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clinical proced II


is an acute pathway for pain myelinated or not myelinated? its myelinated. very fast
where does the gate theory occur? spinal cord
whats an example of the gate theory? putting smashed finger in cold ice water
whats the endogenous opiate theory? we have natural pain killers tht are released through laughter, injury, and exercise
what are the phases of tissue healing? inflamation 1-10 days...proliferation phase 3-20 days...maturation phase 9 days and on
how long can maturation phase last? years
what is a keloid scar? overproduction of collagen can result in this hypertropic scar
true or false..if there is no inflammatory response then there is no healing. TRUE
true or false...if there is too litle inflammatory response healing is fast.. FALSE...Slow
true or false... if there is too much inflammatory response, healing is prolonged and excessive sccar tissue forms TRUE
in the inflammatory stage of healing, what is a rule we use in PT? RICE
if a trauma includes and open wound, what kind of therapies could we try? hydrotherapy, electrical stimulation, vacuum-assisted closure, pulsed ultrasound,ultraviolet c radiation, mobilization, positiioning, seating systems, pt and family education
what goals are physical agents and mechanical modalities most used for? decreasing pain, reducing soft tissue/joint swelling and inflammation, increasing blood flow,promoting mm relaxation, increasing exensibility of connect. tissue, increase mm strength
True or False.. where there is scar tissue there is altered circulation and the response to heat will be different. TRUE
why are heating agents commonly applied? to promote circulation which will enhance the nutrient base for tissue healing.
true or false. immature scar tissue's temperature will increase more slowly then mature scar tissue FALSE.. It will increase faster then mature scar tissue
describe the blanching test. putting pressue on the skin should cause those with normal circulatin to temporarily lose color.areas where arterial circulation is impaired may take longer then 3 sec's or may remain unchanged
what is mottling of the skin? spotting patches or erythema tht occur after the application of thermal agents
if the skin is mottling, what could tht be telling us? overheating or overcooling of the skin.
what does the application of heat cause? local vasodilation which is accompanied by erythem.
what does the application of cold cause? decrease in surface temperature of the skin acompanied by a reflex vasodilation erythem.occurs after about 8 min)
what are some possibilities when rom is limited? pain secondary to mm gaurding, joint restriction, nerve impingments and edema are some
what is edema? abnormal increase in the amount of interstitial fluid
what is joint effusion? when sweliing is contained witin a joint capsule
how can prolonged or massive edema interupt repair? by impeding the diffusion of nutrients to cells or perhaps by leadin to tissue fibrosis.
what is mm guarding? an indication of the degree of motor unit firing present in a mm tht exists to protect the area from further trauma
what happenes to the number of sarcomeres in the mm during muscle guarding. they may actually decrease due to the prolonged immobility and shortened position of the mm
what does muscle tone refer to? resistance of mm to passive stretch or elongation or how tight it feels
what is buoyancy? a force that works in the opposite directin to gravity
what happens when an object is placed in water? water displacement occurs because of the upward pressure of bouyancy
is there greater or less buoyant forces acting on large objects? greater
true or false...smaller objects create more water displacement then larger objects. FALSE...larger creates more displacement of water
what is the center of bouyancy?(COB) refers to a pont when a body is under water
where is the COB located? in the chest region
what are bouyancy and floatation devices used for? to help maintain an upright position in the water.
what does an anateriorly placed bouyancy device tend to cause? extension of the spine to assist in maintaing proper body alignment
what is hydrostatic pressure? pressure exerted by water on an object immersed in the water
what does hydrostatic pressure help with? helps control inflammation with water exercise.also assist in venous return, heart rate reduction and a centralizatino of peripheral blood flow
why are exercises easier to perform closer to the surface of the water? because hydrostatic pressure is porportional to the depth of immersion and the pressure is less near the surface
what is specific gravity? weight of a particular substance compared with the weight of an equal volume of water.
does the specific gravity of a person increase or decrease when there is increased bone and muscle mass? increases
does the specific gravity of a person increase or decrease when there are greater amounts of adipose tissue? decreases
why does the human body tend to float beneath the surface of the water? because water has a specific gravity of 1.0 and the body has a specific gravity of .87 to .97
why do children with chronic debilitating diseases do well in water therapy? because they expend little energy to stay afloat and the bouyant forces assist in reducing the weight-bearing
what is viscosity? measure of the fricctional resistance cause by cohesive or attractive forces between the molecules of a liquid
what is resistance? created by the viscosity of the liquid and is proportional to the velocity of movement through the liquid
true or false..water has a higher viscosity than air but less then oil TRUE
what are some benefits of exercise training in an aqautic environment? increase strenth, improved cardiovascular response and improved VO2 maximums
what is a bouyancy resisted movement? a movement down to the bottom of the pool
how would you decrease the resistance in a buouncy resisted movement? by decreasing the length of the lever arm
does adding a boot or paddle increase the resistance of an activity? yes, because increasing the surfacec area of the part to be moved will also increase the resistance
what is specific heat? amount of heat in calories required to raise the temperature of 1 gram af a substance by 1 degree C.
is the specific heat or thermal capacity of water lesser or greater then that of air? greater....this will cause more heat loss in the water compared with out of water at the same temperature
what temperature of water is best for a long exericse session? cool ar tepid water
what temperature of water is best for a short-duration exercise and manual techniques? warm water
will pt's diagnosed with ms perform better in warmer or cooler water and why? cooler water, because it assists in keeping their iinner core body temp low, preventing exacerbations of their symptoms.
would pt's with arthritis benefit from cooler or warmer water and why? warmer water, because of increased circulation and tissue elasticity
if obese pt's are exercising in water, what water temperature should we use? cooler water. warm water may be inappropriate if they are exercising because it can also increase their core body temp
what is hydromechanics? movement through water
what is turbulence? product of several forces acting on an object immersed in water.
what is frontal resistance? its encountered as a body moves through the water.
true or false..the faster the movement, the greater is the resistance in water.. TRUE
how can we increase progressive resistance in aquatic exercise? by increasing the velocity of movement, increasing surface area, or by moving closer to the surface of the water where the turbulence is greater
what is drag? inhibits movement by resisting forward motion
what is laminar flow? horizontal flow of water passing over a body part in motion tht creates drag
how can we raise the level of effort needed to accomplish a task in the water? increase the velocity, surface area, and change in direction
why is temperature regulation more difficult in water? b/c of diminshed body surface area to lose heat
what temperature is considered therapeutic warmth? 94 degrees F
true or false..warm water mau act as a superficial heating agent and has been reported to elevate pain threshold and decrease mm spasm TRUE
what are full body tanks called? low boys
describe full body tanks or low boys? they resemble a bathtub. can hold as much as 200 gallons. pt's can long sit in these. they also have a turbine for aeration.
describe high boy tanks. tall and are more appropriate for large body areas. hold up to 100 gallons of water.
what are low boy and high boy tanks used for? treatment of open wounds, peripheral joint stiffness, sprains/strains, and postoperative joint replacements
what are hubbard tanks? whirlpool tanks tht accommodate a pt in a supine position
what do turbines do? mix air and water to provide agitation and turbulence to teh water in a tank
what does the mechanical stimulation from the agitation of the turnines do? the agitation to the skin receptors may promote an analgesic effect. this can reduce pain
what is the water temp for therapeutic aquatic pools? 86-96 degrees F
true or false...water is an ideal environment for early interventions for many musculoskeletal and neurologic conditions TRUE
what are deep water exercises? those tht take plac in an aquatic pool tht is deep enough so tht the patients feet do not touch bottom
are deep water exercises open or closed chain? open
how deep should the water be in deep water exercise? at least 5-6 feet
what should the water temperature be for deep water exercises and why? 80-90 degrees F. because active and sometimes aggessive exercises is performed for treatment times tht may approach 45 min.
why is deep water exercises sometimes more favorable then land exercises for pt's recovering from stress fx's? because the weight-bearing load is decreased
is the resting heart rate generally lowered or raised when patients are immersed in water? lowered
what is the water depth for midlevel aquatic exercises? T-12 to chin
what is the water depth for shallow level aquatic exercises? knee to T-12
are midlevel to shallow-level exercises closed or open chain? closed
when would open-chain exercises be contraindicated in medlevel to shallow level aquatic exerise? with an unstable lower extremity or recent joint reconstruction where wight bearing is desired
to treat patients who have trunk weakness, dynammic stabilization of the trunk can be first addressed how? in midlevel water usin buoyancy and hydrostatic pressure forces for support
when is manual stretching performed? when there is a restriction in soft tissue movement
in aquatic exercise, how can we accomplish an effective manual stretch? the pt's weight can be used to offer the overpressure needed to provide for an effective stretch.the pt's is lying supported by buoyant force of the water an his body weight acts as resistance b/c of the drag tht it creates to mvvmnt
if a pt has a hypomoblie glenohumeral joint and the goal is to inccrease shoulder rom, how can the clinician use aquatics to reach tht goal? the clinician can apply stretching of the joint, long-axis distraction, and joint mobilization to the patient lying supine supported by the water
what are some items tht should be documented in aquatic therapeutic exercise programs? equipment used..buoyancy-assisted buoyancy-assistd devices were used.where weights were locatd and purpose.depth in water
if a pt is being treated for decubitus ulcer on the ischial tuberosity, is an aquatic pool indicated or contraindicated? CONTRAINDICATED..a low boy or hubbard tank would be most appropriate
would deep water, midlevel or shallow level exercise be best for a pt with a total hip replacement after sutures were removed? deep water walking
true or false...whirlpool tanks and their turbines must be cleaned between pt's. TRUE
what can hydrotherapy be used for? debridement, cleansing, hydration, circulatory stimulation, and analgesia
what is debridement? rapid removal of necrotic and devitalized tissue to allow reepithelialization and granulation.
when is debridement indicated? indicated for wounds with extensive necrotic tissue
if a pt is nonambulatory and has a small wound, would pulsatile lavage or whirlpool treatment be more appropriate? pulsatile lavage
what does cleansing do? removes dirt, foreign bodies, exudate, or residue from topical agents and bacteria.
how does increasing local circulation facilitate healing? by increasing oxygen levels and metabolite removal
what happens if we increase circulation to an area of venous insufficiency? y does this happen? it facilitates circulatory compromise, increases edema, and impedes healing. it happens because blood is entering the area an hydrostatic pressure is increased more thn the venous systm can compensate
will a primarily closed, clean reepithelializing or granulating(red) or chronic wound with greater than 50% black eschar benefit from hydrotherapy? usually not
what is the recomended temp for hydrotherapy application in a wound treatment? 92 degrees to 96 degrees F
Created by: babyb06
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