Traumatic Injuries
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| What is a Strain? | An injury to a muscle when it is stretched or pulled beyond its capacity characterized by microscopic muscle tears as a result of overstretching
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| How late can the S/Sx of strain appear? | several hours after muscle use
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| How should a PT with a strain sleep? | firm mattress and sleep on the back, with a pillow under the knees
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| What strain are exersizes almost always prescribed, and what is the goal of these exercises? | Exercises is almost always prescribed if the strain is in the lumbosacral region. Exercises are aimed to strengthen lower abdominal muscles
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| When are contusions at risk for developing into cellulitis? | Large areas of soft tissue bleeding and a slow absorption of blood
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| What is a Sprain? | Injuries to the ligaments surrounding a joint which can from wrenching or hyperextension of a joint, tearing the capsule and ligaments and involve bleeding into a joint (hemarthrosis)
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| What is done for a sprain the first 12-36 hours? | Ice for 15 to 20 minutes intermittently
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| What is done for a sprain after the first 24 hours? | Heat for 15 to 30 minutes, four times a day
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| Why would one Ice, then Heat a a sprain? | Ice the first 12-36hrs will reduce swelling, Heat after the 1st 24hrs will promote absorption of blood and fluid
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| What is the most common symptom of whiplash? | Pain radiating down the arm to the fingers
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| In a PT with whiplash, what must you suspect if the PT developes HTN with widening pulse pressure and bradycardia? | Increasing ICP
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| If ICP is suspected, how often should neuro assessments be conducted? | q 15-30 minutes
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| What are partial or incomplete dislocations called? | subluxations (stretching of joint capsule)
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| When is the use of heat contraindicated in sprains/dislocations? | Evidence of uncontrolled bleeding
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| What is carpal tunnel syndrome? | Disorder of the wrist and hand induced by compression on the median nerve
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| What are the symptoms of carpal tunnel syndrome? | *Paresthesia *Hypoesthesia *Hypesthesia
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| What is Hypoesthesia? | Decreased sensation in the thumb, index finger and middle finger
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| What is Hypesthesia? | Decreased sensation in the thumb, index finger and ring finger
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| What relieves pain in carpal tunnel syndrome? | Shaking or execise of hands
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| What are the objective signs of carpal tunnel syndrome? | *Edema of hand, wrist, or fingers *Muscle atrophy *Depressed appearance of soft tissue at base of thumb on palmar side
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| What is a Phalens test? | (Wrist-Flexion test) PT places wrist in complete but unforced flexion. If numbness/tingling are produced or exaggerated in hand within 60 sec, test result is positive. In PTs with limited motion, gentle compression over median nerve may simulate
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| What is Tinels sign? | a method for checking the regeneration of a nerve, usually in patients with carpal tunnel syndrome. This test is performed by having the examiner gently tap the area over the median nerve at the wrist palmarly. Positive is tingling sensation.
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| What is the Tx of mild carpal tunnel syndrome? | *Application of immobilizer to promote comfort *Hydrocortisone acetate *ROM exercises
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| What is the Tx of severe carpal tunnel syndrome? | Surgery - Decompression of the median nerve by section of transverse carpal ligament
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| What is a Herniated Intervertibral Disk (HNP)? | Rupture of the fibrocartilage surrounding an intervertebral disk with resulting pressure on nerve roots
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| What are the most common locations for a HNP? | Lumbar and Cervical spine
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| What is the most common S/Sx of a Lumbar HNP? | Lower back pain that occurs with slight movement
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| Where does the pain from a Lumbar HNP radiate? | over the buttock and down the leg, causing numbness and tingling along the sciatic nerve pathway (Radicular Pain)
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| What are the most common S/Sx of a Cervical HNP? | Neck pain, headache, and neck rigidity
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| How long should a PT with a HNP sit, and in what kind of chair? | Limit sitting to 30 minutes at a time in a firm, straight back chair
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| PTs with a HNP should not lift more than what for how long? | No lifting anything heavier than 5 lbs for at least 8 weeks
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| What is a Laminectomy? | Surgical removal of the bony arches or one or more vertebrae performed to relieve compression of the spinal cord caused by bone displacement from an injury or degeneration of a disk or to remove a displaced vertebral disk
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| Chemonucleolysis is performed to remove a herniated disk in which PTs? | PTs with HNP that has no nerve involvement
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| What is Chemonucleolysis? | Chemonucleolysis is the injection of an enzyme into a bulging spinal disc, with the goal of reducing the disc's size. This procedure is done in a hospital or surgical center as an outpatient procedur
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