Burn Deformities: Shoulder
ADD and IR contraction
endocrine system: hormone that depresses the secretion of insulin and glycogen; decrease the motility of the stomach, duodenum,
Pregnancy: acute HTN after the 24th week of gestation
Closed Packed Position for Distal Radioulnar
5 Deg Sup
Closed Packed Position for Proximal Radioulnar
MAx ext, 5 deg Sup
Closed Packed Position for Humeroulnar
Max Ext and Sup
Closed Packed Position for Humeroradial
90 Flex, 5 Deg Sup
Pathological End Feel: Firm decreased Elasticity?
Soft tissue Fibrosus
Pathological End Feel: Boggy?
Closed Packed Position for Knee
Max ER and Ext
Closed Packed Position for Hip
Bone: 90 Flex, Slight Abd and ErLig: Max Ext, Abd, IR
Pathological End Feel: Empty?
Muscle Guarding
Pathological End Feel: Rubbery?
Muscle Spasm
Grades of Accessory Joint Motion: 4
Slightly Hypermobile
Incontinence: Leakage associated with teh inability of unwillingness to toilet due to impaired cognition, impaired physical functioning or environmental barriers
functional Incontinence
Burn Deformities: Anterior Neck
Flexion contraction
Grades of Accessory Joint Motion: 5
Hepatitis: Transmission from blood, body fluids or body tissues, through blood transfusion, oral or sexual contact or contaminated needles
Spinal Cord: conveys proprioception information from M. spindles, golgi tendon organs, and touch and pressure receptors
Spinocerebellar tract
Spinal Cord: convey sensations of crude touch
Ant Spinothalamic tract
Cardiac Rehabilitation: Strength training can begin in Stage 2 after how many weeks 1) cardiac rehab 2) post MI 3) post-CBG
1) 3 weeks 2) 5 weeks 3) 8 weeks
CPR: Compression Rate for 1) adults/children/infants
Medication: Side affects of chronic Corticosteroids
1) muscle Wasting 2) pain 3) Weakness 4) Osteoporosis
Blood Flow of Integ: reduced O2 level in the blood causing advanced lung disease, congenital heart disease and abnormal hemoglobins
Central Cyanosis
Medication: Prednisolone is a type of what
Ventilation: volume of gas that remains in the lung after ERV has been exhaled
Residual Volume
Cardiac Rehabilitation: MET guideline for Stage 1 rehab
Initial 2-3 METS, 3-5 at D/C
Cardiac Rehabilitation: HR elevation in stage 1 rehab
10-20 BPM
MET Level: Show shoveling, lawn mowing, Walking 5 mph, biking 11mph, tennis, light swimming light downhill skiing
6-7 METS
Cardiac Rehabilitation: Stage 1 Length of Hosp stay for uncomplicated MI
3-5 days
Muscle Action: Obturator Internus
Hip ER
Muscle Action:Glut Max
Hip Ext, Hip ER
Muscle Action: Piriformis
Hip ER
Muscle Action: TFL
Hip Abd, Hip Flex, Hip IR
Muscle Action: Glut Min
Hip Flex, Hip IR, Hip ABD
Muscle Action: Glut Med
Hip Flex, Hip IR, Hip ABD
Muscle Action: Gracilis
Muscle Action: Adductor Brevis
Communication: Verbal Apraxia is a lesion to what area of the brain
cortical, dominant hemisphere
Spinal Cord: voluntary motor control that arise from the primary motor cortex
corticospinal tract
Communication: The result of a lesion to the third frontal convolution of the left hemisphere
Brocca's Motor Aphasia
Communication: impairment of volitional articulatory control
Verbal apraxia
RLA: 1) able to recall and integrate past and recent events 2) Shows carryover for new learning and needs no supervision once activities are performed
VIII. Purposeful Appropriate
Grades of Accessory Joint Motion: 0
Communication: A central language disorder in which speech is typically awkward, restricted interrupted and produced with effort
Non-Fluent Aphasia/Brocca's Aphasia
Muscle Action:Biceps Femoris
Knee Flex, Hip Ext, Leg ER
Muscle Action:Gemelli
Hip ER
RPE: RPE of 16 correlates to what percentage of HR
Contraindications: Exercises contraindicated if resting BP is what
Capacity: IRV+TV+ERV; amount of air that is under volitional control; measured as forced expiratory vital capacity (FVC)
Vital Capacity
Heart: SV/left ventricular diastolic Volume
Ejection Fraction
Heart: Percentage of blood emptied from the ventricle during systole
ejection fraction
Heart: Average CO for an adult at rest
4-5 L/ min
Heart: the amount of blood discharged form the left or right ventricle per minute
Heart: the force the LV must generate during systole to overcome aortic pressure
Heart: the ability of the ventricle to contract
Heart: the amount of blood left in the left ventricle at the end of diastole
Motor Learning Strategies: the acquired capability to apply what has been learned to other similar tasks
Heart: amount of blood ejected with each myocardial contraction
Stoke volume
Heart: Steps of electric current in heart
1) SA node 2) Atria 3) AV node 4) bundle of his 5) Purkinje fibers 6) ventricles
Auscultation Landmarks: 4th left intercostal space at the sternal boarder
Tricuspid valve
Special Tests: 1) Pt supine 2) shld max abd 3) push humeral head ant while rot humerus externally
Clunk test
ECG Potassium Levels: flattens T wave prduces U wave
ECG Potassium Levels: widens QRS, flattens P wave T wave becomes Peaked
Ventilation: volume of gas that can be inhaled beyond a normal Tidal Inhalation
Special Tests: + post internal impingement test
reproduction of pain
ECG: Abnormal Q or QS in leads V1-V4
Anterior infarction
ECG: Larger R waves in V1-V3, ST depression V1, V2 or V3
posterior infarction
Special Tests: 1) Pt supine 2) arm moved into 90 deg of abd, max ER and 15 deg of horz abd
Post internal impingement test
Arrhythmias: Abnormal delay r failure to conduct through normal conduction system
AV Blocks
Special Tests: IDs glenoid labrum tear
Clunk test
ECG: Abnormal ST segment
depression or elevation greater than 1 mm measure .8 mm from J point
ECG: impaired coronary perfusion causes a change in this segment
ST segment
PNF techniques: Combines concentric, eccentric, and isometric contractions of one muscle gropu
Combination of isotonics ( Agonist Reversals)
PNF techniques: an isometric contraction performed in the mid to short range followed by a voluntary relaxation and passive movement into lengthened range, and resistence to an isotonic contraction into the lengthened range
Replication (Hold-Relax-Active Motion
Special Tests: ID tear and/o impingement of supraspinatus tendon and possible suprascapular N. pathology
Supraspinatus Test/Empty Ca
Special Tests: + sign for Froment's Test
IP flexion of the thump due to compensation of add pollicis weakness
Special Tests: 1) Pt sitting with shld at 90 deg and no rotation 3) Resist shld abd 4) Then place shld in IR and 30 deg of horz add 5) resist shld abd
Supraspinatus Test
Spinal Level Reflex: Crossed extension reflex function
Coordinates reciprocal limb activities (Gait)
PNF techniques: a relaxation technique usually performed at a a point of limited ROM in the agonist pattern
Contract Relax
Special Tests: Positive sign for supraspinatus test
Reproduces px in supraspinatus tendon or weakness in empty can position
Degenerative Disorder: Usually affects extraocualr, facial, muscles of mastication and proximal limb girdles
myasthenia gravis
Degenerative Disorder: neuromuscular Disorder with progressive muscular weakness and fatgiability on exertion
Myasthenia Gravis
Degenerative Disorder: Common ROM problems with PD
1) contractures in flexors and ABductors
Degenerative Disorder: Common oromotor problems with PD
1) dysphagia
Vestibular Dysfunction: an acute infection with prolonged attack of symptoms
Vestibual neuronitis
Cerebellar Disorder: 1) intension tremmor 2) dysdiadokinesia 3) Dysmetria 4) dysynergia
Lesion to the neocerebellum
Cerebellar Disorder: 1) hypotonia 2) truncal ataxia 3) Ataxia gait
Lesion to the paleocerebellum
Cerebellar Disorder: 1) Central Vestibular Symptoms 2) gait and trunk ataxia
Lesion of the archcerebellum
Wound Color: Covered in eschar
Wound Color: include slough (necrotic or dead tissue) fibrous tissue
Acid-Base Balance: 1) decrease in pH 2) Increase in PaCO2 3) HCO3- WNL
Respiratory Acidosis
Acid-Base Balance: 1)increase in pH 2) PaCO2 WNL 3) Increase in HCO3-
Metabolic Alkalosis
Wound Exudate: containing pus
Wound Exudate: watery-like serum
Wound Color: Healthy granulating with absence of necrotic tissue
Wound Exudate: containing blood
Flow Rate: Normal FEV1
Ventilation: PaCO2> 45
Capacity: ERV+RV; the amount of air that resides in the lungs after normal tidal exhalation
Functional Residual Capacity
Capacity: IRV+TV+ERV+RV; the total amount of air that is contained within the thorax during max inspiratory effort
Breath Sounds: a musically pitched sound caused by airway obstruction
Acid-Base Balance: 1)increase in pH 2) Decrease in PaCO2 3) HCO3- WNL
Respiratory Alkalosis
Breath Sounds: distant sound not heard over a healthy thorax often associated with COPD
Breath Sounds: indicates atelectasis, fibrosus or pulmonary edema
MET Level: Level walking, level biking,
2-3 mets
Regulation of Electrolytes and Fluids: Caused by excessive loss due to diarrhea, vomiting metabolic acidosis, renal tubular disease or alkalosis
CA: Can result from small cancer cells in the lung
Cushing's Syndrome
CA: Treatment for pt with <20,000 platelet count
1) AROM,ADL exercise only
Ventilation: volume of gas that can be exhaled after normal Tidal expiration
Normal Values: WBC
Special Tests: 1) Pt make fist 2) Passively moves wrist into Ulnar Deviation
Finklestein's Test
WBC: Exercise prescription when WBC <5000 with fever
Edema: Returns to normal within 15 sec 1/4 to 1/2 inch
Normal values: RBC 1) Men 2) female
1) 4.6-6.2 2) 4.2-5.9
Normal values: Hemoglobin 1) male 2) female
1) 13-18 2) 12-16
Sickle Cell: Contraindicated due to vasoconstriction and increased sickling
Cold Therapy
Special Tests: IDs ulnar nerve dysfunction in the hand
Froment's Sign
Brain: Important for voluntary movement, contains and important centers for cardiac, respiratory and vasomotor function. located in the brainstem
Medulla Oblongata
Brain:connects with the vestibular system, helps with equilibrium and regulation of muscle tone, coordination of smooth muscle movements
Brain: Important for motor control and muscle tone located in the midbrain of the brainstem
Substantia nigra
Brain: contains abducens trigeminal, facial, vestibulocochlea
Brain: secretes hormones that influence the pituitary gland and circadian rhythm
pineal gland
Brain: Origin of the rubrospinal tract, important for in coordination and contains CN oculomotor and trochlear. located midbrain of the Brain stem
Red nucleus
MS Pathology Nerves: 1) inability to Abd shld to 90 Deg 2) px in shld on abd
Spinal Accessory N
MS Pathology: inflammation of pronator teres and FCR tendons
golfers Elbow
MS Pathology: Inflammation of ECRB
tennis Elbow
MS Pathology: 1) 50+ YO 2) min or no cervical spine movement 3) (+) spirlings test 4) (+) Distraction Test 5) (+) ULTT 6) (+) Shld Abd test 7) Dermatomes Affected 8) Reflexes Affected 9) Teder over vertebrae
Cervical Spondylosis
MS Pathology: 1) 10-35 YO 2) Px and instability with activity 3) Full or Excessive ROM 4) (+) load and Shift Test 5) (+) apprehension test 6) (+) relocation test 7) Ant or Post Px
Atraumatic Instability
MS Pathology: 1)45+YO 2) Restriction of ER, ABD, IR 3) Not pxful unless capsule is stretched
Frozen Shld
MS Pathology: 1) 30-50 YO 2) Px and weaknees after eccentric load 3) Weakness in Abd/ROT 4) (+) drop arm test 5) (+) empty can test 6) Tender of RC
Rotator Cuff Lesion
Precautions: After Surgical repair for shld impingement pts should avoid _____?
Shld Elevation of greater than 90deg
Special Tests: Tests for RC tendonitis
1) Supraspinatus test 2) Neer's Test
Special Tests: Test for AC or SC disorders
1) Shear Test
Skin disorders: Viral infection that causes vesicular genital eruption, spread by sexual contact
Herpes 2
Skin: Contain lymphatics, blood vessels, nerves and nerve endings, sebaceous ad sweat glands
Medication: used to decrease mucosal edema, inflammation, and airway reactivity
Anti-inflammatory Agents
Skin: Outer most Layer
Medication: block leukotrienes released in allergic reactions, Inhibit airway edema and smooth muscle contraction
Leukotriene Receptor anatagonist
Medication: prevent release of mast cells after contact with allergens
Cromolyn sodium
Skin disorders:viral infection that causes Itching and soreness, followed by vesicular eruption if the skin on the face or mouth
Herpes 1
Heart Sounds: abnormal tremor accompanying a vascualr or cardiac murmur
Heart Sounds: Decreased in aortic stenosis
Heart Sounds: Dub; normal closure of the aortic and pulmonary valves; end of systole
Contraindication: at what ABI do you not apply compression therapy
Heart Sounds: Lub; normal closure of the mitral and tricuspid valves: beginning of systole
LOC: pt respondes appropriately, can open eyes, look at examiner, respond fully
Muscle Action: Psoas Minor
Spine Flex
Muscle Action: Rotatores intertransversarii
Spine Extension, Spine Rot
Muscle Action: Interspinals
Spine Extension
Muscle Action: Travsversospinalis
Spine Extension, Spine Rot
Spinal Nerves: Form cervical and brachial plexus
Cervical Ventral Rami
Spinal Nerves: Innervate Structures on Post Trunk
Dorsal Rami
Muscle Action: Rotators
Spine Rot
Muscle Action: QL
Spine Lateral Flex
Grades of Accessory Joint Motion: 2
Slightly Hypomobile
Grades of Accessory Joint Motion: 3
Spinal Nerves: vorm Lumbar and lumbosacral plexus
Lumbar Ventral Rami
Spinal Nerves: Innervates anterior structures in thoracic region
Thoracic Ventral Rami
Grades of Accessory Joint Motion: 6
Myotomes: C4
Upper Trap/Shld Shrug
Myotomes: C5
Shld Abd/ Delt
Myotomes: C6
ECR and Biceps/ Wrist Ext and Elbow Flexion
Receptive Function: Fluent Aphasia
Wernicke's Aphasia
Incontinence: bladder continuously leaks due to urinary retention due to an anatomical obstruction, Acontractile bladder or a neurogenic bladder
Overflow Incontinence
Exercise Prescription: uses a smaller muscle mass, results in lower VO2
Arm ergometry
Drugs ECG: prolongs QRS and QT intervals
Antiarrhythmic Agents
BP: Pre hypertension
Skin disorders: Avoid using what with dermatitis
Heart Sounds: abnormal heart rhythm with three sounds in each cycle
Incontinence: bladder contracts and urine is leaked after sensation of bladder fullness; inability to delay voiding
Urge incontinence
Drugs: increases HR
MET Level: Running 5.5 mph, biking 13 mph, moderate swimming, basketball
8-9 METS
ECG: elevates ST segment; slows rhythm
PNF: Response to stimulation spreads to adjacent M. working in synergistic patters
ECG Calcium levels: widens QRS shortens QT interval
MS Pathology:1) bil px and paresthesia in back 2) px decreases with spinal flexion and increases with extension 3) pain increases with walking 4) px relieved with prolonged rest
Spinal Stenosis
PT Treatment: Position to optimize gapping to improve Left posterlateral lumbar disc herniation
1) Right side lying with pillow under trunk 2) Flex both hips and knees 3) Rotate trunk to left
MS Pathology: 1) fracture of the pars interarticularis 2) (+) scotty dog in oblique xray view
MS Pathology: 1) ant or post slippage of the vertebra following bilateral fracture of pars interarticularis
MS Pathology: Fracture of a portion of the epiphysis and metaphysis
Salter Harris Type IV
MS Pathology: Compression injury of the epiphyseal plate
Salter Harris Type V
MS Pathology: Entire Fracture of the epiphysis and portion of the metaphysis
MS Pathology: Fracture of only a portion of the epiphysis
Salter Harris Type III
MS Pathology: etiologies of Shin Splints
1) Abnormal biomechanic alignment 2) Poor Conditioning 3) improper Training Methods
MS Pathology: Entire Fracture of the epiphysis
Salter Harris FX type I
Motor Learning Strategies: practice in which rest time is large
distributed practice
Motor Learning Strategies: cognitive rehearsal of a skill without physical performance
Mental practice
Motor Learning Strategies: practice of a group of motor skills in serial or predictable order
serial practice
Motor Learning Strategies: relatively continuous practice in which the amount of rest time is small
Massed practice
Motor Learning Strategies: practice of varied motor skills in which a performer is required to make rapid modifications in order to match the demand of the task
Variable practice
Motor Learning Strategies: practice of a group or class of motor skills in random order
Random practice
Motor Learning Strategies: feed back given after every a set time
Feedback Schedule
Motor Learning Strategies: Practice of a single motor skill repeatedly
Blocked Practice
Motor Learning Strategies: Augmented feedback about the outcome of a movement
knowledge of results
Motor Learning Strategies: augmented feedback about the nature of movement produced
knowledge of performance
Muscle Action: Iliopsoas
Hip Flexion
Myotomes: S1
Ankle EVR/ CFL and CFB
Muscle Action: Quads
Knee Ext
Muscle Action: Sartorius
Hip Flexion, ER, Hip Abd
Myotomes: L3
Knee Ext/Quad
Myotomes: L1-L2
Hip Flex/ Illiopsoas
Myotomes: L5
Great Toe Ext/ EHL
Myotomes: L4
Ankle DF/Ant Tib
PNF: Stimulates afferent nerve endings and facilitates extensor muscles
Muscle Action: Adductor Longus
Muscle Action: Pectineus
Sensory: Cortical Sensation
1) Stereognosis 2) Tactile localization 3) Two-point discrimination 4) Barognosis 5) graphesthesia 6) bil simultaneous stimulation
Sensory Test: ability to perceive movement in response to your moving the pt's limb
Exercise Tolerance Testing: with increase workload what should increase
1) HR 2) Systolic BP 3) O2 uptake (VO2)
Exercise Tolerance Testing: Diastolic BP should do what with increasing workloads
remain the same
Differential Dx: 1) min to mod steady pain 2) aching pain with prolonged standing 3) muscle compartment tenderness 4) Dark, cyanotic, thickened, brown skin 5) ulcer may develop at sides of ankles
Chronic venous Insufficiency
Exercise Tolerance Testing: Kavonen's Formual
60-80% x ( HR Max-resting HR) + Resting HR = Target HR
Medication: decrease platelet aggregation may prevent MI
Differential Dx: 1) intermittent Claudication 2) worse with exercise relieved with rest 3) pain in lower leg 4) loss of hair, pale shinny skin 5) ulceration may develop in toes or feet
Chronic Arterial Insuffiency
Medication: increase contractility and decrease HR, used for the treatment of CHF
Medication: decrease myocardial work, control HTN
Exercise Tolerance Testing: ECG changes with exercise in a healthy individual
1) Shorten QT interval 2) ST depression, upsloping less than 1 mm 3) reduced R wave 4) increased q wave
Exercise Tolerance Testing: ECg changes for pt with MI or CAD
1) tachycardia at lower intensity 2) increased vent arrhythmias 3) ST segment depression of greater than 1mm
Cranial Nerves: CN II (Optic) Function
Vision and pupillary Reflexes
Cranial Nerves: Test for CN II
1) Snelling Eye Test 2) peripheral vision 3) Shinning a light in eye
Gait: Phases of gait that require 60 deg of knee flex
1) initial swing
Gait: Knee ROM
0-60deg of flex
Cranial Nerves: CN IV (trochlear) Function
turn add eye down
Cranial Nerves: CN IV test
pursuit eye movement
Cranial Nerves: CN III (Oculomotor) Function
Pupillary Reflex, turns eye up, down and in and elevates eyelid
Cranial Nerves: CN III Test
Shining a light in eye, ocular movements
gait: limb transitions from acceleration to deceleration
Mid swing
gait: Foot loses contact with ground and accelerates fwd
Initial swing
Gait: Divisions of Swing Phase
1) initial swing 2) mid swing 3) terminal Swing
gait: toe takes on final contact, force is accelerated to provide momentum for propulsion
Gait: Phases of gait that requires 10 deg of hip ext
Terminal Stance
Gait: Phases of gait that requires 30 deg of hip flex
1) mid Swing 2) terminal swing 3) initial contact 4) foot flat
Gait: Hip ROM
0-30 of Flex 0-10 deg of ext
Gait: limb decelerates and prepares for foot strike
terminal swing
Increased concentration of potassium ion
Heart: A decrease in the rate and force of contractions and widened PR and QRS interval and tall T Wave
Special Tests: 1) pt sitting 2) Find radial pulse 3) move shld into max abd and er 4) pt take deep breath and rotates head to opposite side
Wright's Test
Chemoreceptors: Increase in O2 levels will result in which changes in the heart
Decrease in HR
Special Tests: + wright test
Produces neuro and vascular symptoms
PNF techniques: Stabilizing reversal is indicated for
1) decreased stability 2) poor antigravity control 3) weakness
Special Tests: 1) Pt standing 2) shlds fully ER , 90 deg abd, and slight horz abd 3) elbows 90 deg flex 4) pt open closes hand for 3 min
Roos test
Heart: increases heart actions caused by an inbalance in calcium levels
Special Tests: + Roos test
produces neuro and vascualr symptoms
Auscultation Landmarks: 2nd right intercostal space at the sternal boarder
Aortic Valve
PNF techniques: isometric holding is facilitated first on one side of the joint followed by alternate holding of the antagonist muscle group
Stabilizing Reversals (alternating isometrics)
Thyroid Disorder: weight gain, mental and physical lethargy, dry skin and hair, low bp, intolerance to cold goiter, metabolic processes are slowed
Burn Healing: Phase that fibroblast form scar tissue; wound contraction occurs and reepithelialization occurs if tissue is viable
Proliferation Phase
Burn Healing: Phase where scar tissue remodeling occurs and can last up to 2 years
maturation phase
Referral Pattern: Visceral Pain from the esophagus refers to
mid back
Thyroid Disorder: hyperreflexia, nervousness, tremor, weight loss, fatigue, tachycardia metabolic process accelerated
Burn: Healing for Deep Partial Thickness Burn
Slow healing through scar formation
Burn: Healing for Full thickness Burn
Eschar removal and skin grafting necessary, hypertrophic scarring and wound contraction
Burn: Healing for Superficial Burn
Spontaneous 3-7 day, no scarring
Respiration: Accessory muscles of respiration
1) Scalenes 2) SCM
Burn Healing: Results in scar formation the injured tissue is replaced by connective tissue
Dermal Healing
Burn Healing: Phase that is characterized by redness and edema, decreased ROM that last 3-5 days
inflammatory phase
Burn: Healing for Sub-dermal Burn
Heals with skin grafting and scarring
Burn Healing: Retention of viable cells for epithelialization to grow
Epidermal Healing
Adrenal Disorder: decreased production of cortisol and aldosterone, increased bronze pigment, weakness, weight loss , anexity, intolerance to stress
Addison's Disease (primary adrenal insufficiency)
endocrine system: Control the release of mineral corticosteroids, glucocorticoids, adrenal androgens
Adrenal Cortex
Adrenal Disorder: excessive production of cortisol by adrenal cortex, decreased glucose tolerance, round moon face, obesity,
Cushing's Syndrome
WBC: Exercise prescription when WBC >5000
light exercise
Dying: Stages
1) denial 2) Anger 3) Bargaining 4) Depression 5) Acceptance
Sensory: Deep Sensations
1) Joint position 2) Kinesthesia 3) Pallesthesia (vibration)
Wound Care: Type of electrical stimulation for wounds
1) Cont wave form with direct current 2) High-voltage pulsed current 3( Microcurrent Electrical stimulation 4) alternating bi-phasic current
Sensory: Superficial Sensations
1) Pain 2)temp 3) Touch
Wound Dressing: semi-permiable dressing for stage I and II ulcers
Transparent Film
ANS: 1) Dilates Pupils 2) Inc HR and Force of Contraction 3) Break down glycogen into glucose 4) Increase Blood Sugar level 5) Increases blood flow to skeletal muscles 6) decreases blood flow to skin 7) Increases BP 8
Sympathetic NS
Pregnancy: Abdominal exercises to be avoided
1) Full sit ups 2) Bil SLR
Pharmacology: side affect of muscle relaxants
1) drowsiness 2) lethargy 3) ataxia 4) decreased alertness
Pelvic Floor: herniation of the bladder into the vagina
CNS Examination: Tests for meningeal irritation
1) Neck mobility 2) Kernig's Sign 3) Brudzinski's Sign
Brain: Relays motor information from cerebellum and globus pallidus to pre-central gyrus located in the diencephalon
Motor Nuclei of the Thalamus
Spinal Level Reflex: Stimulus: cutaneous sensory stimuli Reflex Arc: cutaneous receptors to flexor muscles
Flexor (withdrawal) reflex
Brain: integrate and relay sensory information from body, face retina, cochlea and tongue to cerebral cortex and found in the Dienscephalon
Sensory Nuclei of the thalamus
Brain: Functions to scale amplitude and velocity of movements, reinforces selected patterns, suppresses conflicting patterns, prepares for movement located within the basal ganglia
Skeletomotor Circuit (putamen loop)
Brain: Functions with saccadic Eye Movements found within the basal ganglia
Occulomotor circuit ( caudate loop)
Brain: basic functions include feeding, aggression, emotions, and sexual response
Limbic System
Brain: receives/processes visual stimuli located in occipital lobe
primary visual cortex
Brain: language comprehension located in temporal lobe
Wernicke's Area
Brain: receives/processes auditory stimuli located in temporal lobe
primary auditory cortex
Brain: Receives fibers that convey touch, proprioception, pain, and temperature sensation from opposite side of body
Parietal Lobe
Brain: Primary sensory cortex for integration of sensation located in parietal lobe
postcentral gyrus
Skin: Underneath the dermis, provides insulation and muscle and fascia lie underneath it
Subcutaneous Tissue
Skin disorders: Skin is taut, firm, edematous, firmly bound to subcutaneous tissue
BP: Hypertension
>140 SBP >90 DBP
Receptive Function: Result of a lesion to the posterior first temporal gyrus of the left hemisphere
Wernicke's Aphasia
Vex/Cave Rule for Cuboid and Calcaneus?
Vex/Cave Rule for Talus?
Loose packed Position for Hip ?
30 Deg Flex, 30 Deg Abd, Slight ER
Loose packed Position for Talocrural ?
10 Deg PF
Loose packed position for Humeroulnar joint ?
70 deg flex, 10 deg Sup
Loose packed Position for Proximal Radioulnar Joint?
Full Ext 35 deg Sup
Loose packed Position for Distal Radioulnar Joint?
10 deg sup
Vex/Cave Rule for Navicular, Cuneiform?
Medications: Purpose of a Corticosteroid
Suppress inflammation
Closed Packed Position for Acromioclavicular?
90 Deg Abd
Closed Packed Position for GH
Max Abd and ER
Pregnancy: Shift in COG
Fwd and Upward
Topical Management: acts only on surface organisms and applied with wet dressings; requires frequent dressing changes
Silver Nitrate
Special Tests: Evaluation of median N and ant interosseous N (C5, C6, C7)
Referral Pattern: Visceral Pain from the colon, appendix or pelvic viscera refers to
1) pelvis 2) low back 3) sacrum
Burn Deformities: KNee
Flexion COntraction
Receptive Function: A central language disorder in which speech is preserved and flows smoothly but comprehension is impaired
Wernicke's Aphasia
Skin disorders: Dermatitis causes by photosensitivity, reaction to sunlight or UV rays
Burn Deformities: Hip
Flexion and ADD contraction
Chronic Obstructive Disease: widespread narrowing of the airways due to inflammation and increased secretions
Burn Deformities: Hand
Claw Hand Contraction
Communication: impairment of speech production in the CNS?PNS mechanisms that control respiration, articulation, phonation and movements of jaw and tongue
Burn Deformities: Elbow
Flex and pronation contraction
Pregnancy: normal Postural changes
1) kyphosis with scap protraction 2) cervical lordosis with fwd head 3) lumbar lordosis
Sensory Stimulation Techniques: produces calming affect generalized inhibition
Maintained touch
Chronic Obstructive Disease: Thickened secretions of all exocrine glands, may present as obstructive, restrictive or mixed disease, pt unable to gain weight
Muscle Action: Gastroc/Soleus
Ankle PF
Muscle Action:FDL
2-5 DIP Toe Flex
Special Tests: 1) Pt supine with knee in extension, hip flexed and Abd to 30 deg 2) Place valgus force and flex knee
Pivot Shift
Special Tests: Indicates ACL integrity
Lachman's and Pivot Shift
Special Tests: Helps differentiate between Meniscus tear and ligamentous Lesions
Apply's Test
Special Tests: + finding of Mc Murray's Test
Click or px in knee joint
Special Tests: 1) Pt supine with knee in max flex 2) Passively ER and Extend knee
Mc Murray's test ( Medial Menisci)
Special Tests: 1) Pt supine with knee in max flex 2) Passively IR and Extend knee
Mc Murray's Test (Lateral Menisci)
Muscle Action:Semitendenosus
Knee Flex, Hip Ext
Muscle Action: Semimebranosus
Leg ER
Muscle Action: Ant Tib
Ankle DF
Muscle Action: EDL
2-5 toe Extension
Muscle Action: EHL
Great Toe Ext
Muscle Action: Peroneous Longus/Brevis
Ankle EVR
Muscle Action:Popletitus
Leg IR
Muscle Action:Tib Post
Ankle INV
Capsular Patterns: Thoracic Spine?
Capsular Patterns: HR Joint?
Capsular Patterns: Hip?
Capsular Patterns: Lumbar Spine?
Capsular Patterns: talocrural?
Capsular Patterns: Knee?
Capsular Patterns:Midtarsal?
Capsular Patterns: Subtalar?
Grades of Accessory Joint Motion: 1
Spinal Level Reflex: part of the stretch reflex, allows muscle tension to come under control of descending pathways
Gamma Reflex Loop
RLA: Pt shows goal-directed behavior, but is dependent on external input or direction. Follows simple direction consistently and shows carryover. Responses may be incorrect but are appropriate to situation
VI. Confused Appropriate
Capacity: IRV+TV, amount of air that can be inhaled from resting end expiratory pressure (REEP)
Inspiratory Capacity
Referral Pattern: Visceral Pain from the gallbladder, stomach, pancreas or small intestine refers to
midback or scap
endocrine system: Controls the release of GH, ACTH, follicle-stimulating hormone, lutinizing hormone, and prolactin
Ant pituitary
Regulation of Electrolytes and Fluids: Caused by excessive vomiting, excess diuretics, hypokalemia or excessive intake of antacids. can cause hypoventialtion
Metabolic Alkalosis
Heart: Close when ventricular wall contract
Atrioventricular valves
Heart: Prevent back flow of blood from aorta and pulmonary arteries in the ventricles during diastole
Semilunar Valve
Motor Learning Strategies: Readies the system in advance of movement; anticipatory responses that adjust the system for incoming sensory feedback or for future movements
Feed forward
Heart Cycle: amount of blood in the ventricle after systole usually 50 mL
End Systolic Volume
Heart Cycle: period of ventricular contraction and filling
Heart Cycle: usually about 120 mL of blood
end diastolic volume
Heart: supplies the right atrium, most of the right ventricle, inferior wall of left ventricle, AV node and bundle of His
Right Coronary Art
Heart: supplies most of the left ventricle
left coronary Artery
supplies the left ventricle and the interventricular septum, the inferior areas of the apex, originating from the left coronary art
Left Descending Art
Respiration: a period of apnea lasting for up to 60 sec followed by gradually increasing depth and frequency
Cheyne-Stokes respiration
RLA: 1) Pt appropriate and oriented 2) goes through daily routine automatically but robot like 3) min to no confusion 4) shows carry over for new learning but at decreased rate 5) judgement remains impaired
VII. automatic Appropriate
Brain: Controls emotions and judgement located in the frontal lobe
Precentral cortex
Brain:Controls motor aspects of speech located in frontal lobe
Brocca's area
CPR: Compression depth for 1) adults 2) children 3) infants
1) 2 in 2) 2 in 3) 1 1/2 in
Spinal Cord: conveys deep and chronic pain
Spinoreticular Tract
CPR: CPR sequence
1) Compression 2) Airway 3) Breathing
BP: Stage 1 HTN
BP: Stage 2 HTN
Special Tests: + drop arm test
unable to lower arm
Heart: Flattened T wave, prolonged PR and QT intervals, arrhythmias leading to ventricle Fibrillations
Drugs: decreases HR, blunts HR response to exercise
Beta Blockers
Special Tests: IDs impingement between RTC and Greater tuberosity or post glenoid and labrum
Post internal impingement test
Special Tests: IDs tear and/or rupture of the RTC
Drop arm test
ECG Drugs: depresses ST segment, flattens T wave, QT shortens
Special Tests: 1) Pt sitting with shld passively abd to 120 deg 2) Pt instructed to slowly lower arm
Drop arm test
ECG Calcium levels: prolonged QT interval
PNF techniques: voluntary relaxation combined with slow passive rhythmic rotations of the body or body part
Rhythmic Rotation
PNF techniques: Rhythmic initiation is indicated for
1) apraxia 2) uncoordinated motion 3) tonal impairments 4) motor learning deficits
PNF techniques: voluntary relaxation followed by passive increasing ROM 2) followed by active assisted movements 3) progressing to resistive movement 4) pt arom
Rhythmic initiation
PNF: Stimulates afferent Nerve ending and facilitates flexor M
Crania and Peripheral Nerve disorders: Polyneuritis with progressive symmetrical muscular weakness progressing from LE to UE form a distal to proximal fashion,
Crania and Peripheral Nerve disorders: a degenerative disease affecting the ant horn cell sand descending corticobulbar and corticospinal tract
Pain: syndrome that is continuous, intense occurring on the contralateral hemiplegic side. due to a stroke in the postlat thalmus
Thalamic Pain
Pain: Pain pathway for slow pain
1) C fibers 2) spinal cord lamina 3) ant spinothalamic tract 4) brainstem reticular formation and thalamus
Cranial and Peripheral Nerve disorders: cutting of the nerve with severance of all structures and complete loss of function
Crania and Peripheral Nerve disorders: Bell's Palsy involves which Nerve
CN VII Facial
Crania and Peripheral Nerve disorders: Weakness of the muscle innervated by the motor nuclei of the lower brainstem
Bulbar Palsy
Crania and Peripheral Nerve disorders: Affects the muscles of the face, tongue, larynx, and pharynx
bulbar Palsy
Vestibular Dysfunction: bilateral vestibular disorder related to vestibular neuropathy, otosclerosis
Paget's Disease
Vestibular Dysfunction: Postive sign for BPPV
Hallpike dix
Cranial and Peripheral Nerve disorders: injury to nerve that causes transient loss of function caused by compression
Cranial and Peripheral Nerve disorders: injury to nerve that causes transient loss and wallerian degeneration caused by a crush injury and regenertion is possible
Wound Dressing: Semi-permiable membranes that are either hydrophillic or hydrophobic for partial or full thickness wounds
Immune System: located in the upper left abdominal cavity between the sotmach and diaphragm to filter out antigens and produce leukocytes, monocytes, lymphocytes and plasma cells in response to infection
Wound Dressing: adhesive wafers containing absorptive particles that react with wound fluid to form a gel; for the protection of partial thickness wounds
Wound Dressing: Water or glycerine based gels for partial are for partial of full thickness wounds
Wound Dressing: Advantages: 2)impermiable to external liquids 3) promotes autolytic debridement
Transparent Film
Wound Dressing: Disadvantages 1) non absorptive 2) not to be used on wound with fragile surroundings
transparent Film
Medication: produces smooth muscle relaxation
Medication: inhibition of the PN, increase HR, BP and bronchodilation
Medication: Mimic activity of SNS allowing for brochodilation
Long-Acting Beta 2 Agonist
Respiration Therapy: Pt lies on abdomen with two pillows under hips. Percussion over middle of back
Lower lobes superior segment
Respiration Therapy: Foot of table elevated 20 in. Pt lies on abdomen, head down with pillow under hips. percussion over lower ribs close to spine
Posterior lobes Posterior Basal
Respiration Therapy: Foot of table elevated 20 in. pt lies on abdomen head down with 1/4 turn upward. percussion over uppermost portion of lower ribs
Lower lobes Lateral Basal Segment
Respiration Therapy: Foot of table elevated 20 in. pt lies on side with head down. Percussion over lower ribs
Lower lobe Anterior Basal Segment
Respiration Therapy: Foot of table elevated 16 in. Pt lies head down on right side with 1/4 rotation backward. Percussion over left nipple area
Left Middle Lobe
Respiration Therapy: Foot of bed elevated 16 in. pt lies head down on left side and rotates 1/4 turn backwards. Percussion over right nipple
Right middle lobe
Respiration Therapy: Pt lies on back with pillow under knees. Percussion between clavicle and nipple
Upper Lobe Anterior Segment
Special Tests: + sign for FABERs Test
Unable to assume relaxed Position
Cranial Nerves: Pure Sensory CN
Neurons: Pain, reflex response C fibers
Dorsal Root
MS Pathology Nerves: 1) increased px on FWD shld flex 2) Shld Weakness 3) Px increases with scapular abd 4) Pain increases with cervical rot to opp side
Suprascapular N.
Neurons: Touch pressure A fibers
Beta Fibers
Neurons: Proprioceptive, somatic a fibers
Alpha Fibers
Neurons: Large, myelinated fast conduction
A fibers
Meninges: thin vascular membrane that covers the brain surface
Pia Matter
Neurons: Small unmyelinated and slow conducting
C fibers
Neurons: small, myelinated preganglionic fibers
B fibers
Neurons: pain, temperature, touch A fibers
Delta Fibers
Neurons: motor to muscle spindle A fibers
Gamma Gibers
MS Pathology Nerves: 1) Px on flex fully ext arm 2) inability to flex fully ext arm 3) winging starts and 90 deg Fwd Flex
Long Thoracic N
Special Tests: 1) Pt lies supine 2) Passively felx, abduct and ER leg so that foot is resting above knee of opp leg 3) Lower leg down to table
FABER test
MS Pathology Nerves: 1) inability to abd with neutral rot
Axilary N.
MS Pathology Nerves: Weak elbow flex with froearm sup
musculocutaneous n
MS Pathology: 1) Medial elbow px 2) paresthesia to 5th and medial 4th digit
ulnar N entrapment
MS Pathology: Causes of Ulnar N Entrapment
1) Direct Trauma to cubital tunnel 2) traction of ulnar N 3) Compression due to thickened retinaculum 4) hypertrophy of FCU M.
MS Pathology: 1) Repetitive gripping activities 2) aching pain and weakness in forearm M. 3) paresthesia in 1-4 palmar digits
Median N entrapment
MS Pathology: 1) lat elbow Px 2) px over supinator M. 3) parathesis in dorsal side digits 1-4
Radial N entrapment
Special Tests: Pt max flexes both wrist holding them against each other for 1 min
Phalen's Test
MS Pathology: Complication of Colles Fx
1) loss of motion 2) decreased grip strength 3) CRPS 4) CTS
Special Tests: Normal amount of distance that can normal be detected during two point discrimination test
Special Tests: IDs hip dysfunction and mobility restriction
Special Tests: 1) Pt grasps paper between 1st and 2nd digits 2) PT pulls paper out and looks for IP flexion of thumb
Froment's Sign
Heart: Normal Stroke volume
55-110 ml/beat
MS Pathology: 1) most common wrist fx
Colles Fx
Cranial Nerves: CN I Function and Name
Smell and Olfactory
Special Tests: IDs compression of the Median N. in the carpal tunnel
Tinnel's Sign or Phalen's Test
Skin disorders: Viral infection by HPV
Thyroid Disorder: Graves disease
Skin disorders: Viral infection reactivation bu a virus lying dormant in cerebral ganglia; pain and tingling affecting spinal Nerve dermatomes
Herpes Zoster (Shingles)
Respiration Therapy: Pt leans back on a pillow at 30 deg. percussion between clavicle and top of scapula each side
Upper Lobe Apical Segment
Sensory Stimulation Techniques: facilitates agonist muscle and inhibits antagonist muscles
Quick stretch
Skin disorders: pus inflammation of cellular or connective tissue in or close to the skin; skin is hot red and edematous
Skin disorders: superficial skin infection caused by bacteria; presented as inflammation, small pus filled vesicles and itching
Cranial Nerves: CN VI (abducens) Function
Turns Eye out
Respiration Therapy: Pt leans over pillow at 30 deg. Percussion on upper back
Upper Lober Posterior Segment
Auscultation Landmarks: 2nd left intercostal space at the sternal boarder
Pulmonic Valve
Cranial Nerves: CN VI Test
observes position of eye and pursuit movement
Skin disorders: Stage of dermatitis with erythematous skin, scaling scattered plaques
Sensory Stimulation Techniques: inhibits agonist muscle and dampens high tone
prolonged slowly applied stretch
Respiration: Depression of the frontal lobe and diencephalic dysfuntion
Cheyne-Stokes Respiration
Skin disorders: Stage of dermatitis that presents as red, oozing, crusting rash; extensive erosions, exudate
Symptoms: No px in reclined or semi-reclined position 2) px increases in WB activities 3) Shooting , burning, stabbing px 4) altered strength inability to perform ADLs
Discal with Nerve Root Compromise
Symptoms: 1) Px related to position 2) Flexed position decrease px 3) ext positions increase px 4) numbness, tightness or cramping 5) walking increase px 6)px last for hours after quitting activity
Spinal Stenosis
Symptoms: Px is constant in all spinal positions 2) px increases with physical exertion 3) px relived promptly by rest 4) numbness 5) decreased or absent pulses
Vascular Claudication
Symptoms: gnawing, intense , penetrating px 2) px not resolved by changes in position, time of day or activity level 3) px will wake pt
Neoplastic Disease
Spinal Nerves: Spinal Cord Ends at what section of the Spine
ROM: TMJ Opening
Symptoms: 1) Px and Stiffness upon rising 2) Px eases through Morning 3) Px Increases w/ repetitive bending activities 4) constant discomfort with exacerbation 5) Sore nagging Px
Symptoms: 1) Stiff upon rising 2) Px eases within an hour 3) Loss of Motion with px 4) Sharp pain with certain movements 5)movement in px free Range reduces symptoms 6) Stationary increase symptoms
Facet joint Dysfunction
Skin disorders: thickened skin, increased skin marking secondary to scratching
ROM: Shld 1) Flex/EXT 2) ABD/ADD 3) ER/IR 4) Horz ADD
1) 160-180/50-60 2) 170-180/50-75 3) 80-90/60-100 4) 130
ROM: Elbow 1) FLEX/Ext 2) Sup/Pro
1) 140-150/0-10 2) 90/90-90
PNF techniques: simultaneous isometric contractions of both agonist and antagonist perfromed without relaxation
Rhythmic Stabilization
Sensory Stimulation Techniques: recuits motor units, facilitates strengthen agonist contraction
Chemoreceptors: An increase in CO2 or decrease in O2 or decrease in pH levels results in what changes in heart
Increased in Heart Rate
Burn Management: dressing applied on top of topical agent and prevents bacterial contamination, and fluid loss
Occlussive (closed) technique
Heart: Decreases in heart actions caused by an imbalance in calcium levels
Heart: Risk Factors for CAD
1) Men > 45 Women > 55 2) MI or Sudden death in 1 degree male relative before 55 female 65 3) Sedentary Lifestlye 4) >30 bmi >40 in waist men >35 in female 5) SBP >140 DBP> 90 6) LDL > 130 HDL <40
PNF techniques: slow isotonic contraction of first agonist the antagonist
Dynamic Reversals (Slow reversals)
Pharmacology: 1) cyclobenzprine HCL (Flexeril) 2) methocarbamol (Robaxin) 3) carisoprodol (soma)
muscle relaxants
Regulation of Electrolytes and Fluids: Caused by acute renal failure, kidney disease metabolic acidosis diabetic ketoacidosis, sickle cell
Muscle Action:Dorsal Interossei
Muscle Action: FHL
Great IP Flex
Muscle Action: FDB
2-5 PIP Toe Flex
Muscle Action:Plantar Interossei
Pathology: What motion can aggravate the Deep trochanteric bursa
Hip Flex and Hip IR
Pathology: Aggravation of Ischiofemoral Bursa can cause pain in what nerve distribution?
Blood Supply: Femoral Head
Branch of Obturator A.
Blood Supply: Proximal Femur
Medial and Lateral Femoral Circumflex A.
Gait: Normal ROM For the knee
15 Deg
Blood Supply: Acetabulum
Branch of INF/SUP Gluteal A.
SCI: Steps to take for Autonomic Dysreflexia
1) Elevate Head 2) check and Empty Catheter
SCI: Loss of Pain temperature and light touch below level of lesion
Contralateral Spinothalmic Tract Lesion
SCI: 1) 1) ipsilateral weakness and loss of position and vibration sense below level of lesion 2) contralateral loss of pain and temp a few segment below the lesion
Brown Sequard Syndrom
SCI: bilateral loss of pain and temperature and preservation of proprioception and discriminatory senses in UE
Central Cord LEsion
Wheelchair Prescription: C1-C4 Lesion
1) Electric Wheelchair 2) tilt-in-space 3) puff and -sip controls
RLA: Pt able to respond to simple commands fairly consistently. Responses become non-purposeful when commands become more complex. Has gross attention to environment but is highly distractible
V. Confused-Inappropriate
Coxa Vara Angle
Normal anterior Antetorsion of the hip
Angle of Inclination of the Hip
Coxa Valga Angle
Innervation: Hypothenar Region, 5th digit and medial half of 4th
Ulnar N.
Innervation: Palmar Lateral 1/2 of 4th and 3rd, 2nd, and 1st digit and Dorsal 2nd, 3rd and lateral 1/2 4th
Median N.
Ligament Function: Annular
protects radial head
Blood Supply: Elbow Joint
1. Brachial Artery 2. anterior ulnar Recurrent A3. Post ulnar Recurrent A. 4. Radial Recurrent A.5. Middle Collateral branch of deep brachial A.
Excessive Anteversion
Excessive Retroversion
ECG: abnormal Q or QS in leads II, III, aVF
inferior infarction
RLA: Pt is in a heightened state of activity. Behavior is bizarre and non-purposeful. unable to cooperate directly with treatment efforts. Verbalizations are incoherent. Attention is brief. Lacks short term and long term recall
IV. Confused-Agitated
Arrhythmias: rapid and repetitive firing, P wave abnormal
Atrial Arrhythmias
endocrine system: control the release of hormones
1) hypothalamus 2) pituitary gland
WBC:Exercise prescription when WBC <1000
use mask, standard precaution
MS Pathology: 1) Decalcification of bone due to Vit D deficiency
MS Pathology: 1) Congenital deformity of skeleton and ST 2) limited joint motion 3) sausage like appearance of limbs
Arthrogryposis Multiplex Congenita
Skin disorders: causes itching redness and skin lesions
Vestibular Dysfunction: Breif attacks of vertigo and nystagmus that occur with certain head positions
MS Pathology: 1) Chronic, erosive inflammatory disorder 2) occurs in joins of digits and axial skeleton
Psoriatic Arthritis
MS Pathology: 1) Pain referral 2) px with hyperextension and rot 3) spine stiffness 4) M. Spasm
Facet Syndrome
MS Pathology: 1) Pain Referral 2) Pain with hyperextension and Rot of the Neck 3) Parathesis 4) M. Spasms 5) (+) tension test
Cervical N Root
MS Pathology: Symmetrical pattern of dysfunction in synovial tissues and articular cartilage 2) ulnar drift 3) volar subluxation
Gait: Ankle ROM
1) 0-10 deg of DF 2) 0-20 deg PF
Gait: Phases of gait that requires 10 deg of DF
Gait: Phases of gait that requires 20 deg of PF
MS Pathology:1) AM Stiffness 2) Male > women 3) Bil Si px refers to post thigh 4) Restricted AROM and PROM
Ankylosing Spondylosis
Heart Sounds: murmur of arterial or venous origin common with atherosclerosis
Special Tests:+ Adson's test
Neuro or vascular symptoms will be reproduced
Special Tests: 1) Pt sitting 2) Find radial pulse 3) move extremity down and back
Costoclavicular Syndrome Test
Vestibular Dysfunction: recurrant and usually progressive, tinnitus, deafness, sensation of pressure, edema of labryinth
Meniere Disease
Heart Sounds: Decreased when there is 1st degree heart block
Special Tests: IDs pathology of structures that pass through thoracic inlet
Adson's test
Auscultation Landmarks: 5th left intercostal space at the midclavicular area
mitral valve
Special Tests: 1) Pt sitting 2) find radial pulse of extremity being tested 3) rotate head toward tested side 4) extend and ER shld while extending head
Adson's Test
PNF techniques: an isometric contraction of the range-limiting antagonist pattern is performed against slowly increasing resistance followed by relaxation and passive movement into new range
Special Tests: + Costoclavicular Test
Nuero or vascular symptoms will be produced
Heart Sounds: associated with ventricular filling: heard in older individuals with congestive heart failure
PNF techniques: repeated stretch linked to voluntary effort to contract stretched muscles
Repeated Stretch
Burn: Healing for Superficial partial thickness Burn
Spontaneous 7-21 day min scarring
Skin disorders: disease of connective tissue characterized by edema, inflammation, and degeneration of the muscles, Affects primarily proximal muscles
Diagnostic Testing : Measure Central Venous Pressure, pulmonary artery pressure,
Central Line
Skin disorders: Chronic diffuse disease of connective tissues causing fibrosus of skin, joint, blood vessels, and internal organs
Skin disorders: Lupus that affects multiple organs, skin, joints, and can be fatal. Butterfly rash across the bridge of the nose is a sign
systemic Lupus
Skin disorders: Lupus that only affects the skin; flareups with sun-exposure
Discoid Lupus
PNF techniques: isotonic movement is performed followed by an isometric hold or the range limiting muscles in the agonist pattern against slowly increasing resistance, then relaxation and active contraction into new range
Skin disorders: PT treatment for psoriasis
long wave UV light with photosensitizing drugs
Skin disorders: Chronic disease of the skin characterized by erythematous plaques covered with silver scales affecting the ears, scalp, knee and elbows
Skin disorders: Fungal infection of the foot, which can progress to cellulitis if left untreated
Athlete's Foot (tinea pedis)
Skin disorders: fungal infection involving hair, skin or nails and form ring shaped patches
Edema: 0-1/4 inch indentation
PNF techniques: UE D1F (Diagonal 1 Flexion)
1) Shoulder flex 2) Shoulder Add 3) Shoulder ER
Heart: Left heart valve
Bicuspid (mitral valve)
PNF techniques: UE D1Ext
1) Shld Ext 2) Abd 3) IR
edema: Last for 30 sec or more > 1 inch pitting
MS Pathology: Most shld dislocation occur in what direction
Ant and inf direction
MS Pathology: Deg of structural Scoliosis where surgical treatment is performed
>45 deg
Special Test: Test to ID maligering pts with LBP
1) hoover 2) Burn's 3) Waddell's
radiology : 1) air is black 2) Fat is absent 3) Bone is white
radiology: 1) air is black 2) Fat is black 3) bone is white 4) bone marrow is gray
CT scan
Radiology: 1) Air is black 2) Fat is white 3) Bone is black 4) bone Marrow is white
radiology: 1) air is black 2) fat is gray 3) bone is black 4) bone marrow is gray
Brain: primary motor cortex located in the frontal lobe
Precentral Gyrus
MS Pathology: Separation of articular cartilage from bone 2) usually involve medial femoral condyle
osteochondritis dissecans
MS Pathology: 1) Abnormal collagen synthesis 2) imbalance between bone deposition and reabsorbtion 3) Bone become very weak and thin
Osteogenesis Imperfecta
MS Pathology: 1) dysfunction of sympathetic Nervous system 2) triggered by tissue injury
CRPS type I
MS Pathology: 1) Precipitated by direct trauma resulting in hematoma and calcification of muscle belly 2) also be induced by early mobilization, stretching and aggressive PT after Muscle trauma
Myositis Ossificans
MS Pathology: 1) Metabolic bone disease with abnormal osteoclastic and osteoblastic activity 2) Results in Spinal Stenosis 3) Facet arthropathy 4) Spinal Fractures
Paget's Disease
MS Pathology: 1) Dysfunction of Sympathetic nervous system 2) associated with Nerve injury
MS Pathology: Deg of structural Scoliosis where spinal orthosis must be worn
25-45 deg
MS Pathology: Deg of structural Scoliosis where conservative treatment can be done
<25 deg
Heart: smooth lining of the inner surface and cavities of the heart
Blood Values: Normal PaCO2
CN: Controls the cardiac plexus and innervates all myocardium and releases of ACH
CN X (vegas)
Cranial Nerve and Peripheral Nerve Syndrome: 1) asymmetrical weakness and atrophy 2) abnormal fatigue 3) cold intolerance 4)
Blood Values: PaCO2 increases with what
Ulcer Debridement: natural debridement under occlusive moisture retentive dressings, proper for pt who cant tolerate other forms of debridement. Not for infected wounds, immunosupressed pt or dry ischemic wounds
Heart: Indicates and impaired LV
Low EF
Obesity: BM I Formula
weight (KG)/height(m)ˆ2
Degenerative Disorder: Common visual Problems with MS
1) diplopia 2) blurred vision
Obesity: BMI≥40
morbidly obese
Obesity: BMI ≥30
Obesity: BMI 25-29.9
Diabetes Mellitus: A fasting Glucose level of what is diabetic
Sensory Stimulation Techniques: enhances joint awareness, action of flexors relieves muscle spasm
Joint Traction
Diabetes Mellitus: a glucose level of what is considered to be diabetic
Sensory Stimulation Techniques: Firm pressure on long tendons that inhibit muscles dampens tone
Inhibitory pressure
Ulcer Debridement: using sterile instruments to remove necrotic wound tissue
Degenerative Disorder: Coordination problems with MS
Sensory Stimulation Techniques: initiates phasic withdrawl reactions
light quick touch
Ulcer Debridement: removes foreign material and contaminated tissue and may remove healthy tissue as well, good for moist necrotic wounds not for granulated wounds
Special Tests: + 90-90 Hamstring Test
Unable to reach 10 deg from full extension
Special Tests: 1) Pt supine with foot of test leg passively placed lat to opposite knee 2) Test hip is add
Piriformis Test
Special Tests: IDs abnormal femoral ante-torsion angle
Craig's Test
Special Tests: Normal angle based on Craig's Test
8-15 deg
Diagnostic Imaging: assess soft tissue structures
Diagnostic Imaging: Suppresses fat and demonstrates tissues with high water content
Special Tests: IDs weakness of Glut Med or unstable Hip
Trendelenberg's Sign
Special Tests: Special Tests: + Trendelenberg's Sign
Ipsilateral pelvis drops
Diagnostic Imaging: Images are multi-planar and tissues can be viewed from multiple angles
CT Scan
Diagnostic Imaging: Used for complex fractures, facet dysfunction, disc disease or spinal stenosis
CT Scan
Diagnostic Imaging: demonstrates fat within the structures and assess bony anatomy
Diagnostic Imaging: Radiopaque Dye Injected into disc to id abnormalities
ROM: Hip 1) Flex/EXT 2) ABD/ADD 3) ER/IR
1) 110-120/10-15 2) 30-50/30 3) 40-60/30-40
ROM: wrist 1) Flex/ext 2) Radial/Ulnar
1) 80-90/70-90 2) 15/30-45
ROM: Ankle 1) Sup/Pro 2) PF/DF
1) 45-60/15-30 2) 50/20
ROM: knee 1) Flex/EXT 2) ER/IR
1) 135/0-15 2) 30-40/20-30
Muscle Substitution: Finger Flexors Weak?
Tenodesis, Passive Finger Flex with Wrist Ext
Muscle Substitution: Pecs Weak
LOng Head Biceps, Coracobrachialis, Ant Delt
Muscle Substitution: Shoulder Abd weak?
Scap Stabilizers
Muscle Substitution: Hip Abductors Weak?
Lat Trunk M. TFL
Capsular Patterns: OA Joint?
Capsular Patterns: AA Joint?
Muscle Substitution: Hip Extensors Weak?
Low Back Extensor, Adductor Magnus, QL
Muscle Substitution: Hip Flexors Weak?
Lower Obliques, Low Abs, Lat Dorsi, Hip Add
Regulation of Electrolytes and Fluids: Caused by water intoxication and can cause confusion decreased mental alertness and poor motor coordination
Capsular Patterns: GH Joint?
Capsular Patterns: HU Joint?
GCS: Scores of Severe brain injury
GCS: Scores of moderate brain injury
Cranial Nerves: Pure Motor CN
Skin disorders: Chronic, progressive inflammatory disorder of connective tissues; characterized by a red rash with raised red scaly plaques
Special Tests: IDs DJD of Hip
Grind Test
RLA: Pt acts specifically but inconsistently to stimuli. May follow simple commands in an inconsistent and delayed manner
III. Localized response
Special Tests: 1) Pts supine with hip in 90 deg flex and knee max flex 2) PT places compressive load into femur
Grind Test
endocrine system: control the release of testosterone
RLA: Pt reacts inconsistently and non-purposefully to a stimuli. Responses are limited and often the same regardless of the stimulus
II. generalized response
endocrine system: hormone that allows the uptake of glucose from the blood system, suppresses hepatic glucose production
Sensory Stimulation Techniques: slow repetitive rocking that produces generalized ihibition of tone relaxion and calming effect
Slow, maintained vestibular stimulation
MET Level: Carrying 80 lbs, jogging 5mph, biking 12 mph, vigorous skiing,
7-8 METS
Sensory Stimulation Techniques: spinning or fast rolling that produce generalized facilitation of tone improved motor coordination and improved retinal image stability
Fast irregular vestibular stimulation
Regulation of Electrolytes and Fluids: caused by diabetes, renal insufficiency, diarrhea. can cause deep respiration, nausea, poor skin turgor
Metabolic Acidosis
Medication: alter conductivity, restore normal HR rhythm, improve cardiac output
endocrine system: controls te release of insulin, glucagons and somatostatins
pancreatic islet cells
Heart Cycle: the period of ventricualr contraction
endocrine system: control the release of calcitonin
thyroid C cells
endocrine system: controls the release of parathyroid hormone
Parathyroid gland
Pain: fast pain is transmitted over what fibers
A Delta Fibers
Pain: Pain pathway for fast pain
1) A delta Fibers 2) spinal cord dorsal horn lamina 3) excites lateral spinothalamic tract 4) brainstem reticular formation and thalamus 5) cortex
Peripheral Vascular System: Curvature of fingernails associated with chronic O2 deficiency Heart Failure
BP: Stage 3 HTN:
Peripheral Vascular System: ABI .8-1
mild Peripheral aretery disease
Peripheral Vascular System: Bil edema associated with
Heart Failure
Peripheral Vascular System: peripheral causes of edema
chronic venous insufficiency and lymphedema
Peripheral Vascular System: Pain is typical in calf, and can be experienced at rest, worse at night
Arterial insufficiency
Crania and Peripheral Nerve disorders: 1) muscular weakness that spreads over time 2) spasticity, hyperreflexia 3) leading to death in 2-5 years
Special Tests: Indication of a retroverted hip
<8 deg
Stages of ALS: Moderate Weakness in groups of muscles, some wasting modified independence with AD
Stage 2
Stages of ALS: Severe weakness of specific muscles, increasing fatigue, mild to moderate functional limitation, ambulatory
Stage 3
Stages of ALS: Severe weakness of LEs mild weakness in UEs, mod assistance and assitive devices required, WC user
Stage 4
Stages of ALS: Progressive weakness with deterioration of mobility and endurance, increased fatigue, moderate to severe weakness of all limb and trunk, spasticity hyperreflexia loss of head control, max assist
Stage 5
Stages of ALS: bedridden, dependent,
Stage 6
Special Tests: Deg of an anteverted hip
>15 deg
Gait Training and Orthotic Prescription: Mid Thoracic Lesion (T6-T9)
1) Supervised amb for short distances 2) Bil KAFO and crutches 3) Swing-to gait pattern
Wheelchair Prescription: Hand Function (C8-T1)
1) Manual WC 2) Standard hand rims
Gait Training and Orthotic Prescription: Low Lumbar Lesions (L4-5)
1) IND with bil AFO and Crutches/Cane
Gait Training and Orthotic Prescription: High Lumbar Lesions (T12-L3)
1) IND in ambulation on all surfaces and stairs 2) swing through gait or 4 point 3) Bil KAFO and Crutches 4) Household Distance
Degenerative Disorder: Chronic, progressive, demyelinating disease of the CNS affecting Young Adults
Contraindication for Exercise for SCI pt
1) Autonomic Dysreflexia 2) UTI 3) uncontrolled Spasticity 4) Unstable Fx 5) uncontrolled hot environment 6) Insufficient ROM
Degenerative Disorder: Common in pyramidal tracts, dorsal columns, and periventicular areas of the cerebrum
Degenerative Disorder: impair neural transmission cause nerves to fatigue rapidly
Degenerative Disorder: MS disease progression from onset without plateaus or remission
Primary-progressive MS
Degenerative Disorder: MS that relapses with full recovery or some remaining sign
Relapsing-Remitting MS
Skin Ulcers: Stage of Pressure Ulcer 1) full thickness skin loss that involves the destruction of the muscle, bone or supporting structures
stage 4
CAD: coronary insufficiency with risk for MI, doe snot occur at predictable RPP and pain is difficult to control
uncontrolled Angina
LOC: Pt appears drowsy: can open eyes and look at examiner, respond to questions, but falls asleep easily
Chronic Obstructive Disease: Abnormal dilation of bronchi and excessive sputum production
Chronic Obstructive Disease: Alveolar collapse in premature infants resulting in lung immaturity and inadequate levels of surfactant
Respiratory distress syndrome
Chronic Restrictive Disease: etiologies for restrictive diseases
1) alteration in lung parenchyma and pleura 2) alteration in the chest wall 3) alteration in neuromuscular apparatus
Trauma: two of more fractures in two or more adjacent ribs
flail chest
Trauma: air in pleura space
LOC: pt can open eyes, look at examiner, but responds slowly and is confused: demonstrates decreased alertness and interest in environment
Blood Values: pH increases with
respiratory Alkalosis and metabolic alkalosis
Blood Values: pH below 7.35
Blood Values: Normal INR
< 2
Blood Values: ph decreases with
respiratory acidosis and metabolic acidosis
Blood Values: INR>3
increased risk of hemarthrosis
Examination of the Skin: Pruritus; common in Diabetes
LOC: pt can be aroused from sleep only with painful stimuli; verbal responses are slow or absent; pt returns to unresponsiveness state when stimuli are removed; min awareness of self or environment
CAD: imbalance in myocardial O2 supply and demand
Angina Pectoralis
CAD: modifiable risk factors of Atherosclerosis
1) cigarette smoking 2) high BP 3) elevated cholesterol level 4) obesity 5) inactivity 6) stress
Referral Pattern: Visceral Pain from the liver, diaphragm, or pericardium refers to
LOC: pt cannot be aroused, eye closed, no response to external stimuli or environment
endocrine system: hormone that stimulates hepatic glucose production
Heart: Responds to change in BP
Circulatory Reflex
RPE: values of 12-13 correlate to what percentage of HR
Spinal Level Reflex: Flexor reflex function
protective withdrawal mechanism to remove body part from harmful stimuli
ECG: abnormal Q or QS in Lead 1, aVL
Lateral infarction
Shock: Caused by hemorrhage, vomiting or diarrhea
Hypovolemic Shock
CA: Cautious exercise when platelet counts between
Spinal Level Reflex: flexors of one side are excited causing extensors to be inhibited Opposite action on opposite side of body
Crossed extension Reflex
CA: Contraindicated when platelet counts below 20,000
Meninges: Delicate, vascular membrane
Meninges: formed by arachnoid and pia matter, contains CSF and cisterns
Subarachnoid Space
Spinal Cord: innervations of the smooth M. heart, glands, and helps maintains homeostasis
Spinal Cord: Prepares body for flight or fight response, increases heart rate and BP, constricts peripheral blood vessels and redistributes blood
Sympathetic ANS
Spinal Cord: Conserves and restores homeostasis, slows HR and reduces BP, increases peristalisis and gladular activity
Parasympathetic ANS
Meninges: Outer, tough fibrous, attached to inner surface of cranium
Dura Matter
Spinal Cord: important for control of muscle tone, antigravity M. and postural reflexes
Vestibulospinal Tract
Spinal Cord: Assists in motor function arising from the red nucleus
Rubrospinal Tract
Spinal Cord: Modifies transmission of sensation and influences gamma motor neurons and spinal reflexes
Reticulospinal System
Spinal Cord: Assists in head turning responses and visual stimuli
Tectospinal tract
Special Tests: 1) pt supine with knee in extension 2) Place one hand on suprapatellar pouch 3) Place other hand on ant aspect of joint line 4) alternate pushing down with one hand at a time
Flucuation Test
Special Tests: Indicates Knee joint effusion
Fluctuation Test
Special Test: Anterior Drawer test IDs instability in which ligament?
Special Tests: + Sign for fluctuation test
movement of fluid
Special Tests: Pt Supine with knee in extension 2) Push Post on Sup pole 3) Ask pt to perform active quad contraction
Clark's Sign
Special Tests: IDs patellofemoral Dysfunction
Clark's Sign
Special Tests:+ Patellar tap Test
perception of patella floating
Special Tests: Indicate infrapatellar effusion
Patellar Tap Test
Special Tests: IDs dysfunction of ulnar n at olecranon
Tinel's Sign
Which N is trapped if performing a pronator teres test
Median Nerve
Special Tests: + lat epicondylitis test
px in lateral epicondyle
Special Tests: 1) Pt sitting 2) elbow 90 deg flex 3) passive sup of forearm 4) extend elbow 5) extend wrist
Golfer's Elbow test (medial epicondyle test)
Special Tests: Talar Tilt IDs instability in which lig if moved into ABD
Deltoid Lig
Special Tests: Talar Tilt IDs instability in which lig if moved into ADD
Special Tests: IDs deQuervain's Tenosynivitis
Finklestein's Test
Pathology: Paratendonitis of the abd pollicis longus and/or brevis
deQuervain's Tenosynovitis
Motor Learning Strategies: Afferent information sent by various sensory receptors and control centers
Hepatitis: transmission primally through fecal-oral route; contracted through contaminated food or water
Hep A
Hemophilia: Rarely used due to the risk of myositis ossificans
Passive Stretching
Medications: a common sign of hepatotoxicity (resulting from HIV medication)
Pharmacology: Commonly prescribed for skeletal muscle spasm
muscle relaxants
Pharmacology: Side effects to NSAIDS
1) GI irritation 2) fluid retention 3) renal or liver problems 4) prolonged bleeding
Skin Ulcers: associated with chronic venous insufficiency, hx of DVT
Venous Ulcer
Burn Deformities: Ankle
PF contraction
Immune System: 2 major criteria for chronic fatigue syndrome
1) six months of new fatigue unrelieved by rest 2) Exclusion of chronic conditions
PT Interventions: Oscillations are large in amplitude and at the end range of joint play
Grade III JT
PT Interventions: oscillations are large in amplitude and at the midrange of joint play
Grade II JT
PT Interventions: High velocity and low amplitude at the end of joint play
Grade V JT
PT Interventions: Oscillations are small in amplitude and at the end of joint play
Grade IV JT
PT Interventions: Contraindication for joint manipulations/ joint mobilization/ joint oscillation
1) joint ankylosing 2) malignancy involving bone 3) disease that affect integrity of ligs 4) arterial insufficiency 5) active inflammatory of infective process 6) DJD 7) metabolic bone disease 8) hypermobility 9) Joint replacement 10) pregnancy 11) spondylolisthesis
PT Interventions: Used to regain normal joint mechanics as well as decrease pain and muscle guarding
Grade V
Pharmacology: 1) ibuprofen (Motrin) 2) naproxen sodium (aleve) 3) salsalate (discaled) 4) indomethacin (indocin)
Pharmacology: Prescribed for pain relief for MusculoSkeletal dysfunction
Brain: Control of sensory, motor and reticular pathways located in the Diencephalon
Brain: Maintains body homeostasis: regulates body temperature eating, water balance, sexual behavior ant pituitary located in the diencephalon
Degenerative Disorder: rigidity, bradykinesia, resting tremors, impaired postural reflexes
Cranial Nerves: VII (Facial) Function
Facial Expression
Motor Learning Strategies: capability to apply what has been learned to other environmental contexts
Resistance to Contextual Change
Heart: Supplies blood to the lateral and inferior walls of the let ventricle and orginates from the left coronary art
Circumflex art
immune System: primary central gland of the immune system
Spinal Cord: contains efferent (motor) neurons
Anterior horn
Shock: Caused by a drop in SBP of 10-20 or more
Orthostatic Shock
Spinal Cord: Neurons that effect muscles
Alpha Motor neurons
PT Intervention: When is exercise contraindicated for pts with platelet disorder
Regulation of Electrolytes and Fluids: caused by reduction in albumin level, hypothyroidism, malabsorbtion of VIT D and calcium
Muscle Action: External Intercostals
Muscle Action: Ant Interior Intercostals
Blood Supply of the Ankle
Deep Tibial and Fibular A.
Muscle Action: Diaphragm
Muscle Action: External Obliques
Forced Expiration, Spine Flex, Spine Rot
Muscle Action: Post Int Intercostals
Forced Expiration
Muscle Action: Internal obliques
Forced Expiration, Spine Flex, Spine Rot
Muscle Action: Transverse Abs
Forced Expiration
RLA: Pt appears to be in a deep sleep and is completely unresponsive to any stimuli
I. no response
Assesses cognitive recovery from a TBI
Ranchos Los Amigos Levels of Cognitive function
Muscle Action:Rectus Abdominus
Forced Expiration, Spine Flex
Muscle Action: Erector Spinae
Spine Extension
MMSE: Score that indicates mild cognitive impairment
scores of minor brain injury
MMSE: Score that indicates severe cognitive impairment
MMSE: Score that indicates moderate cognitive
ANS: parasympathetic and sympathetic control center is regulated by which area of the brain
Medulla Oblongata
SNS: Changes of the heart caused by the SNS
1) increase in rate and force of contraction 2) coronary a. vasodilation 3)
PNS: the PNS causes which changes in the the heart and vascular system
1) Slows rate of the Heart and Force of the contraction 2) Coronary A vasocanstriction
Special Test: Procedure for Vertebral Art Test
1) Ext head 2) Extend Head With Rot to LEft then to Right 3) Head extended off table 4) Head extended off table with rot to left then right
Special Test: Differentiates between vascular vs. vestibular causes of Vertigo
Hautant's Test
Cardiac Rehabilitation: Termination of Exercise in Stage 1 rehab
1) >110 DBP 2) Decrease in SBP >10 3) dysrhythmias 4) 2nd-3rd degree heart block
BP: An increase in BP will cause which changes in the ANS
1) Stimulation of PNS 2) Inhibition of SNS
Arrhythmias: a Serious PVC
>6 time per minute
Arrhythmias: a run of three or more PVCs occurring sequentially; ECG wide, bizarre QRS no P wave
PVC Tachycardia
Skin Ulcers: 1) irregular dark pigmentation with good granulation 2) Med malleoli 3) little pain 4)
venous ulcer
Heart Sounds: ventricular filling an aortic contraction: indication of CAD, MI, aortic stenosis or chronic HTN
ECG: Atrial depolarization
P wave
ECG: time required for impulse to travel from atria to Purkinje fibers
P-R interval
ECG: Ventricular depolarization
QRS wave
ECG: beginning of ventricular repolarization
ST segment
ECG: Ventricular repolarization
T wave
ECG: time for electric systole
QT interval
Arrhythmias: premature beat arising from the ventricle; no P wave, a bizarre and wide QRS followed by a compensatory pause
PNF techniques: UE D2 Ext
1) Shld Ext 2) ADD 3) IR
Special Tests: 1) Pt supine 2) Shld 90 deg abd 3) slowly ER shld
Ant Apprehension sign
Special Tests: IDs past ant shld dislocation
Ant apprehension sign
PNF techniques: LE D1 Flex
1) Flex 2) Add 3) ER
PNF techniques: LE D2 Ext
1) Hip Ext 2) ADD 3) ER
PNF techniques: LE D2 Flex
1) hip Flex 2) Abd 3) IR
Special Tests: Positive test for Neer's
Reproduces Px in shld region
Special Tests: + clunk test
clunk heard
Special Tests: Pt sitting and shld is passively IR then fully abducted
Neer's Impingement Test
Neuro Techniques: Focus on enhancing motor skills, postural control, and quality of movements through movement experiences
Special Tests: Impingement of long head of biceps and supraspinatus tendon
Neer's Impingement Test
Special Tests: + ant apprehension test
pt does not allow or does not like shld being moved like that
Special Tests: Positive Test for Speed's
reproduction of Px in long head biceps tendon
Chronic Respiratory Disease: 1) FEV1/FVC < 70% 2) FEV1<30% 3) impaired quality of life
Stage 4 very severe
Chronic Respiratory Disease: 1) FEV1/FVC < 70% 2) 30%<FEV1<50% 3) greater SOB, decreased exercise capacity
Stage 3 (severe)
Examination of the Skin: Smooth red, elevated patches of skin, hives
Examination of the Skin:Excessive dryness of skin with shedding of epithelium
Examination of the Skin: Color caused by CO poisoning
Cherry Red
Examination of the Skin: indicated by lack of O2, HF, advanced Lung disease Congenital Heart Disease
Examination of the Skin: Lack of color that can indicate anemia, internal hemorrhage
Sensory Stimulation Techniques: enhances joint awareness, facilitates concontraction, action of postural extensors and stabilizing muscles
Joint Approximation
Lung Volumes: Decrease in IRV, IC, ERV, VC, TLC and FRC
Restrictive Lung Desease
Acid-Base Balance: 1)Decrease in pH 2) PaCO2 WNL 3) Decrease in HCO3-
Metabolic Acidosis
Acute Respiratory Disease: infection spread by aerosolized droplets
Lung Volumes: Decrease in ERV and VC, increase in FRC, RV and TLC
Chronic Respiratory Disease: airflow limitation that is not fully reversible
CPR: Compression/breath ratio 1) Adult 2) Children/infant 1 rescuer 3) Children/infant 2 rescuers
1) 30:2 2) 30:2 3) 15:2
Chronic Respiratory Disease: COPD 1) FEV1/FVC < 70% 2) 50%<FEV1<80% 3) with symptoms of SOB on exertions
Stage 2 (moderate)
Chronic Respiratory Disease:COPD 1) FEV1/FVC < 70% 2) FEV1>80% 3) with or without chronic symptoms
Stage 1 (mild)
Skin: inner layer comprised of collagen and elastin
endocrine system: controls the release of estrogen and progesterone
PNF techniques: UE D2 Flex
1) Shld Flex 2) Abd 3) ER
Regulation of Electrolytes and Fluids: Caused by hyperthyroidism, tumors, hyperparathyroidism and vit a intoxication
PNF techniques: LE D1 Ext
1) Hip Ext 2) Abd 3) IR
Spinal Cord: convey sensations of pain and temperature
Lateral Spinothalamic Tract
Spinal Cord: Dorsal column pathway that convey sensations of proprioception, vibration and tactile discrimination for the LE
Fasciculus Gracilis
MS Pathology: Common area of compression for TOS
1) Sup Thoracic outlet 2) Scalene triangle 3) B/T clavicle and first rib 4) B/T pec minor and thoracic wall
Special Tests: Tests for TOS
1) Adson's 2) Roo's 3) Wright's 4) Costaclavicular
Spinal Cord: Contains afferent (sensory) neurons
Posterior Horn
Spinal Cord: Neurons that effect muscle spindles
Gamma motor Neurons
Spinal Cord: Dorsal column pathway that convey sensations of proprioception, vibration and tactile discrimination for the UE
Fasciculus Cuneatus
Spinal Cord: convey sensations of proprioception, vibration and tactile discrimination
Dorsal Columns
MS Pathology: Results of Shld Dislocation
1) Compression fx (hill-sachs lesion) 2) Tearing of the superior glenoid labrum from ant to post ( SLAP lesion) 3) avulsion of antinf capsule and ligs associated with glenoid rim (Bankart Lesion) 4) bruising of axillary N.
MS Pathology: 1)Tear of the glenoid labrum below the middle of the glenoid socket 2) involves the inf GH lig
Bankhart Lesion
MS Pathology: Cause of ANt-inf shld dislocation
abd UE is forced into ER
MS Pathology: Cause of Post Shld Dislocation
HORZ ADD shld is forced into IR
MS PT Outcomes: When an instability or labrum tear pt can begin sport related activities
6 week S/p
MS PT Outcome: Time it takes a labral tear or instability pt to fully recover
3-4 months
MS Pathology: 1) Shld pain which can not be localized to specific point 2) Px made worse by overhead activities 3) Weakness 4) Instability in Shld 5) Px on resisted elbow flex 6) tenderness in front of shld
Labral Tear
MS PT Outcomes: Length of time that a pt with instability or labral tear is in a sling
3-4 weeks
Peripheral Vascular System: intermittent claudication with pain cramping and fatigue during exercise and relieved by rest is associated with
PNF techniques: Upper trunk Ext with rotation; hands clasped with lead arm moving into D2 Flex
Peripheral Vascular System: pale, shinny, dry skin with loss of hair associated with
PNF techniques: Upper Trunk Flex with rot and hands clasped, with the lead arm moving into D1Ext
Classification by percentage of body burned: less than 2% with 3rd deg burns and 15% with 2nd deg burns
Neuro Techniques: Facilitation of normal movement and postural patterns and inhibition of abnormal and compensatory patterns of movement
Burn: Damage to the Epidermis and upper layers of the dermis, blisters, moist, weeping, painful
Superficial Partial Thickness Burn
Heart: Normal EF
Diabetes Mellitus: inadequate utilization of insulin
DM 2
endocrine system: controls the release of epinephrine norepinephrine
Adrenal Medulla
Stages of ALS: mild focal weakness, asymmetrical distribution, symptoms of hand cramping and fasciculations
Stage 1
Burn: Complete destruction of epidermis, dermis and subcutaneous tissues, may extend into muscle, little pain
Full thickness (third degree) Burn
Peripheral Vascular System: < .5
Severe PAD
Shock: Contraindicated due to risk of increased hemorrhage
Strenuous Exercise
Skin disorders: The ABCDEs of malignant melanoma
1) Asymmetry (uneven edges, lopsided) 2) Borders (irregular, poorly defined edges) 3) Color (variations, esp mix of black, blue, red) 4) Diameter (larger than 6mm) 5) Elevation ( usually elevated)
Peripheral Vascular System: ABI .5-.8
Mod PAD (+) for intermittent claudication
Ulcer Debridement: Chemical debridement that promotes liquefication of necrotic tissue by applying topical preparations. For necrotic wounds, home bound ind, pt who cant tolerate surgical debridement
Diabetes Mellitus: Prone to ketoacidosis (presence of Ketone in the urine from the by-products of fat-metabolism
DM 1
endocrine system: controls the release of thyroxine
Special Tests: 1) upper limb in full extension and forearm supinated 2) resisted shld flex
Speed's Test
Special Tests: Positive test for Yergason's
1) biceps long head will pop out of groove or 2) px in long head of biceps
Special Tests: IDs Bicipital Tendonitis
Speed's Test
Diagnostic Imaging: Used to assess pts with possible RA, stress fractures, bone CA, or bone infection
Bone Scan
Special Tests: 1) Pt sitting with shld in neutral stabilized against trunk, elbow at 90 degrees and arm supinated 2) Resistance applied to forearm supination and Shld ER
Yergason's Test
Diagnostic Imaging: Used to ID abnormalities within a joint such as tendon ruptures
Diagnostic Imaging: Injected radioactive tracer settle in areas where bone is highly metabolic
Bone Scan
Diagnostic Imaging: Water soluble dye is injected into area and observed with radiograph
Diagnostic Imaging: Demonstrates where fluid moves within a joint
Requirements for Full Arm elevation
1. Scap Stabilization2. Inf glide of Humerus3. ER of humerus 4. Rotation of clavicle at SC joint 5. Scap Abd and ER of Acromion 6. Straightening of thoracic kyphosis
Deg of Movement from GH for ABDDeg of Movement from Scapthorac for ABD
120 Deg 60 Deg
GH and Scapulothoracic Rhythm ratio at 180 deg of ABD
Ligament Function: Glenohumeral Lig
Reinforce GH Capsule
Ligament Function: Coracohumeral Lig
reinforce bicep tendon, prevent caudal dislocation, reinforces superior capsule
Myotomes: C3
Neck Lateral Flex
Myotomes: C1-C2
Neck Flex
Myotomes: T1
Finger Abd/ Interossei
endocrine system: controls the release of antidiuretic hormone and oxytocin
Post pituitary
Examination of the Skin: indicate liver disease
Ligament Function: Radial Collateral
Reinforces Joint Laterally
Ligament Function: Ulnar Collateral
reinforces Joint Medially
Diabetes Mellitus: decrease in number of islet cells resulting in decrease production of insulin
DM 1
Burns: Zone where cells are irreversibly injured, cell death occurs
Zone of Coagulation
Burns: zone where cells are injured; may die without specialized treatment
Zone of Stasis
Wheelchair Prescription: Cervical Lesion with Radial wrist Extension (C6)
1) Manual Chair 2) Surface Friction Hand Rims 3) Ind
Medications: affect the ability of the HR to rise in response to exercise stress
Beta blockers and calcium blockers
Wheelchair Prescription: Cervical Lesion Tricep (C7)
1) Manual Chair 2) Surface Friction Hand Rims 3) increased propulsion
Motor Learning Strategies: an overall strategy for movement: an action sequence requiring a coordnation of a number of motor programs
Motor plan
Diabetes Mellitus: insulin dependent, juvenile-onset
DM 1
Acute Respiratory Disease: precautions for TB pt
1) Negative pressure room 2) TB mask and universal precautions
Motor Learning Strategies: a set of pre structured muscles commands that results in the production of coordinated movements
Motor program
MS Pathology: Excessive lateral tibial torsion 2) Excessive lateral patellar positioning
genu valgum
MS Pathology: Excessive medial tibial torsion 2) Medial patellar Positioning 3) pigeon toe
Genu Varum
MS Pathology: Structures involved in unhappy triad
1) MCL 2) ACL 3) Medial Meniscus
MS Pathology: Causes of Piriformis syndrome
Excessive pronation of the foot
MS Pathology: Malalignment in which patella track inferiorly 2) Restricted knee extension with abnormal cartiliginous wearing
patella Baja
MS Pathology: Malalignment in which patella tracks superiorly in femoral intercondylar notch 2) (+) camel back sign
Patella Alta
Special Tests: Used do determine Hip Anteversion
Craig's Test
MS Pathology: Femoral Anterversion causes what stance abnormalities
1) squinting Patella 2) toeing in
Coxavalga Angle
Coxavara angle
<115 deg
Diagnostic Testing : Cath inserted through vessels into Right side of Heart
Central Line (Swan-Ganz Cath)
Special Tests: IDs meniscal tear
Mc Murray's Test
Blood Values: normal PaO2
Blood Values: PaO2 decreases in which situation
Heart: prevent back flow of blood into atria during ventricular systole
Atrioventricular valves
Motor Learning Strategies:ability to demonstrate the skill after a period of time
Edema: Takes 15-30 sec to rebound 1/2 to 1 inch
Special Tests:+ sign for pivot shift
tibia relocates during test
Heart: heart muscle, the major portion of the heart
Heart: inner layer of the pericardium
Heart: right heart valve
TRicuspid Valve
Motor Learning Strategies: determine overall quality, level of automaticity, level of effort and speed of decision making
Motor Learning: Stage in which the learner practice movements, refines motor program, spatial and temporal organization, decreases errors, and extraneous movements
Associated Stage
Special Test: Procedure for slump test
1) Pt slump sits at edge of table 2) Passive flex of pt head 3) Passive ext of one knee 4) Passive DF of ankle
Motor Learning: Stage in which the learner develops an understanding of the task, identifies the stimuli performs initial approximation of task, structures a motor plan and modifies initial response
Cognitive Stage
Heart: Fibrous protective sac enclosing the heart
Motor Learning: stage in which the learner practice movements, continue to refine motor responses, spatial and temporal are highly organized, movements are highly error free, and min level of cognitive monitoring
Autonomous Stage
Degenerative Disorder: Common sensation problems with MS
1) paresthesias 2) hyperpathia 3) dysesthesias 4) trigeminal neuralgia 5) Lhermitte's Sign
Sensory Test: ability to id familiar object when touched
Degenerative Disorder: MS initial relapsing-remitting course followed by progression at a variable rate
Secondary-Progressive MS
Degenerative Disorder: MS progressive from onset but without clear, acute relapse
Progressive relapsing MS
Degenerative Disorder: Chronic, progressive disease of the CNS with degeneration of dopaminergic substantia nigra and nigrostrital pathways
Degenerative Disorder: PD affects what part of the brain
1) basal ganlia 2) substantia nigra
Degenerative Disorder: Common muscle tone problems with MS
1) spasticity 2) hyperreflexia
SCI: Sign of Autonomic Dysreflexia
1) HTN 2) Bradycardia 3) Headache 4) diaphoresis 5) Diplopia 6) convulsions
HEart: Main mechanism in controlling heart rate
Loose packed position for GH Joint?
50-70 Deg Abd, 35 Deg Horz Abd
Degenerative Disorder: Common communication problems with PD
1) Dysarthria 2) hypophonia
Motor Learning Strategies: externally presented feedback tat is added to that normally acquired during task performance
Augmented feedback
MET Level: Light shoveling, Walking 4mph, biking 10mph,
5-6 METS
MET Level: scrubbing floors, raking leaves, walking 3 1/3 mph, biking 8 mph, golfing, tennis doubles
4-5 METS
Medication: decrease HR, decrease contractility, dilate coronary arteries, reduce BP
Calcium Channel Blockers
Motor Learning Strategies: Feedback from Sensory information normally acquired during performance of a task
Intrinsic Feedback
MET Level: Standing, strolling, flying, playing cards, sewing
1.5-2 mets
MET: amount of 02 consumed at rest
3.5 mL/kg per min
MET Level: mopping floors, cleaning windows Walking 3 mph, biking 6 mph
3-4 METS
CAD: angina that occurs at a predictable Rate pressure product and is relieved with rest or nitro
Stable Angina
CAD: Artery responsible for lateral MI, ventricular ectopy
Circumflex A
CAD: Artery responsible for Anterior MI, disturbance of lower conduction system
left anterior descending A
CAD: prolinged ischemia,, injury, and death of an area of the myocardium caused by an occlusion of the coronary A
CAD: Artery responsible for inferior MI, right ventricle infarction or disturbance of the upper conduction system
Right coronary A
Medication: decreases preload through peripheral vasodilation, reduce myocarial O2 demand, improve coronary blood flow
Medication: reduce myocardial demand by reducing HR and contractility; controls arrthymias, chest pain, reduce BP
Beta-adgergenic blocking agents
CAD: Signs of right sided Heart Failure
1) Nausea 2) Right upper Quandrant Pain 3) Increase in CVP 4) tricupid insuffiency 5) Peripheral Edema
CAD: Signs associated with Left Sided HF
1) Fatigue 2) SOB 3) Diaphoresis 4) Tachycardia 5) S3 Gallop 4) Crackles 5) Decreased Urine output 6) Confusion 7) Cheyne-Stoke
endocrine system: control the release of pituitary hormones
Regulation of Electrolytes and Fluids: caused by insufficient water intake and can cause HTN tachycardia,
Vex/Cave Rule for capitate, lunate, scaphoid and triquetrum?
Incontinence: Sudden release of urine due to intra-abdominal pressure (coughng, laughing) and a weakness in the pelvic floor
Stress Incontinence
Wheelchair Prescription: Cervical Lesion Shoulder Function Elbow Flexion (C5)
1) manual chair with propulsion aids 2) Ind for short distance 3) electric for distances
Special Tests: + Sign of Apply's if Ligament problem
Pain or decreased motion during distraction
Regulation of Electrolytes and Fluids: Caused by hypoventilation, chronic pulmonary disease or hypermetabolism. Can lead to dyspnea, hyperventilation cyanosis
Respiratory Acidosis
Cranial Nerves: CN V test
feeling of pain, light touch on forehead cheeks and jaw, the corneal reflex and have pt clench teeth
Cranial Nerves: CN V (Trigeminal) Function
sensory to face and cornea and motor to temporal and masseter muscles
Cranial Nerves: CN VII Test
raise eyebrows, frown, show teeth, smile
Special Tests:+ Sign of Apply's test if Meniscus Problem
Pain or decreased motion during compression
Cranial Nerves: CN VIII Test
Balance, gaze instability with head rotation, Auditory acuity, webers test and rinnes test
Cranial Nerves: CN VIII (Vestibulocochlear) Function
Vestibular Function, VOR, Cochlear
CN Test: Comparing air and bone conduction: place vibrating tuning fork on mastoid bone, then close ear canal.
Rinne's Test
CN Test: Test for auditory lateralization. place vibrating tuning fork on top of head and check to see if sound is heard equally in both ears
Weber's Test
Cranial Nerves: CN IX/X Test
Listen to voice quality, Examine Difficulty in swallowing, have pt say ah, and stimulate throat
Cranial Nerves: CN IX/X(Glossopharengeal/Vagus) Function
Phonation, Swallowing, pharynx control, Gag Reflex
Trauma: Blood in pleural space
Gait: heel strikes ground and limb prepares to accept GRF
Initial Contact
Gait: limb is loaded
Foot Flat
Gait: division of Stance Phase
1) initial contact 2) Foot Flat 3) Midstance 4) Heel off 5) Preswing
Special Test: Vestibular procedure for Hautant's Test
1) 1) Pt sitting 2) shlds at 90 deg with palms up 3) have pt close eyes for 30 sec
Special Test: Vascular procedure for Hautant's Test
1) Pt sitting 2) shoulders at 90 deg with palms up 3) have pt close eyes 4) cue pt into head extension with rot to left and right
Special Tests: 1) pt sitting 2) elbow and 90 deg 3) resist wrist ext with RD and forearm PRO
lat epicondylitis test
Special Tests:IDs Tennis elbow (lat epicondylitis )
LAt epicondylitis Test
BP: A decrease in BP will cause which changes in the ANS
1) SNS stimulation
Special Tests: Evaluation of ulnar N C8, and T1
Special Tests: Evaluation of Radial N.
Special Tests: Evaluation of Musculocutaneous N. Median N. and Axillary N.
Gait: foot fully flat and trunk aligned over stance limb
Gait: wt distribution shifts from entire foot to forefoot
Heel off
Burn: Complete destruction of epidermis, dermis, subcutaneous tissues with muscle damage Charred appearance
Sub-dermal Burn (Fourth degree)
Cranial Nerves: CN XII Test
Listen to pts articulation, examine resting position of tongue and have pt move tongue from side to side
Cranial Nerves: CN XII (hypoglossal) function
Tongue Movement
Burns: Rules of 9
1) Head and neck: 9 2) Ant trunk 18 3) Posterior trunk 18 3) Arms 9 each 4) Legs 18 each
Burns: Zone whee there is minimal cell injury and cells should recover
Zone of hyperemia
Classification by percentage of body burned: less than 10% with 3rd deg burns and 15-30% with 2nd deg burns
Classification by percentage of body burned: 10% with 3rd deg burns and 30% or more with 2nd deg burns
Burn: Damage to epidermis only, no blistering, min edema, Delayed pain
Superficial (First Degree) Burn
Cranial Nerves: CN XI test
Shrug shlds against resistance and turn head toward resistance
Burn: Severe damage to epidermis and dermis with injury to nerve ending, mixed red and waxy look, broken blisters, wet
Deep-partial thickness Burn (Second Degree)
Blood Values: INR >2
increased rick of bleeding
Skin Ulcers: 1) sensory loss present 2) caused by repetitive trauma to insensitive skin
Diabetic Ulcer
Cranial Nerves: CN XI (Spinal Accessory) Function
Innervates trapezius and SCM
Skin Ulcers: areas where pressure (decubitus) occur
1) sacrum 2) heel 3) trochanter 4) lat malleoli 5) ischial areas 6) elbows
Spinal Level Reflex: inverse stretch reflex function
1) provide agonist inhibition 2) diminution of force of agonist contraction 3) stretch protection reflex
Skin Ulcers: Stage of Pressure Ulcer: 1) nonblanchable, erythema of intact skin
Stage 1
Spinal Level reflex: Stimulus: muscle contraction Reflex Arc: afferent Ib fiber from GTO to muscle origin
Inverse Stretch Reflex
Myotomes: C7
Elbow Ext and Wrist Flex/ Triceps
Skin Ulcers: Stage of Pressure Ulcer 1) partial-thickness skin loss that involves the epidermis, dermis or both 2) ulcer is superficial 3) presents as a abrasion, blister, shallow crater
Stage 2
Spinal Level Reflexes: Function of stretch reflex
1) maintenance of muscle tone 2) support agonist muscle contraction 3) provide feedback about muscle length
Myotomes: C8
Thumb Ext/ EPL and EPB
Skin Ulcers: Features: 1) Can occur anywhere in the LE most happen over medial malleoli 2) Dark pigmentation 3)
Venous ulcer
Spinal Level Reflexes: Stimulus-muslce stretch, Reflex Arc-Afferent Ia fiber from muscle spindle back to alpha motor neuron to muscle of origin
Stretch Reflex
Skin Ulcers: Features 1) can occur anywhere in the LE most common in small toes, feet on bony areas of trauma 2) poor absent pulses 3) severe intermittent claudication progressing to pain at rest 3) loss of hair on foot and toe 4) gangrene adjacent to ulcer
Arterial Ulcer
Pelvic Floor: herniation of the rectum into the vagina
PT Interventions: Used to initiate an acute inflammatory response for a tissue with tendonosis
Transverse friction massage
PT Interventions: oscillations of small amplitude at the beginning of joint play
Grade 1 Jt
Skin Ulcers: Stage of Pressure Ulcer 1) Full thickness skin loss that involves damage to the subcutaneous tissue 2) deep crater
Stage 3
Skin Ulcers:1) irregular, smooth edges 2) min granulation 3) lat malleoli, ant tib, toe and feet4) painful when legs elevated
Arterial Ulcer
MS Pathology: 1) pain radiating to back 2) pain with swallowing 3) dysphagia 4) weight loss
esophageal CA
MS Pathology: deep gnawing pain that radiates from chest to back
pancreatic CA
Special Tests: To ID SIJ Dysfunction
1) Gillet's Test 2) Ipsilateral ant rotation test 3) Gaenslen's Test 4) Long Sitting Test 5) Goldthwait's Test
MS Pathology: 1)pain in back that is unvarying and progressive 2) not relieved by rest 3) more pronounced at night
Bone Tumors
PT Interventions: Functional Restoration Phase
1) Return to optimal level of pt function 2) normalize flexibility 3) Restore loading capacity of connective tissue to normal strength 4) Functional Strengthening exercises 5) Functional Stabilization exercises for the joint
PT Interventions: Contraindications to Soft tissue techniques
1) ST breakdown 2) infection 3) Cellulitis 4) inflammation 5) neoplasm 6) Hyper mobility 7) sensitivity
PT Interventions: Acute Phase
1) immobilization for 1-2 days 2) Control inflammatory response 3) Grade I/II Joint oscillations 3) 40-60% of ORM TE 4) Assisted movement with injured tissue
PT Interventions: Subacute Phase
1) Joint Mobilization 2) TE 3) Postural Education 4) Biomechanical education