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someone said "this is on boards" (SCI funct outcomes previous)

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
Created by: jessigirrl4



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