Kinesiology OTA module 1 and 2 it is a mess
Paravertebral muscle causes neck?
Flexion
Natural physical environment can affect function in many ways because?
Geographic terrain can impair or enhance movement
Dynamic balance is the opposite of?
Static balance
Recent surgery examples for not using range of motion and manual muscle testing are?
Surgery for shunt placement or to treat a fracture
Pollicis
Thumb or first digit of hand
Thoracic and lumbar spine flexion ROM is?
0-80 degrees
Wrist flexion ROM is?
0-80 degrees
What are some movement examples of a ball and socket joint?
Hip abduction and adduction, hip flexion and extension, and hip internal and external rotation
Common soft tissue contracture sites related to prolonged positioning in supine are?
Hip and knee flexors, ankle plantar flexors, shoulder extensors, adductors, and internal rotators, and hip external rotators
Common soft tissue contracture sites related to prolonged positioning in side lying are?
Hip and knee flexors, hip adductors and internal rotators, and shoulder adductors and internal rotators
Inspiration
The active phase of respiration when the person breathes in also referred to inhalation
Axis
The center, point, or line passing through the two poles of aspherical body about which the body may rotate and the place around which an object rotates
Motor development
The changes in movement behavior that occur as the client progresses through the lifespan from infancy until death
Postural control
The regulation of the body's position in space for the dual purpose of stability and orientation
Gravity is measured as?
The weight of the body through its center of gravity or COG
What is an example of a saddle joint?
Thumb carpometacarpal joint
Opposition occurs when the?
Thumbpad crosses the palm toward the last pinkie finger
What is the curve of the cervical vertebra?
Convex
Coactivation is also referred to as?
Co contraction
Rotation pertains only to the?
Axial skeleton specifically the head and vertebral column
Lateral epicondyle of humerus consideration is?
Axis for elbow flexion and extension and decubitus
Range of motion is used in many OT clinics to do what?
Determine available mobility and identify impairments, establish a baseline, document improvements in mobility, and aid in selecting effectiveness of interventions
When both compression and tension are balance a object is said to be?
In equilibrium
Dependent transfer
In which the patient cannot participate and the therapist moves the patient
The residual limb or RL should not be?
Elevated on a pillow while the patient is supine for more than a few minutes of each hour
Cervical vertebrae vertebral foramen is?
Large and triangular
Magnus
Large or great dentoing a structure of large size
Alternative grading scale for isometric grading for manual muscle testing is?
Normal or N, good or G, good - or G-, and fair + or F+
Health care associated infections were know as?
Nosocomial infection
Lateral deviation occurs at the?
Mandible during talking and chewing
There are a variety of?
Manual and electoral lifting deceives that can be used to transfer patients of any weight
Tachycardia
Rapid pulse more than 100 bpm
The descriptive terms medial and lateral correlate to the?
Sagittal plane
What are the planes of movement?
Sagittal, frontal, and horizontal
Adults normal values for blood pressures are?
Systolic less then 120 mm Hg and diastolic of less than 80 mm Hg
Elderly so 65 years old or older normal values for blood pressures are?
Systolic of 120-140 mm Hg and diastolic of 80-90 mm Hg
Adults high normal values for blood pressures are?
Systolic of 130-139 mm Hg and diastolic of 85-89 mm Hg
The range of motion of the lumbar vertebral column for lateral flexion is?
20 degrees
The OT domain labeled areas of occupation include?
Activities from getting up and performing morning ADL to attending school or contributing at work
Sartor
A tailor as used in the muscle sartorius which allows us to sit crossing our legs in the tailor position
Syncope
A temporary suspension of consciousness as a result of cerebral anemia or fainting
Syncope
A temporary suspension of consciousness caused by cerebral anemia or fainting
Microorganism
A tiny living animal or plant that can cause disease
Context
A variety of interrelated conditions that are within and surrounding the client such as cultural, personal temporal, and virtual
Thready pules indicates?
A weak force to each beat and irregular beats
Central nervous system or CNS
The division of the nervous system that includes the brain and spinal cord
Point of application
The point on the object where the force is applied for a muscular force this is commonly considered to be at insertion of the muscle to the bone
Visual analog scale or VAS
Left or 0 is no distress and right or 10 is unbearable distress
Manual muscle testing for screening test grade of 2+ or poor+ is where the client?
Moves the joint through less than half of the available range of motion against gravity
Contact guarding
The caregiver is positioned close to the patient with his or her hands on the patient or a gait belt it is very likely the patient will require protection during the performance of the activity
Standing from a chair is often more difficult if?
The chair is low or the seat cushions are soft dense cushions may be added to increase height and provide a firm surface to which to transfer
Ischemia
Deficiency of blood in part of the body from functional constriction or obstruction of a blood vessel
Gowns or aprons material can be?
Natural or man made, reusable or disposable, and resistance to fluid penetration
Wrist ulnar deviation or adduction ROM is?
0-30 degrees
Ankle and foot inversion ROM is?
0-35 degrees
Thoracic and lumbar spine rotation ROM is?
0-45 degrees
What degree of freedom does a hinge joint have?
1 or uniaxial
Equipment and supplies for medical asepsis are?
Disinfect, sterilize, or dispose of after contact with the patient and use clean materials
Force arm
Distance from the axis to the point of application of the force in diagrams referred to as FA
Resistance arm
Distance from the axis to the point of application of the resistance or load in diagrams referred to as RA
Dysfunction
Disturbance, impairment, or abnormality of functioning of a body part
Horizontal or transverse plane
Divides the body at the waist so top and bottom halves of the body
Sharps so needles and scalpel blades standard precautions are?
Do not ben, recap, break, or manipulate by hand used needles, use safety features when available, and use a one handed scoop technique only, dispose of all sharps in puncture proof container immediately after their use, do not uncap or expose needles until they are needed, and use caution when you handle and dispose of the item to avoid wounding yourself
Burning, pressure like, stinging, aching pain related structure is?
Sympathetic nerves
A OT profile will include?
Subjective, objective, UE observations, LE observations, sensory/perception/cognition, short term goals, and long term goals
Context and environment for a OT?
Cultural, personal, physical, social, temporal, and virtual
Face shields should?
Cover forehead and extend below chin and wrap around side of face
Necrosis
Morphologic changes indicative of cell death
Sternocleidomastoid muscle nerve is?
Cranial nerve XI which is a accessory nerve and the 2nd and 3rd cervial nerves
Examples of body projections are?
Crest, epicondyle, process, spine, and trochanter
Lumbar vertebrae vertebral foramen is?
Intermeidate
Center of gravity or COG
The pont at which the mass of a body or object is centered
The range of motion of the thoracolumbar vertebral column for rotation is?
0 degrees
Thumb adduction or radial and palmar ROM is?
0 degrees
Shoulder extension ROM is?
0-60 degrees
Newtown's law of inertia
Every object persists in its state of rest or uniform motion in a straight line unless it is compelled to change that sate by forces impressed upon it
Severe visual impairments in academics negotiability example is?
No clutter in hallways and sound notification crosswalks
Seven of the 14 facial bones are?
Palpable as are the numerous bony landmarks of the mandible
Hemiplegia
Paralysis of one side of the body
Paresis
Partial or incomplete paralysis
Objectives of barrier for surgical asepsis are?
Prevent all microorganisms from reaching the patient or contaminating sterile field and surgical wound
Contracture
Shortening or tightening of the skin, muscle, fascia, or joint capsule that prevents normal movement or flexibility of the involved structure
COPD example for not using range of motion and manual muscle testing is?
Shortness of breath and inability to move extremity adequately
The organ of equilibrium is the?
Vestibular organ
Vestibular is related to the?
Vestibule of the ear
Cultural standards are different in the?
Virtual realm behavior standards related to what is acceptable are often altered
Scooting to the edge of the bed when working with a patient who has had a stroke or traumatic brain injury?
Walk the patient's hips toward the edge of the bed, shift the patient's weight to the unaffected side, position your hand behind the opposite buttock, and guide the patient forward, shift the patient's weight to the affected side and repeat the procedure if necessary move forward until the patient's feet are flat on the floor
Deviation means to?
Wander from the usual course
Atrophy
Wasting of tissue especially in muscle due to lack of use
Resistance is also called?
Weight or load
Strong and regular pulse
Steady and strong
Decubiti is also called?
Bed sores
Myositis ossificans
Bony growth at the joint or bone affecting muscles
Irregular pulse
Both strong and weak beats
The ANS has cell bodies in?
Both the CNS and PNS
COG
Center of gravity
Sliding board transfers are best used with those who?
Cannot bear weight on the lower extremities and who have paralysis, weakness, or poor endurance in their upper extremities
The bent pivot transfer is used when the patient?
Cannot initiate or maintain a standing position
Use PPE?
Carefully don't spread contamination
What is an example of a gliding joint?
Carpal bones
Swimming the backstroke requires?
Circumduction at the shoulder joint
When you use gloves work from?
Clean to dirty
Brachial plexus
Composed of spinal nerve roots form the fifth cervical nerve or C5 through the first thoracic nerve or T1 and it supplies the upper extremities
Lumbosacral plexus
Composed of spinal nerve roots from first lumbar or L1 through the third sacral nerve root or S1 it innervates the lower extremities
Bone cancer examples for not using range of motion and manual muscle testing are?
Compromised bone function and structure
Goal of action for medical asepsis is?
Confine organisms and prevent spread to others
Don PPE before?
Contact with the patient generally before entering the room
Rectus abdominus insertion is?
Costal cartilage ribs of 5 to 7 and xiphoid process of sternum
To take respiration do what?
Count either inspirations or exhalations for 1 min and report as respirations/minute
For activities that require prolonged standing use a?
Cushioned mat and wear low heeled shoes with good arch supports place on foot on a footstool or railing and alternate feet occasionally for comfort as when ironing or washing dishes perform a 30 second exercise routine every hour that includes low back flexion and extension, hip and knee flexion so knee to chest while standing, neck extension, lateral bending, and should range of motion in all planes
Disease affects respiration because?
Disease that affects various components of the pulmonary system usually increases RR and may affect depth of respiration
Equipment and supplies for surgical asepsis are?
Disinfect or sterilize before contact with patient all items must be sterile
Dysrhythmia
Disturbance of rhythm
Posterior can also be called?
Dorsal
Change your gloves?
During use if torn and when heavily soiled even during use on the same patient and after use on each patient
Force arm is also called?
Effort arm or moment arm
Muscle endurance
Endurance
Efferent muscles
Excite the CNS
In a car transfer the clinician often uses the patient's?
Existing transfer technique
Stabilizers are also referred to as?
Fixators
Sharp, severe, intolerable pain related structure is?
Fracture
Anteroposterior
From the front to the back of an object or a living being
The frontal or coronal plane divides the body into?
Front and back portions
What are the axis and axes of the hinge joint?
Frontal
What are the planes of a condyloid joint?
Frontal and sagittal
The terms anterior and posterior relate to the?
Frontal plane
Adduction and abduction happen along the?
Frontal plane and pertain only to the appendages
What are the axis and axes of the saddle joint?
Frontal, sagittal, and multi
Hip abductors insertion is?
Greater trochancter of the femur
HR
Heart rate
The dependent transfer is designed for use with the patient who?
Has minimal to no functional ability
To feel the transversospinalis muscle do what?
Have partner prone locate the spinous processes of the lumbar vertebrae slide your fingers laterally off the spinous processes sinking between them and the erector spinae fibers pushing the erectors laterally out of the way explore deeply for the dense diagonal fibers of the multifidi progress inferiorly to the sacrum rolling your fingers in a perpendicular direction to the multifidi fibers then move superiorly exploring the lamina groove of the thoracic and cervical areas then turn your partner supine and palpate the cervical region
Wheelchair to bed or mat transfer steps are?
Help the patient scoot to the edge of the surface and put his or her feet flat on the floor the patient's ankles should be pointed toward the surface to which the patient is transferring, stand on the patient's effected side with hands either on the patient's scapulae or around the patient's waist or hips stabilize the patient's foot and knee with your own foot and knee provide assistance by guiding the patient forward as the buttocks are lifted up and toward the transfer surface, the patient either reaches toward the surface to which he or she is transferring or pushes off the surface form which he or she is transferring, guide the patient toward the transfer surface and gently help him or her down to as sitting position
The stand pivot transfer is most commonly used with patients who have?
Hemiplegia, hemiparesis, or a general loss of strength or balance
HBV
Hepatitis B virus
Altitude affects respiration because?
High altitudes cause RR to increase until a person is acclimated
Transverse plane can also be called?
Horizontal
HIV
Human immunodeficiency virus
Example of a bony crest is the?
Iliac crest and crest of tibia
Hip extensors origin is?
Ilium and sacrum
Hip extensors so gluteus maximus origin is?
Ilium and sacrum
Vertical gravity line or VGL
Imaginary vertical line that passes through the center of gravity of an object
Synarthoridal joints
Immovable such as the suture joints of the skull
Popliteal pulse measurement site is?
In the midline of the posterior knee crease between the tendons of the hamstring muscles
Ataxia
Incoordination so the inability to execute coordinated voluntary movement with loss of smooth execution of movement
Due to the increased drag of water over air water exercise can also be used to?
Increase resistance
Hypertonia
Increased muscle tone
Health care associated infections
Infections associated with health care delivery in any setting
Thoracic vertebrae size is?
Intermediate
Thready pulse
Irregular weak beats
Patient draping is important for what reasons?
It provides modesty for the patient, it helps the patient maintain an appropriate body temperature, it provides access and exposure to areas to treated while protecting other areas, and it protects the patient's skin or clothing from being soiled or damaged
The landmark for measuring hip extension is the?
Lateral aspect of greater trochanter
The landmark for measuring hip flexion is the?
Lateral aspect of greater trochanter
Bony prominences that may cause pressure injuries in head and trunk in side lying position are?
Lateral ear, lateral ribs, and lateral acromion process
Example of a bony epicondyle is the?
Lateral epicondyle of humerus
Iliacus muscle besides acting on the trunk does what?
Lifts trunk from supine
When transferring to a sofa or chair the clinician and patient need to aware that the chair may be?
Light and not as stable as a bed or a wheelchair
Weak grasp at mealtime negotiability example is?
Lightweight utensils with easy-grip handles, and light weight glasses or use of straw to drink
Movement at the SI joint or sacroiliac joint is?
Limited because it is a nonaxial joint with cartilage in between the bony aspects of the joint also the addition of ligaments at this joint limits the amount of mobility thus providing quite a bit of stability
LOG
Line of gravity
Bony crest is a?
Linear elevation or ridge that is narrow
Auscultation
Listening for sounds produced within the body by using the unaided ear or a stethoscope
Prone
Lying face downward on the ventral or front surface of the body so lying on the abdomen and chest
Supine
Lying on back in a face up position
Prone
Lying on stomach in a face down position
Supine
Lying with the face upward or on the dorsal or back surface of the body so lying on the back
Manual muscle testing for isometric grading 4- or good- is where the client?
Maintains the testing position against gravity and less than moderate resistance
Thoracic vertebrae spinous process are?
Long, slender, and point inferiorly
Contact precautions common clinical syndromes are?
MRSA, VISA, VRE, aminoglycoside-resistant gram-negatives, uncontrolled diarrhea, clostridium difficle, lice, scabies, impetigo, EVD, and Zika virus
Sacral plexus
Made up of the fourth and fifth lumbar nerve roots or L4 and L5 in addition to the first, second, and third sacral nerve roots so S1 through S3
Autonomic division helps?
Maintain an internal balance as it responds to internal stimuli providing functions such as maintaining body temperature, regulating heart rate, and regulating blood pressure
A clinician often prefers to keep a patient in the bent knee position in a transfer to?
Maintain equal weight bearing, provide optimal trunk and lower extremity support, and perform a safer and easier clinician assisted transfer
Isometric
Maintaining or pertaining to the same length
Airborne precautions common syndromes are?
Measles or pulmonary and tuberculosis
Metric
Measure
Metron
Measure
The universal goniometer is the tool most widely used to?
Measure joint ROM in the clinical environment
Vital signs
Measurement of a person's body temperature, heart and respiration rates, and blood pressure also referred to as cardinal signs
Hip adductors insertion is?
Medial and posterior surface of the femur
Elements of a respiratory protection program are?
Medical evaluation, fit testing, training, and fit checking before use
Restrain drug
Medication used to control behavior or restrict a patient's freedom of movement that is not a standard treatment for the patient's medial or psychiatric condition
What is an example of a condyloid joint?
Metacarpophalangeal joints 2 through 5
MRSA
Methicillin resistant Staphylococcus aureus
Droplet transmission
Microorganisms that are transferred by direct or indirect contact but respiratory droplets carrying infectious pathogens transmit infection when they travel a short distance directly from the respiratory tract of the infected individual to the mouth, conjunctivae, or nasal mucosa of the recipient it necessitates that the caregiver wear a mask or face shield respiratory droplets may be transmitted during a sneeze, cough, or talking some examples of diseases or conditions spread this way are strep throat, meningitis, pneumonia, influenza, the common cold, pertussis or whooping cough, smallpox, and mumps
A person who has a normal body temperature before treatment can be?
Monitored during or at the conclusion of the treatment to determine whether normal responses occur if an excessive temperature value is measured or any signs or symptoms of excessive temperature are observed the patient should have adequate period of rest to allow the body temperature to become stabilized at the normal value
A person whose body temperature is lower than normal before treatment should be?
Monitored to be certain the treatment is tolerated and to determine whether the temperature changes during or at the conclusion of the activity
Is the cervical vertebra fixed or flexible?
Moveable or flexible
Is the lumbar vertebra fixed or flexible?
Moveable or flexible
Is the thoracic vertebra fixed or flexible?
Moveable or flexible
Kinesia
Movement
Linear motion
Movement along a path pertaining to or representing a line that may be straight or curved and all parts of the object move in the same direction at the same speed
Retraction like retreat is?
Movement posteriorly
Synergists
Muscles that are not prime movers but assist the agonist in the motion and also help to cancel out undesired motions
Sharp, bright, lightning like pain related structure is?
Nerve
When joint measurements may be performed in more than one position like shoulder internal and external rotation the practitioner should?
Note the position used on the ROM form
To asses pain use?
Numeric or faces pain scale and asses it before, during, and after treatment
Occupational Therapy Practice Framework 2nd Edition
OTPF-2
Vertebral foramen
Opeing formed by the joining of the bodies of the vertebrae
Temperature can be taken?
Oral, ear, axilla, or rectal
Viscera
Organs located within body cavities
Wheelchair use in a home universal design example is?
Original construction with 17 inch high toilet instead of customary 14 to 15 inch, curbless showers, and stepless entrances so flexibility and ease of use
Passive range of motion
PROM
Patient considerations while planning a transfer are?
Patient's experience and physical ability
Gluteus minimums and medius muscle effects?
Pelvic stability and posterior pelvic tilt
Clients are categorized into what three groups?
People, organizations, and populations
Philosphiae Nautralis Principia Mathematica or Mathematical principles of natural philosophy is commonly know as the?
Principia by John Newton
Values
Principles and standards that in individual considers to be essential to follow in order to lead a good life
Sterilization
Process by which all microorganism including spores are destroyed
Motor development is a?
Process of continuous modification caused by neurologic growth and maturation, residual effects of previous experiences, and effects of new motor experiences
Diaphoresis
Profuse perspiration
Range of motion and manual muscle testing are useful in identifying?
Progress and achievement of OT goals and in providing a measurement for functional outcomes
What are the general motor stages of the developmental sequence?
Prone, reaches for objects, sits with support, rolls prone to supine, wriggles and crawls, palmar grasp, rolls supine to prone, sits unsupported, stands with support, pulls sit to stand, walks with support, stands alone, climbs stairs holding railings, climbs stairs alone, jumps on both feet, walks on tips of toes, stands on one foot, rides tricycle, skips on one foot, hops on one foot, climbs stairs with one foot per step, skips on both feet, walks heel to toe, and then kicks, throw, and climbs
Face shields are used to?
Protec face, mouth, nose, and eyes
Gowns or aprons are used to?
Protec skin and or clothing
Hip adductors origin is?
Pubis
Range of motion
ROM
Medial or internal rotation
Rotary movement around vertical axis of bone toward midline of body
SARS-Cov
Severe acute respiratory syndrome coronavirus
Dehydration effects blood pressure because?
Significant decrease of body fluids may cause low BP
Decubiti
Sores that often form when pressure is maintained over a body protuberance
The insertion of the semispinalis of the transversospinalis is?
Spinous processes of upper thoracic, cervical except C-1, and superior nuchal line of occiput
Govles can be?
Sterile or non-sterile
Elevation is movement?
Superiorly
A muscle categorized by location could be?
Tbialis anterior, and lastissimus dorsi
Tonos
Tension
Negotiability
The ability to access a feature of the environment and use it for its intended purpose in a manner acceptable to the person
Excursion ratio
The difference between how long a muscle is when stretched as compared to its length when contracted for most muscles it is 2 to 1 indicating that most muscles are capable of stretching twice as long as they can shorten
Kinematic chain
The bones and joints moving in sequence following a specified pattern depending on whether the chain is open or closed
Muscle insertion
The end point for the muscle it is usually distal or farther away from the trunk and midline of the body and is considered the most movable part
Torque
The expression of the effectiveness of a force in turning a lever system it is the product of a force multiplied by the perpendicular distance form its line of action to the axis of motion so T= F x D
Intubation
The insertion of a tube into the larynx to maintain an open airway
Transfer
The moving of a patient from one surface to another surface
A isotonic contraction that is an eccentric contraction is if?
The muscle contracts with less force than needed to overcome the resistance
Isotonic contraction is considered concentric when?
The muscle shortens and the joint angle is decreased like the elbow when you bring a glass to your mouth
Tone or muscle tone
The normal state of tension of muscles caused by partial contraction of some of the muscle fibers
Resistance
The object one is trying to move in diagrams referred to as R
Perineum
The pelvic floor and associated structures occupying the pelvic outlet
Anterior pelvic tilt
The pelvis is dipping forward lifting the buttocks upward and creating a hyperlordosis in the lumbar spine it can be observed in women who are pregnant or in people who carry excessive weight in the abdomen it causes teh center of gravity to shift forwared it can also be caused by a muscle imbalance in the abdomen, lower limb, and pelivs
Systole
The period when the greatest amount of pressure is exerted on the walls of the arteries during heartbeat it usually indicates the contractile phase of the heartbeat
Neural arch
The posterior portion of the vertebrae
Sepsis
The presence of pathogenic microorganisms or their toxins in the blood or tissues
Social environment
The presence, relationships, and expectations of persons, groups, and organizations with whom the client has contact
Infection
The production of a disease or harmful condition by the entrance of disease producing germs into an organism
Ischial tuberosity
The protuberance of the ischium so the inferior, distal portion of the pelvis
Occipital tuberosity
The protuberance of the occipital bones so the posterior area of the skull
Apical pulse
The pulse that is found when a stethoscope is placed on the chest wall over the apex of the heart it may be found by palpation
Joint compression
The pushing together of both sides of the joint toward the center of the joint it occurs naturally in the ankles, knees, and hips during walking or jumping and in the joints of the upper extremity when doing a push up
Acceleration
The rate in change of velocity with respect to time
Beliefs
Things that are true to him or her regardless of what another person might say, think, or believe
Work
The transference of energy that is produced by the motion of the pint of application of a force and is measured by multiplying the force and the displacement of its pint of application in the line of action
Rotation happens within?
The transverse plane
Torque
The turning or rotary effect of a force
Transverse process
The union of the manina and pedicale where the ligaments and muscle attach to the spine
Kinematics means?
Things that move
The cardiovascular and respiratory systems rely on the skeletal muscular system to operate properly and example of this occurs when?
There is a contraction of muscles in a limb that aids the return of blood to the heart and decreases the occurrence of edema in the extremities
Korotkoff sounds in phase IV or 4 are?
There is a distinct and abrupt muffling of sounds until a soft blowing quality is heard this phase is the initial indication of the diastolic pressure and is the best indicator of diastolic pressure in adults according to the AHA
Special precautions for total hip replacement especially within initial 2 weeks after surgery for anterior approach are?
This surgical approach permits the patient to have little or no postsurgical restrictions or precautions after surgery because none of the posterior structures of the hip have been compromised the incision is smaller and no muscles are split or detached during the procedure guidelines do not limit hip flexion caution should be taken to limit excessive hip extension and adduction but follow protocol as presented ty the hospital and physician
Latissimus dorsi nerve that acts on the trunk is?
Thoracodorsal nerve
Motions of the body occur in?
Three cardinal planes of movement
Blanch
To become pale
Stoop
To bend the body forward or downward by partially bending the knees
Occlude
To fit close together or to close tight or to obstruct or close off
Squat
To sit on the heels with the knees fully bent
Negotiability is the ability of a person to interact with the environment and independently use common features such as?
Toilet paper dispenser it implies that the built environment is also designed so that features such as doors, household appliances, light switches, and sinks are usable by everyone
When you use gloves limit opportunities for?
Touch contamination protect yourself, other, and the environment so don't touch your face or adjust PPE with contaminated gloves and don't touch environmental surfaces except as necessary during patient care
Proximal
Toward or closer to the attachment to the trunk or origin so nearer to the center of the body
Posterior or dorsal
Toward the back of the body or buttocks so relating to the back
Inferior or caudal
Toward the feet, downward from another body part, or below in relationship to another structure
Anterior or ventral
Toward the front of the body so toward the belly
Deep
Toward the inside of or within the body so below the surface
Rotation movements happen along the?
Transverse plane
The terms superior and inferior refer to the?
Transverse plane
Iliopsoas origin is?
Transverse process of lumbar vertebrae
Psoas major muscle effects?
Trunk flexion, trunk stability, and pelvic stability
Rotary motion
Turning or movement about an axis the parts of the object further from the axis move at a greater speed than those close to the axis
Factors influencing PPE selection are?
Type of exposure anticipated like splash or spray versus touch and category of isolation precautions, durability and appropriateness for the task, and fit
Normal atypical movement reflects the motor behavior response of a client or individual when?
Typical movement strategies are temporarily or completely no longer feasible additionally a new task may require novel or previously inexperienced motor behaviors
By assessing manual muscle testing of the uninvolved intact extremity the clinician will be able to gain information of?
Typical normal movement that may be characteristic of the involved impaired extremity
CDC
US Centers for Disease Control and Prevention
Brachial plexus name of the nerves?
Ulnar and Radial
The transverse plane divides the body into?
Upper and lower parts
Shoulder abduction associated girdle motion is?
Upward rotation and elevation
Airborne precautions
Used to prevent transmission of infectious agents that remain infectious over long distances when suspended in the air like varicella virus or chickenpox, rubella virus or measles, mycobacterium tuberculosis, or SARS-Cov you should wash your hands thoroughly on entering and leaving the room, use a N-95 respirator or dust/mist respirator or higher level must be worn before entering the room it must be fit tested before use then discard the mask after leaving the room and whenever possible nonimmune health care workers should not work with patients with vaccine preventable airborne diseases like chickenpox, measles, or smallpox, they should be in a private airborne infection isolation room and the door must remain closed, and if the patient must be transported place a surgical mask on the patient if possible
The transverse abdomens is important in the?
Valsalva maneuver
Throbbing diffuse pain related structure is?
Vasculature
A muscle categorized by size and location could be?
Vastus lateralis
Anterior can also be called?
Ventral
Paravertebral muscle nerve is?
Ventral primary rami of the cervical nerves
Trunk
Vertebral column, ribs, and sternum
Motor skills are?
Voluntary movements used to complete a desired task or achieve a specific goal they are goal directed and observable as a client interacts with the environment and task
World Health Organization
WHO
Gait patterns
Walking patterns and impairments such as asymmetric gait and stiff gait they are considered in relation to how they affect ability to engage in occupations in daily life activities
Guidelines for carrying are?
When carrying an object hold it close to your body the best positions are in front of your body at the level of your waist or on your back, if you carry an object in one hand like a suitcase or a briefcase alternate carrying it in one hand and then the other do not twist your back when moving the object from one hand to the other and stoop to lift it from the floor, balance the load whenever possible, some bulky or heavy objects can be carried on your shoulders especially if you must carry them for a substantial distance, avoid carrying or balancing a call child on one hip use and infant carrier or hold the child close to your chest or on your back with use of an approved child carrier, and when a backpack is used apply both shoulder straps
What is an example of horizontal adduction?
When in the driver's seat reaching across chest with right arm to reach shoulder belt
Arm position effects blood pressure because?
When the person is stated or standing the standard arm position is with the forearm maintained at the level of the fourth intercostal space and elbow extended no adjustment in arm position ifs required when the person is supine because it is supported on the bed at the proper level BP may increase when the arm is lowered from the level previously described and may decrease when the arm is raised above that level
CDC recommends?
When, what, and how to use PPE
Is it possible to have activity or participation restrictions without having an impairment of the body or a body part?
Yes
0-10 numerical pain distress scale
0 is no pain, 5 is distressing pain, and 10 is unbearable pain
Fingers MP hyperextension ROM is?
0 to 15-45 degrees
Hand rubbing procedure
1. Remove jewelry from the hands and wrists 2. apply a cleansing agent which may be in foam, gel, liquid, or spray form from the dispenser to one palm 2. rub the hands vigorously using friction or rubbing motions to the flowing areas palms together, interlace finger rub web space and between and around each finger, dorsum of each hand with the palm of the opposite hand, fingertips of each hand in the opposite palm, dorsal finger creases of each hand with opposite palm, each thumb while it is clasped by the opposite palm, and each wrist while it is clasped by the opposite palm 4. rub for at least 15 seconds or until the hands are dry do not rinse the hands with water or dry them with a towel
Blood pressure normal range in adults is?
120-139/80-89
Prehypertension range is?
120-139/80-89
Manual muscle testing for gravity eliminated test has numerical grade of what?
2, 2-, 1+, 1, 0
Transversospinalis group has?
3 branches but lies deep to the erectors its name refers to its muscles fibers which extend at varying lengths form the transverse and spinous processes of the vertebrae
When the body is in the standard anatomical position which is standing erect with the palms facing forward it can be divided into?
3 imaginary planes
What is the degree of freedom of the ball and socket joint?
3 or triaxial
Manual muscle testing screening test numerical grade is?
3, 3-, 2+
Average average sized adult sphygmomanometer bladder measurements are?
3-6 inches or 7-15 centimeters
How many segments are in the lumbar vertebra?
5
How many segments are in the sacral fused with the coccyx?
5 and the coccyx
The range of motion of the lumbar vertebral column for rotation is?
5 degrees
Resting heart rate for children so 1 to 10 years is?
70-130 beats/min
Resting normal pulse range for a child 1 to 7 is?
80-120 bpm
Lever arm
A component of a mechanical lever it may be the force arm or the weight or resistance arm when the length of the force arm is increased or the length of the weight are id decreased a greater mechanical advantage is created for the lever system
Orthopnea
A condition in which breathing is easier when the person is seated or standing
When moving from a chair to the wheelchair the patient should use?
A hand to push off from the seat of the chair as he or she comes to standing
Internal locus of control
A person believes he or she has control over what will happen to him or herself
External locus of control
A person believes that what happens to him or her is a result of outside influences and that the outcome is not under personal control
Joint distraction
A pulling apart of two joint surfaces it is often produced by external forces such as in the use of an external fixator like to help a broken bone realign for proper healing it occurs naturally in the shoulder, elbow, and wrist joints as a child swings across the monkey bars and lower extremity knee and hip joint when the child is hanging upside down with legs wrapped around a jungle gym
Serratus
A saw, notched, or toothed
Vertigo
A sensation of rotation or movement of one's self or of one's surroundings
Rectus femoris origin is?
ASIS
Shoulder horizontal adduction associated girdle motion is?
Abduction and lateral tilt
Hypertension
Abnormally high blood pressure
AAROM
Active assist range of motion
AROM
Active range of motion
Weak grasp at mealtime accessibility example is?
Adapted utensils, containers opened by others, and pre-cut food
Blood pressure normal range in children 4 to 12 yr old is?
Add 2mg per yr to 100/60-70
Shoulder horizontal abduction associated girdle motion is?
Adduction and reduction of lateral tilt
Amphiarthrodial or cartilaginous joints
Allow for limited movement as in the pubic symphysis
Diarthrodial joint
Allows the most movement and is considered freely movable its movement is limited primarily by muscle, tendon, and ligaments rather than by the joint structure itself
Dorsal pedal pulse measurement site is?
Along the midline or slightly medial on the dorsum of the foot
Rale
An abnormal, discontinuous, nonmusical sound heard on auscultation of the chest primarily during inhalation it is also called a crackle
Shear
An applied force that tends to cause an opposite but parallel sliding motion of the planes of an object to subject to a shear force
Lordosis
An increase in one of the forward convexities of the normal vertebral columns a lumbar or cervical one can occur
Exacerbation
An increase in the severity of disease or any of its sympotms
Stethoscope
An instrument used to convey sounds produced in the body of a person to the ears of examiner it is composed of a diaphragm, tubing, and earpieces
Sphygmomanometer
An instrument used to measure blood pressure it may use a mercury column or an enclosed air pressure spring system
Foramen
An opening
Body structures
Anatomical parts of the body such as joints, bones, muscles, and structures of related body systems
Body structures
Anatomical parts that support body functions everything from the microscopic cell to the organ or limb
Body structures focus on?
Anatomy and specific body parts like organs, skin, muscles, bones, limbs, and other anatomical features
Common soft tissue contracture sites related to prolonged positioning in prone are?
Ankle plantar flexors, shoulder extensors, adductors, and internal or external rotators, and neck rotors left or right
Psoas major nerve that acts on the trunk is?
Anterior rami, T12 to L5
Example of bony spine is the?
Anterior superior iliac spine
Femoral nerve area of body innervated?
Antrior thigh
Restrain physical
Any manual method physical or mechanical device, meatier, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely
Some of the precautions you should follow when you treat a patient who is in protective isolation are?
Apply PPE carefully and follow the provided recommendations for their application, avoid causing excessive air currents in the patient's room so move slowly and arrange linen or equipment carefully, do not enter the patient's room with PPE that has been worn to treat patients in another area of the hospital because you may bring undesired microorganisms into the patient's environment, perform proper hand hygiene before applying and after removing PPE, and adherence to these precautions helps to protect both you and the patient from becoming infected
When using gloves discard them in a?
Appropriate receptacle and never wash or reuse disposable gloves
Passive range of motion is the?
Arc of motion through which the joint passes when moved by an outside force
Active range of motion is the?
Arc of motion through which the joint passes when voluntarily moved by muscles acting on the joint
Ectopic
Arising or produced abnormally
Afferent muscles
Ascending to the CNS
The movable or distal bar of the goniometer is?
Attached at the center or axis of the protractor and acts as a dial
Bone processes
Attachments for tendon, ligament, or fascia and axis for movement or risk for decubiti
Wheelchair use in a home negotiability example is?
Automatic doors and lower light switches
Miscellaneous standard precautions are?
Avoid eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses in a patient care area, avoid hand contact with mucous membranes of your eyes, nose, mouth, or ears, handle all laundry and textiles carefully especially linen soiled by a patient's body fluids or waste dispose and transport it in the proper bag hamper, or container, avoid unnecessary contact with a patient who places you at risk with contact of a body fluid or waste product especially blood, and report incidents of contact with a patient's body fluids or waste product on an unprotected are of your body and seek immediate assistance if a direct blood to blood contact occurs between you and a patient
Lateral rotation swings the limb?
Away from the midline
Systolic pressure is the?
BP at the time of contraction of the left ventricle so systole
Diastolic pressure is the?
BP at the time of the rest period of the heart so diastole
Infectious agent examples are?
Bacteria, fungi, protozoa, or prion
Flexion
Bending a joint usually reduces the joint angle with two bones moving closer together
BP
Blood pressure
Standard precautions apply to?
Blood, all body fluids, secretions, and excretions except sweat regardless of whether they contain visible blood, nonintact skin, and mucous membranes
Fever
Body temperature that is above the normal level it is also referred to as pyrexia
Brachial plexus nerve roots are?
C5 through T1
Amphiarthrodial joints are also called?
Cartilaginous joints
The nervous system is broken down into what major parts?
Central nervous system or CNS and the peripheral nervous system or PNS
Superior can also be called?
Cephalic
Lift
Change in fluid pressure as a result of differences in air or liquid flow velocities around an object it is produced when flow over one side of the object is faster than the flow over the opposite side of the same object it acts perpendicular to the discretion of fluid flow
Transitional movements
Change or movement from one position to another
In preparation for a transfer do what?
Check the patient's chart for precautions surgical procedure orders, joint disease, pain levels, or osteoporosis, plan the transfer across the shortest distance, plan to move the patient toward hos or her strongest side and assist the weak side, obtain necessary equipment or assistance before initiating the transfer, ensure the patient is properly dressed for the transfer excessively lose clothing, long trousers, slacks, or pajamas should be avoided shoes with nonskid soles should be worn, wash your hands and don gloves if appropriate, introduce yourself to the patient, explain the transfer procedure to the patient and demonstrate it if necessary explain the patient's role in the procedure provide simple concise commands and help carry them out, and obtain the patient's consent after you have explained the activity and the possible risks if any associated with it
Airborne plus contact precautions common syndromes are?
Chickenpox, disseminated herpes zoster in immunocompromised hosts, and smallpox
OSHA specifies?
Circumstances for which PPE is indicated
The planes of the body help?
Clarify and specify movements
Independence level for activities of daily living or ADL is the?
Client completes 100% of task typically by self
Modified independence level for activities of daily living or ADL is the?
Client completes ADL task with adaptations
Supervision level for activities of daily living or ADL is the?
Client requires assistance of someone present to complete a task this may include stand by assistance or standing next to the person
A bent pivot transfer is used to allow increased?
Clinician interaction and support it allows the clinician greater control of the patient's trunk and buttocks during the transfer
Circumduction
Combination of flexion, extension, abduction, and adduction leading to circular motion
Inversion and eversion occur as a?
Combination of movements of several joints of the feet
What is an example of lateral or external rotation?
Combing back of head or fastening necklace behind neck
The stand pivot transfer requires the patient to be able to?
Come to a standing position and pivot on one or both feet
What is commonly used for seated bathing?
Commercially produced bath bench or bath chair or a well secured straight back chair
Agonists muscles are a muscle that?
Concentrically contracts causing movement at a joint at most joints several muscles act together each as an agonist causing the movement
The disease specific precautions are divided into three designations of precautions abased on the route of transmission which are?
Contact which can be direct or indirect, droplet, and airborne
Respiratory hygiene or cough etiquette standard precautions are?
Contain the source of infectious respiratory secretions in symptomatic patients beginning at the initial point of encounter so emergney departmens, outpatient clinics, waiting rooms, and physician offices, instruct symptomatic persons to cover the nose and mouth when sneezing or coughing, use tissues and dispose in a no touch receptacle, perform hand hygiene after soiling of hands from respiratory secretions, and wear a surgical if tolerated or maintain spatial separation or over 3 feet if possible
Sterile
Containing no microorganism so free from germs so aseptic
All domains of an OT are affected by the aspects of?
Context and environment
Eccentric contractions work to?
Decelerate movement as a brake would of for a car
Hyotonia
Decreased muscle tone
For less mobile clients certain boney landmarks need to be observed or examined periodically to inspect for?
Decubiti
Olecranon process consideration is?
Decubitus
The Iliac crest and crest of tibia are for?
Decubitus
The location of the transversospinalis muscle is?
Deep to erectors and alongside spine
Manual muscle testing purpose is to?
Determine strength and identify impairments, establish a baseline, document improvements in strength, and aid in selecting effectiveness of interventions
Special precautions for low back trauma or discomfort are?
Excessive lumbar rotation, trunk side bending, and trunk flexion should be avoided when turning patients may experience less discomfort if they logroll like roll the entire body simultaneously rather than roll segmentally like rolling the shoulders and upper trunk first, then the pelvis, and then the lower extremities they also may be more comfortable with the hips and knees partially flexed with a pillow under or between the knees when they are in a supine or side lying position
In general a patient who is inactive, has restricted mobility, or is unable to alter body positions should not be positioned for an extended period so more than 30 minutes in any position that causes or produces what?
Excessive rotation or bending of the spine, bilateral or unilateral scapular abduction or a forward head position, compression of the thorax or chest, plantar flexion of the ankles and feet, hip or knee flexion, hyperextension of the knees, adduction and internal rotation of the glenohumeral joint, elbow, wrist, or finger flexion, and hip adduction or internal or external rotation
Bed to wheelchair eclectic mechanical lift transfer procedure is?
Explain the activity to the patient the firs time it is to be performed and obtain consent for the maneuver, position and lock the wheelchair and ensure that sufficient space is available for the equipment, apply the body sling under the patient by rolling the patient into one side then onto the other side, position the lift perpendicular to the bed open the base legs and position the spreader bar over the shoulders or midchest, lower the lift arm until the sling loops or clips can be attached to the spreader bar with the shorter straps going at the shoulders and the longer straps by the hips securely attach the loops or clips to the spreader bars fold the patient's arms over his or her chest and check the sling position, gradually elevate the patient until the body clears the surface of the bed check the security of the sling attachments, transport the patient to the wheelchair turn the body so that the back is toward the chair seat and position the body over the middle of the chair seat, gradually lower the patient push on the knees to direct the hips to the most posterior portion of the seat guide the body into the chair and adjust the body position as necessary, lower the lift arm until the sling loops or clips can be removed from the spreader bar, ensure that the patient is clear of the lift and move the lift away check the body position for safety and security the sling may be removed or remain in place for the return transfer
Manual muscle testing for isometric grading 3+ is?
Fair+ or F+
Manual muscle testing screening test grade of 3- is?
Fair-
Common causes of back problems or discomfort are?
Faulty posture, stressful living and work habits such as being unable to relax or maintain a posture for a prolonged period, faulty or improper use of body mechanics, repetitive sustained microtrauma to structures of the back and trunk, poor flexibility of muscles and ligaments of the back and trunk, decline in general physical fitness, use of improper techniques to lift, push, pull, reach, or carry, and episodes of trauma that culminate in one specific or final event so the final straw like stress, strain, or tearing of a muscle or ligament, change in the shape of a disk which then impinges on nerve roots, and irritation of vertebral joints
Pennate is derived form the Latin word for?
Feather
The name transversospinalis refers to the fact that the?
Fibers of this muscle extend at varying lengths from the transverse and spinous processes of the vertebrae
Syndesmosis joint
Fibrous joint where the ligaments provide the stability
All articulations have a?
Fibrous, cartilaginous, or synovial structure
Bariatric
Field of medicine that is concerned with weight loss or that deals with causes, prevention and treamtnet of obesity
For a protective transfer to and from the floor for a person with low back dysfunction the patient should be encouraged to use a?
Firm stable object for support to reduce stress to the back as movement from standing to the floor or from floor to sanding is being performed
Korotkoff sounds in phase I or 1 are?
First faint clear tapping sounds are detected and gradually increase in intensity these sounds are the initial indication of systolic pressure in an adult according to the AHA
The patient in a bathtub may exit by?
First placing one foot securely outside the bathtub on a nonskid floor surface and then performing a standing or seated transfer back to the wheelchair
Goggles should?
Fit snuggly over and around eyes, personal glasses are not a substitute for goggles, and antifog feature improves clarity
Is the sacral fused with the coccyx vertebra fixed or flexible?
Fixed
A LMN injury either at the anterior horn cell or a peripheral nerve axon results in?
Flaccid paralysis, decreased muscle tone or hypotonia, loss of the stretch reflex, and significant atrophy
Guidelines for pushing and pulling are?
Flex your knees and face the object squarely, use your arms and legs to push or pull push with your arms partially flexed, push or pull in a straight line and your force should be parallel to the floor, and be certain there are no objects in your path and doorways are wide enough for the object to pass through
OUCHER pain rating scales for children
For children 3-13 y it consists of 6 photographs of a child's face representing no hurt to biggest hurt you can ever heave it includes a vertical scale with numbers 0-10
Newton's law of action and reaction
For every action there is an equal and opposite reaction
Cervical vertebrae transverse process is a?
Foramen for vertebral artery
End feel or how the joint movement feels at the end of the range of motion influences the amount of?
Force a clinician will use to identify the available range of motion
When transferring to a toilet adaptive devices such as?
Grab bars and raised toilet seats can be added to increase the patient's independence during this transfer but keep in mind raised toilet seats are poorly secured to toilets and may be unsafe for some patients but the patient can use theses devices to support himself or herself during transfers and maintain a level surface to which to transfer
Scooting to the edge of the bed in the case of an individual with spinal cord injury do what?
Grasp the patient's legs from behind the knees and pull the patient forward placing the patient's feet firmly on the floor and being sure that the ankles are in a neutral position
Example of bony trochanter is the?
Greater trochanter of femur and malleolus
Standards and rules related to the use of restraints and seclusion are contained in the?
Hospital Conditions of Participation: Patients' Rights of the Medicare and Medicaid Programs which was published in the Federal Register on December 8, 2006
Reservoir examples are?
Humans, contaminated food, water, insects, animals, or soil
Horizontal abduction
Humerus positioned in horizontal plane with arm raised to 90 degrees with movement away from midline and toward back of body
When a joint can extend beyond its normal range of motion it is called?
Hyperextension
During the OT evaluation range of motion and manual muscle testing help to?
Identify problems with movement, assist in developing treatment goals, and aid in the overall analysis of occupational performance
The Occupational Therapy Practice Framework 2nd Edition or OTPF 2 considers body functions and structures as?
Inter related parts under client factors body functions focus on the physiological functions of body systems whereas body structures focus on the underlying anatomy
Screw
Is technically a type of inclined plane it converts rotary motion into linear motion either forward or backward
Site of measurement is a factor that affects body temperature because?
Its values are slightly higher if measured rectally and slightly lower if measured in the axilla compared with oral values
Extension
Joint angle increases so straightening
The shoulder or glenohumeral joint is an example of a?
Joint capable of circumduction and is a ball and socket joint
Synovial joints contain a?
Joint cavity which is absent in fibrous and cartilaginous joints
When stated at a workstation for prolonged periods do what?
Keep elbows, knees, and hips level and bent at 90 degrees, feet should be flat on the floor or supported at a slight incline, forearms should be supported by armrests, and the back should be supported by the chair back or a lumbar roll
Soft end feel examples are?
Knee flexion and elbow flexion
What is an example of extension?
Knee position in standing
What is important to know and apply when you establish the sterile field of asepsis using items that are part of the field?
Know which items are sterile, know which items are not sterile, separate sterile items from nonsterile items, and if a sterile item becomes contaminated remedy the situation immediately
Lumbosacral plexus nerve roots are?
L1 through L4 and L5 through S3
Dyspnea
Labored breathing
Dyspnea
Labored or difficult breathing
In the case of an eccentric contraction the muscle is actually?
Lengthening under stress
Iliopsoas insertion is?
Lesser trochanter of the femur
In sitting the center of gravity is?
Lower and the base of support is greater than that of standing the increased stability of the body with proper support for the buttocks, the feet, and the back will increase one's abilbity to perform fine motor activities with the hands
Sliding board transfer is most often employed with persons who have?
Lower extremity amputations or individuals with spinal cord injuries
Manual muscle testing for isometric grading 5 or normal is where the client?
Maintains the testing position against gravity and maximal resistance
Unlike the long vertical erector fibers the branches of the transversospinalis consists of?
Many short diagonal fibers
Manual muscle testing for screening test grade of 3 or fair is where the client?
Moves the joint through full available range of motion against gravity or maintains the testing position
Manual muscle testing for gravity eliminated test grading of 2 or poor is where the client?
Moves the joint through full range of motion with gravity eliminated
Manual muscle testing for screening test grade of 3- or fair- is where the client?
Moves the joint through greater than half but less than full available range of motion against gravity
Cramping, dull, aching pain related structure is?
Muscle
Contractility
Muscle's ability to shorten in length however not all contractions result in muscle shortening so it can also refer to a muscle's ability to develop tension against resistance
Stabilizers
Muscles that surround a joint or body part to stabilize the joint against unwanted movement when muscles contract the insertion can move toward the origin or vice versa these muscles prevent motion at one of these locations in order to allow controlled movement at the other location during normal muscle use these muscles stabilize the origin of the agonist muscles that stabilize a portion of the body against a particular force which may internal form other muscles or external such as gravity or weight being lifted
Tracheal breath sounds are best heard in the?
Neck region and are high pitched, harsh, hollow, and loud
What is a example of flexion?
Occurs at elbow when bringing fork to mouth
In a two person dependent bent pivot transfer transfer or gait belts may be employed to?
Offer a place to grasp while one is assisting the patient in a transfer the belt is placed securely around the waist and often used instead of the patient's waistband the belt should not be allowed to slide up the patient's trunk
Example of bony process is the?
Olecranon process
Posterior tibial pulse measurement site is?
On the medial aspect of the foot inferior to the medial malleolus
A pivot joint is designed to allow?
One bone to rotate around the surface of another bone
The clinician should be cautious when assessing or teaching bathtub transfers because the bathtub is?
One of the most hazardous areas of the home
Sitting dependent lift transfer
One, two, or three persons may be required to lift the patient from one surface to another while maintaining the patient in a sitting or squat position as mechanical lift may also be used this transfer is used when the patient is physically unable to assist
Exit examples are?
Open wound, respiratory tract, intestinal tract, or blood and body fluids
Pain examples for not using range of motion and manual muscle testing are?
Pain with joint movement to touch or resistance
Autonomic nervous system or ANS
Part of the peripheral nervous system it has efferent or motor innervation controlling the viscera it innervates smooth and cardiac muscle as well as glands and supplies information from the internal environment
PPE types for respiratory protection are?
Particulate respirators, half or full face elastomeric respirators, and powered air purifying respirators or PAPR
Rectus femoris insertion is?
Patella and tibial tuberosity
Bony prominences that may cause pressure injuries in the lower extremity in prone position are?
Patella, ridge of tibia, and dorsum of foot
Medial
Pertaining to or situated toward the midline of the body or a structure
Inguinal
Pertaining to the groin
In a stand pivot and or stand step transfer the clinician's intervention may range from?
Physical assistance to accommodate for potential loss of balance to facilitation of near normal movement, equal weight baring, and maintenance of appropriate posture for patients with hemiplegia or hemiparesis
Body functions
Physiologic functions of the body and include a category called neuromusculoskeletal and movement related functions
Rotation of the head occurs because of the?
Pivot joint between the 1st and 2nd cervical vertebra called the atlanoaxial joint
Manual palpation for apical pulse do what?
Place two or three fingertips on the patient's skin on the left lateral side of the base of sternum in the intercostal space between the fourth or fifth or the fifth and sixth ribs then count and record the pulse rate
How to perform a sliding board transfer is?
Position and set up the wheelchair as previously outlined, lift the leg closer to the transfer surface place the board midthigh between the buttocks and knee angled toward the opposite hip the board must be firmly under the thigh and firmly on the surface to which the patient is transferring, block the patient's knees with the practitioner's knees, instruct the patient to place one hand on the edge of the bed and the other hand on the wheelchair seat, instruct the patient to lean forward, the patient should transfer his or her upper body weight in the direction opposite to which he or she is going the patient uses both arms to lift or slide buttocks along the board, and then assist the patient where needed to shift weight and support the trunk while moving to the intended surface
Thoracic vertebrae superior articular process faces?
Posterior and laterally
The coordination between head, trunk, and arm movements such as self-feeding in children is dependent on adequate?
Postural control
Before rolling the hemiplegic patient in bed the practitioner may need to?
Put his or her hand under the patient's scapula on the weak side and gently mobilize it forward to prevent the patient form rolling into the shoulder potentially causing pain and injury
Radialis
Radial side
When transferring to a chair the patient must be instructed to?
Reach for the seat of the chair the patient should not reach for the armrest or back of the chair because this action may cause the chair to tip over
What is an example of medial or internal rotation?
Reaching into paonts pocket
Cardiovascular conditions examples for not using range of motion and manual muscle testing are?
Recent heart surgery or cardiac precautions
Anticipatory postural movements
Reflect movements of the trunk or posture in response to changes in task or environmental demands
How to perform deep breathing and breathing awareness is?
Relax as much as possible, close your eyes and mentally scan your body for tension, pay attention to your breathing by placing one hand on the part of chest or abdomen that seems to rise and fall the most with each breath if this spot chest you are not utilizing the lower part of your lungs, place both hands on abdomen and follow breathing noticing how abdomen rises and falls, breathe through your nose, notice if chest is moving in harmony with abdomen, place one hand on abdomen and one on chest, inhale deeply and slowly through nose and feel abdomen rise with this inhalation the chest should move only slightly, exhale through mouth keeping mouth, tongue, and jaw relaxed, relax and focus on the sound and feeling of long, slow, deep breaths
Flaccid
Relaxed so without tone
Accessibility
Removing barriers that prevent people with activity limitations from the use of services, products, and information
Dependent
Requiring some level or type of assistance which may be human or mechanical the patient is unable to assist with transfers
RL
Residual limb
Drag
Resistance to forward motion
RR
Respiratory rate
Respirators protect?
Respiratory tract form airborne infectious agents
Diastole
Rest period
Wheelchair to bed electric mechanical lift transfer procedure is?
Reverse the sequence of bed to wheelchair transfer check the security of the sling attachments before lifting the patient and position the patient on the bed or mat for safety and security
Wheelchair to bed manually operated mechanical lift transfer procedure is?
Reverse the sequence of the activities of the transfer form the bed to chair position the patient on the mattress and remove the sling, be sure to check the position of the sling or slings and the security of the chains or web straps before lifting the patient form the chair, remember to close the valve after the spreader bar has been positioned to attach or remove the chains or web straps
Three person lift transfer return to bed from a new support surface procedure is?
Reverse the sequence of the transfer form the bed to a new support surface to return the patient to the bed
A muscle categorized by shape could be?
Rhomboid and trapezius
What are ipsilateral to each other?
Right are and right leg
Scalene muscle causes neck?
Rotation, tilts the neck, and elevates the ribs
Teres
Round, smooth, and cordlike as in teres major or pronator teres muscles
Bony epicondyle
Rounded projection proximal to condyle
Spinal extensors so iliocostalis, longissimus, and spinalis muscles insertion is?
Runs parallel to the vertebral column
What are the planes of the saddle joint?
Sagittal, frontal, and multi
Isometric
Same measure
Elevation and depression refer to the movement of the?
Scapula and jaw
Glenohumeral mobility depends greatly on?
Scapular mobility if the scapular musculature is spastic, contracted, or orthopedically restricted the ROM will be affected
Diaphragmatic breathing exercise position is?
Seated or standing
For complete natural breathing the position can be?
Seated or standing with good posture
Axis
Second cervical vertebra it is characterized by a short protrusio know as the odontoid process for the dens with the atlas it endables the head to turn right and left and it also allows for a nodding type movment most head movemtns occur at this place and the atlas or C1 and C2
Muscles can be categorized by?
Shape, size, location, action, direction of fibers, number of fibers, number of divisions, pints of attachment, action and shape, action and size, size and location, shape and location, location and attachment, and location and number of divisions
Inflammation examples for not using range of motion and manual muscle testing are?
Significantly swollen hand or upper extremity
Stretch reflex
Slight stretching of a muscle lengthens fibers causing stimulation of sensory endings which leads to contraction of the muscle this is a protective reflex to avoid overstretching one role of the muscle spindle is to detect stretch and respond to it via the stretch reflex this phenomenon is in constant use and provides adjustment to muscle tone
Bradycardia
Slow pulse less than 60 bpm
Cervical vertebrae body shape is?
Small and oval
The stationary or proximal bar of the goniometer includes a?
Small protractor or half circle of 0 degrees to 180 degrees or a full circle printed with a scale form 0 degrees to 360 degrees
In a gliding joint only?
Small shifting movements are possible such as those between the carpals in the wrist or tarsals in the foot
Cervical vertebrae size is?
Smallest
Vesicular breath sounds are?
Soft and low pitched and are hard over the periphery of both lung fields the expiratory phase heard is shorter than the inspiratory phase
What are some types of end feel?
Soft end feel, firm end feel, hard end feel, and abnormal end feel
Method of transmission examples are?
Soiled dressings, exudate from the wound, soiled linen, ingestion of contaminated food or water, needle stick, insects or animals, respiratory droplet, or contaminated dust
Abnormal end feel examples are?
Spasticity, muscle guarding, or springy sensation
Personal protective equipment
Specialized clothing or equipment worn by an employee for protection against infectious materials
Dermatome
Specific area of skin on the body that receives feedback from a dorsal nerve root when injury occurs to even a single nerve root sensation supplied by that nerve root will be diminished or altered
Muscles that cause anterior pelvic tilt are?
Spinal extensors so iliocostalis, longissimus, and spinalis muscles, iliopsoas, hip adductors, rectus femoris, and iliotibial band with hip internal rotation
The insertion of the multifidi and rotatores of the transversospinalis is?
Spinous processes of lumbar vertebrae through second cervical vertebrae multifidi span two to four vertebrae and rotatores span one to two vertebrae
To abduct the fingers or toes is to?
Spread them apart
Quadratus
Square or having four equal sides so denoting the number four
Guidelines for reaching are?
Stand on a footstool or ladder to reach or place an object above your head, move the object close to you or move close to the object before grasping, lowering, or raising it be certain you will be able to control the object safely, hold the object close to your body as you step down from or into a footstool, and do not simultaneously reach and twist your body
A muscle categorized by points of attachment could be?
Sternocleidomastoid and coracbrachialis
Muscles of the neck are?
Sternocleidomastoid, scalene, and prevertebral
What is an example of circumduction?
Stirring or churning a large vat of apple butter or molasses
Rectus
Straight as in rectus femoris or rectus abdominus
Muscle power
Strength
Motor reflexes
Stretch, asymmetrical tonic neck, and symmetrical tonic neck
CVA
Stroke
Somatic division
Subdivision of the PNS the sensory receptors and nerves are related tot he external environment with nerves linking these to the CNS and efferent nerves returning to the skeletal muscle
In a OT evaluation what data should be gathered?
Subjective, objective, functional skills, range of motion, strength, balance, posture, assessment, short term goals, and long term goals
The erector spinae group is the?
Superficial of the spinal muscles and has 3 major branches
Children from 1 year to 4 years normal values for blood pressures are?
Systolic of 100-108 mm Hg and diastolic of 60 mm Hg
Infants from birth to 3 months normal values for blood pressures are?
Systolic of 85-90 mm Hg and diastolic of 35-65 mm Hg
Hypertensive crisis ranges for blood pressure are?
Systolic of more then 180 mm Hg and diastolic of more than 110 mm Hg
Pulse measurement sites are?
Temporal, carotid, brachial, radial, femoral, popliteal, dorsal pedal, and posterior tibial
A muscle categorized by size could be?
Teres major and teres minor
Natural physical environment includes?
Terrain, bodies of water, sensory aspects including climate, scents, plants and animals, and forces such as gravity and friction
Protraction like protrude occurs when?
The clavicle, head, or jaw moves anteriorly
The patient and caregiver should demonstrate safe use of the mechanical lift before?
The clinician prescribes it
Universal design
The design of products and environments to be usable by all people to the greatest extent possible without the need for adaptation or specialized design
Force
The effort or energy used to move or hold the object in diagrams it is referred to as F
End feel
The feel experienced by a clinician at the end range of motion for a joint
Firm end feel
The feel experienced when a normal joint or ligament is stretched
Abnormal end feel
The feel experienced when the typical quality of feel is different
Hard end feel
The feel experienced when two bones block motion
Expiration
The passive pahse of respiration when the person breathes out also referred to as exhalation
Independent transfer
The patient can perform a transfer without any type of verbal or manual assistance
Minimal assistance
The patient performs 75% or more of the activity assistance is required to complete the activity
Fundamental position
The subject is standing in an upright posture, eyes looking forward, feet parallel with toes pointed forward, and arms slightly abducted at the side of the body with palms facing the side of the body
Posterior pelvic tilt
The tailbone is tucking beneath the body or the posterior superior iliac spine or PSIS shifiting backward it will cause the lumbar spine to flatten and the thoracic spine to flex or become kyphotic
In a two person dependent bent pivot transfer the clinicians should be sure?
They coordinate the time of the transfer with the patient and one another by counting to three aloud and instructing the team to initiate the transfer on three
A muscle categorized by location and number of divisions could be?
Triceps brachii and biceps femoris
Hypotonia
Under tone or having a lesser degree of tension so diminished muscular tone
Pulley
Used to change the direction of force or the point of application of force it consists of a rope around a small wheel that has a grooved rim to keep the rope in place
Contact precautions
Used to prevent transmission of infectious agents including epidemiologically important microorganisms that are spread by direct or indirect contact with the patient or the patient's environment also used where the presence of excessive wound drainage, fecal incontinence, or other discharges from the body suggest an increased potential for risk of transmission and extensive environmental contamination transmission based isolation precautions are used in addition to standard precautions when a patient is in isolation you should wash hands thoroughly on entering the room and wash with chlorhexidine gluconate antiseptic soap on leaving the room, wear gloves on entering the room, wear a gown when having direct contact with the patient, environmental surfaces, or patient items then remove gown before leaving the room, the room should be private or cohort with preferably more than 3 feet between beds, and patient care items like thermometer, stethoscope, blood pressure cuff should remain in the room and if any item must be removed it must be disinfected or placed in a bag labeled biohazard
What are some examples of ways to increase friction to enable client participation and independence?
Using gloves for wheelchair propulsion, placing gripper pads under throw rugs, using dycem or gripper pads under dishes while eating or cooking, and using sticky or tacky finger cream to count or separate money or turn pages in a book
Social environment
The attribute of human presence
Fingers DIP flexion ROM is?
0-80 degrees
Forearm pronation ROM is?
0 to 80-90 degrees
Forearm supination ROM is?
0 to 80-90 degrees
Thumb DIP flexion ROM is?
0 to 80-90 degrees
Fingers PIP flexion ROM is?
0-110 degrees
Hip flexion ROM is?
0-120 degrees bent knees
Shoulder horizontal adduction ROM is?
0-130 degrees
Knee flexion ROM is?
0-135 degrees
Ankle and foot dorsiflexion ROM is?
0-15 degrees
Shoulder abduction ROM is?
0-170 degrees
Shoulder flexion ROM is?
0-170 degrees
Blood pressure normal range in children 1 to 4 yr old is?
100-108/60
Oblique abdominals insertion is?
ASIS and pubic crest
Goggles protect?
Eyes
Thoracic and lumbar spine extension ROM is?
0-30 degrees
Hip adduction ROM is?
0-35 degrees
Hip abduction ROM is?
0-40 degrees
Shoulder horizontal abduction ROM is?
0-40 degrees
Glove material can be?
Vinyl, latex, nitrile, or other
Pursed lips breathing positon is?
Seated or standing
Body of the vertebra
A cylindrical mass of cancellous bone it is the anterior and weight bearing portion of the vertebrae it is not palpable on the back and C1 does not have a body
Osteoporosis
A decreased mass per unit volume of normally mineralized bone compared with that in age matched and sex matched control subjects so loss of bone mass
Rotation of the head and neck occurs as?
A driver turns to check whether a car is coming form behind in the next lane
The wo splenius muscles are located?
Along the posterior neck deep to the trapezius
Both flexion and extension take place?
Along the sagittal plane
The semisphinalis of the transversospinalis is located?
Along the thoracic and cervical vertebrae and ultimately reaches the cranium
Sensory neuron
Also called afferent it transmits signals from receptors to the CNS and carries information toward the CNS
Motor neuron
Also called efferent it relays information from the CNS to structures that need to react or respond it carries information away from the CNS
To reduce stress producing positions?
Alter your posture or position frequently and avoid prolonged standing or sitting
Examples of OTA incorporating the LE or lower extremity in treatment include what?
An OTA walking a client to the commode during ADL retraining using a rolling walker, an OTA collaborating with physical therapy and reinforcing functional safe transfer techniques by the client, an OTA adapting and grading static or dynamic standing and sitting balance while looking at the base of support or BOS, muscle activation, and sequence of LE movement, trunk, posture, and weight shifting as they influence UE functional reaching, an OTA reaching into a kitchen cabinet for a plate using appropriate adaptive equipment and safety while monitoring static and dynamic standing balance, and aiding a patient diagnosed with spinal cord injury to perform circle sitting for the self care task of dressing
Tachycardia
An abnormally fast heartbeat like a pulse rate of more than 100 beats/min
Gonio
Angle
What is an example of abduction?
Arm and leg position in upward stroke of jumping jack exercise
Size and condition of arteries effects blood pressure because?
Arteries that have a reduced lumen produce an increased BP value and arteries that have decreased elasticity produce an increased systolic value and a decreased diastolic value there two factors tend to account for the changes that occur in BP values of elderly patients
Distal
Away from or further from the midline of the body or attachment to the trunk so farther from the pint of reference or origin
Normal atypical movement
Awkward, uncoordinated, inefficient, conscious thought, limited movement options, low complexity, increased time, low joint angle, one joint motion, low velocity, and low acceleration
Lateral flexion occurs only at the?
Axial skeleton
Anterior superior iliac spine consideration is?
Axis for hip abduction and adduction it is decubitus
Greater trochanter of femur and malleolus consideration is?
Axis for hip flexion and extension and then axis for ankle plantar and dorsi flexion both it is decubitus
Shoulder adduction associated griddle motion is?
Depression, adduction, and downward rotation
Shoulder extension associated girdle motion is?
Depression, adduction, and upward tilt
Seven of the eight cranial bones are?
Directly accessible the eight the ethmoid is accessible only by way of the nasal cavity most are superficial
After aligning the goniometer the OTA should note any?
Discomfort, unusual restriction or freedom of movement, or audible noise or crepitation from the joint
Motor neurons are generally regarded as?
Efferent and terminates on muscle fibers causing a contraction
What is an example of a hinge joint?
Elbow and knee joint
What are some movement examples of a hinge joint?
Elbow flexion and extension
Diarthroidial joints are?
Enclosed within a joint capsule that secretes synovial fluid to lubricate the joint so they are also called synovial joints the majority of the joints in the body are these
EPA
Environmental Protection Agency
Isos
Equal
Cervical vertebrae vertebral notches are?
Equal in depth
Range of motion is the?
Extent of movment that occurs at a joint
Supination and pronation also occur at the?
Feet
How to perform diaphragmatic breathing exercises is?
Gently place one hand on abdomen and one hand on chest, breathe in and out through nose while keeping mouth closed, notice the hand over the abdomen moving out as you breathe in, the hand placed over the heart should remain still, breathe in through nose slowly counting to 3 pacing it so your lungs are full on the count of 3, exhale counting backwards so your lungs empty on the count of 3, repeat this process 3 to 5 times, and focuse on movement of lower stomach
What are the basic principles of body mechanics?
Get close to the patient or move the patient closer to you, square off with the patient so face head on, bend knees, use the legs, not the back, keep a neutral spine so not bent or arched back, keep a wide base of support, keep your heels down, do not tackle more than you can handle so ask for help, do not combine movements for example avoid rotating at the same time as bending forward or backward, and consider some things before a transfer
The OT domain of performance patterns includes?
Habits, rooutines, rituals, and roles
Performance patterns for a OT?
Habits, routines, roles, and rituals
Thoracic vertebrae body shape is?
Heart shaped with facets that articulate with ribs
Bronchovesicular sounds are?
High pitched and soft and are best heard between the scapulae or at the triangle of auscultation these sounds come from the main stem bronchi
Horizontal adduction
Humerus positioned in horizontal plane with arm raised to 90 degrees with movement toward the midline and front of body
Dementia example for not using range of motion and manual muscle testing is?
Inability to follow commands due to agitation or cognitive impairments
Interoceptors
Internal receivers which are afferent nerve endings or receptors that respond to stimulation form within the body primarily from visceral organs
Hand hygiene standard precautions?
Immediately after glove removal, wash hands after touching blood, excretions, secretions, body fluid, and contaminated items, avoid wearing artificial fingernails because they may separate from the real nail producing a pocket for pathogen growth, avoid contact with the outer surface of the gloves when they are removed, and wash hands or use a hand rub before and after patient care
PPE use in healthcare settings program goal is to?
Improve personnel safety in the healthcare environment through appropriate use of PPE
Air quality affects respiration because?
Impurities in the atmosphere may cause RR to increase or decrease depending on the effects of carious components of the person's pulmonary system
When the joint medially rotates the limb turns?
In toward the midline
Multiple sclerosis example for not using range of motion and manual muscle testing is?
Increased fatigue unwarranted
Valsalva phenomenon or maneuver
Increased intrathoracic pressure caused by forcible exhalation against a closed glottis
What are the general categories of an activities of daily living or ADL scale?
Independence, modified independence, supervision, minimum assistance, moderate assistance, maximum assistance, and dependent assistance
Lateral
Indicates a position away from the median plane or midline of a body or structure
Insufficiency
Indicates that the muscle is not able to work to its full potential at all joints at the same time it is lack of completeness of function
Client motivation is derived from and affected by?
Individual factors such as personality, values, beliefs, and spirituality however it may also be affected by external factors
The cycle of infection includes what elements?
Infectious agent, reservoir, exit, transmission, infection, and susceptibility
Carotid pulse measurement site is?
Inferior to the angle of the mandible and anterior to the sternocleidomastoid muscle
Depression is movement?
Inferiorly
Hepatitis
Inflammation of the liver
A decision regarding the appropriate type of transfer is based on what general factors?
Information gathered from the medical record review, the patient, or the patient's family or caregiver, physician's order, your assessment of the patient's ability to assist, and goals of treatment
Blood volume effects blood pressure because?
It decreases when blood loss occurs and increases with increase in blood volume so like after transfusion of whole blood or plasma
Standing dependent pivot transfer
Level both surface heights and secure both surfaces it requires that the patient WB on at least one LE lift the patient into a standing position using a gait belt with both hands at the patient's back stabilize the legs for the pivot with both of your knees squeezing the patient's knees lift the patient and pivot quickly, and assist the patient to sit do not attempt a dependent lift unless you are physically able use a mechanical lift if available
Scalene muscle nerve is?
Lower cervical nerves
Face protection includes?
Masks, goggles, and face shields
Is HIV positive an activity limitation?
Maybe
MAP
Mean arterial pressure
Pelvic tilt or inclination
Movement of the pelvis so that the anterior superior iliac spine moves anteriorly or posteriorly to produce an anterior or a posterior tilt or inclination of the pelvis
Flexion
Movement that bends a joint or brings the bones closer together
Extension
Movement that straightness or opens a joint
Patent's physical ability considerations while planning a transfer is that you should have understanding of what characteristics of the patient?
Muscle strength, pain level, joint and soft tissue flexibility, sitting and standing balance, endurance, tolerance of sitting and standing positions, motor control, cognitive and mental status, visual and hearing status, communication abilities, and available footwear
Isometric contraction
Muscle tension develops but the muscle length does not change so the joint angle or measurement does not change it can be thought of as static as they maintain the joint angle in a relatively stationary nonmoving position
NWB
Non weight bearing
Manual muscle testing for isometric grading 5 is?
Normal or N
Clearing patient from MRSA or VRE isolation should?
Not be attempted if receiving antibiotics that treat that infection
Supination and pronation describe the?
Pivoting action of the forearm
A joint or articulation is the?
Point of contact between bones
Examples of LMN injuries may include?
Poliomyelitis or a deep cut on a limb that severs a peripheral nerve
Manual muscle testing for gravity eliminated test has alternative grading scale of?
Poor or P, poor- or P-, trace+ or T+, trace or T, and zero or 0
Manual muscle testing for screening test grade of 2+ is?
Poor+
Lamina
Portion of the vertebrae that connects the spinous process to the transverse process
Pedicle
Portion of the vertebral arch that lies posterior to the bodyand anterior to the lamina
Pronation
Position of forearm when palm is facing down
Supination
Position of forearm when palm is facing up
What is an example of supination?
Position of hand when holding a handful of small candies and fingers are open not fisted
What is an example of pronation?
Position of hands on computer keyboard when typing
When moving a patient remember to lower your trunk by flexing your hips and knees before moving the patient if the bed or mat cannot be adjusted this movement will?
Position your center of gravity or COG as close to the patient's COG as possible
Alternate methods of recording ROM are?
Possible and the OT practitioner should adapt to the method required by the facility
What are some general transfer principles?
Predetermine that patient's mental and physical capabilities to perform the transfer including weight bearing status, the patient's clothing and footwear should be suitable for the transfer, mentally preplan the activities and sequence associated with the transfer teach and practice components of the transfer before attempting the transfer, assess the patient's pain status before and at the completion of the transfer, instruct the patient slow, clearly, and concisely; allow time for the patient to process and apply the information, select, position, and secure any needed equipment; apply a gait belt or use a sling, be alert for unusual events that may occur such as patient dizziness or distractions, do not guard the patient by using clothing or grasping the arm use a gait belt or a sling and the trunk, position yourself to guard, guide, direct, and protect the patient throughout the transfer, ask the patient to initiate and perform the transfer in simple directive terms; assist as necessary, and at the conclusion of the transfer position the patient for comfort, stability, and safety, and document changes in the patient's performance
In hemiplegia when the patient's lower extremity is involved what positions should be avoid?
Prolonged hip and knee flexion, hip external rotation, and ankle plantar flexion and inversion these positions are the ones that are most likely to lead to soft tissue contractures caused by muscle spasticity, reduced function of the opposing muscle, and lack of active motion
Goggles are used to?
Protect eyes
Respiratory protection purpose is to?
Protect from inhalation of infectious aerosols like Mycobacterium tuberculosis
Gloves are used to?
Protect hands
Standard precautions are designed to?
Protect health care workers and patients in a hospital and other health care settings regardless of their diagnosis or infection status these precautions are considered to be the best means to control infection
Masks and respirators are used to?
Protect mouth and nose
What are the muscles of the pelvis that act on the trunk?
Psoas major, hip flexors rectus femoris, iliacus, latissimus dorsi, and gluteus minimus and medius
Rectus abdominus origin is?
Pubis
Before rolling the hemiplegic patient in preparation for transfer the practitioner may need to?
Put his or her hand under the patient's scapula on the weak side and gently mobilize it forward to prevent the patient from rolling into the shoulder potentially causing pain and injury
Abnormal respiratory rate in response to exercise or other treatment activities are?
RR slowly increase during exercise or activity, RR does not increase during exercise or activity, RR increase as intensity of exercise or activity plateaus, RR slowly declines as intensity of exercise or activity declines and terminates, RR does not decline as intensity of exercise or activity declines, RR declines during exercise or activity before intensity of exercise declines, increase in rate or amount of increase in patient's RR is excessive during exercise period, or rhythm of respiration pattern becomes irregular during or after exercise or activity
What is an example of a pivot joint?
Radioulnar joint and atlantoaxial
Supination like carrying a bowl of soup occurs when the?
Radius and ulna lie parallel to one another
Pronation like prone to spill it takes place when the?
Radius crosses over the ulna turning the palm down
Anatomical position
Reference position most widely used for definitions the subject is standing in an upright posture, eyes looking forward, feet parallel with toes pointed forward, and arms slightly abducted at the side of the body with palms facing forward
Peripheral nerves have the capacity to a certain degree for?
Regeneration and repair if the cell body remains intact in general they can regenerate at about 2 to 4 mm per day
Core stabilization
Relates to a group of muscles bounded by the abdominal wall, pelvis, diaphragm, and lower back that are contracted to assist in posture, balance, and stability
Isolation
Separation from others
Circumduction is possible at the?
Shoulder and hip joints
Medial rotation and lateral rotation sometimes referred to as internal and external rotation occur at the?
Shoulder and hip joints
What is an example of a ball and socket joint?
Shoulder and hip joints
Appendicular skeleton
Shoulder and pelvic girdles and the upper extremities and the lower extremities it is composed mostly of long bones
Normal typical movement
Smooth, coordinated, efficient, automatic, variety of movement options, high complexity, decreased time, high joint angle, multiple joints motions, high velocity, and high acceleration
Lumbar plexus
Spinal nerve roots beginning with the first through fourth lumbar nerves or L1 through L4
Follow hospital protocol for precautions and contraindications for hip replacement based on the?
Surgical approach
A limitation in ROM is indicated when the?
Start position is not 0 degrees examples are extension limitation at elbow joint 15-degree to 140-degree, flexion limitation at the elbow joint 0 degrees to 110 degrees and abnormal hyperextension of elbow joint 20 degrees to 140 degrees
Posture
State of the body in relationship to gravity, the ground, and to its body parts or extremities
Gluteus minimus and medius nerve that acts on the trunk is?
Superior gluteal, L4, L5, and S1
Considering the personal context younger people tend to?
Text more than those in retirement years
The domain of a OT called performance skills are?
The abilities clients demonstrate in the actions they perform like the interrelated skills of motor and praxis, sensory and perceptual, emotional and cognitive, communication and social
Sitting balance
The ability to maintain a seated posture without falling and also the ability to reach
Stability
The ability to maintain the body in equilibrium it is essential to movement to prevent falls and enable distal mobility of the extremities to occur
Mobility
The ability to move in an environment with ease and without restriction
Praxis
The ability to plan and perform purposeful movement
Apnea
The absence of breathing
Motor learning
The acquisition and or modification of learned movement patterns over time
Respiration
The act of breathing
Friction
The act of rubbing one object against another
Range of motion
The arc of motion through which a joint moves
What must the OT practitioner have complete understanding of in order measure joints?
The degree and type of motion that will occur at a specific joint, average or normal ROM, and how to position himself or herself and the patient during measurement
Disinfection
The destruction or removal of pathogenic organisms but not necessarily their spores
Closed kinematic chain
The distal segment is fixed or stabilized so movement in one joint will automatically necessitate movement at connecting joints it represents weight bearing
Open kinematic chain
The distal segment is freely moving and therefore one joint can move without impacting movement of the other joints it represents non weight bearing
Factors that affect body temperature are?
Time of day, age, environmental temperature, infection, physical activity, emotional status, site of measurement, menstrual cycle, and oral cavity temperature
Variations in the bent pivot transfer from bed to wheelchair is?
Using both hands and arms at the waist or trunk or one or both hands under the buttocks the clinician never grasp under the patient's weak arm or grasp the weak arm which is an action that could cause significant injury because of weak musculature and poor stability around the shoulder girdle
When working with a patient who has had a stoke or traumatic brain injury on scooting to the edge of the bed do what?
Walk the patient's hips toward the edge of the bed shift the patient's weight to the unaffected side position your hand behind the opposite buttock and guide the patient forward shift the patient's weight to the affected side and repeat the procedure if necessary move forward until the patient's feet are flat on the floor in the case of an individual with spinal cord injury grasp the patient's legs from behind the knees and pull the patient forward placing the patient's feet firmly on the floor and being sure that the ankles are in a neutral position
Patient's experience considerations while planning a transfer are?
What has the patient accomplished previously?, How does the patient transfer now?, What are the patient's activity limitations and abilities?, How much assistance is required to move the individual in bed or to perform a transfer?, Does the patient need to sue orthotics or splints during the transfer to ensue safety?, Must specific precautions be used to protect the patent or to avoid further injury?, What is the structural environment in the patient's living quarters like for example carpet, stairs, railing, location of bedroom and bathroom?
In a bathtub transfer whether a standing pivot, bent pivot, or sliding board transfer is performed the technique is similar to a?
Wheelchair to chair transfer
Passive insufficiency
When a muscle cannot be stretched any further yet it has not stretched the amount required for full range of motion at all joints crossed at the same time
Active insufficiency
When a muscle cannot shorten or contract any further and fails to shorten to the extent required for simultaneous full range of motion at all joints crossed
Pain concerns are?
Where, when, with what activities or positions, and how it impacts occupations
Contamination
When something is rendered unclean or nonsterile
Locus of control refers to?
Who or what has impact over outcomes
Avoid bending at the waist while?
Working, washing your face, brushing your teeth, or performing activities that are below your waist like bathing children in a bathtub or removing clothes from the washer or dryer sit, stoop, or kneel instead of bending
OSHA issues?
Workplace health and safety regulations
In anatomical position most joints are?
Extended
Agonists are referred to as?
Moves
Elbow flexion ROM is?
0 to 135-150 degrees
Blood pressure normal range in adolescents is?
100-120/65-75
Resting normal pulse range for a newborn is?
100-130 bpm
Resting heart rate for newborns so from 0 to 3 months is?
100-150 beats/min
Resting heart rate for infants so 6 to 12 months is?
100-160 beats/min
The range of motion of the thoracolumbar vertebral column for flexion is?
105 degrees
What degree of freedom does the saddle joint have?
2 or more so bi or multiaxial
Reservoir
A place where microorganisms can grow and reproduce so a host animals and human beings are both examples of microorganisms hosts
Exit
A place where microorganisms can leave the host or reservoir they can do so though a person's nose, mouth, throat, ear, eye, intestinal tract, urinary tract, body fluids like blood, or wounds
Adduction is opposite of?
Abduction
What are movement examples of a condyloid joint?
Abduction and adduction, and flexion and extension of the lesser digits
Shoulder internal rotation associated girdle motion is?
Abduction and lateral tilt
Built or man-made environment can have a significant impact on an individual's?
Ability for independent engagement in occupation
The dependent transfer should be practiced with?
Able bodied persons and initially used with patient only when another person is available to assist
Adaptive motor behaviors movement options are categorized into what groups?
Abnormal atypical movement, normal atypical movement, normal typical movement, and normal or enhanced typical movement
Kyphosis
Abnormally increased convexity in the curvature of the thoracic spine as viewed from the side
Hypotension
Abnormally low blood pressure
Hypertonia
Above or over tone so extreme tension of the muscles
Asepsis
Absence of microorganisms that produce disease it is the prevention of infection by maintaining a sterile condition
Anoxia
Absence of oxygen in the tissue
One important feature of the goniometer is the?
Axis or fulcrum the rivet that acts as the fulcrum must move freely but hold tightly enough to keep the arms at the measured position when the goniometer is removed from the body
Examples of motor and praxis skills are?
Bending and reaching for a toy or tool in a storage bin, pacing tempo of movements to clean the room, coordinating body movements to complete a job task, maintaining balance while walking on an uneven surface or while showering, anticipating or adjusting posture and body position in response to environmental circumstances such as obstacles, and manipulating keys or lock to open the door
Assessment tools for the identification of movement include?
Bennet hand tool dexterity test or H-TDT, Berg balance scale, Bruiniks-oseretsky test of motor proficiency 2nd edition or BOT-2, Children's handwriting evaluation scale or CHES, Erhardt developmental prehension assessment or EDPA, Jebson-hand function test, box and block test, nine-hole peg test, Crawford small parts dexterity test or CSPDT, Fine dexterity test, Fine motor task assessment, Fugl-meyer evaluation of physical performance, Grooved peg board test, Lincoln-oseretsky motor development scale, Minnesota rate of manipulation test, Motor activity log, Purdue peg board, Range of motion, and Manual muscle testing
Pursed lips breathing is used for?
COPD
If your client is in stage 4 hypertension you should?
Call a nurse and not work with the client
Ataxic gait is described as?
Drunken
Hard end feel examples are?
Elbow extension
In hemiplegia when the patient's upper extremity is involved what positons should be avoid?
Elbow flexion, forearm supination or pronation, wrist, finger, or thumb flexion, and finger and thumb adduction these positions are most likely to lead to soft tissue contractures caused by muscle spasticity, reduced function of the opposing muscles, and lack of active motion
It is particularly important to establish baseline vital sign values for which kinds of patients?
Elderly patients which is older than 65 years, very young patients which is younger than 2 years, debilitated patients, patients who have performed limited aerobic activities for several weeks or months, patients with a previous or current history of cardiovascular problems, and patients recovering from recent trauma, patients with a condition or disease that affects the cardiopulmonary system like a spinal cord injury, a cerebrovascular injury hypertension, peripheral vascular disease, or chronic obstructive pulmonary disease, or patients recovering from recent major surgery
Eversion like turn out?
Elevates the foot's lateral side and moves the sole laterally
Inversion like turn in?
Elevates the foot's medial side and brings the sole of the foot medially
The action of the multifidi and rotatores of the transversospinalis is?
Extend the vertebral column and rotate the vertebral column to the opposite side
The action of the semispinalis of the transversospinalis is?
Extends the vertebral column and head
Hyperextension
Extension of a limb or part beyond the normal limit so overextension of a limb or part
Bending your knee is called?
Flexion of the knee flexion of the leg would require an ambulance
Circumduction involves a combination of?
Flexion, extension, adduction, and abduction together these actions create a cone shaped moment
Sternocleidomastoid muscle causes neck?
Flexion, lateral flexion, and rotation
Axis is also called?
Fulcrum or pivot
Bony prominences that may cause pressure injuries in the lower extremity in side lying position lowermost extremity are?
Greater trochanter of femur, medial and lateral condyles of femur, malleolus of fibula and tibia, and fifth metatarsal
Hip abductors so gluteus medius and minimus insertion is?
Greater trochanter of the femur
Bony prominences that may cause pressure injuries in the lower extremity in sitting position are?
Greater trochanter, popliteal fossa, and posterior calcaneus if resting against a hard surface
Normal enhanced typical movement is reflective of?
Highly trained motor skills and motor control it allows for high efficiency, adaptability, and consistency in performance of a task in a variety of environments quite often it does not occur naturally and is very specific to the individual, task, and context and can be found in may different situations
Common soft tissue contracture sites related to prolonged positioning in sitting are?
Hip and knee flexors, hip adductors and internal rotators, and shoulder adductors, extensors, and internal rotators
Muscles that cause neutral pelvic tilt are?
Hip extensors so glueus maxmius, oblique abdominals, hip abductors, and hip adductors
Muscles that contribute to pelvic position are?
Hip extensors so gluteus maximus, oblique abdominals, hip abductors, hip adductors, hip extensors, hip abductors so gluteus medius and minimus, rectus abdominus, iliotibial band with hip external rotaion, spinal extensors so iliocostalis, longissimus, and spinalis muscles, iliopsoas, hip adductors, rectus femoris, and ilitibial band with hip internal rotation
Environmental temperature effects pulse because?
It tends to increase with high temperature and decrease with low temperature
Infection effects pulse because?
It tends to increase with major infectious process
Physical activity is a factor that affects body temperature because?
It usually increases slightly with physical activity reaches a plateau as the person becomes better conditioned
Movement of the body occurs at the?
Joints where bones articulate or connect
Droplet precautions common syndromes are?
Mumps or rubella, Neisseria meningitides, and streptococcus A
Manual muscle testing for isometric grading 4 or good is where the client?
Maintains the testing position against gravity and moderate resistance
Some patients because of body size, extent of disability, or the health and well being of the caregiver require the use of a?
Mechanical lift
A common error for beginners is to position the patient and goniometer correctly and then?
Misread the actual measurement
Lateral flexion or side bending
Movement of head, neck, or trunk laterally away form midline or center of body with abduction of the spine
Flexion
Movement that decreases the angle between two adjoining body parts or bones
Extension
Movement that increases or straightens the angle between two adjoining body parts or bones
Adduction
Movement toward an axis or toward the median place of the body so movement of a body part toward the middle of the body
Abduction
Moves a limb laterally away form the midline so abduct or carry away
Lumbar vertebrae transverse process are?
No foramen and no articulation
Infectious agent
Pathogens that cause communicable diseases
Reservoir of infection for medical asepsis is?
Patient
Gloves purpose is?
Patient care, environmental services
When transferring with a transfer board if the bed height can be adjusted it should be?
Positioned as near to the height of the wheelchair seat as possible before the transfer is attempted and the bed wheels should be locked
Proper positioning is important because it?
Prevents soft tissue injury, pressure, and joint contracture, it provides patient comfort, it provides support and stability for the trunk and extremities, it provides access and exposure to areas to be treated, it promotes efficient function of the patient's body systems, and it relieves excessive prolonged pressure on soft tissue, bony prominences, and circulatory and neurologic structures
Agonists can be broken into?
Primary agonists and assistant agonists
Abnormal responses of the pulse rate during or after exercise or physical activity are?
Pulse rate slowly increases during active exercise, pulse rate does not increase during active exercise, pulse rate continues to increase or decreases as intensity of exercise or activity plateaus, pulse rate slowly declines as intensity of exercise or activity declines, pulse rate declines during exercise before intensity of exercise or activity declines, increased pulse rate or amount of increase exceeds level expected to occur during exercise period, or rhythm of pulse becomes irregular during or after exercise or activity like dysrhythmia, arrhythmia, or ectopic beats occur
Activities of daily living or ADL
Self care tasks performed to take care of one's body such as bathing, brushing teeth, dressing, eating, bowel and bladder functions, and mobility
A ball and socket joint is?
Self explanatory
The entire nervous system is made up of?
Sensory and motor neurons
Iliotibial band with hip external rotation insertion is?
Tibia and patella
Iliotibial band with hip internal rotation insertion is?
Tibia and patella
Superior or cephalic
Toward the head, upward, or higher than another structure
Medial or internal
Toward the middle of the body or midline
Normal breath sounds are classified as?
Tracheal, bronchial, bronchovesicular, or vesicular and depend on the area of the chest being examined
Joint distraction is also called?
Traction
Hierarchy of safety and health controls are?
Training and administrative controls, engineering controls, work practice controls, and personal protective equipment
What are the axis and axes of a gliding joint?
Variable
Personal protective equipment or PPE
Various barriers and respirators used alone or in combination to protect skin, mucous membranes, eyes, airways, and clothing from contact with infectious agents it includes gloves, respirators, masks, face shields, goggles, shoe covers, caps, and gowns
Medications effects blood pressure because?
Various medications may cause BP to increase or decrease depending on their effect on the cardiovascular system medications frequently used to control hypertension my result in a temporary state of hypotension in some patients
During a stand pivot and or stand step transfer if a patient demonstrates impaired cognition or a behavior deficit including impulsiveness and poor safety judgment the clinician may need to provide?
Verbal cues or physical guidance
What are the axis and axes of a pivot joint?
Vertical
The axis in the horizontal plane is the?
Vertical axis
Line of gravity
Vertical line from the center of gravity to the earth and base of support is contained within the area of the body parts in contact with the ground
Transmission
Where microorganisms pass from one person to another to spread the infection it can occur through the air, droplets from a cough or sneeze, or direct contact with items such as another person's skin, equipment, mat pads, instruments like needles, scalpels, and thermometers, eating utensils, toys, linens, and body fluids like blood, semen, saliva, and vaginal secretions
Ankle and foot plantar flexion ROM is?
0-50 degrees
Thumb MP flexion ROM is?
0-50 degrees
Thumb palmar abduction ROM is?
0-50 degrees
Shoulder internal rotation arm in adduction ROM is?
0-60 degrees
Shoulder internal rotation arm in abduction ROM is?
0-70 degrees
Wrist extension ROM is?
0-70 degrees
Shoulder external rotation arm in adduction ROM is?
0-80 degrees
Shoulder external rotation arm in abduction ROM is?
0-90 degrees
Blood pressure normal range for infants from birth to 3 months is?
85-90/35-65
Graft
Any tissue or organ for transplantation or implantation
ROM is?
Joint movement active, passive, or a combination of both
Cervical vertebrae superior articular process faces?
Medially
Sagittal plane
Anteroposterior place or body section that is parallel to the median plane of the body
Buoyancy
Commonly considered a phenomenon of water and is where the upward force equals the weight of the displaced liquid the body displaces air
Elbow extension ROM is?
0 degrees
Bony process
Any notable projection
Tachycardia pules indicates?
A rapid HR over 100 beats/min
Bradycardia pules indicates?
A slow HR less than 60 beats/min
Dys
Bad or difficult
Medial can also be called?
Internal
Vertical plane can also be called?
Longitudinal
SI joint
Sacroiliac joint
Axial skeleton
Skull and trunk
Shoulder adduction ROM is?
0 degrees
Irregular pules indicates?
Both strong and weak beats occurring during the period of measurement
Opposition happens only at the?
Carpometacarpal joint of the thumb
The action of the transversospinalis muscle is?
Extend and or rotate your spine
Adduction
Medial movement toward midline or center of body
Stage 4 hypertension range is?
More than 210/120
Motor behavior
Observable and measurable movement
How to Don a gown is?
Select appropriate type
Korotkoff sounds in phase II or 2 are?
Sounds heard have a murmur or swishing quality to them
Axis
The point about which the rigid bar turns in diagrams it is referred to as A
MAP formula is?
{Systolic pressure +(Diastolic pressure x 2)} /3 an example for a BP of 130/80 would be {130+ (80x2)} / 3 = 96.7
Cervical spine flexion ROM is?
0-45 degrees
Cervical spine lateral flexion ROM is?
0-45 degrees
Sciatic nerve area of body innervated?
Posterior leg
Hip flexors so rectus femoris muscle effects?
Posterior pelvic tilt
Inferior can also be called?
Caudal
Extesion is the opposite of?
Flexion
Internal or medial rotation
Inward turning or pivoting around an axis
ROM
Range of motion
The range of motion of the lumbar vertebral column for extension is?
0 degrees
Simple descriptive pain distress scale
1 is none, 2 is annoying, 3 is uncomfortable, 4 is dreadful, 5 is horrible, and 6 is agonizing
What degree of freedom does a pivot joint have?
1 or uniaxial
Average infant sphygmomanometer bladder measurements are?
1-1.5 inches or 2.5-4 centimeters
Closed glove technique for asepsis procedure is?
1. After proper hand hygiene and donning of a sterile gown, respiratory protection, eye protection, and a cap is necessary carefully open the inner packet containing the sterile gloves and place them on a table in front of you your hands remain covered by the sleeves of your sterile gown 2. pick up one glove with your hand which is still inside the gown and place it palm down on one hand so that the thumb of the glove rests on the thumb of your gown covered hand 3. grasp the lower cuff of the glove by using your gown covered fingers and grasp the upper side of the glove cuff with your opposite covered hand and peel the cuff over your gown covered hand then gently maneuver your fingers and hand into the glove you other had remains in the gown sleeve do not extend it beyond the cuff 4. repeat steps 2 and 3 to apply the reaming glove once both gloves have been applied completely and are covering your gown cuffs hold them above waist level and avoid touching your gown or other objects to maintain sterility until it is time to treat the patient 5. the two person method to apply sterile gloves works too and all garments and gloves are sterile at this time the gloves are applied over the gown cuff
Rolling the hemiplegic patient in bed in preparation for transfer steps are?
1. Assist the patient in clasping the strong hand around the wrist of the weak arm and lift upper extremities toward the ceiling 2. flex the patient's knees 3. the practitioner may assist the patient to roll onto his or her side by moving the arms, then the legs, and by holding one hand at the scapula area and the other at the hip guiding the roll
What are the steps from side lying to sit up at the edge of bed?
1. Bring the patient's feet off the edge of the bed 2. stabilize the patient's lower extremities 3. shift the patient's body to an upright sitting position 4. place the patient's hands on the bed at the sides of his or her body to help maintain balance
After treating a patient in protective isolation PPE should be removed and discarded in what order?
1. Gloves 2. goggles or face shield 3. gown 4. mask or respirator 5. hand hygiene
Donning of PPE consists of?
1. Hand hygiene 2. gown 3. mask or respirator 4. goggles or face shield 5. gloves
PPE application for isolation precautions procedure is?
1. perform hand hygiene prepare to enter the isolation room your choice of barrier protection depends on the type of isolation the patient has been prescribed and on the agency's policy for example if airborne precautions are being observed for the patient apply only a fit tested particulate respirator and keep the room door closed 2. apply gown making sure it covers all your outer garments pull the sleeves to the wrist and tie the gown securely and the neck and waist 3. apply either a surgical mask or a fitted respirator around your mouth and nose 4. press the metal tab on the mask against your nose for a secure fit the type of mask and fit testing depends on the type of isolation the patient has been prescribed and on agency policy you must have a medical evaluation and be fit tested before using a respirator 5. if eyewear or goggles are needed fit them snuggly around your face and eyes if prescription glasses are worn use a face shield 6. apply clean gloves that are unpowdered if you or the patient has a latex allergy the gloves should be latex free bring the cuff of the gloves up over the edge of the gown sleeves
What is the checklist of nonverbal pain indicators?
1. Vocal complaints that are nonverbal like sighs, gasps, moans, groans, and cries with movement and at rest 2. facial grimaces or winces like furrowed brow, narrowed eyes, clenched teeth, tightened lips, jaw drop, and distorted expressions with movement and at rest 3. bracing like clutching or holding into furniture, equipment, or affected area during movement with movement and at rest 4. restlessness like constant or intermittent shifting of position, rocking, intermittent or constant hand motions, and inability to keep still with movement and at rest 5. rubbing like massaging affected area with movement and at rest 6. vocal complaints that are verbal like words expressing discomfort or pain like ouch or that huts, cursing during movement, exclamations of protest like stop or that's enough with movement and at rest
Measuring body temperature orally procedure is?
1. Wash your hands and obtain a thermometer, probe cover, recording form, and pen 2. position the patient and explain the procedure observe the patient and evaluate signs and symptoms related to body temperature like skin color, temperature so hot, warm, or cool, and condition like moist or dry 3. turn on the unit and apply the disposable probe cover to the probe 4. instruct the patient to open his or her mouth position the probe under the tongue and hold the probe in place with the lips and not with the teeth and breathe through the nose 5. leave the probe in place until the digital readout or alarm indicates that a constant temperature level has been reached note the value 6. remove the probe from the patient's mouth, discard the probe cover, turn off the unit, and wash your hands 7. record the results suing even increments to report tenths of a degree
Measuring respiratory rate procedure is?
1. Wash your hands and obtain a timepiece that measures second observe that patient for sings or symptoms of abnormal respiration like gasping, painting, open mouth breathing, or use of accessory neck muscles the patient may be sitting, laying, or standing as long as the abdomen or thorax can be observed to avoid voluntary control of reparation by the patient do not explain the procedure 2. simulate measurement of the radial pulse with the patient's forearm resting on abdomen observe or tactilely measure the outward and inward movement of the patient's thorax or abdomen 3. count either the inspirations or the expirations for 1 minute one inspiration and one expiation equal one respiratory cycle the rate is reported in respirations per minute once the rate, rhythm, depth, and character of the person's respirations have been determined to be within normal parameters the measurement period can be reduced to 30 seconds but the number of inspirations or expatriations must be multiplied by 2 to determine the rate for 1 full minute 4. reposition the patient's clothing or bed linens if they were removed or adjusted toe expose the patient's abdomen or thorax 5. note and record the rate, depth, rhythm, and character of the patient's respiration record the rate as respirations per minute and describe the depth, rhythm, and character of the pattern if they vary form normal
How many segments are in the thoracic vertebra?
12
Thermometer pain rating scale
1st level is no pain at all, 2nd level is little pain, 3rd level is moderate pain, 4th level is quite bad pain, 5th level is very bad pain, 6th level is the pain is almost unbearable
What degree of freedom does a condyloid joint have?
2 or biaxial
The range of motion of the thoracic vertebral column for lateral flexion is?
20 degrees
The skull is composed of?
22 bones eight in the cranium and fourteen in the facial region
Normal temperature for oral, ear, or axilla is?
98.6-99.3 F or 36-37.3 C
Susceptible host examples are?
A person with low or limited systemic resistance to the organism, children who are not fully immunized, infants, or elderly and debilitated
Pulse oximeter
A medical device that measures levels of blood oxygen saturation, monitors pulse rate, and calculates heart rate
Pathogen
A microorganism that produces disease
Extensibility
A muscles capacity to be stretched or lengthened
Vector
A physical quantity or force possessing both magnitude or size and direction it can be represented by a straight line
Hyperextension
A posterior movement from the anatomical position in the direction of extension that is beyond normal limits
Vector
A quantity possessing magnitude and direction such as a force or velocity
Stridor
A shrill harsh sound especially the respiratory sound heard during inspiration in a person with laryngeal obstruction
Active range of motion
AROM
Agonists are usually active during?
Acceleration of a body segment
Factors affecting respiration are?
Age, physical activity, emotional status, air quality, altitude, and disease
Factors that affect blood pressure are?
Age, physical activity, emotional status, medications, size and condition of arteries, arm position, muscle contraction, blood volume, dehydration, cardiac output, and site of measurement
Precautions for patient positioning are?
Avoid clothing or linen folds beneath the patient, observe skin color over body prominences before, during, and after treatment, protect bony prominences from excessive and prolonged pressure, avoid positioning the patient's extremities beyond the support surface, avoid excessive prolonged pressure on soft tissue, circulatory and neurologic structures, and use additional caution when positioning patients who are cognitively challenged or confused, comatose, very young or elderly, paralyzed, or lacking normal circulation or sensation
Burn special precautions are?
Avoid creating a shear force across the surface of the burn wound, graft site, or area form which the graft was taken sliding creates a shear force causing friction and disruption of the haling process that patient should be instructed to elevate the body or extremities when moving an area with a burn to avoid the effect of shear force
ROM is measured by an instrument or tool know as a?
Goniometer
A properly trained caregiver even one who is considerably smaller than the patient can learn to use the?
Mechanical lift safely and independently
BOS
Base of support
What are the two most important plexus?
Brachial and lumbosacral
A muscle categorized by location and attachment could be?
Brachioradialis
Severe visual impairments in academics accessibility example is?
Braille, white cane, and seeing eye dog
Protraction and retraction pertain to the?
Clavicle, head, and jaw
Transfers from the wheelchair to the bottom of the bathtub are extremely difficult and used only with patients who have?
Good bilateral strength and motor control of the upper extremities like patients with paraplegia and lower extremity amputation
Manual muscle testing for isometric grading 4- is?
Good- or G-
The sequence for donning PPE is?
Gown first, mask or respirator, goggles or face shield, and then gloves
Moderate assistance level for activities of daily living or ADL is the?
Client requires between 20% to 50% assistance for ADL tasks
Maximum assistance level for activities of daily living or ADL is the?
Client requires between 50% to 80% assistance for ADL tasks
Dependent assistance level for activities of daily living or ADL is the?
Client requires between 80% to 100% assistance for ADL tasks
Minimum assistance level for activities of daily living or ADL is the?
Client requires less than 20% assistance contact guard assistance may also be included in this category
Those who receive OT series are?
Clients
What is the curve of the sacral fused with the coccyx?
Concave
What is the curve of the thoracic vertebra?
Concave
Cardiopulmonary disease effects pulse because?
Condition of both the heart and the peripheral vascular system and their ability to function normally affect the pulse rate for example a patient with hypertension may exhibit a slower or lower pulse rate whereas a patient with hypotension may exhibit a faster or higher pulse rate to compensate for the higher or lower blood pressure
Objectives of barrier for medical asepsis are?
Confine pathologic organisms to the room, unit, or specified locale, reduce the number of organisms after they leave the body and prevent the spread to others, and used in the care of a patient with infectious diseases to prevent reinfection of patient
Spasticity
Continuous resistance to stretching by a muscle because of abnormally increased tension
Systole
Contraction of left ventricle
Postural movements and changes are important because they do what?
Contribute to the development of motor ability, precede limb movement for increased function, maintain stability, center of gravity, and base of support, and prepare the body for movement
Widening your base of support and flexing your hips and knees to position your center of gravity close to the patient's center of gravity when moving a patient allows you to?
Control the patent better, reduce stress and strain to your arms and back, and reduce the energy required to move the patient
What is the curve of the lumbar vertebra?
Convex
Kyphosis
Deformity of the spine characterized by extension it often results in cervical hyperextesnsion if the individual is in a seated posutre such as wheelchair the trunk flexes where the rib cage ends and the thracici spine forms a C shaped ben it is often seen in elderly women and may also be present in the lumbar spine in children with spina bifida
Muscle tone
Degree of muscle tone so flaccidity, spasticity, and fluctuating
Manual muscle testing for gravity eliminated test grading of 0 or zero is where the client?
Demonstrates no joint movement and no palpable or observable muscle contraction
Manual muscle testing for gravity eliminated test grading of 1 or trace is where the client?
Demonstrates no joint movement but there is a light observable or palpable muscle contraction
A person whose body temperature becomes lower than normal during treatment may be?
Demonstrating an abnormal response to the treatment
Streptococcus A precautions are?
Droplet precautions with private room and does not require negative airflow, mask when working within 3 feet of patient, contact precautions if skin lesions are present so yes to gown, yes to gloves if skin lesions are present, and minimize transport of patient
Neisseria meningitides precautions are?
Droplet precautions with private room and does not require negative airflow, mask when working within 3 feet of patient, no gown, no gloves, and mask patient when transport if necessary but minimize transport
Strong and regular pules indicates?
Even beats with a good force to each beat
Weak and regular pules indicates?
Even beats with a poor force to each beat
Weak and regular pulse
Even beats with poor force
Newtown's law of acceleration
Force is equal to the change in momentum or mV per change in time for a constant mass force equals mass times acceleration this is expressed in the famous equation F=ma
Tension
Force that produces a pull on an object
Compression
Force that produces a push on an object
Bony prominences that may cause pressure injuries in head and trunk in prone position are?
Forehead, lateral ear, tip of acromion process, sternum, and anterior superior iliac spine
What are the planes for the ball and socket joint?
Frotnal, sagittal, and horizontal
FWB
Full weight bearing
Masks should?
Fully cover nose and mouth and prevent fluid penetration
A joint's structure determines its?
Function
Clinicians are generally concerned with?
Functional range of motion
Types of PPE used in healthcare settings are?
Gloves, gowns or aprons, masks and respirators, goggles, and face shields
Normal enhanced typical movement
Highly trained motor skills or motor control that allow for high efficiency, adaptability, and consistency in a variety of environments
Muscles that cause posterior pelvic tilt are?
Hip extensors, hip abductors so gluteus medius and minimus, rectus abdominus, and ilitibial band with hip external rotation
Weak grasp at mealtime universal design example is?
In this situation the principles are similar to examples in negotiability so lightweight utensils
Independent transfer
In which the patient moves independently while the clinician merely supervises, observes, or provides input for appropriate technique as related to the patient's disability
Menstrual cycle is a factor that affects body temperature because?
It is slightly higher at the time of ovulation and pregnant woman's body temperature tends to be slightly higher than usual
Contraindications and precautions to range of motion and manual muscle testing are?
Inflammation, pain, recent surgery, myositis ossificans, bone cancer, osteoporosis, dementia, COPD, cardiovascular conditions, multiple sclerosis, and arthritis
A muscle categorized by direction of fibers could be?
Internal oblique and transverse abdominus
Movements about the vertical axis are termed?
Internal or medial rotation, external or lateral rotation, rotation to the right or left, horizontal abduction and adduction, supination, and pronation
During the OT intervention process range of motion and manual muscle testing aid in?
Intervention planning, treatment implementation, and treatment review needed to modify the treatment plan as needed
The short diagonal fibers of the transversospinalis form an?
Intricate stichlike design that links the vertebrae together
Valsalva maneuver
Involuntary action that occurs during activities such as defecation, child birth, lifting, vomiting, and sneezing
Seclusion
Involuntary confinement of a person in a room or area where the person is physically prevented from leaving
Chorea
Irregular involuntary movements of the limbs or facial muscles often described as dance like motions
Environmental temperature is a factor that affects body temperature because?
It may increase slightly in hot environment and decrease slightly in a clod environment
The rationale for using a lumbar lordotic posture is?
It reduces mechanical stress on the lumbar ligaments and the intervertebral disk, when the back is in the posture compression forces on the intervertebral disk are directed anteriorly rather than posteriorly which is a direction that reduces the potential for a posterolateral rupture of the disk, lumbar spine stability is increased as a result of approximation of the vertebral facets, function of the lumbopelvic fore coupe is maximized, and anterior and posterior lower trunk muscles and hip and thigh extensor muscles are positioned to function more effectivity
Age is a factor that affects body temperature because?
It tends to decrease slightly with age and is increased slightly in the very young
Joint stability
Joint alignment
Lumbar vertebrae body shape is?
Large and oval
Lumbar vertebrae size is?
Largest
Bony prominences that may cause pressure injuries in the upper extremity in side lying position lowermost extremity are?
Lateral head of humerus and medial or lateral epicondyle of humerus
Abduction
Lateral movement away form midline or center of body
Medial or internal rotation is the opposite of?
Lateral or external rotation
Latissimus dorsi muscle effects?
Lateral trunk flexion and anterior pelvic tilt
Recumbent
Laying down
What is an example of lateral flexion or side bending?
Leaning over sideways while seated to pick something up off the floor
The sagittal plane divides the body into?
Left and right halves
Coactivation
Limited to simultaneous action of agonist and antagonist to provide stability to increase torque at a joint when learning a new movement
How to perform pursed lips breathing is?
Loosen up neck and shoulder muscles with gentle movement in all planes, with mouth closed slowly breathe in for 2 sec, maintain relaxed shoulders and neck, then breathe out slowly through pursed lips
Paralysis
Loss of power of voluntary movement in a muscle through injury or disease of its nerve supply
Paralysis
Loss of power of voluntary movement in a muscle through injury or disease to its nerve supply
Motor control is the outcome of?
Motor learning involving the ability to produce purposeful movements of the extremities and postural adjustments in response to activity and environment demands it includes the term purposeful movements but also recognizes postural adjustments
The purpose of the dependent transfer is to?
Move the patient from surface to surface
The one person dependent sliding board transfer can be adapted to?
Move the patient to other surfaces it should be attempted only when clinician and patient feel secure with the wheelchair to bed transfer
Kinematics
Movements of each part of the body with body movements in relation to one another and the form or pattern of movement in relation to time
Manual muscle testing for gravity eliminated test grading of 2- or poor- is where the client?
Moves the joint through greater than half but less than full available range of motion with gravity eliminated
What is a example of adduction?
Normal resting position while seated or standing of arms at side of body
Physcial activity effects pulse because?
Normally the pulse rate should increase rapidly in response to vigorous physical activity then plateau or stabilize as the intensity or severity of exercise plateaus and then decline as the intensity of exercise declines the pulse rate after exercise should revert to the person's resting pulse rate within 3 to 5 min after cessation of exercise a person with a conditioned cardiopulmonary system will probably exhibit less change in the pulse rate and the rate should return to its normal resting level in a shorter time than required by an unconditioned or debilitated person
Activity demands for a OT?
Objects used and their properties, space demands, social demands, sequaencing and timing, required actions, required body functions, and required body structures
Muscle fibers in a pennate arrangement are?
Oblique or at an angle to the tendon some of these muscles are peroneus longus and brevis as well as the deltoid
Bony prominences that may cause pressure injuries in head and trunk in supine potion are?
Occipital tuberosity, spine of scapula, inferior angle of scapula, vertebral spinous processes, and sacrum
OSHA
Occupational Safety and Health Administration
The ability to perform reaching tasks while seated is fundamental to?
Occupational performance, self care, independence, and quality of life
With gloves you can have?
One or two pair
Dorsiflexion is the?
Opposite movement of plantar flexion
After removing PPE immediately?
Perform hand hygiene
PPE
Personal protective equipment
What are some examples of ways to decrease friction to enable client participation and independence?
Placing a plastic bag in the seat of a chair to help the client slide forward or pivot in the chair, placing tennis balls over the feet of a walker or on chair legs to make them easier to slide across the floor, and placing heavier items such as a pan of water on a smooth cloth or pillow case before sliding them over the counter, floor, or other surfaces
OSHA regulations regarding PPE is employers must?
Provide appropriate PPE for employees and ensure that PPE is disposed or reusable PPE is cleaned, laundered, repaired, and stored after use
Wheelchair use in a home accessibility example is?
Ramps, elevators, and grab bars
What are the two most common assessments in the physical disability setting used by OT practitioners?
Range of motion and manual muscle testing
Physical activity affects respiration because?
Rate and depth of respiaration increase during exercise
Emotional status affects respiration because?
Rate and depth of respiration increase during episodes of high stress, anxiety, or emotion like anger or fear
Stage 2 hypertensions ranges for blood pressure are?
Systolic of 160-179 mm Hg and diastolic of 100-109 mm Hg
Performance skills for a OT?
Sensory perceptual skills, motor and praxis skills, emotional regulation skills, cognitive skills, and communication and social skills
The combination of PPE used will affect?
Sequence of donning PPE
A muscle categorized by shape and location could be?
Serratus anterior and tibialis posterior
Bony spine
Sharp elevation or projection that is slender
Cervical vertebrae spinous process are?
Short and stout
Enter and leave an automobile with a?
Sideward rather than a twisting motion of the trunk, adjust the car seat so that your knees are at the same level as or slightly higher than your hips, tuck your chin and hold your head erect, and use a lumbar support also stop frequently when driving long distances to walk or stretch your arms, legs, and back
Gloves can be for?
Single use or reusable
Posterior
Situated at or direct toward the back of a body or object it is the opposite of anterior
What are movement examples of pivot joint?
Supination, pronation, and neck rotation
For deep breathing and breathing awareness the positon can be?
Supine or seated
Physiologic function can?
Support or hamper engagement in occupations
Iliotibial band with hip external rotation origin is?
Supracondylar tubercle of the femur
Iliotibial band with hip internal rotation origin is?
Supracondylar tubercle of the femur
A stand pivot and or stand step transfer is generally used when a patient can?
Take small steps toward the surface goal and just pivot toward the goal
The SI joint or sacroiliac joint is part?
Synovial and part syndemosis
Prehypertension ranges for blood pressure are?
Systolic of 120-130 mm Hg and diastolic of 80-89 mm Hg
Stage 1 hypertension ranges for blood pressure are?
Systolic of 140-139 mm Hg and diastolic of 90-99 mm Hg
Open-pack position
The joints are not at optimal fit so the joint is not as stable because there is less total contact area of the joint surfaces
The articulations of the cranial bones are different from the articulations of the appendages in that?
The joints of arms and legs have a synovial or mobile joint structure and the cranial bones have fibrous joints that are woven together to form tight fitting sutures
Standard precautions synthesize?
The major components associated with universal precautions and apply to all body fluids, secretions, and excretions of any patient the use of these precautions decreases the rick of transmission of pathogens from moist body substances and protects against the transmission of undiagnosed and diagnosed infections
Intervertebral foramen
The opeing formed by the inferior vertebral notch and the superior vertebral notch
Close-pack position
The optimal fit of joints and generally is the position that offers the most stability
Motor control
The outcome of motor learning involving the ability to produce purposeful movements of the extremities and postural adjustments in response to activity and environment demands
An ellipsoid joint consists of?
The oval shaped end of one bone articulating with elliptical basin of another bone
Sitting independent transfer
The patient is able to move from one surface to another while maintaining a sitting or squat position without the assistance of another person the patient may use a sliding board, overhead bar or frame, overhead strap, or other equipment
Standing independent pivot transfer
The patient is able to perform the transfer safely and independently without the physical or verbal assistance of another person
Standing standby pivot transfer
The patient is able to stand, pivot, and sit as he or she transfers form one surface to another the assistance required may include verbal cueing, tactile cueing, and close or causal guarding safety is a concern so the caregiver must be alert to provide protection when needed
Modified independent transfer
The patient may require verbal cues or uses cues or uses assistive equipment or adaptive equipment like bed rail, grab bars, transfer board, or furniture
Moderate assistance
The patient performs 50%-74% of the activity assistance is required to complete the activity
What must be considered to order the appropriate mechanical lift?
The patient's physical size, the environment in which the lift will be used, and the uses to which the lift will be put
In a car transfer what must be considered?
The patient's size, degree of disability, and vehicle style so two door vs. four door theses factors will affect level of independence and may necessitate a change in the usual technique to allow a safe easy transfer
Susceptibility
The person who receives the microorganism called the susceptible host so a person whose body system cannot destroy, repel, remove, or ward off the microorganism
Site of measurement effects blood pressure because?
The values are often higher in the left upper extremity than in the right upper extremity if the thigh is used as the measurement site the systolic pressure is usually higher than that found in the arm partly because of the need to use a wider bladder in the cuff but the diastolic pressures will be essentially the same as that found in the arm
Accessory motions
They increase the pain free movement available at a given joint but the movements cannot be performed voluntarily they occur between the articular surfaces of a joint in conjunction with voluntary movement
Lumbar vertebrae spinous process are?
Thick and points posterior
Age effects blood pressure because?
Younger patients so adolescents and younger exhibit lower systolic and diastolic values and elderly patients so 65 years old or more may exhibit slightly higher systolic and slightly lower diastolic pressure
Client factors for a OT?
Values, beliefs, spirituality, body functions, and body structures
What are the planes of a gliding joint?
Variable
What is the degree of freedom of a gliding joint?
Variable
Arrhythmia
Variation from the normal rhythm
Severe visual impairments in academics universal design example is?
Varied and flexible means of attending, teaching, engaging students, and testing them
Maunal muscle testing screening test grade of 3 is?
Fair
Manual muscle testing screening test alternative grading scale is?
Fair or F, fair- or F-, and poor+ or P+
Ankle and foot eversion ROM is?
0-20 degrees
Wrist radial deviation or abduction ROM is?
0-20 degrees
Fingers abduction ROM is?
0-25 degrees
Hip extension ROM is?
0-30 degrees
Thoracic and lumbar spine lateral flexion ROM is?
0-40 degrees
Cervical spine extension ROM is?
0-45 degrees
Hip external rotation ROM is?
0-45 degrees
Hip internal rotation ROM is?
0-45 degrees
Thumb opposition ROM is?
0-50 degrees
Thumb radial abduction ROM is?
0-50 degrees
Cervical spine rotation ROM is?
0-60 degrees
Fingers MP flexion ROM is?
0-90 degrees
Vestibule
A small space or region at the entrance of the ear canal
The cranial bones are?
Ethmoid, frontal, occiput, 2 parietal, sphenoid, and 2 temporal so there are 8 total
The opposite of horixontal adduction is?
Horizontal abduction
Although movement affects the placement of bones the terminology of movement always refers to?
Joints
Articulations of bones is also know as?
Joints
Average large adult arm sphygmomanometer bladder measurements are?
6-8 inches or 15-20 centimeters
The range of motion of the thoracolumbar vertebral column for extension is?
60 degrees
Entry examples are?
A cut, abrasion, cuticle tear, urinary or genitourinary tract, respiratory tract, intestinal tract, or mucus membrane
Lumbosacral plexus area of body innervated?
Anterior thigh and posterior leg
A muscle categorized by action and size could be?
Adductor magnus and extensor carpi radialis longus
Sensory neurons are?
Afferent and send sensory information to the cortex for interpretation the input can be received from any stimulation internal or external to the body
Measles or pulmonary precautions are?
Airborne precautions, private room with negative airflow and keep door closed N-95 respirator, use dust dust/mist mask, no gown, no gloves, and minimize transport of patient
Tuberculosis precautions are?
Airborne precautions, private room with negative airflow and keep door closed N-95 respirator, use dust dust/mist mask, no gown, no gloves, and minimize transport of patient and mask patient when transport is necessary
Activity demands includes?
All aspects of the actual activity including the objects used underlying required actions, body functions, and body structures are taken into considering when determining whether or not a client can engage in a certain activity
In a bathtub transfer if a standing pivot transfer is employed the wheelchair should be placed?
At a 45 degree angle to the bathtub if possible the patient should stand, pivot, sit on the bathtub chair, and then place the lower extremities into the bathtub
Radial pulse measurement site is?
At the wrist on the volar forearm medial to the stylus process of radius
Pain descriptors are?
Sharp, dull, burning, radiating, spreads, constant, and intermittent
Passive range of motion
Joint movement created by the OTA moving the extremity the client relaxes muscles to not participate in joint motion
The nerve innervation of the multifidi and rotatores of the transversospinalis is?
Dorsal primary divisions of spinal nerves
The nerve innervation of the semispinalis of the transversospinalis is?
Dorsal primary divisions of spinal nerves
Active range of motion
Joint movements as the client alone moves a joint through the available range of motion
Joint mobility
Joint range of motion
The healthcare facility has the responsibility or provide its employees with information and instruction in techniques to protect themselves form infectious disease especially blood borne disease each health care facility must take what steps to do this?
Educate employees on the methods of the transmission and the prevention of HBV and HIV, provide safe and adequate PPE and teach employees where the equipment is located and how to use it, teach employees about work practices used to prevent occupational transmission of disease including but not limited to standard precautions, proper handling of patient specimens and linens, proper cleaning of body fluid spills, and proper waste disposal, provide proper containers for disposal of waste and sharp items and teach employees the color coding system used to distinguish infectious waste, offer the HBV vaccine to employees who are at substantial risk of occupational exposure to HBV, and provide education and follow up care to employees who are exposed to a communicable disease
An example of a hinge joint is the?
Elbow or humerounlar joint
Neutral pelvic tilt
Equal weight distribution across the femurs in a sitting position it is the natural and functional position for activity participation when sitting it allows weight shifiting across ab stable base of support offered by the ITs or ischial tuberosities and the large muscle groups attached to the pelivs
Control of voluntary movement
Eye-hand and foot coordination, bilateral integration, crossing the midline, fine and gross motor control, and oculomotor so like saccades, pursuits, accommodation, and binocularity
Thoracic vertebrae transverse process are?
Facets that connect with ribs they are long, thick, and point posterior and laterally
Lumbosacral plexus name of the nerves?
Femoral and sciatic
Hip abductors so gluteus medius and minimus origin is?
Gluteal surface of ilium
Hip extensors insertion is?
Gluteal tuberosity and iliotibial band
Hip extensors so gluteus maximus interstation is?
Gluteal tuberosity and iliotibial band
What are the planes of a pivot joint?
Horizontal
International Classification of Functioning and Disability
ICF
Active assist range of motion
Identifies that the therapist manually assisted the client to move the joint however the client also activated some joint motion
The common term for movies cinema is derived from?
Kinematics
Sharp shooting pain related structure is?
Nerve root
A two person bent pivot transfer is often used with?
Neurologically involved patients because trunk flexion and equal weight bearing are often desirable with this diagnosis
Is HIV positive an impairment?
No
Performance skills are related to but distinct from?
Performance patterns
Function
Performing or being able to perform a regular function it also includes the normal and specific contribution of a body part to the economy of a living organism
Before you attempt to life, pull, reach for , or carry an object what actions are required to use proper body mechanics?
Position yourself so that your center of gravity or COG and the object's COG are as close as possible and increase your base of support or BOS
Lumbar vertebrae superior articular process faces?
Posterior
Precautions for any breathing technique is?
SOB, dizziness, or fatigue if it is experienced terminate activity for 1 to 3 min and attempt again if problem re occurs reduce the intensity of the activity or terminate activity
The origin of the multifidi and rotatores of the transversospinalis is?
Sacrum and transverse processes of lumbar through cervical vertebrae
Spinal extensors so iliocostalis, longissimus, and spinalis muscles origin is?
Sacrum and vertebrae
The joint between the trapezium which is one of the small carpals in the wrist and the first metacarpal is an example of a?
Saddle joint
What are the planes of the hinge joint?
Sagittal
What are the axis and axes of a condyloid joint?
Sagittal and frontal
Haptics
Science concerned with the tactile sense
Complete natural breathing is also called?
Yoga or complete breath
Normal typical movement or motor behavior may be able to?
Access and select from numerous movement possibilities to produce multiplanar complex combinations of movement the movement may occur efficiently and effectively with no undue stress or injury production
Time of day is a factor that affects body temperature because?
It is usually lower in the early morning and higher in the afternoon
Measuring body temperature with an ear thermometer procedure is?
1. Position the patient to expose one ear an infant or a toddler may be held on your lap so the head can be stabilized other persons may lie or sit 2. apply a clean lens filter and if the thermometer has an oral or rectal setting select rectal for an infant or toddler and oral for an older child or adult 3. gently but firmly pull and hold the ear to straighten the ear canal pull straight back on an infant's ear and slightly downward pull up and back on the ear of a person who is older than 1 year 4. insert the thermometer lens cone depress and hold the activation button for 1 second after the beep the temperature reading will appear in the liquid crystal display window mentally record the value 5. discarded or thoroughly wash the lens filter if it is to be used again in the home it may be appropriate to wash and reuse a lens filter but in other environments the used lens filter should be discarded then wash your hands 6. record the results using the value form the liquid crystal display reading indicate whether the rectal or oral setting was used and indicate which ear was used
Blood pressure normal range in elderly so over 65 is?
120-140/89-90
Stage 1 hypertension range is?
140-159/90-99
Exteroceptors
External receivers which are afferent nerve endings that respond to stimulation by external agents they are specialized in receiving information from the external environment such as the eyes
Stage 2 hypertension range is?
160-179/100-109
The facial bones are?
2 inferior nasal concha, 2 lacrimal, mandible, 2 maxilla, 2 nasal, 2 palatine, vomer, and 2 zygomatic so there are 14 bones total
Sensory receptors are defined as?
Exteroceptors or interceptors
The range of motion of the thoracic vertebral column for rotation is?
35 degrees
The range of motion of the cervical vertebral column for lateral flexion is?
35 to 45 degrees
ROM measurements are usually indicated in?
5 degree increments for example if elbow flexion measures 0 degrees to 128 degrees the measurement would be recorded as 0 degrees to 130 degrees similarly if elbow flexion is 0 degrees to 122 degrees the recorded measurement should be 0 degrees to 120 degrees
Isometric grading numerical grade for manual muscle testing are?
5, 4, 4-, 3+
Resting normal pulse range for an adult is?
60-100 bpm
The range of motion of the cervical vertebral column for extension is?
75 degrees
Average large adult thigh sphygmomanometer bladder measurements are?
8-9 inches or 20-23 centimeters
Resting heart rate for infants so 3 to 6 months is?
90- 120 beats/min
Blood pressure normal range for infants from 3 months to 1 yr is?
90-100/60-67
Wound
A bodily injury caused by physical means with disruption of the normal continuity of structures
Friction
A contact force that is a force acting in the opposite direction to the desired movement and occurring at the area of contact between the two surfaces so it is a force that opposes the efforts of one object to slide or roll over another object it can be considered a special type of shear force
Shear force
A force that acts in the same direction as the desired or attempted movement it might be described as a sliding or rubbing in the same direction as the movement it is important to consider this in therapy as it can cause skin damage or breakdown
Spore
A hard thick walled capsule formed by some bacteria that contains only the essential pats of the protoplasm, of the bacterial cell
Pressure ulcer
A localized injury to the skin and or underlying tissue usually over a bony prominece as a result of pressure or pressure in comination with shear force and or friction a number of contributing or confounding factors are also associated with it the significance of these factors is yet to be elucidated
What are some movement examples of a gliding joint?
Accessory motions
Edema
Accumulation of excessive amounts of watery fluid in cells, tissue, or serous cavities
AIDS
Acquired immunodeficiciency syndrome which is caused by human immunodeficiency virus or HIV
Motor learning is the?
Acquisition and or modification of learned movement patterns over time it takes into consideration the client, task, and environment
Temporal pulse measurement site is?
Anterior and adjacent to the ear
Bony prominences that may cause pressure injuries in the upper extremity in prone position are?
Anterior head of hurmerus and clavicle
The basic steps for using a hand rub are?
Apply a small amount of the product to the palm of one hand the manufacturer usually sets a premeasured amount for deliver, run the product briskly over the hands covering all surfaces of both hands as described for hand washing, and then continue to rub until the hands are dry do not rinse the hands with water or use a towel to dry the hands it may take 20 to 30 seconds for the hands to dry depending on the product
Before rolling the hemiplegic patient in preparation for transfer do what?
Assist the patient in clasping the strong hand around the wrist of the weak arm and lift upper extremities toward the ceiling, flex the patient's knees, and the practitioner may assist the patient to roll onto his or her side by moving the arms, then the legs, and by holding one hand at the scapula area and the other at the hip guiding the roll
An example of normal atypical movement may include a client with flaccid hemiparesis in the dominant upper extremity following a stroke the individual may?
Be able to use his or her non-dominant arm to enable self-feeding or use the flaccid dominant upper extremity as a secondary assist to complete a functional task
Hand hygiene should be performed when?
Before and after patient contact, before and after contact with wounds, dressings, specimens, bed lien, and PEE, after contact with secretions or excretions and when hands are soiled or considered contaminated, before and after toileting, after sneezing, coughing, or nose blowing, after removing gloves, before and after eating
Static balance
Balance where no movement is occurring it can describe a position in sitting or standing it is the ability to maintain a steady position of the head and body in relation to gravity
Dynamic balance
Balance with movement occurring it can describe movement in sitting it is the ability to maintain a controlled position of the head and body during movement in relation to gravity
What are the 6 types of synovial joints?
Ball and socket, ellipsoid, hinge, saddle, gliding, and pivot
When moving a patient positon your feet to widen your?
Base of support or BOS by placing one foot in front of the other so the anterposerior stance
For both medical asepsis and surgical asepsis handwashing has some of the same basic principles which are?
Before handwashing remove jewelry form the hands and wrists especially items with irregular or rough surfaces because they may harbor pathogens and cannot be cleansed effectively artificial fingernails and chipped nail polish should be avoided because they also may harbor pathogens, then to reduce the collection of pathogens under the fingernails nails should be trimmed to less than one quarter inch so they are not visible when the hand is held in front of the face with the palm directed toward the face and the fingertips at eye level, also irritations, lesions, or breaks in the skin of the hands place the caregiver at a greater risk for self contamination or infection it is important to wear gloves if irritations, lesions, or breaks in the skin are present, also warm water should be used for comfort and to promote later that will cleanse the hands more effectively and when rinsed carry pathogens away, last of all after the skin is wet apply soap and rub briskly covering all surfaces of each limb with later friction is an important component of handwashing to loosen dirt, dead skin cells, and pathogens from the skin
Built or man-made physical environment includes?
Buildings, roads, bridges, communication towers, flood walls, and numerous other structures
A hinge joint allows only?
Flexion and extension similar to the movements of a door hinge
Bony prominences that may cause pressure injuries in the lower extremity in side lying position uppermost extremity are?
Medial condyle of femur and malleolus of tibia
It can be difficult to isolate the individual bellies of the transversospinalis muscles as they are?
Closely interwoven however as a group their mass or density can be easily felt along the lamina groove of the thoracic and lumbar vertebrae
EVD precautions are?
Contact precautions with private room or cohort patient with same infection and dedicated equipment in room, mask plus face shield, gown, 2 pairs of gloves, minimize transport as feasible
Zika virus precautions are?
Contact precautions with private room or cohort patient with same infection and dedicated equipment in room, mask, gown, 2 pairs of gloves and standard precautions plus gloves during labor and delivery, and minimize transport as feasible
Dyskinesia
Difficulty in performing voluntary movements
Bony prominences that may cause pressure injuries in the upper extremity in sitting position are?
Medial epicondyle of humerus and olecranon process if resting on a hard surface
The shorter smaller rotatores of the transversospinalis lie?
Deep to the mulgifidi
Lumbar vertebrae vertebral notches are?
Deeper inferior notches
Thoracic vertebrae vertebral notches are?
Deeper inferior notches
The 8 short suboccipitals are the?
Deepest muscles they are located at the base of the head
Bony prominences that may cause pressure injuries in the upper extremity in side lying position uppermost extremity are?
Medial epicondyle of humerus if resting on a hard surface
Radial nerve area of body innervated?
Dorsal aspect of arm, forearm, and hand
The midline or midsagittal plane runs?
Down the center of the body dividing the sagittal plane in two symmetrical halves
Barchial pulse measurement site is?
Medial to the biceps in the antecubital fossa or on the medial aspect of the midshaft of the humerus
A muscle categorized by action could be?
Extensor digitorum and supinator
Lateral can also be called?
External
Somatic division is primarily responsible for responding to the?
External environment or things happening outside the body
Face shields protect?
Face, nose, mouth, and eyes
Iliacus nerve that acts on the trunk is?
Femoral nerve and braches of lumbar plexus
Hip flexors so rectus femoris nerve that acts on the trunk is?
Femoral nerve, L2 to L4
In a fetal position all the joints are in a?
Flexed position
Ellipsoid joint permits?
Flexion and extension and abduction and adduction as seen at the wrist or radiocarpal joint
Hand rubbing especially with alcohol based rubs from a wall mounted dispenser has several advantages over hand washing which are?
It requires less time to use, it is more effective than soap and water, it is more accessible than sinks, it significantly reduces bacterial counts on hands, and it causes less damage to the skin than soap and water
Because of their design fibrous and cartilaginous joints have?
Little or no movement capability
Open-pack position is also called?
Lose packed
Bronchial brath sounds are?
Loud, tubular, and less harsh sounds that are best heard over the manubrium of the sternum these sounds are abnormal if heard in the peripheral lung fields and represent consolidation in a lobe
Oblique abdominals origin is?
Lower eight ribs
What are the principles of stability?
Lowering the center of gravity will increase stability, center of gravity and line of gravity must remain in the base of support for stability, increasing the mass will increase the stability, increasing the base of support will increase the stability, increasing friction between the object and surface will increase stability, and focusing on a spot will increase stability
Isotonic contraction
Maintain the muscle at equal tension the length of the muscle changes causing joint movement so it may be thought of as dynamic because the tension produced by the contraction causes movement
Airborne transmission
Microorganisms that are transferred by small infectious particles that can infective over time and distance in the respirable size range it can occur with measles, varicella or chickenpox, and mycobacterium tuberculosis a fit tested N-95 respirator or higher should be worn
Contact transmission
Microorganisms that are transferred directly form one infected person to another or indirectly when the transfer of an infectious agent is through an object medical equipment, furniture surface or person some diseases that can be transmitted this way are herpes simplex virus, S. aureus, vancomycin resistant enterococcus, and C. difficle
Saddle joint is a?
Modified ellipsoid joint composed of convex and concave articulating surfaces like two saddles
The joint cavity in synovial joints allows for?
Movement at the synovial joint
Abduction
Movement away from an axis or from the median place of the body so movement of a body part away form the middle of the body
Although synovial joints all have the same basic structural components they have different?
Movement capabilities
Ball and socket joint is capable of?
Movement in every plane
Manual muscle testing for gravity eliminated test grading of 1+ or trace+ is where the client?
Moves the joint through less than half of the available range of motion with gravity eliminated
Physical environment
Natural and built nonhuman environment and all objects in them
A spinal cord injury that occurred several months or years earlier special precautions are?
Osteoporosis especially in long bones of the lower extremities and the vertebral bodies may be present even mild to moderate stress or strain to these bones may lead to a fracture some patients could experience a fracture when turning over or transferring form a wheelchair to the floor or to other objects also be aware that the patient may experience syncope when transferring from supine to a sitting positon because the blood pressure may not adapt quickly to the positional change
Reservoir of infection for surgical asepsis is?
Other people and the environment
External or lateral rotation
Outward turning or pivoting around an axis
Motor control are events that occur?
Over short time intervals
Lumbar
Pertaining to the lower region of the back superior to the pelvis
Rectal
Pertaining to the rectum or the distal portion of the large intestine
Nosocomial
Pertains to only infections originating in a hospital
Wheelchair to bed with transfer board transfer procedure is?
Position the chair at an angle next to the bed facing the foot of the bed and midway between the head and foot of the bed lock the chair and remove the armrest nearest the bed swing away the front rigging with caster wheels forward, help the patient move forward in the chair place one end of the board under the things and buttocks the other end should rest on the bed surface position yourself slightly in front of and to one side of the patient to guard and protect him or her, help the patient move across the board onto the bed the legs may dangle over the edge before they ae lifted onto the bed guard and protect the patient as the lower extremities are placed onto the surface, help the patient shift his or her weight away form the board and remove the board help the patient move toward the center of the bed and lie down, then positon the patient's body for safety and comfort and remove the gait belt
What are the steps for gross manual muscle testing?
Position the client and extremity, stabilize the joint, palpate appropriate joint muscle groups, observe muscle contractions, resist muscles, and then grade strength
Bony prominences that may cause pressure injuries in the lower extremity in supine position are?
Posterior calcaneus, greater trochanter, head of fibula, and lateral malleolus with excessive external rotation of hip
Spinous process
Posterior projection found on the neural arch of the vertebra it also is an attachment point for muscles and ligaments the seventh cervical vertebra know as the vertbrae prominens has an unusaually long one can easily palpate this aspect it is where the cervical and thoracic area conjoin
The basic unit of measurement in the united states for the magnitude of force is the?
Pound
Medical asepsis
Practices that help reduce the number and spread of micorrgnaims
Surgical asepsis
Practices that render and keep objects and areas free of all microorganisms
Fundamentals of infection precautions are?
Proper hand hygiene techniques and wearing of glove, use of masks, respiratory protection, eye protection, and face shields especially when fluid splashes or sprays are anticipated, use of personal protective equipment, handling and disposal of linen and protection of laundry personnel, cleaning or disposal of eating utensils and dishes, patient placements like in a private room or with a person who has the same disease, protective transportation of an infected patient, use and care of patient care equipment and articles like disposal of sharps, and routine and terminal cleaning of the patient's environment like the use of disinfectants and consistent housekeeping activities in the patient's room and treatment areas
Masks are used to?
Protect nose and mouth
Transmission based precautions are designed to?
Protect the caregiver from special patients with highly transmissible pathogens who are known or suspected to be infected by epidemiologically important pathogens that can be spread by direct contact with dry skin or contaminated surfaces, droplets of moisture, or airborne particles
Involuntary movement reactions
Righting and supporting
Lever
Rigid bar that rotates about an axis or fulcrum downward motion at one end causes upward motion at the opposite end
Lateral or external rotation
Rotary movement around vertical axis of bone away from midline of body
Anterior
Situated at or directed toward the front of a body or object it is the opposite of posterior
Magnitude
Size or amount
Praxis skills
Skilled purposeful movements so the ability to carry out sequential motor acts as part of an overall plan rather than individual acts the ability to also carry out learned motor activity including following through on a verbal command, visual-spatial construction, ocular and oral motor skills, imitation of a person or an object, and sequencing actions, and organization of temporal sequences of actions within the spatial context which form meaningful occupations
Korotkoff sounds in phase III or 3 are?
Sounds become crisp and louder than those previously heard
Korotkoff sounds in phase V or 5 are?
Sounds essentially disappear totally this phase is also refereed to as second diastolic pressure phase
Korotkoff sounds
Sounds heard during auscultatory determination of body pressure it is believed to be produced by the vibratory motion of the arterial wall as the artery suddenly distends when compressed by a pneumatic blood pressure cuff the origin of the sound may be within the blood passing through the vessel or within the wall itself
An UMN lesion such as seen in a cerebrovascular accident or CVA usually causes?
Spastic paralysis, increased muscle tone or hypertonia, exaggerated stretch reflexes, and little to no atrophy except with prolonged disuse
When measuring ROM the practitioner should observe and proceed with caution when?
Spasticity, pain, or abnormal pathology is present
Respiratory hygiene or cough etiquette
The US Centers for Disease Control and Prevention standard that applies to all persons entering a health care setting including visitors, patients, and health care personnel
Performance skills
The abilities clients demonstrate in the actions they perform body structures and body function have impact on it as does context, specific activity demands, and multiple other factors
Cardica output
The amount of blood that is pumped form the ehart during each contraction
Base of support or BOS
The area on which an object rests and that provides support for the object
Abnormal atypical movement
The inability to produce the desired movement strategies and characteristics necessary to complete an activity or occupation within generally accepted parameters
Reversal of muscle function
When the insertion is stable and the origin moves toward the insertion like when stabilizing the hands during a push up or elevating and propelling the trunk forward during crutch walking
Deep to the erector spinae muscle group is the?
Transversospinalis muscle group
TBI
Traumatic brain injury
Soft end feel
The feel experienced when two muscle groups are compressed
Oral cavity temperature is a factor that affects body temperature because?
The measurement may be inaccurate if measured orally within 14 to 30 min of ingestion of warm or cold substances or smoking the body core temperature probably is not affected by these factors but a false reading is obtained as a result of the temporary changes in the temperature of the oral cavity
An example of lateral flexion is?
When the head or vertebral column bend laterally to the side
Sitting or lateral assisted transfer
The patient is able to move from one surface to another while maintaining a sitting or squat position with the assistance of a least one person this transfer may require the use of a sliding board, an overhead bar or frame, overhead strap, or other equipment
Maximal assistance
The patient perfromrs 25%-49% of the activity assistance is required to complete the activity
What is the procedure for protective transfer from standing to the floor for a person with low back dysfunction?
The patient places one hand a firm object and moves to a single knee or half kneeling position keeping the trunk erect, the patient briefly kneels on both knees or high kneeling and moves to all fours so hands and knees, the patient moves the hands forward until he or she is prone or gently side sits if this is not painful and then lowers onto one elbow to a side lying position, the patient adjusts his or her body position as desired
The actions of flexion and extension occur along?
The sagittal plane
Spirituality
The search for meaning in all that one does which includes values and beliefs it is a overarching principle
Maceration
The softening of a solid by soaking
Recumbent dependent lift transfer
This transfer is used with patients who are physically unable to assist with the transfer and cannot be placed into a sitting position one, two, three, or more persons or special equipment may be required to transfer the patient equipment can include a mechanical lift, draw sheet, bed linen, or plastic transfer board
The transversospinalis is composed of?
Three branches multifidi,rotatores, and semispinalis and extends the length of the vertebral column
Lateral or external
Toward the sides of the body, away from the midline, or on or to the side
Superficial
Toward the surface of the body it is used to describe relative depth of muscles or other tissue
In a bathtub transfer if the transfer requires the assist of a caregiver a?
Transfer sling is an additional option during a bare bottom transfer
The origin of the semispinalis of the transversospinalis is?
Transverse processes of thoracic vertebrae and articular processes of lower cervicals
A gliding joint is usually between?
Two flat surfaces and allows the least amount of movement of all synovial joints
Force couple
Two or more forces with equal magnitude but opposite or significantly different direction vectors or directions the forces must be applied to the same object at the same time and always produce rotation the forces act on opposite sides of the axis of the object it allows for greater strength in movement
A bent pivot transfer can also be employed during a?
Two person dependent transfer
In a bathtub transfer if a transfer sling is used the cloth sling is placed?
Under the patient's trochanters and the sling handles are used in the same manner as grabbing the sides of the patient's pants the sling can either be removed or remain in place during bathing
Self determined extrinsic motivation
When a person will attempt an activity for external reasons but these external reasons hold value for the person they have been chosen by the individual because they are important to that person
Firm end feel examples are?
Wrist flexion or extension
Carpus or carpi
Wrist or pertaining to the wrist
Plinth
A padded table for a patient to sit or lie on while performing exercises receiving a massage or undergoing other physical therapy treatment
Irritability
A muscles capacity to receive and respond to a stimulus whether the stimulus is chemical, electrical, or mechanical
Bradycardia
A slow heartbeat like a pulse rate of less then 60 beats/min it may be a normal finding in a well conditioned person or and abnormal finding
Draw sheet
A small sheet or linen pad placed underneath the patient that extends form the upper trunk to midthigh
Facet or facet joint of the vertebra
A small, flat, smooth surface on a bone it is the articulation between the superior articular process of the vertebrae below and the corresponding inferior articular process of the vertebrae above it also can refer to the articulation of the throacic vertebrae and the rib bone
What three factors are involved with the use of transmission based precautions?
A source or reservoir of the infectious agent, a susceptible host with a portal of entry receptive to the agent, and a mode of transmission for the agent
Ball and socket joint
A spherical surface of one bone fits into the dish shaped depression of another bone
Spasticity
A state of increased muscular tone
Measurement of apical pulse usually requires a?
A stethoscope but manual palpation is possible wash your and explain the procedure to the patient the patient must be positioned so that the left anterior side of the chest is accessible
Gait belt
An adjustable belt or strap that is secured around a patient's waist or hips and is used to protect and control the patient during gait activities or transfers
AFO
Ankle foot orthoses
How to perform a bent pivot transfer from bed to wheelchair is?
Assist the patient to scoot to the edge of the bed until both of the patient's feet are flat on the floor grasp the patient around the waist or hips or even under the buttocks if a moderate or maximal amount of assistance is required, assist the patient to align the trunk into a midline position, assist the patient to align the trunk into a midline position, shift the weight forward from the buttocks toward and over the patient's feet, have the patient either reach toward the surface he or she is transferring to or push from the surface form which he or she is transferring, then assist the patient by guiding and pivoting the patient around toward the transfer surface
Adaptive motor behaviors
Certain ways the body acts in a situation, appropriate and efficient movement strategies used by the body, and the body's ability to apply normal movement strategies to achieve functional goals it reflects the body's ability to select and choose form a variety of movement options
What are some considerations when making a wheelchair to car transfer?
Car seats are often much lower than the standard wheelchair seat height which makes the uneven transfer much more difficult especially form the car seat to the wheelchair, occasionally patients have orthopedic injuries that necessitate the use of a brace such as a halo body jacket or lower extremity cast or splint the clinician often must alter technique to accommodate theses devices, the clinician may suggest use of an extra long sliding board for this transfer to compensate for the large gap between transfer surfaces, and because uphill transfers are difficult and the level of assistance may increase for this transfer the clinician may choose a two person assist instead of a one person assist transfer to ensure a safe and smooth technique
Remove and discard PPE?
Carefully either at the doorway or immediately outside patient room remove respirator outside room
Osteoporosis examples for not using range of motion and manual muscle testing are?
Compromised bone function and structure
Arthritis example for not using range of motion and manual muscle testing is?
Compromised joint function and structure
Orthopnea
Difficulty breathing when recumbent
Pathogens can be transmitted through what means?
Direct contact or indirect contact, air currents, contaminated linen or clothing, inadequately cleaned eating utensils, instruments, toys, or equipment, and moisture droplets
The surprisingly thick multifidi of the transversospinalis are?
Directly accessible in the lumbar spine they are the only muscles with fibers that lie across the posterior surface of the sacrum
Frontal or coronal plane
Divides the front and back halves of the entrie body
Sagittal or median plane
Divides the left and right sides of the entire body
Inclined plane
It is used for elevating objects it is a flat surface or plane that is at an angle to the horizontal surface it is placed upon
Various sensory systems provide us with the ability to use pain, sight, hearing, taste, smell, touch, temperature, and vestibular, and proprioceptive feedback to?
Modify movement
Bony prominences that may cause pressure injuries in the upper extremity in supine position are?
Medial epicondyle of humerus and olecranon process
Ulnar nerve area of body innervated?
Medial forearm and 4th and 5th digits
Brachial plexus area of body innervated?
Medial forearm, 4th and 5th digits, dorsal aspect of arm, forearm, and hand
Functional range of motion typically describes the?
Minimum ROM needed to execute performance in essential areas of occupation without the use of special equipment
Caregiver instruction and PPE for surgical asepsis are?
Must perform surgical scrub and all PPE must be sterile to protect the patient including the sterile gown, mask or face shield, gloves, special shoe covering, and hair covering
The opposite of supination is?
Pronation
Hemiplegia special precautions are?
Pulling on the involved or weakened extremities should be avoided to control or move the patient this is particularly important for the effected shoulder because the muscles will not provide adequate support to the joint secondary to the effects of paralysis many patients experience pain or discomfort when they lie on or roll over the involved shoulder
Children from 4 years to 12 years normal values for blood pressures are?
Systolic of plus 2 per year to 100 mm Hg and diastolic of 60-70 mm Hg
Wheel and axle
Used to move things over a greater distance it is a circular object that rotates around a shaft
Droplet precautions
Used to prevent transmission of pathogens spared through mucous membranes or close respiratory contact with reparatory secretions you should was hands thoroughly on entering and leaving the room, a mas is required when working in close contact with the patient, they must have a private room, and if the patient must be transported place a surgical mask on patient if possible and fallow respiratory hygiene/ cough etiquette
Medications effects pulse because?
Various medications may cause the pulse rate to increase or decrease depending on their effect on the cardiovascular system
What questions should you consider before performing a transfer?
What medical precautions affect the patient's mobility or method of transfer?, Can the transfer be performed safely by one person or is assistance required?, Has enough time been allotted for safe execution of a transfer like are you in a hurry?, Does the patient understand what is going to happen if not does he or she demonstrate fear or confusion and is the practitioner prepared for this limitation?, Is the equipment that the patient is being transferred to and from in good working order and in a locked position?, What is the height of the bed or surface in relation to the wheelchair and can the heights be adjusted?, Is all equipment placed in the correct position?, Is all unnecessary bedding and equipment moved out of the way to work without obstructions?, Is the patient dressed properly in case you need to use a waistband to assist if not do you need a transfer belt or other assistance?, What are the other components of the transfer such as leg management and bed mobility?, and know what type of transfer to use for each situation.
Infection
Where a microorganism is able to enter another person it must have a portal of entry examples of such portals are a break in the person's skin barrier, the mucous membranes, the mouth, the nose, the ears, and genitourinary tract
Muscle origin
Where a muscle begins or originates the point is usually proximal or closer to the trunk or middle of the body and is often considered to be more stable
Is HIV positive an participation restriction?
Yes they are dined insurance or services, denied access to certain community activities due to fear and stereotypes
Measuring blood pressure by palpation procedure is?
1. Wash your hands and obtain a stethoscope and sphygmomanometer explain the procedure and rationale for measurement to the patient observe the patient for signs or symptoms of stress or recent exercise if the patient has exercised, ambulated, or experienced emotional stress he or she should rest for 15 to 30 minutes before the blood pressure is measured position the patient sitting with the forearm supported on a firm object approximately at the level of the heart if the patient is standing elevate the arm and support it between your arm and lateral area of the chest while you face the patient 2. expose the antecubital space of the left or right arm do not roll the shirt or blouse sleeve too tightly because it may partially occlude the artery palpate the brachial pulse so you know where to place the diaphragm of the stethoscope 3. apply the deflated cuff to the arm with the center of the bladder over the medial aspect of the arm the cuff should be applied approximately 2.5 cm above the antecubital space with the manometer attached to the cuff or placed so that the needle and scale can be observed easily without being held in your hand 4. palpate the brachial artery pulse in the antecubital space with two or three fingers and maintain your fingers over the pulse 5. inflate the cuff as normal 6. deflate the cuff as normal and observe the manometer mentally note the needle position when the first pulse in the artery is palpated this reading is the systolic pressure value 7. continue to deflate the cuff while observing the manometer mentally note the needle position when the last distinct pulse is pated this reading is the diastolic pressure 8. completely deflate the cuff and remove it from the patient 9. record the values as normal and indicate that the palpation method was used
Measuring the pulse procedure is?
1. Wash your hands obtain a timepiece that measures seconds and explain the procedure to the patient observe the patient for signs or symptoms of stress, anxiety, or cardiovascular distress the patient may be recumbent, sitting, or standing 2. select an arterial site and firmly but gently place two or three fingertips over the artery avoid using your thumb because you may perceive your own pulse rather then the patient's pulse and because the thumb's pad is less sensitive than the pads of the other finger avoid applying excessive pressure which may occlude the artery an exception to light pressure is when you attempt to palpate the popliteal artery very firm deep pressure may be required to locate that artery and palpate its pulse when determining a patient's resting heart rate for the first time allow the person to rest supine or seated for approximately 5 min before performing the measurement measure the pulse rate for 1 full min to reduce the potential for error and improve the accuracy of the measurement 3. mentally count each beat if you measure the rate for 10 seconds and multiply that value by 6 the margin of error is 6 beats/min if you measure the rate for 15 seconds and multiply that value by 4 the margin of error is 4 beats/min if you measure the rate for 30 seconds and multiply that value by 2 the margin of error is 2 beats/min 4. record the results in beats/min , indicate any variations in rhythm or volume, and identify the location you used to palpate and measure the pulse for example 68 beats/min, regular, right brachial pulse or 86 beats/min, irregular with every fourth beat absent in 1 minute, left redial pulse, patient sitting
Pulse
A palpable wave of blood produced in the walls of the arteries with each heartbear or contraction
Triangle of auscultation
A relative thinning of the musculature of the back situated along the border of the scapula the space is bounded by the lower border of the trapezius, the latissimus dorsi, and the medial margin of the scapula
A muscle categorized by number of divisions could be?
Biceps brachii
Frontal plane can also be called?
Coronal
What are movement examples of a saddle joint?
Flexion and extension, abduction and adduction, and opposition
Motor development are events that occur?
Covering months, years, or decades
Mumps or rubella precautions are?
Droplet precautions with private room and does not require negative airflow, mask when working within 3 feet of patient, no gown, no gloves, and minimize transport of patient
Environment
External physical and social environments that surround the client and in which the client's daily life occupations occur
Soiled patient care equipment standard precautions are?
Handle in a manner that prevents transfer of microorganisms to others and to the environment
When transferring to a toilet the clinician and patient should attempt to position the wheelchair?
Next to or at an appropriate angle to the toilet
In a bathtub transfer if a bent pivot or sliding board transfer is used the wheelchair is placed?
Next to the bathtub with the armrest removed the transfer tub bench may be used which removes the need for a sliding board this approach allows the wheelchair to be placed right next to the bench thus allowing a safe and easy transfer of the buttocks to the seat
Guidelines for positioning and draping procedure is?
Introduce yourself to the patient by providing your name and title like physical therapist, physical therapist assistant, physical therapy student, aide, or technician confirm the patient's identity and current relevant information like diagnosis, complaints, previous treatment and response, and name of the patient's physician, inform the patient of the planned treatment apply the principles of informed consent and obtain consent for treatment, specifically describe how the patient is to be positioned and provide assistance if required, if the patient is wearing street clothes indicate the specific articles of clothing to be removed or request permission to remove them if assistance is necessary, provide temporary clothing or linen to protect modesty and provide warmth, ensure that sufficient linens, pillows, and equipment needed for the treatment are available in the cubicle or treatment area, provide safe and secure storage for the patient's personal items, specifically describe how you want the patient to apply linen items a gown, a robe, or exercise clothing to cover or drape the body provide privacy while the patient is disrobing and dressing, instruct the patient to inform you when he or she is positioned and draped or confirm that the patient is clothed or draped before you enter the cubicle, at the end of treatment instruct the patient to remove draping items and temporary clothing and put on his or her own clothing provide assistance if required or provide privacy while the patient is dressing, provide linen so the patient can remove perspiration, massage lotion, electrotherapy gels, water, or other substances, return personal items to the patient, dispose of used linen in the proper container, and prepare the cubicle or treatment area for future use or assign the task to another person
In performing the transfer do what?
Lock all the wheels on the wheelchair, bed, or gurney, be alert to paraphernalia such as intravenous lines, cardiac leads, and catheters if you are in a hospital setting, and ensure that this equipment is of adequate length so it is not pulled out in the process of the transfer, a gait belt or a transfer sling, sheet, or towel under the buttocks should be used if the patient will move form one surface to another especially during the early treatment sessions, use a gait belt or sling and the patient's knees, pelvis, or upper thorax for stabilization or control do not use the patient's upper extremity or clothing for guidance or stability because this technique will not enable you to control the patient adequately and you may injure the extremity, remain close to the patient and guard him or her properly, the caregiver and any assistants should use proper body mechanics so lift with your legs and avoid twisting, avoid trunk flexion and rotation, position your center of gravity or COG as close to the patient's COG as possible, increase your base of support or BOS lower your COG and maintain your vertical gravity line within your BOD, and continue to instruct the patient and persons assisting with the transfer by using short statements it may be possible to incorporate some patient teaching while the activity is performed
Instrumental activities of daily living or IADL
More complex tasks than ADL they support daily life and may occur in the community as well as the home like caring for pets or other people, finical management, meal preparation, shopping, and home management
Dorsiflexion is like?
Moving the ankle to let of the gas pedal
Neutralizers
Muscles that prevent unwanted accessory action or substitutions or cancel out multiple actions by the same muscle when a muscle with multiple actions contracts it attempts to perform all of its actions unable to determine which one is necessary for the movement for example the biceps brachii both flexes the elbow joint and supinates the forearm if elbow flexion is the desired goal then theses muscles will cancel out the supination action of the biceps muscle
Antagonists
Muscles with actions opposite those of the agonist so muscles that are acting against a position or movement they are often located on the opposite side of the joint as the agonist during many movements they are passive or perform an eccentric contraction slowing the movement and are active during deceleration
Bed to wheelchair with transfer board procedure is?
Position the wheelchair at an angle next to the bed facing the foot of the bed with the caster wheels forward and opposite the patient's hips cloak the chair remove the armrest nearest the bed and swing away the front rigging, help the patient into a long sitting position apply a gait belt and help the patient move to the edge of the mattress the lower extremities may be positioned over the edge of the mattress or mat or remain parallel, position one end of the transfer board under the patient's upper thighs and buttocks the other end rests on the chair seat position yourself slightly in front and to the near side of the patient to guard and protect him or her throughout the transfer, help the patient move across the board into the chair seat guard and protect the trunk if the lower extremities need to be lowered from the bed help the patient shift his or her weight away form the board and remove the board, then place the feet on footrests position the body for safety and comfort and remove the gait belt
Decontamination
The use of physical or chemical means to remove, inactivate, or destroy blood borne pathogens on a surface or item to the point at which they are no longer capable of transmitting infectious particles and the surface or item to the point at which they are no longer cable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal
Stage 3 hypertension range is?
180-209/110-119
The range of motion of the cervical vertebral column for flexion is?
40 degrees
Resting heart rate for well conditioned athletes is?
40-60 beats/min
The range of motion of the cervical vertebral column for rotation is?
45 to 50 degrees
Bed to wheelchair manually operated mechanical lift transfer procedure is?
Explain the activity to the patient the first time it is performed, place the individual slings or body bling under the upper trunk and buttocks and upper thighs by rolling the patient into one side and then onto the other side, the sling attachments should be exposed with the outside seams of the sling directed away from the patient, position the lift perpendicularly to the patient and close the bed with the legs of the base spread wide and the spreader bar over the chest attach the chains or web straps to the spreader bar, partially open the control valve to slowly lower the spreader bar until the chains or web straps can be attached to the sling or slings close the valve so that the spreader bar does not continue to lower, attach the rings of the web strap or the S hook of the chain to the sling attach the shortest segment of the chain or web strap to the upper part of the sling and attach the longest segment to the lower part of the sling these positions will ensure that the patient will be lifted into a sitting position, when S hooks are used they should be directed away form the body to prevent injury to the skin, before you attempt to lift the patient check all the attachments adjust the slings and attachments as necessary, caution the patient not to reach for or grasp the spreader bar when he or she is being raised, fold the patient's arms over the abdomen and elevate the body using the pump handle, elevate the patient until the buttocks clear the surface of the bed reevaluate the position and the location of the slings and the security of the attachments before moving away form the bed, assist in the lift by moving the patient's lower extremities form the bed so that the patient sits properly in the slings the knees can be allowed to flex or can be kept extended as you carefully move the lift away form the side of the bed and then turn the patient to face the support column, transport the patient to the wheelchair using the cross handles on the center post, maneuver the patient so that his or her buttocks are over the front or the middle of the seat of the locked wheelchair, partially open the control valve to slowly lower the patient into the chair move the body toward the back of the seat close the valve when the person is seated, remove the sling attachments and move the lift away form the chair the slings remain under the patient to permit a transfer back to bed if the slings are removed they will be difficult to reposition under the patient, position the feet on the footrests and apply a lap or chest strap if necessary to protect or stabilize the patient
Contralateral
On the other or opposite side
Ipsilateral or homolateral
On the same side
Physical activity effects blood pressure because?
Systolic pressure should gradually increase with exercise, plateau as exercise intensity plateaus, and then gradually decline as exercise intensity declines it should return to normal resting value within 3 to 5 min after termination of exercise diastolic pressure should remain essentially unchanged throughout exercise period although an increase of approximately 10 to 15 mm Hg is usually not considered abnormal an increase of more than 15 mm Hg is considered abnormal
Diastole
The period when the least amount of pressure is exerted on the walls or the arteries during the heartbeat it usually indicates the resting phase of the heart
What are the synovial joint types?
Ball and socket, hinge, saddle, pivot, gliding, and condyloid
Proprioceptor
A sensory end organ in muscles, tendons, joint capsules, and inner ear allowing us to know the location of one body part in relation to another it is activated by movement or action of the organism itself
When using a manually operated lift what steps must be performed?
Ensure that the valve that controls the adjustable arm is closed as you position the lift, ensure that the floor is free of objects and sufficient space is available to maneuver the lift objects that could interfere with or block the caster wheels from moving smoothly such as throw rug, door threshold, or line cords should be avoided, the valve must be closed as soon as the patient is properly positioned in the chair so the adjustable bar does not continue to lower and strike the patient's head
Goal of action for surgical asepsis is?
Reduce the number of organisms and prevent spread of infection to the patient
Guidelines for lifting are?
Stoop or squat to lift any object below the level of your hips, widen your feet to increase your base of support and improve your balance and stability, move close to the object before you lift keep the object close to your body as you lift or carry it, maintain the lumbar curve in your lower back as you lift do not flatten your lower back, visualize the lift be certain you can safely lift the object without assistance have sufficient space to perform the lift, and test the weight of the object before you lift it, tighten your core stabilizers before you perform the lift, do not lift and twist your back simultaneously instead pivot when you need to turn, do not lift quickly or with a jerky motion, move the object by pushing, pulling, sliding, or rolling rather than by lifting when possible push rather than pull, avoid repetitive and sustained lifting use equipment or assistance to lift heavy objects, and use care when removing groceries, tools, and other items form the trunk of a car do not bend at the waist and lift bend your hips and knees slightly and move the object close to you before lifting it
During monitoring of the patient's BP the caregiver should be aware of abnormal BP responses to exercise or other treatment activities which could be?
Systolic pressure rapidly increases during active exercise, systolic pressure does not increase during active exercise, systolic pressure continues to increase or decreases as intensity of exercise or activity plateaus, systolic pressure rapidly declines as intensity of exercise or activity declines and terminates, systolic pressure does not decline as intensity of exercise or activity declines, systolic pressure declines significantly below its resting level at termination of exercise or activity, systolic pressure declines during exercise before intensity of exercise declines, systolic pressure rate or amount of systolic pressure increase is excessive during exercise or activity period, or diastolic pressure increases more than 10-15 mm Hg during exercise or activity period
What are some measures to increase standardization for manual muscle testing?
When possible have the same clinician perform repeated manual muscle testing measures or at least ensure the client performs the same procedures, practice applying manual muscle testing to develop service competency, control contextual considerations to limit impact on manual muscle testing like the temperature of the room, effects of gravity, and temperature of mat or OTA's hands, document any factors that may have influenced the manual muscle testing measurements like pain, dementia, edema, age, gender, weakness, or command following, observe and measure the unaffected extremity first to provide insight into the typical movement capability of the other arm, gain information prior to the manual muscle testing through reviewing medical records, observing the client move and perform a functional task, and assessing the intact bilateral extremity first, and minimize variations to manual muscle testing and identify when variations exceed standardization to the point that accurate manual muscle testing may not be possible
Principles for proper posture are?
Maintain normal anterior and posterior curves of the spine for proper balance and alignment, stand and sit with your body erect so that the shoulders and pelvis or hips are level avoid slouching or round back positions, stand with your ankles, knees, hips, and shoulders aligned keep your head over your body not in front of the shoulders, stand with your abdominal wall flat your head in neutral your shoulders level your chin parallel to the floor and slightly tucked and your body weight evenly placed on each leg keep your knees slightly flexed and maintain lumbar lordosis, sit with your head in a neutral position your chin tucked or parallel to the floor and your elbows knees, and hips flexed to 90 degrees with your feet flat on the floor or supported in a slightly inclined position your forearms and low back curve should be supported during prolonged sitting avoid slouching or a kyphotic posture, avoid standing or sitting in one position for a prolonged time occasionally alter your position move you head, neck, shoulders, back, hips, knees, and ankles periodically, and when supine or partially lying on your side flex your hips and knees use a pillow under or between the knees for support avoid lying prone use a small or medium sized pillow to support your head but do not position it under the shoulder use a bed mattress that is firm and provides support to the natural curves of the spine
Ipsilateral
On the same side of the body
A muscle categorized by action and shape could be?
Pronator quadratus
Motor learning are events that occur?
Over hours, days, and weeks
Sex effects pulse because?
Male pulse rates are usually slightly lower than female rates
Manual muscle testing for isometric grading 4 is?
Good or G
The patient who is going to assist the caregiver in a sliding board transfer should have?
Good upper extremity strength
Caregiver instruction and PPE for medical asepsis are?
Hand wash, gown, face mask,PPE must be clean , follow facility policy regarding isolation procedures, discard PPE after contact with the patient, and separate clean from contaminated materials
Psoas major muscle besides acting on the trunk does what?
Maintains disk space
Manual muscle testing for isometric grading 3+ or fair+ is where the client?
Maintains the testing position against gravity and minimal resistance
What are the axis and axes of the ball and socket joint?
Sagittal, frontal, and vertical
Cardiac output effects blood pressure because?
Systolic BP increase with increased cardiac output and decreases with decreased cardiac output
Haptic perception
A person's ability to control his or her hand movements as related to the orientation of his or her head over the trunk for example tilting the head may influence the ability to write or control fine motor movements it may also influce functional tasks such as swallowing, reading, and eye contact
MRSA, VISA,VRE, aminoglycoside-resistant gram- negatives precautions are?
Contact precautions with private room or cohort patient with same infection no mask, need a gown with direct contact with patient, environment surfaces, or times in patient's room, need gloves, and minimize transport as feasible
Shoulder flexion associated girdle motion is?
Abduction, lateral tilt, slight elevation, and slight upward rotation
AIDS
Acquired immunodeficiency virus
Motor skills
Actions or behaviors a client uses to move and physically interact with tasks, objects, contexts, and environments it includes planning, sequencing, and executing new and novel movements
What are some areas of occupation for a OT?
Activities of daily living or ADL, instrumental activities of daily living or IADL, rest and sleep, education, work, play, leisure, and social participation
Factors affecting pulse are?
Age, sex, environmental temperature, infection, physical activity, emotional status, medications, cardiopulmonary disease, and physical conditioning
Chickenpox, disseminated herpes zoster in immunocompromised hosts, and smallpox precautions are?
Airborne plus contact precaution, private room with negative airflow and keep door closed, a dust/mist mask N-95 respirator, gown, gloves, and minimize transport of patient and mask patient when transport is necessary continue isolation for duration of illness
Plantar flexion and dorsiflexion only refer to movement at the?
Ankle
Femoral pulse measurement site is?
At the femoral triangle slightly lateral and anterior to the inguinal crease
Client factors includes?
Body structures, body functions, and personal belief systems both body functions and body structures are based on human anatomy and physiology
Deep, nagging, dull pain related structure is?
Bone
How to perform complete natural breathing is?
Breath through nose, inhale to count of 5 filling first the lower part of lungs then the middle part, then the upper part, hold your breath for count of 5, exhale slowly to count of 5, relax your abdomen and chest
For side lying to sit up at the edge of bed do what?
Bring the patient's feet off the edge of the bed, stabilize the patent's lower extremities, shift the patient's body to an upright sitting position, and place the patient's hands on the bed at the sides of his or her body to help maintain balance
Gowns or aprons can be?
Clean or sterile
Wedge
Converts downward force into perpendicular force separating or splitting the object the tool is wide at one end and narrow at the other
The requirements for a dependent transfer are that the patient be?
Cooperative and willing to follow instructions
Muscle contraction effects blood pressure because?
The patient should not maintain are position by contraction of the upper extremity musculature because this contraction may produce an increase in BP as a result of the increased resistance
Guidelines for maintaining a sterile field are?
Do not talk, sneeze, cough, or reach across a sterile field the air currents or moisture droplets from your nose or mouth can covey pathogens into the field, do not turn your back to the field because contamination of the objects in the field can occur when you are unable to observe the field, do not allow a nonsterile object to come in contact with a sterile object and do not allow a sterile object to come in contact with a nonsterile object, do not leave the field unattended even if it is covered with a sterile towel or another sterile item in your absence the field can become contaminated, a 1-inch border along the edges of the field is considered to be nonsterile avoid placing any sterile item within 1 inch of the outer edge of the field and do not touch this area with sterile gloves or other sterile objects, when you wear sterile PPE the portions that are considered sterile unless they come in contact with a nonsterile object or environment are the glove, the front of the gown above the waist level, and both sleeves of the gown the remainder of the gown is considered to be nonsterile, when forceps or other items that have been stored in a liquid disinfectant are used they should be handled so that the tip or end that has been in the disinfectant is held downward if the tip or end of the object is held upward the fluid will flow to a nonstrile area on the object then when the tip or end is held downward again the fluid will flow from the nonsterile area back the sterile area and contaminate the object, the base and the area surrounding the field should be void of moisture because moisture is considered to contain microorganisms and can penetrate the field by direct contact, absorption, or the wicking property of any of the materials on the field moisture is considered to be a source of contamination so the field must remain dry if the base of the field or any of the sterile materials on the field become wet they should be considered contaminated, to reduce or avoid movement over the field position the items on the field so that the items to be used first are nearest you, the area below the surface of the sterile field which will usually be tabletop height or waist height is considered nonsterile any item that falls to or is located below waist or tabletop level including your hands should be considered contaminated, and general cleanliness of the treatment area including the furniture, floor, walls, and lavatories should be maintained to reduce the proliferation or deposition microorganisms hand hygiene techniques and practices for a sterile field is required
Hip abductors origin is?
Gluteal surface of ilium
Emotional status effects blood pressure because?
It increases during episodes of high stress, anxiety, or emotion like anger or fear
Emotional status is a factor that affects body temperature because?
It increases slightly during stressful or emotional periods like crying or anger
Infection is a factor that affects body temperature because?
It increases with a mjor or systemic infectious process
Flexor withdrawal or flexor reflex
It is a protective withdrawal of a limb in response to painful stimulation
Contralateral
Opposite sides of body so right versus left
Intrinsic muscles
Originate distal to the joint the muscles are within or acting solely on a specific boy part such as in the hand they allow for dexterity, fine movements, and coordination
Extrinsic muscles
Originate proximal to the joint the muscles originate outside of the body part on which they cause action they allow gross motor skills and strength
Kyphotic
Orthopedic deformity caused by mainataining an abnormal posutre for a long period of time
In the initial assessment of pain the clinician should determine and document what elements?
Pain onset, pattern of pain, exact location of pain, results of a pain questionnaire if available, whether pain radiates or spreads to other parts of the body, description of pain when it is best and worst, whether it is constant or intermittent, what activities make pain better and worse, and time of day when pain is better or worse, what work or social activity is affected by pain, and rate pain from 1 to 10 with 1 being the least and 10 being the worst
SOB
Shortness of breath
Peripheral nervous system or PNS
The division of nervous system that links the CNS with the muscles and glands it provides sensory information to the CNS it is further subdivided into autonomic and somatic divisions
Bony land marks of the transversospinalis muscle is?
Spinous and transverse processes
Adolescents normal values for blood pressures are?
Systolic of 100-120 mm Hg and diastolic of 65-75 mm Hg
Infants from 3 months to 1 year normal values for blood pressures are?
Systolic of 90-100 mm Hg and diastolic of 60-67 mm Hg
Within the virtual environment of text messaging the ___ concept changes from that used with other forms of communication people tend to reply immediately to a text message whereas they may return a phone call, e-mail, or letter hours or even days later
Temporal
Assisted transfer
The patient requires assistance from another person to perform the activity safely in an acceptable time frame physical assistance, verbal or tactile cues, directions, or instructions may be used
Dependent assistance
The patient requires total physical assistance from one or more persons to accomplish the activity safely special equipment or devices may be used
What is the procedure for protective transfer from the floor to standing for a person with low back dysfunction?
The patient starts in the prone position and pushes to his or her hands and knees or logrolls to a side lying position, if the patient is on all fours he or she moves to a half kneeling position then to standing a firm object may be used for assistance, if the patient is lying on his or her side he or she pushes to a side sitting position moves to a hands and knees position and then performs the movements listed in the previous step
Inertia
The state of a physical body in which it resists any force acting to move it form a position of rest or to change its uniform motion
When seated at a computer terminal do what?
The vision display terminal should be directed about 10 degrees below horizontal, the chair used should encourage a supported lumbar lordosis with a seat pan that is tilted slightly forward, the keyboard should be pushed forward to permit the arms to rest in front of it ideally with the wrists supported on a padded surface, and perform a 1 min exercise break every hour that includes neck flexion, extension, and lateral bending stretching exercises, chin tucks, wrist flexion and extension stretches, shoulder pendulum excises, tennis elbow stretch and standing back bends
Bony trochanter
Very large projection that is rounded or blunt
The range of motion of the lumbar vertebral column for flexion is?
0 degrees
Normal rectal temperature is?
97.8-100.3 F or 36.6-38.1 C
PROM
Passive range of motion
Articulations of bones are of immense functional importance because?
All skeletal movement in the body occurs at them
The range of motion of the thoracic vertebral column for extension is?
0 degrees
The range of motion of the thoracic vertebral column for flexion is?
0 degrees
The range of motion of the thoracolumbar vertebral column for lateral flexion is?
0 degrees
Handwashing for surgical asepsis procedure
1. Remove all jewelry from your hands, neck, and ears and approach the wash area with your arms exposed to approximately 3 inches above the elbow and avoid touching the sink and other nearby objects with your clothing or hands 2. turn on the water and adjust water to a warm temperature 3. wet your hands and forearms then apply the soap or detergent according to the previous directions for medical asepsis 4. wash your hands as outlined for medical asepsis except that you will need to wash your entire forearm to approximately 3 inches above your elbow this process requires approximately 7 minutes 5. rinse your hands by holding them with your fingers upward so that the rinse water flows from a clean to an unclean area so from your fingers to your elbows do not allow your hands, forearms, or upper arms to contact the sink or your body 6. clean your fingernails, cuticles, and skin creases with a one time use brush using vigorous strokes you may use a pointed disposable wood probe or orange stick to clean under each fingernail discard the probe and brush after use 7. perform a final rinse with your hands directed upward 8. dry your hands, forearms, and distal are of upper arms though using a sterile towel or air dryer avoid contact between the towel and your clothing and between your washed skin and your clothing or other nosterile areas wrap your hand and forearms in a dry sterile towel before applying PPE or gloves then hold your hands above waist level and slightly away from your body until you begin your treatment or patient care activities
Handwahing for medical asepsis procedure
1. Remove jewelry from the hands and wrists remember that the sink, soap dispenser, and towel container are contaminated 2. turn on the water and adjust it to a warm temperature so the soap will later and there will be less irritation to the skin avoid using cold or hot water 3. wet your wrists and hands with the hands directed downward avoid touching the sink rim or basin 4. apply soap and prepare to wash hands vigorously using friction or rubbing motions 5. wash for 40 to 60 seconds was longer if hands have come in contact with body fluids, an infectious wound, or a contaminated patient lather and scrub the palms together, interlace the fingers and scrub between and around each finger wash the web space between each finger, scrub the dorsum of each hand with the opposite palm or brush, scrub the fingertips with opposite palm or sue a one time disposable brush or a pointed disposable wood probe or orange stick to clean under each fingernail, and encircle each thumb and wrist with the opposite palm and scrub 6. rinse hands thoroughly from the wrist to the fingers do not rinse the skin proximal to the area that has been washed rinse the soap lather completely form all surfaces 7. dry the hands with a disposable paper towel and allow the water to flow while the hands are being dried 8. discard the towels used to dry the hands and use a clean dry towel to turn off the faucet then discard all used towels in an appropriate container and avoid touching the container
PPE removal for isolation precautions procedure is?
1. Remove your gloves and remember that the outside of the gloves is contaminated to remove the gloves grasp the outside of the glove with your opposite hand and gently peel off the glove so that it is inside out hold the removed glove in the gloved hand and slide the finger of your ungloved hand under the reaming glove at the wrist discard gloves in an appropriate container 2. remove your eye protection by using the clean headband at the back or earpieces place in receptacle for reprocessing or an appropriate waste container 3. remove your gown untie the neck string of the gown and carefully unite the waist tie remember that the gown front and sleeves are contaminated another method is the neck snaps can be pulled apart then grasping at the shoulders gently remove the gown using a peeling motion with your arms extended in front of your body pull the gown down from each shoulder toward the same hand the gown will turn inside out gently roll the gown into a ball away form the body and dispose of it into a waste or lien receptacle avoid touching your skin or clothing with the gown 4. remove your mask or respirator remember the front of the mas or respirator is contaminated and must not be touched grasp one side of the ear elastic and then the other an alternative method is unite the bottom tie first and then untie the top tie hold the mas by the elastics or ties and dispose if it if wearing a cap remove by handling it by its ties or by gently grasping the center the top lift it form your head and dispose of it 5. wash your hands as described for medical asepsis
Measuring blood pressure by auscultation procedure is?
1. Wash your hands and obtain a stethoscope and sphygmomanometer explain the procedure and rationale for measurement to the patient observe the patient for signs or symptoms of stress or recent exercise if the patient has exercised, ambulated, or experienced emotional stress he or she should rest for 15 to 30 minutes before the blood pressure is measured position the patient sitting with the forearm supported on a firm object approximately at the level of the heart if the patient is standing elevate the arm and support it between your arm and lateral area of the chest while you face the patient 2. expose the antecubital space of the left or right arm do not roll the shirt or blouse sleeve too tightly because it may partially occlude the artery palpate the brachial pulse so you know where to place the diaphragm of the stethoscope 3. apply the deflated cuff to the arm with the center of the bladder over the medial aspect of the arm the cuff should be applied approximately 2.5 cm above the antecubital space with the manometer attached to the cuff or placed so that the needle and scale can be observed easily without being held in your hand 4. clean the earpieces and diaphragm with an alcohol wipe and apply the stethoscope to your ears with the earpieces directed forward place the diaphragm on the skin where the brachial artery was palpated apply firm but light pressure on the diaphragm to maintain contact with the skin 5. to initially determine the amount of pressure needed in the cuff to occlude the brachial artery palpate the radial pulse and inflate the cuff by closing the valve on the inflation bulb and squeezing the bulb until the radial pulse is no longer palpable this value can be used as a baseline for the cuff pressure inflation level note this value and deflate the cuff after waiting 30 to 60 seconds reinflate the cuff to 15 to 20 mm Hg above the pressure that previously occluded the artery to ensure that the artery is fully occluded 6. to deflate the cuff release the valve on the inflation bulb so that the needle drops at rate of 2 to 3 mm Hg per second listen for normal Korotkoff sounds and mentally note the needle position or reading when the initial sound is heard through the stethoscope this reading is the systolic pressure value continue to deflate the cuff listening for the absence of the sound of a pulse or beat and mentally note the needle position this reading is the diastolic pressure value allow the cuff to deflate completely remove it form the patient and remove the sthoscpe from your ears recorded the values including the patient positon and extremity used for example 130/170 right upper extremity, sitting or 140/80 left upper extremity, sitting clean the stethoscope earpieces and diaphragm with an alcohol wipe
Open glove technique for asepsis procedure is?
1. perform preparatory activities of hand hygiene 2. open the package containing sterile gloves and place the gloves in the sterile field open the inner packet carefully and arrange the gloves so that the cuffs are nearest you by touching only the inside of the folded cuffs with your hands avoid touching the outer surface of the gloves with your hands as your prepare to apply the first glove 3. to apply the first glove grasp the inner side or surface of the folded cuff do not touch the outside of either glove with an ungloved hand insert your hand and finger in the glove and apply the glove as if you were applying a dress glove but allow the cuff to remain folded do not attempt to adjust the cuff or the fit of the glove at this time 4. using your gloved hand lift the other glove by sliding your gloved fingers between the underside of the cuff and the outer side of the palm of the other glove do not touch the inside surface of the second glove or your ungloved hand with your gloved hand to do so will contaminate them insert your hand and fingers in the glove but do not allow the thumb of the hand you are suing to touch the inside of the cuff of that glove 5. pull the cuff of the second globe up by holding the outer surface of the cuff avoid touching the skin of your hand with the outside of the first glove that was applied 6. once the cuff of the second glove is in place slide your fingers under the cuff of the first glove and pull the cuff of that glove all the way up
Resting heart rate for children over 10 and adutls is?
60-100 beats/min
How many segments are in the cervical vertebra?
7
Precautions for patients with total hip replacement anterior and posterior surgical approaches are?
Always follow hospital and physician protocol for total hip replacements based on surgical approach, when the patient is supine maintain the surgical hip abducted from the midline of the body some facilities use abduction pillows and in neutral rotation like the patella and toes are positioned toward the ceiling the hip should not be adducted beyond the midline of the body when the patient lies, sits, or stands, maintain the surgical hip in neutral extension the hip should not be extended beyond the midline of flexion and extension, maintain hip abduction and neutral rotation while the patient is in a side lying position on the unaffected hip by supporting the surgical lower extremity with pillows or a bolster the surgical extremity must be in the uppermost position, avoid external hip rotation when an anterolateral surgical approach was used, avoid internal hip rotation when a posterior or posterolateral surgical approach was used, avoid rotating or twisting the upper body with the lower extremity fixed or immobile as when reaching for an object on a bedside stand while lying in bed such activity indirectly causes hip rotation, avoid hip flexion beyond a range of 60-90 degrees for a posterior or posterolateral surgical approach this guideline means that the patient should not sit erect in a wheelchair or in bed because bringing the trunk closer to the thigh produces hip flexion in addition avoid excessive trunk flexion while the patient is sitting by using a raised toilet seat and elevated chair when available, and the anterior surgical approach guidelines have very few if any hip precautions on the surgically repaired hip follow physician's protocol or orders
ASIS
Anterior superior iliac spine
Sagittal plane can also be called?
Anteroposterior
To adduct the fingers or toes is to?
Bring them together
Adduction of a joint
Brings a limb medially toward the body's midline so adding to the body
Auscultation for apical pulse do what?
Clean the diaphragm and earpieces of the stethoscope with an alcohol wipe position the earpieces in your ears with the earpieces directed forward this position will be the most comfortable and the earpieces will be in line with the auditory canal warm the diaphragm with you hand or by rubbing it with a cloth then place the diaphragm on the patient's skin on the left lateral side of the base of sternum in the intercostal space between the fourth or fifth or the fifth and sixth ribs in an adolescent girl or woman it may be necessary to position the diaphragm slightly medially or laterally and inferior to the left breast count and record the pulse rate then remove the earpieces from your ears and clean them and diaphragm with an alcohol wipe if the stethoscope is a personal one only the diaphragm needs to be cleaned before and after use with patient if the stethoscope is loaned to other persons or belongs to the department the earpieces should be cleaned using an alcohol wipe before and after use this action decreases the possibility of contamination of the earpieces and diaphragm and helps prevent the spread of disease or infection from one person to another
The value of proper body mechanics are?
Conserve energy, reduce stress and strain on muscles, joints, ligaments, and soft tissue, promote effective, efficient, and safe movements, promote and maintain proper body control and balance, and promote effective and efficient respiratory and cardiopulmonary function
Faces pain rating scale for children
Consists of 6 faces with the absence of smiles and tears it is used for children 4-16 y and elderly adults including adults with mild to moderate cognitive impairment
Uncontrolled diarrhea or clostridium difficile, lice, scabies, impetigo precautions are?
Contact precautions with dedicated equipment in room, no mask, need a gown with direct contact with patient, environment surfaces, or times in patient's room, use CHG soap for handwasing, and minimize transportation as feasible
What is the procedure for a standing transfer?
Examine and evaluate the patient's mental and physical capacities to perform or assist with the transfer, position, secure, and stabilize the wheelchair and other items involved with the transfer wing away the front rigging or elevate the footplates and apply a gait belt or transfer sling to the patient, instruct the patient in the steps of the transfer indicate the expected activities and demonstrate the transfer instruct the patient to move forward in the chair and angle his or her backside so that the thighs are parallel to the surface to which he or she is transferring provide assistance if needed position the patient's feet flat on the floor parallel or anteropsterior to each other, the patient initiates the transfer with trunk momentum or by inclining the trunk forward so nose over toes the caregiver is positioned in front and slightly to one side of the patient to protect and guard him or her, the patient uses the upper and lower extremity or extremities to rise to a standing position the caregiver provides assistance as needed by using the knees and a gait belt, the patient stands briefly to establish balance and to acclimate to the upright position then turns or pivots toward the object to which he or she is transferring, the patient contacts the object using the upper and lower extremity or extremities before lowering onto the object the caregiver provides assistance as needed, the patient's position is adjusted for proper support, stability, and safety the caregiver evaluates any reaction and physiologic response to the activity, then remove the gait belt and document the patient's performance and amount of assistance needed
Bony prominences that may cause pressure injuries in head and trunk in sitting position are?
Ischial tuberosities, scapular and vertebral spinous processes if leaning against back of chair, and sacrum if patient is slouched
What areas of the body are at a particularly high risk for pressure for a seated person?
Ischial tuberosities, scapular and vertebral spinous processes, olecranon processes, medial epicondyles of the humerus if the patient is resting on a hard surface, back of the knees if the patient's knees are resting against the seat, and heels and feet
An item, surface, or field is considered contaminated when?
It has come into contact with anything that is not sterile
Emotional status effects pulse because?
It increases during episodes of high stress, anxiety, or emiton like anger or fear and may decrease when the person is asleep or in a state of extreme calm
MMT
Manual muscle testing
Two person lift transfer from bed to wheelchair procedure is?
Move the patient to the near edge of the bed, position the wheelchair parallel to the bed and opposite the patient's hips lock the chair raise the footplates or swing away the front rigging and remove the armrest nearest the bed, elevate the patient's trunk to a long sitting positon guard and protect the patient as necessary, one person stands behind the patient and the patient crosses his or her arms over the abdomen the caregiver reaches through the axillae and grasps either the patient's forearms near the wrists or a gait belt is firmly applied below the rib cage, a second person stands at the side of the patient's lower extremities facing the bed and positons one forearm under the thighs and one forearm under the lower legs to cradle the lower extremities, on command from the persons standing behind the patient the two persons simultaneously lift and lower the patient into the wheelchair the patient's knees should be straight during the transfer until the end of the transfer the person holding the lower extremities must stoop or squat to lower the patient, the patient's body is moved to the rear of the chair seat and the front rigging is replaced or the front plates are lowered the patient's feet are placed on the footrests if necessary a lap or chest belt is applied to protect or stabilize the patient, then the patient's positon is adjusted for safety and comfort note if the bed height can be adjusted it should be lowered to as near the height of wheelchair seat as possible before either transfer is attempted the person at the head of bed should use caution not to run into the push handles of the wheelchair in the process of the transfer if the bed is not adjustable and the person lifting the trunk is too short a secure stool to stand on can be used
Plantar flexion is performed by?
Moving the ankle to point your foot into the earth or stepping on a car's gas pedal
Elasticity
Muscle's ability to return to its original length after it has been stretched
Age effects pulse because?
Persons older than 65 years may exhibit a decreased pulse rate whereas young persons like adolescents and younger usually exhibit an increased rate
Physical conditioning effects pulse because?
Persons who perform frequent, sustained, vigorous arerobic exercise exhibit a lower than normal pulse rate
Lateral
Pertaining to a side so away from the midline of the body or structure
Comatose
Pertaining to or affected with coma so a state of unconsciousness
Wheelchair to bed standing transfer with patient with one non weight bearing lower extremity procedure is?
Position the wheelchair at an angle next to the bed facing the foot of the bed and midway between the head and foot of the bed either lower extremity can be nearest the bed lock the chair facing away the front rigging and apply a gait belt, help the patient move forward in the chair maintain control of and support of the NWB lower extremity position yourself in font of the patient to guard and protect him or her throughout the transfer, instruct the patient to stand by pushing with the upper extremities and FWB lower extremity, instruct the patient to pivot so that the buttocks are toward the bed control and support the NWB lower extremity as the patient sits on the edge of the mattress, assist in lifting the NWB lower extremity into the mattress as the patient lifts the FWB lower extremity avoid excessive hip flexion and adduction if the patient has had a total hip replacement, instruct the patient to move toward the center of the mattress and lie down, then position the patient for safety and comfort and remove the gait belt
Bed to wheelchair standing transfer procedure with patient with one non weight bearing lower extremity is?
Position the wheelchair at an angle on the side next to the hip of the full weight bearing of FWB lower extremity facing the foot of the bed lock the chair and swing away the front rigging or elevate the footplates, help the patient move to the edge of the mattress and sit up apply a gait belt or sling, position yourself in front of the patient to guard and protect him or her assist in moving the non weight bearing or NWB extremity to the edge of the mattress avoid excessive hip flexion and adduction if the patient has had a total hip replacement, help the patient stand on the FWB lower extremity assist in controlling or supporting the NWB lower extremity, instruct the patient to reach for and grasp the far armrest of the wheelchair and pivot on the FWB foot to position the hips in preparation to sit, instruct the patient to use the upper extremities and FWB lower extremity to slowly lower the body into the chair maintain control and support of the NWB lower extremity, position the NWB lower extremity on an elevated leg rest as necessary place the other foot on the footplate, then position the patient for safety and comfort and remove the gait belt
Wheel chair to bed two person lift transfer procedure is?
Position the wheelchair parallel to the side and midway between the head and foot of the bed lock the bed wheels, lock the chair and raise the footplates or swing away front rigging the armrest nearest to the bed should be removed only if it is higher than the surface of the bed, taller and stronger person stands behind the chair the patient crosses his or her arms over the abdomen and the person behind the chair reaches through the axillae and grasps either the patient's forearms near the wrists or a gait belt placed firmly below the rib cage, a second person stoops or squats at the side of the patent's lower extremities facing the bed and positons one forearm under the thighs and one forearm under the lower legs to cradle the lower extremities one forearm must be under the patients thighs to assist in lifting the pelvis/buttocks and to avoid strain to the posterior aspect of the knees, the person standing behind the patient instructs the patient to push down and hold the position with the shoulder muscles, on command form the person standing behind the patient like one, two, three, lift or ready, lit, or prepare to lift, or lift the two persons simultaneously lift and place the patient on the near side of the mattress the patient's knees should be straight during the lift, the person at the patient's back maintains the patient in an upright position so long sitting position, then the two persons partially lift and move the patient to a safe position on the bed the person holding forearms or gait belt assists the patient in laying down and the body position is adjusted for safety and comfort
Medial
Related or located toward the midline of a body or structure
Three person lift transfer from a bed to a new support surface procedure is?
Select one person to lead the lift process, position the had of the new support surface like stretcher, bed, or tilt table perpendicularly so at a right angle to the foot of the bed and lock it in place, the lifters place their respective upper extremities in the following positions under the patient's head and upper trunk, just above and below the pelvis, and under the upper thigh and lower leg to maintain the knees straight, move the patient close to the near edge of the bed to position the patient's center of gravity closer to the centers of gravity of the lifters, on command from the lead lifter roll the patient to a side lying position facing the lifters and cradle the patient with your flexed elbows, on command from the lead lifter lift the patient keeping the person on one side, on command from the lead lifter step back form the bed pivot so that the patient's back toward the surface into which the patient will be placed, the lifters should use short steps and sidestep rather than use a crossover step to avoid stepping on another person's foot, one the patient is positioned over the stretcher and on command form the lead lifter lower the patient to the new support surface by bending your knees and hips keep the body cradled until your elbows rest on the support surface, on command lower your forearms to the support surface to place the patient flat, then move the patient toward the center of the support surface positon the body for comfort and safety and apply security straps pillows and towel rolls as necessary
Two person bent pivot transfer from bed to wheelchair procedure is?
Set up the wheelchair and bed as described previously, one clinician assumes a position in front of the patient and the other in the back, the clinician in front assists in walking the patient's hips forward until the feet are flat on the floor, the same clinician stabilizes the patient's knees and feet by placing his or her knees and feet lateral to each of the patient's, the clinician in back positions himself or herself squally behind the patient's buttocks grasping either the patient's waistband or the sides of the patient's pants creating a slinging effect or placing his or her hands under the buttocks maintain proper body mechanics, the clinician in front moves the patient's trunk into a midline position grasp the patient around the back of the shoulders waist or hips and guides the patient to lean forward and shift his or her weight forward over the feet and off the buttocks the patient's head and trunk should lean in the direction opposite the transfer the patient's hand can rest on the lap, then as the clinician in front shifts the patient's weight forward the clinician in back shifts the patient's buttocks in the direction of the transfer this process can be done in two or three steps making sure the patient's buttocks land on a safe solid surface the clinicians reposition themselves and the patient to maintain safe and proper body mechanics
The procedure for one person dependent sliding board transfer from wheelchair to bed is?
Set up the wheelchair and bed as described previously, position the patient's feet together on the floor directly under the knees and swing the outside footrest away grasp the patient's legs from behind the knees, and pull the patient slightly forward in the wheelchair so that the buttocks will clear the big wheel when the transfer is made, place a sliding board under the patient's inside thigh midway between the buttocks and the knee to form a bridge form the bed to the wheelchair the sliding board is angled toward the patient's opposite hip, stabilize the patient's feet by placing your own feet laterally around the patient's feet, stabilize the patient's knees by placing your won knees firmly against the anterolateral aspect of the patient's knees, help the patient lean over the knees by pulling him or her forward from the shoulders the patient's head an trunk should lean opposite the direction of the transfer the patient's hands can rest on the lab, reach under the patient's outside arm and grasp the waistband of the trousers or under the buttock on the other side reach over the patient's back and grasp the waistband or under the buttock, after your arms are positioned correctly lock them to stabilize the patient's trunk keep your knees slightly bent and brace them firmly against the patient's knees, gently rock with the patient on three holding your knees tightly against the patient's knees transfer the patient's weight over his or her feet keep your back straight to maintain good body mechanics, pivot with the patient and move him or her into the sliding board reposition yourself and the patient's feet and repeat the pivot until the patient is firmly seated on the bed surface perpendicular to the edge of the mattress and as far back as possible this step can usually be achieved in two or three stages, then secure the patient on the bed by easing him or her against the back of an elevated bed or on the mattress in a side lying position then by lifting the legs into the bed
Thoracic vertebrae vertebral foramen is?
Smallest
Standing assisted pivot transfer
The caregiver assists the patient to stand, pivot, and transfer to another object the patient must be able to provide 25% to 75% of the physical effort during the transfer safety is an issue so the caregiver must be alert at all times
Gravity
The force that pulls toward the center of the earth and affects all objects
The actions of adduction and abduction happen along?
The frontal plane
Reverse T position
The position of the upper extremities when they are abducted to 90 degrees and externally rotated at the shoulder with the elbows flexed to 90 degrees
A recent spinal cord injury special precuations are?
The injury site may be protected by an external appliance like a brace, plaster or plastic body jacket, or halo device internal fixation so bone graft, metal rods, and wires because distracting ant rotational forces should be avoided do not move the patient downward by pulling on the lower extremities logroll the patient when turning protective positioning or restraints will be required when the patient is in a side lying position or sits without a back support
Standby or supervision assistance
The patient requires verbal or tactile cues, directions, or instructions form another person positioned close to but not touching the patient to perform the activity safely and in an acceptable time frame the assistant at provide protection in case the patient's safety is threatened
Body functions focus on?
The physiologic functions of body systems such as sensory, neuromuscular, psychological, respiratory, and cardiovascular
Joint alignment
The physiological stability of the joint related to its structural integrity as compared to the motor skill of aligning the body while moving in relation to task objects
COG or center of gravity of an object is?
The point around which the body's mass is evenly distributed
T position
The position of the upper extremities when they are abducted to 90 degrees and internally rotated at the shoulders with elbows flexed to 90 degrees
Special precautions for total hip replacement especially within initial 2 weeks after surgery for posterior or posterolateral approach are?
The surgically replaced hip should not be adducted or rotated, flexed more than 90 degrees, or extended beyond neutral flexion-extension do not cross the ankle of the surgically affected extremity over the opposite extremity, pull on the surgically affected extremity , or allow the patient to lie on the surgically replaced hip maintain the surgical extremity in abduction when moving into a side lying positon and during side lying require the patient to sit in a semireclining position and require the patient to maintain the surgically affected extremity in abduction when moving from side to side if an abduction pillow is available apply it after the patient returns to bed
What are the responsibilities of health care employees as outlined by OSHA?
Use PPE provided by the facility whenever the employees contacts or anticipates contact with body fluids, dispose of waste in proper containers using knowledge and understanding of handling of infectious waste and color coded bags or containers, dispose of sharp instruments and needles into proper containers without attempting to recap, bend, break, or otherwise manipulate them before disposal, keep the work and patient care area clean, wash hands immediately before and after removing gloves and at all other items required by hospital or agency policy, and immediately report any exposures such as needle sticks or blood splashes or any personal illnesses to a supervisor and receive instruction about any follow up action
Age affects respiration because?
Very young patients so infant to 3 years and elderly patients so 65 or older tend have higher RR
Principles of proper body mechanics are?
Visualize and physically plan the activity before attempting it, position yourself close to the object to be moved so that you can use short lever arms, maintain your vertical gravity line within your base of support to maintain stability and balance, position your center of gravity close to the object's center of gravity to improve control of the object, tighten your core muscles before beginning the lift use the major muscles of the extremities and trunk to perform movements or activities and maintain your normal lumbar lordosis, roll, push, pull, or slide an object rather than lift it, avoid simultaneous trunk flexion and rotation when lifting or reaching, look straight ahead and do not twist or turn your body while lifting, take your time and lift the item with a smooth motion and avoid jerking movements, perform all activities within your physical capability, do not lift an object immediately after a prolonged period of sitting, lying, or inactivity gently stretch the back and lower extremities first, and when performing a lift with two or more persons instruct everyone how and when they are to assist and use a mechanical lift or other appropriate equipment if it is available
Measures to increase standardization for range of motion are?
When possible have the same clinician perform repeated range of motion measurements or at least ensure the client performs the same procedures, use the same type and size of goniometer as prior measurements, practice using a goniometer to establish service competency with goniometer placement, control contextual considerations to limit impact on range of motion measurements like the temperature of the room and effects of gravity, use the most appropriate goniometer for the size and shape of the joint being measured, select the client position that will not limit joint range of motion, document any factors that may have influenced range of motion measurements like pain, obesity, or edema, when possible assess active range of motion first to identify need for passive range of motion or isolated range of motion measurements, and observe and measure the unaffected extremity first to provide insight into the typical movement capability of the other arm