 6c Inability to handle mechanics of toileting (i.e., forgets to flush; doesn't wipe properly). 6d Urinary incontinence, occasional or more frequent. 6e Fecal incontinence, occasional or more frequent. 7a Ability to speak limited to about half a dozen words in an average day. 7b Intelligible vocabulary limited to a single word in an average day. 7c Non-ambulatory (unable to walk without assistance). 7d Unable to sit up independently. 7e Unable to smile. 7f Unable to hold head up.
proximal to distal
A baby develops this way meaning the parts closer to the trunk develop before extremities
cephalocaudal
A baby develops this way, meaning head to toe
delirium
A change in mental status related to medical illness.
Torticollis
A child who had surgery for this can be discharged if: • Cervical PROM and AROM is within 5 degrees of normal limits for lateral flexion and rotation • Demonstrate symmetrical posture in all functional positions • Head is held in midline most of the time during activity • Demonstrate symmetrical and age-appropriate gross motor skills
Diplegia
A classification of Cerebral Palsy that involves impairment of two LOWER limbs is called:
Individualized education plan ( IEP)
A collaboration of therapists and family members, educators, and other healthcare team members to provide direct intervention in the classroom setting
second impact syndrome
A danger associated with return to play before symptoms of a head injury have resolved is what?
intracapsular
A femoral neck fracture is this type of hip fracture.
shear force
A force that acts parallel or tangent to a plane passing through the object.
Pervasive developmental disorder (PDD) (PDI)
A group of disorders of neural development characterized by impairments and social interaction and communication and the presence of unusual behaviour a such as repeating actions and poor play skills
Tensile force
A pulling force that tends to stretch the object to which it is applied is called a what?
Timed up and go
A score higher than 14 seconds is considered a high fall risk on this test.
Ankle set at 5-10 degrees
AFOs are used to provide support to foot, ankle, knee to provide a stable base of support and reduce effects of spasticity and hypoextensibility of muscles. At what angle is the AFO set at the ankle to decrease genu recurvatum?
vision
Aging worsens this. Your visual acuity decreases, (cataracts, macular degeneration), dark adaptation, decreased peripheral vision (glaucoma), contrast sensitivity, and accommodation.
pain during activity that does not restrict performance
An overuse injury classified as stage 2 is described as what?
12 months
Arm/heelstrike balance reaction ● Ambulation ● Hips and knees in flexion
fat
At the age of 70, this is what the body is mainly composed of.
Level 4
Based on the Gross Motor Function Classification, what level would it be if patient demonstrate self-mobility with limitations: Children are transported or use power mobility outdoors and in the community?
Level 3
Based on the Gross Motor Function Classification, what level would it be if patient is able to walk WITH assistive mobility devices; Limitations: walking outdoors and in the community?
Level 2
Based on the Gross Motor Function Classification, what level would it be if patient is able to walk WITHOUT assistive devices, limitations: walking outdoors, and in the community?
Level 1
Based on the Gross Motor Function Classification, what level would it be if patient is able to walk without restrictions, and limitations is in more adavance gross motor skills?
Level 5
Based on the Gross Motor Function Classification, what level would it be if self mobility is severely limited, even with the use of assistive technology?
C8-T1
Brachial plexus injury called Klumpke's Palsy which cord segments involves?
bone
Collagen is the major component of all but which of the following tissues? Ligament, tendon, bone or skin?
chemical
Decreased ACH is an example of what kind of changes in the brain from dementia?
Myelomeningocele
Defined as a type of spina bifida cystica, where cyst includes cerebrospinal fluid and herniated cord tissue
Spina bifida cystica
Defined as when the neural tube defect is visible or open lesion. This is called?
Meningocele
Defined as: type of spina bifida cystica, where cyst includes cerebrospinal fluid; cord intact
Plagiocephaly
Deformation of the skull during development caused by prolonged positioning in uterine or in the first few months of life
Individualized family service plan (IFSP)
Detailed total plan of care for the child and the context of the family unit
20 months
Developmental Sequence Summary at what month(s)? - ascends stairs step to pattern (2 feet on each step) - running more coordinated - jump off of bottom step - plays make believe
1 month
Developmental Sequence Summary at what month(s)? - decreased flexion - momentary head elevation with minimal forearm support - tracks a moving object - head usually to side - reciprocal and symmetrical kicking - positive support and primary walking reflexes in supported standing - hand fisted with indwelling thumb most of the time
Thirty-Second Walk Test
Equipment: Tape measure Starting Position: Demarcated walking course Instruct student to walk as if they are line leaders (walk not run), beginning when told and stopping when instructed (30 sec.). Measure the distance walked to the nearest inch. The student's forward-most foot placement is determined by the most advanced part of the foot in contact with the floor (e.g. heel at heel strike, toes at mid stance)
vascular form of thoracic outlet syndrome
The signs and symptoms of this include: - vein- edema; hand stiffness; venous engorgement of arm w/cyanosis; symptoms may present several hours post-exercise - artery - rapid onset of coolness; numbness entire arm, fatigue after overhead activity.
head injury
There should be accurate assessment of this. Conscious ambulatory individuals should not be considered to have only a minor head injury
types 4-6
These degrees of AC sprain are caused by more violent forces • Extensive mobility due to tear of deltoid and trapezius attachment at distal clavicle
sports medicine organizations
These develop professional standards & code of ethics • Exchange of professional knowledge, stimulate research, & promote critical thinking. • Ability to work as a group with a singleness of purpose to achieve objectives that could not be accomplished separately.
external risk factors
These include sports factors, protective equipment, sports equipment and environment
premature
These infants are less active than full term babies, and they tend to remain in any position they are placed • Reflex activity, including sucking, swallowing, gagging, cough, and grasp are weak or absent. • Incomplete ossification of bones and ligamentous laxity are present. • Display hypotonia - lack of muscle tone
C5-6
These roots innervate the deltoid, spinati,biceps, brachioradialis, biceps supinator and flexor muscles of the forearm.
general to specific (simple to complex)
These terms explain the patterns of fetal growth that take place. As the fetus grows, undifferentiated cells migrate to specific locations in the fetus and take on specific roles (brain cells, skin, blood). Limb movements start out as gross patterns that are directed by reflexed and mature to skilled movements.
Parkinson's disease
This disease is staged using the Hoehn and Yahr scale.
signage
This helps with orientation, safety, sequencing, and spaced retrieval
full gestation
This is 40 weeks of pregnancy. The average birth weight is 7 to 7.5 lbs. Infants born before the completion of 37 weeks of gestation are considered premature
osteoporosis
This is a bone mineral density with a T score between 1 and 2.5, where the normal young adult level is 1 or greater
dissociation
This is the ability to separate movement of one body part to another • Ex. turn head without trunk • Reaching with one arm when prone on elbows
polypharmacy
This leads to - More adverse drug reactions - Decreased adherence to drug regimens - Adverse patient outcomes - Poor quality of life - High rate of symptomatology - (Unnecessary) drug expense
Older Adults Protective Services Act
This mandates reporting requirements on suspected abuse. Any employee or administrator of a facility who suspects abuse is mandated to report the abuse. All reports of abuse should be reported to the local Area Agency on Aging and licensing agencies. If the suspected abuse is sexual abuse, serious physical injury, serious bodily injury, or suspicious death as defined under OAPSA, the law requires additional reporting to the Department of Aging and local law enforcement
environmental structuring
This minimizes distractions and maximizes engagement
Part D
This part of IDEA is about research, personnel preparation, professional development
Part B
This part of IDEA says that students with disabilities must be educated in general education settings to maximum extent possible. Segregation is allowed only if supplementary aid and services in general education settings are not sufficient & opportunities to interact with peers without disabilities are provided Continuum of services must be available
small load
This produces a elastic response
Global Deterioration Scale
This uses subjective descriptions to categorize cognition into 7 levels.
Global Deterioration Scale
This was developed by Reisberg, Ferris, and Crook in 1982, is a 7 stage rating scale designed to determine the severity of dementia through observation of an individual's daily function. The rating scale functions by grouping together individuals with similar characteristics. These groupings/ratings provide guidance toward appropriate evaluation and treatment tools to be used by OT, PT, and ST. The scale can also be utilized by nursing as a resource to provide additional insight into functional abilities of residents. This has been found to have correlation with several other instruments, one being the FAST
tpa
This works for large and small vessel occlusions for ischemic strokes within 4.5 hours from onset.
false
True or False: During a basketball game, an athlete falls and strikes their head on the ground. The individual experiences confusion and a mild headache. Within a few minutes, the confusion is no longer apparent. The athlete should be permitted to return to play.
false
True or False? In recurrent anterior glenohumeral dislocations, the forces needed to produce the injury are increased.
subdural and retinal hemorrhages
What are the hallmark signs of shaken baby syndrome?
anisotrophic
When a structure is stronger in resisting force from certain directions than from others, it is said to be what?
deltoid
Which ligaments make up the medial half of the ankle?
premature
With these babies, you should • Assess axillary temperature because it approximates core temperature • Wrap in warm blankets
strains
You will get muscle spasms with these but not with sprains
blocked practice
a practice sequence in which individuals rehearse the same skill repeatedly
force
a push or pull acting on a body (e.g., gravity, friction)
Motor Program Theory
a theory proposing that details of the movement are stored in certain parts of the brain and are generated by chaining or reflexes
trunk righting
body on head 4-6 months to 5 years. Once a child can stand from supine without rotating the trunk, they are no longer using righting reactions Landeau parachute response- 3-4 mos to 2 years of age
periventricular leukomalacia
clinical manifestations of this include: • Most often - spastic diplegia of lower extremities (weakness and increased muscle tone in the legs which causes difficulty with walking) • Arms or eyes could also be involved • Another cause of cerebral palsy
postural reflexs
develop in the following order: primitive reflexes, righting responses, equilibrium responses, tilting responses, protective extension responses
interdisciplinary
different team members make their assessments individually, including recommendations and plan of intervention; meetings are held to plan interventions jointly to discuss the child's needs and progress toward agreed on objectives, team members may incorporate some aspects of each other's care plans in their own interventions, common in school settings, some acute care hospitals, and rehabilitation facilities
dyspraxia
difficulties with this include: • Sequencing movements & actions • Organisation and Time Management • Multitasking • Word finding /articulatory difficulties • Time & space perception • Turn taking in conversation (not ASD) • Self confidence • Mental health problems Motor difficulties often resolve over time • Or not- • 9 out of 10 children with dyspraxia have difficulties as an adult (NHS Direct 2011) • Dyspraxic people may avoid sport ... or may become professional dancers
simple concussion
for this, symptoms resolve on examination in less than 30 mins, injury resolves over 7-10 days
delirium
key indicators of this include rapid onset, fluctuating level of consciousness, impaired attention skills, visual, tactile or olfactory hallucinations
optical righting reflex
position- hold child from armpit in a suspended position then change position of his head from side to side response: eyes will always move to the same side as head Appears by 1 to 2 years and remains throughout life
shoulder injuries
prevention of these include: • Physical conditioning - Flexibility - Strength • Protective equipment - Shoulder pads • Proper skill technique - Throwing motion - Proper falling technique
tonic labyrinthe reflex
primitive response stimulus: position of labyrinth in inner ear-reflected in head position response: head in the supine position, increased extensor tone; head in prone position, increased flexor tone normal age of response: birth to 6 months no integration interferes with ability to initiate rolling, prop on elbows with extended hips, ability to flex trunk and hips to come to sit from supine, sitting and standing balance
rooting reflex
retention of this reflex may include -hypersensitivity around lips and mouth -tongue may remain too far forward in the mouth -speech and articulation problems -poor manual dexterity (Babkin response)
spinal galant
retention of this reflex may include fidgeting, bedwetting, poor concentration, poor short term memory, postural issues
ATNR
retention of this reflex may include: -balance problems as a result of head movement to either side -homolateral, instead of normal cross-lateral movements when walking, marching, skipping -difficulty crossing the midline -poor eye tracking -difficulties with hand-eye coordination, and therefore reading comprehension -poor handwriting or expressing ideas on paper -difficulty bringing both hands together
transdisciplinary
team members work closely with one another in the evaluation process, designing an intervention program and carrying out interventions. Roles can cross boundaries of typical disciplines; common in infant development programs (Child Find) and NICU
middle childhood
the period from 6 until 10-12
infancy
the period from birth until the child is able to stand and walk; usually ~18 months
types 2-6
these AC sprains constitute a referral to emergency medical facility
tendons
these are 2x as strong as the muscles they serve
internal and external risk factors
these can make an athlete more susceptible to injury
internal risk factors
these include things like age, sex, body composition, health, physical fitness, anatomy
type 2
this AC sprain includes rupture of AC ligaments • + displacement; step off deformity • Pain with horizontal adduction • Pain with downward pressure on distal clavicle • Stability: vertical maintained; sagittal plane compromised
birth to 3 months
this age is when babies have ● Initial flexor tone ● Beginning head control
mechanism of injury
this is how an injury occurs - Application of force - Tissue type -severity of force
duration of action
this is the length of time the med is active in the body drugs with long half lives will have a long duration of action drugs with short half-lives will need more frequent dosing
neck on body
this is the reflex that helps the body follow head movement. 4-6 months onset to 5 years
delirium
this may complicate or imitate dementia
locomotion
this movement breaks up bilateral dominance
IDEA
this was enacted to assist states in meeting the educational needs of students with disabilities Allows parental input in decision making and maximizes provision of an appropriate education for students with disabilities
primitive reflexes
those with cerebal palsy and neurogenic dysphagia still have these present
torticollis
• "wry neck" • Condition occurring in which the head is held in side-bending toward one side and rotated toward the other side • Usually resulting from unilateral fibrosis and shortening of the sternocleidomastoid (SCM) muscle; may also involve scalenes, upper trapezius, and other muscles of the face and neck
pre-mature
• 8 to 10% of all live births in the United States are this • Approximately 75 - 80% of neonate mortality and morbidity is due to this • Highest incidence - lower socioeconomic class - more harmful lifestyle, lack of nourishment and prompt and comprehensive prenatal care. • The birth rate for this in black infants is ~ 59% higher than the rate for non-Hispanic white infants and 49% higher than the rate for Hispanic infants.
olecranon bursitis
• Acute and chronic • MOI - Fall on a flexed elbow - Constantly leaning on elbow - Repetitive pressure and friction - Tender, swollen, relatively painless - Rupture - goose egg visible - Motion limited at extreme of flexion - tension increases over bursa • Management - Standard acute - Possible aspiration - NSAIDs
Klumpke's palsy
• Excessive upward pull of limb • Traction (stretching or avulsion) of lower ventral rami (e.g., C8, T1)
periventricular hemorrhage
• Grade IV GM-IVH involving a hemorrhage into the periventricular white matter • Also involves obstruction of blood flow in the veins • Nearly always unilateral • Causes an infant stroke (paralysis on opposite side of body)
Erb's Palsy
• Increase in angle between neck & shoulder • Traction (stretching or avulsion) of upper ventral rami (e.g., C5,C6)
blisters
- Accumulation of fluid between epidermis and dermis - Caused by repeated application of shear in one or more directions
AC
- Acromion process of scapula with distal end of clavicle - Irregular joint; permits movement in all 3 planes - Capsule; minimal stability ligaments; strong stabilizers • Superior and inferior AC ligament • Coracoclavicular ligament
Bennett's fracture
- Articular fracture - proximal end of first metacarpal - Mechanism: axial compression - Pull of APL tendon displaces shaft proximally; deep volar ligament holds small medial fragment in place → fracture-dislocation - S&S • Localized pain and swelling; ↑ pain with inward pressure long axis - Management: immobilize in position of function; ice without compression; immediate physician referral
rotator cuff tendonitis/ impinegment syndrome
- Contributing factors (refer to Box 12.2) - S&S • "Deep" pain - initially at night • Becomes progressively worse • Painful arc: between 70° and 120° • Unable to sleep on involved side - Management: do not permit to continue activity until seen by a physician partial rotator cuff tear is more likely in young. Total tear more common in adults over 30
boxer's fracture
- Distal metaphysis or neck of fourth or fifth metacarpals - Inherently unstable - S&S • Sudden pain, inability to grip, rapid swelling, and deformity • Point tenderness; crepitus • Delayed ecchymosis • ↑ pain with axial compression and percussion
medial epicondylitis
- Due to repeated valgus forces - Combined flexor muscle strain, ulnar collateral ligament sprain, and ulnar neuritis - Common in adolescent athletes - "Little league elbow" - medial humeral growth plate is involved - S&S • Swelling, ecchymosis, & point tenderness at humeroulnar joint or medial epicondyle • Pain with resisted wrist flexion and pronation • If nerve involved, tingling & numbness radiate to forearm & hand - Management • Do not permit to continue activity until seen by a physician • Suggest application of cold to decrease pain and spasm
ulnar tunnel syndrome
- Due to repetitive compressive trauma to the palmar aspect of the hand - S&S • Numbness in the ulnar nerve distribution (especially little finger) • Unable to grasp a piece of paper between the thumb and index finger • Slight weakness in grip strength - Management • Suggest application of cold to decrease pain and spasm • Do not permit to continue activity until seen by a physician • Do not use compression wrap
Frantz and O'Rahilly Classification Congenital Limb Deficiency
-terminal or intercalary -transverse or paraxial -complete or incomplete -additional terms ● amelia total absence of the limb involved ● hemimelia partial absence of the limb involved ● phocomelia absence of the long bones
L4
A child with myelomeningocele at what level is most likely to stand without any assistive device?
Monoplegia
A classification of Cerebral Palsy that involves impairment of one limb is called:
compression
A contusion, metatarsal fracture, or a cervical fracture all result from what type of force?
The allen acls
A key concept of this model is - "functional cognition," which takes in both what our brains pay attention to, and how it determines what it needs to in order to enable us to do certain tasks. - Through use of this model, we can learn more about how the person's brain, through processing the signals it receives from the environment, controls his actions. To a large extent, this is determined by what parts of the environment his brain pays attention to. - By analyzing how the person perceives the environment, and using that information, we can enhance behavioral responses to that environment.
Autism
A neural developmental disorder characterized by impairments in social interaction, communication skills, and repetitive behaviors.
anatomical malalignment
A shallow patellofemoral groove, genu valgum, increased Q-angle, and excessive foot pronation are potential causes of patallofemoral pain associated with what?
anatomical malalignment
A shallow patellofemoral groove, genu valgum, increased Q-angle, and excessive foot pronation are potential causes of patallofemoral pain due to what?
left ventricle
Aging causes a decrease in function of this. Blunted heart rate response to exercise requires a compensatory increase in stroke volume to increase cardiac output.
basal ganglia
Aging causes this region of the brain to atrophy
skin
Aging causes this to be more easily damaged, delayed wound healing, decreased inflammatory response, etc.
Gastrointestinal
As you age, in this region you have decreased absorptive cells, decreased GI mobility or decreased normal sphincter activity, decreased blood flow, decreased gastric acid, and decreased active transport
0-0.1 m/sec
At this walking speed, D/C to an SNF is likely
0.1-1.4 m/sec
At this walking speed, a D/C to home is more likely
0.4 m/sec or less
At this walking speed, an individual is a household walker
large lateral displacements
Children with ataxia walk with what gait deviation in an effort to maintain balance?
Timed Floor to Stand
Equipment: Stopwatch Starting Position: Student seated on floor in a cross-legged position. Student is asked to get up from floor, walk as quickly as possible for 3 meters (9 ft 10 in), turn around, walk back to starting line, and sit back down on the floor in cross-legged position. Mean: 6.6 sec (range 4.4-12.1 sec), age 5-22 yrs.
6-Minute Walk Test
Equipment: Tape measure Starting Point: Mark a walking course in a large open space (gym, large corridor) with the tape, and place a cone or other marker at the starting point of each lap. At "go" student walks as fast as possible (without running) for 6 minutes. The therapist can provide verbal encouragement every 30 seconds. At the end of 6 minutes, measure laps completed and convert it to distance walked.
Pediatric Reach Test (PRT)
Equipment: Tape measure Starting point: Student stands barefoot on tape line on the floor. One end of tape measure is secured to student's fingers while evaluator holds the other end. Record initial reading from tape. Student reaches one arm forward. Student is allowed to use whatever strategy he/she wishes as long as he/she does not touch the wall or take a step. Record final reading. Calculate final reading minus initial reading.
periventricular leukomalacia
Etiology of this includes: • Systemic hypotension (low blood pressure) with resuscitative difficulties after birth • Patent ductus arteriosus • Severe spells of apnea (no breathing) • These three, in turn - Reduce cerebral blood flow in the highly vulnerable region of the brain where the middle, posterior, and anterior cerebral arteries meet causing damage to white matter of the brain and the development of cysts
elder abuse
Examples of this include: • Verbally assaults, threatens, or insults the older person; • Concerned only with the older person's financial situation instead of his or her health or well being; • Has problems with alcohol or drug abuse; • Does not allow the older person to speak for him or herself; • Blames the older person; • Has attitudes of indifference or anger toward the older person; and/or • Socially isolates the older person from others.
impingement syndrome
Factors that contribute to this are often found with swimmers, including: -excessive amount of overhead movement (i.e., overuse) -weakness of the posterior cuff muscles (e.g., infraspinatus or teres minor) -tightness of the posterior cuff muscles -hypermobility of the shoulder joints -imbalance in muscle strength, coordination, and endurance of the scapular muscles (e.g., serratus anterior or rhomboids) -training devices (e.g., use of hand paddles or tubing)
injury (MOI)
Factors that determine this: - Magnitude of force - Material properties of tissues involved
Family assessment
Family interview, survey, or discussion used to obtain the families insights regarding a patient, especially a child; family history, relationships, concerns, needs, resources
myelomeningocele
Features of this include: ● Neurologic defects and impairments ● Functional movement related to level ● Musculoskeletal impairments ● Osteoporosis ● Neuropathic fractures ● Spinal deformities ● Arnold-Chiari type II malformation ● Hydrocephalus ● Hydromyelia ● Tethered spinal cord ● Sensory impairment ● Bowel and bladder dysfunction ● Latex allergy
shearing
Force that moves across the parallel design of the fibers
0.6 m/sec
Gait speed threshold that risk for re-hospitalization is reduced.
Primary walking
Hold infant in supported standing, tilt trunk forward slightly, reciprocal stepping motions in lower extremities. What is this reflex called?
impaired timing and sequencing
The are examples of deficits in motor control, e.g a fall
lower doses
These should achieve the same effect with advancing age because receptor numbers, affinity, or post-receptor cellular effects may change. Changes in homeostatic mechanisms can increase or decrease drug sensitivity
Rooting,sucking
Which two neonatal reflexes are considered to be important feeding reflexes?
physical therapy
a child might be referred to this if they have: • Difficulty in accomplishing tasks without the use of adaptive equipment, environmental modifications, or assistive technology • Poor balance or frequent falling • Postural, orthopedic abnormalities • Delayed gross motor skills • Difficulty learning new motor tasks • Difficulty in moving or moving unsafely in the school environment • Difficulty in maintaining an appropriate sitting posture
GM-IVH
complications of this disease include: • Hydrocephalus - excess fluid in brain enlarged head • Germinal matrix destruction brain damage • Cyst formation • Hypoxic - ischemic lesions (lack of O2) brain damage
palmar reflex
retention of this reflex could include things like -poor manual dexterity/fine motor skills -poor writing skills (messy writing) -speech difficulties (hand and mouth relationship via the Babkin response)
positive direction
the normal growth process moves this way, meaning the infant and child do more with time
topical absorption
this can be increased with heat
first trimester
this is the fetal stage, after the first 8 weeks. Growth and maturation of all the structures that were formed in the embryonic stage occurs. By the end of this, the fetus makes sucking motions with the mouth, the external genitalia are mature, the heart is beating and respiratory movements can be seen
embryonic stage
this is the first 8 weeks of gestation, very critical growth period. The embryo is very susceptible to environmental disruptions. During this period many women do not yet know they are pregnant
posttraumatic headache
this is the result of vasospasm, doesnt usually occur with impact but develops shortly afterward
optical head righting
this is visual tracking and moving the head, 0-2 months, onset to adults
9 mos
this is when babies can crawl
10 mos
this is when babies can cruise
4-6 mos
this is when babies can roll
8 mos
this is when babies can sit
physical abuse
types of this include ◦ Rib fractures ◦ Bruises ◦ Children who are not independently mobile ◦ Face, abdomen, back, hands, ears, neck, upper arms, anterior thigh, buttocks, face, neck ◦ Clusters of bruises ◦Multiple bruises of uniform shape ◦ Bruises that have an imprint ◦ Retinal hemorrhages ◦ Burns consistent with immersion or dunking, cigarettes, iron ◦ Fractures - spiral fractures, fractures of long bones in non-ambulatory children, head trauma and skull fractures ◦ Solid organ trauma from a blow to the abdomen
elbow
• 3 articulations (single capsule) - Humeroulnar (elbow joint) • Trochlea of humerus with trochlear fossa of ulna • Hinge joint; flexion and extension - Humeroradial • Capitellum of humerus with proximal radius • Gliding joint - Proximal radioulnar • Head of radius with radial notch of ulna; joined by annular ligament
Torticollis
• After 6 months of treatment for this: o Child has less than 75 degrees of cervical rotation o Persistence of palpable tumor • Child is 18 months or older at time of initial presentation to therapy ** bracing and intensive therapy are required after surgery
ligaments
• Connect Bone to bone • MOI - Intrinsic: ie. malalignment; muscle imbalance - Extrinsic: ie. training error, faulty technique,technique, poor environmental conditions • Maintain anatomical integrity and structural alignment • Collagen and elastin intermixed (contain elastin - more elastic than tendons) - Viscoelastic
selective neuronal necrosis
• Definition - death of brain cells • Etiology - Hypoxic-Ischemic Encephalopathy • Immediate Clinical Findings • Stupor • Coma • Seizures • Low muscle tone • Problems with eye, sucking, and tongue movements
colles fracture
• Distal metaphysis of radius, with displacement of distal fragment dorsally
dislocations and subluxations
• Joint forced beyond normal limits • MOI: tension • Increased susceptibility for chronic or recurrent dislocations • S&S: - Pain - Swelling - Point tenderness - Deformity - Loss of limb function
stress fracture
• MOI: repeated lower magnitude forces • Can become worse over time • Begins as a small disruption in the outer layers of cortical bone and ending as complete cortical fracture with possible displacement
myositis ossificans
• Mineral deposits in muscle associated with prolonged chronic inflammation - Ectopic calcification - Common site: quadriceps • Calcific tendinitis: mineral deposits in the tendon
neonatal seizures
• Most common sign of neurological disorder • Medical emergency because it could indicate a life-threatening problem that could produce immediate and irreversible brain damage - 15 - 20% later exhibit mental retardation, motor impairment, or both • May result in decreased DNA content and brain cell number • Multiple causes - Asphyxia - deprivation of oxygen - Intracranial hemorrhage - Metabolic - high or low blood sugars or sodium, low magnesium or low calcium - Infections - prenatal, postnatal, or intracranial - Developmental defects - malformations - Narcotic withdrawal - Trauma at birth
cystic fibrosis
● Common presentations of this include ● Chronic cough ● Recurrent pulmonary infiltrates ● Failure to thrive ● Meconium ileus
collaborative
team members work closely together in a combination of a transdisciplinary and integrated therapy approach to service provisions; therapist may not provide the majority of motor instruction during the day, teaching the teacher and classroom aid to carry out programs that are collaboratively designed; common in school setting and adult day health programs
child abuse
the caregiver risk factors for this include ◦ Mental health issues ◦ Poor anger control ◦ Teenage parent ◦ Substance abuser ◦ Abused themselves as a child ◦ Corporal punishment ◦ Single parent ◦ Domestic violence ◦ Poverty, Employment, and financial problems ◦ Non-biologically related male in the home
sitting
the full term head movement in this position is that the head may bob while in kyphotic, supported sitting position; head is typically flexed forward
supine
the full term neonate movement in this position head rotates fully in either direction and can come to midline with arousal
locomotion
the full term neonate movement of this includes may move to side of bassinet while prone
cystic fibrosis
the pathophysiology of this includes: ● Lung ● High rate of sodium absorption and low rate of chloride secretion reduces salt and water content in mucus ● Mucus adheres to airway surface, leads to decreased mucus clearing ● Predisposition to Staph and Pseudomonas infections ● Gastrointestinal ● Pancreas ● destruction of pancreatic tissue. ● Intestine ● Decrease in water secretion leads to thickened mucus and dessicated intraluminal contents ● Obstruction of small and large intestines Gastrointestinal ● Biliary tree ● Retention of biliary secretion ● Focal biliary cirrhosis ● Bile duct proliferation ● Chronic cholecystitis, cholelithiasis ● Sweat ● Normal volume of sweat ● Inability to reabsorb NaCl from sweat as it passes through sweat duct
neck righting
the position to test this is supine blind folded, rotate the childs head to one side. Response: body rotates to that side as a whole generally present at birth but at time may appear as late as 3 months
premature birth
the pregnancy factors for this include - Hypertension - Abruptio placenta or placenta previa - Incompetent cervix - opens too soon - Premature rupture of membranes - Chorioamnionitis - inflammation of fetal membranes due to infection - Polyhydramnios - too much amniotic fluid
righting reactions
the purpose of these is to maintain the correct orientation of the had and body in relation to the ground
multidisciplinary team
the team members recognize the importance of each member. However, the child receives services from one to several providers working in isolation while treating the child. Each discipline assesses the child individually without input from the other team members.
rehabilitation services
the types of these available to children has changed significantly over the past century
premature
these babies - Unable to maintain core temperature, conserve, or generate heat - At risk for hypothermia
eversion
this ankle sprain is injury to the medial ligament. A lot less common because the deltoid ligament is strong
moro reflex
this automatic reflex is considered the "fight or flight" response. It activates the sympathetic nervous system. Triggered by sudden unexpected occurrence of any kind. The arms and legs move outwards with quick inhalation, then freeze momentarily and then arms and legs tuck back in and the child exhales. Accompanied by a possible outburst of cries
cramp
this can be clonic, with alternating contraction and relaxation, or tonic with continued contraction over a period of time
cortical level reflex
this consists of all equilibrium reactions. Usually checked on tilt board or rocking board
GM-IVH
this disorder of premature babies may have: Lesion - bleeding into the subependymal germinal matrix - the gelatinous area that contains a rich vascular supply mostly by Heubner's artery (a branch of the anterior cerebral artery) • This matrix is usually gone by full term but prominent from 26 - 34 gestational weeks and is very fragile because it lacks collagen and smooth muscle. • Usually unilateral
comminuted
this fracture is when the bone fragments into several pieces
motor control
this happens in milliseconds
transverse
this is a break that occurs in a straight line across the bone
grade 3
this is a complete tear of the affected ligaments
tension
this is a force that pulls and stretches tissues
compression
this is a force that squeezes or crushes tissues
grade 2
this is a partial ligament tear
collagen
this is a protein substance that is strong is resisting tension. Its fibers are inelastic but they have a wavy configuration when not under tension. This configuration enables collagenous tissues to stretch slightly under tensile loading as these fibers straighten
second impact syndrome
this is a second head injury before the symptoms associated with a previous one have totally resolved. It does not necessarily require a blow to the head
SCAT3
this is a standardized tool designed for use by multiple different health-care professionals in the assessment of concussion in those 13 or older
diffuse injury
this is a widespread disruption, such as a concussion
cerebral palsy
this is classified by ● Distribution of involvement ● Abnormal muscle tone and movement ● Spasticity ● Transient dystonia ● Rigidity ● Dyskinesia ● Ataxia
cerebral palsy
this is classified by the ● Gross Motor Function Classification System (GMFCS) scale ● Five levels ranging from ambulatory to wheelchair bound
amniotic band sequence
this is entrapment of fetal parts (limbs/digits) in fibrous amniotic bands in utero Causes contriction of rings around digits, arm, and legs, swelling of the extremities distal to constriction, amputation of digits, arms and legs
Plagiocephaly
this is facial and skull asymmetry often present with torticollis
impingement syndrome
this is the abutment of rotator cuff and subacromial bursa against coracoacromial ligament and greater tubercle of the humerus
8 months
this is the age when ● Creeping ● Increased Upper Extremity (UE) strength
growth
this is the development from one cell to millions of cells in 9 months. Directed by inborn genetic material and modified by environmental influences
12 mos
this is when babies can walk
3 mos
this is when babies develop head control
brachial plexus palsy
this occurs in 26% of cases of shoulder Dystocia Both Shoulder dystocia and this are more common in LGA babies and Infants of diabetic mothers Infants of diabetic mothers have a higher incidence of permanent impairment In infants of diabetic mothers, the macrosomic process affects the trunk but not the head (large biacromial diameter) The head shoulder disproportion is difficult to predict in Utero.
motor learning
this occurs in hours, days or weeks
motor development
this occurs in months, years or decades
labyrinthe head righting
this occurs in the inner ear at 0-2 months, onset to adult
Part B
this part of IDEA says that Parents must be involved in evaluation, IEP meetings, and placement decisions Progress reports must be sent as frequent as report cards and other notes of progress in the general education curriculum
zero reject
this part of part B says that all students with disabilities eligible under the IDEA must receive a free appropriate public education (FAPE) No exceptions based on disability type or severity All states must establish a child find system Identify, locate, and evaluate all students suspected of having a disability Applies to all children from birth to age 21 Private schools not required to participate
abuse
this should be considered when ◦History is inconsistent with injuries ◦History is incompatible with child's development ◦History that changes with time ◦Delay in seeking medical care ◦Suspicious injuries
perception-action theory
this theory of motor development states that No action can be performed without resulting perception, and nothing can be perceived without action. Thus movement plays a central role in what we know and can perceive
dynamic system theory
this theory of motor development states that movement emerges from the interaction of multiple body systems
oblique
this type of fracture occurs diagonally
Congenital Torticollis
• A neck deformity primarily involving unilateral shortening and fibrosis of the SCM that is detected at birth or within the first two months of life • Can be sub-divided into three types: a. Torticollis with a palpable mass or tumor in the tight SCM (SMT) b. Muscular torticollis - Without a palpable mass or tumor in a tight SCM (MT) c. Postural torticollis - that w/ all the clinical features of torticollis but w/ no demonstrable tightness nor pseudotumor of the SCM (postural head tilt, late-onset ocular torticollis, SCM imbalance, "positional preference"?) (POST) ** the term "Congenital Muscular Torticollis" (CMT) often includes all of these groups ** the "involved" side is the side of tightness or in which a mass is present - therefore, a child with right-sided involvement would generally present with right cervical lateral flexion and left rotation as their preferred position
Erb's Palsy
• Appearance: drooping, wasted shoulder; pronated and extended limb hangs limply ("waiter's tip palsy") • Loss of innervation to abductors, flexors, & lateral rotators of shoulder and flexors & supinators of elbow • Loss of sensation to lateral aspect of UE • More common; better prognosis Posture of adduction and inward rotation at the shoulder with extension and pronation at the elbow and flexion of the fingers = WAITER'S TIP
contusions
• Arm and forearm vulnerable • S&S - Rapid swelling - can limit ROM • Chronic blows - Development of ectopic bone • Myositis ossificans - brachialis belly; proximal deltoid insertion • Tackler's exostosis • Management - Standard acute - If symptoms persist > 2-3 days, physician referral
dolicocephaly
• Because of the soft skull bones, preterm infants tend to get this, also called "preemie head" caused by positioning the infant on one side and the other on the mattress in the NICU. • Head looks longer from front to back and is flattened on both sides • Positioning on a waterbed or gel mattress can prevent this deformity.
proximal distal development
• Body is a linked structure • Axis provides a stable base fro the head, eye, and extremity movements to occur • Develops head control from prone position • Trunk - needs to be stable for head and extremity movement • Need weight bearing activities • Neck, trunk, proximal shoulder and pelvic girdle control prior to arms, legs, hands, and feet
ligaments
• Bone to bone - Intrinsic (inbalances) - Extrinsic (environmental) • Maintain anatomical integrity and structural alignment • Collagen and elastin intermixed (contain elastin - more elastic than tendons) - Viscoelastic • MOI: - High tensile force • S&S: - Pain; point tenderness; swelling; loss of function; instability
overuse injurties
• Classification - Stage 1: pain after activity only - Stage 2: pain during activity, does not restrict performance - Stage 3: pain during activity, restricts performance - Stage 4: chronic unremitting pain, even at rest
smiths fracture
• Distal radius, with displacement of distal fragment toward palmar aspect
premature
• Due to lack of suck, swallowing, and gag reflexes, feeding and intravenous tubes are necessary in these infants • When able, positioning upright, while stimulating oral motor techniques, is essential.
bone
• Fracture: Disruption in the continuity of bone • S&S: - Rapid swelling - Ecchymosis - Deformity or shortening of the limb - Precise point tenderness - Grating or crepitus - Guarding or disability • Type of fracture dependent upon: - Force applied - The health and maturity of the bone at the time of injury • Bone susceptible to: - Compression, tension, shear, bending, and torsion
frailty
• Frailty is a chronic, progressive clinical syndrome, characterized by dysregulation of multiple physiologic systems leading to increased vulnerability and mortality. The presence of ≥3 of the following features correlate with a phenotype of frailty: 1. Weakness (Decreased grip strength in dominant hand) 2. Exhaustion (Self-reported scale) 3. Weight loss (Unintentional loss of >10 lb. in one year) 4. Slow walking speed (Time to walk 15 feet > 6 or 7 seconds, depending of height) 5. Low activity level (<270 kcal/week expenditure)
environments
• Individuals with dementia are easily influenced by these due to: • Decreased attention • Impaired executive function • Decreased impulse control
Anterior Glenohumeral Dislocation
• Intense pain; recurrent: less painful • Tingling and numbness down arm • Arm held in slight abduction and external rotation; stabilized against body by opposite hand • Deformity - sharp contour and a prominent acromion process • Attempt to bring arm across chest horizontal adduction or internal rotation - severe pain
Posterior glenohumeral dislocation
• MOI - fall on or blow to the anterior shoulder • S&S: • Arm is carried tightly against chest & front of the trunk (rigid adduction and internal rotation) • Deformity: anterior shoulder appears flat, the coracoid process is prominent, • Individual will not allow the arm to externally rotate & abduct produces severe pain; unable to supinate the forearm
Hypoxic-Ischemic Encephalopathy
• Major perinatal cause of neurologic morbidity in premature infant • Etiology - Perinatal asphyxia (deprivation of O2) due to - Altered placental exchange - Reduced maternal blood flow to the placenta - Umbilical cord around the neck of the infant - Maternal hypotension (low blood pressure) - Maternal hypoventilation (slow or shallow breathing) - Traumatic or prolonged deliveries • Results in hypoxemia (reduced amount of O2 in blood) and ischemia (inadequate blood supply to brain)
periventricular leukomalacia
• Principal ischemic lesion of the premature infant • Death of the white matter of the brain due to softening of the brain tissue
osteopenia
• Reduced bone mineral density • Predisposes individual to fracture - Particularly stress fractures • Possible causes: - Amenorrhea, hormonal factors, dietary insufficiencies
ligaments
• Resists large tensile loads along the long axis of the ligament and smaller loads from other directions - static stabilizers • Fail in fast loading situations • Strongest in their middle and weakest at their ends • Healing process - slow due to a limited blood supply
overuse injuries
• Results from repetitive use • Factors: - Intrinsic: ie. malalignment; muscle imbalance - Extrinsic: ie. training error, faulty technique,technique, poor environmental conditions
Becker Muscular Dystrophy
• Same pathogenesis as DMD - Except for inframe mutations for BMD, out of frame for DMD • Slower course - Present between 5-15 years old - Wheelchair bound after 16 years old - Live through their 30s-40s • Less severe course, less likely to have - Cognitive impairment - Cardiac disease - Contractures - Scoliosis - GI issues • CK elevated (5x upper limit of normal) • Muscle biopsy with decreased dystrophin ● Symptoms begin between 5 to 10 years of age ● Life expectancy into the fifties ● Prevent excessive weight gain
The allen-acls
• The test was devised through research which involved the use of three increasingly complex sewing stitches on a piece of leather, known as the Allen Cognitive Levels Screening (ACLS). • This measure was standardized in 1978, and successive studies established inter-rater reliability, as well as correlations between the ACLS and other standardized psychological assessments. • The standardized directions for administration of the ACLS were first published in 1985, and have been revised several times since then. • In 1992, an alternate form of the test was made available for those with visual impairments and impaired hand function.
National Athletic Trainers Association
• To enhance the quality of health care for athletes and those engaged in physical activity, and to advance the profession of athletic training through education and research in the prevention, evaluation, management and rehabilitation of injuries • The NATA now has 28,000 members • June 1991- AMA officially recognized athletic training as an allied health profession • Committee on Allied Health Education and Accreditation (CAHEA) was charged with responsibility of developing essentials and guidelines for academic programs to use in preparation of individuals for entry into profession through the Joint Review Committee on Athletic Training (JRC-AT)
equilibrium reactions
● Develop after righting reactions and protective responses ● Body adapts to slow changes in the relationship of the center of gravity with the base of support ● Lateral weight shifts - trunk rotates in opposite direction ● Developmental timetable
Cystic Fibrosis
● Inherited monogenic disorder presenting as a multisystem disease. ● Typically presents in childhood ● 7% of CF patients diagnosed as adults ● Most common life limiting recessive trait among whites ● Prognosis improving ● >38% of CF patients are older than 18 ● 13% of CF patients are older than 30 ● Median survival ● Males: 32 years ● Females: 29 years
cystic fibrosis
● Major objectives of this include ● Promote clearance of secretions ● Control lung infection ● Provide adequate nutrition ● Prevent intestinal obstruction ● Investigation into therapies to restore the processing of misfolded CFTR protein
Duchenne muscular dystrophy
● Pathophysiology and natural history • X-linked recessive, 1:3300 males - Xp21, dystrophin gene mutation (2/3 familial, 1/3 new mutations) • Typically presents at 5 years old - difficulty running - abnormal gait (waddling) - historic motor delay • Physical Exam - Musculoskeletal • lumbar lordosis • calf pseudohypertrophy (muscle fibers replaced with fat and connective tissue - Neurologic • Neck flexor weakness • Symmetric and proximal UE and LE weakness, LE > UE • Diffuse hypotonia, DTRs 1+ diffusely Muscle Disease Neurology Rotation Lecture Series Last Updated by Lindsay Pagano Summer 2013 !32 Duchenne muscular dystrophy (DMD) • Other system involvement - Dystrophin is found in skeletal muscle, smooth muscle, cardiac muscle and brain - May have cognitive impairment - All develop cardiomyopathy - May develop intestinal pseudo-obstruction • Gower Sign • Diagnosis - CK elevated (10x upper limit normal) - Muscle biopsy (absent dystrophin) - Genetic/DNA testing - +/- EMG/NCV • Prognosis - Supportive care - +/- steroids - Wheelchair bound by 13 years old - Death in 20s from respiratory or cardiac failure.
child abuse
◦ "Any act or failure to act by a perpetrator which causes: ◦Serious physical injury ◦Serious mental injury ◦Sexual abuse or exploitation ◦Serious physical neglect ◦ Imminent risk of serious physical injury or sexual abuse"
Sports Physical Therapy Section of APTA
The goal of this section is • To provide a forum to establish collegial relations between physical therapists, physical therapist assistants, and physical therapy students interested in sports physical therapy • Promotes prevention, recognition, treatment and rehabilitation of injuries in an athletic and physically active population • Provides educational opportunities through sponsorship of continuing education programs and publications • Promotes the role of the sports physical therapist to other health professionals • Supports research to further establish the scientific basis for sports physical therapy • Offers certification as a sports physical therapist (SCS) • Approximately 9,000 members • Many sports physical therapists are also certified athletic trainers
nursemaids elbow (pulled elbow)
The injury is a subluxation or dislocation of the radial head and is often associated with an immature annular ligament. The mechanism of injury is longitudinal traction of an extended and pronated upper extremity. The injury is more common in children and adolescents; most patients are younger than 20 years old. Limited or painful pronation and supination is an indication of a radial head dislocation.
ulnar dislocation
The mechanism of injury is usually hyperextension or a sudden, violent unidirectional valgus force that drives the ulna posterior or posterolateral. Additional signs and symptoms include: - snapping or cracking sensation on impact - arm held in flexion, with the forearm appearing shortened - olecranon and radial head are palpable posteriorly - slight indentation in the triceps visible just proximal to the olecranon. The injury should be treated as a medical emergency. As such, activation of the emergency action plan is warranted, including summoning of EMS.
clavicle fracture
The mechanisms include: compressive forces caused by a blow or fall on the point of the shoulder, a direct blow to the bone by an opponent or object, or falling on an outstretched arm. S&S - visible and palpable deformity at fracture site - pain with any motion; pain may radiate into trapezius
periventricular leukomalacia
The medical management of this includes: • Maintain adequate ventilation • Maintain blood pressure • Serial Ultrasonography because the evolution is related to the prognosis • Physical therapy for the spastic diplegia - Stretching - Strengthening - Gait training
Respiratory insufficiency
The most likely cause of death of individuals diagnosed with Duchenne's Muscular Dystrophy is?
Neural tube defect
The neural tube fails to clothes completely during the first month of gestational development
ordered
The normal growth process is this, which means every step is based on what comes before.
Asymmetrical Tonic Neck Reflex (ATNR)
The oneset of this is about 0-2 months and the integration of this is about 4-6 months. This is done by turning the infants head to one side. Response observed: On the opposite side, arm is flexed, on the same side, limbs are extended Functional significance- persistence of this reflex may indicate CNS damage
palmar grasp spinal reflex
The onset of this occurs at 10 weeks gestation and is integrated at about 4-6 months. Testing position is supine with the head midline, arms and hands free. Procedure is placing a finger in infant's hands from the ulnar to the palmar surface. Normal response should be that the infants fingers will flex around the finger Functional significance is following the development of grasy, the infant can reach for objects and utilize a crude palmar grasp to hold them
physical therapy
The recommendation for continuation or graduation from these services is determined by the professional expertise of the physical therapist in collaboration with the IEP (Individualized Education Program) team. • There are several factors to consider when making decisions regarding physical therapy service completion. Possible Factors Include: •The student's needs being addressed by physical therapy no longer negatively affect his/her educational performance in the regular education or special education program. •The student no longer requires PT as a related/ DIS service in order to benefit from his/her special education program. •Therapy is contraindicated because of the change in medical or physical status. •The student's needs will be better served by an alternative program and/or service, as determined by the IEP team. The student consistently demonstrates behaviors that inhibit progress in physical therapy: •such as lack of cooperation, motivation, or chronic absenteeism. •IEP team should consider the initial eligibility decision since these behaviors may reflect social maladjustment, environmental, cultural, or economic factors rather than an actual disability. •IEP team may also explore alternative services or strategies to remedy the interfering behaviors or conditions. •He/she graduates from high school and/or reaches the age of 22 years.
return to play guidelines
These are Individually tailored to the activities in which the athlete wishes to complete post discharge
interventions
These are now based out of a systems model, motor learning, concepts, motor control and motor development
clavicular fractures
These are often associated with shoulder dystocia , but the incidence of brachial palsy in these Cases is only 11%. these =more mobility of shoulder Not always associated with difficult delivery (Intrauterine Maladaption palsy). Cases of in utero origin supported by EMG findings if denervation at birth.
antibiotics
These are routinely ordered to prevent or treat infection preoperatively and postoperatively
neonatal (primitive) reflexes
These are the inborn behavioral patterns that develop during the uterine life
objective measures
These are used often in PT, examples include: • Muscle tone • Muscle testing • Timed Tests: • 10 m walk • TUG • 2 min. walk • supine to stand • ascend 4 stairs • Pediatric Balance Test • vestibular testing • vision dissociation
intertrochanteric fractures
These are usually fixed with an ORIF, and have better outcomes than femoral neck fractures
premature
These babies have very fine lanugo hair which can be abundant on body and feathery on head
frontotemporal degenerations
These cause behavioral disinhibition and fluctuating mental status. Early onset typical.
ectodermal cells
These cells will mature into skin, hair, teeth, nails, pituitary glands, adrenal medulla, lens of the eye and nerves
physical therapists
These individuals analyze the curriculum and tasks of children -Sitting upright in a chair or on the floor during circle time - Keeping up with peers when walking from the classroom to the play yard - M o v i n g w i t h i n t h e s c h o o l environment with minimal need for assistance - Negotiating obstacles within school setting - Navigating the play structure with the least amount of supervision necessary for safety - Navigating and engaging in movement exploration during playground activities
physical therapists
These individuals determine the supports and barriers to learning in the educational environment by assessing the child across the school campus in order to paint an accurate picture of the child's ability to access and make progress in his/her program • Consider the curriculum, and relate foundational skills to the child's ability to function in his/her program • Gather all the evidence including observations in context, teacher and family input, formal and informal assessments, etc.
physical therapists
These individuals look at this in a child referred to PT Gross Motor Skills - Endurance - Postural Control - Motor Control and Coordination - Strength and Stability - Balance - Functional Mobility - Tolerance for Positioning and Movement - Environmental Adaptations and Modifications
physical therapists
These individuals use evidence-based practice by integrating child factors, professional expertise and research evidence • Consider how the child's goals and desires, affect participation • Determine how services will impact the child's ability to access and make progress in his/her program • Make recommendations to reduce the barriers to learning (e.g., accommodations, adaptive devices, etc.) • Use the assessment process to predict future needs
neonatal reflexes
These should be fully present at birth and are gradually inhibited by higher centers in the brain during the first 3 to 13 months of postnatal life
emergency plan
These signs and symptoms the activation of what? including summoning EMS - Obvious deformity suggesting a suspected fracture, separation, or dislocation - Significant loss of motion or weakness in the myotomes - Joint instability Assessment (cont'd) • S &S that require activation of emergency plan, including summoning EMS (cont'd) - Abnormal sensation in the shoulder, arm, or hand - Absent or weak pulse distal to the injury - Any significant, unexplained pain
developmental
These time periods ● Infancy ● Birth to 2 years old ● Childhood ● 2 years to adolescence ● Adolescence ● Puberty to adulthood ● Adulthood ● Approx age 20 to 70 years ● Older adulthood
newborns
They go from a total flexion pattern to phasic motor system activity. Actions go from mobile, to stable to controlled
type 3
This AC sprain rupture of AC ligaments and coracoclavicular ligament • Visible prominence of the distal clavicle • Depression or drooping of the shoulder girdle
5 months
This age is the age when ● Head movement into flexion in supine ● Dissociation of head and limbs
Montessori
This approach is based on activities and interventions. It uses everyday materials, and provides structure and order, immediate feedback, high probability of success, repetition, and task break down
return to sport and play
This assessment was individually tailored to the activities in which they wished to complete post discharge; in this case a return to full task work at the trampoline gymnasium and return to social netball. As such the following Assessment specific to her goals was designed and scores recorded. this Assessment was considered to be completed successfully and the patient able to return to sport and full time work, however, post discharge instructions were put in place and education delivered regarding re-injury or set back may require further treatment. Post discharge instructions were primarily involved with the softening of landing mechanics and the benefits of seeing an exercise physiologist or strength and conditioning coach regarding this matter.
plantar spinal reflex
This develops at about 18 weeks in utero. Integrated about 6 months after birth. Stimulated by stroking the sole of the foot. The toes of the foot should fan out and the foot itself should curl in
attention
This domain of cognition includes: - Early deterioration more noticeable in vascular dementia vs. SDAT - Decline in SDAT in midstage - A precursor to memory function - Also affected by psychiatric issues, especially depression and anxiety - Related to focus, concentration, mental control - Significant impact on function
insight, reasoning, judgment
This domain of cognition includes: - Higher order cognitive skills dependent upon executive function - Heavily dependent upon function in all other areas - Subtle changes can occur, even when other primary areas appear intact - THIS is the deficit that makes folks challenging
executive function
This domain of cognitive function includes: - Managed by frontal lobe function - Higher order skill affected by other functions - Planning, organization and self control • "Stop-start" mechanism • Shifting gears • Perseveration
femoral neck fracture
This has a risk for avascular necrosis, generally requires surgical fixation by an arthroplasty or an ORIF,
person centered care
This includes • Life history to inform care • Life review to enrich communication • Relationship as the foundation of care • Strength based care planning • Validation of emotion and experience • Focus on the "moment" • Ongoing assessment of function • Tailor care to current functional status
Pharmokinetics
This includes absorption, distribution, metabolism and excretion of a drug
Volkmann's contracture
This is a complication from a forearm fracture. It is caused by increased pressure and swelling inside one of the forearm compartments that compromise circulation to the surrounding muscles and nerves. As the pressure builds, ischemic necrosis can lead to permanent loss of nerve and muscular function. As a result, the hand is cold, white, and numb. Passive extension of the fingers leads to severe pain. These symptoms indicate a serious problem.
osteopenia
This is a condition of reduced bone mineral density that predisposes an individual to all types of fractures, but particularly stress fractures. The condition is primarily found among adolescent female athletes who are amenorrheic
second impact syndrome
This is a danger associated with return to play before symptoms of a head injury have resolved
boutonniere deformity
This is a deformity that presents with hyperextension at the MCP joint, flexion at the PIP joint, and hyperextension at the DIP joint?
Lasix
This is a diuretic used for treating HTN or water retention
little league shoulder
This is a fracture of the proximal humeral growth plate in adolescents. The proximal humeral epiphysis does not close until age 18 to 21 years of age. The condition results from repetitive medial rotation and adduction traction forces placed on the shoulder during pitching. Catchers may also get this fracture since they throw the ball as hard and often as pitchers, but with less of a windup. The injury usually occurs during the deceleration and followthrough phases of throwing or pitching.
dementia
This is a progressive decline in cognitive function due to damage or disease of the brain and affecting two or more areas of cognitive function and interfering with day to day function.
Protonix
This is a proton pump inhibitor that decreases stomach acid
rooting reflex
This is a spinal reflex Stroking of perioral region results in head turning to that side with mouth opening. This is an important feeding reflex. stimulus: touching cheek response: turning head to same side with mouth open normal age of response: 28 weeks of gestation to 3 months no integration interferes with oral motor development, development of head midline control, optical righting, visual tracking, and social interaction
mild cognitive impairment
This is a stage where there may be - Concern regarding a change in cognition - Impairment in more than one cognitive domain - Preserved functional ability - Rule out dementia and possible treatable causes -Not all will progress to AD
Synthroid
This is a thyroid hormone
Confusion Assessment Method
This is a tool used to screen for delirium
Lisinopril
This is an angiotensin converting enzyme inhibitor. Used for treating high blood pressure, CHF, and to improve survival after a heart attack
Ativan
This is an anti-anxiety med
dypraxia
This is often found in students who also have: • Dyslexia • ADHD • Specific Language Disorders - receptive or expressive • Aspergers syndrome
16 to 18
This is the age when babies do arm swing/ heelstrike balance
2 years
This is the age when babies will be able to kick a large ball, true running
4 years
This is the age when children will be able to gallop or catch a small ball
Horner syndrome
This is the involvement of the sympathetic nerves from T1 that give rise to superior cervical sympathetic ganglion that can result in this. Symptoms include Ptosis, Miosis, and anhydrosis
elder abuse
This is the mistreatment or neglect of an elderly person, usually by a relative or other caregiver. At greatest risk are the frail and/or isolated. This may include physical violence, threats of assault, verbal abuse, financial exploitation, physical or emotional neglect, or sexual abuse.
musculotendinius junction
This is the most common site for injuries to the musculotendinous unit
lasix
This is the most commonly prescribed medication in the elderly
subtrochanteric fractures
This is usually fixed with an ORIF, and the force associated with muscle attachments in this area may complicate recovery
1-1.2 g/kg body weight
This is what protein intake should be in older adults
anistrophic
This is when material is stronger in resisting force from certain directions than others (mostly inversion sprains, not as much eversion sprains)
simple concussion
This is when no loss of conscienceness is experienced, only a brief period of posttraumatic confusion, poor concentration, an inability to process information or sequence tasks or posttraumatic amnesia
yield point
This is when the load exceeds the ultimate failure point of the tissue resulting in mechanical failure
complex concussion
This is when there are persistent symptoms, specific sequelae, or prolonged cog. impairment
AC joint
This joint is injured by a direct blow, a fall on the point of the shoulder, or a force transmitted up the long axis of the humerus during a fall on an outstretched arm. S&S - slight elevation of the lateral clavicle (i.e., clavicle rides above the level of the acromion) - a minor step or gap is present at the joint line - pain increases when the distal clavicle is depressed or moved in an anterior-posterior direction - pain with active with abduction past 90° and passive horizontal adduction.
Montessori method
This method of treating dementia includes: • Method to create and present activities based on models of learning and rehabilitation created by Maria Montessori • Combats invasive memory loss by focusing on spared capacity though procedural memory and environment cues that build on existing abilities • Procedures are implemented so individuals circumvent existing deficits and achieve a higher level of functioning
Nashner's
This model of postural control in standing: visual, vestibular, and somatosensory systems provide the body with information about movement and cue appropriate postural responses in standing ● Ankle strategy ● Hip strategy ● Stepping strategy
gingko biloba
This natural supplements can interfere with warfarkin, insulin or oral diabetes medicine, narcotic medicine, or an NSAID
phrenic nerve
This nerve arises from C3-C5 can be involved resulting in ipsilateral diaphragmatic paralysis causing a decrease in thoracic space, tidal volume and vital capacity.
vascular stiffness
This occurs in smooth muscle, because of increased thickness of intima and media matrix. Collagen deposition and increased crosslinking, and fragmentation of elastin cause this.
ulnar dislocation
This occurs in those younger than 20, the MOI is hyperextension or sudden violent unidirectional valgus force that drives the ulna posterior or posterolateral - S&S • Snapping or cracking sensation • Severe pain, rapid swelling • Total loss of function • Obvious deformity • Arm held in flexion, with forearm appearing shortened • Olecranon and radial head palpable posteriorly • Slight indentation in triceps visible just proximal to olecranon - Management • Activate emergency plan, including summoning of EMS • Coach should avoid changing position of the arm • If tolerable, apply cold
Part C
This part of IDEA is about early intervention for children birth - 2
Part A
This part of IDEA is justification for the IDEA; terminology
Part B
This part of IDEA outlines educational requirements for students ages 3 - 21
Part B
This part of IDEA requires identification and placement decisions to be based on multiple sources of information Allows parents, school personnel, or state personnel to initiate an evaluation Introduces a 60 day timeframe for eligibility decision, unless parent does not produce the child for evaluation
Part C
This part of IDEA says that States must develop and implement statewide interagency programs of early intervention services Early interventions services designed to meet the needs of children with developmental delays from birth - 2 Services provided in natural environments to the maximum extent possible
Part B
This part of IDEA says that Technology-Related Assistance for Individuals with Disabilities Act passed in 1988 Includes both assistive technology devices and services Provision of assistive technology mandated If necessary for provision of FAPE Must be considered for all students with disabilities
large load
This produces a plastic response
atypical
This type of behavior absence could mean isolated finger movement, head always positioned to one side, inability to clear face in prone position, exaggerated back extensor arching
lipophilic drugs
This type of drugs are distributed to the CNS, and cause a decrease in lean body mass and increase body fat.
school based
This type of model has the goal of educating children so that they become productive members of society. Interdisciplinary
Education for All Handicapped Children Act
This was created in 1975 to address concepts of zero reject, education in the least restrictive environment, right to due process, nondiscrimnatory evaluation, individualized educational program, parent participation, and the right to related services, which include PT
The Montreal Cognitive Assessment
This was designed as a rapid screening instrument for mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. Time to administer the MoCA is approximately 10 minutes. The total possible score is 30 points; a score of 26 or above is considered normal • There is no correlation between the this and the FAST or GDS.
functional assessment staging tool (FAST)
This was developed by Dr. Barry Reisberg. This staging tool provides an understanding of the progression of Alzheimer's disease. Each stage has a well defined duration and set of cognitive and behavioral abilities affected. • The FAST is able to be related to a GDS level
PT evaluation
This will asses the child's: ● Mobility ● Muscle and joint function ● Strength and endurance ● Cardiopulmonary status ● Posture and balance ● Oral motor skills & feeding ● Sensory & neuromotor development ● Use of assistive technology
thoracic outlet compression syndrome
Thoracic outlet compression syndrome - Nerves and/or vessels become compressed in the proximal neck or axilla • Neurologic syndrome - Stretch or compression involving lower trunk brachial plexus - S&S • Aching pain, pins-and-needles sensation, or numbness in the side or back of the neck extends across the shoulder down the medial arm to the ulnar aspect of the hand • Weakness in grasp and atrophy of the hand • Vascular syndrome - Compression of subclavian artery or vein - S&S • Vein: edema, hand stiffness, venous engorgement of arm with cyanosis, symptoms may present several hours after exercise • Artery: rapid onset of coolness, numbness entire arm, fatigue after overhead activity • Management: immediate referral to a physician
polypharmacy
Those at risk for this are usually: - Age > 85 years - Estimated Creatinine Clearance < 50 mL/min - Low body weight or low BMI (<22) - More than 6 chronic diseases - Prior adverse drug events - Taking more than 12 doses of medication per day - Taking 9 or more medications
metabolism
Though liver function tests are unchanged with age, there is some overall decline in this from drugs - Decreased liver mass and hepatic blood flow • Highly variable, no good estimation algorithm • Minimal clinical manifestations
Down Syndrome
Three types of this have been identified, and all types are diagnosed by a chromosomal analysis—frequently a blood test—ordered by a physician • trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21 ● Clinical features ● Hypotonic ● Joint hypermobility ● Flat nasal bridge ● Intelligence ● IQ of 25 to 50 ● Development ● Slow motor development: Difficulty learning complex movement tasks ● Life expectancy 60 years
True
True or False? Bursitis may be acute or chronic and may be caused by a single traumatic tension force or repeated compression associated with overuse of the joint.
True
True or False? Collagen is a non-elastic substance, but the arrangement of collagen fibers allows for a certain amount of elastic-type deformation.
True
True or False? The glenohumeral joint is the most frequently dislocated major joint in the body.
True
True or False? The primary responsibility of the coach is to recognize potential signs and symptom of a concussion. It is not to determine the level of a concussion.
neglect
Types of this include ◦Physical - lacking basic hygiene, foul smelling, poor dentition ◦Medical - delaying medical attention, noncompliance with treatments ◦Emotional - lack of nurturing; common in unwanted pregnancies and disabled children ◦Educational Neglect
IDEA
Under this act, students between the ages 3 - 21 with disabilities that adversely affect their education 13 specific categories of eligibility Absolute coverage for ages 6 - 17 Early intervention for birth - 2
Klumpke's palsy
Upon examination it is observed the following - lower arm paralysis, involving intrinsic muscles of hand, flexors and extensors of wrist and hand. which brachial plexus is this finding most consistent with?
Erb's palsy
Upon examination it is observed the following - paralysis of upper arm with possible involvement of: rhomboids, levator scapulae, serratus anteior, deltoid, supra/infra spinatus, biceps brachii, brachioradialis, brachialis, supinator, and long extensors of wrist, fingers and thumb Which brachial plexus injury is this finding most consistent with?
What historical events impacted the growth of Pediatric Physical Therapy?
World War 1; Polio Epidemic; Cerebral Palsy; Education for All Handicapped Children Act 1975
immediate physician referral
You should get this if the patient has - Weakness in a myotome - Gross joint instability - Absent or weak pulse - All adolescent wrist sprains because of possible epiphyseal or apophyseal injuries - Any unexplained pain
intellectual disability
a child has this if: • Intellectual functioning level (IQ) is 70 or below • Concurrent deficits in adaptive functioning in two or more of the following areas: - Communication - Self care - Home living - Social interpersonal skills - Use of community resources - Self direction - Functional academic skills - Work - Leisure - Health - Self • The condition is present from childhood (prior to age 18) • Mild ID IQ 55 to 70 • Moderate ID IQ 35 to 55 • Severe ID IQ 20 to 35 • Profound ID IQ below 20
ageism
a form of discrimination that relegates people to an inferior or limited position simply because of age
cerebral palsy
associated deficits of this include -Feeding and speech impairments ● Breathing inefficiency ● Intellectual disability ● Seizures ● Visual impairments ● Hearing, speech, and language impairments
primitive reflexes
automatic motor responses developed in utero and are fully present at birth, and should be integrated by the first 6 months; provide infant with set of survival skills
neonatal seizures
clinical signs of these include • Ocular-tonic horizontal deviation of eyes (jerking) and sustained eye opening with ocular fixation • Eyelid blinking or fluttering • Sucking, lip smacking, drooling • Abnormal movements and alteration of muscle tone in trunk and extremities such as "rowing" or "bicycling" • Autonomic manifestations - - Apnea (no breathing) - Blood pressure and heart rate changes - Dilated pupils
dyspraxia
difficulty with actions • Dyspraxia is a motor learning difficulty that can affect planning of movements and coordination as a result of brain messages not being accurately transmitted to the body (NHS Direct, 2008). • Complex neurological condition • Difficulties vary between individuals • Dyspraxia is characterized by difficulty in planning smooth, co-ordinated movements. This leads to: • Clumsiness • Lack of co-ordination • Problems with language, perception and thought (NHS Direct, 2011).
Sister E. Kenny
in the 1940's this person used active treatment including exercise to treat polio
neurophysiological
in the 1940's-the 1960's this type of foundation was used for treatments but later found to be flawed. Interventions are now based on scientific foundations. Voss called this the "era of spasticity"
cerebal palsy
in the 1950's many children were institutionalized for the care of this. Treatment services expanded when the de-institutionalization movement began in late 1960's and 1970's.
ligaments
in the elbow, these include the - Ulnar (medial) collateral - Radial (lateral) collateral - Annular
first degree
in this degree of sprains, there is less than a 5 mm distraction with stress tests
third degree
in this degree of sprains, there is more than 10 mm distraction with stress tests
school setting
in this setting the team asks, "Does the child have access to their educational environment, with the least restrictions"; may need access to the classroom such as mobility deficits; may need assist with physical education; will most likely need to be with other services,, PT does not typically stand alone in the educational environment
carpal tunnel syndrome
include activities that involve repetitive or continuous flexion and extension of the wrist, such as cycling, throwing sports, racquet sports, archery, and gymnastics. Signs and symptoms of this include: pain that awakens the individual in the middle of the night and is often relieved by "shaking out the hands." pain, numbness, tingling, or a burning sensation felt only in the fingertips on the palmar aspect of the thumb, index, and middle finger only one extremity is affected grip and pinch strength may be limited common complaint is difficulty manipulating coins 8.
tendinitis
inflammation of a tendon - Related to aging and degenerative changes - S&S: pain and swelling with tendon movement
tenosynovitis
inflammation of the tendon sheath - Acute: rapid onset, crepitus, local swelling - Chronic: same as acute, thickened tendon, nodule formation in sheath
Torticollis
interventions for this include: - Caregiver instruction in home program - Education on basic pathology of CMT - Education on environmental adaptations and positioning to reduce deformational forces to face and skull, and to encourage active movement out of preferred cervical position; stretching tight muscles out of preferred position - Review/parent demonstration of current HEP - Update HEP as indicated with additional exercises, developmental activities and environmental adaptations as appropriate - Reassessment of cervical ROM, skull/facial shape, posture/positioning - Developmental activities as appropriate - Screen of trunk, UE, and LE ROM
stroke
leading cause of acute neurologic admission to hospital and death worldwide
grade 1
mild stretching or tearing to the ligaments, little to no joint instability.
motor development
milestones of the developmental sequenced the kinesiology components of movement. Motor abilities that develop over months, years and decades.
moro reflex
primitive reflex stimulus: head dropping into extension suddenly for a few inches response: arms abduct with fingers open, then cross trunk into adduction; cry normal age of response: 28 weeks of gestation to 5 months no integration interferes with sitting balance reactions, sitting protective responses, eye hand coordination, visual tracking
walking/stepping reflex
primitive reflex stimulus: supported upright position with soles of feet on firm surface response: reciprocal flexion/extension of leg normal age of response: 38 weeks of gestation to 2 months no integration interferes with standing and walking, balance reactions and weight shifts in standing, development of smooth and coordinated reciprocal movements of the LEs
rooting reflex
primitive reflex stimulus: touching cheek response: turning head to same side with mouth open normal age of response: 28 weeks of gestation to 3 months no integration interferes with oral motor development, development of head midline control, optical righting, visual tracking, and social interaction
positive support reflec
primitive reflex stimulus: weight placed on balls of feet when upright response: stiffening of legs and trunk into extension normal age of response: 35 weeks of gestation to 2 months no integration interferes with standing and walking, balance reactions and weight shifts in standing, can lead to contractures of ankles in plantarflexion
positive support reflex
primitive reflex stimulus: weight placed on balls of feet when upright response: stiffening of legs and trunk into extension normal age of response: 35 weeks of gestation to 2 months no integration interferes with standing and walking, balance reactions and weight shifts in standing, can lead to contractures of ankles in plantarflexion
symmetrical tonic neck reflex (STNR)
primitive response stimulus: head (neck) positioned in flexion or extension response: when head is in flexion, arms are flexed and legs extended, when head is extended arms are extended and legs are flexed normal age of response: 6-8 months no integration interferes with ability to prop on arms in prone, attaining hands and knees, reciprocal crawling, sitting balance when looking around, use of hands when looking at objects
asymmetrical tonic neck reflex (ANTR)
primitive response stimulus: head turned to one side response: arm and leg on face side are extended, arm and leg on scalp side are flexed, spine curved with convexity toward face side normal age of response: birth to 6 months no integration interferes with feeding, visual tracking, midline use of hands, bilateral hand use, rolling, crawling, skeletal deformities (scoliosis, hip dislocation)
tonic labyrinthe reflex (TLR)
primitive response stimulus: position of labyrinth in inner ear-reflected in head position response: head in the supine position, increased extensor tone; head in prone position, increased flexor tone normal age of response: birth to 6 months no integration interferes with ability to initiate rolling, prop on elbows with extended hips, ability to flex trunk and hips to come to sit from supine, sitting and standing balance
plantar grasp reflex
primitive response stimulus: pressure on base of foot response: toe flexion normal age of response: 28 weeks of gestation to 9 months no integration interferes with ability to stand with feet flat on surface, balance reactions and weight shifting in standing
galant reflex
primitive response stimulus: touch skin along spine from shoulder to hip response: lateral flexion of trunk to side of stimulus normal age of response: 30 weeks of gestation to 2 months no integration interferes with development of sitting balance and can lead to scoliosis
palmar grasp reflex
primitive response stimulus:pressure in palm on ulnar side of hand response: flexion of fingers causing strong grip normal age of response: birth-4 months no integration interferes with ability to grasp and release objects voluntarily, weight bearing on open hands for propping, crawling, protective responses
tonic labyrinthine reflex
retention of this reflex could include: poor posture- stoop (flexion) or toe walking (extension) -hypotonus- weak muscle tone, stiff jerky movements -vestibular problems -poor visual tracking -poor sequencing -dislike of sporting activities -poor sense of time -poor organizational skills
mallet finger
- Avulsion of extensor mechanism - MOI: forceful flexion (due to object hitting the end of the finger) - S&S • Pain; swelling • Mallet deformity • Lack of active extension at DIP joint - Management: • Standard acute • Immediate physician referral
carpal tunnel syndrome
- Contains median nerve, finger flexors, & flexor pollicis longus - Due to direct trauma, repetitive overuse, or anatomic anomalies - S&S • Awakening pain in middle of night; often relieved by "shaking out their hands" • Pain, numbness, or tingling sensation only in fingertips on palmar aspect of thumb, index, and middle finger • Grip and pinch strength may be limited - Management • Suggest application of cold to decrease pain and spasm • Do not permit to continue activity until seen by a physician • Do not use compression wrap
tendinitis and stenosing tenosynovitis
- Due to strenuous and repetitive training inflame tendon and tendon sheaths - Abductor pollicis longus and extensor pollicis brevis are commonly affected - S&S • Stiffness and an aching pain that is aggravated by activity - may appear several hours after participation in physical activity • Pain localized over the involved tendons • Pain aggravated with passive stretching and resisted motion of the affected tendons - Management • Do not permit to continue activity until seen by a physician • Suggest application of cold to decrease pain and spasm
humeral fracture
- MOI • Direct blow • Fall on upper arm • Fall on outstretched hand with elbow extended - S&S • Pain, swelling, hemorrhage, discoloration • Inability to move arm • Inability to supinate forearm • Possible paralysis - Management • Cold; sling & swathe; immediate referral to a physician or emergency care facility
glenohumeral sprain
- MOI • Forceful abduction • Forceful abduction and external rotation - Joint capsule stretches or tears; humeral head moves in anterior inferior direction - S&S • 1°: AROM - slight limitation • 2°: swelling, ecchymosis, decreased ROM, especially abduction - Management • Cold; sling; physician referral
elbow sprain
- MOI • Repetitive tensile forces • Hyperextension injury (from fall on extended arm) • Sudden violent valgus or varus force - S&S • UCL • Pain on medial aspect of the elbow • Point tenderness over the ligament • Pain with valgus force • RCL • Pain lateral aspect of elbow • Pain with varus force - Management: standard acute; physician referral
wrist
- MOI: axial loading on proximal palm during fall on outstretched hand - S&S • Point tenderness on dorsum of radiocarpal joint • ↑ Pain with active or passive extension - Management: • Immobilize • Standard acute • Physician referral to rule out fracture or carpal dislocation
scapular fracture
- MOI: direct or indirect force - S&S • Localized pain and hemorrhage • Reluctant to move injured arm; prefers to maintain adduction; abduction - very painful - Need to rule out pulmonary injury - Management: cold; sling & swathe; immediate referral to a physician or emergency care facility
clavicular fracture
- MOI: direct or indirect force - S&S • Swelling, ecchymosis, and a deformity may be visible and palpable • Pain with any shoulder motion • Greenstick fracture - Management: cold; sling & swathe; immediate referral to a physician or emergency care facility
lateral epicondylitis
- Most common overuse injury in adult elbow - Due to eccentric loading of the extensor muscles - Contributing factors - S&S • Pain anterior or just distal to lateral epicondyle; may radiate into forearm extensors during and after activity • Pain with resisted wrist extension; Pain with action of picking up a full cup of coffee - Management • Do not permit to continue activity until seen by a physician • Suggest application of cold to decrease pain and spasm
Posterior walker or postural control walker
Which mobility aid (walker) provides the following benefits? - Encourage trunk extension - Encourages shoulder depression, elbow extension, neutral wrist which may decrease scissoring in lower extremities
Forward walker or anterior rollator walker
Which mobility aid (walker) provides the following benefits? - Encourages forward trunk leaning - Provides maximum anterior stability
Plantar grasp
Which neonatal reflex MUST be integrated before walking can occur?
trisomy 18
Which of the following chromosomal abnormalities does not lead to Down Syndrome? Trisomy 18, mosaicism, translocation or trisomy 21
head righting reactions
Which of the following develops first in infants? Equilibrium in all postures, protective reactions head righting reactions, or trunk righting?
spasticity
Which of the following is a characteristic sign of cerebral palsy? Spasticity, cardiac deficits, falccid muscles, or deafness?
achilles tendinitis
Which of the following is an example of a chronic injury? GH dislocation, iliac crest contusion, ankle sprain or achilles tendinitis?
The child will ambulate a certain distance to play with peers and siblings
Which of the following is an example of a family centered meaningful goal? -The child will independently maintain an upright head position for 15 minutes. -The child will improve knee extension by 10 degrees. -The child will ambulate a certain distance to play with peers and siblings. -The child will increase active range of motion.
individual family service plan
Which of the following is created after eligibility for early intervention services is established?
independence
Which of the following is not an area where children with autism generally show deficits? Language skills, eye contact, social interaction, or independence
health care that is affordable
Which of the following is not an important concept of family-center care? -Health care that is responsive to family-identified needs -Health care that is affordable -Health care that is flexible -Health care that is culturally competent
cephalic to caudal
Which of the following is the correct directional concept of motor development? Right to left, distal to proximal, caudal to cephalic, or cephalic to caudal?
movement from one posture to another
Which of the following is the definition of a skill? maintenance of posture, random movement, movement from one posture to another, or movement within the posture?
Education for all handicapped children act
Which of the following laws first mandated that an individual education plan be developed for each child with a disability? Individuals with disabilities education improvement act, education for all handicapped children act, no child left behind act, or individuals with disabilities education act?
outpatient clinical model
Which of the following may have a physical therapist and physical therapist assistant as the primary/only team member(s)? -School model -Early intervention model -Medical Model -Outpatient clinical model
adjusted age
Which of the following refers to the child's age after correcting for prematurity? Post-conceptual age, gestational age, chronological age, or adjusted age?
RGO
Which orthotic may present with the following benefits? - HKAFO with molded body jacket - Cable system allows forward step with lateral weight shift - Used by children with Thoracic level spinal bifida or spinal cord injuries
Duchenne's Muscular Dystrophy
Which pediatric population this PT intervention is best described for? - Maintain mobility as long as possible by encouraging recreational and functional activities to maintain strength and cardiopulmonary function - Maintain joint ROM through the use of active and passive ROM exercises, positioning devices such as prone standers or standing frames - Gastrocnemius and tensor fascia lata shorten first - ESTIM for younger children has bee able to increase contractile ability - Do not exercise at maximal level (no strength training), may injure muscle tissue (overwork injury)
Duchenne's Muscular Dystrophy
Which pedriatic population the follwing description is best described? - An X-link recessive inherited by boys, and carried by recessive gene of mother. Lack dystrophin. this gene is missing which results in increased permeability of sarcolema and destruction of muscle cells. - Collagen, adipose laid down in muscle leading to pseudohypertrophic calf muscles
Transdisciplinary
Which service delivery model is the most integrated? Transdisciplinary, interdisciplinary, multidisciplinary, or early intervention model?
tensile force
While stretching for an overthrown ball a first baseman strained an adductor muscle. What type of force would have produced this injury?
repeated lower magnitude forces
What is the MOI for a stress fracture?
compression
What is the MOI for bursitis?
tension
What is the MOI for joint dislocations and subluxations?
compression
What is the MOI for muscle contusions?
high tensile force
What is the MOI for sprains?
abnormally high tensile force
What is the MOI for strains?
fall on an outstretched hand
What is the MOI of fractures and dislocations in the wrist and hand?
8.1 seconds
What is the average TUG speed of those 60-69 years of age?
9.2 seconds
What is the average TUG speed of those 70-79 years of age.
11.3 seconds
What is the average TUG speed of those 80-99 years of age
ATNR
What neonatal reflex, if persists, may result in scoliosis or hip dislocation, and may interfere with grasping, and hand to mouth activities?
≥ 7
What score is considered to be good in the APGAR test?
early intervention
What services are mandated by the guidelines set forth in Part C of the Individuals with Disabilities Education Act?
force
When acting on the body, these can cause acceleration or deformation
neurological problem
When an infants reflexes are not eventually inhibited, the child usually has this
9 months
When does an infant usually begin creeping?
reflex theory
When it comes to motor control, this theory says that movement is acquired from the chaining together of reflexes and reactions
Hierarchial theory
When it comes to motor control, this theory states that the ultimate level of motor control, voluntary movement is achieved by maturation of the cortex
congenital limb deficiencies
-Incidence estimated at 4 per 10,000 births -Congenital 60% to Acquired 40% - Male : Female ● Congenital 1.2:1 ● Acquired 3:2 - Left : Right ● 2:1 in unilateral UE Transverse Deficiency -Limbs form 4-7 weeks gestation -Proximal to distal in sequence -Upper limb develops slightly ahead of the lower limb simultaneously with organ development -Associated with Radial deficiency
biceps tendon rupture
The following can increase susceptibility to what? -prolonged tendinitis -degenerative tendon (typically seen in older individuals) -history of corticosteroid injections into the tendon
in utero-4 months
The following list are neonatal reflexes that are tested as part of pediatric examination, when are these reflexes emerge and integrated? - Rooting
cellular
The formation of senile plaques and neurofibrillary tangles are examples of what kind of changes in the brain from dementia?
prone
The full term neonate movement in this position head elevates to clear face and reposition it; flexor bias of trunk and extremities
return to play in concussion
The general stages of this include no activity; light activity; sport specific exercise; non-contact drills; full contact practice; back to the game
NET
The goal of this is to - Improve the function by fully engaging individuals in therapeutic activities that address underlying physical impairments • Use creative, person centered techniques/exercises . • Interventions draw upon the life history and abilities of the individual • Impairments targeted are those that align with intact processing and memory domains - reduced strength, endurance, aerobic capacity , balance, motor function, sensory integration, range of motion, communication and swallowing.
focal and diffuse?
What are the two categories of TBI?
acceleration and deformation
What are two potential effects that occur when a force acts on an object?
Erb's Palsy
What is a brachial plexus injury that occurs during birth to the C5, C6, nerve roots?
gravity
What is an infants first hindrance to movement?
shearing/torsion force
What is the MOI for a patella dislocation?
torsion force
What is the MOI for a spiral tibial fracture?