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Clinical Exercise
Clin Ex Exam 1
68
Physiology
Graduate
02/16/2012

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Cards

Term
Components of ICF
Definition

Impairment of body stucture and function

Activity Limitation

Participation restriction

Impact of contextual factors (enviroment/personal)

Term

Why do we now use the ICF model?

Who was it developed by?

Definition

It integrates function and disability and shifts focus to how people live with a condition.

developed by WHO

Term
Give an example of an impairment?
Definition
decrease of mobility or flexibility
Term
Give an example of a activity limitation?
Definition
inhibit an activity of daily living
Term
What is a participation restriction?
Definition
the patients role in society
Term
What does impact of contextual factors include?
Definition
past medical history, work enviroment, etc.
Term
Requirements for clinical decision making?
Definition

Knowledge, recall, investigative instinct

Experience

Efficient information gathering and processing

Evidence Based practice

Critical thinking

patient centered

reflective thought process

Term
what are the 6 steps in patient management model?
Definition

Examination/Re-exam

Evaluation

Diagnosis

Prognosis

Intervention

Outcome

Term
Purposeful and skillful interaction b/w PT and pt., occurs via various methods/techniques to produce changes in pt's condition?
Definition
Intervention
Term
3 main types of intervention?
Definition

Procedural intervention

Patient-related instruction

Communication/coordination

Term
What are examples of procedural interventions?
Definition
manual therapy, modalities, strength, balance, agility, gait, transfer, bed mobility
Term
what intervention includes functionally connected, support of evidence, safe and progressive?
Definition
procedural intervention
Term
what are examples of Patient-related instruction?
Definition
HEP, family education, educate pt. on diagnosis, getting pt actively involved
Term
Way the PT helps the pt learn how to get better via active participation. Can be pathology, pt, and/or family focused. Understand learning/recognize learning style.
Definition
Patient-related instruction
Term
What are examples of Communication/coordination?
Definition
talking or writting to other doctors, nurses, therapist, physical letter to update
Term
What determines the success of intervention and possible modification of intervention/goals?
Definition
Outcome measurement
Term
Systematic, planned performance of bodily movements, postures, or physical activities intended to help the patient?
Definition
Therapeutic exercise
Term
Therapeutic exercise is intended to provide a patient with means to?
Definition

address/prevent impairments

restore, improve, enhance physical function

prevent/reduce health related risk factors

optimize overall health status, fitness, or sense of well-being

Term
what are the types of therapeutic exercise?
Definition
aerobic, muscle performance, stretching, neuromuscular/postural awareness training, stability, balance/agility, functional training
Term
How do we ensure pt safety?
Definition

health hx and status

enviroment

accuracy of exercise

Term
how do we ensure our safety?
Definition
body mechanics
Term
What are benefits of HEP?
Definition

performance, functional independence and decreased disability

decreased risk of recurrence, frequency, and intensity of care

decreased supervision for tasks and improved self awareness

improved knowledge and awareness

improved health status and physical function

Term

development strageties are dependent on what 2 factors?

which is more important?

Definition

efficiency and efficacy

efficiency is more imp

Term
What development stragety produces the desired effect and has a time component?
Definition
efficiency
Term
what development stragety includes getting the desire result?
Definition
efficacy
Term
what are some factors that affect compliance?
Definition

Outside barriers(pscyhological, enviromental)

Initial compliance

Continued compliance

Term
Precondition for continued compliance?
Definition
We want to reduce the symptoms in the clinic to increase their ability and willingness to continue with HEP. Get positive outcomes.
Term
What are some guidelines for a HEP?
Definition
Show one exercise at a time, simplicity, professional materials, technology, individualized, photos, color, video, customizable, compliance
Term
What are the muscular consequences of immobilization and disuse?
Definition
Decreased muscle mass and strength/XSA, Decreased magnitude and number of muscle activation, increase of N+ excretion by 5th day (Muscle breaking down)
Term
do flexors or extensors become more week with immobilization?
Definition
extensors are more weak than the flexors
Term
Are fast-twitch or slow-twitch weaker after immobilization?
Definition
Fast-twitch are weaker after immobilization, and slow twitch also decrease but not as much as fast-twitch
Term
Do large or small muscle fibers get weak quicker with immobilization?
Definition
Large get weaker quicker
Term
What are the changes in intramuscular fluid volume with immobilization?
Definition
increases in UE and decreases in LE
Term
What changes occur in the ultrastructure of muscle fibers?
Definition
z-line streaming (lot less defined), cellular edema, myofibril protein disorganization, mitochondrial location
Term
What is decrease muscle power due to with immobilization?
Definition
mechanical properties, change in Ca levels at the NMJ
Term
what are the bony consequences of immobilization?
Definition
decreased diatary calcium absorption, decreased mineral density in WB bones, decreased fracture threshold
Term
Loss of Ca through fecal during immobilization is due to what?
Definition
role of the parathyroid gland
Term
Loss of Ca through urine during immobilization is due to what?
Definition
Skeletal loss
Term
Have to have Ca absorption where to get Ca absorption to the bone?
Definition
GI tract
Term
What happens to ligaments with immobilization?
Definition
decreased XSA, increased turnover (bad bc you want it constant), decreased mechanical properties and structures, and decreased stress level
Term
What happens to tendons that are immobilized?
Definition

Decrease metabolic turnover, decrease vascularity and circulation

Need to stress a tendon to realign the collagen fibers

Term
What happens to articular cartilage with immobilization?
Definition
decreased chondrocyte production, controlled loading and unloading, fibrous ankylosis, compression necrosis, obliterative degeneration
Term
What forces is proteogylcan important in for articular cartilage?
Definition
stress forces
Term
What force is collagen important for in articular cartilage?
Definition
Tensile forces
Term
What does controlled loading and unloading do for articular cartilage?
Definition
Cellular nutrition- brings fluid in and out carrying nutrients and waste
Term
What is fibrous ankylosis? how early can it occur with immobilization?
Definition
replacement of fibro-fatty tissue for articular cartilage, can happen in as little as 1 month
Term
What is continuous pressure on articular surface that leads to tissue death?
Definition
compression necrosis
Term
What is articular surfaces no longer in contact with each other so no waste or nutrition go to or leave the area?
Definition
obliterative degeneration
Term
What is the influence of therapeutic exercise in articular cartilage with immobilization?
Definition
Synovial fluid levels decrease with immobilization, but when the joint moves there is an increase in synovial fluid
Term
What are the effects of immobilization on the neuromuscular components?
Definition
Decrease in electrical efficiency
Term
effects of immobilization on hematological?
Definition
decreased blood flow to the abdominal aorta and femoral arteries, increased risk of pulmonary embolus and DVT, Increased venous stasis in lower extremities
Term
Effects of immobilization on cardiovascular?
Definition
Decreased plasma volume, decreased cardiac stroke volume, decreased cardiac distensibility, increased heart rate
Term
effects of immobilization on pulmonary?
Definition
decreased pulmonary capacity and secretions not mobilized effectively, decreased functional residual capacity, dependent pulmonary edema, weakened respiratory muscles, weak and ineffective cough, increased risk of hypoxia, hypercardia, pneumia, increased risk of thrombophlebitis and deep vein thrombosis, hindering of cellular functions and tissue healing
Term
effects of immobilization on  integumentary?
Definition
increased turgidity, increased skin atrophy, primary risk factor for development of pressure ulcers
Term
effects of immobilization on gastrointestinal?
Definition
decrease in gastrointestinal motility and gastric secretions, swallowing difficulty, catabolic state, increased fluid loss via diuresis and constipation
Term
effects of immobilization on urinary?
Definition
increased diuresis, extracellular to intracellular fluid shift
Term
effects of immobilization on metabolic?
Definition
decreased insulin sensitivity, decreased basal metabolic rate, risk of increased body fat
Term
the ability to perform whole body activities for extended periods of time without undue fatigue is?
Definition
cardiorespiratory endurance
Term
why should aerobic intervention be part of a POC?
Definition
to maintain existing levels of aerobic capacity during the rehabilitation period
Term
what is the purpose of the cardiorespiratory system?
Definition
provides a means by which oxygen is supplied to the various tissues of the body
Term

the ability to perform work is?

the total of all energy processes is?

Definition

energy

metabolism

Term

Catabolic reactions do what?

Anabolic?

Definition

break down molecules

build up molecules

Term
What is ATP used for?
Definition

x-bridge formation

Na-K pump

Ca pump

stores energy

Term
ATP is produced in muscle by what?
Definition
blood glucose or glycogen
Term
What are other nutrients that can produce ATP but first must be changed?
Definition
fats and proteins
Term
If glucose is not used, what's its storage form?
Definition
glycogen in resting muscle or liver
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