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Physical Dysfunction test 2
n/a
222
Medical
Graduate
03/02/2013

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Cards

Term
FIM stands for
Definition
functional independence measure
Term
make up of the FIM test (how many items)
Definition
18 items (13 motor+5 cognitive)
Term
A 7 on the FIM indicates...
Definition
complete independence
Term
FIM score ranges
Definition
18-126
Term
Is FIM standardized?
Definition
yes
Term
How long does it take to administer a FIM?
Definition
30-45min
Term
Does FIM account for stages of motor development?
Definition
No.
Term
Refers to the type and amount of assistance required for a disabled individual to perform basic life activities effectively.
Definition
burden of care
Term
FIM levels for independence
Definition
6, 7
Term
FIM levels of complete dependence
Definition
1, 2
Term
FIM levels for modified dependence
Definition
3,4, 5
Term
FIM level- individual can complete a task, but requires cuing, set up, and/or coaxing.
Definition
5 (needs another individual present)
Term
Levels that do not require another individual present...
Definition
6 and 7
Term
FIM- requires assist for 50-74% of activity
Definition
3, moderate assistance
Term
FIM- can complete the activity independent, but requires an assistive device...
Definition
6
Term
FIM- can complete the activity independently, but requires 3x normal amount of time to complete.
Definition
6
Term
FIM- Pt. can complete activity independently after a helper applies orthoses...
Definition
5
Term
FIM- Patient performs 75% or more of the effort and requires no more help than touching
Definition
4: minimal assistance
Term
Pt. can perform 85% of activity with no more than touching from helper...FIM
Definition
4: minimal assistance
Term
FIM- Pt. requires verbal cues, but no touching from helper.
Definition
5: supervision or set-up
Term
pt. expends between 25-49% of the effort... FIM
Definition
2: maximal assistance
Term
Pt. requires assistance from two people...FIM
Definition
1: total assistance
Term
can reports from medical records, staff, and family members be used to complete the FIM?
Definition
Yes, but direct observation is the preferred method.
Term
FIM score if the activity did not occur...
Definition
0
Term
Likely FIM score for pt. going up and down stairs for patient with bilateral lower extremity paresis
Definition
0, due to safety concerns.
Term
FIM score when Pt. refuses to do the activity...
Definition
0 (must be justified in paperwork).
Term
FIM score of "O" may not be used for...
Definition
for Bladder Management, Bowel Management, or any of the cognitive items
Term
T/F- a pt. can be scored a "O" upon discharge if the activity was never observed.
Definition
FALSE.
Term
What score do you give a pt. if you did not observe the activity before discharge?
Definition
1...total assistance
Term
When CAN a "0" be given at discharge?
Definition
only for the 10 function modifiers on questions 35-38 and 33. CANNOT be used for shower transfers though. the overall FIM score for each item cannot be "0"
Term
FIM... during bed to wheelchair transfer, requires one arm assist.
Definition
4: minimal assist
Term
FIM... during a wheelchair to bed transfer, requires two-arm assist.
Definition
3: moderate assist (no higher, but can be lower).
Term
If patient shows different levels of ability transferring onto and off of a surface, record the higher/lower score
Definition
record the lower score.
Term
Wheelchair transfer FIM- Transfers in a safe and timely manner with no device (eg: sliding board),handling all aspects of wheelchair management (locking brakes, lifting footrests,etc.)
Definition
7: complete independence
Term
Wheelchair transfer FIM: Adaptive or assistive device is used (eg: grab bars, sliding board), or activity takes more than a reasonable amount of time. Use of a prosthesis or orthosis, if used in transfer, is considered an assistive device
Definition
6: modified independence
Term
Wheelchair transfer FIM: Supervision provided or assistance given with setup (moving footrests, positioning sliding board)
Definition
5: supervision or set-up
Term
wheelchair transfer FIM: Steadying assistance given in transfers
Definition
4: minimal assistance
Term
FIM: Patient performs 50%--74% of tasks
Definition
3: moderate assistance
Term
FIM: Patient performs 25%--49% of transferring tasks
Definition
2: max assistance
Term
FIM: Patient performs less than 25% of transferring tasks
Definition
1: total assistance
Term
FIM for toilet transfers: If patient uses only a bedpan and/or urinal, never using a toilet/commode.
Definition
"0" (use this rarely!)
Term
Give transfer score and toilet transfer score:
The patient is able to transfer to and from his wheelchair to the bed at modified independent with the slide board. However the patient requires cues for board placement when transferring on and off the toilet with the board.
Definition
transfer score: 6 (no assistant needed)
toilet transfer score: 5 (for verbal cues)
Term
for the function modifier of locomotion, can travel 150ft in a wheelchair...FIM score
Definition
3: mod assistance
Term
T/F- Pt. can score a 7 with the use of a wheelchair?
Definition
False, maximum FIM score of 6 with a wheelchair.
Term
FIM for locomotion: Pt. can walk a minimum of 150ft/50m with no assistance.
Definition
7
Term
FIM- pt. can walk in prosthesis leg for 150ft/50m.
Definition
6: modified ind
Term
FIM: Patient walks only short distances independently with or without a device
Definition
5 (can't walk full 150ft)
Term
Patient requires standby supervision, cueing, or coaxing to go a minimum of 150 feet (50 meters)
Definition
5: supervision
Term
Patient performs 75% or more of walking effort to go a minimum of150 feet/50 meters
Definition
4: contact assistance
Term
Level 3: Moderate Assist – Patient performs 50-74% of walking effort to go a minimum of 150 feet/50 meters
Definition
3: moderate assistance
Term
Patient performs 25-49% of effort and requires the assistance of 1 person to go a minimum of 50 feet
Definition
2: max assist
Term
The patient performs less than 25% of effort
or requires the assistance of 2 people
or walks less than 50 feet/17 meters
Definition
1: total assist
Term
going up and down a flight of stairs – 12 to 14 steps, but patient needs handrail, side support, cane, or portable support; activity may take more than a reasonable amount of time; or there are safety considerations
Definition
6: modified assist
Term
Patient can safely and independently climb 12-14 stairs with handrail.
Definition
6: modified independent
Term
The FIM score may range from Level 1 - __ if patient uses, for example, gastrostomy or parenteral feedings
Definition
1-6
Term
If patient can safely and affectively eat soft and mushy food independent, what FIM score?
Definition
6: modified ind
Term
If the helper checks for pocketing of food, what is the max FIM score?
Definition
4: minimal assistance
Term
If the patient receives tube feedings and the helper does all of the administration, the score to use is...
Definition
1: total assist
Term
When are dentures considered assistive devices?
Definition
Only if they are necessary to eat.
Term
In eating, Patient may need help to open containers, pour liquids or butter bread, but is otherwise independent.
Definition
max score of 5 (for set-up)
Term
Cancer of the bones and/or connective tissue
Definition
Sarcomas
Term
cancers in lymphatic system
Definition
lymphoma
Term
cancer involving blood cells, bone marrow, and/or blood-forming organs.
Definition
leukemia
Term
Cancer originating in the body organs
Definition
carcinoma
Term
Prevalence of cancer diagnosis in men
Definition
1 in 2
Term
Prevalence of cancer diagnosis in women
Definition
1 in 3
Term
Most prevalent forms of cancer in men
Definition
prostate, lung, and colorectal cancers.
Term
Most prevalent forms of cancer in women
Definition
lung, breast, and colorectal cancers.
Term
TNM stands for in grading cancer?
Definition
T=primary tumor (T1-T4)
N=regional lymph nodes (N1-N3)
M= distant metastasis (Mx, M0, M1)
Term
In the stages of cancer, what stage is it if cancer has spread to another organ besides the primary organ?
Definition
stage 4
Term
Stage if carcinoma is in situ?
Definition
stage 0
Term
undifferentiated cells are considered what grade?
Definition
G4, high grade
Term
Cancer developing from fat, muscle, nerve, fibrous tissues surrounding joints, blood vessels, and deep skin tissues
Definition
soft-tissue sarcoma
Term
cancer developing from both bone and cartilage
Definition
primary bone tumor sarcoma
Term
2 types of hematological cancers
Definition
lymphomas and leukemias
multiple myelomas
Term
Negative effect of chemotherapy
Definition
Chemotherapy can cause induced peripheral neuropathy or tremors
Term
An unusual, persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with functioning.
Definition
CNF (cancer-related fatigue)
Term
Psychological distress is mostly caused by... (cancer diagnosis or disability)
Definition
“The risk of psychological distress in individuals with cancer relates much more strongly to their level of disability than it does to the cancer diagnosis itself.”
Term
The Role of OT in Oncology
Definition
“to facilitate and enable an individual patient to achieve maximum functional performance, both physically and psychologically, in everyday living skills regardless of his or her life expectancy”
Term
CRF stands for?
Definition
cancer-related fatigue
Term
Treatment for cancer can include:
Definition
Fatigue management and energy conservation
Sensory reeducation and desensitization
Wheelchair seating and positioning
Scar management
Conditioning (range of motion, strengthening, endurance)
Fall prevention and other activities to promote home safety
Cognitive training/strategies
Stress and anxiety management
Pain management
Lymphedema Management
Management of ADL’s
Term
Goal of this type of care:
“Loss of independence and role can result in social death prior to biological death. Occupational therapy can help a person to adopt new and appropriate functions and roles and to maintain self-esteem.”
Definition
OT and hospice care
Term
T-P-R-BP-Pn-Sat. stands for?
Definition
Temperature
Pulse per minute
Respiratory rate per minute
Blood Pressure
Pain Level
Saturation of O2
Term
if a pt. has a temperature of 98 degrees F, what is it in Celcius?
Definition
C=5/9(98-32)
C=37.2
Term
common Pulse Sites
Definition
Radial (most common)
Gives an overall picture of client’s health
On wrist near thumb
Brachial (upper arm)
Carotid – (neck) Not a preferred site
Femoral (groin)
Popliteal (behind knee)
Pedal (feet)
Term
Pulse <60bpm
<50 Low
<40 Very Low – may require intervention
Definition
Bradycardia
Term
Pulse > 100 bpm
>130 High – may require intervention
>140 Very High – intervention frequently needed
Definition
trachycardia
Term
how do you calculate maximum aerobic heart rate?
Definition
220 – Age = Maximum Aerobic Heart Rate
Term
Abnormal respiratory rates
Definition
Abnormal <10 / minute
Abnormal > 24/minute
Term
Measurement of pressure of blood in the arteries when ventricle are contracted
Definition
systole
Term
when ventricles are relaxed
Definition
diastole
Term
BP normal ranges
Definition
Systolic blood pressure (SBP)
<120 mmHg
Diastolic blood pressure
<80 mmHg
Term
BP hypertension
Definition
SBP > 130, DBP > 89
Term
BP for hypotension
Definition
SBP <100 and/or DBP <60
Term
What is Orthostatic hypotension?
Definition
Drop of 20mmHg or more from the recorded sitting BP
Term
T/F- place stethoscope over 1 layer of clothing to take measurements.
Definition
DO NOT place over clothing
Term
Avoid taking BP from an arm with:
Definition
Cast
Surgery (breast/axilla)
Lymphadeopathy / Swelling
Intravenous lines (IV) / Intrarterial Lines (IA)
Arteriovenous shunts/fistulas
Term
T/F- take BP on non-dominant arm first.
Definition
F- take BP on dominant arm first.
Term
Pulse-Ox. Probe Locations
Definition
Finger
Bridge of Nose
Toe
Ear lobe
Term
Pulse oximetry accuracy
Definition
If patient does not display any of the above, and the waveform is regular with clear peaks and troughs then the saturation is accurate +/- 2% for any saturation over 70%.
Even in ideal conditions and a perfect waveform, Below 70%, saturation is only accurate +/- 5%.
Term
What is on its way to being the "7th vital sign"?
Definition
End-tidal CO2 measurement
Term
What is EtCO2?
Definition
end-tidal CO2 is a measurement of the percentage of carbon dioxide exhaled.
Term
As a patient becomes sedated, what happens to their CO2 levels?
Definition
They rise
Term
What is the BEST predictor of over sedation?
Definition
end-tidal CO2 measurements (better than pulse ox)
Term
What are the majority of amputations caused by?
Definition
traumatic injury
Term
Primary cause for lower extremity amputation?
Definition
Disease, DM (diabetes) and PVD (peripheral vascular disease).
Term
AEA stands for?
Definition
above elbow amputation
Term
BEA stands for?
Definition
below elbow amputation
Term
cut across the bone
Definition
trans
Term
taken off at the joint
Definition
disarticulation
Term
Perception of presence of amputated limb
Definition
Phantom limb sensation
Term
treatment for edema in amputee pts.
Definition
limb wrap
Term
treatment for edema in amputee pts.
Definition
limb wrap
Term
treatment for edema in amputee pts.
Definition
limb wrap
Term
Phantom limb sensation is most common in UE or LE?
Definition
UE
Term
In the case of healing an amputated limb, it is best to elevate and not move the limb?
Definition
False, make sure to increase strength and ROM by movement. Increases circulation and decreases edema.
Term
Prosthetic Options
Definition
No Prosthesis
Passive/Cosmetic Prosthesis
Body Powered Prosthesis
Myoelectrically Controlled Prosthesis
Hybrid Prosthesis
Term
Type of prosthesis: Usually for recreational purposes. Can be created for many activities, including:
Water-skiing
Cycling
Gymnastics
Weightlifting
Music
Disadvantage is that its specificity limits what other activities can be performed outside of its intended use.
Definition
Activity-specific Prosthesis
Term
Describe the prosthetic training program...
Definition
1. evaluation (compliance, purpose, comfort, appearance)
2. orientate (donning and doffing, wearing schedule, care)
3. control training
4. use training (endurance)
5. functional training (functional tasks)
6. final stage= Instrumental activities of daily living
Term
Types of lower limb amputations
Definition
Transmetatarsal Amputation
Ankle Disarticulation
Transtibial Amputation
Knee Disarticulation
Transfemoral Amputation
Hip Disarticulation
Hemipelvectomy
Term
When the leg is preserved below the knee and inserted at the hip joint (rotated foot backwards)
Definition
Van Ness rotationplasty
Term
For LE, what is the PT responsible for vs. the OT?
Definition
Physical therapy is responsible for the following:
Skin care
Limb wrapping
Lower limb strengthening exercises
Range of motion
Ambulation training
Occupational therapy is responsible for the following:
Daily living activities
Upper extremity strengthening exercises
Safety precautions related to specific activities
Principles of energy conservation and body mechanics
Use of adaptive devices
Review of dietary restrictions when appropriate
Term
ORDER the following ADLs for LE amputation:
-Energy, effort, and mobility skills in the kitchen
-Wheelchair propulsion and management
-Functional transfers-with and without prosthesis
-Hygiene and grooming
-Dressing including donning and doffing the prosthesis
-Bed mobility
Definition
Activities of daily living are addressed in the following sequence:
Bed mobility
Hygiene and grooming
Dressing including donning and doffing the prosthesis
Wheelchair propulsion and management
Functional transfers-with and without prosthesis
Energy, effort, and mobility skills in the kitchen
Term
What is extremely important to check when beginning to use a prosthesis?
Definition
check skin integrity
Term
RA stands for?
Definition
rheumatoid arthritis
Term
OA stands for?
Definition
osteoarthritis
Term
Systemic, inflammatory disease that affects joints and can affect the major organs of the body.
Common Symptoms:
Symmetric polyarticular pain and swelling during the inflammatory stage
Morning stiffness
Malaise
Fatigue
Definition
Rheumatoid arthritis
Term
T/F- rheumatoid arthritis only affects specific joints.
Definition
False, RA is systemic, affecting the whole body.
Term
meaning of malaise
Definition
body discomfort.
Term
Joints most often involved in RA?
Definition
Temporomandibular
Elbows
Wrists
MCP
PIP
Metatarsophalangeal
Term
T/F- RA most commonly affects dominant side.
Definition
FALSE- RA tends to affect symmetric joints. (ie. both wrist joints at the same time)
Term
Characterized by the following:
Gradual loss of articular cartilage
Thickening of the subchondral bone
Bony outgrowths at joint margins
Mild, chronic nonspecific synovial inflammation
Definition
osteoarthritis
Term
Group of disorders in which biomedical, biochemical, and genetic factors play a role.
Characterized by the following:
Gradual loss of articular cartilage
Thickening of the subchondral bone
Bony outgrowths at joint margins
Mild, chronic nonspecific synovial inflammation
Definition
osteoarthritis
Term
what is the etiology of RA?
Definition
unknown
Term
What is the etiology of OA?
Definition
biomedical, biochemical, and genetic factors
Term
Characterized by hand/finger ulnar deviation?
Definition
Most common in RA (some in OA)
Term
Heberden nodes in finger joints is common in ________.
Definition
osteoarthritis
Term
Deviation of the phalanx from the metacarpal head and a lateral shift of the phalanx upon the metacarpal
Definition
ulnar drift
Term
the medical term for inflammation of the synovial membrane.
Definition
synovitis
Term
Wrist synovitis causes _____ deviation of the wrist, and then the dynamics of finger flexor tendons change as they cross the MCP, providing an ulnar force.
Definition
radial
Term
Anterolateral PIP synovitis stretches the transverse retinacular ligament, allowing the lateral band to migrate dorsally.
Results in PIP joint hyperextension with DIP flexion
Definition
Swan neck deformity (interphalangeal deformity)
Term
PIP joint is hyperextended
DIP in flexion.
Definition
Swan neck deformity
Term
In swan neck deformity, what does a 1 vs a 4 signify in grading?
Definition
Type 1 is more mild, type 4 is more extreme
Term
PIP flexed, DIP hyperextended.
Definition
Boutonniere interphalangeal deformity
Term
PIP flexion with DIP hyperextension
Central slip and lateral bands stretch and migrate volarly.
Definition
Boutonniere
Term
Thumb- Characterized by MCP joint hyperextension and adduction and IP joint flexion
Definition
swan-neck deformity
Term
Thumb- Characterized by MCP joint flexion and IP joint hyperextension
Definition
Boutonniere Deformity-Most Common
Term
Thumb- Characterized by MCP adduction and lateral instability of the MCP joint resulting from attenuation (tearing) of the ulnar collateral ligament. Lateral instability=difficulty moving the thumb.
Definition
Gamekeeper's thumb
Term
T/F- Rheumatoid arthritis has less endurance.
Definition
True
Term
With this condition, it is important to teach about joint protection...
Definition
OA osteoarthritis
Term
describe the most stable position for muscles/tendons...
Definition
one in which muscle, not ligament (bone to bone connection), provides resistance to the motion.
Term
For RA and OA:
Performing active ROM to affected joints every ___ to __ minutes may minimize stiffness and facilitate muscle function.
Definition
15-20min
Term
Ways to adapt for RA and OA...
Definition
use strongest joints (Towards core)
allow rest breaks
ROM every 15-20min
isometric strengthening
use most stable anatomical positioning
reduce force and use adaptive equipment (built up silverware, knobbers, etc).
splinting
modify the environment
Term
Diagnosis characterized by widespread tissue pain, typically concentrated in the neck and lower back.
Definition
Fibromyalgia
Term
Factors that can exacerbate fibromyalgia...
Definition
Moderate physical exercise
Inactivity
Poor sleep
Emotional stress
Humid weather/change of weather
Term
What should you ask your pt to do to keep track of fibromyalgia pain?
Definition
keep a pain journal
Term
What is the leading cause of death in the US?
Definition
heart disease
Term
primary causes of heart disease...
Definition
May be due to blockage of the coronary arteries, diseases of the heart muscle, or structural anomalies of the heart
Term
The death of heart muscle caused by lack of blood flow of the coronary artery
Transmural
Anterior STEMI
Non-STEMI
Definition
Myocardial infarction (MI) aka. heart attack
Term
ST elevation on EKG
Definition
STEMI
Term
What do women present with before a heart attack?
Definition
Prodromal Syndrome (up to one month before heart attack), in order of frequency:
Unusual fatigue – 70%
Sleep disturbance – 48%
Shortness of breath – 42%
Indigestion – 39%
Anxiety – 35%
Term
signs and symptoms of heart attack:
Definition
SOB=shortness of breath
Chest pain/pressure, often radiating
Diaphoresis=excessive sweating
Nausea/Vomiting
Fatigue
Women may experience Prodromal Syndrome
Other acute symptoms may also be different in women
Term
inability of heart to function effectively.
Heart muscle stretches beyond its ability to contract efficiently
Definition
Congestive heart failure
Term
What percentage of pts with CHF have a history of hypertension?
Definition
75%
Term
Increase in weight of 2-5lbs or more over several days.
inability to sleep.
persistent dry hacking cough
shortness of breath with normal activity.
swelling in ankles or feet.
fatigue.
Definition
signs and symptoms of congestive heart failure.
Term
Heart pain caused by a temporary inadequate supply of blood to the heart muscle.
Definition
Angina pectoris
Term
diseases of the muscle tissue. Three main types: dilated, hypertrophic & restrictive
Definition
cardio myopathies
Term
Type of cardiomyopathy- the most common, caused by a variety of diseases
Enlarged heart w/ decreased pumping capacity that ~ results in CHF
Of those hospitalized, 10-50% will die within one year
Enlarged left ventricle & decreased heart function = poor prognosis
Definition
dilated
Term
type of cardiomyopathy:
a condition in which the heart muscle becomes thick. Often, only one part of the heart is thicker than the other parts. 
The thickening can make it harder for blood to leave the heart, forcing the heart to work harder to pump blood. It also can make it harder for the heart to relax and fill with blood.
Definition
hypertrophic
Term
type of cardiomyopathy:
changes in and weakening of the heart muscle, which causes the heart to fill poorly, squeeze poorly, or both. The heart is of normal size or only slightly enlarged. However, it cannot relax normally during the time between heartbeats when the blood returns from the body
Definition
restrictive
Term
Describe an Atherectomy
Definition
a treatment for angina pectoris- a catheter with a rotating blade cuts out the plaque & suctions it out
Term
most successful type of angioplasty?
Definition
Drug-eluting (medicated coating) success = 90-95%
Term
Procedure that usually involves sternotomy to allow the surgeon to work on the heart.
Definition
open heart surgery
Term
the replacement of occluded coronary arteries w/ artery or vein grafts
Grafts from aorta to below the occlusion
Try to use arteries because they stay patent (open) longer
If they must use veins, they usually get them from the legs
Definition
Coronary Artery Bypass Graft (CABG)
Term
two types of open heart surgery:
Definition
Coronary Artery Bypass Graft
Valve Replacement
Term
restrictions following a coronary artery bypass graft:
Definition
No lifting, pushing, pulling greater than 5 pounds for 6-8 weeks
No driving for 4 weeks (one month)
No shoulder flexion/abduction over 90 degrees
No submersion in water for 2 weeks
Term
things to include in a clinical pathway for cardiac rehab...
Definition
detailed treatment plan for a dx
Usually a grid with each day & the activities to be done
IADLs
Rehabilitation
Nutrition
Interventions and Treatments
Patient Education
Psychosocial/Spiritual Care
Discharge Planning
Term
after a MI, how long does the heart muscle take to heal on ave?
Definition
4-8weeks
Term
A unit of measure used to describe the amount of oxygen the body needs for a given activity.
Definition
METs- One MET is equal to oxygen consumption a rest.
Term
Chronic Obstructive Pulmonary Disease (COPD) is what?
Definition
Combination of emphysema and bronchitis
Term
what is emphysema?
Definition
Progressive and irreversible destruction of alveoli walls
Term
Excessive sputum production and cough of least 3 months in duration occurring 2 years in a row
Definition
chronic bronchitis
Term
THE key feature to cOPD?
Definition
dyspnea (a feeling of breathlessness)
Term
O2 sats required for medicare to cover at-home oxygen?
Definition
below 88%
Term
Breathing techniques for pulmonary problems...
Definition
Need to use diaphragmatic & pursed lipped during ADLs
Pulse ox can be used to help train
Exhaling w/ exertion
Term
Strengthening of what area is very important for pulmonary rehab?
Definition
UE
Term
For pulmonary problems, keep the patient in a warm and humid environment T/F
Definition
FALSE, keep the patient cool and dry
Term
T/F
In dressing, be sure to put the catheter bag through before you put on pants.
Definition
True
Term
PEG stands for?
Definition
Percutaneous endoscopic gastrostomy
Term
An injury involving only the epidermal layer of skin
Definition
superficial burn (aka. 1st degree burn)
Red Skin
blanching present
Tender- sensation intact and very sensitive
i.e. Sunburn
Term
Heal time for a superficial burn
Definition
Spontaneous re-epithelialization in 14 days or less
Term
A burn injury extending through the epidermis down into the dermis
Hair follicles and Nerve Endings are intact
Definition
Partial thickness burn aka. 2nd degree burn
Pink in color
Blisters
Weeping of skin
Peeling of skin
Very Painful!
Term
2nd degree wound closure time
Definition
Re-epithelialization from the epithelial bed in 3-6 weeks

keep in mind that partial thickness burn may progress to a full thickness burn!
Term
Necrosis of tissue the entire thickness of the skin
Hair follicles and Nerve Endings at burn site are no longer intact
Definition
Full thickness burn (3rd degree)
Term
Characteristics of a full-thickness burn:
Definition
Cherry Red or White but may appeared mottled (broken capillaries)
Loss of Sensation
No Pain reported by patient at burn surface
Eschar (Leather or Tacky)
Term
what is Eschar and what are the types?
Definition
a slough or coagulum of necrotic tissue produced by a burn
Leather Eschar: hard like rawhide
Tacky Eschar: white or ivory; more pliable
Term
Wound closure for a full thickness burn
Definition
Skin grafts required
Spontaneous re-epithelialization impossible due to destruction of epithelial elements
Term
Burn degree:
Black in color
Exposed Muscle, Tendons or Bone
Usually associated with Electrical Burns
Definition
4th degree- subdermal
Term
Types of thermal burns:
Definition
Scald
Most common kind of burn
Children and elderly are at a higher risk
Fire/ Heat
Flame
Flash
Flash burns to face usually are associated with upper airway burns (patients may need intubation)
Grease
Most often full thickness burns
Steam
Term
Special characteristics of electrical burns:
Definition
Pure: entrance and exits sites
Arc: electricity flows external to the body
Flame: electricity ignites the body
Patients who sustain high voltage electrical burns are at a higher risk for developing compartment syndrome in the first 48 hours after injury.
Compartment Syndrome:is an acute medical problem that may lead to nerve damage and muscle death.
Term
After discharge, burn patients are susceptible to developing what condition?
Definition
Neuropathy: Injury to nerve that can cause numbness, tingling, and pain.
Term
When was scar massage for burn victims first developed?
Definition
1607
Term
85% of these hospitalizations for burns are for what body part?
Definition
hand/UE
Term
Men are how many more times likely to get burned?
Definition
5X
Term
Most accurate method for estimating burn extent, & must be used in the evaluation of all pediatric patients
Definition
Lund-Browder chart:
Term
Functions of the skin
Definition
Protects against infection
Prevents loss of bodily fluids
Controls body temperature
Sensory organ
Excretory organ
Produces vitamin D
Influences body image
Term
Order the phases of wound healing:
-Wound Contraction
-Wound Contracture
-Maturation Phase
-Epithelialization
-Proliferative Phase
-Inflammatory Phase
Definition
Inflammatory Phase
Response to injury with influx of neutrophils and macrophages
Proliferative Phase
New matrix is laid with fibroblasts and in-growth of capillaries
Maturation Phase
Resolution of inflammation in which collagen is laid down to form the scar.
Epithelialization
Re-establishment of the basement membrane and epidermis
Wound Contraction
Open margins are brought together by fibroblasts
Wound Contracture
Shrinkage of the scar through collagen remodeling. This causes functional restriction of motion
Term
Erythema
Definition
redness
Term
Ecchymosis
Definition
bruising formed by hemorrhaging of tiny blood vessels
Term
It is the removal of eschar to expose viable tissue and prepare the wound bed for coverage
Definition
debridement
Term
4 phases of burn injury Recovery
Definition
1. Emergent
2. Acute
3. skin grafting phase
4. rehabilitative phase
Term
important during the skin grafting stage:
Definition
Move once staples are removed!
Keep extremity elevated
Splint at all times until staples are removed to decrease shear of graft!
Term
TBSA stands for...
Definition
total body surface area
Term
Primary goal with acute burn therapy
Definition
Edema management
Term
T/F- Position of comfort is position of contracture
Definition
TRUE
Term
The formation of bone in abnormal locations, secondary to pathology
Definition
heterotropic ossification
Term
What burns should you splint?
Definition
OT’s should splint everything as long as it doesn’t limit function
Term
Used in clinical practice and research to document change in scar appearance
Definition
Vancouver scar scale
Term
How much exercise therapy should be provided to a burn pt?
Definition
For every 1% of burn injury they should receive 5 minutes of therapy.
Term
when should compression garments begin to be worn?
Definition
Should begin within 2 weeks of wound closure
Term
how soon should a burn pt be mobilized?
Definition
as soon as possible with MD safety... usually 2-3 days after admittance
Term
Common gait deviations
Definition
Foot drop
Decreased heel strike
Knee
Decreased knee extension in stance
Decreased knee flexion in swing
Decreased weight bearing on affected leg resulting in decreased step length
Hip
Lack of hip extension in toe off (pre swing)
Forward flexed posture
Trunk
Rigid, guarded posture
Forward shoulders and head
Lack of pelvic rotation
You may also see an increased reliance on assistive devices
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