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BOARDS
someone said "this is on boards" (SCI funct outcomes previous)
Term | Definition |
---|---|
Pelvic floor strengthening | Keigles:3-5 sec contract/relax or 15-20 quick |
postural drainage R & L upper lobes- anterior apical segments | pt in sitting (leaning back a little), percussion is applied directly under clavicle |
postural drainage R & L upper lobes-posterior apical segments | pt in sitting (bent fwd, head on arms, pillow, table), percussion is applied above the scap, your fingers over the top of the shoulders |
postural drainage R & L upper lobes-anterior segments | pt in supine, percussion applied bilaterally, directly over the nipple or just above the breast |
postural drainage L upper lobe-posterior segment | (only one w/head elevated) pt 1/4 turn from prone & rests on R side. head & shd elevated 45 degrees or ~ 18 in. if pillows are used. percussion is applied directly over L scap |
postural drainage R upper lobe-posterior segment | pt lies flat & 1/4 turn from pron on the L side. percussion is applied directly over the R scap |
postural drainage L upper lobe- lingula | pt lies 1/4 turn from supine on R side, supported w/pillows & in a 30 degree head-down position. percussion is applied just under L breast |
postural drainage R middle lobe | pt lies 1/4 turn from supine on L side, supported w/pillows behind the back & in 30 degree head-down position. percussion is applied under the R breast |
postural drainage R & L lower lobes- anterior segments | pt lies supine, pillows under knees, in a 45 degree head-down position. percussion is applied bilaterally over the lower portion of the ribs |
postural drainage R & L lower lobes-posterior segments | pt lies prone w/pillow under abdomen in 45 degree head-down position. percussion is applied bilaterally over the lower portion of the ribs |
postural drainage L lower lobe- lateral segment | pt lies on R side in 45 degree head-down position. percussion is applied over the lower lateral aspect of the L rib cage |
postural drainage R lower lobe- lateral segment | pt lies on L side in 45 degree head-down position. percussion is applied over the lower lateral aspect of the R rib cage |
postural drainage R & L lower lobes- superior segments | (only one of lower lobes that isn't head-down)pt lies prone w/a pillow under the abdomen to flatten the back. percussion is applied bilaterally, directly below the scap |
where does pes anserine insert? | ant medial surface of the proximal tibia- goose foot |
what are points on Q angle | measure from ASIS to patellar midpoint & line of tibial tuberosity thru patella |
cause of patellar malalignment & increased Q angle | tight ITB, wk glute med, lax medial retinaculum, wk VMO |
Thoracic Outlet Syndrome | compression of the neurovascular bundle that runs thru the thoracic outlet & carries the brachial plexus, subclavian artery & subclavian vein |
Thoracic Outlet Syndrome S&S | pn in shd &/or UE, tingling, numbness, coldness in arm or hand, loss of biceps jerk, triceps jerk, positive Adson's test |
Thoracic Outlet Syndrome common areas of compression | ant & middle scalene, 1st rib, clavicle, pec minor |
Thoracic Outlet Syndrome causes | tight scalenes, cervical rib-a congenital anomaly, trauma, postural changes, clavicular fx |
most common contractures for AK amputation | hip flex, abd |
most common contractures for BK amputation | knee flex |
DeQuervain disease/tenosynovitis | abductor pollicis longus & ext pollicis brevis tendons & sheaths-pn on radial side of wrist-cause often not clear |
DeQuervain disease/tenosynovitis S&S | tender radial styloid, pn w/active abd of thumb, positive Finkelsteins Test (pn w/passive thumb flex/abd & wrist ulnar deviation) |
ulnar nerve sensory distribution (hand) | 4th finger (medial portion), 5th finger |
median nerve sensory distribution (hand) | palmar aspect of thumb, 2nd, 3rd, 4th (radial half) fingers |
radial nerve sensory distribution (hand) | post arm, post forearm & radial side of post hand |
coma lasts... | 3-4 weeks |
vegetative state lasts... | 4 weeks- 1 yr |
persistent vegetative state lasts | over a year |
Levels I, II, III Rancho Los Amigos Scale of Cognitive Functioning | comatose |
Levels IV, V, VI Rancho Los Amigos Scale of Cognitive Functioning | Confused |
Levels VII, VIII Rancho Los Amigos Scale of Cognitive Functioning | appropriate |
Levels VIII, IX, X Rancho Los Amigos | purposeful, appropriate |
Level 1 Rancho Los Amigos | no response/total assistance |
Level II Rancho Los Amigos | Generalized response/total assist, response w/gross body mvmnt (ex roll in bed), physiological changes, &/or vocalization. response delayed |
Level III Rancho Los Amigos | Localized response/total assist. specific response consistent w/stim. strongest response to pn, odors |
rx for levels I, II, III Rancho Los Amigos | explain to & involve family, talk & rx pt as if awake, use facilitory techniques, control environment, small # people, same staff, short rx, familiar stim, ROM w/facilitation inhib, positioning/splinting, inc tol to upright |
rx for levels IV, V | structure, same staff, consistency, PTA-calm, focused, guiding; have backup plan, watch for aggression. give choices, watch for fatigue, safety, don't correct confabulation, bed mob, trsf, WC, gt trng, ther ex, NM re-ed, strength, stretch |
Level IV Rancho Los Amigos | Confused-agitated (Bizarre world)/max assist. attention:brief, general. no STM or learning. behavior:aggressive/flight, mood swings, no purpose, no cooperation, egocentric. confabulating, incoherent |
Level V Rancho Los Amigos | confused-inappropriate-nonagitated/max assist. alert, wandering-"go home", brief attn w/structure more specific, impaired memory some return of old learning, no new learning, random/nonpurposeful behavior, confab w/structure, no prob solv or goals |
Level VI Rancho Los Amigos | approp/mod A, may realize in hospital, but not sure why, attn increase to 30 min w/structure & supv, increase memory, recognize staff, inc LTM, new learning, no carryover, follow simple commands, poor awareness of limits, speech appropriate w/structure |
Level VII Rancho Los Amigos | robot phase-auto appropriate/min assist, realize what happened to them, oriented, attn 30 min, self-care, household routine, new learning, unaware of others feelings, inapp behav, uncooperative, superficial awareness of limits, overestimates future |
Levels VIII, IX, X Rancho Los Amigos | purposeful appropriate/SBA to Mod I, prob solv w/declining structure, figuring out probs they may not overcome, irritable, depressed, selfish, attn 1 hr, STM & LTM improved, new learning |
rx for levels VI-X | cont w/structure & consistency, can take out of room, memory book, schedule, simple commands, gt trng, AD/orthotics, WC, environ adapt, caregiver, balance, perceptual, congnitive, safety trng, less structure, simulate real world |
how do you rx autonomic dysreflexia? | id cause (often kinked/blocked catheter or position) & rx. monitor BP, sit up, notify medical staff may require meds to lower BP |
autonomic dysreflexia S&S | severe HA, restless, HTN, decreased HR, c/o chest tightness, face flushed, pupils constricted, blurred vision, runny nose, sweating, chill bumps, vasodilation above, constriction below |