someone said "this is on boards" (SCI funct outcomes previous)
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| Pelvic floor strengthening | Keigles:3-5 sec contract/relax or 15-20 quick
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| postural drainage R & L upper lobes- anterior apical segments | pt in sitting (leaning back a little), percussion is applied directly under clavicle
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| 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
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| postural drainage R & L upper lobes-anterior segments | pt in supine, percussion applied bilaterally, directly over the nipple or just above the breast
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| where does pes anserine insert? | ant medial surface of the proximal tibia- goose foot
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| what are points on Q angle | measure from ASIS to patellar midpoint & line of tibial tuberosity thru patella
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| cause of patellar malalignment & increased Q angle | tight ITB, wk glute med, lax medial retinaculum, wk VMO
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| Thoracic Outlet Syndrome | compression of the neurovascular bundle that runs thru the thoracic outlet & carries the brachial plexus, subclavian artery & subclavian vein
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| 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
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| Thoracic Outlet Syndrome common areas of compression | ant & middle scalene, 1st rib, clavicle, pec minor
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| Thoracic Outlet Syndrome causes | tight scalenes, cervical rib-a congenital anomaly, trauma, postural changes, clavicular fx
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| most common contractures for AK amputation | hip flex, abd
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| most common contractures for BK amputation | knee flex
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| DeQuervain disease/tenosynovitis | abductor pollicis longus & ext pollicis brevis tendons & sheaths-pn on radial side of wrist-cause often not clear
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| 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)
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| ulnar nerve sensory distribution (hand) | 4th finger (medial portion), 5th finger
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| median nerve sensory distribution (hand) | palmar aspect of thumb, 2nd, 3rd, 4th (radial half) fingers
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| radial nerve sensory distribution (hand) | post arm, post forearm & radial side of post hand
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| coma lasts... | 3-4 weeks
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| vegetative state lasts... | 4 weeks- 1 yr
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| persistent vegetative state lasts | over a year
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| Levels I, II, III Rancho Los Amigos Scale of Cognitive Functioning | comatose
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| Levels IV, V, VI Rancho Los Amigos Scale of Cognitive Functioning | Confused
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| Levels VII, VIII Rancho Los Amigos Scale of Cognitive Functioning | appropriate
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| Levels VIII, IX, X Rancho Los Amigos | purposeful, appropriate
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| Level 1 Rancho Los Amigos | no response/total assistance
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| Level II Rancho Los Amigos | Generalized response/total assist, response w/gross body mvmnt (ex roll in bed), physiological changes, &/or vocalization. response delayed
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| Level III Rancho Los Amigos | Localized response/total assist. specific response consistent w/stim. strongest response to pn, odors
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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| 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
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