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5 criteria for reducing exercise intensity or terminating it, per American College of Sports Medicine
- 1) mod to severe angina (min is ok)
- 2) SBP > 240 a/o DBP > 110 (or over 260/115, depending where you look)
- 3) > 1 mm ST depression, horiz or downsloping (or >2 elevation)
- 4) increased frequency of ventricular arrhythmias
- 5) 2nd or 3rd degree AV block
also: drop in SBP, signs of exertional intolerance (pallor, cyanosis, cold/clammy skin, unusual SOB; CNS signs (ataxia, vertigo, visual or gait problems)
rehab guidlines for arterial disease / claudication
- intermittent walking w mod intensity and duration
- 2-3x /day
- 3-5 days/wk
- up to point of cluadication pain (usually within 3-5 min), then rest
WC seat heights
- standard: 20 inches
- hemiplegia or low-seat: 17.5 inches (lower than standard bc the pt wants to use the sound leg for steering and propulsion)
compression rate for CPR for an adult
- compression to ventilation ratio -- 30:2
- untrained rescuers should use compressions only
when to use an automated external defibrillator?
asap after beginning CPR
angle of cervical facets
- cervical: 45 degrees
- thoracic: 60 degrees
- lumbar: 90 degrees
coupled motion in thoracic and lumbar spine (per Fryette)
- in neutral spine, SB and rot are contralat
- in flex or ext, SB and rot are ipsilat
flex, ext, rot, SB, -- open/close facets?
- flex: open
- ext: close
- ipsilat rot: open
- contralat rot: close
- ipsilat SB: close
- contralat SB: open
atropine is what kind of drug
- anticholinergic (blocks action of acetylcholine at parasymp sites in smooth muscle, secretory glands, and CNS)
- produces symp results: increased HR and contractility
- sinus bradycardia, exercised induced bronchospasm
osteoporosis pts should avoid what trunk motions
- trunk flexion or rotation exercises
- they can cause compression fractures
e-stim for decubitus ulcer, settings?
- high-volt monophasic pulsed current
- use neg charge for bactericidal effect
- pos charge to promote wound healing
burst current -- aka?
beat current -- aka?
- burst = Russian
- beat = interferential
- both are medium frequency biphasic currents
best positioning for lumbar traction
- best: prone
- second best: prone w pillow under abdmomen
- pt w spinal stenosis: supine, knees flexed
extraoccular eye movements -- aka?
- lateral eye movments
- CN VI: abducens
exercise tolerance test optimal time duration?
can calcium alginate facilitate autolytic debridement?
yes. (nevermind an earlier card that leaves alginate off that list)
skills of calcium alginate
use on what kind of wound
- grade III ulcer with lots of exudate
- maintain moist wound, absorb exudate, facil autolytic debridement, reduce pain, promote faster healing (reepithelialization)
- permeable to bacteria, urine, etc
use what kind of precautions with hepatitis B
for what pts?
- gown & gloves
- pts w infection that can be spread by contact w skin, wounds, vomit, feces, etc
- ex: salmonella, scabies, pressure ulcers, hepatitis B
- for an infection that can be spread through close respiratory or mucous membrane contact with respiratory secretions
- ex: flu, pertussis (whooping cough), rhinovirus (common cold)
- mask, gown, gloves
- for a disease w small particles that can be spread over long distance
- TB, chickenpox, measles
- pt needs "airborn infection isolation room"
when in gait are knee extensors maxiamally active
heelstrike / initial contact, to stabilize the knee and counteract the flexion moment
most effective mobilization for frozen shoulder, and positioning for this?
- inf glide at 55 degrees abd
- (think convex-concave...)
most effective glide to improve GH ER?
capsule-ligamentous pattern for TMJ
limitation on opening, lat dev greater to uninvolved side, dev on opening to involved side
normal TMJ opening
25-35 is functional, but 35-50 mm is normal
normal jaw protrusion distance
normal lat deviation of jaw distance
weak lat pterygoid will present how?
upon protrusion, jaw will deviate to contralat side
capsular pattern of C-spine
for upper, occiput -C2
for lower c-spine, C3-T2
- Upper: flex > ext
- A/A jt: limits w rotation
- Lower: (SB = rot) > ext ....flex isn't limited
best arm pos for giving US to supraspinatus tendon?
slight abd and IR to expose it from under the acromion process
ABCDE of an atypical dysplastic nevus (a nevus is a common mole, this is a changing mole)
- irregular borders
- color variation
- diameter > 6 mm
typical presentation of LV failure
- fatigue and dyspnea after mild activity
- persistent spasmodic cough
- elevated HR
- mild edema in both ankles
- S3 heart gallop
- paroxysmal nocturnal dyspnea
- pulmonary edema
signs of pulmonary edema (these are seen w LV failure)
- marked dyspnea,
typical presentation of RV failure
- dependent edema of ankles (usually pitting)
- wt gain w anorexia
- R upper quadrant pain
- bloating, R sided S3 or4
- cyanosis of nail beds
- decreased urine output
- +1 (Trace) Slight indentation, rapid return to normal
- +2 (Mild) 4mm indentation, rebounds in a few seconds
- +3 (Mod) 6mm indentation, 10-20 seconds to return to normal
- +4 (Severe) 8mm indentation, > 30 seconds to return to normal
signs of pericarditis
- substernal pain that may radiate to neck, upper back
- difficulty swallowing
- pain aggravated by coughing, relieved by leaning forward or sitting upright
- history of fevers, chills, weakness, or heart disease
pts w ant knee pain typically have what weaknesses in hips?
- weak abd and ER
- seen during a squat -- there'll be increased add and IR bc the abd and ER-ers aren't doing good ecc control
deep partial-thickness burn w/o infection takes how long to heal?
- goes under the navic to reduce inversion/pronation
- (navic used to be named scaphoid)
- a heel that's longer on the medial side
- brings the heel of the foot into varus to prevent depression in the region of the head of the talus