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Biomech Midterm

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anskorczewski12's version from 2017-03-06 04:11

First stuff

Question Answer
the areas that sends sensory info to that nerve rootdermatome
the area innervated by a nerve rootmyotome
estimated outcomeprognosis
hypoesthesiadiminished sensation
hyperesthesiahypersensitivity
ischemialack of oxygen
dead tissuenecrosis
infection from initial site to bloodstreamseptis
blood poisoning by toxins from bacterial infectiontoxemia
pain from periphery that alerts us to potential damagenociceptive pain
pain from damage to the nerveneuropathic pain
pain from a stimulus that is normally not painful (e.g. touch)allodynia pain
pain that is more intense or lasts longer than expected (e.g. sensitive to novicane)hyperpathia pain
not sweatinganhedosis
sweatingdiaphoretic
term referred to getting light-headed from suddenly changing body positionorthostatic hypertension
see clinical monitoring notes in ICU notes(see notes)
what are the 9 areas of the OFM1.sense of self-efficacy/esteem 2.satisfaction with life roles 3.competence in tasks of life roles 4.activities/habits 5.abilites/skills 6.developed capacities 7.first level capactities 8.organic substrate 9.environment/context
occupation as end focuses on which level of OFMactivities and habits
occupation as means focuses on which level of the OFMdeveloped capacities
what is the relation of OFM terms to OTPF termsoccupations, performance patterns and skills, client factors
peoples belief in their performance capabilitesself-efficacy
categories of abilities/skills (many categories involved in a skill)motor, sensory, cognitive, perceptual, socioemotional, cardiorespiratory
phases of OTIPM(intervention process model) 1.evaluation and goal-setting 2.intervention phase 3.reevaluation
sensory homunculus is where?on postcentral gyrus (parietal lobe)
peripheral polyneuropathydamage to multiple peripheral nerves, maybe from diabetes or peripheral vascular issues? (recovery of sensation is unlikely with this)
recovery sequence of sensationpain/temp, then moving touch, then light touch, then touch localization
Moberg pick up testmeasures stereognosis and function of median (and ulna) n. (and nerve roots C6, C7, and C8)
what pathway is pain through & how is it testedlateral spinothalamic tract; test with sharp-dull ad pinprick test
test moving touchwith 2 point discrimination test
test measuring threshold levels of sensory receptorsSemmes-Weinstein Monofilament test
goal of sensory reeducatonmaintain/restore cortical hand representation and regain use of sensation of the hand
phases of sensory reeducation1: preserve cortical representation (positioning, open-close movements, massages, elevation, work with eyes closed and perform mental practice, alternative senses used); Phase 2 happens when able to feel deep touch and moving touch (eyes closed open closed procedure through 5 stages)
deep and moving touch happent through which tractanterior spinothalamic tract
5 stages of phase 2 of sensory reeducation1. object recognition using feature detection 2.prehension with refined prehension pattern 3.control of prehension force while holding objects 4.maintain prehension force during trasnfer 5.object manipulation
common damage from no protective sensation1. continuous pressure (frequent position changes and cushions) 2.concentrated high pressure (careful strategies) 3.excessive heat/cold (awareness) 4.repetitive mechanical stress (avoid friction and high repetitions) 5.pressure on infected tissue (edcuate on skin care)
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pain

Question Answer
untreated pain may lead tolow effective vascular circulation, high oxygen needs, compromised immune system, high risk for venous thrombosis/pulmonary embolism
painful diagnosis with no clear explanation, sympathetic NS is involved (in thoracic spinal cord region)complex regional pain syndrom (CRPS)
types of CRPS type 1 (no known n. injury) or type 2 (direct n. injury); or can be blocked SNS or nonblocked SNS (blocking SNS either helps or doesnt)
interventions for CRPSmust get movement through extremity, bilateral activities/ADLs, TENs, mirror therapy, placebo treatments
physical illness that can't be explained by organic disease and no structural lesion/biomechanical changefunctional somatic syndrome
symptoms are out or proportion to the impairment (but not conscious and unintentional)somatoform disorders (such as hypochondriasis, body dysmorphic disorder, conversion disorder)
have symptoms without objective medical evidence of impairment (occurs frequently)somatization disorder
fatigue not explained, longer than 6 months, know definit onset time, and low activity level not from exertion (and not relieved with rest)chronic fatigue syndrome
autoimmune disease with pain on both sides of body, both above and below waist, and tenderness at 11 or more of 18 specific areas (most common in females)fibromyalgia
interventions for fibromyalgiaaquatherapy, meds, exercise, progressive strengthening, CBT, relaxation, and ergonomics
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acute care

Question Answer
screeningreview data, observe pt., use screening tools to determine need for further assessment
deteremines presence/location of deep vein thrombosis (DVT) or pulmonary embolismvenous duplex scans
finds fractures/asses/fluidcomputed tomography (CT) scan
outline image of tissues, organs, and blood vesselsultrasound
surgically created airways in cerivical tracheatracheostomy
common vitals and usual numbersblood pressure (120/80mmHg), arterial blood pressure (10-105mmHg), intracranial pressure (5-15mmHg), respiratory rate (12-16bpm), heart rate (60-100bpm), oxygen saturation (95-100%)
6 elements in continuum of acute care1.observe environment 2.observe patient 3.initiate pt contact (SAFE guidelines) 4.assess body function and structures 5.assess functional activities 6.intervention
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disorders/diseases

Question Answer
rare diabetes, lack of response to adh (vasopressin), causes polydipsia (thirst), polyuria (urination) and dehydrationdiabetes insipidus
difference between type 1 and 2 of diabetes mellitus1. absolute deficiency in insulin secretion (early onset/IDDM) 2.body is resistant to effect of insulin/beta cells do not produce enough insulin (developed through life NIDDM), from obesity
normal glycemic levelabout 120mg/dL
over 200mg/dL glycemic levelhyperglycemia (polyuria, polydipsia, dry mouth, low appetite, fatigue, drowsiness, ANS impacted)
less than 70 mg/dL gycemic levelhypogycemia (hunger, perspiration, weakness, tremors, anxiety, irritability, headache, sleepness, infection)
reduced neutrophils (at risk for infection)neutropenia
long term complications associated with diabeteslarge vessel diseases (MI, stroke, PVD) or small vessel diseases (neuropathy, retinopathy, nephropathy), paresthesia (tingling), atherosclerosis, gastroparesis, depression, decreased wound healing
two types of immunityinnate immunity (immediate, nonspecific response) and adaptive immunity (specific to antigens)
infection in the blood that involves multiple systems, impairs cognitionsepsis/ systemic inflammatory response syndrome
anginachest pain (precurser to MI?)
three phases of cardiac rehab1. inpatient 2.outpatient 3.community-based
osteophytebony spurs
OA nodes on DIP jointsHaberden's nodes
OA nodes on PIP jointsBoushard's nodes
narrowing of open spaces in spine (common in OA)spinal stenosis
inflammed synovium causes destruction to surrounding tissues (autoimmune systemic disease)Rheumatoid Arthritis
difference in joint feeling of RA and OARA feels unstable, OA feels pain and stiff
flexion at DIP joints and extension at PIP joints (RA)swan neck deformity
extension at DIP joints and flexion at PIP joints (RA)Boutonniere deformity
what is common at MCP joints with RAulnar deviation (from radial collateral ligament being affected)
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Amputations

Question Answer
focus of postoperative carewound care, maintenance of skin integrity and joint mobility, reduction of edema, prevent scarring, and pain management (phantom lib); also psychological aspects (body scheme, self-esteem)
aspects of preprosthetic programprovide emotional support, instruct limb hygiene and expedite wound healing, maximize limb shrinkage and limb shaping, desensitize limb (encourage weight bearing, massage, and tap), an maintain or increase ROM and strength
types of prosthetic systemsbody powered, externally powered, hybrid, activity-specific, passive prosthesis (cosmetic)
parts of prosthesissock, socket, harness, control system
elbow unit typesbody-powered terminal device (voluntary open or voluntary closed), electrically powered terminal (myoelectric control or myoelectric site testing and training)
myoelectric site testing and trainingcontrol through use of agonist and antagonist m.
myoelectric controlfrequently for transradial; uses the contraction of close muscles
preprosthetic training programteach don/doffing, wearing schedule, hygiene and care, then teach controls and functional use, then teach IADLs and other activities
specialized device that is task specific, or may be post to provide oppositionpassive functional prosthesis
cable driven or scapular/humeral drivenactive functional prosthesis
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splinting

Question Answer
joints hard to get back movementMP flexion, PIP extension, wrist extension, elbow extension, forearm supination
modified week's testhelps determine orthotic needed
cmmscastng motion to mobilize stiffness (for chronic stiffness, when splinting isn't enough)
when not to splintjt instability, avascular necrosis, acute inflammation, infection, unstable fractures
types of splintsmobilization, immobilization, restriction/static, serial static, static progressive, dynamic
when is static splint usedimflammatory stage
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fractures

Question Answer
types of breakslongitudinal, transverse, spiral (also either linear or comminuted)
avulsion fractureoccurs when a tendon/ligament attachment tears away from the bone with a fragment attached
complicated fracturemay involve other soft tissues
compoundassociated with open wound; high infection risk
greenstickimpacted/buckling from bony cortex (bends but doesn't snap); only in peds
osteochondral fracturesinvolves articular cartilage; primarly caused by either ischemia or trauma
Process of fracture care1. immobilization/early mobilization (0-6 wks) 2.early consolidation (6-8 wks.)
what are you doing during stage 1teach adaptation during restricted movement, pendulum exercise, AROM/AAROM (restricted to midrange), isometric contraction
what are you doing during stage 2focused and functional active use, edema management, stiffness and pain management (paraffin, fluidotherapy, passive stretching, splinting), scar formation (deep presssure tissue massage)
joints of the elbowulnohumeral, radiohumeral, and radioulnar
volkmann's ischemiacompartment syndrome of forearm (pale/bluish skin, no raadial pulse, decreased hand sensation, severe pain)
what is acute compartment syndrome and where is it most commonraised pressure within a closed osteofascial compartment compromises the circulation and function of tissues; forearm is most common site
how to hande complex elbow fracturesopen reduction with well-secured fixation, then active motion and splinted in flexion (not extension)
radial head fracture protocolclosed reduction and possible excision of radial head, immobilize with sling, active pronotion/supination done early; continuous passive motion; dynamic supination splint or static progressive spinting
bennett fracturebase of first metacarpal bone extending into CMC joint (most common thumb fracture), commonly with subluxation of CMC
what is attached to radial styloidbrachioradialis t. and radial collateral ligaments
type of deformity caused by Colles fracturedinner fork/bayonet (distal fragment goes anterior and proximal goes dorsally)
type of deformity caused by smiths fracturegarden spade deformity
caused by fall on extended and pronated wrist, increasing carpal compression forcebarton's fracture (has intraarticlar component, so different than smiths/colles)
closed-packed positionjoint position in which contact between the articulation structures is max.
loose-packed positionposition where joint surfaces are not congruent and joint capsule is lax
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